Many patients in the U.S. today have the opportunity to choose between treating their ailments with medical marijuana or prescription medications.
Despite marijuana remaining federally prohibited, a growing body of evidence suggests that more patients in the United States are now opting for medical marijuana as an alternative to traditional prescription medications. Since 1996, more than half of U.S. states have passed laws permitting the use of marijuana for medical purposes, giving patients and physicians more options when determining the ideal course of treatment.
Here we compare the differences between medical cannabis and prescription drugs, including investigating their respective benefits and drawbacks, how they interact with the body’s systems to elicit their effects, and the laws regulating access to each.
What is Medical Marijuana? What are Prescription Meds?
Medical marijuana refers to the use of cannabis to treat symptoms or a disease or condition. Cannabis plants contain cannabinoids, natural compounds that interact with our natural systems. In states where medical marijuana is legal, patients who have obtained a recommendation from a licensed physician can purchase cannabis products from a dispensary. Medical marijuana products are available in a variety of forms. The most commonly used product is smokable marijuana flowering buds, but cannabis pills, liquid extracts, edibles, patches, and topical creams are also commonly used for treatment purposes.
A prescription medication is a pharmaceutical drug intended for use in the cure, mitigation, treatment, prevention, or diagnosis of disease. Prescription drugs can come in the form of pills, creams, patches, and injections. They are federally legal, provided a patient has obtained a medical prescription from a licensed physician. With a prescription, the drugs can be purchased from a pharmacy.
Benefits of Medical Marijuana Vs. Prescription Medications
There are a large number of different prescription drugs on the market that are used for a wide variety of symptoms and conditions. According to WebMD, the medication most commonly prescribed in the U.S. is hydrocodone, an opioid used to treat severe and chronic pain. Doctors wrote 289 million prescriptions for opioids in 2012. The other more commonly prescribed drugs, as reported by WebMD, are designed to treat high cholesterol, high blood pressure, and hypothyroidism.
For both medical marijuana and prescription medications, a single condition dominates their treatment applications – pain.
How Medical Marijuana Works Vs. How Prescription Medications Work
Medical marijuana contains more than 100 cannabinoids, which are chemical compounds that once absorbed interact with the body’s native endocannabinoid system. The endocannabinoid system is responsible for regulating a wide array of the body’s functions, such as mood, appetite, pain response, immune response, and sleep. Cannabis-derived cannabinoids, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), mimic the chemical makeup and behavior of endocannabinoids, and as such are able to interact with cannabinoid receptors found throughout the body’s brain, central nervous system, peripheral nervous system, and immune system. By interacting with the endocannabinoid system’s receptors, the cannabinoids regulate the release of neurotransmitter to manage pain levels.
The various types of prescription medications vary in how they interact with the body. The most commonly prescribed medication — opioids — are a class or narcotic drugs that act on opioid receptors in the brain to stimulate feelings of pleasure and euphoria. The opioid system is part of the brain that controls feelings of pain, pleasure, and reward. Opioid drugs share a similar chemical structure to the brain’s natural transmitters, and the powerful drugs activate opioid receptors in the brain to effectively reduce pain.
Dangers of Medical Marijuana Vs. Dangers of Prescription Medications
While effective for pain relief, prescription opioids unfortunately also carry a high risk of addiction and can lead to a fatal overdose. Nearly 100 Americans die every day from an opioid-related overdose. Over time, opioids adjust the way the brain’s nerve cells function and patients must consume a greater amount to experience the same pain relief. Eventually, the brain can associate opioids with pleasure, making patients unable to experience pain-relief at all without the drugs, triggering addiction. Because opioid receptors are found in the brainstem, which control the body’s automatic systems like breathing, opioids can depress a person’s breathing and lead to a fatal overdose. Despite its dangers, opioids are still commonly prescribed for pain management. In 2015, more than 33,000 Americans died as a result of an opioid overdose and nearly half of those involved an opioid that was prescribed by a doctor. In 2016, abuse of prescription opioids took the lives of 17,536 people in the U.S., up 4 percent from the year prior.
Short term side effects of opioid use include nausea and vomiting, sedation, constipation, dizziness, and respiratory depression. When used long-term, opioids can cause brain damage, muscle rigidity, involuntary muscle contractions, and liver damage.
Medical cannabis has never been responsible for causing a fatal overdose. There are no cannabinoid receptors found in the brainstem, which means that no matter how much is consumed, there’s no way that they cause a stoppage in breathing. Cannabis products containing significant levels of THC can temporarily alter senses and impair body movement, problem solving, and cognitive function, which means patients should avoid driving or operating heavy machinery for a time after consumption
Leslie Iverson, PhD, Professor in the Department of Pharmacology at the University of Oxford, has been quoted as saying, “Cannabis is a safer drug than aspirin and can be used long-term without serious effects.”
Potential Benefits of Medical Marijuana Replacing Prescription Medications?
Proponents of medical marijuana argue that cannabis can serve as a safer alternative to prescription drugs. Opioid-related hospitalizations have shown to drop significantly in states after the passing of medical marijuana laws. New research published earlier this month revealed that marijuana legalization in Colorado has reduced opioid-related overdose deaths by 6.5 percent. Pain patients who incorporate medical marijuana into their treatment regimen have shown to be able to reduce their prescription drug intake. Given the choice between medical marijuana and opioid drugs, many patients appear to prefer the former.
Opponents of medical marijuana replacing prescription medications argue that cannabis lacks FDA-approval and that the already-available and legal prescription drugs make marijuana unnecessary. Many claim that marijuana is addictive and can lead to more dangerous drug use, although data indicates otherwise.
Laws Around Medical Marijuana Vs. Laws Around Prescription Medications
Since the late 1990s, opioid prescription drugs have been widely accepted by the medical community and distributed to patients legally. Pharmaceutical companies at that time reassured doctors that opioids were a safe and non-addictive pain-relieving option for patients, and subsequently the sales of prescription opioid drugs in the United States nearly quadrupled between 1999 and 2014. In the U.S., the Federal Food, Drug, and Cosmetic Act defines the drugs that require a prescription. The federal government authorizes physicians, dentists, physician assistants, nurse practitioners, optometrists, and other advanced practice nurses to prescribe medications.
Medical marijuana, on the other hand, has faced decades of prohibition because of the stigma associated with cannabis use. Marijuana remains prohibited on the federal level, although 29 U.S. states and Washington D.C. have passed laws allowing marijuana use when recommended by a doctor. Attitudes toward cannabis have shifted significantly in recent years, however, and today 94 percent of American voters support the use of marijuana for medical purposes.
The severity of the opioid epidemic in the U.S. is daunting, although marijuana could play a role in the solution to the health crisis. We invite you to learn more about the potential therapeutic applications of marijuana by visiting our research and education page.