Marijuana would worsen, not improve, the opiate crisis

Back in October 2015, U.S Attorney Thomas Delahanty recruited around 3 dozen professionals from around Maine to sit on the three task forces making up the Maine Opiate Collaborative.  The law enforcement, treatment, and prevention task forces were to charged with developing comprehensive, evidence-based strategies to address the worsening heroin crisis.  Along with my fellow Co Chair, William Paterson, Substance Abuse Prevention Director at the University of New England, we have convened the prevention task force every two weeks to develop our plan. We have had some of the top prevention, harm reduction, recovery, and medical experts around the table working to create the strategic plan.  The work has involved gathering the latest data and latest research on effective prevention approaches to this public health epidemic.  Our final plan will be released in early May.

Here is what you won’t find in any of the final recommendations from any of the three task forces; treating opiate addiction with medical marijuana.  Yet, tomorrow at the Department of Health and Human Services, there will be a hearing on a petition to add opiate addiction as a qualifying condition for Maine’s Medical Marijuana Program.  As I wrote about in a previous article, this legislative session the marijuana industry in Maine has been trying to take advantage and cash-in on the heroin crisis.  They have made several unsuccessful attempts to shoe-horn into the various heroin bills, language to add opiate addiction to the list of allowed conditions for the medical marijuana program.  This is the next phase in their agenda.

As I mentioned, you will not find treating opiate addiction with medical marijuana in the recommendations of any of the three task forces.  Why?  Well, it is quite simple.  Our charge was to create plans using scientific, evidence-based strategies for treatment and prevention.  First, let’s be very clear, broadly, medical marijuana doesn’t meet the criteria for scientific and evidence-based, as researchers from the Journal of the American Medical Association make it clear there is only, at best, modest evidence for medical marijuana and only for the conditions of nausea related to chemotherapy and multiple-sclerosis symptoms.  No other condition currently on Maine’s approved list meets the long-established and rigorous scientific FDA standards for effective medicine.

There is certainly no reliable, scientific evidence pointing to marijuana as an efficacious treatment for opiate addiction.  Assuredly, there are anecdotes out there, and we will likely hear those at the hearing tomorrow.  But while anecdotes are interesting, we don’t base medicine on anecdotes, we base medicine on a rigorous, scientific process to ensure that it is reliable and replicable on a population level.

In fact, data and reports from Colorado reinforce that marijuana does not improve the issues with opiate addiction.  Earlier this month, the Denver Post reported that in 2015, Colorado experienced the highest level of overdose deaths on record.  Meanwhile, since marijuana was legalized in 2012, use amongst adults has soared.  If the hypothesis of the marijuana industry was correct, one would have expected to see rates of overdoses decrease, not go up.  Of course, this is the same marijuana industry that has pitched marijuana as an alternative to alcohol, and again, the data in Colorado shows the opposite as alcohol sales continue to climb in that state.

Meanwhile, emerging science points to marijuana as a threat to worsen, not improve, the opiate epidemic.  An article published last month describes this new science that shows how marijuana use can actually prime the brain to be more at risk to developing an opiate addiction.  In her article, Heidi Heilman writes:

“This new science suggests that a person who uses marijuana as a teenager may be increasing his/her risk of opiate addiction later in life. For example, a 20-year-old who takes an opiate pain-killer for a skiing injury or wisdom tooth removal may be much more at risk of becoming addicted to that pain-killer as a result of his or her earlier marijuana use — no matter how insignificant that earlier use may seem.

The science suggests, therefore, that legalizing marijuana will not only expose more people to a serious decline in cognitive & mental-health functioning (as revealed from the volumes of marijuana studies showing harmful outcomes of memory loss, depression, paranoia, psychosis, schizophrenia and addiction), but possibly also prime certain segments of the population — including unborn children — for more opiate addiction and brain changes.”

Leading addiction experts in Maine, such as Dr. Mark Publicker, will explain to you that we do have effective, scientifically proven medical treatments for opiate addiction.  Methadone and Suboxone, along with the appropriate level of counseling, have proven to be effective in treating opiate addiction.  These methods of Medication Assisted Recovery (of MAR) have allowed Mainers to regain control of their lives, get back to work, and take care of their families.  Additionally, Dr. Publicker would explain to you, as he has in the press, the limitations of MAR has been the lack of sufficient access to those Mainers suffering from opiate addiction.  We have a proven medical/clinical solution for opiate addiction, we just need to increase access to it.  Proposing marijuana as a “medical” solution to opiate addiction is akin to sending patients to bars to treat their depression because we have a shortage of mental health clinicians.

The proposal to add opiate addiction to Maine’s medical marijuana approved conditions list is naked corporate and political opportunism. I fully support expanding research in the medical possibilities of the components of marijuana.  Should we find an efficacious treatment for opiate addiction, I would support it.  However, we are in a dire situation and need to focus all of our energy and resources on solutions based in science and proven to actually make a difference.  We must rebuff and reject snake oil, pseudo-science treatments seeking to take advantage of the crisis.  It is for these reasons I strongly encourage Commissioner Mary Mayhew to deny the petition to add opiate addiction to the Maine Medical Marijuana Program.  I am confident when she sees the lack of science and evidence supporting it, and the science and evidence showing it would cause more harms, that is the decision she will reach.

Science and evidence, the way medicine should be.

Scott M. Gagnon, MPP, PS-C

About Scott M. Gagnon, MPP, PS-C

Scott M. Gagnon, MPP, PS-C is a Certified Prevention Specialist and is the Director of Operations at AdCare Educational Institute of Maine, Inc. He currently serves on the Maine Substance Abuse Services Commission as well as the U.S. Substance Abuse and Mental Health Services, Center for Substance Abuse Prevention National Advisory Council. Scott volunteers as the Chair of the marijuana policy education and advocacy group, Smart Approaches to Marijuana Maine and is the current Board President of the Maine Council on Problem Gambling. Scott also serves as a Co-chair of the Prevention & Harm Reduction task force of the Maine Opiate Collaborative, the effort convened by U.S. Attorney Thomas E Delahanty, II to address Maine's growing opiate and addiction crisis. Scott is the recipient of the 2015 Maine Public Health Association's Ruth S. Shaper Memorial Award and 2015 Healthy Androscoggin Will Bartlett Award and is also the 2013 recipient of the Maine Alliance to Prevent Substance Abuse Prevention Award.