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Why Cannabis Can Save America From The Opioid Epidemic

By Roger Malespin

We often read about the American Opioid Epidemic in the news these days, and hear it cited by legalization advocates as a reason for drug law reform. But why exactly is cannabis thought to be an answer for the crisis?   

Opioids are a diverse class of moderate to strong painkillers including oxycodone, hydrocodone, and fentanyl. They are synthesized to resemble other opiates like opium-based morphine and heroin. They have been heavily prescribed by doctors in the US and Canada for almost 20 years despite their high risk of addiction and overdose. According to the National Institute on Drug Abuse (NIDA), the amount of deaths attributed to opioid overdose has more than quadrupled since 1999.

The roots of the epidemic stem from reports in the late 90’s that 100 million, or about one third of Americans, were experiencing some form of chronic pain, which lead to drug companies and the federal government to push for increased prescriptions for opioid class painkillers. Their potency made them popular, but in far too many cases problems such as tolerance increase and a need to increase dosage to ward off withdrawal symptoms took over. Exacerbating this is the fact that most insurance companies for working class and poor people will pay for pills but not more expensive therapies, essentially forcing people below upper-middle class to risk painkiller addiction for their ailments.
However, cannabis is thought to be one of the main potential weapons in this new front of war on drugs. A growing body of evidence suggests that cannabinoids — chemical components in Cannabis plants or certain synthetic compounds — can be effective in alleviating pain, either alongside or in place of opioids. Medical Marijuana has been proven to soothe nausea and increase appetite, quiet pain, soothe anxiety and reduce epileptic seizures.

A recent pair of studies published by JAMA Internal Medicine compared opioid prescription patterns in states that have enacted medical cannabis laws with those that have not - they covered the years 2010-2016. The research concluded that states that allow the use of cannabis for medical purposes had 2.21 million fewer daily doses of opioids prescribed per year under Medicare Part D, compared with those states without medical cannabis laws. Opioid prescriptions under Medicaid also dropped by 5.88% in the same states. 

According to NIDA, research suggests that the cannabinoid and opioid receptor systems rely on common signaling pathways in the brain, including the dopamine reward system that is central to drug tolerance, dependence and addiction. Dr. Kevin Hill, an addiction psychiatrist at Beth Israel Deaconess Medical Center and an assistant professor of psychiatry at Harvard Medical School said "All drugs of abuse operate using some shared pathways. For example, cannabinoid receptors and opioid receptors coincidentally happen to be located very close by in many places in the brain, “So it stands to reason that a medication that affects one system might affect the other."
Medical cannabis is clearly a safer alternative to opioids. Millions of innocent people have died of opioid overdoses but no one has ever died from marijuana. The moral high ground can no longer belong to the lawmakers who want to keep the draconian federal ban on cannabis on the books. If we are in the middle of a crisis and need action, then legalization at the federal level is now both the practical and moral action for congress to take.