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Medical marijuana laws can seem like bullshit. In states like California, Colorado, and Oregon, getting a medical marijuana card is so easy that the law feels a lot like the full legalization of recreational use. Just about anyone can go to Venice Beach in Los Angeles, pay around $40 for a card, and legally buy and smoke a joint within five minutes.
But although medical marijuana laws are often a back door to legalization and abused for recreational use, a growing body of research shows pot may serve a big public health purpose.
Last month, a review of the research found good evidence to support pot's use for chronic pain. Prior to that, a study indicated that medical marijuana could lead to fewer prescription painkiller overdose deaths. And now, a new study went further: States with laws that allow medical marijuana dispensaries have seen a relative reduction in opioid overdose deaths and addiction treatment admissions.
All of this research suggests marijuana could help solve one of the trickiest problems in health care today: How does the US balance caring for 100 million chronic pain patients and preventing opioid painkiller addiction and deaths? If marijuana is a good pain reliever, the answer could be that America doesn't need to, at least for some patients — instead, just give them pot.
What the latest study on medical marijuana and opioid painkiller deaths found
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The working paper from David Powell and Rosalie Pacula of the RAND Corporation and Mireille Jacobson of the University of California, Irvine, concluded, "Our findings suggest that providing broader access to medical marijuana may have the potential benefit of reducing abuse of highly addictive painkillers."
The researchers looked at both treatment admissions for opioid pain reliever misuse and state-level opioid overdose deaths. They found relative decreases in misuse and deaths in states with medical marijuana dispensaries. But they didn't find decreases in states that allow medical marijuana but not dispensaries.
The study also found that legal opioid painkiller distribution didn't seem to decline in states with pot dispensaries, which, according to researchers, suggests people are replacing illegally obtained opioids with pot. But the overall result is still less misuse and fewer deaths.
So states with legal pot dispensaries have fewer opioid deaths and less misuse than states that don't allow medical marijuana and states that allow medical marijuana but not dispensaries. And the reduction in misuse and deaths may be attributable to people obtaining fewer illegal opioids.
The study is very timely: Right now, the US is dealing with a three-pronged crisis of 100 million people suffering from chronic pain, thousands dying from opioid painkiller overdoses, and more evidence that opioid painkiller users are turning to a more accessible but deadlier opioid, heroin. Medical marijuana could help address all of these issues.
The evidence is mounting that marijuana could substitute for deadly prescription painkillers
Since the late 1990s, the number of people dying from opioid painkiller overdoses has steadily risen — with more than 16,000 deaths reported in 2013. What's worse, one study in JAMA Psychiatry found opioid painkiller use has contributed to the rising use of heroin, which is deadlier and more addictive than painkillers. And a 2015 CDC analysis found people who are addicted to prescription painkillers are 40 times more likely to be addicted to heroin.
But these concerning numbers come into conflict with another medical issue: Approximately 100 million Americans suffer from chronic pain, according to a 2011 report from the Institute of Medicine. And although there's no good evidence to suggest that opioid painkillers are a good treatment for chronic pain, they can help with acute pain and are commonly prescribed for long-term issues.
If marijuana can relieve pain, it can substitute opioid painkillers with none of these problems. No one has ever reportedly died from a marijuana overdose. And pot isn't an opioid, so dependence — which does happen with marijuana, but at much lower rates than opioid addiction — can't lead to an addiction to heroin.
The study from RAND and UC Irvine researchers isn't the first to find promising results for medical marijuana. A review of the research, published in JAMA, found good evidence that marijuana can treat chronic pain and muscle stiffness, but not much evidence for other conditions. And another study published in JAMA also found that medical marijuana laws may reduce opioid overdose deaths.
While the researchers involved in all of these studies say that more research need to be done on the potential benefits of medical marijuana, their findings are very promising. For all the hoopla about whether medical marijuana is just a back door to legalization, we're beginning to see pretty good evidence that it is medicine and it might be better medicine in some cases than some of the fully legal drugs — the positive findings for chronic pain in particular stand in stark contrast to the findings for opioid painkillers, for which, again, there's no good evidence that they're a good treatment for chronic pain.
That may not justify the very easy access just about anyone has to pot at Venice Beach. Whether marijuana should be accessible for recreational use and whether it should be accessible for medical use are two entirely different questions. But at least the latter seems to be getting more and more evidence behind it.
