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Can Marijuana Reduce Opioid Dependance?

The Washington Post has reported on the variable laws, views and use of marijuana in treating pain.

Currently 1.4 million patients in 28 states use legal medical marijuana for a variety of medical conditions - chronic pain being one.

Legislative changes that have allowed widespread use of medical marijuana has risen as the opioid abuse crisis has peaked in the US.

Few recent studies suggest that states with medical marijuana laws may have fewer opioid overdose deaths and that prescriptions for potent narcotics have dropped substantially in states that adopted medical marijuana laws.

While some states (New York) will allow for treatment chronic pain (under certain circumstances) with marijuana, others (Connecticut, Illinois, New Hampshire, New Jersey) do not allow marijuana to manage chronic pain.

Debates are in progress as many claim the potential advantages to medical marijuana while many physicians are not convinced that good evidence and safety studies are available to make the change. 

In the current era of highly restrictive pharmacologic options for chronic pain, many are turning to non-pharmacologic measures such as physical therapy, yoga, ­acupuncture, nutrition counseling, hypnosis and behavioral health counseling before resorting to opioids or any other medications.

In January, the National ­Academies of Sciences, Engineering, and Medicine released a ­review of more than 10,700 medical marijuana studies published since 1999, showing that substantial evidence supports the use of marijuana or its extracts for the treatment of chronic pain.

Currently, the Controlled Substances Act of 1970 classifies marijuana along with heroin and LSD as illegal substances with “no currently accepted medical use” and “a high potential for abuse.” Such law limits the potential to study medical marijuana with federal funds.

Nearly all agree there is an opioid problem in the United States. There is no consensus and there needs to be more research on the efficacy and indications for marijuana use in managing chronic pain.

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Disclosures
The author has no conflicts of interest to disclose related to this subject