Can Medical Marijuana Treat Opioid Addiction?
Medically reviewed byIsaac Alexis, M.D., AAMA, AMP-BC
January 29, 2019
Medical marijuana is an up-and-coming treatment used for medical conditions and illnesses, including opioid addiction. Medical marijuana shows promise in helping opioid-addicted individuals reduce harm and safely wean off opioids.
It’s one of the most controversial forms of treatment today: medical marijuana. Currently legal in 29 states, the District of Columbia, Guam, and Puerto Rico, medical marijuana is now used to treat a number of different medical conditions and illnesses.
Opioid addiction is one of the newest illnesses medical marijuana is used to treat. Why? Marijuana as medicine is believed to help opioid addiction in one significant way—that is, by helping people reduce the number of opioids consumed, according to CNN.
To some, this method may seem counterproductive. After all, abstinence is still such an important part of recovery. However, total abstinence is not always possible right at first. Finding a way to help addicted individuals reduce use of opioids to work on getting better is important to recovery success.
Medical marijuana may help people to reduce use of opioids through a method called “harm reduction.” Essentially, this means reducing use of harmful opioids to lessen risk of overdose and other dangerous consequences.
As stated in the CNN article, “cessation of drug use can be a goal for some people, but pacing is also important.”
About Opioid Addiction
Opioids, also called narcotics, are potent, pain-relieving drugs. This class of drugs includes both prescription pain relievers like Oxycodone and Fentanyl, and the illicit drug heroin.
Opioids work in your brain by attaching to opioid receptors and altering the way your brain responds to both pain and pleasure. When opioids enter your body, you experience an immediate rush in the first few minutes, and pleasurable feelings of euphoria, relaxation, and calm.
Following the rush, you likely experience a “high,” within 30 minutes up to a few hours. During the high, you experience a number of side effects. The desirable ones, coupled with uncomfortable withdrawal symptoms, are what keep people stuck in opioid addiction.
Perhaps the most dangerous thing about opioids is the strongly addictive properties of the drugs. Most prescription opioids are intended for use of just a few days, yet abuse can occur within that time. Addiction is not far off with opioid abuse, and can happen after just a few uses because of how the drugs alter your brain.
With continued abuse can come tolerance to the drugs, or inability to feel the effects of them. If you no longer feel the effects of opioids, and have already formed addiction to them, you may begin taking more of the drugs or taking them in higher frequency. This pattern increases your risk of overdose.
The goal for opioid addiction treatment should always be to reduce or cease use of the drugs, and make the patient as comfortable as possible. Several methods are proven effective at this, and medical marijuana may be one of them.
Opioid Side Effects And Withdrawal
Abuse of opioids comes with a whole host of adverse side effects. These may include the following:
- Chronic constipation
- Extreme cravings
- Increased sensitivity to pain
- Increased sweating
- Reduced pupil size (“pinpoint” pupils)
- Reduced sex drive
- Shallow breathing
- Slurred speech
One of the most uncomfortable side effects of opioid abuse is withdrawal. If you’ve been abusing opioids for an extended period of time, and begun to develop physical dependence to them, you may begin to feel physical symptoms when not taking the drugs.
Withdrawal symptoms are rarely life-threatening, according to the U.S. National Library Of Medicine. It’s when you feel these symptoms but already have a tolerance that opioid addiction can be dangerous. Withdrawal can push you to keep taking opioids, especially if you aren’t feeling the effects anymore.
The following are possible withdrawal symptoms:
- Aching muscles
- Agitation or anxiety
- Goose bumps
- Increased tearing
- Pupil dilation
- Runny nose
- Stomach cramps, nausea, or vomiting
- Sweating or yawning
- Trouble sleeping
Withdrawal symptoms may occur anywhere from 12 hours of last use of the opioid, up to several days after abuse. While dependence is what keeps people going back to opioid abuse, withdrawal ensures they will probably stay there until they get help.
Just as the amount of time to become dependent on opioids differs from person to person, so does the amount of time and method by which to recover. What works for one person isn’t always as effective for another, which is why variation in treatment methods is so important.
Medical Marijuana Treatment For Opioid Addiction
How would marijuana work to treat opioid addiction? The drug contains cannabinoids, or chemicals that make it a mind-altering drug. These include THC (delta-9-tetrahydrocannabinol) and many others.
As with other drugs, some of these cannabinoids, which have been produced in labs, can be harmful when misused. However, growing evidence suggests that cannabinoids may be useful in treating certain illnesses and conditions, according to the National Institute On Drug Abuse (NIDA).
The two largest cannabinoids of interest right now are THC and CBD. The NIDA explains that:
- THC, “can increase appetite and reduce nausea. It may also decrease pain, inflammation (swelling and redness), and muscle control problems.”
- CBD has similar effects, but does not result in the high that THC creates. CBD may also help control seizures due to epilepsy, decrease pain, and may even be a viable treatment for mental illness or addiction.
If medical marijuana (the whole, unprocessed plant) or cannabinoids (extracts from marijuana) show such promise of helping to treat opioid addiction, why has medical marijuana not been approved for medical use by the FDA?
“The FDA requires carefully conducted studies (clinical trials) in hundreds to thousands of human subjects to determine the benefits and risks of a possible medication,” states the NIDA. In other words, to be federally approved, the medication will have to first undergo large-scale studies to prove that it produces more benefits than harm.
This outcome doesn’t seem to be far away. As previously mentioned, many states, the District of Columbia, Guam, and Puerto Rico have already approved use of medical marijuana. Also, “recently approved efforts in 16 states allow for use of ‘low THC, high cannabidiol (CBD)’ products for medical reasons in limited situations or as a legal defense,” states the National Conference Of State Legislatures (NCSL).
This may mean careful regulation of medical marijuana, but it also means the use of the drug in treatment may be well on its way to being validated. Validation will simply require more use in treatment and more long-term studies of this use.
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Medical Marijuana: Pros And Cons
As with any and all treatments, medical marijuana comes with both risks and benefits. The risks, as well as lack of longitudinal studies, are what keeps it from becoming a widely accepted form of treatment.
So, what are the benefits? The NIDA states that, of the studies that exist for medical marijuana, the conclusions suggest that it can help decrease opioid overdose and death. Unfortunately, “researchers don’t have enough evidence yet to confirm this finding.”
A separate analysis conducted by the NIDA found that medical marijuana dispensaries that are protected by law directly correlate with decreases in opioid prescribing, self-reported opioid abuse rates, and treatment admission rates for opioid addiction.
In other words, the availability of medical marijuana could make it possible for those addicted to opioids to replace this addiction with treatment. But isn’t medical marijuana just replacing one addiction with another?
That is the big debate in the medical field right now. As previously explained, medical marijuana isn’t meant to become a separate addiction for opioid-addicted people, but to help them wean off use of opioids.
When it comes down to it, marijuana can be the lesser of two evils. Marijuana would not be used to cure addiction, but to help with harm reduction. As stated in a CNN article, “with cannabis, there is no known lethal dose; it can be helpful for certain conditions.”
And opioid abuse is only one of those conditions. Medical marijuana has already been used to treat epilepsy, especially in children, and for victims of cocaine addiction.
The following are all conditions or illnesses marijuana has recently helped treat:
- Chronic pain
- Diseases that pertain to your immune system, i.e. HIV/AIDS and multiple sclerosis (MS)
- Mental health disorders
- Substance use disorders
Limited evidence exists to support the benefits of these specific conditions, and not enough is known about how marijuana would affect everyone. For instance, it’s unknown how medical marijuana would affect those of old age or weakened by illness.
Further, the NIDA reports, “those suffering from diseases such as cancer or AIDS could be more vulnerable to the drug’s harmful effects, but more research is needed.” Marijuana is also still regarded as unsafe for pregnant women because some studies suggest it could affect the unborn child, especially with regard to social interaction.
Overall, medical marijuana may be useful for opioid addiction for the simple fact that it helps addicted individuals to gradually wean or quit use of a more potent drug. Most treatment programs still advocate for complete abstinence, but this method may not work for all. For those people, this method may be an option.
Can You Get A Prescription For Medical Marijuana?
The easy answer is no, you can’t get a prescription for medical marijuana. Because it is not a federally approved drug, it is illegal for doctors to prescribe it. Yet by some state legislation, the drug can be used in medical treatment.
This can present a tricky situation for those who need the drug. The NCSL explains that because marijuana is still a Schedule 1 drug, “medical marijuana ‘prescriptions’ are more often called ‘recommendations’ or ‘referrals’ because of the federal prescription prohibition.”
So, how can you prove you have marijuana for medical use? People in states that have approved marijuana for medical use typically have registration systems for patients, allowing them to be in possession of a certain amount of marijuana at a given time.
Regulations are made at the state and local levels for amounts of marijuana recommended, possessed, and the number of dispensaries allowed in a certain area.
What Other Methods Treat Opioid Addiction?
As mentioned above, there is no one-treatment-fits-all method for those in need of opioid addiction treatment—it’s the reason marijuana was considered an option and has begun to show promise.
For those looking for treatment from opioid addiction, there are other options as well. Just as marijuana works by harm reduction, so do other forms of medication used to treat opioid addiction.
Medications like buprenorphine (brand name, Suboxone) work not by giving the addicted individual a high similar to that of opioids, but by reducing cravings and preventing uncomfortable withdrawal symptoms.
Contrary to popular belief, medication-assisted treatment does not replace one addiction with another.
The NIDA explains, “when someone is treated for an opioid addiction, the dosage of medication used does not get them high… these medications restore balance to the brain circuits affected by addiction, allowing the patient’s brain to heal while working toward recovery.”
Any treatment used to treat opioid addiction should be paired with a comprehensive treatment program. Opioids affect your brain, which affects mood, behaviors, and thought processes. Addiction to opioids can cause dependence and withdrawal, which results in physical symptoms.
Treatment has to work to address all aspects of addiction. In addition to medication to ease withdrawal symptoms, the following evidence-based methods are proven effective methods for treating opioid addiction:
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavioral Therapy (DBT)
- Nutrition and exercise regimens
- Counseling: group, individual, and family sessions
- Adventure therapy
- Wilderness therapy
- Gender-specific therapy
- Dual diagnosis treatment
Can You Overdose On Opioids?
Opioids are dangerous because they are addictive, but are scary because of the tendency of that addiction to lead to overdose. Many prescription opioids are extended-release medications, which means they don’t take effect right away.
When people abuse these prescriptions, they tend to crush and snort the tablets, or dissolve the crushed powder in water and drink it or inject it. This forces a quicker release than intended, meaning you’ll experience a rush of effects meant to happen slowly over time.
Perhaps this doesn’t seem as dangerous as it sounds; many opioids are medications after all. Opioids are also narcotics, which means they’re powerful and abusing them increases your risk of overdose every time.
In 2015, more than 33,000 people died of opioid-related overdose, according to the American Society Of Addiction Medicine (ASAM). This tragic rate has escalated quickly in just the last couple decades, nearly quadrupling from 1999 to 2008.
To combat overdose, and fatal overdose, comprehensive treatment is needed, especially since many who need treatment never get it.
Opioid overdose is a medical emergency, and should always be regarded with extreme care. If you suspect someone is experiencing an overdose from opioids, seek medical attention right away. The following are opioid overdose symptoms:
- Loss of consciousness
- Pinpoint pupils
- Respiratory depression
Other Consequences Of Opioid Addiction
From the moment you begin abusing opioids, your life will be affected. You’ll experience brain changes, behavioral changes, mood and thought changes, and adverse physical symptoms. These changes extend beyond your control, and eventually begin to affect every part of your life.
Many people who experience addiction experience dire effects on personal relationships. At first, it may seem easy to hide your addiction, especially if, like many others, you are ashamed by it. At first, you may even try to quit on your own, but withdrawal can keep that from happening.
Before long, life becomes all about the drugs. Seeking them, preventing cravings of them, and seeking alternatives when you no longer have access to them. The large, residual problem with addiction to prescription opioids is that your prescription will eventually run out.
People who run into this problem but have already developed addiction to the medication may try to “doctor shop,” or contact several doctors in an effort to get a prescription. Addiction may also cause you to lie to family members or employers about your problem, or take prescriptions that don’t belong to you.
These are not always behaviors in which you’d normally take part, but addiction knows no bounds. When you no longer have access at all to an opioid prescription, you may start seeking alternatives.
Heroin is the less expensive, easily-obtained alternative to prescription opioids, and has nearly as large an epidemic. In fact, the majority of people new to abusing heroin began abusing prescription opioids first.
Bigger than, perhaps, all of this is the risk of overdose. Addiction can quickly create tolerance, which leads you to believe that you should take more of the drug. Opioid addiction claims more people to overdose each year than any other accidental deaths, including gun-related homicides, according to CBS News.
To reverse this trend, we need to get more people into treatment—the treatment that is right for them—before overdose rates continue to skyrocket.
How To Find Help In Treatment
Finding treatment that works for you is as easy as knowing which treatment centers offer the best treatment options, and we can help you find them.
If you or a loved one are struggling with opioid addiction, we’d like to help you today. Contact us at RehabCenter.net, today.Article Sources
National Conference Of State Legislatures - State Medical Marijuana Laws
National Institute On Drug Abuse - DrugFacts: Marijuana As Medicine
National Institute On Drug Abuse - Effective Treatments For Opioid Addiction
U.S. National Library Of Medicine - Opiate And Opioid Abuse
U.S. National Library Of Medicine - Opioid Abuse And Addiction
World Health Organization - Information Sheet On Opioid Overdose
American Society Of Addiction Medicine - Opioid Addiction: 2016 Facts And Figures