19 Oct States Allowing Medical Marijuana Have Fewer Opioid Fatalities
Opioid painkillers are leading to an unprecedented level of fatal overdoses in the U.S., and reducing the number of fatalities due to pain medication addiction is a priority for public health advocates. New research has suggested that help may come from an unlikely source: medical marijuana. The finding is controversial, but if it’s genuine, it may call for further research into marijuana’s potential to help those in chronic pain, as well as for some difficult discussions to be made surrounding drug laws. However, there are issues with the study, and it’s important to find out more about what the researchers did (and didn’t do) before coming to any conclusions.
Do Medical Marijuana Laws Impact Overdose Deaths?
The premise behind the study is that the use of medical marijuana for chronic pain may reduce the number of deaths from drug overdoses, which are primarily related to prescription opioids such as Vicodin, Percocet and OxyContin. To look for a link between the two, researchers analyzed medical marijuana laws across all 50 states and looked at death certificates to determine the numbers of prescription opioid deaths from 1999 to 2010. At the beginning of the study period, just three states (California, Oregon and Washington) had medical marijuana laws in effect, but another 10 enacted them during the study period. Currently, the total number of states with medical marijuana laws is 23, as well as the District of Columbia.
Fewer Overdose Deaths in States With Medical Marijuana
The findings initially appear promising: states allowing medical marijuana had, on average, a 24.8 percent lower annual opioid overdose rate than states that ban marijuana. The fact that many states implemented the laws during the study period means that researchers were able to investigate the change in overdose rates over time, and showed that the reduction in deaths generally grew year by year. In 2010, states with medical marijuana laws had an average of 1,700 fewer opioid overdose deaths than would have been expected based on the statistics before the laws were passed.
The research didn’t attempt to explain the apparent correlation, but the authors speculate that people are either supplementing their opioid treatment with marijuana or completely replacing it.
Lead author Dr. Marcus Bachhuber says: “We can’t know directly the underlying mechanism of our findings, but based on what we know, we think it could be due to safer treatment of chronic pain.”
Problems With the Study
The research was far from perfect, and there are a few problems that limit how well the findings can be interpreted. The researchers made no effort to differentiate between strict and relaxed medical marijuana laws, and failed to consider how methadone or buprenorphine programs may have impacted the number of deaths. Major law enforcement operations (such as shutting down “pill mills”) may have also affected the findings. Additionally, they didn’t look at data on prescriptions in the states, meaning the reduction in deaths could be due to changes in prescribing practices rather than the increased availability of marijuana. Lead author Dr. Bachhuber agrees that more research needs to be conducted before any firm recommendations can be made.
Marijuana-Based Medicines for Chronic Pain
Despite the limitations of the findings, it’s unlikely that the observed differences are completely explained away by things the researchers failed to consider, and the sheer number of opioid overdose deaths means any promising strategy should be investigated. Our current best approach to treating chronic pain is with addictive and dangerous medicines, and while marijuana is also addictive and potentially dangerous (particularly for the developing brains of teens), it’s clearly the lesser of two evils. People don’t overdose on marijuana, but prescription painkillers kill more Americans than heroin and cocaine combined.
The American Academy of Pain Medicine believes that the DEA should reduce marijuana from Schedule I to Schedule II to facilitate research into its potential for pain patients. Although medical marijuana is prescribed for many issues, one of the most common is pain control.
The goal would ultimately be to produce effective marijuana-based medicines to help people with chronic pain. Said Kevin Sabet of the Drug Policy Institute at the University of Florida: “There may be promise in marijuana-based medications, but that’s a lot different than ‘here’s a joint for you to smoke.’ ”
If this research serves as a catalyst for future studies into the specific chemical components of marijuana that help fight pain, the results might significantly reduce overdose deaths. The debate over marijuana is intensifying, however, and it’s important that people understand both the limitations of this research and why it doesn’t mean that pain patients should simply be given pot to prevent them from overdosing on opioids.
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