Doctors testifying about the opioid epidemic on Capitol Hill on Tuesday made clear that marijuana has medical potential as an alternative pain treatment option and that federal prohibition is inhibiting cannabis research.
The Senate Health, Education, Labor and Pensions Committee held a hearing to discuss how to manage the nation’s opioid crisis, and medical marijuana was a point of particular interest raised by several lawmakers.
Sen. Lamar Alexander (R-TN), who chairs the panel, asked Dr. Andrew Coop of the Maryland School of Pharmacy what he considered “the most promising, non-addictive painkiller treatments or medicines that are coming down the road.”
“The drugs that are coming—I mentioned cannabinoids,” Coop said. “I know that’s a controversial topic, but this is great—”
The senator cut in to ask why it was controversial and Coop said it was because cannabis remains federally illegal. He clarified for Alexander that he was referring to “medical marijuana” when he brought up cannabinoids.
“Medical marijuana, yes,” Coop said. “I think that has great potential.”
Sen. Mitt Romney (R-UT) later said that while he didn’t have time during his allotted five minutes to ask about marijuana, he wanted Coop to “instruct us as to the path forward on cannabis research.”
The next senator to bring up cannabis was Sen. Jacky Rosen (D-NV). She said her state’s medical marijuana program “has reduced the prescriptions for high-potency painkillers” and asked Coop whether cannabis could serve as “a non-addictive approach or alternative to chronic pain—just another tool in the toolbox.”
“I, first of all, think it has great potential to be another tool in the toolbox,” he said. However, “I don’t think there’s ever going to be a one-size-fits-all magic bullet because pain is different in different people.”
“In terms of how to move the research forward in medical marijuana, one of the issues has been because of the usual legal status in the United States, research has been limited,” he said. “There’s no consistency between the different types of marijuana, the studies done. We need good, consistent, well-designed clinical studies with good, consistent material so that we can fully assess the impact, and don’t get me wrong, also the potential drawbacks.”
David Mangone, director of government affairs for the advocacy group Americans for Safe Access, said in a press release that it was “great to see witnesses and senators alike discuss the potential of medical cannabis as a tool in combating the opioid crisis,” but that “we need real action from from our lawmakers to change federal laws.”
Sen. Doug Jones (D-AL) was the last to raise marijuana at the hearing. He emphasized that while lawmakers sometimes approach their questioning in hearings with an agenda in mind, “this is not one of those” situations. He wanted to hear from the three other witnesses who hadn’t testified on the topic.
Cindy Steinberg, national director of policy and advocate at the U.S. Pain Foundation, said “cannabis has helped a number of people living with pain” and that it’s “another option” in the toolbox for pain patients. She stressed that marijuana’s legal status make it hard to standardize cannabis treatment.
“Doctors need to be the one prescribing it, but they don’t know what they’re doing with it,” she said. “They’re not trained with it either. Without having a really good research base, we’re just flying blind.”
So what’s preventing that research, Jones asked?
“The fact that it’s not legal,” Steinberg said.
While Mayo Clinic physician Halena Gazelka said she wasn’t convinced that cannabis isn’t addictive, she agreed that “the impediment has been that it’s a Schedule I substance and it’s not permissibly prescribed by providers.”
“But I do think that there may be some significant areas where this may be very useful,” she said. “I have some palliative medicine patients using it for nausea, appetite, pain, and I think it can be helpful.”
Finally, Anuradha Rao-Patel, a physician representing the health insurance company Blue Cross Blue Shield of North Carolina, said “the limitations such as the fact that it is illegal in some states as well as on a federal level makes research [on marijuana] difficult.”
“From a physician’s standpoint, I think there is some potential to the utility of medical marijuana for the treatment of chronic pain,” she said. “I’ll say, putting on my other hat as an insurer, that we obviously only cover procedures and drugs that are [Food and Drug Administration]-approved, so we would obviously need some clinical evidence and support to be able to cover these kinds of medications.”
Don Murphy, director of federal policies at the Marijuana Policy Project, told Marijuana Moment that the “questions from senators proved there is a need for a hearing devoted exclusively to cannabis as an alternative to opioids.”
“Of course, such a hearing may expose a truth some of them don’t want to hear,” he said.
Photo courtesy of Philip Steffan.