Trump Administration’s dubious claims about pot and opioids are dead wrong

The Hill

Paul Armentano, opinion contributor 1 day ago

The Trump administration hinted yesterday of a forthcoming federal crackdown in the eight states that have elected to regulate their marijuana markets. White House Press Secretary Sean Spicer alleges that such federal intrusion is necessary in order to try and stem the rising tide of prescription opioid abuse sweeping across various parts of the nation.

Spicer stated , "I think that when you see something like the opioid addiction crisis blossoming in so many states around this country, the last thing we should be doing is encouraging people (by regulating the adult use of marijuana)."

Yet even a cursory look at the available evidence finds Spicer's concerns to be misplaced and his allegations to be dead wrong.

In reality, permitting legal access to cannabis is consistently associated with reduced rates of opioid use, abuse, and mortality.

For example, a widely publicized study in the esteemed Journal of the American Medical Association Internal Medicine reported that the enactment of medical marijuana legalization laws is associated with year-over-year reductions in opioid analgesic overdose mortality. Overall, researchers determined, "States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws."

The JAMA study is hardly unique.  A 2015 examination by investigators at the RAND Corporation similarly determined, "[S]tates permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not."

A 2016 assessment by Castlight Health, an employee health benefits platform provider, reported that adults are more than twice as likely to engage in doctor shopping for opioids in states without cannabis access as compared to states that permit it.

Allowing adults legal access to marijuana is also associated with the reduced use of other, potentially more dangerous prescription drugs. For example, investigators at the University of Georgia assessed the relationship between medical marijuana legalization laws and physicians' prescribing patterns in 17 states over a three-year period. Specifically, researchers assessed patients' consumption of and spending on prescription drugs approved under Medicare Part D in nine domains: anxiety, depression, glaucoma, nausea, pain, psychosis, seizures, sleep disorders, and spasticity.

Authors reported that prescription drug use fell significantly in seven of the nine domains assessed. "Ultimately, we estimated that nationally the Medicare program and its enrollees spent around $165.2 million less in 2013 as a result of changed prescribing behaviors induced by ... jurisdictions that had legalized medical marijuana," they concluded.

Similar results appeared earlier this month in a new study published in The International Journal of Drug Policy. Investigators reported that patients' prescription use of opioids, benzodiazepines, and antidepressants fell significantly when they had legal access to marijuana.

Studies of chronic pain patients similarly find that cannabis' analgesic properties are sufficiently effective to motivate patients to reduce their opioid intake or to give the drugs up all together. For instance, a recent assessment of chronic pain patients by University of Michigan researchers reports "a 64 percent decrease in opioid use, decreased number and side effects of medications, and an improved quality of life" following cannabis intervention. Another trial, conducted last year in conjunction with the Israeli government, similarly reported a 44 percent reduction in opioid use among pain patients who had access to legal pot.

Separate clinical trials also indicate that marijuana may play a role in assisting some subjects kick their opioid dependence. In fact, several studies now show that the moderate use of cannabis is associated with greater treatment attention among this struggling population.

Proponents of marijuana prohibition have long alleged that experimentation with pot acts as a 'gateway' to the use and eventual abuse of other illicit substances. But the evidence does not support this claim.

In reality, permitting marijuana sales to be regulated by licensed, state-authorized distributors rather than by criminal entrepreneurs and pushers of various other illicit drugs results in fewer, not more, Americans abusing other, potentially more dangerous substances. 

Paul Armentano is the deputy director of NORML (the National Organization for the Reform of Marijuana Laws) and an adviser for Freedom Leaf. He is the co-author of the book "Marijuana Is Safer: So Why Are We Driving People to Drink?" (Cheslea Green, 2013) and author of the book "The Citizen's Guide to State-By-State Marijuana Laws" (Whitman Press, 2015). 

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