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America Doesn’t Have to Choose Between Chronic Pain and Opioid Addiction

Congress recently passed an opioid policy package allocating $8.4 billion to address the drug epidemic that claimed 72,000 lives just last year. Although this number seems large, experts say it is only a fraction of the funding needed to stem the tide of overdoses crippling America. Although the bill increases access to drug treatment facilities, expands doctors’ ability to prescribe medication that treats opioid addiction, and seeks to prevent fentanyl from being sent through the US Postal service, it misses an opportunity that states have begun to try: access to marijuana. While this bill funds research into non-opioid painkillers, states long left to fend for themselves on the front lines of the opioid crisis point out that such a drug already exists. Indeed, the long-vilified drug marijuana can provide an innovative solution to America’s painkiller addiction.

Part of the problem with dismantling the national dependence on opioids is the reason these addictive drugs were prescribed in the first place. According to an NIH study, 25.3 million Americans suffer from daily chronic pain. Living with chronic pain can increase a person’s chances of suffering from depression, anxiety, and insomnia. It is not hard to understand why so many Americans have turned to prescription opioids, which ostensibly promise a safe way to manage pain.

Americans should not have to choose between chronic pain and addiction. Long cast as a public enemy in America’s War on Drugs, marijuana is an increasingly appealing alternative. Two recent studies have affirmed cannabis as an effective pain management drug. According to one study tracking opioid overdose deaths from 1999 to 2010, states that have legalized marijuana, whether medical or recreational, displayed a 25% lower rate of opioid overdose fatalities compared to other states. Moreover, in areas with higher densities of medical marijuana dispensaries, there is a 15 to 35 % decrease in admissions to opiate addiction facilities. Fewer opioid-related deaths have also been reported in these areas.

Cannabis users themselves confirm that using the drug turns them away from more dangerous substances. In a Canadian study which surveyed medical cannabis patients, 80.3% of participants reported substituting marijuana for prescription painkillers. 32.6% reported substituting marijuana for illicit substances, like heroin.

Dr. Jean Talleyrand, the founder of MediCann, has seen people switching from opioid prescriptions to cannabis firsthand. “Patients would hand over their opioid bottles and say ‘I don’t need this anymore’,” after they had gotten a cannabis recommendation.  “People are throwing out their pills in front of me.”

As more states legalize cannabis, the demographic makeup of cannabis users for medical purposes has been shifting. When Dr. Talleyrand began working as a doctor in the California cannabis industry in 2004, the average age of a patient was 35. Now, the average age is around 50. This shift can be partially attributed to the new kinds of cannabis available for pain management. CBD oil is extracted from the marijuana plant but does not cause psychoactive effects, and its use has exploded over the last few years. Since CBD oil can reduce pain without the high, older patients looking for pain relief have increasingly relied upon it. Conservative states like Georgia and South Carolina have legalized CBD oil for medical use. The demographic of patients turning to cannabis for medical purposes is expanding, and increased access to the drug will in turn increase its use across demographics.

Once cannabis is used for pain relief, “people will either reduce their opioid use or cut it out completely,” says Dr. Talleyrand. For states struggling to eradicate an entrenched opioid dependency, cannabis can offer a way out of the vicious cycle of relapse and recovery, especially since it can offer a relatively low-risk way to deal with the pain of opioid withdrawal.

For decades, marijuana has been advertised as dangerous and addicting. The War on Drugs introduced new and frightening terms for marijuana such as “gateway drug.” Yet the US government got it wrong: marijuana can be a gateway out of addiction, not into it. Studies show that cannabis is safer than opioids, even those prescribed by a doctor. When used for pain treatment, its side effects are less dangerous than prescription opioids or heroin. Cannabis is much less addictive than any form of opioid. The rates of marijuana addiction are dwarfed by those of prescription opioid and heroin addiction, and the danger of overdosing from marijuana is minimal.

In another Canadian study published in the journal Pain, research participants who used medical marijuana were no more likely than people who used other substances to experience serious side effects. Because marijuana is a Schedule I drug in the United States, the federal government would not fund any research examining its medical implications. In contrast, research on cannabis has not been restricted in Canada. The wave of state-led legalization of marijuana is pressuring the National Institute on Drug Abuse to change its tune, and a few studies researching the pain relieving effects of cannabis have been funded more recently.

States have leapt ahead of the federal government in reforming marijuana laws. 31 states have legalized marijuana for medical use, and 9 states have legalized recreational marijuana use. Even traditionally conservative states, such as West Virginia, Louisiana, and Oklahoma, have recently passed laws legalizing marijuana for medical purposes.

States should continue to rehaul marijuana laws to make a dent in the opioid crisis. While the lingering rhetoric of the War on Drugs warns that marijuana poses a threat to communities, this movement failed to prevent the rise of the opioid crisis. Prescription opioid pills are more dangerous than pot: they are more addictive, more likely to cause a fatal overdose, and extremely painful to quit. The most recent package of legislation to address the opioid epidemic funds the development of non-opioid painkillers, yet marijuana is just that.  

By legalizing marijuana, states offer a chance for people suffering from chronic pain another option for relief, and the chance to refuse that first opioid prescription. States need to take the lead in addressing the opioid crisis because the federal government’s response is woefully inadequate. One way to do that without federal funds is to legalize marijuana.

Photo: Discount Medical Marijuana

About the Author

Cartie Werthman '21 is a Senior Staff Writer for the US Section of the Brown Political Review. Cartie can be reached at