Cannabis prevents opioid overdose

by Dr. Adie Wilson-Poe

The opioid overdose epidemic is arguably the greatest healthcare crisis of the 21st century. In 2015 alone, its economic cost in the US is estimated at more than $500 billion (largely driven by healthcare costs, criminal justice, and lost productivity).

The magnitude and mortally indiscriminate nature of this crisis are unprecedented; for the first time in US history, drug overdoses are killing more people than gun violence or motor vehicle accidents. The fatalities are tragic enough, but the residual effects on surviving children, family members, and communities are no less devastating.

A major contributor to the overdose crisis is the doctor’s prescription pad. Over-prescription of narcotics (too many pills or refills) and “doctor shopping” (finding another doctor when one won’t refill a prescription) are common.

In 2016, the Centers for Disease Control (CDC) issued a new set of opioid prescription guidelines for physicians to try to remedy these issues. A recommendation to treat most cases of chronic pain with non-opioid drugs was included (and especially notable since opioids are least effective and most dangerous when taken long-term).

The CDC wanted non-opioid alternatives, and they soon came from an unexpected source.

Enter the cannabis alternative

Then, in January of 2017, the National Academies of Science and Medicine (NASEM) reviewed more than 10,000 studies in humans to evaluate the safety and efficacy of cannabis for dozens of different diseases and symptoms. The NASEM definitively concluded that cannabis, a non-opioid pain-relieving drug, is indeed safe and effective for the treatment of chronic pain.

When a US state enacts a medical cannabis law, the opioid mortality rate drops by 25% — and that goes up the longer a state has had legalization¹. Furthermore, non-fatal opioid hospitalizations also go down by 23%, and that’s true whether people are using prescription opioids OR illicit drugs like heroin and fentanyl³. Specifically, in Vancouver BC, illicit opioid users are four times less likely to be hospitalized with an overdose if they also use cannabis somewhat regularly.

These findings aren’t entirely surprising to the addiction recovery community, where anecdotal reports of using cannabis to wean off opioids are quite common. Cannabis is said to minimize the symptoms of opioid withdrawal, making the first few days of opioid detox far more tolerable — which boosts the likelihood of staying sober.

Since chronic opioids produce physical dependence, one of the most powerful tools in relapse prevention is weak stimulation of the opioid system with an opioid replacement drug like methadone or Suboxone. Interestingly, cannabis users are also more likely to stick to such treatments¹⁷.

A new era of recovery

Given ongoing placebo-controlled clinical trials using cannabis as a replacement for methadone, we’re in an exciting new era of addiction treatment. Recovery specialists and clinics are beginning to embrace this medication-assisted recovery approach while also acknowledging that abstinence alone simply doesn’t prevent people from relapsing.

The single greatest public health impact that cannabis could possibly have is its ability to alleviate the opioid overdose crisis — which means cannabis’ ability to reduce the harmful impacts of opioid use is too obvious to ignore.