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Does Cannabis Use Really Cause Opioid Use Disorder?

 Does Cannabis Use Really Cause Opioid Use Disorder?

This may seem like a big leap, but some people still manage to make it. So we thought maybe we should take a look at both sides of this argument to understand the issue.

The Attorney General for the Trump Administration, Jeff Sessions, consistently comes into conflict with advocates for cannabis in America. His stance has been about the same for as far back as his career in politics, and recent actions by Jeff Sessions have caused a stir with those in support of legalization, whether medical or recreational.

Now, it seems Sessions believes that cannabis use is actually why we have an opioid crisis.

Looking at Opioid Stats

Recently, Jeff Sessions was speaking at the Heritage Foundation to the Reagan Alumni Association this week. As part of the conversation, Sessions did put a lot of focus on cutting prescriptions for opioid painkillers as a critical element to fighting the crisis. So many people who use illicit opioids like heroin or fentanyl start with prescription drug abuse. This much has been shown in several studies, such as one from 2017 published in Addictive Behaviors which found:

  • 9% of people getting opioid use disorder treatment in 2015 started with prescription drugs
  • This is an improvement from 84.7% in 2005

Some would argue that better regulations put into practice over the last several years have helped to curb that trend.

However, Sessions went on to say,

“The DEA said that a huge percentage of the heroin addiction starts with prescriptions. That may be an exaggerated number; they had it as high as 80 percent. We think a lot of this is starting with marijuana and other drugs too.”

It was that last comment that caught a lot of attention. It wasn’t all that shocking, considering Sessions never been a supporter of cannabis use. Still, some people found this commitment to the gateway drug mentality to be a little out of touch.

So, we should look into the argument from both sides.

Can You Connect Cannabis and Opioids?

A recent paper in the American Journal of Psychiatry shows Mark Olfson and a research team delves into data concerning the gateway drug concept.

The team uses data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to examine the association between:

  • Cannabis use reported in the 2001-2002 survey
  • Non-medical use of prescription opioids 3 years later

In relation to the survey the term ‘non-medical use of a prescription opioid’ is defined as using the drug “without a prescription, in greater amounts, more often, or longer than prescribed, or for a reason other than a doctor said you should use them” during the previous 12 months.

Olfson and his group claim that according to the data:

  1. Cannabis users more often ended up using opioids

People who used cannabis in the 12-month period prior to the initial interview were at increased risk of non-medical use of prescription opiates 3 years later.

They even checked the variables, and found this was true even when the data were adjusted to control for:

  • Age
  • Sex
  • Race/ethnicity
  • Family history variables
  • Antisocial personality disorder
  • Other substance use disorders
  • Mood or anxiety disorders

Those studied who used marijuana were still at higher risk of opioid use.

  1. Increased cannabis use correlated with increased opioid use disorder

According to the researchers, the percentage of people with Incident Prescription Opioid Use Disorder at the second interview increased as the level of cannabis use reported at the first interview increased.

To clarify, Incident Prescription Opioid Use Disorder was defined as use that occurred after the first interview that qualified to be considered opioid use disorder, restricted to people who had no prior lifetime history of opioid use disorder.

So essentially, the people who reported to using more cannabis at the beginning of the study were more likely to show signs of opioid use disorder 3 years later.

But Does Connection Equal Causality?

One thing the authors do acknowledge outright is that the majority of adults who use cannabis do NOT start using or increase use of prescription opioids.

Another thing the researchers acknowledge is that their study isn’t proof that cannabis use causes opioid use. The association of marijuana use with non-medical prescription opioids after 3 years in no way means that marijuana use is proven to actually cause opioid use.

The researchers do have a few ideas though.

  1. Brain Changes

Some animal studies seem to have shown that it is possible for cannabis to lead to changes in the brain that make individuals more susceptible to opioid misuse.

  1. Environment

Another argument is that there are several non-biological factors that can elevate the risk of opioid use. Those who regularly use marijuana may be more likely to interact with people who have access to opioids.

Correlating Drug Use

Many researchers have actually cautioned that there’s no solid evidence that marijuana use causes harder drug use.

In fact, a lot of experts and advocates argue that while marijuana use can easily correlate with harder drug use, so can alcohol and tobacco.

The first drugs many people ever use are alcohol or tobacco, which are both legal for adults and fairly easy to get. Yet, no one automatically assumes drinking or smoking cigarettes will lead to heroin use. However, if the same data and logic used by Olfson and his group were applied to alcohol and tobacco, we would probably see a huge correlation. So many advocates argue why should cannabis use be treated any different?

A 2002 report by RAND’s Drug Policy Research Center (DPRC) suggests that it is not marijuana use, but individuals’ opportunities and unique propensities to use drugs that determine their risk of initiating hard drugs. The Institute of Medicine came to a similar conclusion to the ‘gateway drug’ concept back in 1999.

So, no evidence thus far has been conclusive, only correlational.

The Anti-Gateway Affect?

There are also those out there that believe marijuana legalization would actually have the anti-gateway affect, meaning studies have suggested there is evidence that access to marijuana actually reduces some opioid use.

This growing body of investigation indicates that medical marijuana legalization, in particular, can lower the number of people misusing opioids. Some insist it is because cannabis can help to treat chronic pain instead of opioids. Others even think access to marijuana would cause people to substitute their alcohol use. However, research in this area is still finite. Now it’s far too early to tell if this would actually be an effective strategy.

There is even a new study from David Powell and Rosalie Pacula of the RAND Corporation and Mireille Jacobson of the University of California Irvine that examines how medical marijuana legalization- particularly in states with the most access- impacts opioid-related deaths. These researchers concluded,

“These findings suggest that broader access to medical marijuana facilitates substitution of marijuana for powerful and addictive opioids.”

So while there are those who would put the data behind marijuana being a big part of the problem, there are those who avidly believe it is actually a huge part of a different strategy to overcome the opioid crisis.

What Can We Do?

Whichever side of this argument you’re on, there needs to be more time and energy put into exploring both perspectives. If the correlation between cannabis and opioids were ever proven to be more than meets the eye, then more needs to be done to make sure that legalization or decriminalization efforts co-exist with addiction treatment and support options.

If medical cannabis is found to be useful to help treat some who otherwise would be at elevated risk of chronic pain issues, opioid use disorder or even opioid-related death, then more should be done to make sure this method of treatment is safely studied and developed.

Either way, we must continue to work toward helping every individual suffering from substance use disorder of any kind. Whether it is marijuana use disorder or opioid use disorder, there should be safe and effective treatment options available.

There should always be resources available to help people who suffer from abuse. Supporting addiction recovery means breaking the stigma and offering holistic and effective solutions. Palm Healthcare Company is here to help. If you or someone you love is struggling, please call toll-free now.

CALL NOW 1-800-951-6135

Jeff Sessions Continues the Failing War on Drugs

Jeff Sessions Continues Failing War on Drugs

Author: Justin Mckibben

For the last few years, if you ask most experts in the field, it has become abundantly clear across the board that the ‘War on Drugs’ has failed us all. By many accounts, the war on drugs declared by President Nixon in 1971 has had a devastating impact on the people and not the problem. Both addicts and average citizens have suffered under this endeavor. Long-term statistic have shown systematic failures in these archaic policies, and despite efforts to stop the supply of drugs coming in, prices of drugs have gone down while purity has gone up.

In the press, the former President Barack Obama persistently spoke out against the failures and misguided strategies of the war on drugs, calling for a reform in policies. This was one of the primary issues on the campaign trail in 2016 as the opioid epidemic raged out of control. The Obama administration launched a concerted effort to reform harsh prison sentences and commute record numbers of non-violent drug offenders.

With Obama, the idea was to create a climate of compassion and support, breaking stigma and trying to give more people the opportunity for rehabilitation while abandoning a system of mandatory minimums that only made matters worse.

Now, however, under the Trump administration the Attorney General Jeff Sessions means to revert back to the war on drugs.

Attorney General’s Memo

Attorney General Jeff Sessions reversed an Obama-era policy aimed at keeping non-violent drug offenders out of federal prisons, and received some bipartisan backlash. A memo from Sessions was released last Friday, in which he instructed federal prosecutors nationwide to seek the strongest possible charges and sentences against defendants they target. The memo states:

“It is a core principle that prosecutors should charge and pursue the most serious, readily provable offense,”

“This policy fully utilizes the tools Congress has given us. By definition, the most serious offenses are those that carry the most substantial guidelines sentence, including mandatory-minimum sentences.”

Thus, this policy change essentially rejects the Obama-era progress of instructing federal prosecutors to avoid the strictest sentences for defendants charged with low-level drug offenses. This should come to many as no surprise, since Trump and his campaign surrogates were openly supportive of a ‘tough on crime’ and a ‘law and order’ approach to dealing with drug problems.

The bigger picture is, the war on drugs stance has been a waste of resources that ultimately cost far more lives than could have been saved with a more compassionate and connected approach to helping addicts get the help they need.

Jeff Sessions Wants Drug War

There is plenty of evidence to indicate Attorney General Jeff Sessions is all in for continuing the war on drugs. Law enforcement officials report that Sessions and Steven H. Cook, a member of Sessions’ inner circle of the Justice Department, are planning to prosecute more drug and gun cases, and to pursue mandatory minimum sentences.

These same reports indicate that Sessions is very enthusiastic to return to the ‘good old days’ of the 1980s and 1990s at the apex of the drug war. This is the same system that helped exacerbate mass incarceration in America. The war on drugs tore apart countless families and homes across the nation by sending low-level, non-violent drug offenders to prison for longer periods of time. The data later showed this also was a policy that was disproportionately inflicted upon minority citizens.

Attorney General Jeff Sessions insists that this approach is necessary to be tough on crime. This is the same guy quoted for saying things like,

“Good people don’t smoke marijuana”

As if stigma wasn’t already a big enough problem, wait… there’s more. Sessions has also been quoted as saying,

“[the Klu Klux Klan] was okay until I found out they smoked pot”

Advocates for marijuana reform has referred to Sessions as a “drug war dinosaur” and argued that is the last thing this nation needs.

Sessions has gone as far as to say in a speech,

“Psychologically, politically, morally, we need to say — as Nancy Reagan said — ‘Just say no.’ ”

Yes… because we should completely ignore that for over 40 years this injustice has crippled many communities and alienated millions of Americans to the point they would sooner die on the streets than seek help.

Why the War on Drugs Failed

The core problem with the war on drugs strategy was the philosophy that eliminating drugs would eliminate the problem, so the approach was said to focus on wiping out drug supplies and imprisoning traffickers. This may sound pretty cut and dry, but it comply ignores the most basic fundamental of any market; supply and demand.

Reducing the supply without first trying to reduce the demand only drives the price up. The drug market is not price-sensitive. People will continue to use regardless of cost. This new high-price marketplace inspires more traffickers to take more risk for bigger rewards, and the markets continue to grow.

Not only that, but many would say the crimes often associated with drug use are actually caused by the drug war. As purity goes up and the market becomes more competitive, violence among traffickers escalates because of the high demand. According to some, the United States homicide rate is 25% to 75% higher because of the war on drugs.

Opposing Ideas

Sessions’s aides continue to claim that the attorney general does not intend to completely overturn every aspect of criminal justice policy that has changed, but that isn’t all that reassuring at this point when he has already appointed a man to head the revamping of criminal justice who thinks there is no such thing as a non-violent drug offender.

These two politicians have already fought against progressive legislation in the Senate that would have reduced some mandatory minimums and given judges more flexibility with some drug cases. Kevin Ring, president of Families Against Mandatory Minimums (FAMM), states,

“They are throwing decades of improved techniques and technologies out the window in favor of a failed approach,”

California Senator Kamala Harris served as a prosecutor, district attorney and state attorney general before winning her seat in Congress, and this week Harris attacked Attorney General Jeff Sessions’ new sentencing guidelines, stating:

“I saw the War on Drugs up close, and, let me tell you, [it] was an abject failure,”

“It offered taxpayers a bad return on investment,” Harris continued, “It was bad for public safety. It was bad for budgets and our economy. And it was bad for people of color and those struggling to make ends meet.”

Harris urged her fellow progressives in session to fight for more resources to treat addiction, and to elect progressive prosecutors at the state and local level in hopes of fighting back against these counterproductive measures.

In the end, the war on drugs costs millions of dollars annually, while ruining countless lives and making matters worse in essentially every aspect of the issue. Hopefully, this new revival of the war on drugs won’t last.

There should always be hope for a better future. Anyone can make a difference in their own future. Reach out and get the help. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.

   CALL NOW 1-800-951-6135

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