An Insane Proposal for Pot

Using marijuana to treat opioid addiction? Maine lawmakers are actually considering it.

“Treatments should be based on evidence — on research that’s high-quality, patient-centered, and evidence-based research. We don’t have that with marijuana,” Dr. John Meigs, president-elect of the American Academy of Family Physicians, told LifeZette.

“Until we’ve got evidence that says it works, we can’t endorse or recommend that.”

Health officials in Maine will soon decide whether to put opioid addiction on the state’s list of approved conditions that can be treated with medical marijuana. A decision is expected within a few months. If it happens, Maine would be the first state in the nation to add opiate addiction as a qualifying condition, the Maine Medical Association reports.

Advocates showed up at a recent hearing in the state to testify about how it has worked for them.

Dr. Bertha Madras, a professor of psychobiology and the chair of the Division of Neurochemistry at Harvard Medical School, told LifeZette that Maine officials need to look at proven evidence that marijuana can treat opioid addiction. And there is no evidence marijuana can treat opioid addiction, she said.

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“A legislative body that rules on a treatment for opioid addiction without strong scientific evidence is practicing medicine without a license and should be legally liable if adverse events set in,” she said.

Two Marijuana Compounds
Madras said there is a fundamental problem with the proposed method of “treatment” for opioid addiction — there is mounting evidence marijuana may “prime the brain to enhance opioid reward.” It’s been shown in animals and is increasing in humans.

“Treating opioid addiction with a substance that conceivably enhances the rewarding effects of opioids is counter-intuitive,” she said, adding that it is a “travesty” to recommend any form of marijuana or cannabidiol for opioid treatment before undertaking a rigorous Food and Drug Administration approval process.

“This has gotten to be a bandwagon movement. Without definite research, you’re not much more than a snake oil salesman.”

Dr. Kevin Sabet, an assistant professor of psychiatry at University of Florida and former senior adviser to the White House Office of National Drug Control Policy under President Obama, feels strongly that this is a bad move.

“It’s a very dangerous precedent with little to no data to show for it,” he told LifeZette. “Anyone in treatment will tell you that marijuana is a contributing cause to addictions in many people — it can’t also simultaneously be a solution.”

CBD and THC are the two main ingredients in marijuana. THC is the main psychoactive ingredient. CBD on its own is not considered a hallucinogenic and may have therapeutic potential.

Where opioids are concerned, proponents believe CBD alone could block drug-seeking behavior, dampen anxieties, and prevent psychosis-like events. But, as Madras pointed out above, that has yet to be scientifically proven.

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Meigs also noted that without the FDA regulation of marijuana, it’s hard to know what concentrations are in different plants. It is also difficult for people to know if the marijuana they’re getting is higher in one compound over another.

“It’s hard to know what you’re getting,” he said. “Unless you’ve got objective data [showing CBD can help], you’re playing with fire.”

Now Personal Opinions are Medical Advice?
Other approved medications can be used to treat opioid addiction, Madras noted. Methadone, buprenorphine, and naltrexone have been shown to work effectively. Meigs concurred that the AAFP supports those, along with behavioral counseling.

“There is a concerted effort to normalize marijuana use for multiple purposes, medically or not,” Madras said. The case in Maine is “another example of using marijuana for a purpose in which the evidence is thin or non-existent,” he said.

Meigs said there simply isn’t enough evidence to show marijuana is an acceptable treatment for opioid addiction.

“This has gotten to be a bandwagon movement,” Meigs said. “Without definite research, you’re not much more than a snake oil salesman.”