Could Medical Marijuana Curb The Heroin Epidemic?

May 11, 2015

In this Nov. 5, 2014 file photo, a sample of medical marijuana is displayed at a dispensary in Portland, Ore.
Credit AP Photo/Don Ryan, File

Heroin abuse has been on the rise in America, killing hundreds in Allegheny County last year. Public safety and public health officials are scratching their heads for a solution as nothing seems to be slowing down the drug.

Dr. Neil Capretto, medical director at Gateway Rehabilitation Center, said he’s watched the numbers grow.

“In 1985 there were 22 drug overdose deaths in Allegheny County," Capretto said. "Last year 2014, the count is already up to 299, they’re still working on those numbers. It’s probably going to be somewhat higher, and the vast majority of those are prescription medicine and heroin."

So what is the cause of the high number of overdoses? Capretto said about 95 percent of people he sees who become addicted to heroin originally got addicted to prescription opioid drugs.  

“People start using prescription drugs, get tolerant, need to continue to increase the amount that they use, then they often reach a point where it becomes difficult or next to impossible to afford it or find it, and somebody tells them, ‘You can get the same feeling or keep yourself from feeling sick by switching to heroin,’ which is maybe 1/5th or 1/6th the daily cost,” said Capretto.

Other states that have passed medical marijuana have reportedly seen a decrease in the projected number of opioid overdose deaths.

JAMA Internal Medicine published a study last August that examined states for their opioid overdoses, including prescription drugs and excluding suicides. The study examined CDC death certificates in states with and without medical marijuana from 1999-2010.

“We were interested in wither the availability of medical marijuana, as an alternative to prescription narcotics for pain management could affect overdose deaths, since medical marijuana isn’t subject to the same susceptibility in terms of unintentional overdoes,” said Colleen Barry, associate chair for research and practice at John’s Hopkins Bloomberg School of Public Health.

The study reported that there was about a 25 percent decrease in the projected amount of people expected to overdose in those states in 2010. This means that about 1,700 less people died than were expected to in states with medical marijuana.  

Barry said the study did not prove a correlation between medical marijuana and less opioid deaths because this is a complex issue with a lot of factors.

“While there are important risks out there that need to be managed on the regulatory end, our study suggests that there may be unintended benefits of these medical marijuana laws as well — in particular the unintended benefit in reducing opioid overdose deaths,” said Barry.

State Sen. Michael Folmer feels that medical marijuana does have the potential to help the heroin problem in Pennsylvania.

“Let cannabis come is as an alternative to pain medication, which number one we’ve seen, and Dr. Colleen Barry has done a great job. In the first five years prescription overdoses were down 25 percent, and past those five years it goes over 30 percent, and I think you’re going to see it get even better and better because you’re not going to be able to OD from cannabis,” said Folmer.

His bill — Senate Bill 3 — would legalize medical marijuana in Pennsylvania. The bill was introduced in January and is in the appropriations committee now.

Others are skeptical about this potential solution, and a recent Washington Post story says states that have legalized marijuana have seen an increase in heroin and meth due to Mexican cartels no longer being able to push marijuana. That assumption is based on the amount of each drug coming over the border in California. 

But some say it’s too soon to draw that conclusion.

“There is a lot of heroin and a lot of methamphetamine being supplied right now to the country. At the same time there probably is a downslide in marijuana, but that could be for a number of reasons," said DEA Special Agent Matthew Barden. "I don’t know that we’ve had enough time to evaluate if the down trend is because of legalization or because of some other cause and effect."

Some other groups say that there has not been enough research into the long-term effects of cannabis.

“It’s premature for the Legislature to enact a new law legalizing medical marijuana until those studies and that research can be done," said Pennsylvania Medical Society’s Legislative Council, Scott Chadwick. "That’s why five years ago we began calling on the FDA to relax marijuana status as a schedule 1 drug, and make it a schedule 2 drug to facilitate more testing.”

Another benefit of medical marijuana, according to Folmer, is that the universities and other organizations can begin to study the effects so that we can get a better understanding of the drugs impact. 

Recently an anti-overdose drug Narcan (Naloxone) has become more readily available. Gov. Tom Wolf has ordered state police to carry the drug that can potentially reverse the deadly effects of an overdose, and it is now available through a prescription. This change and other programs will cost the state about $7.5 million more dollars in the 2015-2016 year — at a time when Pennsylvania is facing a billion dollar unfunded pension crisis.

Medical marijuana gives Pennsylvania the opportunity to make money through tax revenue and licensing, but the exact consequences of a change that big are still unknown.

As for a solution to the heroin epidemic — the water is still a little murky.