Opioid abuse (opium derivatives such as heroin, synthetic opioids like fentanyl and some painkillers such as oxycodone, hydrocodone, codeine, and morphine) in the U.S. is a public health issue now, a national emergency health authorities are trying to tackle as best they can. And it's no surprise. Almost 2.5 million U.S. citizens are currently fighting opioid addiction and over 150 overdose deaths are registered every day, claiming more lives than traffic accidents or weapons.
Opioids are great for pain relief. That's why, during these last 20 years, they've been the favorite pick for doctors treating patients in pain, no matter how serious their pain was. What big laboratories didn't say, though, was how addictive these substances were.
So, in 2000, opioids were the only viable option for relieving pain. At that moment, painkillers such as Vicodin, OxyContin, Percocet… started to appear on the market, followed by fentanyl, a synthetic opioid 50 times more addictive than heroin. And their use grew disproportionately: in just 10 years: opioid prescriptions went from 35,000 to 14 million. According to the National Institute on Drug Abuse (NIDA), between 8% and 12% of people prescribed opioids grow addicted to them, while 80% of heroin users have at one point received an opioid prescription.
A brisk walk through Philly's history
One of the places where this national emergency is at its peak is Pennsylvania. One of the highest rates of overdose deaths in the country is right here, with 44 people out of 100,000 dying from opioid abuse in 2017 and beyond, slightly behind West Virginia and Ohio. Surprising as it may seem, this is 4 times the road death rate.
February 15, 2018, was a historic day in Pennsylvania. Less than 2 years after the governor signed Act 16 into law, dispensaries started selling medical weed. This medical marijuana market was expected to turn into one of the largest in the country. However, they didn't come up with the only real solution to the countless opioid deaths: the legalization of medical marijuana as a substitute for opioids.
It wasn't until after a month, though, on May 12, 2018, that the Pennsylvania Department of Health published revised temporary regulations that brought substantial improvements to the existing medical marijuana program, one of the most significant of all being the increase in the number of diseases to be treated with weed and the possibility of using only cannabis in the event that other treatments failed to help opioid addicts or if prescribed by a doctor as complementary to traditional therapies.
Why is marijuana more effective for pain relief?
A recent study published by a group of researchers in The Journal of Headache and Pain revealed that over 2/3 of the patients with chronic pain who were legally allowed to access cannabis-based medical products had stopped opioid use to start using these alternative methods. The reason is simple: they offer better results.
The findings, which were recently published at the journal of the American Medical Association, confirm what previous investigations had already revealed: hospitalization rates for opioids had reduced 23% and opioid overdoses had decreased as much as 25% in regions with medical marijuana programs.
Free access to marijuana results in fewer opioid prescriptions, and so in more chances to survive. No other measure or policy or medical prescription or therapy has had as big an impact as cannabis in the use of opioids.
Why does this happen?
For starters, both cannabis and opioids have a similar effect on our bodies when it comes to alleviating pain. The compounds of cannabis, though, have anti-inflammatory properties while opioids don't, and inflammation is commonly associated with pain. Opioids can effectively relieve pain, but cannabis improves our bodies' ability to cope with such pain, teaching us to live with it.
However, the greatest differences are others. In the first place, marijuana is far less addictive than opioids, and its side effects can be easily managed. Only this would make cannabis far more advisable and safe for long-term use, a regular occurrence in patients with chronic pain. But there's more. A lethal cannabis overdose is never going to happen, which is not the case for the opioids.
Is recreational weed the solution?
On July 19, 2018, Auditor General Eugene DePasquale released a paper claiming that the state could reap $581 million every year by taxing and regulating cannabis for those over 21.
Some politicians could think Pennsylvania has still a long way to go when it comes to medical marijuana before even thinking of legalizing recreational weed but dealing with medical and recreational marijuana simultaneously would actually allow for a better harmonization of both systems in such a way that not only patients but also the most disadvantaged communities could benefit from it.
Legalization critics often claim that, although legal weed could, in fact, lead to a reduction in the cases of overdose, many more health problems would arise. However, the Drug Policy Alliance has confirmed that all these horrible predictions haven't materialized in the states where cannabis is now legal.
A major health benefit of legalization would be the one associated with the decline in cannabis arrests. Arrests and convictions, even for minor offenses, often lead to dramatic consequences that could last forever and badly affect health: imprisonment, no housing or employment rights, family separation, poor medical attention, and much more.
In Pennsylvania, the war on drugs has mostly affected communities of color, with excessive policing and criminalization in their areas. The legalization of weed would mean that thousands of people every year, primarily young black people, would no longer die for having decided to consume marijuana. The legalization would also allow Pennsylvania to invest every penny generated by cannabis taxation in health, with a greater volume of money destined to the communities worst-affected by prohibition.
The outright legalization of pot may not be the solution to the overdose crisis, but it's a common sense policy that would acknowledge the close relationship between public health, safety, and the criminal justice system. In view of the proven efficacy of this plant, it's definitely time for action.