MEDICAL CANNABIS: AN ANTIDOTE TO THE OPIOID EPIDEMIC?

Naturopathic Doctor New & Review
In Detoxification Medicine, Pain Medicine

Jamie Corroon, ND, MPH

NATUROPATHIC PERSPECTIVE

In the absence of a few basic statistics, the significance of the opioid epidemic in the United States can be easily underappreciated. In 2015, the most recent year for which the Centers for Disease Control and Prevention (CDC) has published data, over 2 million Americans aged 12 years or older had a substance use disorder involving prescription pain-relievers. This estimate increases to 2.5 million when non-prescription opioids are included.1

Why would non-prescription opioids be included? Almost 80% of heroin users report having used prescription opioids before initiating heroin use.2 And often these individuals have their opioid prescriptions discontinued by concerned physicians after dependence has developed. In a 2014 survey, 94% of respondents reported that they decided to use heroin because prescription opioids were “far more expensive and harder to obtain.”3

In 2015, more than a thousand Americans were treated in emergency departments each day across the country for misusing prescription opioids. That’s more than 365 000 visits for the year. Death by a prescription drug is the #1 cause of accidental death in the United States.4 In 2015, drug overdoses accounted for 52 404 deaths. More than 63% involved an opioid, and more than 15 000 of these deaths involved a prescription opioid.5 Put another way, 91 Americans died each day from an opioid overdose in 2015, 44 of whom died from a prescription opoid.1 In the 17-year period from 1999-2015, the opioid overdose mortality rate, and sales of prescription opioids, increased by 500%, while the prevalence of Americans reporting chronic pain remained stable.6,7

In an effort to address this issue, the CDC issued new guidelines for opioid prescribing in March of this year.8

So, what does this have to do with cannabis?

MEDICAL CANNABIS

In a comprehensive 2017 report entitled “The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research,” the Health and Medicine Division of the National Academies of Sciences, Engineering and Medicine stated, “There is conclusive or substantial evidence that cannabis or cannabinoids are effective…for the treatment of chronic pain in adults.”9

According to a multitude of surveys, the most common medical reason for using cannabis or cannabinoids (compounds contained in the cannabis plant) is chronic pain.10,11 Survey respondents report that cannabis use is an effective means of managing their pain, both as a solo therapy10 and as an adjunctive therapy when combined with opioids.12,13 They also report substituting cannabis for prescription opioids11,14,15 and reducing their dose of opioids, thereby experiencing a reduction in the associated side effects while also reporting a higher quality of life.13,15

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