New study: marijuana for medical purposes might not help fight the epidemic of opioids


One of the main arguments in favor of marijuana for medical purposes has been that it could help fight the epidemic of opioids by offering doctors an alternative to opioids for the treatment of pain. Some research has corroborated this claim, indicating that states with legal marijuana had fewer opioid overdose deaths than those without cannabis for medical purposes.

But a new study has questioned this argument and the research that supports it.

Previous studies, particularly a widely cited 2014 study, have found a correlation at the state level between the legalization of cannabis for medical purposes and the reduction in overdose deaths. This line of research indicates that marijuana for medical purposes can lead to a reduction in overdoses, according to the theory that people could use cannabis to treat pain rather than opioids. Some state lawmakers have endorsed the studies, citing these to legalize the medical pot or allow marijuana for medical purposes to help treat opioid addiction.

But a new study, which uses the same methodology and the same data as the 2014 study that launched this line of research, revealed that the trend was reversed: marijuana for medical purposes is now correlated with more overdose deaths from opioids. The new study, published in PNAS, found that marijuana for medical purposes correlated with a decrease in the number of opioid overdose deaths from 1999 to 2010. But by using new data until 2017, the study has revealed that states with marijuana laws for medical purposes more overdose deaths from opioids.

A graph measuring the correlation between marijuana laws for medical purposes and deaths overdose opioids.

A graph measuring the correlation between marijuana laws for medical purposes and deaths overdose opioids.

The researchers argue that the correlation is misleading – suggesting that there is no generalized and generalizable connection between medical marijuana and opioid overdose deaths, and that the link previously found was probably a coincidence .

"We, the authors, think it's a mistake to look at this and say," Oh, cannabis was saving people 10 years ago and it's killing people now, "Chelsea Leigh told me. Shover, the lead author of the study. "We think that a more likely interpretation is that the adoption of cannabis laws for medical purposes simply does not affect opioid deaths at the population level."

The study also looked at whether broader laws on marijuana for medical purposes and recreational legalization of marijuana were linked to a decrease in the number of opioid overdose deaths, concluding that even The most lax laws were not closely correlated with overdoses.

Marijuana reform "still needs to be considered, but it does not seem that the reduction of opioid overdoses at the population level [its effects]Said Shover.

Shover worked with the lead author of the original 2014 study to ensure that the models and data from his study were the same. This has essentially made this new study a replica of the original – a contradiction with previous findings.

"If you believe the first study, you have to believe ours," said Shover. "These are the same methods and the same data."

Additional research is needed in this area, and further research is forthcoming. But for now, the new study suggests that the potential role of marijuana for medical purposes in the fight against the opioid epidemic has been overexpressed.

We have a lot of evidence for other approaches to the epidemic of opioids

Shover argued that his research suggested that policymakers are considering alternative approaches to combat the opioid epidemic, instead of relying on the hype around marijuana to medical purposes.

As experts have been saying for a long time, there is no silver bullet to solve the opioid epidemic overnight, but there is a set of policies that would certainly help a lot: increased access to treatment (especially drugs such as methadone and buprenorphine), increased harm reduction (such as the distribution of naloxone, antidote to opioid overdose), fewer prescriptions for painkillers (while ensuring that medicines remain available for those who really need them) and policies that tackle the root causes of addiction (such as mental health problems and socio-economic despair). All of these approaches are also based on the need to reduce the stigma of addiction.

These approaches rely on much more evidence than marijuana for medical purposes. Studies have consistently shown, for example, that drugs such as buprenorphine and methadone reduce the death rate of patients with opioid dependence by half or more and keep patients on treatment better than non-drug approaches. This is why experts consider drugs to be the gold standard treatment for opioid disorders.

Yet, treatment remains inaccessible in the United States. Federal data suggest that 1 in 10 people with substance use disorder and 1 in 5 people with opioid use disorder benefit from specialized treatment. Even when a drug treatment clinic is available, less than half of the facilities offer opioid addiction medications. In other words, the treatment is sufficiently inaccessible that most people who need it do not get it, and even if treatment is available, it does not meet the highest standard of care.

To address this, policy makers will likely need to devote more resources to treatment and to the epidemic of opioids in general. But that means looking beyond medical marijuana to find other solutions.

"I really hope it works," said Shover, referring to marijuana for medical purposes and the opioid crisis. "But it's not, so I'm in the unpopular position that it does not seem to work, so we should focus on things for which we have evidence and find new things that might [work]. "

To learn more about how to fight the opioid epidemic, read Vox's explanation.


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