Can Marijuana Assistance Resolve the Opioid Epidemic?
James Feeney, a surgeon in Connecticut, heard it from his sufferers. A couple of essentially turned down his prescription for oxycodone, the common opioid painkiller that has also gained notoriety with the opioid epidemic.
His sufferers, Feeney recalls, would say, “Listen, do not give me any of that oxycodone garbage. … I’m just going to smoke weed.”
“And you know what?” says Feeney. “Every single 1 of these sufferers does not have a lot of discomfort, and they do fairly effectively.”
Marijuana has worked effectively adequate, anecdotally at least, that Feeney is following his patients’ lead and conducting a trial at Saint Francis Hospital and Health-related Center in Hartford, Connecticut. The self-funded study will examine opioids and health-related marijuana for treating acute discomfort, such as that from a broken rib.*
That distinction—acute discomfort from an injury—is also an crucial 1. A tiny physique of proof suggests that health-related marijuana is efficient for chronic discomfort, which persists even following an injury should really have healed and for which opioids are currently not a good therapy. But now Feeney desires to attempt health-related marijuana for acute discomfort, exactly where opioids have lengthy been a go-to drug.
“The significant concentrate from my standpoint is that this is an try to finish the opioid epidemic,” he says. Overdoses from opioids, which contains heroin as effectively as prescription painkillers like oxycodone and morphine, killed additional than 30,000 persons in 2015.
“Listen, do not give me any of that oxycodone garbage. … I’m just going to smoke weed.”
Marijuana could have a larger function in curbing this drug abuse than previously believed. Its prospective utilizes are essentially threefold: to treat chronic discomfort, to treat acute discomfort, and to alleviate the cravings from opioid withdrawal. And it has the benefits of getting a lot much less risky and addictive than opioids.
The significant roadblock? Marijuana’s status beneath federal law as a Schedule I drug—the most tightly restricted category—which tends to make it quite hard for researchers to study. Scientists initially have to apply for a license from the Drug Enforcement Administration, which “can take persons years,” says Yasmin Hurd, a neuroscientist at Mount Sinai who has a license to study marijuana and its derivatives. An additional challenge is sourcing. Scientists can only get marijuana from a farm at the University of Mississippi, which grows a restricted selection. “You want to be capable to study unique formations, but if you can only get the compounds from 1 supply, that tends to make it challenging,” says Hurd.
This is particularly relevant to Hurd’s operate for the reason that her interest is not necessarily THC, the psychoactive chemical in marijuana, but cannabidiol, also identified as CBD. Cannabidiol does not get you higher, but it impacts the receptors in your brain additional indirectly. In a tiny pilot study, Hurd has identified that cannabidiol can cut down the cravings of persons addicted to heroin. “They relapse for the reason that they are in circumstances that induce craving,” says Hurd. By controlling their anxiousness, cannabidiol also appears to be controlling their cravings.
Hurd is now operating a bigger trial to investigate if the substance could assistance persons addicted to heroin, and she published a current evaluation on cannabidiol’s function in curbing substance abuse.
Utilizing marijuana to treat chronic discomfort is a additional established thought. A 2015 evaluation of 28 randomized clinical trials identified “moderate-high quality evidence” that compounds derived from marijuana or synthetic versions thereof have been effective.
Interestingly, sufferers currently appear to be replacing opioids with marijuana for chronic discomfort. A handful of observational research have also identified correlations among states legalizing health-related marijuana and a drop in painkiller prescriptions, opioid use, and deaths from opioid overdose. And in 2016, Dan Clauw and his colleagues published a survey of sufferers with chronic discomfort who began patronizing a health-related marijuana dispensary. They reduce their earlier opioid use by two-thirds.
“They felt a lot greater when their discomfort was getting controlled by cannabis rather opioids for the reason that opioids have a lot of side effects,” he says. These side effects incorporate dizziness, constipation, sexual dysfunction and—in the case of overdoses—breathing challenges. That is for the reason that opioids receptors are also in the brainstem, the element of the brain that regulates breathing. Marijuana acts on a unique set of receptors.
Clauw, who runs a discomfort lab at University of Michigan, says he would to like have an understanding of how marijuana quells discomfort on a molecular level, but obtaining the license has proved also significant a hurdle.
Meanwhile, Feeney’s hospital trial for acute discomfort is capable to get about the logistics concern of marijuana as a scheduled substance. Health-related marijuana is legal in the state of Connecticut, but neither Feeney nor his hospital supplies it straight to sufferers. Rather, a medical doctor certifies a patient to use marijuana, and the patient then picks it up at a dispensary or pharmacy. “The strains I have to pick from are so pure and so potent that the stuff they get from the University of Mississippi pales in comparison,” says Feeney.
The trial, which was just got began, will enroll 60 sufferers with rib injuries in total—30 on marijuana, 30 on opioids. The medical doctors chose rib injuries to study for the reason that the discomfort lasts a predictable six weeks. Simply because of the study’s style, sufferers get to opt for regardless of whether they use opioids and marijuana to manage discomfort. So far, the hospitals has enrolled a handful of sufferers. They’ve all selected marijuana.
* This post initially stated that the study at Saint Francis Hospital and Health-related Center is state-funded. We regret the error.