Why to Prescribe Cannabis Before Opioids

Why to Prescribe Cannabis Before Opioids

Just over three years ago, I was in a manager meeting. I’ll never forget receiving the call and leaving immediately. My cousin from back home in New Hampshire rang me, and the words shook me to my core. One of my best friends, Josh, had overdosed on opioids and was found dead.

The why was never clear, as it often isn’t. But fentanyl, an extremely concentrated opioid, was found in his body upon autopsy. It appeared that he’d maybe had a bad day, and like so many other former addicts, went back out, found anything with opioids, and put the fentanyl patch on to get his fix. Then he nodded off, patch still on. Having no tolerance from being clean, the opioid quickly overpowered his body and killed him.

I couldn’t understand how or why this happened. I’d last seen him two years prior, and he’d beaten his oxycontin addiction, cut his friend circle very short, and was making progressive moves in his life. I knew he was clean because he was calling me to smoke weed every day the last time I’d visited home, which was for about six weeks. It helped him combat the long-term mental effects of opioid withdrawal.

You see, when an opioid addict is using opioids, they won’t call you to smoke cannabis. They only care about maintaining their next opioid fix. Nothing else matters. If your recovering addict friend is bugging you to come blaze up, you know they aren’t using any more. They’re trying to subdue their opioid cravings.

Josh wasn’t the only one. At least 20% of my cousin’s high school class (one year younger than Josh’s), has died from an opioid overdose. Over-prescribed oxycontin hit small, working-class New England towns like a plague, and people dropped like flies before they realized the consequences of addiction. I personally know dozens of people who have died from going back out to use opioids; they used their “normal dosage” from when they were an addict and died immediately. The story repeats itself over and over.

What happened to Josh isn’t an isolated incident. Over 49,000 lives were documented to have been lost directly from an opioid overdose in 2017 alone, with over half of all opioid overdose deaths being from legal, prescription synthetic opioids.1 This number is double the 24,000 opioid overdose deaths just five years prior in 2013.2 This accounts for almost 70% of overall drug overdose deaths in the nation.3

Death from opioid overdose is an epidemic in many parts of the country, including the Northeast where I am from. Even more people who remain alive are crippled by addiction, taking pills over-prescribed by doctors paid by big pharma. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health (NSDUH), in 2016, over 11 million Americans misused prescription opioids, nearly 1 million used heroin, and 2.1 million had an opioid-use disorder due to prescription opioids or heroin.4 Nobody knew just how bad it could get.

This epidemic has been going on for years, and finally, opioid prescriptions are subject to some restrictions, but for so many people, it’s too little, too late. So many people became heroin addicts because they couldn’t get the pharmaceutical version anymore. Opiate and opioid withdrawals cause horrendous physical and mental sickness that people just cannot handle. Over 80% of current day heroin users started with opioids that were prescribed to them.5 Deaths from drug overdoses involving heroin tripled from 8% in 2010 to 25% in 2015.6

Yet here we stand as cannabis, which nobody has ever overdosed from in the history of humanity, is classified as Schedule 1, federally-illegal substance. This means that, federally, cannabis is deemed to have no medical value. Opioids are classified as Schedule 2 drugs, considered to have medical value under prescription. The consequences for possession of cannabis are worse from a federal point of view than opioids. Thousands of people lie in jail for getting caught using cannabis to help pain–a drug that is far less dangerous than the legal alternatives. Many of those people were trying to relieve their opioid addiction.

These facts force me to turn a coin that asks, what if my friend Josh had access to concentrated cannabis substances like rosin, shatter, live resin, or RSO? What if indica edibles could have subdued his urges enough that he found himself eating a pizza instead of being dead? Some rehabilitation facilities are experimenting with this, with raving testimonials from former in-patient recovered addicts.

Greener Pastures of Maine rehab facility boasts research studies showing that cannabis is effective in reducing opiate addiction.7 Furthermore, their studies found that people using opioids for pain management take fewer opioids when they combine them with cannabis.8 Greener Pastures uses strong cannabis extracts to subdue the urges of actively-withdrawing addicts. Researchers are compiling glaring evidence about the benefits of cannabis use to help opioid addicts, but the large-scale studies needed widespread treatment have been stunted. The fact is, big companies and research facilities need to provide nationally accepted empirical data, but they do not want to undertake studies with a Class 1 illegal substance.

While I write this article, opioids are still being largely over-prescribed nationwide. Many states have taken measures to reduce synthetic opioid distribution, but again, it is too little, too late. I want people to know that cannabis can be an alternative pain medication and to know just how slippery the slope of opioids truly is. Let’s reconsider how we view pain management as a nation. At the very least, we know nobody is dying from cannabis.

While we know that opioids surely do work for temporary pain relief, the consequences can be life altering and deadly. Wouldn’t it be wise to integrate cannabis concentrates as an alternative for pain management in Western medicine before stepping up to something so knowingly consequential? Especially when we know that withdrawals from high dosage are far less severe, and that nobody has overdosed on cannabis ever? And in particular, that CBD (a non-addictive, non-psychoactive derivative of cannabis) can be used to help ease withdrawals of heavy-dosage cannabis medication?9

The facts are there, and the time for change is now. Keeping the people under the thumb of big pharma, and life-altering/ending addiction caused thereby, is a nonsensical notion when a plant that can be grown in your own backyard can change the outcomes of these addictions.

1 https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
2 https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
3 https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
4 https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2017/federal-efforts-to-combat-opioid-crisis-status-update-cara-other-initiatives
5 https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
6 https://www.cdc.gov/nchs/products/databriefs/db273.htm
7 https://scienceblog.com/497482/study-finds-medical-cannabis-effective-reducing-opioid-addiction/
8 https://www.ncbi.nlm.nih.gov/pubmed/27001005
9 https://www.ncbi.nlm.nih.gov/pubmed/23095052


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