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Investigating the Possibility of Cannabis as a Substitute for Opioids

By Ann Mazotta, California Business Journal

In 1995, the president of the American Pain Society advocated for the inclusion of pain as a fifth vital sign, alongside the original quartet of body temperature, heart rate, respiration, and blood pressure. This move led to the widespread practice of assessing and managing pain by healthcare professionals. With approximately 20% of adults grappling with chronic pain, the prescription of opioids surged, and Americans found themselves consuming a staggering 80% of the global opioid supply.

In October 2017, President Trump formally declared the opioid crisis a “public health emergency.” By that time, the United States had witnessed nearly 50,000 opioid overdose deaths, with nearly 60% attributed to illicit synthetic opioids like fentanyl or tramadol. Unfortunately, the crisis has only worsened since then. In the past year, the number of opioid overdose deaths exceeded 80,000, with approximately 90% linked to highly potent synthetic variants. It is evident that this crisis persists and calls for innovative strategies to address it.

Cannabis has demonstrated promise in addressing various health conditions. If you are an individual seeking to use cannabis for medical purposes in Baton Rouge, your first step is to obtain a medical marijuana card baton rouge. This card will grant you legal access to medical cannabis.

Can the legalization of cannabis lead to a decrease in opioid consumption?

Several factors suggest that the idea of legalizing cannabis as a solution to the ongoing opioid crisis is promising. Initially, data from early population studies indicated that states permitting medical cannabis experienced a decline in opioid overdose fatalities. However, this positive effect does not appear to persist when examining the data over an extended timeframe; any potential reduction in opioid overdoses due to cannabis legalization seems to be short-lived.

States that legalized recreational cannabis did observe an initial drop in opioid-related emergency room visits by 7.6% compared to non-legalizing states. Nevertheless, this effect vanished within six months. While cannabis might serve as a substitute for commonly prescribed opioids such as oxycodone, codeine, or hydrocodone, it appears insufficient to address the dependency associated with more potent illicit opioids like fentanyl or heroin, which are increasingly abused.

Certain studies suggest significant reductions in the use of prescription opioids among patients who also use cannabis, although this benefit does not consistently translate into results in rigorously controlled clinical trials. These trials fail to consistently support the notion of cannabis co-use with prescription opioids, despite many patients expressing a preference for cannabis over opioids.

What are the potential ways in which cannabis could serve as an alternative to opioids?

Currently, there are 15 active clinical trials exploring the potential of cannabis to diminish the necessity for opioids. These clinical investigations are motivated by compelling evidence from animal research, which examines the pain-relieving interactions between the endocannabinoid system, activated by cannabinoids like THC, and the opioid system.

Studies involving pain experiments in rodents consistently reveal that THC can reduce the opioid requirement. Across seven separate studies, THC decreased the effective morphine dose by a factor of 3.5. This favorable outcome is substantiated by three crucial pieces of evidence:

Many cannabinoids, including THC, stimulate CB1 receptors within the endocannabinoid system, which are located in the same brain regions responsible for processing pain as opioid receptors. This co-stimulation may contribute to pain alleviation.
CB1 receptors within the body interact with opioid receptors, enhancing their pain-relieving efficacy, as demonstrated in rodent investigations.
CB2 receptors, another target for cannabinoids, can trigger the release of the body’s own opioids, which activate pain-relieving opioid receptors.

So, why is there a disparity between these ongoing clinical trials and the population-based studies mentioned earlier?

The precise reason remains unclear. Some argue that a sense of control over pain management, experienced when individuals opt for cannabis, could lead to better outcomes. This effect might elucidate why patients who had the choice to incorporate cannabis into their pain management, as opposed to participants in randomized clinical trials, displayed a reduced reliance on opioids.

It’s also conceivable that these advantages stem from the placebo effect, wherein individuals can elevate their opioid levels and alleviate pain solely because they believe they are receiving an active pain medication.

What are the potential dangers associated with the concurrent use of cannabis and opioids?

In certain instances, the concurrent use of cannabis and opioids has been linked to deteriorated mental health, particularly for individuals aged 65 and older. However, some safety concerns, such as opioids’ impact on respiratory function, do not appear to worsen with the co-use of cannabis, offering some relief from those concerns.

Furthermore, in the majority of cases, the co-administration of cannabis does not lead to an increase in opioid consumption, dispelling the notion that cannabis serves as a gateway drug, a claim often voiced by anti-drug advocates.

Is it feasible for cannabis to serve as a substitute for opioids?

The verdict is still pending. A majority of patients express a preference for using cannabis instead of opioids for pain relief, viewing it as a viable alternative. Nevertheless, the diverse array of usage patterns, product choices, cannabinoid and terpene compositions, as well as the various reasons for requiring pain medication, render this a complex research inquiry to investigate empirically.

Achieving control over the specific cannabis products used, coupled with the development of optimized formulations for pain management (with moderate THC potencies), will contribute to a more definitive assessment of cannabis’ capacity to supplant opioids.

If you wish to use cannabis for alleviating your medical conditions, obtaining legal access to medical cannabis is essential. Fortunately, you can conveniently apply for your medical marijuana cards in New Orleans from the comfort of your own home.