Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Friday, January 23, 2015

"Legalized marijuana might be the best thing to ever happen to heroin addicts"

The title of this post is the headline of this notable new piece via Quartz.  Here are excerpts (with links from the original):

By 1970, legislation codified cannabis as one of the nation’s most dangerous drugs: the Controlled Substance Act classified marijuana as a Schedule 1 drug, meaning it possessed high potential for abuse and had no acceptable medical use. Over 40 years later, the classification remains.

But research has shown that marijuana, while still criminalized at the federal level, can be effective as a substitute for treating opioid addictsand preventing overdoses. Massachusetts, which recently legalized medical marijuana — and where heroin overdoses have soared — could be a fertile testing ground for this potentially controversial treatment.
 
Before being criminalized, marijuana was used in the US to cure depression and a variety of other mental health ailments. Many studies have supported the therapeutic benefits of cannabinoids, along with the ability of marijuana’s psychoactive ingredients to treat nausea, help with weight loss, alleviate chronic pain, and mitigate symptoms of neurological diseases.
 
Other research, however, contradicts claims regarding the benefits of cannabidiol treatment. Some say marijuana actually poses a risk for psychosis and schizophrenia. Although the FDA has approved some synthetic cannabinoids for medical treatment, federal agencies do not support marijuana as a legitimate medicine until more clinical studies have been conducted....
 
Among drug treatment specialists, marijuana remains controversial. Although some research has shown marijuana to be an alternative treatment for more serious drug addiction, addiction treatment specialists still view marijuana as highly addictive and dangerous. These views handicap policy reform, but despite its status as a Schedule 1 drug, recent research shows marijuana could be part of the solution to the most deadly drug epidemic our country has seen in decades.
 
In 2012 Massachusetts became the 18th state to legalize medical marijuana, though the first 11 dispensaries are not scheduled to open until sometime in the coming year. This situation presents an opportunity to implement sensible, research-based policy.
 
Massachusetts, like many states across the US, has seen a dramatic rise in opioid addition fueled by the increase in opiate prescription pills.  In Boston, heroin overdoses increased by 80% between 2010 and 2012, and four out of five users were addicted to pain pills before turning to heroin.
 
Meanwhile, the leading cause of death among the Boston’s homeless population has shifted from AIDS complications to drug overdoses, with opiates involved in 81% of overdose deaths. This is an alarming finding given recent expansion in clinical services for the city’s homeless.
 
Addiction specialists and health care professionals in Boston have been at the forefront of integrating behavioral and medical care.  Naloxone and methadone are currently the main solutions to address the growing opiate addiction and overdose problem. But Naloxone is an overdose antidote, not a cure or a form of preventative therapy.
 
Methadone, like heroin and other opioids, has a very narrow therapeutic index (the ratio between the toxic dose and the therapeutic dose of a drug).  This means that a small change in dosage can be lethal to the user. Marijuana, however, has one of the safest (widest) therapeutic ratios of all drugs.
 
Research shows that marijuana has been used as a form of self-treatment, where users take cannabis in lieu of alcohol, prescription opiates, and illegal drugs.  That’s one reason why researchers are calling for marijuana to be tested as a substitute for other drugs.  In this capacity, marijuana can be thought of as a form of harm reduction. While researchers don’t seek to discount some of the drug’s potential negative effects, they view it as a less damaging alternative to other, harder drugs. Despite these findings, marijuana is rarely incorporated in formal drug treatment plans.
 
A recent study might change this policy. Comparing states with and without legalized medical marijuana, it found a substantial decrease in opioid (heroin and prescription pill) overdose death rates in states that had enacted medical marijuana laws. In their conclusions, the researchers suggested that medical marijuana should be part of policy aimed to prevent opioid overdose....
 
Since Massachusetts has not yet opened its medical marijuana dispensaries, it is too early to see if medical marijuana legislation will help reduce opiate addiction in the Commonwealth. Using recent research findings, Massachusetts policymakers have a unique opportunity to implement medical marijuana policies that address its contemporary opiate overdose.  Medical marijuana could be part of drug treatment for heroin and opiates.
 
For homeless people, however, getting a marijuana card is expensive and buying medical marijuana from a dispensary is beyond their economic means. Street drugs are more prevalent in their social setting, easier to obtain, and can be much cheaper.  From a policy perspective, addressing the alarming rates of overdose deaths among the homeless in Boston could mean distributing medical marijuana cards to homeless addicts for free and providing reduced cost medical marijuana.
 
Formerly demonized and later legislated as a Schedule 1 substance, marijuana could diminish the damage wrought by harder drugs, like heroin.  While opioid use is a nationwide epidemic, Massachusetts — long at the forefront of developing scientifically based public policy — has the opportunity to be at the forefront of cutting-edge, socially-informed drug policy.

https://lawprofessors.typepad.com/marijuana_law/2015/01/legalized-marijuana-might-be-the-best-thing-to-ever-happen-to-heroin-addicts-.html

Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink

Comments

I wish the author would have capitalized on some more jaw dropping statistics and the costs associated with them, such as the fact that drug overdoses have long since surpassed car crashes as the leading cause of injury death in states including Ohio, as well as nationally among ages 1-44. With the legislative furor around the opioid epidemic, It will be interesting to see if more studies have more direct success linking marijuana as a pragmatic solution.

Posted by: Dilynn Roettker | Jan 23, 2015 10:34:47 AM

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