Countering the Opioid Crisis with Cannabis

 

This article contains my research on the potential for cannabis to help curb the opioid crisis. As this is an ever-moving subject, I plan to periodically edit the below and provide more links/resources as they become available. If you have news or updates that you would like to share with me, please leave a comment or send me an email. This issue is happening now, so thank you for your interest in the topic and let’s get to talking and influencing.

I remember once standing in a parking lot, in the Fremont neighborhood of Seattle, on a cold, wet, drizzly day. I think it was winter 2016 or 2017. I looked up and saw the following billboard:

A valuable PSA.

A valuable PSA.

I will always remember the immediate feeling I got when I saw this billboard. I felt as though I had experienced a sharp chill, one that rattled me a little more than the weather already had, but also hint of optimism.

The topic of the opioid epidemic is a very personal one for me. For instance, if anyone cracks a joke or makes light of this issue on TV, I get upset. At the end of 2015, my best friend passed away due to an opioid overdose. This event rocked me. For any of you who have experienced significant grief… I’m so sorry. Anyway, you can imagine the cocktail of emotions that I felt when looking at this advertisement; I remember thinking, “bless the person that put up this billboard, and also screw it because it was too late”. According to the CDC, 33,000 Americans died in 2015 due to the opioid crisis, and my bestie was one of them.

However, my bitterness has waned over time and I have realized that for many others, it is not too late. Additionally, now that cannabis is becoming more and more accessible to the American public, now is the time for us to properly explore using cannabis as a means for countering the opioid crisis.

According to the below infographic, sourced from the US Department of Health & Human Services, there are approximately 2.1 million people with opioid misuse disorder (based on 2016-7 data).

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The company who puts out the cannabis PSA billboards is called Weedmaps, and I am so inspired by this company’s mission to educate and inform our community about how cannabis can actually contribute to society. They launched the weed statistic billboard campaign for the sole purpose to trigger more constructive conversation about weed legalization. Sure, they probably gained some brand awareness through the campaign, as well, but hey - brownie points were still earned. Check out Weedmap’s most recent “weed facts” here. Their site also contains a lot of educational resources on various weed topics, including how cannabis interacts with the human body as well as cannabis history. I can guarantee that I will be nerd-ing out on the historical content this evening.

How Can Cannabis Help Opioid Addicts?

Pain Management

Based on an article in Nursing Outlook, one of the most prevalent reasons that people initiate misuse of opioids is to deal with extreme or chronic pain, and therefore, “an integrative approach to pain management, involving safer, nonaddictive, alternatives to POMs [prescription opioid medications], are essential to continue to treat patients in pain.” It is estimated that 100 million Americans live with chronic pain, which is awful to think about given the strenuous work week that is the norm for most Americans. It is very important that as a society, we acknowledge that chronic pain is one of the root causes behind the current epidemic - I don’t think this is a concept that everyone understands. When researchers, politicians, and involved citizens can share a common understanding of why something is happening, then we are better poised to work together to overcome the original problem and work toward solutions and provide reasonable solutions to pain management that can replace opioid misuse. So, one of the key problems we have to solve is one of chronic, physical pain. How can we provide cost-effective solutions that will address day-to-day discomfort but not risk the lives of those patients? Hmm… mindfulness-based-stress-reduction and cannabis, anyone?

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The US government is not yet convinced that cannabis is the answer to dealing with chronic pain for millions of Americans. However, what’s great is that market data can tell us what the people actually think (ahh, Democracy). Per the Periodic Effects Podcast, market research has shown cannabis retailers that individual cannabis consumers use recreational cannabis products for three main reasons, 1) pain management, 2) anxiety, and 3) sleep. If the average cannabis user can cite that they use cannabis for pain reduction, then I think we can start to draw some connections to how cannabis can replace more dangerous forms of pain management, including opioids.

In fact, patients who have access to medical marijuana have provided insights into the fact that cannabis is actually the preferable approach to seeking relief to chronic pain. Patients have reported less severe side effects, less withdrawal potential, ease of access, and better symptom management for their conditions.

Treatment and Recovery

There is some data pointing to the fact that cannabis use can provide value during the opioid treatment process. According to a study released in 2018, cannabis has molecules called CB1 that have been associated with a reduction in opioid withdrawal symptoms in mice. Cannabinoid and opioid receptors are located in a similar section of the brain, and so researchers are not surprised that the introduction of cannabis in the brain can have substantial impacts to the way an individual’s opioidergic system reacts. There is also data to suggest that certain cannabinoid molecules can create an aversion to opioids/morphine by impacting the “reward” feeling or dopamine hit that would normally be associated with opioid use. Although these mechanisms have not been well studied in humans, the data so far makes researchers optimistic that the science backs up the need to leverage cannabis for dealing with opioid treatment to quell the current epidemic.

Certain clinical researchers are also recommending the co-administration of cannabis and small-doses of opioids. When administered together, cannabis and opioid analgesics have a “synergistic” effect - the overall pain relief felt is greater than the sum of its parts. It’s possible that during rehabilitation, treatment professionals could direct patients to take a very small dose of opioids combined with cannabis to achieve the same relief they would normally achieve through a much larger dose of opioids, ultimately helping over time to reduce tolerance and dependence. A 2016 report by the NCIA also highlights the benefit of this synergistic effect. The NCIA spoke with a medical marijuana doctor in Maine who had this to say, “Usually if a patient is taking opioids, you expect them to come back and ask for more, because their effectiveness diminishes over time,” he says. “But we saw patients using cannabis decreasing and stopping their use of opioids without even being asked to. None of us had seen anything like it in any area of medicine.”

So, why isn’t everyone on board with this solution?

More Research is Needed

Unfortunately, the one thing that everyone researching this topic can agree upon is this: for us to truly understand the potential of cannabis to counter the opioid epidemic, providing patients with a safer, alternate route to reduced pain, we need to first have more research about the correlation between marijuana and opioid misuse. There is not a lot of reliable data on the subject due to the classification of marijuana as a Schedule 1 drug at the federal level. At this point, researchers cannot even receive federal grant money for research into medical marijuana, and even worse, they could be jeopardizing their reputation if they research it anyway. Sheila Vakharia of the Drug Policy Alliance had this to say, “The longer marijuana remains a Schedule I drug, the longer we will have to wait for these answers, and the longer it will be until we can understand its potential as a therapeutic drug.” So, while many scholars have enough research to come out and say that cannabis can and will play an effective role in curbing the opioid crisis, and the retail behavior of cannabis consumers backs this up, there is work to be done to convince our leaders within state and federal government. Alas, it looks like I’ll be getting into weed activism faster than I had originally anticipated. And time is of the essence, as approximately 130 people are dying every day. Those are people’s siblings, sons and daughters, and best friends.

More cannabis research is required before cannabis can become a mainstream response to opioids, but research is stalled due to marijuana’s Schedule 1 classification.

More cannabis research is required before cannabis can become a mainstream response to opioids, but research is stalled due to marijuana’s Schedule 1 classification.

While the US government hums and haws over what to do, maybe we can learn something from our kind neighbors to the north (I must admit, I’ve been saying this a lot lately). Canada has recently legalized recreational cannabis use at the federal level. Yay, Canada! Seth Rogan must be the happiest guy on Earth. Anyway, Canadian health researchers are starting to look into how cannabis can provide value in the face of the opioid epidemic. I hadn’t even realized this, but Canadian citizens have also been hit hard by the opioid crisis (this is the most devastating epidemic in Canada since the AIDs crisis in the 80’s and 90’s). I plan to keep my eyes open for the research studies that start to come from the Canadian government. This can allow the cannabis businesses in the States to start anticipating what the future of the market might look like. Will cannabis-based forms of relief be available for opioid addicts in both recreational shops as well as medical dispensaries? Let’s hope so, and ideally, soon.

The role of Cannabis in Grief Management

As someone who has experienced personal loss due to the opioid epidemic and found some relief through regular cannabis use in the subsequent years, I am very interested in the correlation between cannabis and grief management. In going through this experience myself and talking with others who are experiencing similar grief, I have learned that there is really no “right” way to deal with grief - but there certainly are incorrect, destructive ways to deal with it.

For example, some people (and I struggled with this myself) can turn to alcohol to try to dull the pain of a loss. This approach tends to further alienate you and does not contribute to high personal performance, so over time, drinking due to grief can unintentionally result in loss of control over areas of one’s life.

When I went through my darkest time, months after my friend passed - I felt as if I was just trying to make it from moment to moment, and alcohol was all too tempting because, in my mind, it was an option through which I could “turn off” my brain and my severe, messed up emotions. However, while drinking on nights and evenings would sometimes dull the pain, it was not serving me well in other areas of my life (work success, health, relationships, etc). I remember feeling as if my problems were just piling-on, one after the other, and I just couldn’t catch a break. After one particularly painful day at work, I went to the doctor to chat with a professional and discuss options for moving forward. I left the doctor’s office with his approval to use cannabis to help deal with my grief, and I was optimistic about the potential to get through the moment in a way that helped me to appropriately remember and honor my friend but also maintain my other commitments. This transition was a game-changer for me. In retrospect, I can look back at that moment and point to some of the good things that happened afterward - including a work promotion, getting engaged, and a renewed focus on my health and subsequent weight loss - as a direct result of me deciding to kick the booze and opt for cannabis to get through that period.

Using cannabis to help manage grief is a very self-compassionate approach. For me, the quote that is currently on the homepage of this blog really encapsulates what cannabis is able to help facilitate, “Cannabis is like a mirror in that she will show you your true self and hold your hand as your fix yourself.” Getting high doesn’t allow you to avoid your problems, but also lessons your stress and anxiety so that you can look at them, head-on, and thoughtfully consider how best to go about solving them. It’s amazing.

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There is a lot of buzz on the internet about the ways that cannabis can help with managing grief. This article in Tonic discusses the grief journey of multiple women who have used cannabis to help them traverse the difficult time after the loss of a loved one. Many of their insights line up with my own experience with cannabis for grief management. One women who had lost her mother shared this, “What I love about cannabis is that it keeps me positive, keeps me focused on the good and not the bad. It's definitely a balancer rather than making you ‘not feel.’ I think it just helps you kind of identify what those feelings are and think about them in a different way.” This, in my mind, touches on the root of why cannabis is so gracious for those who are experiencing intense feelings of loss - when you’re “high”, you’re not tuning out what happened, but you’re able to look upon the situation with less judgement and sadness. It enables you to find acceptance and become more accustomed to your new reality without feeling prickly and scary.

I also want to point out that everyone impacted by the opioid crisis has the right to grieve. For example, you don’t need to have someone you know pass away before you are allowed to grieve and express emotion. This may be obvious to some, but I want to point it out because sometimes I can feel like I don’t have permission to grieve or feel the way that I do. Everyone’s emotions around the opioid crisis are valid. The best thing we can do moving forward is to take care of each other as well as our peers suffering from chronic pain or opioid misuse disorder until we can come up with sustainable, long-lasting solutions to this issue.

Heather