A trio of recent studies seem to bolster the argument that legal marijuana can help combat the opioid epidemic.
Though it might sound counterintuitive to some, researchers have turned up strong evidence that providing access to cannabis can curb opioid prescriptions and prevent overdoses. These latest studies explore the issue from different perspectives, adding to an already growing body of research that’s demonstrated how marijuana is being used as a substitute to pharmaceuticals—particularly prescription painkillers.
1. People with severe arthritis that required reconstructive joint surgery are using more cannabis and fewer opioids.
Published in the journal Orthopedic Proceedings, a new study examined toxicology tests administered to more than 520 patients in 2012 and 2017. Researchers found that the “prevalence of preoperative cannabis use increased from nine percent to 15 percent while the prevalence of opioid use decreased from 24 percent to 17 percent.” Whether the two trends are related is not entirely clear, but the correlation is there and is in line with previous studies demonstrating similar findings. Additionally, in the new study, very few patients (three percent) tested positive for both opioids and marijuana.
2. The number of opioid prescriptions, days of opioid supply and patients receiving opioid prescriptions are lower in states that have legalized marijuana for medical or adult use.
Researchers analyzed more than 1.3 billion opioid prescriptions from 2011 to 2018, looking at the data to see if a connection existed between prescribing trends and marijuana laws. The number of morphine milligram equivalents prescribed each year were reduced by 6.9 percent in fully legal states and 6.1 percent in medical cannabis states.
“In other words, cannabis access laws reduce the average provider’s opioid prescriptions by the equivalent of half a kilogram of morphine,” the researchers wrote. The research paper was accepted by the University of Alabama Legal Studies division.
3. Opioid misuse dropped from 2016 to 2017, while cannabis usage increased.
The 2017 National Survey on Drug Use and Health, which receives federal funding, included some promising data points on the prevalence of opioid misuse among Americans aged 12 and older. Specifically, 11.4 million individuals misused opioids in 2017, compared to 11.8 million in 2016. On the other hand, about 26 million Americans 12 and older consumed cannabis in 2017, compared to 24 million in 2016. The increase in cannabis use was especially pronounced among individuals 18 to 25.
The survey authors did not attempt to link the two trends, but again, other studies have demonstrated that legal marijuana access is associated with reduced opioid overdose rates.
Photo courtesy or WeedPornDaily.
Denver’s Teen Marijuana Education Campaign Seems To Be Working, Survey Finds
A year after Denver launched a marijuana-focused educational campaign targeting local youth, a new survey released Tuesday reports that the majority of teens familiar with the city’s efforts said they decided against underage cannabis consumption.
The research, conducted by Insights Lab, was commissioned to measure the effectiveness of Denver’s High Costs campaign, which was launched in 2017 and is funded by the city’s tax revenue on retail cannabis. Among the myriad ways the city is working to get teens talking about marijuana and its associated risks for underage users are social media campaigns, billboards, school bus signage, an online game show called “Weeded Out” and a Weeded Out trivia card game.
More than 500 teens who live in the city and county of Denver participated in the survey, which was available online November 21 through December 18, 2018. Sixty-four percent said they were aware of the High Costs campaign, most having seen online ads on Facebook and YouTube. A majority recognized that the campaign’s intended message was to provide facts about underage marijuana use, though 53 percent also said the program “provides biased information” to discourage use.
Many teens also said they thought High Costs was trustworthy (75 percent) and likable (73 percent), while about half indicated the tone was “preachy or judgmental.”
In terms of effectiveness, the survey found that 75 percent of the participants who were aware of High Costs said the campaign made them either not want to use, less likely to use or think twice about using marijuana.
“Teens want facts and they want to be able to make their own decisions,” Denver Mayor Michael Hancock (D), who called the city’s legal cannabis system a “success” last year, said in a statement. “When we give teens the facts and equip them with knowledge, they make smarter choices about using marijuana.”
In order to build on the first year’s success, the survey report’s authors suggest the city continue growing its online presence and consider more nontraditional marketing methods, including giveaways.
The report also points out that 18 percent of teens said they currently use marijuana. According to the survey’s findings, they appeared skeptical of the campaign and less likely to share its information with friends.
“This audience is going to be difficult to reach, as they’ve already decided to use and naturally are going to reject information that contradicts their decision,” the report states. “For now, focus on the core audience of non-users and past-users, and evaluate the opportunity to target this segment again in a year.”
Last week, Denver officials released an interactive map that tracks how the city spends cannabis tax revenue on educational efforts.
Photo by Element5 Digital on Unsplash.
Feds Ramp Up Calls For Research Into Marijuana Treatment For Chronic Pain
A federal health agency is seeking the public’s help in identifying studies that explore the potential benefits and harms of using marijuana instead of opioids for chronic pain treatment.
In three separate notices published in the Federal Register on Tuesday, the Agency for Healthcare Research and Quality (AHRQ) said it is in the process of reviewing existing research on chronic pain—specifically alternatives to opioid-based painkillers—and requested “supplemental evidence and data submissions” from the public.
The agency provided guidelines for what exactly it was interested in learning. One notice called for studies on the “comparative effectiveness” of using non-opioid therapies, “including marijuana,” instead of opioids. The studies should explore differences in “outcomes related to pain, function, and quality of life.” The filing also includes a prompt for evidence about utilizing cannabis in tandem with opioids, including how the harms of the prescription pain medications vary for patients who also use marijuana.
In another notice, AHRQ, which is part of the U.S. Department of Health and Human Services, said it wants help completing its review of non-invasive and non-pharmacologic chronic pain treatments such as exercise, mindfulness, acupuncture—and yes, medical marijuana. The request specified that the agency is interested in research on “any formulation” of cannabis.
Finally, a third notice included marijuana in a list of non-opioid pharmacologic treatment options that AHRQ is interested in exploring. The public is encouraged to submit studies and data on the risk of “overdose, misuse, dependence, withdrawals due to adverse events, and serious adverse events” for medical cannabis, as well as more conventional oral and topical treatments.
Altogether, the package of solicitations demonstrates that while marijuana remains a Schedule I drug (meaning the federal government does not recognize it as having medical value), there are federal agencies that are compelled by the prospect that cannabis effectively treats pain without the risks posed by opioids.
And there are any number of studies that AHRQ might want to take into consideration. For example, there are surveys that show patients often use marijuana as a substitute for opioid painkillers and other pharmaceuticals, as well as several comprehensive studies indicating that states with legal cannabis access experience lower opioid overdose rates and have fewer opioid prescriptions compared to non-legal states.
The deadline to submit studies and data for all of the new notices is April 18.
These are the latest in a series of notices that AHRQ and other federal agencies have published in recent months. Last year, the National Center for Complementary and Integrative Health hosted a workshop that specifically addressed barriers to cannabis research while the substance remains federally prohibited.
Photo courtesy of Philip Steffan.
Marijuana Tourism From China To Amsterdam: Study Sheds Light On Motivations
Marijuana use in China is strictly forbidden. In fact, when Canada legalized cannabis last year, the Chinese government sternly reminded its citizens living in or visiting the country to “please avoid contact or using marijuana.”
Yet, despite their nation’s strict views on marijuana, research shows that significant numbers of Chinese tourists are heading to Amsterdam to take part in its prolific cannabis culture. A new study published in the journal Current Issues in Tourism sheds light on some of the motivations for the cross-continental cannatourism.
The punishment for drug use of any kind in China, including marijuana, is up to 15 days in detention and mandatory rehabilitation, the study’s authors write. But the Chinese government has been known to enforce harsher sentences for other cannabis-related charges. For example, Jaycee Chan, the son of actor Jackie Chan, spent six months in a Beijing jail after police discovered more than 100 grams in his apartment.
Because Chinese citizens are “widely educated to stay away from any kind of drugs,” the study states, researchers were curious to know more about who these tourists heading to the Netherlands for cannabis really were. Between February 2014 and October 2016, they randomly approached Chinese tourists in or exiting Amsterdam coffee shops where marijuana is sold over the counter and invited them to complete a confidential questionnaire. A total of 654 surveys were collected and analyzed.
About 80 percent of respondents said they’d never tried marijuana prior to their trip to Amsterdam.
Participants were divided into three segments based on their responses: cannabis enthusiasts, diversionists/recreationists (people who were seeking pleasure or a diversion from their daily lives) and people who were simply curious about cannabis culture.
Survey responses from the first and third groups “demonstrate that Chinese drug tourists desire to ‘experience all’ and seek authenticity out of their normal daily life and society during the overseas travel,” the study authors wrote.
The largest number of tourists surveyed (almost 44 percent) fell into the category of diversionist/recreationist. In other words, they used cannabis as a way to enjoy their vacation—not unlike tourists from other countries.
“They travelled and consumed cannabis mostly for the sake of experiencing/experimenting with the local cannabis culture in Amsterdam as well as relaxation, pleasure, and to escape from stressful social environments,” the authors write.
Cannabis enthusiasts were the smallest segment of the sample. In terms of demographics, almost half of the survey respondents were women. Overall, a majority of participants reported being college-educated, under 35 years old and not married.
In a recent interview, lead study author Jun Wen discussed why Chinese tourists are especially attracted to the Netherlands.
“You can do a lot of things there that are illegal in China – gambling, paying for sexual services, and buying cannabis for recreational use,” he said. “So Chinese tourists want to go there to find a different way to relax that’s not traditional.”