Is Turning to Medical Cannabis as a Substitute, an Option?
As the relative widespread acceptance of medical marijuana has led to rapid growth in the cannabis industry, more and more patients are exploring other opportunities in pain management and symptom control. In turn, this has lead to a growing movement that is driving patients away from conventional medications and toward medical cannabis usage.
Thus far, the evidence has largely been anecdotal: doctors share stories about patients who have been helped by medical marijuana, while patients tell friends and family about the improvement in treatment outcomes. In spite of this, however, the scientific community has largely shied away from promoting medical marijuana universally due to the stigmas associated with illegal drug use that remain in modern culture.
However, as use continues to increase – an estimated 3.5 million American adults use medical marijuana regularly as of 2018 – science is starting to explore how, why, and when cannabis can be used as a substitute for other substances.
Substance Use for Pain Management
Substance use, prescribed and non-prescribed, has long been used to deal with pain – both physical and mental. The rise of opioid pain medications in the 1990s seemed like a benefit at first but due to the propensity for addiction that has come forward in the wake of the opioid epidemic, this is no longer as popular among patients or their doctors.
For those who have had frustrating experiences with doctors or traditional pain medications, self-medicating isn’t uncommon. Many people living with either physical pain or mental illness, like anxiety and depression, often use recreational drugs, alcohol, and tobacco as a way to offset the reality of symptoms – and sometimes in conjunction with legal prescriptions.
Mixing substances or abusing substances can lead to serious issues with overall health, including the deterioration of mental health. As such, it’s not surprising that those living with chronic conditions are actively considering other options.
The Rise in Medical Marijuana as a Substitute
Medical marijuana’s prominence in the United States has only grown since California first legalized the concept in 1996. Today, 33 states as well as Washington DC have legalized medical marijuana, with more expected to do so in the upcoming years. Not all of these laws are the same, however – some states have taken a more stringent approach, limiting use to high CBD and low THC products.
However, cannabis is still stigmatized in the United States, leading to doctors’ reluctance to prescribe medical marijuana when other known and proven substances are also available. This is in part, of course, due to the unknown efficacy of marijuana versus traditional painkillers in scientific studies – but the laws on this are now starting to change. States like New York and Illinois permit the use of medical marijuana in place of opioid painkillers, leading to increased physician confidence in these prescription choices.
Further, increased research on the efficacy of marijuana is also beginning to turn the tide. While the evidence for and against marijuana use does not meet the standards of rigor that physicians like to see in making treatment choices, systematic reviews in research studies have yielded low-strength results that may begin to tip the scales. These analyses revealed insufficient evidence for many forms of pain but do denote relief in those living with neurological pain. While these studies do tend to be low methodology and utilize small sample sizes, the efficacy described is similar to the results seen in opioid pain medication tests, albeit on a smaller scale.
Personal Substitution Choices
Whether advised by a doctor or not, many patients are making the call themselves to look toward medical marijuana in pain cases.
In one survey of 2,032 Canadian participants, 62% of whom were male and 91% Caucasian, respondents outlined their preferences in medication to treat both physical and mental issues. Of those surveyed, around 75% of respondents reported daily marijuana use of an average amount of 1.5 grams. A majority of these individuals substituted marijuana use for prescription drugs – about 70% – followed by alcohol, then tobacco, and finally illicit drugs like heroin or meth. For those who chose medical marijuana over prescription drugs, around a third of were seeking to replace the use of opioids.
While the use of medical marijuana can be used to replace any number of medications, from antidepressants to painkillers, opioids are a common topic of substitution. Of the over 600 survey participants who specifically mentioned opioids, around 60% were able to completely cease use with the support of medical marijuana.
While anecdotal in nature, this study does offer compelling evidence that when medical marijuana is available, some users will choose it over potentially abusive substances. This is most notable when related to opioid use – as a serious cause for concern across the U.S., anything that can play a hand in minimizing the epidemic is potentially worth consideration.
Considering Medical Marijuana?
While marijuana has many purported advantages to offer those seeking a natural alternative to opioid medications, medical cannabis isn’t always the right choice. Before deciding to move forward, it’s important to speak to a doctor about your options based on the source of your pain. Also, consider things like the pain management options you have already tried, the the severity of your pain, the possible interactions between marijuana and the other medications you’re taking. You may also want to consider your options regarding THC levels – low THC products are available for those who want the benefits without a perpetual high.
Medical marijuana can be a valuable way to embrace the power of natural medicine. With the current growth in the industry and research that indicates that many patients are considering medical marijuana versus traditional options, this trend may continue over the upcoming years.