Marijuana contra heroin and Oxycodone (not in that order)

Paul Danish/Sue France

If you spent any time following the New Hampshire primary, you probably noticed that heroin has turned into a hot issue in New England.

It turns out there’s been a big spike in heroin overdose deaths in the last few years, both nationally and in New England in particular. But it also turns out there is more to the latest heroin epidemic than heroin.

The “heroin epidemic” is really an opiod painkiller epidemic that includes both heroin and prescription opioid painkillers like Oxycodone. The prescription opioids account for roughly two-thirds of the deaths.

In New Hampshire, for example, there were 203 deaths from heroin and prescription opioids in 2013, of which only 68 were from heroin.

Nationally, in 2013 there were 24,492 heroin and prescription opioid deaths, of which 8,257 were ascribed to heroin. The comparable national figures for 2014 were 29,467 from prescription opioids and heroin, with 10,574 due to heroin.
What does this have to do with marijuana? Plenty, it turns out. And in a good way.

The prescription painkiller/heroin epidemic has prompted Massachusetts Senator Elizabeth Warren to write Thomas Friedan, the head of the Centers for Disease Control and Prevention (CDC) urging him to have the CDC investigate, among other things, 1) “the use, uptake and effectiveness of medical marijuana as an alternative to opioids for pain treatment in states where it is legal” and 2) “the impact of the legalization of medical and recreational marijuana on opioid overdose deaths.”

The Warren letter in turn prompted the Washington Post’s Christopher Ingraham to compile a short list of what researchers have already found out so far. Three studies in particular stand out:

• A 2014 study published in one of the journals of the American Medical Association (JAMA Internal Medicine) found that states with medical marijuana laws had fewer painkiller overdose deaths. States in which medical marijuana was available saw a 24.8 percent reduction in opioid overdose deaths compared with states without such laws.

• A 2015 Canadian study published in the journal Drug and Alcohol Review looked at the use of cannabis “as a substitute for alcohol, illicit substances and prescription drugs” among 473 adults who were using marijuana for medical purposes. It found that 87 percent of the study’s subjects reported substituting pot for alcohol, illicit substances, or prescription drugs or some combination of them — with 80 percent reporting substitution for prescription drugs, 51 percent for alcohol and 32 percent for illicit substances. In other words, the medical marijuana users were less likely to drink or take other painkillers.

• A working paper published in 2015 for the National Bureau of Economic Research (NBER), a highly respected Massachusetts think tank found that the presence of marijuana dispensaries in an area was associated with a 15 to 35 percent drop in substance abuse admissions and a similar drop in overdose deaths. “Our findings suggest that providing broader access to medical marijuana (and presumably by extension recreational marijuana) may have the potential benefit of reducing abuse of highly addictive painkillers,” the researchers concluded.

While the studies tend to focus on medical marijuana, probably because medical marijuana still represents the majority of legally sold pot in most places, the findings pretty obviously apply to recreational marijuana as well.

To be sure, all three studies show correlation, not cause and effect, but they are highly suggestive, and the CDC would be derelict if it did not aggressively follow up on them.
Beyond that, these studies bear on the broader national debate about marijuana legalization.

Pot prohibitionists and marijuana recriminalizers routinely claim that marijuana is a “gateway drug,” which will lead its users to try and become addicted to hard drugs like heroin. What these studies suggest is that the putative gate marijuana opens is the one out of addiction, not into it.

This opinion column does not necessarily reflect the views of Boulder Weekly