Can Cannabis Replace Opioid Pain Medication?

The rise in cases of opioid addiction, including from prescribed medicine, has led to policymakers declaring an “opioid crisis” in the United States. Opioids are widely used for a wide variety of medical applications, ranging from over-the-counter anti-diarrhea medicine to anesthetic for major surgery. They are also widely prescribed and used off-label for a number of other ailments, including insomnia, anxiety, coughs, and chronic pain.

While highly effective, many types of commonly-used opioids carry with them a high potential for abuse. This is especially concerning for instances where regular use is needed, such as when a patient experiences chronic pain. Opioid-related deaths have reached a peak, with 64,000 people dying in 2017 alone. This correlates with the increased prescription of opioid medications for pain management.

Medical cannabis may be a solution

Cannabis, specifically the non-psychoactive compound cannabidiol, has been seen as a possible part of the solution to the crisis. Cannabis’s pain-reducing properties have been recognized since at least the third millennium B.C.E., but adoption in modern mainstream medicine has been relatively slow due to politics as well as the unease at the psychoactive effects of tetrahydrocannabinol (THC), the main active compound responsible for most of the effects of cannabis.

On the other hand, studies on cannabidiol, a compound of cannabis with most of the pain-reducing qualities of THC but without the “high” has put medical cannabis at the forefront of possible solutions to the opioid crisis. While regular medical cannabis with THC also shows plenty of promise, the potential for psychological abuse and the psychoactive properties of this class of medical cannabis has made it far less appealing for this application.

The pain-reducing qualities of CBD are proven in multiple studies. While the effects are not strong enough for some applications such as open surgery, they are already seen as a viable substitute for reduced strength opioids in applications where repeated use is needed, such as in chronic pain management.

In states where medical cannabis is legal, opioid-related deaths have already been drastically-reduced, thanks in large part to the ready availability of CBD-derived pain medication.

CBD has another surprising benefit for opioid addiction

What’s more, not only does CBD provide pain relief, initial studies seem to indicate that it can block the “reward mechanism” in the brain that causes opioid addiction. This means that not only is CBD an effective pain relief treatment in and of itself, but there is also a good chance that it can directly help opioid-dependent patients recover.

This means that CBD potentially has direct uses for enabling the recovery of opioid addicts who do not necessarily need pain control as well, such as in the case of heroin and prescription opioid addicts. This means not only is CBD a substitute for opioids in pain relief, but it can also likely treat symptoms associated with opioid dependence and withdrawal.

On the other hand, CBD research is still in its infancy, and it may take more research to uncover the best course of treatments for different classes of patient.  Without further legislation and full legalization, it will also be difficult to realize the full potential of medical cannabis in preventing further opioid-related deaths.