Feds to Study Medical Marijuana’s Effect on Opioid Use

Leafly/August 11, 2017

The National Institutes of Health (NIH) recently awarded a five-year, $3.8 million grant to researchers for the first long-term investigation to see if medical marijuana reduces opioid use among adults with chronic pain.

The federal grant, given to scientists at Albert Einstein College of Medicine and Montefiore Health System, could provide peer-reviewed evidence of the widespread but anecdotal phenomenon of chronic pain patients stepping down from opioid use to a safer reliance on medical cannabis to manage and alleviate their pain. Notably, the study will use real medical cannabis from licensed dispensaries in New York State, not the lower-quality “research grade” cannabis grown by federal contractors in Mississippi.

“There is a lack of information about the impact of medical marijuana on opioid use in those with chronic pain,” Chinazo Cunningham, associate chief of general internal medicine at Einstein and Montefiore and principal investigator on the grant, said in a media release. “We hope this study will fill in the gaps and provide doctors and patients with some much needed guidance.”

The study will have a special focus on chronic pain patients with HIV. Cunningham plans to enroll 250 HIV-positive and HIV-negative adults with chronic pain who use opioids and who have received certification from their physicians to use medical marijuana, which is provided through approved dispensaries in New York State.

Over 18 months, the study subjects will complete web-based questionnaires every two weeks, which will focus on pain levels and the medical and illicit use of marijuana and opioids. They’ll also provide urine and blood samples at in-person research visits every three months. In addition, in-depth interviews with a select group of these participants will explore their perceptions of how medical marijuana use affects the use of opioids.

Compared to the general population, chronic pain and opioid use is even more common in people with HIV. Between 25 and 90 percent of adults with HIV suffer from chronic pain. Previous studies have reported that despite the high risk for misuse of opioid pain relievers, adults with HIV are likely to receive opioids to help manage their pain. In recent years, medical marijuana has gained recognition as a treatment option. Twenty-nine states, plus the District of Columbia, have legalized its use; in those states, chronic pain and/or HIV/AIDS are qualifying conditions for medical marijuana use.

Researchers have never studied—in any population—if the use of medical marijuana over time reduces the use of opioids. Additionally, there are no studies on how the specific chemical compounds of marijuana, tetrahydrocannabinol (THC) and cannabidiol (CBD), affect health outcomes, like pain, function, and quality of life. Most studies that have reported negative effects of long-term marijuana use have focused on illicit, rather than medical, marijuana.

“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,” Cunningham said.

 

How Many Prescriptions Are Replaced by Cannabis? Canada Study Explores an Answer

Leafly/May 19, 2017/Bailey Rahn

In the US, we’ve seen a marked drop in opioid overdoses in legal states, prodding the question of whether patients are replacing their prescription medicines with cannabis. Recent survey data collected from patients enrolled in Canada’s MMPR program indicates this may be more than just a correlation.

Led by researchers Philippe Lucas and Zach Walsh, this investigation surveyed 271 patients purchasing medical cannabis from Canadian LP Tilray (which, like Leafly, is owned by Privateer Holdings). Seeking to understand who is using medical marijuana and why, they discovered some staggering statistics pertaining to substitution–63% of respondents reported using cannabis in place of prescription medications.

Breaking down the results by drug classes, Lucas and Walsh found that:

  • 30% of respondents replaced opioids with cannabis
  • 16% replaced benzodiazepines
  • 12% replaced antidepressants

The reason? “Less adverse side effects,” said 39% of patients. Others responded that cannabis was safer (27%) and more effective in treating symptoms (16%).

“In light of the growing rate of morbidity and mortality associated with these prescription medications, cannabis could play a significant role in reducing the health burden of problematic prescription drug use,” the authors wrote.

Putting to rest concerns of cannabis dependence, the survey also established a strong tendency for recreational use to precede medicinal use, not the other way around as we see with many pharmaceutical medications. A transition from medical to recreational use was only reported by less than 3% of respondents, indicating a low risk potential.

The substitution effect reaches beyond just the medicine cabinet; cannabis also helped patients curb other types of substance use:

  • 25% of respondents replaced alcohol with cannabis
  • 12% of respondents replaced cigarettes/tobacco with cannabis
  • 3% of respondents replaced illicit drugs with cannabis

Though widely supported by anecdotal evidence, this study is one of hopefully many to substantiate what patients have been experiencing for themselves when it comes to replacing other drugs and habits with cannabis. How might these statistics look in the US, where prescription medication use and abuse runs rampant? That’s a question for future research.