Could marijuana be an effective pain alternative to prescription medications?
July 1, 2019
Science Daily/Taylor & Francis Group
A new study has shown how cannabis could be an effective treatment option for both pain relief and insomnia, for those looking to avoid prescription and over the counter pain and sleep medications -- including opioids.
The study, published in the Journal of Psychoactive Drugs, which looked at 1,000 people taking legalized marijuana in an American state found that among the 65% of people taking cannabis for pain, 80% found it was very or extremely helpful.
This led to 82% of these people being able to reduce, or stop taking over the counter pain medications, and 88% being able to stop taking opioid painkillers.
74% of the 1,000 interviewees bought it to help them sleep -- 84% of whom said the marijuana had helped them, and over 83% said that they had since reduced or stopped taking over-the-counter or prescription sleep aids.
The study suggests that cannabis could lower opioid use. However, the researchers caution that more needs to be done to understand the potential therapeutic benefits of cannabis.
"Approximately 20% of American adults suffer from chronic pain, and one in three adults do not get enough sleep," says Dr Gwen Wurm, Assistant Professor of Clinical Pediatrics at the University of Miami Miller School of Medicine.
Traditional over the counter medications and painkillers can help, however they may have serious side effects. Opioids depress the respiratory system, meaning that overdoses may be fatal.
"People develop tolerance to opioids, which means that they require higher doses to achieve the same effect," says Dr. Julia Arnsten, Professor of Medicine at Albert Einstein College of Medicine. "This means that chronic pain patients often increase their dose of opioid medications over time, which in turn increases their risk of overdose."
Although less common, sleeping pills can lead to dependence, and can also cause grogginess the next day, interfering with people's work and social lives.
As a consequence, some people are looking to marijuana to help with their symptoms.
To find out more about these users, Wurm and her colleagues used survey data from people who purchased cannabis from two retail stores in Colorado, US, where it is legal for both medical and recreational use -- meaning any adult over 21 with a valid government ID may purchase product.
"In states where adult use of cannabis is legal, our research suggests that many individuals bypass the medical cannabis route (which requires registering with the state) and are instead opting for the privacy of a legal adult use dispensary," says Wurm.
Although the survey was conducted among customers willing to participate -- meaning the results may not reflect the overall population of dispensary customers -- other national survey data, and data from medical patients at medical cannabis dispensaries, also demonstrate that people who use cannabis to treat symptoms both decrease and stop their use of prescription medications.
The study adds weight to the theory that widening access to medical cannabis could lower the use of prescription painkillers, allowing more people to manage and treat their pain without relying on opioid prescription drugs that have dangerous side effects.
This is backed up with other research that shows that states with medical cannabis laws have a 6.38% lower rate of opioid prescribing, and that Colorado's adult-use cannabis law is associated with a relative reduction in opioid overdose death rate from 1999 to 2010.
Wurm adds: "Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen cause GI bleeding or kidney damage with chronic use. Paracetemol (Acetaminophen) toxicity is the second most common cause of liver transplantation worldwide, and is responsible for 56,000 ER visits, 2600 hospitalizations, and 500 deaths per year in the U.S."
However, the researchers caution that more research is needed to understand the health benefits and side effects of cannabis.
"The challenge is that health providers are far behind in knowing which cannabis products work and which do not. Until there is more research into which cannabis products work for which symptoms, patients will do their own "trial and error," experiments, getting advice from friends, social media and dispensary employees," says Wurm.
https://www.sciencedaily.com/releases/2019/07/190701224523.htm
Legalized medical cannabis lowers opioid use
April 2, 2018
Science Daily/University of Georgia, School of Public and International Affairs
States that have approved medical cannabis laws saw a dramatic reduction in opioid use, according to a new study by researchers at the University of Georgia.
In a paper published today in the Journal of the American Medical Association, Internal Medicine, researchers examined the number of all opioid prescriptions filled between 2010 and 2015 under Medicare Part D, the prescription drug benefit plan available to Medicare enrollees.
In states with medical cannabis dispensaries, the researchers observed a 14.4 percent reduction in use of prescription opioids and nearly a 7 percent reduction in opiate prescriptions filled in states with home-cultivation-only medical cannabis laws.
"Some of the states we analyzed had medical cannabis laws throughout the five-year study period, some never had medical cannabis, and some enacted medical cannabis laws during those five years," said W. David Bradford, study co-author and Busbee Chair in Public Policy in the UGA School of Public and International Affairs. "So, what we were able to do is ask what happens to physician behavior in terms of their opiate prescribing if and when medical cannabis becomes available."
Since California approved the first medical cannabis law in 1996, 29 states and the District of Colombia have approved some form of medical cannabis law.
"Physicians cannot prescribe cannabis; it is still a Schedule I drug," Bradford said. "We're not observing that prescriptions for cannabis go up and prescriptions for opioids go down. We're just observing what changes when medical cannabis laws are enacted, and we see big reductions in opiate use."
The researchers examined all common prescriptions opiates, including hydrocodone, oxycodone, morphine, methadone and fentanyl. Because heroin is not a legal drug, it was not included as part of the study.
Last year, the U.S. Department of Health and Human Services declared a public health emergency related to the abuse of opiates. Opioid overdoses accounted for more than 42,000 deaths in 2016, more than any previous year on record, and more than 40 percent of opioid overdose deaths involved a prescription opioid, according to HHS.
Opioid prescription rates increased from about 148 million prescriptions in 2005 to 206 million prescriptions by 2011, Bradford said. This coincided with an increase in the number of opioid-related deaths.
"There is a growing body of literature that suggests cannabis may be used to manage pain in some patients, and this could be a major component of the reductions we see in the use of opiates," he said.
The researchers did not, however, see any significant reductions in the number of non-opioid drugs prescribed during the study period.
"In other studies, we examined prescription rates for non-opioid drugs such as blood thinners, flu medications and phosphorus stimulants, and we saw no change," said Ashley Bradford, lead author of the study and graduate student in UGA's department of public administration and policy. "Medical cannabis wouldn't be an effective treatment for flu or for anemia, so we feel pretty confident that the changes we see in opioids are because of cannabis because there is a legitimate medical use."
The researches concede that if medical cannabis is to become an effective treatment, there is still much work to be done. Scientists are only just beginning to understand the effects of the compounds contained in cannabis, and an effective "dose" of cannabis would need to be defined clearly so that each patient receives a consistent dose.
"Regardless, our findings suggest quite clearly that medical cannabis could be one useful tool in the policy arsenal that can be used to diminish the harm of prescription opioids, and that's worthy of serious consideration," David Bradford said.
Coauthors on the paper Amanda Abraham, assistant professor of public administration and policy at UGA and Grace Bagwell Adams, assistant professor of health policy and management in UGA's College of Public Health.
https://www.sciencedaily.com/releases/2018/04/180402202236.htm