Advocates of Illinois’ “Opioid Alternative Pilot Program,” which allows patients eligible for an opioid prescription the option to receive medical cannabis instead, argue that drug is proven to be the safer and less addictive option. But addiction researchers writing in this month’s edition of the Journal of American Medical Association are pushing back.
In a commentary piece called “Should Physicians Recommend Replacing Opioids with Cannabis?” Richard Saitz, MD, and Keith Humphreys, PhD, argue that cannabis is actually associated with more subsequent pain, and pain patients who take prescription opioids and cannabis actually tend to consume more opioids, not less. In the largest prospective study substituting cannabis for opiods the authors write, “There was no substitution; rather, cannabis was simply added to the mix of addictive substances taken by patients with pain.”
“The evidence here is pretty sketchy,” Humphreys told WBEZ in an interview. “We need to hold things to a higher standard, like we would any other part of medicine.”
The Opioid Alternative Pilot Program launched just a few weeks ago, but it could dramatically expand the number of medical cannabis patients in Illinois. Just 52,000 people are eligible for cannabis currently – but almost 2.5 million Illinois residents had an opioid prescription in 2017, according to data from the Illinois Department of Public Health. As of last week, 357 patients had signed up for the project in its first few weeks.
Champions of the project have argued that the rising toll of the opioid epidemic makes trying cannabis as a treatment for pain worthwhile, despite the unknowns.
“I’m not a doctor, but the one thing I know is that thousands of people are dying from opioid overdoses and nobody has ever died from a cannabis overdose,” said State Senator Don Harmon, who sponsored the opioid alternative program. ‘It’s a chance I am willing to take as a policy maker, even with imperfect information.”
Humphreys said many of his peers in the medical and addiction research feels have reached out in support of his piece since it was published.
“All these people emailing me saying— ‘my god, thank god somebody said something.’” Keith said. “What’s going on in a lot of the health field is anxiety about complete trust in cannabis, coupled with fear of saying you have that anxiety. Nobody wants to be a blue-haired mother from the 1980s right?”