Sometimes it’s hard to believe the chasm that exists between what is true and what is unsubstantiated supposition in this industry.
Sure, this industry is still dealing with a stigma that began in the late ‘30s when it was a victim of one of the original fake news events in modern history – that cannabis makes people crazy, leads to horrible addictions and willful acts of human degradation that could result in the moral bankruptcy of an entire nation.
Less than forty years later, Nixonian doctrine turned those distorted lies into law with the creation of the Drug Enforcement Administration and the scheduling of cannabis as a drug as bad as heroin, which continues to saddle lawmakers and industry developers with a problem that the federal government has yet to seriously address.
I was reminded of all of that backstory when I sat at a meeting of the USC-Brookings Schaefer Initiative for Health Policy event on Friday, November 3 at the Brookings Institution Falk Auditorium in Washington, D.C., listening to what I hoped would be an informed and enlightened presentation about the opioid crisis and the role of cannabis as a potential solution to that crisis.
Speaking at the event was Sir Angus Deaton, presidential professor of economics for the University of Southern California and senior scholar and international affairs emeritus at the Woodrow Wilson School of Public and International Affairs at Princeton University.
Another one of the distinguished speakers was Dr. Bertha Madras, professor of psychology, Department of Psychiatry, Havard Medical School. She was pointed out that she was a member of the World Health Organization board who wrote a 41-page medical cannabis update for WHO review in 2015.
Among her findings in that report is that cannabis represents the third largest group of emergency room admissions for drug toxicity, behind heroin and cocaine, and that high levels of THC may actually promote seizures, while stating that the study is actually more about recreational use since there were few studies that reported on long term consequences of medicinal use. “Cannabis engenders acute pharmacological effects, long term health risks for the brain, body and behavior and public safety concerns,” she wrote about cannabis toxicity in the report.
What I heard at the Brookings event was more of the same diatribe: that cannabis is an addictive drug that could soon spell an epidemic similar to the opioid epidemic; that we can solve the opioid crisis by educating doctors to prescribe fewer opioids instead of handfuls of opioids and just better manage treatment and the unintended consequences; that opioids are good tools for physicians, and have a clear advantage for use especially in the last few years of the life of a person with a terminal illness; and that opioids are not necessarily harmful, just misunderstood and misprescribed.
Year ago, opioids were rarely prescribed for treating pain, Madras explained during her part of the presentation, until doctors jumped on a few sentences in a report in the New England Journal of Medicine saying that addiction was rare with opioids. “Anyone with a science degree or even common sense would know that that was junk science,” she said. “How did they define addiction? Quality science was forgotten.” The result was that the country was “awash with opioids with now 11.8 million people in the U.S. currently misuing them,” she said. “We need to apply the lessons learned regarding legalizing and regulating all scheduled drugs.”
Then she drew parallels with opioids and cannabis, saying that people who use marijuana have much higher rates of opioid use and opioid use disorder. “People who use marijuana for pain medications also have higher rates of opioid use and opioid use disorder,” she said. “The data for long term outcomes – the suppression of evidence that marijuana is addictive – parallels what is happening in the opioid crisis.”
The implication was that use of marijuana could be as bad and addictive as opioids in the long term, and that marijuana leads to harder drugs – the “gateway drug” theory often used by politicians and scientists when discussing marijuana prohibition.
Her presentation appeared to bolster the findings from the recent report “The President’s Commission on Combating Drug Addiction and the Opioid Crisis,” released just two days prior to the Brookings’ presentation. Madras was a member of the commission. The report stated in part:
“The Commission acknowledges that there is an active movement to promote the use of marijuana as an alternative medication for chronic pain and as a treatment for opioid addiction. Recent research out of the NIH’s National Institute on Drug Abuse (NIDA) found that marijuana use led to a 2 1⁄2 times greater chance that the marijuana user would become an opioid user and abuser. The Commission found this very disturbing. There is a lack of sophisticated outcome data on dose, potency, and abuse potential for marijuana. This mirrors the lack of data in the 1990’s and early 2000’s when opioid prescribing multiplied across health care settings and led to the current epidemic of abuse, misuse and addiction. The Commission urges that the same mistake is not made with the uninformed rush to put another drug legally on the market in the midst of an overdose epidemic.”
But according to a recent report from the NIDA, it’s more likely that alcohol and nicotine “prime the brain” for a heightened response to other drugs, and are also typically used before a person progresses to other, more harmful substances.
“An alternative to the gateway-drug hypothesis is that people who are more vulnerable to drug-taking are simply more likely to start with readily available substances..and their subsequent social interactions with others who use drugs increases their chances of trying other drugs.”
The report concludes that further research is needed to explore this question, even amidst new research that suggests cannabis use is actually a gateway out of opioid abuse and addiction.
Aclara Research, a leader in the development of patient and consumer insights within the cannabis industry, released the preliminary results of their latest study examining patient usage of medical cannabis and the impact on prescription opioid usage. The study, which was conducted in partnership with a group of pharmacist professionals active within the cannabis industry, found that 67 percent of patients stopped using opioid medications after using medical cannabis. The study further went on to find that 30 percent of patients stopped using prescription drugs completely after using medical cannabis.
Perhaps it’s time to resolve the disconnect between science and academia, common sense and new research, that has been fueled by baseless arguments from last century and carried on by uninformed lawmakers who keep pushing an agenda to continue the war on drugs.