The Doctor’s Opinion


Are you trying to kick a prescription painkiller habit? Have you been in and out of rehab for several years, trying to find a way of quitting opiates/opioids for good? Is there someone special in your life seeing you walk around like a zombie all day, and it’s just tearing them up inside seeing you like this (and by extension, tearing you up inside as well)?

“It’s Just a Crutch”

Well, cannabis could possibly be the answer you were looking for. Now, people might say, “It’s just a crutch.” In some ways, this is true. However, cannabis is definitely a safer crutch than painkillers, and there has been a reduction in fatal opiate overdoses in states that have medical marijuana programs. I would also like to point out that many people suffering from conditions that cause a vast amount of pain might actually need a crutch. Telling them to live in pain does not sit right with me, especially if it means a significantly improved quality of life.

One of the most common methods used to beat addiction are other addictive opiates/opioids. Furthermore, many patients trying to manage their pain may also use benzodiazepines or alcohol as well, increasing the chances of fatal overdose. Unlike with many prescription painkillers, you can’t have a fatal overdose on cannabis alone. Why? Scientists have posited that this is because of a hormone called pregnenolone, which reduces the effects of THC by “acting as a signaling-specific inhibitor of the CB1 receptor.” 

As the endocannabinoid system (ECS) is involved in the modulation of pain and inflammation, cannabis presents a novel solution for treating long-term, consistent pain without opioid-based painkillers. Moreover, cannabis contains anti-inflammatory terpenoids like alpha-pinene, meaning that it can also potentially treat a broader range of painful conditions that opioids have limited use for (e.g. neuropathic pain). 

Will Cannabis Replace Opioids/Opiates Entirely?

Now, I don’t think cannabis will replace opiates and opioids entirely – at least not yet, anyway. Extreme cases and emergency life-or-death situations will likely need fast-acting opioid-based pain relievers in order to get rid of the pain of major surgery. The standard saying at the moment is that “cannabis doesn’t reduce pain; rather, it makes it more bearable.” However, for postoperative pain, cannabis looks to be a rather interesting medicine for pain management. This is an important area to look at, as many addiction cycles start on the operating table.

I can hear you asking, “But what about those who are already addicted to opioids? Can cannabis help them quit?” I wish I could respond with a resounding “yes” and, although I and many others have seen cannabis used to combat addiction to various substances, I cannot say for certain. Yes medical marijuana can be used to help beat withdrawal symptoms like a lack of hunger, restless legs and insomnia, but as the old saying goes, “not everybody’s the same.”

As many addicts have underlying health conditions that cause pain, cannabis can help reduce opiate/opioid intake significantly. The fact that there are fewer known negative side-effects with cannabis use also helps make the switch easier. With all of these factors in mind, I prefer to think of cannabis to be an “exit drug” rather than “gateway drug” – i.e. it could help wean people off opiates/opioids or even stop them from needing such drugs in the first place.

However, cannabis won’t necessarily take an addict out of a bad or abusive environment, and neither will it solve psychological health issues on its own. As the sample size for opiate/opioid addicts being successfully treated with cannabis is so small, it is difficult to give any definitive answers as to its efficacy for treating addiction. Yet there is anecdotal evidence of people using cannabis to stop using all sorts of hard drugs, not just opiates and opioids.

Getting Back On the Horse

Yes, there is recidivism in many cases, but it’s clear that for many people (not everyone, though) abstinence and 12-step programs not only don’t help, but may make things worse. 12-step programs don’t differentiate between one drink and 100 and neither does it take an objective, non-judgmental stance towards those who fall off the wagon in some instances. 

Oh, and it is very unlikely that a 12-step advocate would be sympathetic to the idea of using marijuana to beat addiction – they will likely just see it as no different from alcohol or cocaine, even though scientifically the effects are significantly different! Cannabis is a Schedule I drug federally, and like many others a 12-stepper will likely treat it as thus. Therefore, switching alcohol for cannabis is seen as a continuation of the problem.

Using cannabis to treat opiate & opioid addiction is a controversial idea, even though it really ought not to be. After all, if it can help stop people becoming addicted in the first instance, why can’t it also help those who are already addicted to beat their addictions? The only things preventing us finding the answer to this question are the legal restrictions (meaning less research) and the sheer bloody-mindedness by which people will stick to short-sighted social conventions.

Yet, for all the negatives surrounding this issue, there are still lots of positives. People are starting to come around to supporting cannabis legalization. Doctors and scientists are changing people’s minds on the subject. Legislators are starting to take note and realize that a practical solution is needed for the prescription painkiller crisis. Cannabis, in my mind, could be one of the big answers to a lot of social and health issues.

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