September 15, 2014

Medical Marijuana Helps Curb Pain, but at a Cost

Medical Marijuana Helps Curb Pain, but at a Cost

Medical marijuana is available in 21 states and the District of Columbia. The results of medical marijuana use are mixed, with some important positive and negative outcomes that should be examined.

New research published in the journal JAMA Internal Medicine, finds that deaths associated with the use of opiate drugs fell in 13 states after they legalized medical marijuana. Compared to states with no formal access to marijuana, those that allowed certain patients legal access to cannabis saw a steady drop in opiate-related overdoses that reached 33%, on average, six years after the states’ medical marijuana laws took effect. This is a substantial decrease resulting in saved lives.

The implication is that medical marijuana laws, when implemented, may represent a promising approach for stemming runaway rates of non-intentional pharmaceutical opioid overdose deaths. However, marijuana as a painkiller has its limits. Although marijuana is likely safer than opioids, it does not deal well with post-operative pain or severe pain.

Lead study author Dr. Marcus Bachhuber explained,

“We found there was about a 25% lower rate of prescription painkiller overdose deaths on average after implementation of a medical marijuana law.” He also said, “It’s important, of course, to weigh the risks and benefits of medical marijuana.”

Medical marijuana for use in relieving the pain associated with rheumatoid and osteoarthritis has shown some success in both women and men. These forms of arthritis are often painful and distressing, and medical marijuana appears to relieve the chronic pain related to arthritis. Preclinical work in animals has found cannabinoids help in nearly every acute pain model tested for arthritis.

However, with the good comes the bad, particularly in terms of brain function. Too much cannabinoid exposure can worsen memory, affect the reward system with addiction implications, and impair cognition. Short-term use alters sensory perception, temporarily impairs memory, and induces thought fragmentation. Furthermore, recent studies suggest that long-term marijuana exposure is associated with structural brain changes as well as decline in IQ. Beyond limited efficacy data and non-standardized formulations, the long term use risks of marijuana are not fully understood.

Although cannabinoids may offer some therapeutic effect, marijuana should be used with caution. Patients need to recognize both the potential rewards and the hazards of using this drug. Please discuss questions you may have with a health professional and consider holistic, evidence-based therapies for pain relief as an alternative to medications, whenever doing so is reasonable.


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