Our Opinion: Reducing painkiller overdoses


A new study has found that in states where medical marijuana is legal, the rates of deaths due to overdoses of opioid painkillers are lower than in states where medical marijuana is illegal. The study, which was published in the journal JAMA Internal Medicine this week, examined a decades worth of data compiled by the Centers for Disease Control and Prevention.

"The striking implication is that medical marijuana laws, when implemented, may represent a promising approach for stemming runaway rates of non-intentional opioid-analgesic-related deaths," wrote Dr. Mark S. Brown and Marie J. Hayes about the study. "If true, this finding upsets the apple cart of conventional wisdom regarding the public health implications of marijuana legalisations and medicinal usefulness."

Marcus Bachhuber, the lead study author, told Medscape that he has treated a lot of people with chronic pain.

"Some would tell me that they tried prescription painkillers, that those didn't work, and that marijuana was the only thing that worked for their pain."

Overall, the study concluded, the death rates related to overdoses of drugs such as OxyContin and Vicodin have increased in all states over that period. Interestingly enough though, the study's authors also found that in the states that allow the use of medical marijuana, overdose death rates were about 25 percent lower.

According to Live Science's Bahar Gholipour, these lower rates translated to about 1,700 fewer deaths than what would have been expected if medical marijuana had not been allowed in these states.

"The researchers also found that the link between lower rates of opioid-overdose deaths and medical-marijuana laws strengthened over time," wrote Gholipour. "The number of deaths was reduced by nearly 20 percent in the first year after a state's law was implemented, and was about 34 percent lower five years after the law's implementation ..."

According to the CDC, three-quarters of prescription drug overdoses are caused by opioid painkillers and since 1990, those death rates have more than tripled. And, according to the study, about 60 percent of those who died of overdoses had legal prescriptions.

"Opioid painkillers are particularly dangerous because users may develop tolerance to the drug over time, and may seek higher doses to experience the same effects," wrote Gholipour.

Melissa Healy, writing for the Los Angeles Times, noted that other research has found marijuana's psychoactive ingredients may enhance the pain-killing effects of opiate drugs, allowing patients using marijuana for pain to take lower, and less dangerous, doses of opiate medications.

"It's so apparent that our patients can decrease, diminish or wean themselves completely off of opiates, and that it improves their quality of life," Dr. Donald Abrams, a University of California oncologist, told the Los Angeles Times.

Healy noted that opioid drug users may take lower doses of their prescription drugs and others may use marijuana in place of benzodiazepine drugs.

"Still other patients who might initiate opioid medication use -- and go on to risk overdose -- may never start if they are able to get pain relief from medical marijuana," wrote Healy.

This is especially important, because these painkillers are causing about 16,000 deaths a year, more than heroin and cocaine combined. The federal and state governments are trying to crack down on the over-prescription and illegal use of opioids, but they face formidable opposition from the pharmaceutical industry.

As Vice's Lee Fang noted, leading anti-marijuana academics are being paid by pharmaceutical companies that produce opioid painkillers.

These include Herbert Kleber of Columbia University, Dr. A. Eden Evins, an associate professor of psychiatry at Harvard Medical School, Dr. Mark L. Kraus, a board member to the American Society of Addiction Medicine, all of whom have submitted professional opinions about the dangers of marijuana and all of whom are "on the payroll of leading pharmaceutical firms with products that could be easily replaced by using marijuana," wrote Fang. "When these individuals have been quoted in the media, their drug-industry ties have not been revealed."

Some of these consultants are also responsible for the explosion in prescriptions for opioid painkillers, he noted.

"These academics, with quiet funding from major pain pill firms, encouraged doctors to over-prescribe these drugs for a range of pain relief issues, leading to where we stand today as the world's biggest consumer of painkillers and the overdose capital of the planet. What does it say about medical academia today that many of those painkiller-funded researchers are now standing in the way of a safer alternative: smoking a joint."

As Fang noted, despite the decades of scare stories promulgated by the anti-marijuana forces, "There are no known overdose deaths from pot."

Yes, there are legitimate concerns about who should qualify for medical marijuana. But it seems a no-brainer that if someone has been prescribed a high-powered painkiller from a doctor, marijuana would also be appropriate in most cases. We would hope that states that haven't yet legalized the use of medical marijuana will seriously consider this latest research if and when legislation is proposed. It would behoove them to turn the volume down on the anti-marijuana rhetoric and review this evidence with a keen eye. It might save some lives.


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