Tuesday, March 17, 2015
The question in the title of this post is the headline of this new piece by Miriam Boeri appearing in This Week magazine. Here are excepts (with links preserved):
[R]esearch has shown that marijuana, while still criminalized at the federal level, can be effective as a substitute for treating opioid addicts and 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....
With each state crafting unique medical marijuana regulations, we find ourselves at a crucial turning point in drug policy.... 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 percent 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 percent 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....
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.