In recent years, cannabis has been proven therapeutically beneficial for a number of medical conditions. Many doctors and healthcare professionals across the world are now prescribing medical marijuana for a range of symptoms or conditions including chronic pain, inflammation, epileptic seizures, appetite loss, depression, anxiety, stress, schizophrenia and PTSD. In addition to these,nowadays there is much chatter about potential cannabis use for OUD(opioid use disorder) treatment. Given the severity of the opioid crisis in recent times, this seems to be a piece of very useful information. What do the experts say about cannabis use for OUD treatment? What are the patients’ experiences? This post will give you an idea about cannabis’ role in dealing with one of the major health crises of this century – the opioid epidemic.
The opioid epidemic in North America and cannabis use for OUD
In recent years, a number of experts and scholars have argued that the opioid overuse crisis in North America has assumed the nature of an epidemic. In 2017, nearly 72,000 opioid-related deaths were recorded in the US alone. That is approximately 200 deaths per day. More Americans have died from opioid overuse in a single year than the total number of casualties recorded in the 20 years of Vietnam War. The opioid crisis is also growing in Canada; in 2016 the country has witnessed nearly 2861 opioid-related deaths. As a 2018 study states, ‘this is a national public health crisis that affects people in communities across Canada, across all ages and across all socioeconomic groups’.According to 2018 estimate, nearly 26-36 million people all over the world are abusing opioids.
One of the main factors contributing to this recent opioid overuse epidemic is thought to be the over-prescription of opioid analgesics like morphine, oxycodone, fentanyl, hydromorphone. According to a study published in a 2018 issue of Cannabis and Cannabinoid Research, opioid prescriptions in the US have gone up by 300% since 1991. Besides, there is also the issue of growing illicit use of synthetic opioids in countries like US and Canada. The Cannabis and Cannabinoid Research study have found that ‘Patients who became physically dependent upon POAs [Prescription Opioid Analgesics] frequently switch to illicit opioids because POAs are more costly and/or difficult to obtain’. In Canada, illegal, non-prescription consumption of fentanyl and its analogs have become more prevalent over the last few years. Fentanyl and its analogs are now responsible for over 53% of the opioid-related deaths in the country.
Opioid addiction – medication-assisted therapies and cannabis use for OUD
There is no doubt that opioid use disorder has become a major public health concern across the world. While the over-prescription of opioid analgesics must be stopped to tackle the opioid epidemic, those who are already suffering from a dependence on opioids also need to be treated. People suffering from OUD require effective therapy that will help them to manage the withdrawal symptoms and overcome their dependence on opioids. Simple abstinence-only methods, as experts suggest, are not very effective as there is a high chance of the patient relapsing within a year. Therefore, a good Medication-Assisted Treatment (MAT) of OUD, combined with social support, is necessary. However, access to MAT is severely limited until now. This brings us to the question of alternative therapies for OUD and cannabis’ role in this.
Cannabis use for OUD – role of cannabis in reducing opioid overuse
As recent scientific studies and clinical trials have shown, cannabis can be an extremely good alternative medication for treating chronic pains and inflammation. It is a natural first line analgesic that has very few side-effects compared to the synthetic opioids commonly prescribed. The 2018 study published in Cannabis and cannabinoid Research has found out that patients using prescription opioid analgesics for chronic pain could reduce their dependence on opioids by 40-60%. Two different studies by the researchers from Florida International University and San Francisco Veterans Affairs Medical Center have also claimed that everyday consumption of cannabis reduces the use of prescription painkillers and opioids by patients suffering from chronic pain.
A similar survey recently published in the PLOS Medicine has claimed that patients are also using marijuana to replace the illicit opioids like heroin. Not only that, but researchers from the Alabama School of Law and Vanderbilt University Law School have also even claimed that the number of opioid prescriptions has gone down in those states where medical or recreational marijuana is legal. In light of these new researches, it seems that cannabis can provide a real breakthrough in the recent global opioid crisis.
Cannabis use for OUD treatment
There is plenty of anecdotal evidence to suggest that cannabis can be very effective in treating OUD and relieving the common symptoms of opioid withdrawal. In a recent survey conducted by the researchers from the Jon Hopkins University School of Medicine, nearly three-quarters (72%) of the 125 OUD patients interviewed claimed that marijuana use alleviated the symptoms of opioid withdrawal. ‘Ratios reflecting the participants who experienced improved versus worsened symptoms indicated that’, the study concluded, ‘more individuals found cannabis to improve rather than worsen all evaluated symptoms’ like anxiety, tremors, inability to sleep, bone and muscle aches, nausea, opioid carvings and others. A few preliminary scientific studies have started to indicate the same.
A path-breaking study on cannabidiol (CBD) by YasminaHurd, PhD, has shown that heroin-addicted patients have fewer cravings and fewer withdrawals while on pharmaceutical cannabidiol like Epidiolex. There are physicians and addiction treatment experts like Peter Grinspoon, MD, of the Massachusetts General Hospital and Frederick E. Kahn, MD, a psychiatrist with the New Jersey Forest Recovery, who prescribe medical marijuana as an adjunct to buprenorphine in treating OUD. A combination of marijuana and methadone has also been found to be effective in treating opioid withdrawal symptoms. In the US, there are now states like Pennsylvania, New Jersey, and New York which accept OUD as a qualifying condition for the use of medical marijuana.
Though more clinical trials and controlled scientific studies are required to fully understand the efficacy of cannabis in OUD treatment, the anecdotal evidence and early studies have shown much promise. Given cannabis’s usefulness in relieving chronic pain and its impact on the body’s endocannabinoid system, one hopes that it will play a major role in combatting the recent opioid-related public health crisis across the world.