Pubdate: Fri, 28 Aug 2015
Source: Boston Globe (MA)
Copyright: 2015 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Evan Horowitz

COULD MEDICAL MARIJUANA ALLEVIATE THE STATE'S DRUG EPIDEMIC?

Consider this counterintuitive fact: One reason overdose deaths in 
Massachusetts have shot up 50 percent in the past few years is that 
the crackdown on prescription opioids has worked extremely well.

It has become a lot harder for users to get those drugs but that 
doesn't mean they all sought treatment or were suddenly freed of 
their addiction. Rather, the evidence suggests that many turned to 
heroin, which is even deadlier.

Here's one approach that's rarely discussed but seems to curb abuse 
of prescription opioids - without the risk of driving users to 
heroin: Increase access to medical marijuana.

Are we fighting a prescription opioid crisis or a heroin crisis?

We seem to be at a transition point. Prescription opioids became a 
scourge in the 2000s, when pill mills made it easier to get the 
drugs, and overdose deaths in the United States shot up from about 
4,000 per year to more than 16,000, according to the Centers for 
Disease Control and Prevention.

But those harrowing death rates stopped growing around 2010, thanks 
in large part to effective new regulations that made prescription 
opioids harder to get, and harder to abuse.

Yet, that wasn't the end of the opioid crisis. It was just the 
beginning of a new phase, centered around heroin.

A 2012 study in the New England Journal of Medicine found that the 
crackdown on prescription drugs really did drive some users toward 
heroin. It's not a huge number of users: The Drug Enforcement 
Administration estimates that only about 3.6 percent of prescription 
opioid addicts make the switch to heroin. But given that heroin is 
more potent, and deadlier, even a relatively small influx of users 
can have devastating consequences.

Since 2010, heroin deaths in the United States have more than doubled.

It's hard to say for sure whether the trend is identical here in 
Massachusetts, since state data don't distinguish between deaths from 
heroin and deaths from other opioids. But if Massachusetts looks 
anything like the rest of the nation, heroin is what's fueling the 
recent surge in overdose deaths.

Is there a way to end this crisis?

Prescription opioids have a legitimate, and vital, medical purpose: 
They help people manage pain. Unfortunately, they are also quite 
addictive and seem to put some users on a path toward heroin.

The ideal solution would be to find a better, less addictive, and 
less dangerous way to treat pain. And one drug that might fit the 
bill is medical marijuana.

Not only has marijuana been shown to treat chronic pain, but a recent 
study from researchers at the RAND Corporation and University of 
California Irvine found that increased access to medical marijuana 
curtailed prescription opioid abuse and overdose deaths.

You might object that this amounts to swapping one drug for another, 
but marijuana is a very different kind of drug. First, marijuana 
overdose deaths are vanishingly rare - virtually non-existent. For 
another, marijuana isn't a gateway drug for heroin; Because it's not 
an opioid, it doesn't create the kind of addiction that heroin could soothe.

This hardly makes medical marijuana a panacea. It's still vital to 
pursue many of the recommendations unveiled last month by the 
governor's Opioid Working Group, including raising awareness, 
improving treatment, distributing anti-overdose drugs, and treating 
addiction like a disease, rather than a crime.

But the fact that Massachusetts' first medical marijuana dispensary 
opened this summer, with others slated to arrive in the coming 
months, means that marijuana could play an unexpected role in the 
ongoing fight against opioids and heroin.
- ---
MAP posted-by: Jay Bergstrom