For Many, Pot Is Now an Alternative to Opioids or Sleep Meds

For Many, Pot Is Now an Alternative to Opioids or Sleep Meds

TUESDAY, July 2, 2019 -- In places where it's legal, people are often turning to pot to relieve pain and insomnia, a new study finds.

For many, cannabis is replacing over-the-counter painkillers, prescription opioids and sleep aids.

"These aren't the only reasons people are using marijuana, but it's one of the drivers for use," said study author Dr. Gwen Wurm, an assistant professor of clinical pediatrics at the University of Miami Miller School of Medicine.

"People who are using it for those reasons are finding it to be effective," she said.

The findings stem from a survey of 1,000 people who use marijuana in Colorado, where it is legal. Of the 65% who said they use pot to quell pain, 80% said it was very or extremely helpful.

A similar percentage said they had been able to cut back on use of over-the-counter painkillers by using pot instead, and 88% said they stopped taking opioids, the study found.

Three-quarters of the interviewees said they used pot to help them sleep. Of those, 84% said it helped, and 83% said they were no longer using over-the-counter or prescription sleep aids.

Compared with other drugs, cannabis is safe, Wurm believes.

On the plus side, marijuana users are not at risk of the respiratory arrest opioids can cause, and pot won't make you dependent as some sleep medicines do, she said.

"That doesn't mean that it doesn't have its own risks," Wurm cautioned. "But until we can begin to study cannabis use, we are really not going to know how best to counsel patients."

Other pain and sleep medications can have serious side effects, Wurm noted. Opioid addiction is an epidemic in the United States, and fatal overdoses are not uncommon. And over-the-counter pain relievers like ibuprofen can cause stomach bleeding if used for extended periods, Wurm said.

Also, people can become dependent on sleeping pills, which leave them groggy during the day and affect their work, she said.

However, marijuana is still a drug with its own addictive properties and risks, another expert warned.

Emily Feinstein, the Center on Addiction's chief operating officer and executive vice president, previously told HealthDay, "Misinformation and misunderstanding about marijuana is rampant. Marijuana is addictive, and people who are dependent on the drug exhibit the same symptoms as those with other addictions, including cravings and withdrawal."

For the study, Wurm's team relied on a survey of people who bought pot at two retail stores in Colorado, where any adult with a valid ID can purchase it for medical or recreational use.

But if states like Colorado think legalizing weed will help curb the opioid epidemic, a study in the June 10 issue of the Proceedings of the National Academy of Sciences casts doubt on that assumption.

In that study, researchers found no association between medical marijuana laws and opioid overdose death rates.

In fact, the overdose death rate increased by about 23% between 1999 and 2017 in states that legalized medical pot, though only an association was seen, researchers emphasized.

Paul Armentano is deputy director of NORML, a group working to legalize marijuana nationwide. He called the findings in the new study "significant, though not altogether surprising."

Other studies have found that use of medical marijuana is associated with the reduced use or even elimination of prescription opioids, he noted.

Another researcher thinks cannabis has a role to play in relieving pain and aiding sleep.

"Is use of cannabis for pain relief and improvement of sleep defensible?" said Dr. David Katz, director of the Yale-Griffin Prevention Research Center in New Haven, Conn. "The answer is yes, whenever cannabis can contribute a therapeutic effect with less risk than the established alternatives."

Treatments need not be completely risk-free, and few, if any are, Katz said, adding their use is justified when benefits outweigh risks.

Using cannabis to treat pain and insomnia seems worthwhile when you consider the risks of opioids and sleep medications, he said. But a survey alone doesn't prove its effectiveness, he added.

"We need trials directly comparing the efficacy and safety of therapeutic alternatives," Katz said. "The best treatments are those that win these contests of comparative efficacy."

The report was published July 2 in the Journal of Psychoactive Drugs.

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Posted: July 2019