Will Cannabis Replace Opioids as Painkillers?

By Paul Fuhr 12/06/17

The debate continues over whether cannabis is a viable alternative to opioid painkillers.

We're still not over Reefer Madness.

With America caught in the throes of the opioid epidemic, researchers and drugmakers alike continue to suggest that the answer lies in marijuana-based painkillers. In fact, a number of studies also hint that medical cannabis might be the magic bullet everyone is looking for.

Not so fast, some key experts said at the Forbes Healthcare Summit. Dr. Tom Frieden, the former head of the Centers for Disease Control and Prevention (CDC) under President Obama, leveled sharp criticism at the idea of marijuana replacing opioids as viable painkillers. Frieden, who now spearheads the non-profit Resolve to Save Lives—a $225 million, five-year global health campaign—was quick to say medical marijuana won’t end the crisis.

“The huge problem with legalization is that in the current legal context of the U.S., if you legalize a product you cannot restrict its market, and what we’re looking at is the prospect of having Big Tobacco paralleled by Big Marijuana actively promoting marijuana use,” Frieden said. “It could be very harmful for some people and some communities. That said, there may be a role for some individuals, and obviously this is a tough issue.”

Currently legal in 29 states and the District of Columbia, medical marijuana continues to grow and expand in the U.S. As such, drug companies like GW Pharmaceuticals and Cara Therapeutics are actively looking to exploit marijuana as a less harmful alternative to opioids, a Forbes piece said.

Yet there aren’t enough research studies to prove that it’s a sustainable solution. At the summit, the National Institute on Drug Abuse’s deputy director Wilson Compton observed that the studies that do exist tend to be too few and far between. “While it looks like there’s a general signal, we don’t know who the marijuana, or the cannabinoids within the plant, might be useful for,” Compton said. “And that’s where I think research needs to move.”

Compton echoes the stance of the Drug Enforcement Administration (DEA), which still considers marijuana to be a Schedule I drug, defined as having no accepted medical uses and a high potential for abuse.

“Could marijuana be a life raft out of this sea of painkillers?” AC Shilton asked in a Vice story from earlier this year. Using Tennessee as an example, the writer examined how the state maintains that marijuana is illegal in every application while lawmakers vote against limiting opioid prescriptions even while record numbers of overdoses happen under their watch.

“It's a life raft with a slow leak at best,” Shilton considered, though “a leaky raft starts to look pretty appealing” when it comes to the opioid epidemic. Still, it’s not so much the research that’s confounding as it is all the legalities around marijuana, which are “confusing, especially for medical professionals.”

All that red tape means that continuing marijuana research is, at best, a nightmare to secure federal research money. (Interestingly, the Vice piece notes that “it’s easier to score research grants if your hypothesis is one testing the negative impacts of [marijuana].”)

We shouldn’t let red tape tangle up marijuana’s potential as a painkiller, Andrew Kolodny told attendees at the healthcare summit. Kolodny, the co-director of Brandeis University’s Opioid Policy Research Collaborative, thinks medical pot isn’t a perfect solution—but it’s something.

“If I had a patient who was suffering from severe intractable pain and had tried everything, I would sooner try marijuana on a patient than heroin,” he said. “When you are prescribing opioids, you are essentially giving them heroin.”

And given that 60,000 Americans died from drug-related overdoses last year alone, it seems irresponsible to not try everything possible to save lives.

Please read our comment policy. - The Fix

Paul Fuhr lives in Columbus, Ohio with his family and two cats, Vesper and Dr. No. He's written for AfterParty MagazineThe Literary Review and The Live Oak Review, among others. He's also the host of "Drop the Needle," a podcast about music and addiction recovery. More at paulfuhr.com. You can also find Paul on Linkedin and Twitter.