The word "epidemic" is often thrown around to describe any uptick in societal behavioral patterns. Recently, the word has been used to describe the increase in heroin use, overdose and treatment seeking in the United States. The data seem to support that something is in fact going on. Treatment admissions for heroin increased from 14 percent to 16 percent between 2010 and 2012, and deaths from heroin related overdoses increased nearly fourfold between 2002 and 2013. Furthermore, rates of use are up, especially among young people, women and others with economic disadvantages. At the same time, treatment admissions for other opiates has remained stable, and deaths from overdose due to other opiates has decreased. One could hypothesize that this situation results from restrictions on continued access to prescription opiates for specific populations deemed most "at risk" for substance dependence, which forces those seeking relief from opiates into the illicit heroin market. There has been a drop in price for heroin and this would explain why. The elephant in the room is the powerful tool we already have for preventing opiate related overdose and death by preventing opiate dependence, cannabis.
The idea of using cannabis as a substitute for opiates is not new. In 2011, several doctors penned an article called "Cannabis in Palliative Medicine: Improving Care and Reducing Opioid-Related Morbidity." Other research studies have examined the occurrence of substitution within the medical cannabis patient population, and last year, an article in the Journal of the American Medical Association made the connection between states that had passed medical cannabis laws and reductions in opiate related overdose death. Most recently, a report from the National Bureau on Economic Research looked at the relationship between access to medical cannabis and problematic opiate use. The authors found that specifically, states that have dispensary systems for medical cannabis had significantly less problematic opiate use. This outcome was echoed in another recent study that found that people who inject opiates use fewer opiates when they use cannabis.
Even with the exciting opportunity to be proactive against opiate dependence by introducing cannabis as a treatment option, opponents still claim that the FDA-approved opiate is preferred to the non-toxic plant that presents little risk of dependence and no risk of fatal overdose. I cannot help but wonder if the families and loved ones of the 8,200 people who died from an opiate overdose in 2013 would agree? Or would they do anything, even embracing the use of a centuries old pain treatment, to have those people back with them today? The CDC lists several actions that communities can take to combat this growing issue. Among them, good solid advice, such as expanding naloxone programs and access to sterile syringes. Both great tools for reacting to opiate dependence. But, what is missing from this list, the use of cannabis as a first line pain treatment, can actually prevent opiate dependence in the first place. It is time to let go of the last grasps of Reefer Madness, it is a matter of life and death.