Two years ago, an estimated 95 Americans died every day as a result of opioid overdose. Today, that daily death toll is 115. Though our country has spent billions of dollars on efforts to end the opioid crisis, it grows only worse.
One big reason why: we are not using cannabis — marijuana — one of the most effective tools in all of medicine, to combat the problem.
OPINION
Unlike opioids, cannabis is a safe, sustainable option for pain relief that does not put its users at risk for overdose. The plant produces unique molecules, known as cannabinoids, which interact with receptors in our bodies’ own endocannabinoid system. These receptors are widely found throughout our brain’s pain processing regions. In pre-clinical studies, when cannabinoids are administered directly into these areas, they produce robust pain relief.
In Illinois, patients are legally allowed to use cannabis to help alleviate a range of ailments, many with a strong chronic pain component — fibromyalgia, for instance. In 2015, the number of registered adult patients in Illinois using cannabis to treat pain was about 2,600. By June 2017, that number increased to nearly 22,000 — a more than 700 percent increase.
Nearly 7,000 of these patients reside in Cook County and are registered to use cannabis for conditions ranging from cancer, glaucoma, and lupus, to Parkinson’s disease, epilepsy and PTSD. There are 42 qualifying conditions in all.
But one condition is noticeably absent from Illinois’ list: substance use disorder, more commonly known as addiction.
This brain disease (yes, addiction is a disease) causes people to engage in compulsive substance use despite harmful or fatal consequences. Of all the addictive disorders, opioid abuse is particularly problematic.
When individuals use opioids for prolonged periods, their bodies develop a physical dependence on them. And when people attempt to quit, excruciating withdrawal symptoms, including nausea, vomiting, stomach cramps and depression are common. Pre-clinical studies show cannabinoids alleviate these symptoms. And addiction specialists corroborate these results: Cannabis lessens opioid cravings during withdrawal.
Even when withdrawal symptoms have subsided, relapse is common. Among the most prevalent relapse triggers are negative mood and anxiety. Again, cannabis plays an effective role because of its profound ability to enhance euphoric feelings and positive mood. Cannabinoids also alleviate the anxiety that fuels drug craving.
These findings suggest that, rather than a stigmatized gateway to addiction, cannabis should be considered an exit drug. Exciting new data demonstrates that cannabis has measurable impacts on decreasing opioid prescriptions, overdoses and deaths. Two recent studies conducted by the American Medical Association’s peer-reviewed journal, found that opioid use is lower in states that allow medical and recreational cannabis use. These studies corroborate previous work which revealed opioid-related deaths drop by nearly 25 percent after a state legalizes medical cannabis.
New Jersey and Pennsylvania recently added opioid use disorder to their list of qualifying conditions for medical cannabis. New Mexico, Arizona, New York, Maine, Massachusetts, Hawaii and Maryland have tried to do the same, but their efforts are currently stalled. Illinois has made no efforts to add substance abuse disorder to its list of qualifying conditions.
If state leaders are truly interested in fixing the opioid problem in Illinois, they should do so soon. There are people suffering with no time to waste.
Local citizens, however, are taking action. In January, a circuit judge ordered the Illinois Department of Health to add intractable pain to the list of qualifying conditions for use of medical cannabis. The decision was made as a result of a lawsuit from Ann Mednick, a Rolling Meadows woman who wanted an alternative to opioid-based medication for her osteoarthritis pain. The State has appealed the decision.
Cannabis is a critical tool with the potential to improve and save lives of thousands of people in Illinois, and millions across the country. But a tool is only good if we use it.
Adie Wilson-Poe, Ph.D. is on the faculty of the Washington University School of Medicine in Saint Louis, MO. She is also the scientific advisor to Weedmaps, where she helps lead The Exit Drug campaign.
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