Nine hundred people in Philadelphia dropped dead last year due to drug overdoses — three times the number of homicide victims — and the city’s opioid problem has become a full-blown crisis.
Task forces have been organized, legislation has been proposed, organizations and nonprofits have mobilized. But what if an answer to the city’s growing heroin and opioid addiction epidemic is already on its way?
Some physicians and public officials believe Pennsylvania’s nascent medical marijuana program could have a significant impact and save lives by serving as an alternative prescription for chronic pain management as opposed to opioids, the prescription drugs that studies show can serve as a gateway to heroin addiction.
Other officials aren’t so sure treating a drug problem with another drug is the right move. And there’s little research to lean on here, as marijuana is classified by the Drug Enforcement Agency as a Schedule I drug (alongside things like meth and heroin), making it difficult and time-consuming for medical researchers to study its impacts.
Bruce Nicholson, a Lehigh Valley pain management physician who was a member of the state’s Medical Marijuana Advisory Board, believes medical cannabis can provide a solution to the over-prescribing of opioids to treat pain.
“Rather than reach for a needle,” he said, “they use either a vape pen or whatever they use to quell that impulsive behavior that may end up being destructive.”
Fatal drug overdoses in Philadelphia in 2016 reached more than 900 people, a whopping 30 percent increase over the previous year. Of those, 80 percent were related to opioids, including prescription drugs and heroin. Statewide, more than 3,500 people died of drug overdoses in 2015, also a 30 percent increase over the year prior and making Pennsylvania’s drug overdose rate one of the highest in the country.
Officials in Harrisburg and locally have made addressing the issue a priority. But some lawmakers say Pennsylvania’s medical marijuana program, which is still in its early phases, could be part of the solution.
“Opioid abuse has no party, has no color, has no religion,” Sen. Mike Vereb, a Republican from Montgomery County, said when the state passed medical marijuana legislation last year. “Let’s face it, that’s the killer. What we’re doing today is the healer.”
It’s been a year since Pennsylvania officially legalized medical marijuana for a handful of specific conditions, including chronic pain management. The Department of Health is in the process of rolling out provisions and digging through applications for growing and dispensing licenses.
State Sen. Daylin Leach, a Montgomery County Democrat and a prime sponsor of the state’s medical marijuana legislation, testified before Philadelphia City Council in September about the law, telling them it’s “the most important piece of social legislation we’ve passed in Harrisburg in decades” and claiming that it could save some 500 lives a year if it’s used as an alternative to prescribing opioids.
Leach referenced a 2014 study by the American Medical Association that found that states with medical marijuana programs saw a 25 percent decrease in opioid overdose mortality rates, and it found that people who used medical marijuana to treat certain conditions decreased their opioid usage by 50 percent. A similar study conducted by researchers at Johns Hopkins University found medical marijuana cut into prescription overdose deaths by 25 percent, as well.
It’s not a given that Pennsylvania would see the same decrease in opioid overdoses. It’s still unclear how many doctors and patients will even take part in the state’s medical marijuana program, and some local officials remain concerned that patients in Philadelphia could struggle with access to medical marijuana.
There’s also very scant research in this area because the federal government’s marijuana distinction means the supply of legal marijuana available for study is small. Besides the 2014 AMA study, there have only been a handful of scientific reviews examining how medical marijuana could impact the widespread usage of opioids. (Pennsylvania’s law does include funding for research institutions in the state to study the drug.)
What there seems to be even less research on is if medical marijuana can be used to effectively treat opioid addiction, rather than simply be used for chronic pain management as opposed to drugs like Oxycodone or Vicodin. While Nicholson said he sees medical marijuana as an alternative to prescribing opioids, “clearly our current model and paradigm for treatment for opioid addiction is an abysmal failure.”
There’s been some experimentation in this field. High Sobriety, a drug and alcohol treatment facility based in Los Angeles, practices what they call “cannabis inclusive treatment,” a program that stresses that marijuana is non-lethal while other drugs can kill.
Don’t expect a facility like that to open in Pennsylvania any time soon. But some physicians like Nicholson are waiting on the full roll-out of the state’s medical marijuana program to see what — if any — impact it might have on the state’s severe opioid addiction problem.
“I prescribe a lot of opioids,” he said. “I see [medical marijuana] as absolutely an alternative. I see it as an opportunity to have a dialogue with a patient in saying to them ‘here’s your opportunity’… I can see the future being that you give people options.”