Pubdate: Tue, 26 Aug 2014
Source: Honolulu Star-Advertiser (HI)
Copyright: 2014 Star Advertiser
Contact: 
http://www.staradvertiser.com/info/Star-Advertiser_Letter_to_the_Editor.html
Website: http://www.staradvertiser.com/
Details: http://www.mapinc.org/media/5154
Author: Melissa Healy, Los Angeles Times
Page: A3

MEDICAL MARIJUANA COULD HELP COUNTER PAINKILLER DEATHS

A new study suggests medical marijuana could be an antidote for the 
nation's scourge of painkiller overdose deaths and it has set off a 
flurry of medical debate over the risks and benefits of making 
cannabis more widely available to patients.

The new research, published Monday in the journal JAMA Internal 
Medicine, finds that deaths associated with the use of opiate drugs 
fell in 13 states after they legalized medical marijuana. Compared to 
states with no formal access to marijuana, those that allowed certain 
patients legal access to cannabis saw a steady drop in opiate-related 
overdoses that reached 33 percent, on average, six years after the 
states' medical marijuana laws took effect.

"The striking implication is that medical marijuana laws, when 
implemented, may represent a promising approach for stemming runaway 
rates of non-intentional opioidanalgesic-related deaths," wrote 
opiate-abuse researchers Dr. Mark S. Brown and Marie J. Hayes in a 
commentary published alongside the study. "If true, this finding 
upsets the apple cart of conventional wisdom regarding the public 
health implications of marijuana legalizations and medicinal usefulness."

That apple cart has already been shaken by a growing body of research 
that suggests marijuana's psychoactive ingredients may enhance the 
pain-killing effects of opiate drugs, allowing patients using 
marijuana for pain to take lower doses of opiate medications.

"It's so apparent that our patients can decrease, diminish or wean 
themselves completely off of opiates, and that it improves their 
quality of life," said Dr. Donald Abrams, a University of California 
at San Francisco oncologist who was not involved with the study.

In a small study published in 2011, Abrams found that cancer patients 
taking morphine and oxycodone experienced greater pain relief at 
lower opiate blood-concentrations when a vaporized form of marijuana 
was added to their drug regimen. He has just begun recruiting for a 
study of whether the same formulation can reduce pain, inflammation 
and opiate doses in patients with sicklecell disease.

But those who have opposed expanding access to medical marijuana said 
they were not convinced that cannabis - a plant designated by the 
Drug Enforcement Agency as having "no recognized medicinal use" - is 
a safer alternative to opioids.

"Clearly the study raised an intriguing hypothesis, but many 
questions still need to be answered," the National Institute on Drug 
Abuse said in a statement released Monday.

Roughly 60 percent of the nation's fatal opioid overdoses occur among 
patients who have prescriptions for their medications. The authors 
wrote that in states where access to medical marijuana is legal, 
legitimate opioid drug users might take lower doses of that 
prescription pain medication, making overdose less likely. Others may 
use marijuana in place of benzodiazepine drugs - sedatives that make 
a fatal overdose much more likely. Still other patients may never 
start opioid medication use if they are able to get pain relief from 
medical marijuana, the study authors wrote.
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