Last updated on: 2/25/2019 2:42:31 PM PST

Is Marijuana an Effective Alternative to Opioid Treatment?




PRO (yes)

Ashley C. Bradford, Master of Public Administration student at the University of Georgia, and W. David Bradford, PhD, George D. Busbee Chair in Public Policy in the Department of Public Administration and Policy at the University of Georgia, wrote in their Aug. 1, 2017 article titled "Why Jeff Sessions Is Going to Lose His War against Cannabis," available at washingtonpost.com:

"[T]he medical community has largely resolved the question of whether cannabis is clinically useful... Cannabis may prove to be a pain management strategy that could substitute for opioids for many desperate patients, and the National Institute on Drug Abuse (NIDA) acknowledges that cannabis may be an effective tool to combat the opioid crisis. Researchers studying the relationship between medical cannabis laws and opioid use have found that states with such laws have nearly a 25 percent reduction in opioid-related deaths. The contrast between opioids — which killed more than 33,000 Americans in 2015 — and cannabis could not be more striking."

Aug. 1, 2017 - W. David Bradford, PhD 
Ashley C. Bradford 



Frank D'Ambrosio, MD, an orthopedic surgeon and medical marijuana advocate, wrote in his Jan. 25, 2019 article titled "Why I Recommend Medicinal Cannabis as a Replacement Analgesic for Opioids," available at blogs.bmj.com:

"I am an orthopaedic spine surgeon... In the United States in 2017, 70,237 patients died from opioid overdoses. Five years ago, I decided that I would not contribute more patients to these devastating numbers. I stopped prescribing opioids and instead gave all of my patients recommendation letters to obtain medicinal cannabis in the State of California...

The legalisation of cannabis and its acceptance as a medical alternative to opioids is at times a polarizing subject, but it does not need to be. The research exists, and my clinical practice confirms that thousands of deaths from opioid overdoses could be avoided."

Jan. 25, 2019 - Frank D'Ambrosio, MD 



Amanda Reiman, PhD, former Manager of Marijuana Law and Policy for the Drug Policy Alliance, et al., reported in their June 2017 study titled "Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report," published in Cannabis and Cannabinoid Research journal:

"Prescription drug overdoses are the leading cause of accidental death in the United States. Alternatives to opioids for the treatment of pain are necessary to address this issue. Cannabis can be an effective treatment for pain, greatly reduces the chance of dependence, and eliminates the risk of fatal overdose compared to opioid-based medications. Medical cannabis patients report that cannabis is just as effective, if not more, than opioid-based medications for pain...

Respondents overwhelmingly reported that cannabis provided relief on par with their other medications, but without the unwanted side effects. Ninety-seven percent of the sample 'strongly agreed/agreed' that they are able to decrease the amount of opiates they consume when they also use cannabis, and 81% 'strongly agreed/agreed'that taking cannabis by itself was more effective at treating their condition than taking cannabis with opioids."

June 2017 - Amanda Reiman, PhD 



CON (no)

Keith Humphreys, PhD, Esther Ting Memorial Professor at the Stanford University School of Medicine, and Richard Saitz, MD, MPH, Professor of Community Health Sciences at Boston University School of Public Health, stated the following in their Feb. 1, 2019 viewpoint article titled "Should Physicians Recommend Replacing Opioids with Cannabis?," available at jamanetwork.com:

"Recent state regulations (eg, in New York, Illinois) allow medical cannabis as a substitute for opioids for chronic pain and for addiction. Yet... substituting cannabis for opioid addiction treatments is potentially harmful. Neither recommendation meets the standards of rigor desirable for medical treatment decisions...

To date, no prospective evidence, either from clinical trials or observational studies, has demonstrated any benefit of treating patients who have opioid addiction with cannabis...

Without convincing evidence of efficacy of cannabis for this indication, it would be irresponsible for medicine to exacerbate this problem by encouraging patients with opioid addiction to stop taking these medications and to rely instead on unproven cannabis treatment."

Feb. 1, 2019 - Richard Saitz, MD, MPH 
Keith Humphreys, PhD 



Kenneth Finn, MD, President and Founder of Springs Rehabilitation, P.C., explained in his May/June 2018 article titled "Why Marijuana Will Not Fix the Opioid Epidemic," published in Missouri Medicine:

"There is currently a large and growing body of evidence showing that cannabis use increases, rather than decreases non-medical prescription opioid use and opioid use disorder...

Inhaled cannabis in patients with chronic low back pain does not reduce overall opioid use, and those patients are more likely to meet the criteria for substance abuse disorders, and are more likely to be non-adherent with their prescription opioids...

There is sufficient and expanding evidence demonstrating that medical marijuana use will not curb the opioid epidemic. There is further evidence that marijuana is a companion drug rather than substitution drug and that marijuana use may be contributing to the opioid epidemic rather than improving it."

May/June 2018 - Kenneth Finn, MD 



Joseph Garbely, DO, Medical Director at Caron Treatment Centers, wrote in an Apr. 20, 2018 press release titled "Marijuana Is Not a Band-Aid for the Opioid Crisis, Warns Caron Treatment Centers," available at marketwatch.com:

"We should be focusing on proven addiction treatment methods that we know work and have been studied extensively, not bringing in another substance that has known and documented addictive qualities and little to no research on its use and efficacy as a medical treatment.

There are no adequate studies showing marijuana is effective for general medical use, let alone to treat opioid addiction—a chronic and fatal disease that requires tested and proven lifesaving treatment. While some studies have been conducted on the use of marijuana for certain conditions, it hasn't undergone anything close to the rigorous screening needed for FDA approval. In fact, as a whole, it appears that the medical marijuana industry has side-stepped FDA clearance."

Apr. 20, 2018 - Joseph Garbely, DO