Why marijuana might not be such a great weapon to fight opioid addiction

The opioid crisis is an ongoing national tragedy. One commonly suggested response is cannabis. But emerging state and national statistics as well as public health research strongly suggests that cannabis will not help the crisis and may even make it worse.

There is an ongoing push to legalize medical cannabis as an alternative to opioid analgesics. States like New York and Illinois already have cannabis as a replacement for opioids in chronic pain management and as an option for treating opioid use disorder. New Jersey is also considering “weed in the fight versus the opioid crisis.”

However, a recent analysis published in JAMA Internal Medicine found that opioid death rates rose in jurisdictions with legalized cannabis. In the analysis, Dr. Archie Bleyer and Brian Barnes compared opioid overdose rates in jurisdictions with and without legalized medical or recreational cannabis. As reported  in the Bend Bulletin, “Bleyer and Barnes found that by 2016, legalizing states had 55 percent higher overdose death rates than states that had not legalized.”

This may seem to run counter to prior research. For instance, a 2014 JAMA study found that “Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates” between 1999 and 2010. But the study authors note: “our findings apply to states that passed medical cannabis laws during the study period and the association between future laws and opioid analgesic overdose mortality may differ.”

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An often-cited 2017 study from the University of New Mexico showed that people with chronic musculoskeletal pain preferentially used medical cannabis over opioid analgesics. But this result was preliminary and small-scale, suffered from selection bias, and was unrelated to opioid addiction or overdose.

In other words, prior results at most found an association that has not held up with time. And current research and statistics tend to show that cannabis isn’t helping the opioid crisis.

Recent data from Colorado shows  “the number of newborns in the state addicted to opioids jumped 83 percent from 2010 to 2015,” a result that suggests rising levels of long-term opioid use. Similarly significant increases in fatal overdoses involving opioids are emerging in Washington state.

Studies on cannabis for the treatment of opioid addiction have shown little benefit. A recent study on the effect of cannabis availability for methadone treatment of opioid addiction found no benefit. Similar work from earlier this year found that cannabis was ineffective in treating pain, sleep, or anxiety issues in people undergoing medication-assisted therapy (MAT) for opioid addiction.

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Large-scale reviews of levels and dosages of prescription opioids in Medicaid enrollees have shown some benefit from medical cannabis legalization, but only for Schedule III opioids. These represent about 5 percent of all opioids and include buprenorphine, which is used for MAT, and do not include Schedule II opioids like oxycodone, for which no benefit was seen.

And more recent studies are cause for concern. Keith Humphreys, PhD, writes in the Washington Post that “studies of individuals show that using medical cannabis is correlated with higher rates of using and misusing opioids.”

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All of the above strongly suggests that policies using cannabis as a tool in the opioid crisis are unlikely to succeed. As Dr. Susan Weiss stated at the workshop Cannabis and the Opioid Crisis: A Multidisciplinary View: ”We need to be very circumspect in what we are expecting from cannabis with respect to the opioid epidemic.”

But this does not mean that cannabis is a causal factor. Cannabis may instead be acting as a proxy for other factors. Or there may just be an association between cannabis legalization and other issues that are having an effect on the trajectory of the opioid crisis. Nonetheless, mounting evidence shows exactly the opposite of what one would want to see if cannabis were helpful.

So while cannabis has well-established medical uses, policy is ignoring these findings. As Dr. Ziva Cooper, associate professor of clinical neurobiology and psychiatry at Columbia University and member of the National Academies committee that issued the 2017 report on cannabis, stated that “public policy is light years ahead of the science right now.”

There are effective ways to treat addiction, prevent overdose, and reduce drug abuse. But at present cannabis just doesn’t seem to be one of them. And the possibility that legalization is associated with worse outcomes should give pause to policies that promote its use in the opioid crisis.

Roger Chriss is a technical consultant in Washington state, where he specializes in mathematics and research

44 thoughts on “Why marijuana might not be such a great weapon to fight opioid addiction”

  1. The 2017 report suggests an association between early cannabis use and other drug use. A lot of the opioid crisis as with my son is those who already have addictions moving on to harder drugs like opiate pills and heroin. You might want to factor that into your warning about cannabis. My son was assessed as addicted to cannabis (pickled) at 17 and by 19 was shooting up heroin so I am understandably skeptical that cannabis is the answer to opiate addiction. In fact, not using cannabis would have been protective to using heroin.

    • We all know that ‘correlation’ and ‘causality’ are not the same. There are many reasonable claims that legally conflating marijuana and opiates creates a situation that makes it as easy to access opiates as cannabis. There are several accounts (I recommend the coverage in ‘The Guardian’) about Portugal’s very effective management of these issues. To know that is to begin to understand fundamentals of addiction.

      • Samantha, Thank you for sharing your families story. I have experienced the same with my son. Marijuana almost killed him with a psychotic break and then he moved onto meth and heroin.
        People who pushing this toxic drug into our country are doing it for self serving reasons.

          • Yes, I know it’s only about money. But will keep speaking of the costs. Nobody wins in this except drug dealers and drug investors.

          • Drug dealers are the ones benefiting from the ILLEGALITY of cannabis.

            LEGITIMATE businesses are the ones that benefit from Regulated industries.

            But I don’t expect someone that doesn’t know their head from their fat behind to understand that….

            So again, here we are.

          • Drug dealers come in suits too. Good luck manipulating people thinking that the marijuana industry follows the rules. LOL!
            Both markets support and enhance each other. You can’t separate the two. Drug dealers are very manipulative and abusive. They have a product to sell no matter what!

            I’ll wait for my video. It should only take you about 5 mins. You’re a fighter, so go ahead and make it. I’ll wait. You’ll be so glad you did it. It’s really easy. I have about 85 on my YouTube channel. I speak loud and clear on this issue. I don’t hide. It’s time for you to come out of the closest. Be proud to be a drug promoter!!

          • One reason offered for legalizing cannabis is that it will transfer profits made by criminal suppliers to the government and relieve the police of the nuisance of suppressing dealers and victims. They only way to remove criminals is surely to make supplies as accessible as now, cheaper and at least as strong. This cannot reduce consumption, nor is it likely to reduce harm. Tobacco companies already anticipate massive profits from marketing to a population captive to addiction. The individual and social harms are now fairly well ascertained.

          • NO ONE deserves to be punished in any way, shape or form for the responsible consumption/possession of a plant.

            Criminal penalties only CREATE more harms associates with the substance.

            You’re smart enough to understand that, David, correct?

        • Cannabis is no more toxic than alcohol. That said, if it’s going to be used recreationaly they need to legalize it for recreational use, not make wild claims that are not proven and are starting to appear false. The bigger question is what is it in our society that is driving so many people to self-medication and annihilation with drugs or alcohol? I live in WV which has the highest OD rate in the country. Appalachia in general is kind of a hopeless place at this time. Small towns are dying and most of the jobs don’t pay enough to live on. I believe that is the true basis of the opioid epidemic. And unlike what that jerk above says, it is certainly not your fault.

  2. This study is restricted to a truly pathological society: I am not surprised that there are nasty opioid involvements. Including such places as Uruguay, a country which decrimalized cannabis several years ago would give a more representative perspective. Even more to the point, such a study would appropriately be applied to Portugual, which has effectively decriminalized all drugs, replacing legal constraints with therapeutic facilities. It would be appropriate to hypothesize very different results.

    • Um, this article isn’t a study. There are numerous studies referred to, but it is not a study. So you are fundamentally confused. In determining whether or not cannabis can help with the opioid crisis in the US, any studies have to be done in the US or a similar society. What you are suggesting doesn’t make sense. It would not be appropriate to do studies on whether or not cannabis can help with the opioid crisis in the US by doing a study in Uruguay or Portugal.

      • Are people in Uruguay or Portugal made up biological different from Americans? Last I checked opioid addiction exhibits the same in all human beings. Your counter makes no sense.

        • Um, seriously? You don’t think that social inequities, stressors etc impact substance abuse and addiction? I wish I could live in your world because the world I live in has lots of contributing factors including a high incident of childhood trauma which is strongly associated with substance abuse, addiction, and both mental and physical illness.

  3. Thank you. I know families who have lost their children who believed marijuana would help their opioid addiction. The parents of America have grown tired of the marijuana culture preying on our kids. We will not allow this industry to sacrifice our kids and our country on the cannabis altar.

        • No one cares how you’ve failed your son.

          Do better. Get off the internet and take care of your problems directly.

          Not only have you failed your child, you are failing at Prohibition.

          • Hi What,
            My son is well, but many families don’t have their kids any more. I need to know your name. Why do you hide? Say who you are. Also why don’t you say all those things on a video tape and send it to me and I will put it up on my YouTube channel? That would be great. Let’s show America the bully.

          • Never has there ever been a more pressing time for you to re-evaluate your worldview.

            Because the way you have been looking at things, has only created the disasters that you’ve experienced.

            Pearl-clutching and fear-mongering created the environment for your child not to listen to a damn word you said about drugs.

            And you are living with the results of your own actions.

            It’s time to stop making your mistakes over and over and over again.

          • It is easier for you to blame marijuana than it is for you to recognize your own short-comings and take charge in raising your children.

            Get away from your computer and start being a good mom.

          • Dear “What”,
            I know you feel
            ashamed but if you need to talk to me about recovery. I’m here. We all have felt ashamed when experiencing addiction and mental illness. Marijuana was the driver in my son’s problems, and yes everyone plays a part. I’m blessed to be part of a beautiful recovery community where I have peer support and so does my son. I educate others so all communities can have this and not more drug promotion. I work with my sponsor.

            The marijuana industry is a predatory industry and my son fell for their lies. He has taken responsibility now, but I know the marijuana industry will never take responsibility. So hope their are many lawsuits and they are are stopped. Unfortunately they are still preying on America’s youth.

            I also know adults who have believed the lies from the marijuana industry and have long term damage now.

            Rebecca Gavin, Thanks for your support.

            i wish everyone health and happiness.

          • Bad moms gritting for money are just gonna be bad moms gritting for money.

            Again, get off the computer and be a better parent.

          • Your son wanted to get high because you weren’t a good enough parent.

            Your poor parenting has done more irreparable damage to your son than you can fathom… yet it is FAR EASIER for you to blame weed, so here you are.

            Get away from the computer and take care of YOUR problems.

            No one buys your bullshit.

            Clearly, your son doesn’t either.

          • How dare you attack someone you disagree with by blaming them for their adult children’s drug problems? On what basis do you do that other than trolling? GLP is a science based site. Your comments are inappropriate and irrelevant to the subject at hand. I may not fully agree with Ms. Adams but these attacks are idiotic.

          • Aubree Adams is a grifter.

            Check her GoFundMe page.

            Exploitation at its finest.

            Do not fall for her lies.

            Do not pay her any viable attention.

            She needs to focus on her family.

            She has simply lied for years o the internet to feed her agenda.

          • Dear What,

            My Go Fund Me page was at a time I was desperate for treatment and I was told I needed 36,000 just for the 1st 3 months of treatment. I didn’t have that, so my son ended up on the streets again. I have paid thousands of dollars, and I am continue to pay. My son is been in an outpatient program for 2 years now and is doing well because I do my recovery too. I’m sorry you won’t accept that. Please let us know who you are, so you can be transparent like I am. I am so blessed to be part of an amazing recovery community, and I wish the same for you.

            You need to decide to either come public on who you are or stop slandering me. I do not lie. My son has given me permission to share his experience as hope for others. I know your ammo is to continue to harass me, that is so sad for you. Why do you push drugs on our country?

            There is no scam, I testify so other states don’t fall to the marijuana charade.

            Now we know your next comment will be another one that attacks and it is unhealthy to continue this. Good day and good luck. If you want to know more about me, please go to my YouTube channel.
            Every Brain Matters
            Aubree

          • Your son is “fine”, in your own words.

            And what do you know, he DID NOT NEED A $36K Big Rehab facility to be “fine”, did he??!?

            Your approach to drugs CAUSED his deviance.

            You’ve learned nothing.

            You WILL learn nothing.

            Yet you’ll keep spreading lies and misinformation to perpetuate the failed Prohibition of Cannabis.

            I wish you nothing but to stay on your same track of failure after failure.

          • I just did a talk with a group in Mass, a pod cast. My son gave me a hug before my talk and told me how proud he is of me. I’m so grateful for his recovery. I will continue to speak out and defend myself, and give hope to other families and encourage them to speak out too.

            Don’t to just feel helpless that you can’t control me? I know you want the marijuana charade to continue, but I and many other will continue our work. Thanks What!! and Have a great day!!!

          • Jeeeeeeesus…

            Your poor family….

            Prohibition has been exposed for what it is because of you and your fellow pearl-clutching, fear-mongering extremists.

            Keep doing EXACTLY what you have been doing!

            The numbers speak for themselves.

            The science of cannabis is crushing the fear and ignorance of Your Reefer Madness.

          • Oh My!! Bless you little heart! You have to keep this up to help you feel so much better. I will pray for you except I don’t know your name. Do you wish to share it?

            You need to read the science!!! and while you’re at it listen to the people who have been harmed.

            Please, I’m begging you to make a video saying all of this to me and post it!! We need to hear your side of the story! Le’t tell the world!!! Maybe if you are really scared you can continue to hide your identity so people know you don’t stand with your words. A video would be great! So if you decide not to do a video that means you have no business coming at me because that just means you are hiding behind the marijuana charade. You are a coward.

          • This response is little more than personal abuse, evasion of facts, knee-jerk leftist slogans like “reefer madness”. Scientific research into cannabis is increasingly undermining the notion, and commercial prospects, of the lie that it is a “benign substance”.

          • Please show me ANY science that shows cannabis to be anything OTHER than a benign substance.

            Science is against Prohibition.

            Science illustrates that cannabis is less harmful than alcohol and tobacco.

            No more fear-tactics and criminalizing of a plant.

            It’s time to be rational.

            New cannabis laws across the country reflect a new, more logical approach.

  4. we need to start looking at babies born with birth defects and the association with their parents use of marijuana – both men and women. The science is emerging but we need to hear from individuals who have been harmed – or parents who have experienced problems at birth or as their children age from marijuana use. There must be doctors, nurses and practitioners seeing this in their work – we need them to come forward as we also need parents to do the same. …. in this they will help others and dissuade use –

  5. I have chronic pain and I did not find that even high CBD cannabis helped my pain at all. This very large 4 year Australian study shows that people who switched from opioids to cannabis for pain management were mostly doing worse in terms of pain, anxiety, and functioning. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30110-5/fulltext

    There have been a couple of studies that showed a decrease in opioid prescribing in states with medial marijuana but they don’t look at why the rates declined. In my experience pain managements reduce or discontinue opioids for people using medical marijuana for pain management.

    I am all for legalization for recreational purposes. But I wish they would stop confusing the issue by making claims that are at best unproven. It’s starting to appear that cannabis is not helpful for treating opioid addiction, and not effective for pain.

  6. Another one sided view! I spent 20+ years chained as a pain patient desperate for help to very strong opioid medications including fentanyl and oxycodone, I understand and respect these medicines but I can’t say the same for the providers or the government overseeing the providers. They had me at 125mcg of fentanyl with four added narcotics including oxycodone for many years, I followed instructions and abided by the rules given until my Dr. decided the oath he took in school to do no harm wasn’t as important as the fear of government stripping him of his lively hood. Once pressure was on Dr’s to reduce the prescribed “morphine equivalent per day” my wonderful Dr decided to use me to reduce his numbers and look better and took me to 0 mg of fentanyl with absolutely nothing to compensate! One day your at 500mg+ morphine equivalent the next your at zero with no medical assistance whatsoever just sent on your way to figure it out alone! So what to do now? My options for pain control have no been limited as I found myself in a pain patient crisis. So I could turn to the street equivalent drugs like I have to believe is the intended path but not for me sorry, I can cry out for help and wind up in a similar situation to what I’m already in or I can choose to take a different approach. Let’s be honest what options are left? It was time to approach this matter a bit different as my life was on the line. Cannabis took big pharma out of my daily life, cannabis is currently taking this Dr out of my life and cannabis is taking me out of the government’s grips and soon I’ll likely take cannabis out of my life as well and enjoy my stomach being ripped to shreds overdosing on Ibuprofen I’m sure will eventually take a huge toll on the health system soon enough. I thankfully personally do not crave these drugs “they have been at my disposal the entire way with no temptation” but getting a Dr to believe this is impossible nowadays because they have been brainwashed into believing everyone is a addict and are to busy profiling patients to truly assist them. What I’ve been through along with so many others and how it’s been handled should be the article I’m reading not some one sided propaganda article that should have been titled “refer madness” instead. Hell yes propaganda like this must be existing when some of the lucky ones have discovered a way out through cannabis more articles like this will appear! Shame on the author, but after all everyone’s out to make a buck right? Wait…. That’s how we got here!

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