With more than 90 Americans dying every day after overdosing on opioids, the United States is faced with one of its most serious public health issues in history. Drug overdose deaths are the leading cause of injury and death in the U.S.
While the magnitude of the health crisis facing Americans can seem daunting, research suggests that cannabis shows real promise as a viable solution. Here we take a look at the true severity of the opioid health crisis that has overtaken the U.S., and how medical cannabis stacks up versus prescription drugs.
What are Opioids?
Opioids are a class of narcotic drugs that act on the nervous system to produce powerful morphine-like effects. Commonly recommended by doctors for pain relief, opioids interact with opioid receptors on nerve cells in the brain, spinal cord, and other areas of the body to reduce the sending of pain messages to the brain.
Some of the most common pain-relieving opioid medications, which can only be legally obtained with a prescription from a doctor, include the following:
Most prescription opioids can be taken by mouth, although fentanyl is also available in a patch. Opioids also include the illegal drug heroin.
The Magnitude of the U.S. Opioid Epidemic
The level of tragedy the current opioid crisis has inflicted on the United States cannot be understated. The problem is so significant, an economics correspondent recently noted, that the crisis has had a noticeable effect on the nation’s’ labor force.
In 2015, more than 33,000 Americans died as a result of an opioid overdose. Nearly half of those deaths involved a prescription opioid.
A preliminary report recently published by the White House Commission on Combating Drug Addiction and the Opioid Crisis urged the Trump administration to declare the nation’s opioid epidemic a national emergency, citing the harrowing statistic that “America is enduring a death toll equal to September 11th every three weeks.”
Opioid overdose rates have increased since the late 1990s, according to the National Institute on Drug Abuse, after the medical community began to prescribe the prescription opioid pain relievers at higher rates. Pharmaceutical companies had assured the medical community that the drugs could be consumed safely and without any serious risk of addiction. According to the Centers for Disease Control and Prevention, the sales of prescription opioids in the U.S. nearly quadrupled from 1999 to 2014.
It soon became clear that these medications did indeed carry an unsafe addiction risk. Drug overdose deaths have tripled since 2000, and opioid abuse kills nearly a hundred Americans every single day.
Why Opioids are Dangerous
The overdose risk associated with opioids has to do with a combination of their addictive properties and how they interact with receptors in the brain.
The opioid system is the part of the brain that controls feelings of pain, pleasure, and reward. It is also tasked with regulating addictive behaviors. During pleasurable activities, such as eating, sleeping, exercising, and sexual activity, neurons in the brain release a family of endogenous peptides, which activate opioid receptors in the brain and trigger the reward system. Opioid drugs, which share a similar chemical structure to the brain’s natural transmitters, act on those same receptors in the same way to create feelings of euphoria. Eventually, the brain associates opiates with pleasure and addiction develops.
When taken over time, opioids change the way the brain’s nerve cells function. A patient must consume more opioids to experience the same pleasurable feelings. Eventually, that person is unable to experience pleasure at all without the drug. Roughly 21 to 29 percent of patients who are prescribed opioids for chronic pain eventually misuse them. Even when a patient’s prescription for opioids ends, their risk for addiction continues, as about 80 percent of people who turn to illegal heroin first misused prescription opioids.
Opioid receptors are found throughout many areas of the brain, including the brainstem, which among its responsibilities is controlling the body’s automatic systems, such as breathing. Opioids acting on receptors in the brainstem can depress a person’s breathing and cause sedation, creating a perfect storm that can lead to a fatal overdose.
An opioid overdose can be reversed with the drug naloxone, but it must be given almost immediately.
Cannabis’s Potential as a Safer Alternative
A mounting body of evidence indicates that cannabis could play a significant role in solving the nation’s opioid epidemic by serving as a safer alternative for pain management.
First, studies indicate that cannabis is a powerful pain-relieving agent in its own right. A recent comprehensive research review by the National Academies of Sciences, Engineering and Medicine, in which 10,000 studies were examined, concluded that there is “conclusive or substantial evidence” that cannabis or cannabinoids are effective for the treatment of chronic pain. In a recent study, 92 percent of pain patients said they preferred cannabis to opioids.
A Much Safer Alternative
Second, according to the Drug Enforcement Agency, cannabis has never been responsible for a fatal overdose. While cannabinoids found in cannabis interact with cannabinoid receptors found on cells in the central nervous system, there are no cannabinoid receptors in the brainstem. This means that cannabinoids, no matter the level consumed, do not have the capability to shut down the body’s breathing and circulatory system. Two-thirds of Americans consider cannabis to be safer than opioids for pain relief.
There’s already evidence indicating that cannabis works as a safer alternative to opioid prescriptions. Opioid-related hospitalizations were found to drop significantly in states after the passing of medical marijuana laws.
Research suggests that marijuana can reduce the intake of opioids by not only reducing pain, but also by simultaneously treating addiction by reducing cravings. Cannabidiol (CBD), the major non-psychoactive cannabinoid, has also shown to effectively reduce cravings and withdrawal symptoms in those addicted to opioids. Recently, the National Institutes of Health awarded a grant to researchers to further investigate medical marijuana’s effect on opioid consumption.
Laws Regulating Medical Cannabis Vs Prescription Drugs
Despite findings suggesting that cannabis is safer than opioids, the laws regulating their access place more stringent restrictions on cannabis.
Opioids are not legal for over the counter purchase, but they can be obtained legally with a prescription in pharmacies located throughout all 50 states in the U.S.
Cannabis remains classified as a controlled substance and therefore illegal under federal law. However, 29 states and Washington D.C. have passed their own laws legalizing the purchase and possession of medical marijuana, provided patients have obtained a written recommendation by a licensed physician and registered with the state.