NIDA's Nora Volkow: There's No Evidence That Cannabis Can Treat Opioid Addiction

NIDA's Nora Volkow: There's No Evidence That Cannabis Can Treat Opioid Addiction

By Lindsey Weedston 03/22/19
Volkow says that patients using cannabis for opioid use disorder treatment may be putting themselves at risk of relapse.
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NIDA's Nora Volkow discussing opioid addiction
Photo via Flickr/NIDA

National Institute on Drug Abuse (NIDA) Director Nora Volkow has stated that there is no evidence that cannabis use is an effective treatment for opioid use disorders.

This statement comes as NIDA is planning to assess the possibility of such a treatment, with two or three studies either planned or already underway, according to USA Today

Though Volkow says it’s not impossible that cannabis compounds could help treat addiction to opioids, she stresses that no evidence exists yet.

Meanwhile, the Maryland General Assembly is currently considering allowing medical marijuana for this purpose, and New York, New Jersey, Pennsylvania, and Illinois have already passed laws green-lighting cannabis as an acceptable treatment for this growing issue.

Volkow’s concern is that if cannabis compounds are not effective for treating opioid addiction, then patients being treated in this way are at high risk of relapse, and by extension, overdose and death.

"If you don’t treat it properly, your risk of dying is quite high," Volkow said in an interview with USA Today. "My main concern is by basically misinforming potential patients about the supposedly beneficial effects of cannabis, they may forgo a treatment that is lifesaving."

Opioid addiction relapse is particularly dangerous due to the fact that opioid tolerance can be drastically reduced by extended periods of non-use. If an individual relapses by going back to the same dose they were using before they quit, there is a greater chance of overdose and death.

However, there may be some preliminary evidence on the effectiveness of cannabis in treating opioid use disorder. One 2018 study by Beth Wiese of the University of Missouri, St. Louis and Adrianne R. Wilson-Poe of the Washington University School of Medicine reviewed “emerging evidence” of this type of therapy.

In their conclusion, they wrote that the “compelling nature of these data and the relative safety profile of cannabis warrant further exploration of cannabis as an adjunct or alternative treatment” for opioid addiction.

For the most part, the only accepted treatments for opioid use disorders are methadone, buprenorphine, and naltrexone—which reduce cravings without producing a full-blown high.

However, access to these medications can be restricted due to price, stigma, lack of education, and regulatory limits. Young people, people of color, and those living in rural communities have the most difficulty accessing this type of treatment.

Cheryl Glenn, Maryland delegate and sponsor of the Maryland bill to allow cannabis as treatment for opioid use disorder, argues that the situation is too dire to bar people addicted to opioids from any treatment that could be effective.

The Maryland legislature will soon consider an amendment to Glenn's bill that would require patients to try other treatments before resorting to cannabis. Glenn currently opposes this amendment, arguing for patient choice in their health care.

"My mother died from kidney cancer, and no one told the doctor he had to try this medication first, second or third," she said. "I think the same respect ought to be given when you look at opioid disorders."

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