Is Pot The Solution to America’s Opioid Problem

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The definition of insanity is doing the same thing over and over again and expecting a different result.” – Unknown

There is a staggering opioid crisis in America today.  It is not so much an epidemic as it is pandemic, at this point. It has been said that more people are dying from opioid addiction overdoses than car crashes, gun violence and cancer. Pretty unbelievable, right?

To treat this epidemic we need to change how we think about treatment to pain and addiction. We will need patient centered approaches to evidence based medicine.  Recently, Yasmin Hurd, the director of the addiction institute at Mt Sinai Behavioral Health System and a professor of Psychiatry and Neuroscience at the Mount Sinai ‘s Icon School of Medicine wrote article in Fortune titled- ‘There’s a better way to fight the Opioid Crisis, why aren’t we focusing on it?”

What Yasmin Hurd is referring to is medical cannabinoids.  Her argument is that the solution is not about the ‘pot’ itself but the natural cannabinoids present within the plant. While research has shown that THC exacerbates aspects of psychosis and can lead to dependence in some populations, CBD showed the opposite- that it inhibited psychosis and can reduce the addiction of opioids.

Alternately, governor Chris Christie of New Jersey, is the chair of the President’s Commission on Combating Drug addiction and the opioid crisis. The White House commission calls for wide ranging changes for in the opioid pandemic and reducing overdoses is what the governor has been tasked with.  His position is quite clear, with statements made, such as “…the commission urges the same mistake not be made with uninformed rush to put another drug legally on the market in the midst of an overdose epidemic.”  He then made a statement suggesting that if you are a marijuana user, you are 2 and a half more times likely to become an opioid addict.  He provides no soltution to the current opioid crisis but is quick to dismiss anything cannabis related as a potential aid in resolution. The cap off to his argument was that there is not enough sufficient research and outcome data on dose, potency and abuse.

For this last point, the two can agree, it is true we need more resources as anecdotal evidence and casual studies are not proof, so the information cannot be considered strong enough for 100% results. However, support is needed in order to conduct the studies. Still, we don’t know enough about the mechanism of action and the entourage effects of all the plant’s components. However, the data in states with legalization shows lower numbers in prescriptions for opioid painkillers, reduced number of deaths and positive opioid toxicology in fatalities. To develop the proper specific cannabinoid with pharmaceutical interventions, dosing, formulations, etc- cannot be done and we can never move forward with combating this issue then, without the research.

The pros of using CBD has been shown to help treat kids with epilepsy and helps in pain reduction for those with chronic ailments.  For opioid addicts, it helps in decreasing craving and anxiety which is in fact, the potential key to even reversing the addiction itself.  Addiction is a chronic relapsing disorder, and the opioid receptors in our brain stem that mediate the awards of heroin are highly expressed, where as with cannabinoids, they are not, which is very significant difference in terms of producing an overdose.  At this moment, the alternative treatment to opioid addiction is Fentanyl, has shown the greatest lethality and abuse potential, as compared with marijuana, which shows very little to no abuse and/or overdose potential.

We must push for funding in order to provide data that shows specifically how CBD can impact patients. The health care costs alone of opioid pandemic are in the trillions and a shocking number of  80 people die each day in the U.S. We are flooding the planet with these prescription painkillers that have very high abuse potential, the pharmaceutical marketing that has historically surrounded these is just as culpable. We have some ineffective systems in place right now and as the pandemic spreads, we need to look at a better solution, in fact, at this point, it seems morally irresponsible not to.

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