Effect of Marijuana Legalization on Opioid Overdoses

What happened in states after medical marijuana laws were passed? Did opioid overdoses go up, stay the same, or go down?

Millions of people in the United States have been diagnosed with an opioid use disorder, and more than 80 Americans die each day from opioid overdose. Where is this coming from? Most “new heroin users started out misusing opioid prescription painkillers.” This is important because more than 200 million opioid painkiller prescriptions are still written every year. Did you catch that number? Two hundred million prescriptions every year, “a number closely approximating the entire adult population in the United States.” That’s incredible.

“‘When you see something like the opioid addiction crisis blossoming in so many states around this country, the last thing we should be doing is encouraging people’ to smoke cannabis, [White House Spokesperson Sean] Spicer told reporters.” But, if opioid addiction starts with people taking prescription pain pills, maybe cannabis would reduce the problem by offering a substitute painkiller. Alternatively, maybe cannabis would act like a “gateway” drug or “stepping stone” to harder drugs, potentially making the opioid epidemic worse, as I discuss in my video Marijuana Legalization and the Opioid Epidemic.

Well, first, does cannabis work? “Is it a truly effective drug for pain that is arbitrarily stigmatized by many and criminalized by the federal government? Or is it without any medical utility, its advocates hiding behind a screen of misplaced (or deliberately misleading) compassion for the ill?” The official position of the American Medical Association is that marijuana “has no scientifically proven, currently accepted medical use for preventing or treating any disease,” but what does the science say?

“Despite the widespread use of opioids, 50% – 80% of advanced cancer patients die with unmet pain-relief needs.” So, adding cannabis may help. Indeed, double-blind, placebo-controlled clinical trials have found that cannabis compounds do produce pain relief, “equivalent to moderate doses of codeine,” an opioid used to treat mild to moderate pain, but if you’re dying from cancer, don’t you want the good stuff? Why not just crank up the morphine?

If you wanted, you could put someone in coma and erase all their pain, but there’s a very real problem with such high doses of opiates: Here you are, at the end of life, surrounded by loved ones, but you’re so doped up you can’t even say goodbye. This is where cannabis may help. It may allow patients to drop down the opiate dose a bit without compromising pain control.

That’s what many report, anyway. If you look at New England, for example, which can be thought of as ground zero for the opioid epidemic, in just one year, “there were enough opioids dispensed from Maine pharmacies in 2014 to supply every person in the state with a 16-day supply.” What are they doing up there?

Among the New Englanders surveyed who were on opioids, however, most claimed “they reduced their [opioid] use since they started MC,” medical cannabis. Some also reduced their use of antidepressants, alcohol, anti-anxiety medications, migraine meds, and sleeping pills. Forty percent said they were able to reduce their opioid use “a lot,” as you can see at 3:16 in my video.

Cannabis use may even reduce the use of crack cocaine. It may seem strange to give drugs to drug addicts, but if people even make a partial switch from more to less harmful drugs, overall harm may be reduced. So, what happened after medical marijuana laws were passed? Did opioid overdoses go up, stay the same, or go down?

They went down.

“Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates,” about a 25 percent lower rate of overdose deaths. “The striking implication is that medical marijuana laws…may represent a promising approach for stemming” the opioid overdose epidemic. “If true, this finding upsets the applecart of conventional wisdom regarding the public health implications of marijuana legalization and medicinal usefulness.” On the one hand, we have the AMA saying cannabis isn’t medically helpful, but, on the other hand, if people are getting enough benefit using it so they can cut down on their prescriptions, then obviously something is going on.

What about other prescription drugs? As you can see at 4:37 in my video, once medical marijuana laws were passed, fewer people were filling prescriptions—and not only fewer prescriptions for painkillers, but fewer prescriptions for anti-anxiety drugs, antidepressants, anti-nausea drugs, antipsychotics, anti-seizure drugs, and sleeping pills. If all states adopted medical marijuana laws, that could save around half a billion dollars a year. But, the half-billion dollars taxpayers would save, is the half-billion bucks drug companies would lose, so it’s no wonder Big Pharma is freaking out. Why do you think pharmaceutical corporations, including the makers of OxyContin and Vicodin, were major sponsors of the marijuana prohibition lobby, trying to stop legalization? “Other major sponsors of marijuana prohibition were the beer industry, police unions, and the private prison industry.”

KEY TAKEAWAYS

More than 200 million opioid painkiller prescriptions are written annually despite the diagnosis of millions in the United States with an opioid use disorder and more than 80 Americans dying every day from opioid overdose.
Might cannabis act as a gateway to harder drugs, like opioids, or might it reduce opioid addiction by offering a substitute painkiller to prescription pills?
The American Medical Association’s official position is that marijuana “has no scientifically proven, currently accepted medical use for preventing or treating any disease,” but studies have found that cannabis compounds produce pain relief “equivalent to moderate doses of codeine,” an opioid used to treat mild to moderate pain.
At the end of life, cannabis may allow patients to reduce opiate doses without compromising pain relief such that they may not be in such a drug-induced stupor that they cannot say goodbye.
Most New Englanders taking opioids claimed they reduced their opioid use after starting medical cannabis, and some also reduced use of alcohol, antidepressants, sleeping pills, and anti-anxiety and migraine medications. Cannabis may also reduce use of crack cocaine.
After medical marijuana laws were passed, opioid overdoses went down, about a 25 percent lower rate of opioid overdose deaths, and fewer people were filling prescriptions—not only for painkillers, but also for anti-anxiety drugs, antidepressants, anti-nausea drugs, antipsychotics, anti-seizure drugs, and sleeping pills.
About half a billion dollars would be saved annually if medical marijuana laws were adopted across the United States, but the half-billion taxpayers would save is the half-billion drug companies would lose.

I have a whole treasure chest of cannabis videos, which you can see online or in a digital DVD.

Check out:

In health,

Michael Greger, M.D.

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After Marijuana Legalization Did Opioid Overdoses Go Up, Stay the Same, or Go Down?

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