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  • by Paul Armentano, NORML Deputy Director July 11, 2018

    The enactment of medical cannabis access laws is associated with significant reductions in prescription opioid use among Medicaid enrollees, according to just-published data in the journal Addiction.

    Investigators with the University of California at San Diego assessed the relationship between medical cannabis legalization and opioid use among Medicaid enrollees over a period of 21 years (1993 to 2014).

    Authors reported, “For Schedule III opioid prescriptions, medical cannabis legalization was associated with a 29.6 percent reduction in number of prescriptions, 29.9 percent reduction in dosage, and 28.8 percent reduction in related Medicaid spending.” This correlation remained after authors controlled for potential confounders, such as the establishment of prescription drug monitoring programs and variations in patients’ income.

    By contrast, authors did not report similar changes in enrollees’ use of Schedule II opioid drugs, like Oxycodone. Authors speculated that this result may be because physicians are more reticent to recommend medical cannabis options to these patients.

    They concluded: “In this study, we found that statewide medical cannabis legalization implemented in 1993-2014 in the US was associated with close to 30 percent reductions in Schedule III opioids received by Medicaid enrollees.. … It was estimated that, if all the states had legalized medical cannabis by 2014, Medicaid annual spending on opioid prescriptions would be reduced by 17.8 million dollars.”

    Their findings are similar to those of numerous other observational studies – such as those here, here, and here – finding that medical marijuana regulation is correlated with reductions in overall opioid-related use, drug spending, abuse, hospitalization, and mortality. Separate data evaluating prescription drug use trends among individual patients enrolled in state-licensed medical marijuana programs is consistent with this conclusion, finding that many subjects reduce or eliminate their use of opioids following enrollment.

    The abstract of the new study, “Medical cannabis legalization and opioid prescriptions: Evidence of US Medicaid enrollees during 1993-2014,” appears online here.

  • by NORML June 22, 2018

    KY NORML is passionate about education. And with the opioid epidemic consuming our state, we feel that it is our duty to share valuable information regarding the relationship between cannabis and opioids. Cannabis access is associated with reduced rates of opioid use and abuse, opioid-related hospitalizations, traffic fatalities, drug treatment admissions, and overdose deaths. We strongly believe, based on research, first-hand accounts, and testimonials that cannabis is truly the answer to combating this crisis that is killing thousands of Kentuckians each year.

    According to a study by the Journal of Headache and Pain, “the most common prescription medications replaced by medicinal cannabis in this study were opiates/opioids in a large percentage within every pain group, up to 72.8% of patients in the chronic pain as primary illness group. … This is notable given the well-described “opioid-sparing effect” of cannabinoids and growing abundance of literature suggesting that cannabis may help in weaning from these medications and perhaps providing a means of combating the opioid epidemic.”

    Investigators assessed opioid use patterns in patients registered with Health Canada to access medical cannabis products. Among those patients who acknowledged using opioids upon enrollment in the trial, 51 percent reported ceasing their opiate use within six-months. “The high rate of cannabis use for the treatment of chronic pain — and subsequent substitution for opioids — suggests that cannabis may play a harm-reduction role in the ongoing opioid dependence and overdose crisis. While the cannabis substitution effect for prescription drugs has been identified and assessed via cross-sectional and population-level research, this study provides a granular individual-level perspective of cannabis substitution for prescription drugs and associated improvement in quality of life over time.”

    Cannabis access is associated with reductions in overall prescription drug spending. JAMA Internal Medicine “found that prescriptions filled for all opioids decreased by 2.11 million daily doses per year from an average of 23.08 million daily doses per year when a state instituted any medical cannabis law. Prescriptions for all opioids decreased by 3.742 million daily doses per year when medical cannabis dispensaries opened. … Combined with previously published studies suggesting cannabis laws are associated with lower opioid mortality, these findings further strengthen arguments in favor of considering medical applications of cannabis as one tool in the policy arsenal that can be used to diminish the harm of prescription opioids.”

    The Mental Health Clinician  “investigated medical cannabis’ effectiveness in patients suffering from chronic pain associated with qualifying conditions for MC in New York State. … After 3 months treatment, MC improved quality of life, reduced pain and opioid use, and lead to cost savings. … These results are consistent with previous reports demonstrating MC’s effectiveness in neuropathic pain.”

    There are tons more information out there on this topic and the above research barely scratches the surface. We encourage you to see what’s out there for yourself. Knowledge is power and the better armed we are with that knowledge the more effective we can be in getting legislation passed. The opioid crisis that is plaguing our state has harmed so many of our citizens, and if cannabis is able to help, the legislators should get out the way and pass a comprehensive bill to deal with the problems our state is facing.

    High Regards,
    Matthew Bratcher
    Executive Director, KY NORML

    To support KY NORML you can DONATE HERE and follow us on Facebook and Twitter! Your donations help pay the bills and allow us to function and continue to make a difference in our state! Can you kick in $5, $10 or $20 to help us keep going?

  • by Paul Armentano, NORML Deputy Director June 18, 2018

    Legalize MarijuanaA forthcoming report commissioned by the Governor’s office is set to recommend that lawmakers legalize and regulate the possession and sale of marijuana by adults.

    According to statements made today by New York State health commissioner Howard Zucker, the report’s authors have concluded that “a regulated, legal marijuana program [ought to] be available to adults in the state.”

    “We looked at the pros, we looked at the cons, and when were done, we realized that the pros outweighed the cons,” Mr. Zucker said, adding, “We have new facts.”

    A finalized version of the Health Department study is anticipated to be released imminently.

    The health commissioner’s statements come just weeks after an analysis prepared by the New York City Comptroller’s office concluded that the state of New York would gain an estimated $434 million annually in new tax revenue under a regulated adult use marijuana market.

    Democrat Governor Andrew Cuomo, in the past, has been reticent to publicly support calls to regulate the adult marijuana use market in New York state — stating that he is “unconvinced” that legalizing is a preferable public policy to criminalization.

    During today’s remarks, health commissioner Zucker also indicated that the Department is moving to expand medical cannabis access to those using opioids. Under the new regulations, those with chronic pain wishing to use cannabis as a substitute for opiates will be able to do so. “[T]hat means if an individual is taking prescription opioids, they could take medical marijuana as part of the program that we are pushing forward to hopefully come off prescription opioids as well,” he said.

    According to data published in May, patients enrolled in New York state’s medical cannabis program reduce their use of opioids and spend less money on prescription medications. The study’s findings are similar to those reported among enrollees in other states’ medical cannabis programs, including the experiences of patients in Illinois, Michigan, Minnesota, New Mexico, and elsewhere.

  • by Paul Armentano, NORML Deputy Director June 5, 2018

    More than two-thirds of chronic pain patients registered to legally access medical cannabis products substitute marijuana for prescription opioids, according to data published in The Journal of Headache and Pain.

    Investigators from the United States and Canada assessed the use of medical cannabis and prescription drugs in a cohort of over 2,000 Canadian patients licensed to access marijuana products. Among those patients with a primary diagnosis of chronic pain, 73 percent reported substituting cannabis in place of opioids. Among those patients diagnosed specifically with headache/migraine, cannabis was frequently reported as a substitute for other medications – including opiates (43 percent), anti-depressants (39 percent), NSAIDS (21 percent), triptans (8 percent), and anti-convulsants (8 percent).

    “Most patients in the pain groups reported replacing prescription medications with medicinal cannabis, the most common of which were opiates/opioids across all patient groups,” authors concluded. “This is notable given the well-described ‘opioid-sparing effect’ of cannabinoids and growing abundance of literature suggesting that cannabis may help in weaning from these medications and perhaps providing a means of combating the opioid epidemic.”

    The study’s findings are consistent with those of numerous others finding that patients in medical cannabis access programs significantly reduce or eventually eliminate their use of opioid analgesics over the long-term.

    Full text of the study, “Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort,” appears online here.

  • by Paul Armentano, NORML Deputy Director May 15, 2018

    In testimony before Congress last week, by DEA acting administrator Robert Patterson opined that the medicalization of cannabis is exacerbating opioid abuse. But when prompted to provide evidence in support of the agency’s position, he acknowledged that he could not. Further, he denied being aware of any evidence — including recent, well-publicized studies by the US National Academy of Sciences and others — indicating that cannabis mitigates pain or that its legal access is associated with reduced levels of opioid-related mortality.

    I summarize this mind-boggling exchange in my recent Hill op-ed, which is excerpted below

    Specifically, when asked by Florida Republican Matt Gaetz if the DEA was aware of the landmark 2017 National Academy of Sciences study finding, “There is conclusive or substantial evidence that cannabis [is] effective for the treatment for chronic pain,” Patterson answered that he was not.

    He further acknowledged that he was unfamiliar with several state-specific, longitudinal studies, such as those from Minnesota and New Mexico, finding that chronic pain patients who register to partake in cannabis therapy dramatically decrease their use of opioids and other pain-relieving drugs. (Separate assessments of state-authorized medical cannabis patients in Illinois, Michigan, New York, and elsewhere affirm these conclusions).

    He further claimed ignorance with regard to the findings of a highly publicized study in the Journal of the American Medical Association finding that medical cannabis regulation is associated with year-over-year declines in overall opioid-related mortality, including heroin overdose deaths.

    Moreover, when pressed to provide evidence — any evidence — in support of the DEA’s questionable position, Patterson readily admitted that he knew of none. In fact, upon further questioning, he acknowledged that the DEA has, to date, never even so much as reviewed the issue. He further suggested that those patients seeking an alternative to opioid analgesics may wish to try “Tylenol.”

    The testimony concluded:

    Rep. Gaetz: “You’re the acting administrator of the DEA. You cannot cite a single study that indicates that medical marijuana creates a greater challenge with opioids, and you’re unaware of the studies, including studies from the National Academies of Sciences, that demonstrate that medical marijuana can be an acceptable alternative to opioids. Is that what I’m understanding?”

    Robert Patterson: “Yes.”

    To read the entire op-ed, please click the link here.

    To watch a video of this exchange, as archived by MarijuanaMoment.net, please click here.

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