The Relationship Between Opioid Addiction and Marijuana

Recent studies have investigated whether medical marijuana legalization could help curb opioid addiction and the associated opioid overdose epidemic plaguing our nation. The theory is that substituting medicinal marijuana for opioid pain relievers might help reduce opioid-related health consequences. On the other side of the argument, opponents believe marijuana used for recreational purposes may serve as a gateway drug for opioid misuse and eventual opiate addiction. These are two separate issues, so when analyzing this issue, it’s important to differentiate between medical marijuana prescribed for pain and recreational marijuana.

Factors in the Opioid Crisis

The increase in opioid addiction has been linked to opioid pain medicine being overprescribed. Opioid-based drugs and medications have the ability to produce changes in human brain chemistry that may result in physical dependence and addiction. Individuals who receive no medical oversight from a prescribing doctor are more vulnerable. When they are abused, prescription opioids create a euphoric, deeply relaxed state of mind. The reality-bending capacity of prescription opioids makes them appealing to people seeking an escape from chronic physical or emotional pain. When their prescriptions run out, these people often turn to heroin because it is far less costly and can be bought on the street. These are well-documented factors fueling opioid addiction and the current opioid crisis in the U.S.

Research on Marijuana and Opioids

According to a 2014 study published in JAMA Internal Medicine, states that legalized medical marijuana for managing chronic pain saw significantly fewer deaths from prescription painkiller overdoses. On average, these states had a 24.8% lower annual opioid overdose mortality rate compared to states without medical cannabis laws. Moreover, the lower rate of opioid overdose mortality appeared to get stronger over time. An April 2017 Drug and Alcohol Dependence study was the fifth to show declines in opioid use or deaths in states in which medical cannabis is legal. The study demonstrated significant reductions in opioid-related hospitalizations associated with the implementation of medical marijuana policies. Hospitalization rates for opioid painkiller dependence and abuse decreased by 23% on average in states where marijuana was legalized for medicinal purposes, while hospitalization rates for opioid overdoses dropped 13% on average. Medical marijuana legalization had no impact on marijuana-related hospitalization rates. These findings did not necessarily refute prior studies showing an increase in the use of marijuana in states with medical marijuana policies. To date, scientific evidence does not show a correlation between the use of recreational marijuana and subsequent opioid abuse or addiction. That’s not to say recreational marijuana is benign — it is often combined with alcohol and other drugs, can cause psychosis, and about 30% of people who use it recreationally may have some degree of marijuana use disorder. Presently, researchers cannot explain the underlying causal connections between medical marijuana and opioids. More studies are needed to further investigate the potential role of medical marijuana in reducing prescription opioid addiction in individuals with chronic pain.

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