Jerome Adams, MD, the 20th Surgeon General of the United States, recently gave a far-ranging interview on opioids and his stance on marijuana as an alternative to their use.

Adams, speaking at a forum on opioids hosted by the Washington Examiner, stated that concerns over the impact of marijuana on the developing brains of young people and its possible cancer-causing properties, were the impetus for him to reserve a recommendation for its use in pain management. "We know that exposing the developing brain to marijuana can prime the brain to addiction and have potential negative consequences including promoting cancer," he said.

But Adams added that he considered additional studies on the subject "important," and voiced support for the use of the opioid reversal drug naloxone.

Adams, an anesthesiologist and vice admiral in the U.S. Public Health Service Commissioned Corps, said that his opposition to marijuana for medical purposes was hinged largely on studies that suggested use among young people "can prime the brain for addiction."

Adams did not cite specific studies that asserted this notion, but added that marijuana's "potential negative consequences, including promoting cancer," was also a factor in his stance. 

"It would be incredibly disingenuous of me to say that you shouldn't smoke a cigarette, but it is fine to go out and smoke a joint," said Adams, who also noted that as Surgeon General, his name is featured in the boxed warning about the health hazards of smoking featured on all cigarette packaging.

However, Adams did state that he considered it important to examine studies pertaining to marijuana as an alternative to opioids for pain treatment, but again, added, "it is important that we not jump on something that may have more potential consequences down the road."

When the interview touched on the subject of opioid abuse and dependency, Adams expressed opinions on a wide array of issues regarding treatment and intervention. He voiced solid support for naloxone, dismissing opponents of the drug as "folks out there who will suggest that naloxone and these interventions are enabling drug use. I say they are enabling recovery," he stated.

But he was steadfast in his opposition to legalize safe injection facilities (SIFs), which have gained traction with some city and state governments as a harm reduction-based attempt to reduce chances of overdose among drug users.

"I think it's important for everyone to know that I took an oath to uphold the law," said Adams. "And currently, injection facilities are illegal across the U.S. So, I can not and do not endorse safe facilities."

Adams also suggested that a primary line of defense against the opioid crisis could be found in most Americans' homes.

"I want everyone to know there's a killer in our medicine cabinets," he said. "Leaving pills around or unattended is the same thing as leaving a loaded gun."

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