The role of medical cannabis in the opioid crisis

Abstract

Opioid use increased dramatically in the 1990s upon introduction of newer, more relaxed regulations. As opioid prescriptions for pain increased, a parallel increase in opioid abuse and addiction occurred; this phenomenon is widely known as the opioid crisis. Cannabis had long been considered a recreational drug until legislation in 2001 allowed highly limited access to the drug for medicinal purposes. Although small-scale clinical trials show promising results for the use of cannabis in pain management, it is not currently indicated for chronic or severe-to-moderate acute pain, for which opioids are typically considered the standard of care. The impending legalization of recreational cannabis may mark a turning point in pain medicine as the general public becomes able to selfmedicate with cannabis. This increased availability may lead individuals prescribed opioids to combine or replace them with cannabis, with potential positive impacts. There is growing evidence that cannabinoid compounds present in cannabis are able to augment opioid-induced pain relief. Increased availability of cannabis is linked to decreased opioid-related mortality and hospitalizations; furthermore, cannabis might act as a tool to treat opioid addiction. Cannabis does possess adverse effects and addiction risk, and expanded research into its properties is needed. However, its relatively decreased risk profile and potential positive effects indicate that it may serve an important role in addressing the opioid crisis.