PITTSBURGH >> As the opioid epidemic continues to decimate communities here at home and across the country, experts at the first-ever World Medical Cannabis Conference and Expo in Pittsburgh recently looked at what role medical marijuana can play in helping to bring it to an end.
The hour-long Opioids to Cannabis panel looked at recent statistics showing states that have regulated medical cannabis
markets see a decrease not only in opioid related overdoses, but the total number sold as well. The panel discussed the relevant research available and future treatment opportunities.
Included in the discussion were Dr. Matthew Roman, founder of Nature’s Way Medicine, based in Wilmington, Del.; Dr. Thomas Whitten, a pain management specialist based in Greensburg, Pa.; Kevin Boehnke, a doctoral candidate at the University of Michigan School of Public Health in Ann Arbor; Kirk Reid, founder of Captain Kirk’s Edibles, and Nate Jackson, a cannabis user and a former NFL tight end, who played most of his career with the Denver Broncos. Dr. Bryan Doner, a practicing emergency physician and CEO and co-founder of Compassionate Certification Centers, a medical marijuana marketing and consulting company, moderated the discussion.
Recent studies into medical cannabis have found a link between states that legalized medical marijuana and a decreased number of prescriptions for pain killers. According to the Centers for Disease Control, since 1999 opioid deaths have quadrupled and opioid abuse has been estimated to cost over $72 billion in medical costs alone.
Doner sees it every day.
“I deal with this type of thing every day, every shift,” he said. “From overdoses, to addiction, to chronic pain, this is something that’s intrinsically important to me not only professionally but personally.”
Through his work at a detox center, Whitten saw that many patients addicted to opiates “were addicted by their doctors not treating their pain appropriately.”
Roman has been practicing with medical marijuana now for a few years and said the majority of his patients suffer some kind of pain and resorted to pain-relieving narcotics.
“Many in heavy doses, and Delaware is especially bad for that,” he said. “What I’ve been finding is that [medical marijuana] works. It does so and I know so because their narcotics are going down. What they’re getting prescribed is going down.”
He said cannabis can help patients withdraw from opiates and can assist with the symptoms of those trying to go cold turkey off of methadone.
The research available on the positive effects of medical marijuana provides strong evidence that it could play a large role in combating the opioid epidemic.
Boehnke has researched how cannabis affected opioids and other medical use among patients suffering from chronic pain. He cited a report performed by the National Academies of Sciences, Engineering and Medicine, that shows evidence that cannabis is effective for the treatment of pain in adults.
“That’s one of the few conditions where there’s that body of evidence in the published, peer-reviewed scientific literature forum,” he said. “So when it comes to chronic pain there seems to be this clear evidence that this is extremely useful.”
However, because marijuana is classified as a Schedule 1 drug by the United States Drug Enforcement Administration, it’s difficult to do studies to prove the drug is an effective replacement to opioids for patients suffering chronic pain, he said.
“There haven’t been almost any studies like that that have been done,” Boehnke said. “But there have been a lot of things done at statewide levels and in individuals.”
In 2014, he said, a study published in JAMA Internal Medicine found that opioid deaths were down by about 25 percent in states with medical cannabis compared to those without.
“Statewide that’s a pretty significant finding,” Boehnke said. “That’s a lot fewer deaths.”
Likewise, he said, hospitalization rates for opioid painkiller dependence and abuse dropped 23 percent on average in states after marijuana was permitted for medicinal purposes and 13 percent on average for opioid overdose hospitalizations, according to a report published in Drug and Alcohol Dependence.
“We’re also seeing that this is economically potentially going to save money as well,” he said.
A report published in Health Affairs, shows in states with medical marijuana laws, doctors are prescribing about 1,800 few pain killer doses per year, saving on average about $165 million among Medicare Part D enrollees.
“So this is a substantial economic saving,” Boehnke said.
Boehnke conducted his own study in Michigan surveying patients who went to a medical cannabis dispensary with chronic pain. He and his team asked them how their quality of life and medication use changed.
“We found that they decreased their opioid use by about 64 percent,” he said. “At the personal level we’re finding that people are decreasing their use. We found that this was because many of them said they had fewer medication side effects and they had a better quality of life.”
QUALITY OF LIFE
Among former opioid addicts like Reed and Jackson, switching to cannabis helped them get off of opiates.
Reed, who was diagnosed with multiple sclerosis in 2004 and is slowly going blind, admitted that he grew up a misguided teen and became a drug addict.
“There’s not a drug I haven’t tried,” he said.
After his diagnosis, he would complain enough that hospitals would “hand me pills like cotton candy.”
During one MS attack, a local marijuana compassion club gave him a marijuana muffin to help ease the pain. The hospital called him a drug seeker because he had THC in his system and kicked him out after his health insurance policy ran out.
“Nobody would do anything for me because I had THC in my system,” he said.
He was able to slowly ween off most of his medications thanks to cannabis, he said. While it’s not a cure-all, he’s been able to manage his pain and found a successful business selling marijuana edibles.
Jackson used cannabis in high school and college and found it more useful for pain management than pills and he healed faster, he said. He described the NFL as “pill city” with many of his teammates addicted to pills.
“I never became addicted, I didn’t like them,” he said. “I had withdrawal symptoms. I used cannabis and was able to move on.”
While cannabis alone may not be the panacea to end the opioid epidemic, Boehnke and others said it needs to be part of the conversation. “It’s a tool in the tool box.”