Millions of Americans suffer from chronic pain. This is even more common in those who have HIV. 25 to 90 percent of people with HIV experience chronic pain. Most people with chronic pain are prescribed opioids such as Vicodin, Hydrocodone, Oxycodone and morphine by their doctors. Prescription opioids contribute to thousands of deaths each year from accidental misuse and opioid addiction is a high risk factor in all of this. Opioids are highly addictive and, over time, more and more may be necessary for relieving pain which can often lead to an accidental overdose and death.
Statistics Show Drops in Opioid Deaths in Legal States
Opioid addiction is at an all-time high. In the last 20 years, fatalities by drug overdose have become the leading cause of death in the country. In 2011, 55 percent of all drug overdose deaths came from prescription opioids. More recently, medical marijuana has begun to be recommended for the treatment of pain and HIV/AIDS instead of opioids. Medical marijuana has been legalized in 29 states and Washington D.C. and this has been the case in all of these places. In these states, there has been an approximate 25 percent decrease in hospital visits related to opioid use. In 2010, in states with legal medical marijuana, there were 1,700 less opioid related deaths. In 13 states where marijuana was legalized, the number of deaths related to opioid use dropped by 33 percent.
Authorized Research into Medical Marijuana’s Effects on Opioid Addiction
All of the evidence clearly points to medical marijuana as a powerful solution to the opioid addiction and the opioid epidemic. The most important move to make involves research and being able to provide government approved research on the topic. In this aim, the National Institutes of Health (NIH) has given researchers at Albert Einstein College of Medicine and Montefiore Health System a 5 year, $3.8 million grant to conduct the first long-term study to test whether medical marijuana reduces opioid use in adults with chronic pain, including those with HIV. The research will provide a clearer understanding of the relationship between chronic pain and medical marijuana.
“There is a lack of information about the impact of medical marijuana on opioid use in those with chronic pain,” said Chinazo Cunningham in a media release. Cunningham is the associate chief of general internal medicine at Einstein and Montefiore and principal investigator on the grant. “We hope this study will fill in the gaps and provide doctors and patients with some much needed guidance.” He adds in regards to their research that “as state and federal governments grapple with the complex issues surrounding opioids and medical marijuana, we hope to provide evidence-based recommendations that will help shape responsible and effective healthcare practices and public policies.”
Several smaller studies have already been done that have found medical marijuana to be a powerful treatment for chronic pain and a solution for opioid addiction. A 2011 study published in Clinical Pharmacology & Therapeutics showed results indicating that delta-9 tetrahydrocannabinol (Delta-9 THC), cannabidiol (CBD), cannabinol (CBN), tetrahydrocannabivarin (THCV) are the compounds in marijuana that have powerful therapeutic benefits.
The body has an endocannabinoid system (ECS), made of of CB1 and CB2 receptors found throughout the whole body including the brain, nervous system and organs. The ECS manages many bodily functions including mood, sleep, appetite, pain sensation and much more. Several studies on the subject of chronic pain and medical marijuana conclude that the compounds in marijuana activate the CB1 and CB2 receptors in the body, bringing it back into balance. This is considered a key factor when looking at the treatment of chronic pain and sleep disorders, 2 conditions that opioids are often prescribed to treat.
Surveys into Preferences for Pain Relief
Another kind of study on marijuana and opioid use was conducted recently to see what patients themselves felt about which kind of medication they preferred for their pain. Researchers from the University of California Berkeley and Kent State University surveyed 2,810 participants, asking them about their pain as well as their opioid and marijuana usage. 828 were using opioids over the last 6 months to treat their pain. Within that group of opioid users, 97 percent “strongly agreed/agreed” their need for opioids was reduced when they also consumed medical marijuana. Of that group, 89 percent also “strongly agreed/agreed” that the opioids they were taking were giving them unwanted side effects, like nausea and constipation. The most interesting result of the research is that 81 percent of participants in the survey “strongly agreed/agreed” that medical marijuana on its own, with no opioids, was more effective as a treatment than taking cannabis with opioids.
“This study can conclude that medical cannabis patients report successfully using cannabis along with or as a substitute for opioid-based pain medication,” researchers reported in the journal Cannabis and Cannabinoid Research. “Patients in this study who are using cannabis and opioids report that they are able to use less opioids and that cannabis presents less unwanted side effects than their opioid-based medication.”
The Severity of the Opioid Crisis
With the opioid epidemic so out hand, causing 33,000 deaths in 2015 alone, and opioid addiction such a risk for those using it as medication, companies have begun looking at ways to manufacture marijuana based painkillers. Companies like Axim Biotechnologies Inc., Nemus Bioscience Inc. and Intec Pharma Ltd. have already begun this process and have drugs in various stages of development. With opioid addiction causing so much concern and distress, the FDA has been reviewing drugs whose benefits are outweighed by risk. They recently asked Endo International Plc. to remove its Opana ER painkiller from the market for public health reasons. This is the first time the agency has been inclined to take such action.
More research is needed into the benefits of medical marijuana and how to best use it to treat the 100 million or so people suffering from chronic pain in the country. As it stands, marijuana is still classified by the DEA to be a Schedule I drug, placing it in the same high risk category as heroin. Schedule I drugs are considered to have a high risk for addiction, have no medicinal purposes and be too dangerous to test on humans. Prescription opioids are considered by the DEA to be less dangerous with a Schedule II classification. There is no record of any person ever dying from marijuana use.