Why it’s Critical for Patients to Consult Their Physicians Before Using Cannabis
by Chane Leigh
Despite a long history of legal and social barriers to scientifically sound research and clinical trials on the benefits of medical cannabis, evidence-based research into the mysteries of the cannabis plant continues to grow in recent years. Dr. Jahan Marcu, Ph.D., Editor-in-Chief of the American Journal of Endocannabinoid Medicine, recently interviewed researcher Dr. Philippe Lucas, Ph.D. (c), in a piece titled “What is the Role of Medical Cannabis in Substance Use Disorders?” Dr. Lucas is an experienced researcher with expertise on the implications of cannabis for public health. They explored the implications of cannabis as a substitute for highly addictive drugs and as a treatment for a host of conditions and health ailments.
The conversation between Dr. Marcu and Dr. Lucas sheds light on the sometimes controversial evidence that medical cannabis may be a viable treatment for opioid dependency. In their discussion, Dr. Lucas pointed to past studies suggesting that medical cannabis may be as effective at treating chronic pain as highly addictive opioid prescription medications. Study participants reported that cannabis helped relieve their cravings for opioids and helped them decrease their opioid use.
Dr. Lucas is the Vice President of Global Patient Research and Access at Tilray, a medical cannabis producer and global leader in cannabis research, cultivation, processing, and distribution. The 2017 Tilray Patient Survey polled 2,032 patients in Canada’s federal medical cannabis program on their cannabis use. Tilray’s findings suggest that the use of medical cannabis was associated with patients’ decreased use of other drugs, including alcohol, tobacco, antidepressants, and opioids. Some patients completely stopped using opioids with the use of medical cannabis:
“In this study, a high percentage of study participants…. reported substituting medical cannabis for prescription drugs (69%), alcohol (45%), tobacco (31%), and illicit substances (26%). The most commonly substituted prescription drugs were opioids (35%) and antidepressants medications (22%]…Of the 610 patients who reported substituting cannabis for opioids, 59% completely stopped using opioids and an additional 18% reduced their use by 75%.” – Dr. Lucas
Among the many strengths and benefits of medical cannabis, the use of medical cannabis could have a positive impact on the opioid crisis. Tilray’s 2017 survey suggests cannabis may be an effective, low-cost, and low-risk tool for treating substance use disorders with relatively low harmful effects. For example, medical cannabis poses no risk for fatal overdose and is a better option in comparison to other highly addictive substances for the substitution of opioids.
Dr. Marcu and Dr. Lucas also discussed medical cannabis as a substitution for drugs treating other conditions, such as chronic pain, alcohol dependence, benzodiazepines addiction, anxiety, and sleep disorders.
On the growing opportunities for medical cannabis research and treatments for patients, Dr. Lucas looks forward to future possibilities: “I’m optimistic that as more funding becomes available to examine the therapeutic potential of cannabinoids, entirely new modalities will develop in regards to cancer care, and the treatment of Alzheimer’s disease/dementia, arthritis, anxiety and many other serious conditions.” You can read the discussion between cannabis researchers Dr. Marcu and Dr. Lucas in detail here.
Current research on the use of cannabis as a substitute for opioids cited by Dr. Lucas included a study published in 2018 in the journal Addiction, authored by Dr. M. Eugenia Socías, MD, MSc, of the British Columbia Centre on Substance Use. In Dr. Socías’ study (“High-intensity cannabis use is associated with retention in opioid agonist treatment: a longitudinal analysis”), researchers observed 820 people for several years (a median of 81 months). The 820 people were grouped into those who use cannabis on a daily basis and those who used it less often. The study found that the participants who used cannabis at least daily had a 21% greater chance of decreasing their opioid use.
Another study conducted in 2017 and published in the journal of Cannabis and Cannabinoid Research found that medical cannabis patients were more likely to decrease opioid use. The authors argue for the use of medical cannabis in the place of opioids for the treatment of chronic pain. In the study, Dr. Amanda Reiman and her co-authors collected data from 2,897 medical cannabis patients. They found that cannabis is just as effective at treating pain as prescription opioids, and cannabis caused fewer side effects in comparison to other medications. In fact, “81% [of respondents] ‘strongly agreed/agreed’ that taking cannabis by itself was more effective at treating their condition than taking cannabis with opioids.”
These studies provide evidence that cannabis may empower patients battling substance use disorders. Hopefully, we will see more evidence-based research on the therapeutic benefits of cannabis as more universities around the globe begin to offer academic programs and classes on cannabis. Additionally, a new federal commission urged cannabis research for vets struggling with mental health conditions. New cannabis recommendations from the World Health Organization (WHO) call for a rescheduling of cannabis’ drug status and may help lower existing barriers to cannabis research.
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