Volume 17
Issue 2
Summer '19

Opioids, Overdoses, and Cannabis: Is Marijuana An Effective Therapeutic Response to the Opioid Abuse Epidemic?

Written By: Paul J. Larkin, Jr. and Bertha K. Madras

Abstract

Drug overdoses fatalities in America, particularly ones attributable to opioid use, outpace most other preventable causes of death. So far, efforts to dissuade parties from using opioids and to disrupt the supply of that drug have not reduced the number of fatalities. To address that problem, several commentators have argued that we should legalize marijuana use as a legitimate analgesic substitute for opioids. The argument is that marijuana can alleviate pain without posing a risk of overdose, because there are few receptors for marijuana’s constituents in the brain region responsible for autonomic control of respiration. That suggestion, however, is an unsound one. Marijuana’s analgesic effects are not sufficiently powerful to palliate acute pain. Marijuana is also not a reasonable analgesic for chronic pain, for several reasons. For example, a recent, long-term, comprehensive longitudinal study found that participants prescribed opioids, of which 24% also used cannabis daily or less frequently, reported greater pain severity and pain interference (viz., pain effects on sleep, working ability, daily living, social interactions), lower pain self-efficacy, and higher levels of generalized anxiety disorder than those not using cannabis. Moreover, individuals who used marijuana on a near-daily basis were less likely to discontinue opioid use than participants who abstained from cannabis use. Use of marijuana during opioid treatment therefore increases the risk that opioid treatment will be unsuccessful. While further research someday might discover that one or more of marijuana’s constituents could serve as a treatment for long-term chronic pain, there is no such evidence today.

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