Medical Cannabis Patterns of Use and Substitution for Opioids, Other Pharmaceutical Drugs & Illicit Substances

There have been several studies published that have shown a correlation between increased access to legal medical cannabis and a reduction in opioid usage and related harms; however, most of them have focused on the U.S.

In one of the largest polling studies to date, investigators looked at over 2032 surveys provided by Canadian Licensed Producers to understand the patterns of medical cannabis use and its substitution for pharmaceutical and illicit drugs.

Published in the Harm Reduction Journal, the study found the most commonly documented substitution was for prescription drugs (69% of participants), followed by alcohol (44.5%)

This study adds another uniquely Canadian perspective to the growing body of evidence that “increased regulated access to medical and recreational cannabis can result in a reduction in the use of and subsequent harms associated with opioids, alcohol, tobacco and other substances.”

Full article available here.

Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain

A recent study has revealed that cannabis may serve as an adjunct to or substitution for illicit opioid use among people who use drugs with chronic pain in Vancouver, British Columbia. The findings of this study have particular implications for healthcare and harm reduction service providers.

View full article here.

The new grey market: As older users warm up to cannabis, pot companies want to learn more: Financial Post

Cannabis companies hoping to expand the medical market will have to overcome the conservatism towards cannabis amongst medical associations — both the Ontario Medical Association and the Canadian Medical Association support the dismantling of the medical cannabis regime altogether, arguing that with legalization, there remains no need for medical professionals to serve a “gatekeeper role.”

This kind of opposition, said Pearson, is what makes is so difficult to obtain funding to really understand how cannabis can improve the lives of seniors. “I treat seniors in a long-term care setting and I’m weaning down their use of anti-psychotics and opioids. To just say leave it up to themselves, that means you’re saying they should self-medicate, which is absurd.” Read full article here.

TTC subway operator barred while using medicinal cannabis: CBC

This is yet another example of the shocking, dangerous and unfortunately, not surprising, double-standard that exists between medical cannabis and traditional pharmaceuticals.

If organizations want to err on the side of caution for safety-sensitive positions until there is a more accurate way of testing cannabis impairment, than that seems sensible to me. What does not make sense, however, is forcing a TTC driver off of her medical cannabis to keep her job but allowing her to continue driving while taking impairing opioids, which she describes as leaving her feeling "groggy, forgetful and feeling like a zombie." Not to mention their high addiction potential.

Not only that, but this patient was prescribed CBD oil, which only contains trace amounts of THC and is considered non-impairing. Based on the evidence available, how can anyone believe that going back on opioids is a safer choice?

Read full article from the CBC here.

Research: Opioid use lower in states that eased medical marijuana laws, JAMA (April 2, 2018)

On Monday, the Journal of the American Medical Association published two studies investigating whether access to medical cannabis reduces opiate use and abuse. This article from NPR provides a solid, balanced overview.

NPR reports: 

Medical marijuana appears to have put a dent in the opioid abuse epidemic, according to two studies published Monday.

The research suggests that some people turn to marijuana as a way to treat their pain, and by so doing, avoid more dangerous addictive drugs. The findings are the latest to lend support to the idea that some people are willing to substitute marijuana for opioids and other prescription drugs.

Many people end up abusing opioid drugs such as oxycodone and heroin after starting off with a legitimate prescription for pain. The authors argue that people who avoid that first prescription are less likely to end up as part of the opioid epidemic.

"We do know that cannabis is much less risky than opiates, as far as likelihood of dependency," says W. David Bradford, a professor of public policy at the University of Georgia. "And certainly there's no mortality risk" from the drug itself.

Read full article here.

New Jersey Governor, Phil Murphy expands medical marijuana program: NBC

A renaissance is coming to New Jersey’s long embattled medical marijuana program. 

Democratic Gov. Phil Murphy announced a long list of reforms this morning, including lowering fees for patients and caregivers, adding five approved medical conditions and proposing legislation to increase monthly product limit for patients.

Patients receiving hospice care would be eligible for an unlimited supply of cannabis. Effective immediately, patients suffering from anxiety, migraines, Tourette’s syndrome, chronic pain related to musculoskeletal disorders, and chronic visceral pain will be eligible for the medical cannabis program.

Murphy added that he would like to eventually see opioid addiction added to the growing list of approved conditions. He called cannabis “an offensive weapon” to the growing crisis.

Full article 

Medical cannabis safer for elderly with chronic pain than opioids: European Pharmaceutical Review

Medical cannabis therapy can significantly reduce chronic pain in patients age 65 and older without adverse effects, according to researchers at Ben-Gurion University of the Negev (BGU) and the Cannabis Clinical Research Institute at Soroka University Medical Center.

The new study found that cannabis therapy is safe and efficacious for elderly patients who are seeking to address cancer symptoms, Parkinson’s disease, post-traumatic stress disorder, ulcerative colitis, Crohn’s disease, multiple sclerosis, and other medical issues.

“While older patients represent a large and growing population of medical cannabis users, few studies have addressed how it affects this particular group, which also suffers from dementia, frequent falls, mobility problems, and hearing and visual impairments,” says Victor Novack, a Professor of Medicinein the BGU Faculty of Health Sciences (FOHS), and head of the Soroka Cannabis Clinical Research Institute. 

“After monitoring patients 65 and older for six months, we found medical cannabis treatment significantly relieves pain and improves quality of life for seniors with minimal side effects reported.” Read full article here and review research here.

Montel Williams: Cannabis 'changed my life': Yahoo News

After being diagnosed with multiple sclerosis around 1999 and struggling with opioid addiction to manage the pain, Montel Williams says that finding cannabis was a game-changer.

Williams shares with Yahoo Lifestyle that he “took a journey down opioid lane for a year and a half, just trying to shut the pain down to the point that I was walking around in a pseudo-suicidal state.”

He said shifting from opioids to cannabis was what that turned his life around. “The journey that I took with cannabis — it changed my life,” he says.  Full article here.

Sarnia doctor using medical marijuana to treat nursing home residents: Sarnia Journal

Dr. Blake Pearson is using oil produced from cannabis to treat nursing home patients with a wide range of disorders, including arthritis, degenerative discs, sleep disorders and the treatment of chronic pain.

“I’ve been able to lower patient opiate doses in some cases,” the Corunna native said.

“We’ve been able to take people off three or four different medications and replace them with… some form of cannabis drops.” Full article. 

Can marijuana ease the opioid epidemic? Pew Charitable Trust

• A recent PEW Charitable Trust article explores the relationship between medical marijuana and opioid reduction in New York State. Read full article.