Commentary: Embrace medical cannabis to help fight opioid addiction

As a board-certified emergency medicine physician practicing in the New York City area for nearly five years, I consider myself a specialist in chronic pain and addiction. Each shift I encounter a patient or a family member of someone who has been negatively affected by opioids. Opioid overdoses claim the lives of 130 people a day in America, the Centers for Disease Control reports.

The American population is aging — almost 12 percent of people suffer from some form of chronic pain with numbers continuing to rise. The inpatient detox beds at my hospital fill up every day, and the sad reality is that the majority of these patients come back months, weeks, or even days later stating no change or relief from their addiction and suffering.

While methadone and buprenorphine outpatient treatment regimens have succeeded for some opioid-dependent patients, what about those for whom these traditional options don’t work? There is an obvious alternative and complimentary option in medical cannabis, and I’ve made it my mission to help educate more physicians to embrace it as a tool in fighting opioid addiction.

Current research supports the use of medical cannabis in fighting the opioid epidemic and I suspect there will be more research coming soon. According to a 2014 Journal of the American Medical Association study, states with medical cannabis laws had a nearly 25 percent lower annual opioid overdose mortality rate compared to states without medical cannabis laws. A study published two years later in the Health Affairs Journal found that implementing an effective medical cannabis law led to a reduction of 1,826 daily doses of opioids (approximately 11 percent) filled per physician per year. In 2016, yet another study in the Clinical Journal of Pain found that 80 percent of medical cannabis users, specifically patients with pain-related conditions, in Israel reported substituting cannabis for prescribed medications.

Sadly, there remains a lack of openness in the medical community to medical cannabis. While there is a historical stigma against the cannabis plant, there is a true lack of education about the potential benefits of medical cannabis. There remains a critical gap in knowledge about the “endocannabinoid system,” a network of receptors in human bodies designed specifically to process and break down cannabis. To this day, the national medical education complex has failed to incorporate this into the curriculum, possibly because the cannabinoid receptors weren’t discovered until 1988. With new research on the horizon, there is hope to rewrite chapters in textbooks, add to medical education curriculums, and most importantly change the way we as providers treat patients who are suffering.

I support, and encourage my colleagues in medicine to consider supporting, any legislation that expands access to medical cannabis. We must give doctors greater discretion to prescribe medical cannabis to more patients for a greater variety of ailments, as well as increase patients’ access to cannabis-based medicine by increasing the number of dispensaries. Here in New York state, we have one of the more restrictive medical cannabis programs, which has resulted in one dispensary for every 500,000 residents. Compare that to Florida, where there is one dispensary for every 70,000 residents.

The anecdotal evidence is overwhelming. The more I ask patients about supplementing cannabis for pills or needles, the more I realize health care can no longer support the backward notion that cannabis is only a recreational drug of abuse.

We as medical leaders need to take a step back and look at the big picture. We are here to keep our patients and our communities safe and healthy. Medical cannabis must become a more mainstream part of the discussion and the medical community needs to become educated on its benefits.

Horticulture technician Matthew Dobbs bar codes new plants in Vireo Health’s new greenhouse at their medical marijuana cultivation and manufacturing facility Tryon Technology Park Wednesday June 21, 2017 in Johnstown, NY. (John Carl D’Annibale / Times Union)

By Andrew Rizzo