Why aren’t Doctors Prescribing Cannabis over Opioids?
by Nicholas Demski
A brief look at the long history of opioids over cannabis, and their medicinal uses.
Opioids, a drug that is responsible for 80 deaths per day in the United States. Cannabis is responsible for zero deaths per year. Both opioids and cannabis provide relief from chronic pain, both are found naturally in plants. The drugs that routinely kill are regularly prescribed by healthcare providers, while the one with zero fatalities is embarrassingly taboo.
What has led to this cognitive dissonance associated with opioids and cannabis? Why is there such a significant disparity between their toxicity and their legality? Unfortunately, this bizarre relationship between facts and medical laws has existed for over a century. It’s an evolving relationship that needs much more research and honest debate.
Let’s explore why doctors aren’t prescribing cannabis over opioids for pain relief in many situations.
Opioids Have Been Grandfathered In
Around the middle of the 20th century, opioids were labeled as effective drugs for pain relief by the FDA. Their status, as such, has allowed them easy access to the medical market. Despite the problems they cause, their results in pain reduction efficacy are grandfathered into the medical literature as the most effective treatments for chronic pain.
Often, new opioids are marketed as wide-berth chronic pain relievers, even if their data suggests they only target a particular type of chronic pain. These calcified assumptions and old rules create an unleveled playing field for medical marijuana.
The Illegality of Cannabis
With the implications of a Schedule I status by the Federal Government behind it, the field of medical cannabis is strewn with legal issues. Its federal prohibition makes it difficult for healthcare providers to prescribe cannabis. Prescribing cannabis would be operating outside of federal law.
What’s more, Schedule I status also makes cannabis difficult to research; cultivating and obtaining an ample enough supply to study it is a federal crime. Thus, research into medical cannabis has been slow in the United States.
How it all Started
According to Johanna Hari, a British journalist, the War on Marijuana started with a man named Harry J. Anslinger. He was the United States’ first commissioner of the U.S. Treasury Department’s Federal Bureau of Narcotics.
He preceded over the department at the end of the alcohol prohibition. Anslinger was determined to keep his seat and the power he had accumulated. As a result he turned his and his department’s focus on criminalizing cannabis. Unfortunately, he was successful despite the medical community’s consensus that cannabis should not have been made illegal.
His claim that a mentally disturbed teenager’s consumption of marijuana led him to murder his family with an ax was enough of a first push that criminalization occurred. Eventually, the ideas bred from this act lead to the Nixon administration’s labeling of cannabis as a Schedule I drug.
Thus, the reason so many doctors don’t prescribe cannabis as a medicine to this day.
How it’s all Changing
With over half of the states enacting some type of legalized cannabis use, more doctors have been prescribing it for medicinal purposes that universities and institutes have been researching. In a 2014 article published in JAMA, the researchers concluded that “medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates.” In an adjusted model, the results showed a 24.8% decrease in opioid-related overdose deaths in the states with medical cannabis laws. Medical cannabis saves lives.
As research demonstrating the efficacy of cannabis for pain relief piles up, the move to make medical cannabis legal across the United States is quickly gaining momentum. California, along with its massive economy, recently legalized recreational cannabis use.
When influential players (economies) show public health benefits and increased revenues, the momentum will be hard to stop. More universities are taking cannabis seriously; one university in Michigan has created a major studying medicinal plants including medical cannabis. As the research grows with the open minds of scientists around the country, medical cannabis is going to be more widely prescribed as an alternative to opioids.
Opioid overdose deaths have created a “national emergency,” according to the President. Medical cannabis kills no one and eases chronic pain for many. This is an easy point to make. As research improves and public opinion leans towards acceptance, the likelihood of your doctor prescribing you cannabis instead of opioids for your chronic pain is increasing. With that decrease in opioid prescriptions comes fewer opioid overdose deaths. If doctors want to maintain their Hippocratic oath and protect public health, then they’ll soon have no choice but to listen to science. Prescribing cannabis in the fight against chronic pain will be the clinically-correct choice.