Cannabis Connection: A Primer for Jeff Sessions on Marijuana and Opioids

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“I see a line in the Washington Post today that I remember from the ‘80s: ‘Marijuana is a cure for opiate abuse,’” said Attorney General Jeff Sessions recently. ”’Give me a break. This is the kind of argument that’s been made out there to just … [it’s] almost a desperate attempt to defend the harmlessness of marijuana or even its benefits. I doubt that’s true.’”

This is yet another example of why cannabis regulation should be taken out of the hands of law enforcement and put exclusively under the purview of medical professionals. Even the most cursory examination of the evidence suggests that cannabis can likely play a role in pain management and opioid addiction recovery. The same law enforcement agencies that claim cannabis has absolutely no medical value (they really say that) also severely restricts research into its medical benefits since they claim they already know it has none (and they really say that), but consider what evidence researchers have compiled already.

Chronic Pain

In January 2017, the National Academies of Sciences, Engineering and Medicine released one of the most comprehensive studies into the health effects of recreational and therapeutic cannabis in the past decade. A 32-person committee of industry-leading professionals compiled the 440-page The Health Effects of Cannabis and Cannabinoids (cannabinoids are naturally occurring chemicals in cannabis) and put it through an intense 15-person peer-review process. In addition to skewering the federal government for its prohibitionist approach to cannabis research, the report found that chronic pain is one of three conditions for which the evidence most strongly suggests cannabis can help. (The other two were multiple sclerosis-related muscle spasms and chemotherapy-induced nausea and vomiting.) The authors said chronic pain is the most common reason people seek medical cannabis, and patients who do so are “more likely to experience a significant reduction in pain symptoms.”

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Countless other studies confirm the same. In 2015, the Journal of the American Medical Association conducted a meta-analysis of 79 studies and found that cannabis effectively treats chronic pain with “30% or greater improvement in pain with cannabinoid compared with placebo.” In 2016, the same journal published “Opioids Out, Cannabis In” noting that more and more people are replacing opioids with cannabis in treating chronic and neuropathic pain.

Before diving into cannabis as a tool for addiction recovery, it is important to note that medical cannabis can also help people avoid opioids in the first place. The International Journal of Drug Policy in 2017 found that “cannabis is perceived to be an effective treatment for diverse conditions, with pain and mental health the most prominent … [with] cannabis as a substitute for prescription drugs (63%), particularly pharmaceutical opioids (30%).” A study published by The Journal of Pain in 2016 discovered that “cannabis use was associated with 64% lower opioid use in patients with chronic pain,” while a separate study in the same journal said, “The treatment of chronic pain with medicinal cannabis in this open-label, prospective cohort resulted in improved pain and functional outcomes, and a significant reduction in opioid use. Results suggest long-term benefit of cannabis treatment in this group of patients.”

These are just a few examples of studies that show the efficacy of treating chronic pain with cannabis, and countless public figures can attest to the benefits. Actor Patrick Stewart recently told British Esquire that he uses a cannabis-based topical spray to treat arthritic pain, a condition for which Republican Congressman Dana Rohrabacher also uses medical cannabis. Two-time Super Bowl-winning quarterback Jim McMahon said medical cannabis helps manage his pain and enabled him to kick his opioid habit, while an ESPN The Magazine poll in 2016 found that 61 percent of NFL players claimed they would consume fewer painkillers if cannabis was an allowed substance in the league and that they preferred cannabis (41 percnet) to painkillers (32 percent) as the preferred method for recovery and pain control.

For more information, put the words “cannabis chronic pain” in Google Scholar, ideally limiting the search to studies published in the last 10 years, and read for yourself.

Opioid Addiction Recovery

“When you see something like the opioid addiction crisis blossoming in so many states around this country,” said White House Press Secretary Sean Spicer about the Trump Administration’s pending crackdown on cannabis, “the last thing that we should be doing is encouraging people.”

No one thought Spicer won the State Science Fair, but he sounds here like a member of the Kyrie Irving flat earth society. Was he referencing the debunked gateway drug theory that even the Drug Enforcement Administration (DEA) now disavows? Or does he think cannabis is an opiate? Either way, the real science suggests cannabis is a tool to stem the opioid abuse epidemic.

In 2016, the Health Affairs journal published a now-famous study that highlighted the widespread benefits of medical marijuana (MMJ) legalization. Father-daughter authors W. David Bradford and Ashley C. Bradford examined the data on prescription medications filled through Medicare between 2010 and 2013, and they found that the number of opioid prescriptions dropped significantly in states that implemented MMJ programs. This means less abuse and fewer opioid overdoses in addition to $165 million in annual savings from “overall reductions in Medicare program and enrollee spending when states implemented medical marijuana laws.”

In 2014, a study in the Journal of the American Medical Association Internal Medicine found that states with MMJ laws had on average 25 percent fewer opioid-overdose deaths per year than states without legally accessible MMJ. “Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates,” the authors concluded. Moreover, the data showed “a lower rate of overdose mortality that generally strengthened over time,” meaning the number of deaths decreased the longer the MMJ program was in effect. That’s thousands of lives saved in 2010 alone.

Some might think Spicer and Sessions are simply bad at online searches, but the amount of evidence is quickly becoming impossible to miss.

A 2017 study published in Trends in Neuroscience wrote that animal and human studies suggest “cannabinoids, extracts of cannabis legally sold as medical marijuana, could reduce cravings and ease withdrawal symptoms in heroin users,” while another 2017 study published by the National Bureau of Economic Research (NBER) said, “Our findings suggest that providing broader access to medical marijuana may have the potential benefit of reducing abuse of highly addictive painkillers.” In 2015, NBER also found that “states permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not. Our findings suggest that providing broader access to medical marijuana may have the potential benefit of reducing abuse of highly addictive painkillers.”

There’s more. University of California-Irvine and the RAND Corporation researchers similarly found that “states permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.” Drug and Alcohol Review published a study in 2015 that looked at MMJ patients and found that 87 percent substituted cannabis for “one or more of alcohol, illicit drugs or prescription drugs” with more than 80 percent using cannabis in place of pharmaceuticals like opioids. The study published in the same journal that year found that the tetrahydrocannabinol (THC)-based drug dronabinol “reduced the severity of opiate withdrawal during acute detoxification,” did not interfere with the opioid-antagonist XR-naltrexone and possibly helped patients complete treatment. The authors noted, “Participants who elected to smoke marijuana during the trial were more likely to complete treatment.” A 2016 paper from Columbia University even found that opioid-related fatal car crashes went down in states that legalized MMJ.

News headlines related to the issue include titles like “How medical marijuana could literally save lives” (Washington Post 2015), “Can Medical Marijuana Help End the Opioid Epidemic?” (TIME 2016) and “Doctors pioneer pot as an opioid substitute” (The Boston Herald 2015). The latter article noted how clinics in several states are already using cannabis to help treat opioid addiction, a story that was even picked up by the normally anti-cannabis Partnership for Drug-Free Kids. The preliminary evidence is so overwhelming that Senator Elizabeth Warren petitioned the CDC in 2016 to look into “the impact of the legalization of medical and recreational marijuana on opioid overdose deaths.”

Now go back and read the Trump Administration quotes. Sessions suggested all the clinical research cited above is dishonest propaganda published as “a desperate attempt to defend the harmlessness of marijuana or even its benefits,” while Spicer suggested that cannabis deserves some blame for the opioid crisis that studies show it can help reverse. Sessions even doubled down saying that taking cannabis away from drug cartels and putting it into an above-board regulated system has already led to an increase in violence. Spoiler alert: Neither provided evidence for their claims.

What is truly desperate are the number of opioid abusers caught in an addiction cycle that already cost them their jobs, family and health. Tens of millions of people suffer from chronic pain, particularly headaches and back pain, and the government prefers they use drugs derived from the same opium alkaloids as heroin than use cannabis, a non-physically addictive medicine that people can theoretically grow at home at a greatly reduced cost. After years of decline, heroin use is on the rise again largely due to opioid addicts who turned to the needle after their drug prescription ran out or they could no longer afford black-market pills. Lives are being lost, people are suffering and science is being discounted without evidence.

In February 2017, Quinnipiac University released a new poll in which 93 percent of respondents said they support medical cannabis and 71 percent said the federal government should not interfere with state-legal cannabis. Yes, people are desperate… but they are desperate for science, research and national wellness to guide our nation’s drug laws rather than whatever Sessions, Spicer and the anti-MMJ 7 percent are reading, watching or being told.

Image: wackystuff, CC-BY

David Jenison is a Los Angeles native and the editor-in-chief of PROHBTD. He has covered entertainment, restaurants and travel for more than 20 years.