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Harm Reduction Trends: Trading Cannabis for Opioids

As an evidence-based program, we know how addictive opioids can be. We also believe that truly recovering from addiction means abstaining from all drugs. With that said, cannabis replacing opioids as a pain treatment may be the lesser of two evils. If you feel you can benefit from taking cannabis for your pain instead of opioids, there are facts to suggest this reduces harm. Harm-reduction describe the strategies and ideas being used to reduce negative consequences that occur with drugs. In the end, trading cannabis for opioids is reducing the potential for harm, not excluding it completely. Again, we want to make it clear, we do not encourage our clients to use marijuana instead of opiates/opioids. Instead, we suggest they heal completely from dependence from all substances. That is what we consider the highest form of freedom in recovery. For those not ready for a full recovery, this article will lay out the harm reduction approach of trading opioids, such as heroin, for a bit of a safer alternative, such as marijuana.

Opioid Prescription Drugs and Chronic Pain in the U.S.

Chronic pain in the U.S. affects 11.2% of people. There are about 4% of those people that use opioid therapy long-term. It’s been found that using opioids long-term can create addiction to it. There are over 100 million Americans that are using prescription opioids. This comes at a cost of $635 billion per year. The addictive nature of prescription opioids can create indirect issues that are ruining lives of the average American. The dependence of opioids can cause people to find heroin on the street if their prescription runs out. Then you’re all of a sudden dealing with a much heavier addiction and a far more risky opioid.

Study about Cannabis for Pain in 1889

Over 100 years ago, Dr. Edward A. Birch documented how marijuana helped many of his patients. His article was published in the Lancet in 1889. He found that cannabis was extremely helpful in patients that had become addicted to pain medications. Keep in mind that this was a time where heroin was being distributed by Bayer. Morphine was also a housewife’s go-to for pain and respiratory problems. Today, the prescription opioids may not be as harmful but they’re still addictive. Dr. Edward A. Birch said that he prescribed cannabis to use it for insomnia. He found that cannabis did so much more for a person’s health. This is what he said about marijuana, “I prescribed the cannabis simply with a view to utilizing a well-known remedy for insomnia, but it did much more than procure sleep. I think it will be found that there need be no fear of peremptorily withdrawing the deleterious drug, if hemp be employed.” What Birch had to say 127 years ago is becoming an accepted reality. There is controversy still surrounding cannabis as medication. Studies are beginning to close the gap of misconception. One thing is for certain, cannabis is an efficient way of managing some types of pain. It also reduces reliance on opioid medications.

How Effective is Cannabis for Medical Conditions that Opioids Would Treat?

There have been a variety of studies that have shown cannabis is capable of alleviating many conditions. This includes pain management and the ability to reduce general dependency on opioid and non-opioid medications. A Canadian pain study found that when a person inhaled 25 mg. of 9.4% herbal cannabis three times daily for up to five days, positive results ensued. This included a reduction in the intensity of pain and the ability to sleep better. The marijuana was also tolerated well.

Legalization of Cannabis and How It Has Influenced Opioid Overdose

A study about the legalization of marijuana and its influence on opioid overdose came up with some interesting conclusions. In states where cannabis was legal for medicinal use, there were less opiate based deaths. California, Oregon, and Washington had legalized cannabis for medicinal purposes before 1999. This is the year that the CDC started monitoring opioid use, addiction, and overdose. There were ten states that followed in legalizing medical cannabis use from 1999 to 2010. These states that had medical cannabis laws saw less deaths due to opioid overdose. This is compared to states that didn’t allow cannabis. This has shown that laws relating to medical cannabis have had a positive impact on the amount of opioid overdose death rates. Of course, more research needs to be conducted and policies need to be put in place. Preventing prescription opioid overdose is a priority but reducing drug abuse in total is also essential.

Cannabis Can Effectively Replace Opioids for Severe Centralized Chronic Pain

Researchers at University of Michigan conducted a study to find out if cannabis was an effective replacement for opioids when it came to severe centralized chronic pain. They hypothesized that cannabis could be effective for chronic pain like fibromyalgia. The patients in the study rated cannabis as equally effective for their varying degrees of pain. Patients went on to say that with less pain, they experienced less need for opioids and in essence, a greater quality of life. Again, the study cautioned changing clinical practices towards cannabis use. There still hasn’t been enough research done on the downside of using medical cannabis. The study did find that cannabis is effective as a pain medication and prevention of opioid overuse.

Medical Marijuana Prescriptions Caused Opioid Prescriptions to Reduce

Data has been used from Medicare Part D. It comes from analyzing filled prescriptions to help determine how cannabis and opioids relate for medicinal use. What they found from the data was that once the medical marijuana law was implemented, the use of prescription drugs plummeted. A reduction nationwide occurred when stated brought in medicinal marijuana laws.

Patients Seemed to Prefer Cannabis over Opioids for their Pain

A cannabis for pain study that included 2897 participants came up with some interesting findings. There were 34% of the participants who had used opioid medications within the past 6 months. The report found that the effects of pain relief from cannabis were similar to what they got from prescription medications with more tolerable side effects.

  • Out of the 2897, there were 97% that agreed they would be able to decrease their use of opioids.
  • In the same study, 81% said that taking cannabis on its own would be more effective than taking both cannabis and opioids for pain.
  • In the study, 92% of participants strongly agreed that cannabis had more tolerable side effects when compared to opioid-based medications.
  • Of the participants, there were 71% believed that cannabis was more capable of handling their pain than opioid prescriptions.
  • 93% of the people in the study said they’d choose cannabis over opioid medications to help them with their pain if it more available.

What’s the Harm in Opioid Use?

With all this talk about switching up opioid prescription medication for medicinal marijuana, you might wonder what the harm is in opioid use. Most people assume that prescription drugs are harmless but stats prove otherwise. In 2014, the CDC found that 28,000 people died in the U.S. from opioids. This was a combination of heroin and opioid prescription drugs. Using opioids long-term can cause risks. The risks include opioid use disorder, addiction, overdose, and death. There are drugs in marijuana treatment specifically used to get people off opioid medications. As of 2012, the National Institute of Drug Abuse (NIHA) stated that there were over 2 million people suffering from substance use disorders. All of these were related to prescription opioid pain relievers with an additional 500,000 having an addiction to heroin.

How Effective is Cannabis for Chronic Pain?

Research is optimistic about how effective medical cannabis is as an alternative for patients taking opioids. It’s important to note that not all patients will respond well to medical marijuana. There are some patients who don’t tolerate opioids well or are at risk of addiction, this is where medicinal marijuana can be useful. Extensive research comparing opiates and cannabis specifically for neuropathic pain have shown positive results for cannabis. They have found that cannabis works better than opioid medications for some.

How Can Cannabis Help Reduce the Problems Opioids are Causing?

As a harm-reduction tool, cannabis can help in a few ways. It lowers opioid side effects and lowers the cravings. Cannabis also enhances analgesic effects of opioids. This makes it a good way to help someone taper down from opioid use. This allows a patient to lower their dosage of opioids without experiencing pain and major withdrawal symptoms. Studies reported that a patient’s pain was decreased after adding vaporized cannabis to treatment. The theory is that when using cannabis treatment, patients could lower doses and reduce risks of a deadly overdose.

Risk of Cannabis Dependency is Safer than Opioid Addiction

A patient is at risk of dependency on cannabis when used to reduce pain but it’s better than the alternative. Abusing prescription opioids that lead to deadly overdoses have been on the rise for many years. What we’ve also seen over the past few years is that people who stop taking prescription opioids may potentially buy heroin off the streets. If a person is capable of stopping opioid pain medications without a crutch, this is the ultimate goal. In the event that dependence has developed, going the route of medical marijuana is much better than the alternative of heroin.

Cannabis and Harm-Reduction Against Street Drugs

Getting information from addicts that have a history of using extremely risky drugs can be an indication of how effective cannabis is for harm-reduction. For many users trying to recover from heroin, fentanyl, and hydromorphone, they say they won’t give up cannabis. It helps relax them because it naturally numbs the body. Staying relaxed while going through recovery from such potent drugs may help those without access to a proper recovery program. Getting off extreme opioids can cause depression and anxiety which lead to suicidal thoughts. Many addicts will say smoking pot helps them cope with the problems in their life.

Harm-Reduction Doesn’t Discount that there are Risks

There are positive results showing that cannabis does reduce harm when compared to prescription opioids. This doesn’t mean that cannabis doesn’t come with its own risks. When it comes to chronic pain or addiction, cannabis can be used in lieu of opioid medications as a harm-reduction tool. The overdose risk leading to death with opioid medications that are prescribed is calling for unorthodox methods. Although cannabis is another drug with its own set of risks, it is still safer when it comes to mortality rates.

The Final Word on Harm Reduction Techniques

We know that marijuana carries much safer side-effects (such as overdose, health risks, etc.) than an opiate or opioid such as heroin or prescription pain medication.  We also know the freedom that comes with real opioid recovery programs.  And although we can’t discount that harm reduction can be a better choice than nothing, we also want you to know the truth and freedom of recovering from being dependent on any substance.  In the end, our take is still to try to offer our clients the best recovery plan which wouldn’t involve utilizing marijuana as a crutch or to replace opioids.