Can Decriminalizing Pot Help Solve the Opioid Crisis?

Proponents of marijuana legalization have long said that legal marijuana could curb the ever-increasing abuse of opioids. Now, two new studies add powerful support to their claim. The papers suggest that opioid use decreased in states where medical marijuana became decriminalized.

America currently has a major opioid problem. Doctors prescribe medication like percocet or oxycodone to relieve severe pain, but a substantial chunk of patients then go on to abuse the drugs afterwards, eventually looking for cheaper options like heroin or the deadly fentanyl.

Cannabis, on the other hand, can treat the same sort of symptoms with milder consequences, and study authors believe people should ditch the more addictive opioids for pot.

“We do know that cannabis is much less risky than opiates, as far as likelihood of dependency,” W. David Bradford, a professor of public policy at the University of Georgia, told NPR. “And certainly there’s no mortality risk,” he adds.

The researchers argue that legalizing medical marijuana gave people easier access to pot as an alternative, in turn deterring them from the initial opioid prescription that snowballed into addiction.

The opioid crisis

To put the opioid epidemic into perspective, 64,000 people died of an overdose in 2016, and opioid overdoses skyrocketed by 30% from 2016 to 2017. Things have gotten especially worse after fentanyl – originally developed as a power anesthetic in surgery – came around. Up to a 100 times more potent than morphine, a quarter milligram of this synthetic opioid is enough to kill.

It’s no surprise then that people are starting to retort to weed instead.

In one of the studies, Bradford and colleagues found that opioid prescriptions dropped by 14% in Medicare users – which are mostly people over age 65 – if they had easy access to marijuana. The researchers estimate that opioid prescriptions plummeted by 3.7 million in states where medical marijuana stores are available and 1.8 million in states that allow homegrown marijuana for medical purposes. This is an alarming number considering that Medicare users received 23 million daily doses of opioids per year on average from 2010 to 2015.

Hefei Wen at the University of Kentucky and Jason Hockenberry at Emory University reached similar conclusions in another study examining a different set of people. They found that marijuana legalization was associated with less opioid prescriptions for those enrolled in Medicaid, an insurance program for lower-income families.


The balancing act

Marijuana is now legal in 9 states, or 29 when including ones that allow medical use.

But researchers do warn that legalizing medical marijuana alone won’t solve the opioid crisis.

“Like any drug in our FDA-approved pharmacopeia, it can be misused. There’s no question about it. So I hope nobody reading our study will say ‘Oh, great, the answer to the opiate problem is just put cannabis in everybody’s medicine chest and we are good to go.’ We are certainly not saying that,” Dr. Bradford told NPR.

Furthermore, a lot of facts about marijuana use in general are still in the grey, and much remains contested. On the surface, it might seem as though evidence in favor of marijuana is mounting. For instance, the common claim that medical marijuana would increase recreational pot use in teens was debunked by a study from Columbia University in February 2018. But studies are showing otherwise as well; another study by the National Institute of Drug Abuse found that illicit cannabis use appeared to increase non-medical opioid use. Some experts have also voiced concerns about the lack of formal research on the outcomes of medical marijuana use. This partially owes to the federal government’s tight regulations on research, as they regard pot as an extremely dangerous drug.

Nevertheless, researchers seem to think legalization is an effective part of the package for combatting the epidemic. The authors conclude that laws allowing medical and recreational marijuana use can reduce opioid prescription for “a segment of population with disproportionately high risk for chronic pain, opioid use disorder and opioid overdose.”

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