Opioids versus Medical Marijuana: Arkansas Starts the National Debate

As the September 18 deadline for weed-cultivating greenhouses and retail stores inched ever closer in Arkansas, anecdotal accounts of legalized marijuana reducing rates of opioid use, abuse, and fatalities became a key talking point. Republican Doug House, from North Little Rock, told the Arkansas Association of Counties that opioid drug overdoses were declining in states with legal marijuana laws.

House told the AAC in early August that pot legalization is causing opioid fatalities to drop by as much as 40 percent, but confessed that these figures are hearsay. House, chief architect of the state’s weed legislation and opponent of the 2016 ballot question that legalized it, said, “There are facts and figures out there, but there is not a real comprehensive study out there.”

Pharmacist and Republican from Fort Smith, Justin Boyd, recently admitted that his opinions on medical marijuana are changing slightly. Like House, Boyd also did not favor legalization initially, but his research into other markets has made him hopeful. He pointed to a study published in the Journal of the American Medical Association in 2014 that shows lower rates of opioid fatalities in legal states.

Earlier this summer, at a function of the Fort Smith Police Department, Boyd said, “There is data that suggests that in Colorado opioids are abused less, and part of the reason is because marijuana is readily available. In other places where medical marijuana is available, opioid use tends to be lower. I do not know that we have causation, but to me that is one of the potential bright spots.”

Scientists Formally Studying the Issue

Back in August, the National Institutes of Health awarded a five-year, $3.8 million grant to researchers at the Albert Einstein College of Medicine and Montefiore Health System, noting a lack of comprehensive, in-depth analysis on the debate. The grant will finance the first formal, long-term study testing if medical cannabis lowers opioid use among chronic pain sufferers, including those with HIV.

Chronic pain is a major symptom of many, many ailments afflicting Americans today. According to the NIH, millions are in extreme pain because of their afflictions. Most swallow prescription opioids to relieve their symptoms, including oxycodone. However, the escalating dangers of using and misusing opioids have both doctors and patients looking for safer, more effective pain management alternatives.

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

Over the last few years, more than half of the United States made marijuana use legal in some form or other. It is legal in 29 states, including the District of Columbia, and in most of them, HIV/AIDS and chronic pain are qualifying medical conditions for cannabis use. Well over a dozen conditions qualify for marijuana use in Arkansas.

Under the Arkansas Medical Marijuana Act of 2017, anyone with Lou Gehrig’s disease, cancer, glaucoma, HIV/AIDS, Crohn’s disease, hepatitis C, ulcerative colitis, severe arthritis, post-traumatic stress disorder, Alzheimer’s, and other painful conditions automatically qualify to use medical cannabis to treat their illnesses and symptoms.

According to NIH officials, scientists have never researched, in any population, if using medical cannabis over time decreases use of and dependence on opioids. Furthermore, no studies exist showing how marijuana’s chemical compounds, such as cannabidiol and tetrahydrocannabinol, affect human health, function and life quality.

Furthermore, the federal research group says that the majority of studies reporting negative effects of long-term weed use have based their findings on illicit marijuana data, not on medical cannabis. Dr. Cunningham said, “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 health care practices and public policies.”

Advantages and Disadvantages

In an interview with Talk Business & Politics, chairperson of the still-new Arkansas Medical Marijuana Association, Dr. Regina Thurman, said that the healthcare and pharmaceutical communities are still wary about the medicinal value of marijuana and other derivatives of it. Thurman, who is also medical director at Optimal Pain and Wellness in Fayetteville, said:

“No one knows because it has not been tried here in Arkansas. We can only look at the states that have actually approved it. Being a pain clinic, we are going to have to figure out how to implement medical marijuana here.” Her clinic treats patients with severe pain, as well as those suffering from many of the qualifying conditions recognized by the Health Department.

Thurman said that discussions are already underway about how to administer medical cannabis safely to patients in Northwest Arkansas, “We have talked since the November ballot issue, and we are still trying to figure it correctly so that our patients will benefit from this, we will not have any problematic issues, and that everyone is safe. That is still the big thing.”

The doctor from Fayetteville has also seen both the positive and the negative sides of escalating opioid use rates in her state. Her clinic was among the very first to sign up for participation in the Electronic Prescription Monitoring Program, an online database governed by the state that now makes it mandatory to track prescribing and dispensing of scheduled prescriptions to patients in Arkansas.

Thurman said in a statement, “We definitely use that in our clinic on a daily basis, and the hope is that all physicians will begin to use this and we can then decrease the rate of patient ‘doctor-hopping’ trying to get opioids.” However, a medical addiction specialist based in New Jersey remains unconvinced that medical marijuana could even treat chronic pain.

Dr. Indra Cidambi is against medical cannabis expanding across the United States. He believes it will normalize pot as a popular recreational drug for teenagers, and that legalization will increase their exposure to it during crucial stages of development. Cidambi said in a statement, “We will be sending a mixed message legalizing previously illegal drugs while we are in the middle of an opioid epidemic.”

Cidambiwent on to explain, “I can tell you from my experience of having treated more than 2,000 patients and a decade of experience in medicine, the first drug that people use is marijuana, and then they use other illegal drugs, like opioids and cocaine.” The addiction expert is also founder and medical director for the Center for Network Therapy in Middlesex, New Jersey.

Likening the spread of medical and recreational marijuana across the country to the national growth of nicotine and alcohol, Cidambi also said that 30 percent of cannabis users might have some degree of dependency on weed. She said that nearly 1 in 10 people using pot would develop a marijuana use disorder.

Treating Illness Illegally

Corey Hunt, co-founder of Illegally Healed, an online community driven by social media, uses his Instagram, Facebook, Twitter, and YouTube platforms to promote testimonials and other important information on the medical uses of cannabis. With a team of business and medical experts, Hunt is applying for a medical marijuana license to open a dispensary in Mulberry, under a firm named Natural State Healthcare.

After breast cancer stole his mother five years ago, Hunt left PhoneDoctors, his family’s technology company in Tulsa, Oklahoma, to work on Illegally Healed full-time. Before this, he was very skeptical of medical marijuana. However, he started to research cures for cancer and kept finding overwhelming evidence of patients crediting cannabis for their treatment.

“I came across marijuana and cannabis over and over in people who were using it as a treatment to mitigate the side effects of therapy,” Hunt explained. “I first thought people were using this to get high, and as a party drug, but I started researching this and started meeting patients who were using it not only for cancer, but for kids who were having hundreds of seizures a week.”

“They started marijuana oil and they stopped having them,” Hunt exclaimed. Illegal Healed currently has the biggest community of medical marijuana patients on Facebook. Nearly seven million people wait in anticipation every week for his educational and sometimes promotional content on medical marijuana. As the statistics prove, more and more people are replacing opioids with weed as a treatment for pain.

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