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Opioid Use Disorder and Medical Marijuana

According to recent studies, marijuana can be used to treat pain and help avoid opioids that can be highly addictive for some. The findings lend support to the idea that some people are willing to substitute marijuana for opioids and other prescription drugs. These researchers argue that people who avoid that first prescription are less likely to end up as part of the opioid epidemic. Medical marijuana can also be helpful for patients that may already have a dependence on opiate use.

Opioid use disorder

Opioid use disorder for which conventional therapeutic interventions are contraindicated or ineffective, or for which adjunctive therapy is indicated in combination with primary therapeutic interventions, is one of the most recent additions to the list of approved conditions for medical marijuana in PA. According to the American Psychiatric Association, some examples of diagnostic criteria for this disorder include:

• Opioids are often taken in larger amounts or over a longer period than was intended.
• There is a persistent desire or unsuccessful efforts to cut down or control opioid use.
• Craving, or a strong desire or urge to use opioids.

The full list can be found here: https://pcssnow.org/wp-content/uploads/2014/02/5B-DSM-5-Opioid-Use-Disorder-Diagnostic-Criteria.pdf

Medical Marijuana and opioid use disorder

Early research suggests that some people are willing to substitute marijuana for opioids and other prescription drugs. In this way, medical marijuana can help to offer a viable alternative for opioid use while still providing treatment for pain.

States that have approved medical cannabis laws saw a dramatic reduction in opioid use, according to a new study by researchers at the University of Georgia.

In a paper published in the Journal of the American Medical Association, Internal Medicine, researchers examined the number of all opioid prescriptions filled between 2010 and 2015 under Medicare Part D, the prescription drug benefit plan available to Medicare enrollees. In states with medical cannabis dispensaries, the researchers observed a 14.4 percent reduction in use of prescription opioids and nearly a 7 percent reduction in opiate prescriptions filled in states with home-cultivation-only medical cannabis laws. The researchers examined all common prescriptions opiates, including hydrocodone, oxycodone, morphine, methadone and fentanyl.

US Opioid epidemic

In 2017 the U.S. Department of Health and Human Services declared a public health emergency related to the abuse of opiates. Opioid overdoses accounted for more than 42,000 deaths in 2016, more than any previous year on record, and more than 40 percent of opioid overdose deaths involved a prescription opioid, according to HHS.

As research expands, a growing body of literature suggests cannabis may be used to manage pain in some patients, which could be a major component of the reductions seen in the use of opiates. More information can be found here: https://www.solevowellness.com/help-end-opioid-addiction/.

Links

Association between US state medical cannabis laws and opioid prescribing in the Medicare Part D population.

JAMA Internal Medicine

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Opioids Out, Cannabis In Negotiating the Unknowns in Patient Care for Chronic Pain

The Journal of the American Medical Association

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Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999–2010

JAMA Internal Medicine

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Preliminary evaluation of the efficacy, safety, and costs associated with the treatment of chronic pain with medical cannabis

Mental Health Clinician

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