Medical cannabis proponents are known to promote their cause by suggesting that marijuana is a valid alternative to opioid medications. They say that legalizing medical cannabis can reduce the number of opioid prescriptions written as patients elect to use the former rather than the latter. There may be some validity to the proposition, according to a recent study.
A team of researchers from three universities – Purdue University, the University of Florida, and the University of Southern California – looked at the total value of payments made to physicians by opioid manufacturers between 2014 and 2017. They correlated those sales with state-legal medical cannabis to see if legalization had any impact.
Key Findings from the Study
A report from Marijuana Moment says that the researchers created a “novel penalized synthetic control model” as a means of measuring direct payments from opioid manufacturers. Apparently, manufacturers pay doctors directly for writing prescriptions. Whether or not that is ethical is a matter of debate. It is also a separate topic for another post.
Ethics aside, here are the key findings from the study:
- Direct payments decline commensurate with medical cannabis legalization
- Payments also decline because doctors prescribe fewer opioids
- The availability of medical cannabis directly correlates to opioid payment frequency.
The simplest way to understand it is this: in states where medical marijuana is legal, doctors are writing fewer opioid prescriptions as result of patients choosing marijuana instead. Fewer prescriptions mean fewer direct payments from opioid manufacturers.
The Evidence Is Clear Enough
The evidence in support of medical cannabis as a prescription opioid alternative is clear enough. We can debate endlessly about whether cannabis actually does anything to relieve pain. Maybe it doesn’t. Perhaps the placebo effect is real here. Still, patients who would otherwise get opioid prescriptions are choosing medical cannabis. If they are going to take drugs anyway, isn’t medical cannabis the safer choice?
Something else to remember is that opioid prescriptions are primarily for pain management. Can you guess the number one condition for which medical cannabis is recommended? If you guessed pain, you are correct.
Pain is the most cited condition in Utah, according to the operators of the Utahmarijuana.org website. They say it is the same across the country. The majority of people who use cannabis medically do so to help manage chronic pain.
Opioids for Chronic Pain Are Questionable
A traditional approach for managing chronic pain is writing opioid prescriptions. The thinking is that patients looking for any possible relief are willing to take the risks associated with opioids to get it. But such thinking is questionable, at best. Knowing that opioid manufacturers make direct payments to doctors makes such logic suspect.
We already know that prescription painkillers are inherently risky. We know that, as narcotics, they have a high potential for addiction. We also know that a patient addicted to prescription painkillers suffers even more trying to get off them. So why ignore an alternative therapy that could eliminate the need for prescription drugs altogether?
The Proof Is in the People
The proof that medical cannabis is a valid alternative to prescription painkillers isn’t in the pudding, so to speak, it is in the very people who are choosing cannabis over narcotics. They are finding relief – whether it is genuine relief or just the placebo effect. Quite frankly, the mechanism behind their relief really doesn’t matter at this point.
Evidence shows that prescription opioid use declines where legal access to medical cannabis exists. It couldn’t be any clearer. We now know of a way to put a significant dent in the opioid crisis.