Could marijuana help treat painkiller and heroin addiction?
The growing number of patients who claim marijuana has helped them drop their painkiller habit has intrigued lawmakers and emboldened advocates. Many are pushing for cannabis as a treatment for the abuse of opioids and illegal narcotics such as heroin, and as an alternative to painkillers.
Some patients and doctors say medical
marijuana could help wean people off painkillers and heroin, but others
argue there is not enough scientific data to support it.
The growing number of patients who claim marijuana has helped them drop their painkiller habit
has intrigued lawmakers and emboldened advocates. Many are pushing for
cannabis as a treatment for the abuse of opioids and illegal narcotics
such as heroin, and as an alternative to painkillers.
It's
a tempting sell in New England, hard hit by the painkiller and heroin
crisis. But there's a problem: There is very little research showing
marijuana works as a treatment for such addictions.
Advocates
argue a growing body of scientific literature supports the idea,
pointing to a study in the Journal of Pain this year that found that
chronic pain sufferers significantly reduced their opioid use when
taking medical cannabis. Another study, published last year in the
Journal of the American Medical Association, found cannabis can be
effective in treating chronic pain and other ailments.
The research falls short of concluding marijuana helps wean people off opioids
- Vicodin, Oxycontin and related painkillers - and heroin, though. Many
medical professionals say there's not enough evidence for them to
confidently prescribe it.
In Maine, which is considering adding
opioid and heroin addiction to the list of conditions that qualify for
medical marijuana, Michelle Ham said marijuana helped her end a
years-long addiction to painkillers prescribed for a bad back and neck.
Tired of feeling "like a zombie," the 37-year-old mother of two decided
to quit cold turkey, which she said brought on convulsions and other
withdrawal symptoms. Then, a friend mentioned marijuana,
which Maine had legalized in 1999 for chronic pain and scores of other
medical conditions. Ham gave it a try in 2013 and said the pain is under
control and she hasn't gone back on the opioids.
"Before, I
couldn't even function. I couldn't get anything done," Ham said. "Now, I
actually organize volunteers, and we have a donations center to help
the needy."
Bolstered by stories like Ham's, doctors are
experimenting with marijuana as an addiction treatment in Massachusetts
and California. Supporters in Maine are pushing for its inclusion in
qualifying conditions for medical marijuana. Vermonters are making the
case for addiction treatment in their push to legalize pot.
Authorities
are also desperate to curb a sharp rise in overdoses; Maine saw a 31
percent increase last year, and drug-related deaths in Vermont have
jumped 44 percent since 2010. Vermont officials also blame opioid abuse
for a 40 percent increase over the past two years of children in state
custody.
"I don't think it's a cure for everybody," said Maine
Rep. Diane Russell, a Portland Democrat and a leader in the state effort
to legalize marijuana. "But why take a solution off the table when
people are telling us and physicians are telling us that it's working?"
Most states with medical marijuana
allow it for a list of qualifying conditions. Getting on that list is
crucial and has resulted in a tug of war in many states, including
several in which veterans have been unsuccessful in getting
post-traumatic stress disorder approved for marijuana treatment.
This
month, Pennsylvania became the 24th state to legalize medical
marijuana. Sen. Mike Vereb, a Republican, called on lawmakers to take on
what he called "the number-one killer in Pennsylvania" - opioid abuse.
"Opioid
abuse has no party, has no color, has no religion," Vereb said. "Let's
face it, that's the killer. What we're doing today is the healer."
"It's
hard to argue against anecdotal evidence when you are in the middle of a
crisis," said Patricia Hymanson, a York, Maine, neurologist who has
taken a leave of absence to serve in the state House. "But if you do too
many things too fast, you are sometimes left with problems on the other
end."
In New Hampshire, where drug deaths more than doubled last
year from 2011 levels, the Senate last week rejected efforts to
decriminalize marijuana.
There are some promising findings
involving rats and one 2014 JAMA study showing that states with medical
marijuana laws had nearly 25 percent fewer opioid-related overdose
deaths than those without, but even a co-author on that study said it
would be wrong to use the findings to make the case for cannabis as a
treatment option.
"We are in the midst of a serious problem.
People are dying and, as a result, we ought to use things that are
proven to be effective," said Dr. Richard Saitz, chair of the Department
of Community Health Sciences at the Boston University School of Public
Health.
Cannabis could have limited benefits as a treatment
alternative, said Harvard Medical School's Dr. Kevin Hill, who last year
authored the JAMA study that found benefits in using medical marijuana
to treat chronic pain, neuropathic pain and spasticity related to
multiple sclerosis. But he urged caution.
"If you are thinking
about using cannabis as opposed to using opioids for chronic pain, then I
do think the evidence does support it," he said. "However, I think one
place where sometimes cannabis advocates go too far is when they talk
about using cannabis to treat opioid addiction."
The findings in
the Journal of Pain study that found chronic pain sufferers reduced
their opioid use when using medical pot were limited because
participants self-reported the data.
Substance abuse experts argue
there are already approved medications. It would also be wrong to
portray marijuana as completely safe, they say, because it can also be
addictive. But supporters point to doctors like Dr. Gary Witman, of
Canna Care Docs, who has treated addicts with cannabis at his offices in
Fall River, Stoughton and Worcester, Massachusetts. Since introducing
the treatment in September, Witman said 15 patients have successfully
weaned themselves off opioids. None have relapsed.
"When I see
them in a six-month follow up, they are much more focused," Witman said.
"They have greater respect. They feel better about themselves. Most
importantly, I'm able to get them back to gainful employment."
One Thing More
Can medical cannabis help to treat painkiller or heroin addiction?
With Americans facing a growing opioid addiction
problem – either resulting from the use of opioid-based painkillers or
through addiction to drugs such as heroin, medical cannabis may be
a solution for kicking the opioid habit and ending addiction to
painkillers.
A report from Associated Press published by Sci-Tech Today,
says that evidence of cannabis being used as effective treatment for
addiction is primarily anecdotal, and that clinicians are concerned that
claims are being made before there is adequate scientific proof.
On the other hand, the story of Michelle
Ham, previously so badly addicted to opioid based painkillers that she
was unable to function properly in society, is creating a stir among
medical cannabis advocates. She claims that she was able to go ‘cold
turkey’ with the help of Cannabis. Certainly, a tantalizing claim, but
one that should be approached with caution, especially since opioid
withdrawal symptoms can be so bad that medical attention is urgently
needed.
Medical Cannabis painkiller substitute?
In Massachusetts and California, stories
regarding cannabis as a potential treatment for addiction have led
doctors to experiment with the herb, while in Maine, medical cannabis
advocates are trying to get addiction included in the list of ailments
for which medical marijuana can be prescribed.
It is certainly true that an increase in
the number of fatal opioid overdoses is causing concern, and Associated
Press reports that published research findings show a reduction in
opioid use among patients to whom cannabis has been prescribed for pain
relief. A 2014 study published by JAMA
is particularly encouraging. It found that opioid deaths were
significantly lower in states with legislation in favor of medical
marijuana. However, this is not the same as saying that cannabis can
help people to overcome addiction problems. It merely seems to indicate
that cannabis is an effective form of pain relief.
Commenting on the JAMA report, a
prominent doctor says that there is evidence to support the use of
cannabis as a treatment for chronic pain, but feels that taking this
conclusion a step further and concluding that cannabis can treat
addiction, is going too far.
Further anecdotal evidence
Not all doctors feel that using cannabis
to help wean addicts off opioids is a wild idea. Massachusetts
practitioner Dr. Gary Witman says that he has successfully helped more
than 15 patients to kick the habit using cannabis as a medication.
According to his report, there have been no relapses, an unusual state
of affairs in drug rehabilitation, especially when opioids enter the
equation.
Nevertheless, Witman’s evidence is not a
scientific trial and does not deal with sufficiently large numbers of
patients or sufficient amounts of hard evidence for any objective
conclusion to be drawn.
Legislators warn against pushing for
‘too much too soon’. So although the accounts of cannabis being used to
treat addiction may be interesting, they are at best an indication of a
possible research direction to be pursued in future. For the present,
the approach to addiction treatment remains the same as ever: consult
your doctor to discover your treatment options and make decisions based
on the information provided.
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