On August 10, 2016

Marijuana legalization is critical in effort to reduce opiate addiction

By Dave Silberman
A recently VPR poll found that 89 percent of Vermonters view opioid and opiate addiction as a “major problem,” and that more than half of us know someone who has been personally affected by this devastating disease. Fortunately, when the Legislature reconvenes in January, they will have the opportunity to pass a law that a growing scientific consensus agrees is an effective – and cost-effective – tool to reduce opiate addiction, overdose and deaths: legalizing and regulating cannabis for use by adults.
This may seem surprising to some, but not to those of us who have been paying close attention to the public health impacts of drug policy across the nation. We’ve suspected for some time that cannabis (more commonly referred to as marijuana) is a substitute for both medical and non-medical use of opiates, but now the evidence has become undeniable and overwhelming.
For example, a study published just weeks ago by researchers at the University of Georgia found that states which implemented legal access to cannabis saw sharp decreases in Medicare-covered prescriptions for opiates to treat chronic pain (as well as smaller declines in prescriptions for anti-anxiety drugs and anti-depressants). In all, the study found that the Medicare system saved $165 million in 2013 alone – and extrapolated that if cannabis were available nationwide the savings would have been almost half a billion dollars that year.
These dollar savings are great for taxpayers, of course, but the real social benefit is in switching people off of the harmful prescription opiates that we know are causing addiction, and onto a less harmful alternative. This latest study joins a constantly growing body of evidence that cannabis, a much less harmful substance no matter who you ask, is being effectively used as a substitute for opiates.
Vermont’s opiate addiction crisis impacts all of us, and must be addressed with every available effective policy tool.
In 2015, researchers at RAND and the University of California discovered that states with medical cannabis dispensaries experienced a relative decrease in opiate addictions and opiate overdose deaths compared to states without dispensaries. Similarly, doctors at Penn and Johns Hopkins found in 2014 that the 13 states that allowed legal medical cannabis access between 1999 and 2010 experienced 25 percent fewer opiate overdose deaths than those states that did not. Yes, that’s a 25 percent reduction in overdose deaths. At-risk lives literally being saved by cannabis.
With this in mind, it’s no wonder that forward-thinking doctors are starting to use cannabis as part of their addiction treatment regimens, helping patients wean off opiates and overcome the symptoms of withdrawal. It turns out that the old “gateway drug” theory has gotten it completely backwards!
While the research to date has focused on “medical” cannabis, the substitution effect would hold for “recreational” cannabis as well. This is because the key factor is safe, legal access to cannabis, not the doctor’s prescription pad. Indeed, it’s likely that the doctor-gatekeeper model is actually hindering the full substitutive impact, as many doctors in medical-legal states refuse to recommend cannabis to their patients, given the continuing social stigma, federal prohibition and the lingering power of decades of hysterical anti-drug propaganda.
Vermont’s opiate addiction crisis impacts all of us, and must be addressed with every available effective policy tool. Not only is cannabis legalization an important, proven and safe part of the solution, it is the only realistic policy option that contributes to the general fund without raising income or property taxes. What’s more, with the $25 million or more that legalized cannabis would deposit in the state coffers each year, the Legislature would finally be able to adequately fund on-demand treatment services, and save even more lives.
Dave Silberman is an attorney and pro bono legalization advocate in Middlebury. This column does not represent the views of any client.Cannabis, a much less harmful substance no matter who you ask, is being effectively used as a substitute for opiates.

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