Sharif Mohr, MPH, PhD
As the legalization of marijuana gains more and more momentum at the national level, one must pause to question the wisdom of unleashing yet another addictive drug on a society that is still reeling from the worst substance abuse and overdose epidemic in its history. Yet, as with most things related to marijuana, evidence and reason take a backseat to blind belief and dogma as pro-marijuana advocates proffer legalization as a solution to the opioid epidemic. This misguided notion stems from a flawed ecological study that failed to account for other trends that significantly impacted overdose rates such as implementation of prescription drug monitoring programs and more restrictions on opioids prescriptions.(1) In fact, the most current research shows that medical and non-medical marijuana use are associated with prescription opioid misuse and opioid use disorder.(2,3) Can there be surprise about this? Any addictionologist worth his or her salt will tell you that use of any rewarding substance can lead to addiction or trigger craving for other substances (e.g. in those in recovery from opioid use disorder). As we collectively attempt to put out the fire of the third and deadliest wave of the opioid epidemic, we should not pour in the fuel of marijuana legalization.
- Bachhuber MA, Saloner B, Cunningham CO, Barry CL. Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010. JAMA Intern Med [Internet]. 2014 Oct;174(10):1668–73. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25154332
- Liang D, Wallace MS, Shi Y. Medical and non-medical cannabis use and risk of prescription opioid use disorder: Findings from propensity score matching. Drug Alcohol Rev [Internet]. 2019 Jul 25; Available from: http://www.ncbi.nlm.nih.gov/pubmed/31347204
- Olfson M, Wall MM, Liu S-M, Blanco C. Cannabis Use and Risk of Prescription Opioid Use Disorder in the United States. Am J Psychiatry [Internet]. 2018;175(1):47–53. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28946762