Is Marijuana the Answer to the Opioid Epidemic?

Researchers say cannabinoids will be used instead of opioids to treat chronic pain someday. However, we aren’t there yet.


Can marijuana save the day?

Not yet.

But Americans in pain are already turning to the marijuana plant.

The hope: One day you’ll have a choice of varieties or formulations of compounds in marijuana — called “cannabinoids” — that bring relief, aren’t addictive, and leave your mind clear.

“Cannabinoids will replace opioids for chronic pain in 5 to 10 years,” said Dr. George Anastassov, chief executive officer of AXIM Biotec, which is developing several products.

The problem

Millions of people — including more than 40 percent of older Americans — live with back issues, headaches, arthritic joints, and other forms of chronic pain, defined as pain lasting at least three months.

If the pain is severe, critics say it’s too easy to get a prescription for Vicodin, Percocet, OxyContin, and other opioids.

Most people use their medication safely.

Among heroin users, 80 percent first took prescription drugs. And they may be involved in nearly 40 percent of fatal overdoses.

Even if you trust yourself, there are other reasons to avoid opioids. Among them is the possibility that your teen may raid the medicine cabinet looking for a party drug.

Or your prescription may never have been the right treatment.

In 2016, the Centers for Disease Control issued a guideline for primary care doctors, stating there was “insufficient evidence” to back the usefulness of opioids long-term for chronic pain.

The American Academy of Pain Medicine responded that opioids are “an important option” for those with chronic pain.

Using marijuana to treat pain

Marijuana may already be saving lives.

study published in April concluded that new medical marijuana laws reduced hospitalizations for opioid problems in those states by 23 percent. Hospitalizations for overdoses also dropped 13 percent.

The future of cannabis

The marijuana plant comes in many strains and contains hundreds of molecules.

The terms you hear most often are “THC” (tetrahydrocannabinol) and “CBD” (cannabidiol), which doesn’t make you “high.”

THC is most prized in the recreational versions. It also contributes to pain relief.

Any one cannabis plant affects people in many ways, tapping into the “endocannabinoid system,” receptors throughout the body.

“Your body makes its own marijuana-like chemicals similar to endorphins,” Lynch said. Those chemicals are involved in pain and inflammation as well as other functions.

Marijuana helps relieve a number of hard-to-treat conditions: migraine; irritable bowel syndrome, which causes abdominal cramps; and fibromyalgia, muscle pain throughout the body.

Dr. Daniel Clauw, a chronic pain specialist at the University of Michigan who works with fibromyalgia patients, agrees that cannabinoids are promising.

What works

Clauw and Lynch turn to other medications, such as amitriptyline, duloxetine (Cymbalta), and pregabalin (Lyrica).

Clauw suggests patients with widespread muscle pain speak to their doctors about cyclobenzaprine (Flexeril).

Marijuana, he says, would be next best, followed by opioids.

If you’ve had more than one pain problem in your life, he observes, you may have been physically active earlier and cut way back to avoid pain.

Find ways to safely move again. Aerobic exercise is a potent pain reliever.

Therapy can help to change your thinking when you feel pain, moving away from fear and toward acceptance.

Says Hiller, “There’s a clear need for new therapeutic strategies to safely manage acute and chronic pain.”

But cannabis-related treatment will go beyond pain, he adds: “The 4,500-plus years of reported therapeutic use of cannabis is merely the opening chapter to something much more significant.”