Many people are aware that cannabis was first prohibited at the urging of the pharmaceutical drug industry in the early 20th Century. Likewise, Big Pharma has been partially bankrolling an anti-marijuana crusade organized by a hate group in California.

NORML Deputy Director Paul Armentano contributed to this report. NORML’s fact-sheet of relevant, peer-reviewed research specific to the relationship between cannabis and opioids is available online.

More news shows that Big Pharma has plenty to fear from cannabis’ ability to prevent addiction to hard drugs, particularly opioids, which are addictive and highly profitable to the drug industry.

Two recent studies, one in Canada and one in New York, show that cannabis use significantly reduced use of and dependence on pain pills and another shows that opioid abuse drops in states where cannabis is legal. Eighty-four percent of New York physicians agree that pharmaceutical opioids posed greater risks to patients’ health than does cannabis.

This means big trouble for drug companies who rely on patient addiction to secure their corporate profits. However, as long as the DEA controls access to prescription drugs and bans cannabis in the USA, the federal agency protects those profits, at the expense of society in general.

Canadian opioid use drops with cannabis access

Pain patients enrolled in Canada’s medical marijuana program significantly reduce their use of opioids over the long-term, according to longitudinal data provided in May 2018 by one of the nation’s largest, licensed providers of cannabis products, Tilray Canada Ltd.

Investigators assessed opioid use patterns among 573 patients using its products and found that 51 percent of patients who acknowledged using opioids when they enrolled in the trial reported ceasing their opiate use within the first six-months of cannabis treatment. The study’s findings are similar to results among enrollees in U.S. medical cannabis programs, as indicated by patients in Illinois, Michigan, Minnesota, New Mexico, New York, and elsewhere.

“The high rate of cannabis use for the treatment of chronic pain – and subsequent substitution for opioids – suggests that cannabis may play a harm-reduction role in the ongoing opioid dependence and overdose crisis,” said Philippe Lucas, lead investigator of the Tilray Observational Patient Study.

“While the cannabis substitution effect for prescription drugs has been identified and assessed via cross-sectional and population-level research, this study provides a granular individual-level perspective of cannabis substitution for prescription drugs and associated improvement in quality of life over time.”

NY opioid dependence drops with cannabis use

A significant number of patients in New York state’s medical cannabis program have likewise reduced their use of opioids and, as a result, they spend less money on prescription medications, according to data published in May 2018 in the online journal Mental Health Clinician. Monthly analgesic prescription costs declined by an average of 32 percent following enrollment in the program, primarily due to a reduction in the use of opioid pills and fentanyl patches.

Investigators from the University of Buffalo and GPI Clinical Research labs in Rochester assessed trends in patients’ use of medical cannabis and prescription drug in the time period following their enrollment in the state’s marijuana access program.

“After three months treatment, medical cannabis improved [subjects’] quality of life, reduced pain and opioid use, and lead to cost savings,” authors concluded.

The study’s findings are similar to those reported among enrollees in other states’ medical cannabis programs, including the experiences of patients in Illinois, Michigan, Minnesota, New Mexico, and elsewhere.

Kentucky, Georgia also see reductions in opioid use

The enactment of statewide marijuana legalization laws is associated with a reduction in the number of opioids prescribed and filled, according to a pair of studies published online Monday in the journal JAMA Internal Medicine.

Investigators from the University of Kentucky and Emory University assessed the relationship between medical and adult-use marijuana laws and opioid prescription patterns among Medicaid enrollees nationwide. Enrollees included all Medicaid fee-for-service and managed care enrollees — a high-risk population for chronic pain, opioid use disorder, and opioid overdose.

Researchers reported that the enactment of medicalization and adult-use laws were both associated with reductions in opioid prescriptions. Broader legalization policies were associated with the greatest rates of decline.

“State implementation of medical marijuana laws was associated with a 5.88 percent lower rate of opioid prescribing. Moreover, the implementation of adult-use marijuana laws, which all occurred in states with existing medical marijuana laws, was associated with a 6.38 percent lower rate of opioid prescribing,” they concluded.

“[T]he further reductions in opioid prescribing associated with the newly implemented adult-use marijuana laws suggest that there were individuals beyond the reach of medical marijuana laws who may also benefit from using marijuana in lieu of opioids. Our finding that the lower opioid prescribing rates associated with adult-use marijuana laws were pronounced in Schedule II opioids further suggest that reaching these individuals may have greater potential to reduce the adverse consequences, such as opioid use disorder and overdose.”

University of Georgia researchers, meanwhile, evaluated the association between the enactment of medical cannabis access laws and opioid prescribing trends among those eligible for Medicare Part D prescription drug coverage. Researchers reported that access to brick-and-mortar cannabis dispensing facilities, correlated with significantly reduced opioid prescription drug use.

“This longitudinal analysis of Medicare Part D found that prescriptions filled for all opioids decreased by 2.11 million daily doses per year from an average of 23.08 million daily doses per year when a state instituted any medical cannabis law. Prescriptions for all opioids decreased by 3.742 million daily doses per year when medical cannabis dispensaries opened,” they concluded.

“Combined with previously published studies suggesting cannabis laws are associated with lower opioid mortality, these findings further strengthen arguments in favor of considering medical applications of cannabis as one tool in the policy arsenal that can be used to diminish the harm of prescription opioids.”

For more information, contact Paul Armentano, Paul@norml.org