Rising rates of medical cannabis use among Canadian military veterans is associated with a parallel decline in the use of prescription opiates and benzodiazepenes, according to federal data recently provided to The Globe and Mail.
According to records provided by Veterans Affairs Canada, the number of veterans prescribed benzodiazepines (e.g. Xanax, Ativan, and Valium) fell nearly 30 percent between 2012 and 2016, while veterans’ use of prescription opiates declined almost 17 percent. During this same period, veterans seeking federal reimbursements for prescription cannabis rose from fewer than 100 total patients to more than 1,700.
Canadian officials legalized the use of cannabis via prescription in 2001.
While the data set is too small to establish cause and effect, the trend is consistent with data indicating that many patients substitute medical cannabis for other prescription drugs, especially opiates.
Prior assessments from the United States report that incidences of opioid-related addiction, abuse, and mortality are significantly lower in jurisdictions that permit medicinal cannabis access as compared to those states that do not.
Rates of prescription opioid abuse are significantly lower in jurisdictions that permit medical marijuana access, according to data reported by Castlight Health, an employee health benefits platform provider.
Investigators assessed anonymous prescription reporting data from over one million employees between the years 2011 and 2015.
In states that did not permit medical marijuana access, 5.4 percent of individuals with an opioid prescription qualified as abusers of the drug. (The study’s authors defined “abuse” as opioid use by an individual who was not receiving palliative care, who received greater than a 90-day cumulative supply of opioids, and received an opioid prescription from four or more providers.) By contrast, only 2.8 percent of individuals with an opioid prescription living in medical marijuana states met the criteria.
The findings are similar to those reported by the RAND Corporation in 2015, which determined, “[S]tates permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.”
Data published in 2014 in the Journal of the American Medical Association (JAMA) Internal Medicine also reported that the enactment of statewide medicinal marijuana laws is associated with significantly lower state-level opioid overdose mortality rates, finding, “States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.”
Full text of the new study, “The opioid crisis in America’s workforce,” appears online here.
Cannabis use is associated with improved outcomes in opioid-dependent subjects undergoing outpatient treatment, according to data published online ahead of print in the journal Drug and Alcohol Dependence.
Researchers at Columbia University assessed the use of cannabinoids versus placebo in opioid-dependent subjects undergoing in-patient detoxification and outpatient treatment with naltrexone, an opiate receptor antagonist. Investigators reported that the administration of oral THC (dronabinol) during the detoxification process lowered the severity of subjects’ withdrawal symptoms compared to placebo, but that these effects did not persist over the entire course of treatment. By contrast, patients who consumed herbal cannabis during the outpatient treatment phase were more readily able to sleep, were less anxious, and were more likely to complete their treatment as compared to those subjects who did not.
“One of the interesting study findings was the observed beneficial effect of marijuana smoking on treatment retention,” authors concluded. “Participants who smoked marijuana had less difficulty with sleep and anxiety and were more likely to remain in treatment as compared to those who were not using marijuana, regardless of whether they were taking dronabinol or placebo.”
The findings replicate those of two prior studies, one from 2001 and another from 2009, reporting greater treatment adherence among subjects who consumed cannabis intermittently during outpatient therapy.
Population data from states where medicinal cannabis is permitted report lower rates of opioid-abuse and mortality as compared to those states where the plant is prohibited. Clinical data and case reports also indicate that the adjunctive use of cannabis may wean patients from opiates while successfully managing their pain. Survey data of state qualified medical cannabis patients demonstrates that subjects with access to the plant often substitute it for opioids because they perceive it to possess fewer adverse side effects.
Overdose deaths involving opioids have increased dramatically in recent years. While fewer than 4,100 opiate-induced fatalities were reported for the year 1999, by 2010 this figure rose to over 16,600 according to an analysis by the US Centers for Disease Control.
An abstract of the study, “The effects of dronabinol during detoxification and the initiation of treatment with extended release naltrexone,” appears online here.
States that permit qualified patients to access medical marijuana via dispensaries possess lower rates of opioid addiction and overdose deaths, according to a study published by the National Bureau of Economic Research, a non-partisan think-tank.
Researchers from the RAND Corporation and the University of California, Irvine assessed the impact of medical marijuana laws on problematic opioid use, as measured by treatment admissions for opioid pain reliever addiction (compiled from the years 1992 to 2012) and by state-level opioid overdose deaths (compiled from the years 1999 to 2013).
“[S]tates permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not,” authors reported. They found that women over the age of 40 showed the most significant decrease in problematic opioid use.
Data published last year in the Journal of the American Medical Association (JAMA) Internal Medicine reported that the enactment of statewide medicinal marijuana laws is associated with significantly lower state-level opioid overdose mortality rates. “States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws,” investigators reported.
Overdose deaths involving opioid analgesics have increased dramatically over the past decade. While fewer than 4,100 opiate-induced fatalities were reported for the year 1999, by 2010 this figure rose to over 16,600 according to an analysis by the US Centers for Disease Control.
An abstract of the study, “Do Medical Marijuana Laws Reduce Addictions and Deaths Related to Pain Killers?”, is available online here.
NORML reviews the top news stories of 2014.
#1 Marijuana Legalization Measures Win Big On Election Day
Voters in Oregon and Alaska decided on Election Day in favor of statewide initiatives legalizing the commercial production and sale of marijuana for adults, while voters in the nation’s capitol and in numerous other cities nationwide similarly decided on local measures to eliminate marijuana possession penalties.
#2 Colorado And Washington Begin Regulating Retail Marijuana Sales
Two states, Colorado and Washington, initiated retail marijuana sales in 2014. Colorado’s program began on January 1. In Washington, state-licensed retail outlets began legally selling cannabis to adults in July.
#3 Congress Enacts Measure Protecting State-Sponsored Medi-Pot Programs
President Barack Obama signed spending legislation into law in December that included a provision limiting the Justice Department’s ability to take criminal action against state-licensed individuals or operations that are acting in full compliance with the medical marijuana laws of their states. The amendment states, “None of the funds made available in this act to the Department of Justice may be used … to prevent … states … from implementing their own state laws that authorize the use, distribution, possession, or cultivation of medical marijuana.”
#4 Congress Moves To Permit State-Sanctioned Hemp Cultivation
Federal lawmakers approved legislation in February permitting state-sponsored hemp cultivation to move forward despite the plant’s federal status as a Schedule I prohibited substance.
#5 Federal Judge Hears Challenge To Cannabis’ Schedule I Status
United States District Judge Kimberly Mueller heard five days of testimony in October in regard to the constitutionality of marijuana’s Schedule I status under federal law. Defense counsel and their experts argued that the scientific literature is not supportive of the plant’s present categorization. Judge Mueller is expected to make her ruling in early 2015.
#6 JAMA: Fewer Opiate-Related Deaths In Medical Marijuana States
The enactment of statewide medicinal marijuana laws is associated with significantly lower state-level opioid overdose mortality rates, according to data published in August in JAMA Internal Medicine. Researchers reported, “States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.”
#7 President Acknowledges That Booze Is More Harmful Than Marijuana
Consuming cannabis is less harmful to the individual than is drinking alcohol, President Barack Obama acknowledged in January in an interview with The New Yorker. “I don’t think it (marijuana) is more dangerous than alcohol,” he stated. He added, [W]e should not be locking up kids or individual users for long stretches of jail time.”
#8 Study: Medical Marijuana States Have Fewer Violent Crimes
Medicinal cannabis laws are not associated with any rise in statewide criminal activity, according to data published in April in the journal PLoS ONE. “Medical marijuana laws were not found to have a crime exacerbating effect on any of the seven crime types. On the contrary, our findings indicated that MML precedes a reduction in homicide and assault,” authors concluded. “In sum, these findings run counter to arguments suggesting the legalization of marijuana for medical purposes poses a danger to public health in terms of exposure to violent crime and property crimes.”
#9 NYT Editors Opine In Favor Of Legalizing Cannabis
The New York Times editorial board in July called upon federal lawmakers to end the criminalization of cannabis for those over the age of 21. The paper’s editors opined: “The federal government should repeal the ban on marijuana. … Moderate use of marijuana does not appear to pose a risk for otherwise healthy adults. … [W]e believe that on every level, … the balance falls squarely on the side of national legalization.”
#10 Americans Say Marijuana Is Less Harmful To Health Than Sugar
Americans believe that consuming cannabis poses less harm to health than does the consumption of tobacco, alcohol, or sugar, according to the findings of a Wall Street Journal/NBC News poll released in March. Respondents were asked which of the four substances they believed to be “most harmful to a person’s overall health.” Most respondents said tobacco (49 percent), followed by alcohol (24 percent) and sugar (15 percent).