Can Marijuana Aid Resolve the Opioid Epidemic?


James Feeney, a surgeon in Connecticut, heard it from his sufferers. A handful of basically turned down his prescription for oxycodone, the preferred 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 quite effectively.”


Marijuana has worked effectively sufficient, anecdotally at least, that Feeney is following his patients’ lead and conducting a trial at Saint Francis Hospital and Healthcare Center in Hartford, Connecticut. The self-funded study will examine opioids and healthcare marijuana for treating acute discomfort, such as that from a broken rib.*


That distinction—acute discomfort from an injury—is also an vital 1. A smaller physique of proof suggests that healthcare marijuana is successful for chronic discomfort, which persists even just after an injury ought to have healed and for which opioids are currently not a excellent therapy. But now Feeney desires to attempt healthcare marijuana for acute discomfort, exactly where opioids have lengthy been a go-to drug.


“The large concentrate from my standpoint is that this is an try to finish the opioid epidemic,” he says. Overdoses from opioids, which consists of heroin as effectively as prescription painkillers like oxycodone and morphine, killed far more than 30,000 people today 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 makes use of are basically threefold: to treat chronic discomfort, to treat acute discomfort, and to alleviate the cravings from opioid withdrawal. And it has the benefits of getting considerably much less hazardous and addictive than opioids.


The large roadblock? Marijuana’s status below federal law as a Schedule I drug—the most tightly restricted category—which tends to make it really tricky for researchers to study. Scientists initially have to apply for a license from the Drug Enforcement Administration, which “can take people today years,” says Yasmin Hurd, a neuroscientist at Mount Sinai who has a license to study marijuana and its derivatives. One more difficulty 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 diverse formations, but if you can only get the compounds from 1 supply, that tends to make it challenging,” says Hurd.


This is in particular relevant to Hurd’s operate since 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 far more indirectly. In a smaller pilot study, Hurd has located that cannabidiol can decrease the cravings of people today addicted to heroin. “They relapse since 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 people today addicted to heroin, and she published a current assessment on cannabidiol’s function in curbing substance abuse.


Utilizing marijuana to treat chronic discomfort is a far more established concept. A 2015 assessment of 28 randomized clinical trials located “moderate-high quality evidence” that compounds derived  from marijuana or synthetic versions thereof have been valuable.


Interestingly, sufferers currently appear to be replacing opioids with marijuana for chronic discomfort. A handful of observational research have also located correlations amongst states legalizing healthcare 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 healthcare marijuana dispensary. They reduce their prior opioid use by two-thirds.


“They felt a lot superior when their discomfort was getting controlled by cannabis rather opioids since opioids have a lot of side effects,” he says. These side effects include things like dizziness, constipation, sexual dysfunction and—in the case of overdoses—breathing complications. That is since opioids receptors are also in the brainstem, the element of the brain that regulates breathing. Marijuana acts on a diverse set of receptors.


Clauw, who runs a discomfort lab at University of Michigan, says he would to like realize how marijuana quells discomfort on a molecular level, but receiving the license has proved as well large a hurdle.


Meanwhile, Feeney’s hospital trial for acute discomfort is capable to get about the logistics concern of marijuana as a scheduled substance. Healthcare marijuana is legal in the state of Connecticut, but neither Feeney nor his hospital offers it straight to sufferers. Rather, a physician certifies a patient to use marijuana, and the patient then picks it up at a dispensary or pharmacy. “The strains I have to choose 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 physicians chose rib injuries to study since the discomfort lasts a predictable six weeks. Due to the fact of the study’s style, sufferers get to decide on regardless of whether they use opioids and marijuana to handle discomfort. So far, the hospitals has enrolled a handful of sufferers. They’ve all selected marijuana.



* This write-up initially stated that the study at Saint Francis Hospital and Healthcare Center is state-funded. We regret the error.