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Can cannabis replace opioids? | Leafly

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In 1995, the president of the American Pain Society called for pain to be added as a fifth vital sign evaluated and managed by physicians—body temperature, heart rate, respiration, and blood pressure are the original four. Measuring pain subsequently became a widely accepted practice among clinicians. With 20% of adults experiencing chronic pain, prescription opioids soon doubled and Americans began consuming 80% of the global opioid supply.

President Trump officially declared the opioid crisis a “public health emergency” in October 2017. By then, the United States was approaching 50,000 opioid overdose deaths total and nearly 60% of them were due to illicit synthetic opioids such as fentanyl or tramadol. The problem has continued to escalate. Last year, there were more than 80,000 opioid overdose deaths with roughly 90% resulting from highly potent synthetic forms. This crisis is not getting better, and new strategies are needed to solve the problem.

Does legalizing cannabis reduce opioid use?

There are several reasons why legalizing cannabis seems like a promising strategy to combat the ongoing opioid crisis. For one, early population reports found that states that legalized medical cannabis saw a reduction in opioid overdose deaths. However, those findings no longer hold when the timeline of analysis is extended to the present day; any benefit that cannabis legalization has on reducing opioid overdose seems to be short lived.

States that legalized recreational cannabis saw an initial reduction in opioid-related emergency room visits by 7.6% compared to states that did not legalize cannabis, but this difference was gone within 6 months. It remains possible that cannabis may serve as a substitute for common prescription opioids like oxycodone, codeine, or hydrocodone, but can’t overcome the severity of dependence to more potent illicit opioids like fentanyl or heroin that are being abused at escalating rates.

Some studies point to notable reductions in prescription opioid use among patients who also use cannabis, but this benefit disappears in rigorously controlled clinical trials. These clinical trials fail to find consistent results on cannabis co-use with prescription opioids, despite most patients saying that they prefer cannabis over opioids.

Related

How Cannabis Enhances the Effects of Opioids

How might cannabis replace opioids?

There are currently 15 ongoing clinical trials investigating the ability of cannabis to reduce opioid need. These clinical trials are driven by hard-to-ignore evidence from animal studies that look at the pain-relieving interactions between the endocannabinoid system, which is stimulated by cannabinoids like THC, and the opioid system.

Pain experiments in rodents have consistently found that THC reduces the need for opioids. Across seven different studies, THC reduced the effective dose of morphine by 3.5 times. This beneficial effect is supported by three key pieces of evidence:

  1. Many cannabinoids, such as THC, stimulate CB1 receptors in the endocannabinoid system, which are found in the same pain-processing brain areas as opioid receptors and may also contribute to pain reduction.
  2. CB1 receptors in the body interact with opioid receptors to boost their pain-relieving effect in rodent studies.
  3. CB2 receptors, another cannabinoid target, can stimulate the release of the body’s own opioids which activate pain-relieving opioid receptors.

So why is there inconsistency between these ongoing clinical trials and the population studies mentioned above?

A direct reason is unclear. Some argue that a sense of control over pain management, as one experiences when they choose to use cannabis, can promote better outcomes. This effect could explain why patients who could choose to co-use cannabis in certain trials, as opposed to randomized clinical trials, reduced their need for opioids.

Related

What is the endocannabinoid system and what is its role?

It’s also possible that these benefits result from the placebo effect, where people can boost their opioid levels without drugs and dampen pain simply because they think they’re receiving an active pain medication.

Adding confusion to results, cannabis’ opioid-reducing effects may go away with the prolonged use of high-potency THC products, which are increasingly common in legal markets. Rodent studies of THC’s opioid-reducing effects are often short in duration, usually lasting only several days, whereas human use is often chronic—people use for weeks or longer. Repeated use of high-potency THC leads to tolerance, which often results from a reduced number of CB1 receptors and weaker overall endocannabinoid signaling.

The development of THC tolerance would therefore hinder the ability of CB1 and opioid receptors to work together to reduce pain. This could explain why short-duration rodent studies show opioid-reducing benefits of THC, and how these effects are often lost in long-term human clinical trials.

Further, this phenomenon could explain the initial drop in opioid overdoses when states legalize cannabis, but with the eventual onset of tolerance over several months, the opioid-reducing effects of cannabis in the population disappear.  

Considering all the current evidence, there’s no clear consensus over whether cannabis can replace or reduce the need for opioids in pain management.

Are there risks of using co-using cannabis and opioids?

In some cases, the combination of cannabis with opioids was associated with worsened mental health, and this combination may be worse for those over 65 years old. Yet other safety issues, like opioid’s suppression of breathing, were not made worse with co-use of cannabis, at least alleviating some concern.

And in most cases, co-use of cannabis does not increaseopioid use, dispelling the idea that cannabis is a gateway drug, a warning spouted by many anti-drug campaigners.

Can CBD help with opioid dependence?

Despite the lack of clinical evidence that cannabis can replace opioids, CBD is emerging as a potential strategy to help those trying to overcome from opioid use disorder.

Italy unintentionally legalized CBD-rich cannabis in 2017 (essentially “hemp” by United States legal standards), and saw a reduction in opioid use, suggesting that CBD-rich cannabis may replace opioids in the short-term.

Several clinical studies have found that CBD reduces cues that trigger opioid cravings, and dampens the increased stress response that accompanies cravings. Insight from rodent studies shows that CBD diminishes many of the negative changes in behavior, anxiety, and genetic expression that accompany opioid withdrawal and lead to relapse.

These studies have set the stage for additional clinical trials (for example one that’s to take place at the Tarzana Treatment Center in Los Angeles) to study CBD’s potential as an adjunctive therapy for opioid use disorder.  

Related

The complete guide to CBD (cannabidiol)

Can cannabis replace opioids?

The jury is still out. Most patients report that they’d prefer to use cannabis over opioids for pain relief and believe it to be an effective alternative. However, the range of use patterns, product options, cannabinoid and terpene content, and reasons for needing pain medication make this a particularly challenging research question to empirically study.

Control over the types of cannabis products being used together with optimized formulations for pain management (with moderate THC potencies!) will lead to a clearer picture of cannabis’ potential to replace opioids.

Josh Kaplan's Bio Image

Josh Kaplan

Josh Kaplan, PhD, is an Associate Professor of Behavioral Neuroscience at Western Washington University. He is a passionate science writer, educator, and runs a laboratory that researches cannabis’ developmental and therapeutic effects.

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LSD-Based Medication Yields Rapid, Durable Response

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A recent study discussed on Medscape reveals that an LSD-based medication shows promising results in providing rapid and durable responses in patients. This medication has demonstrated effectiveness in improving symptoms with sustained benefits over time, highlighting its potential as a novel treatment option for certain psychiatric conditions.

Promising Results for LSD-Based Medication

Introduction to the Study

A groundbreaking study has shown that a medication based on LSD can offer rapid and long-lasting relief from psychiatric symptoms. This research suggests significant potential for the treatment of mental health disorders.

Key Findings

The study found that patients experienced quick and sustained improvements in their symptoms after taking the LSD-based medication. The effects were durable, indicating long-term benefits and stability in mental health.

Mechanism of Action

LSD’s interaction with serotonin receptors in the brain is believed to play a crucial role in its therapeutic effects. This interaction helps modulate mood, perception, and cognition, contributing to its effectiveness in treating psychiatric conditions.

Implications for Mental Health Treatment

These findings highlight the potential of LSD-based medications to revolutionize the treatment of mental health disorders. The rapid onset of relief and durability of effects make it a promising option for patients with conditions that are resistant to traditional treatments.

Why This Is Important

The study’s results underscore the need for innovative approaches in mental health treatment. LSD-based medications could provide new hope for patients who have not responded to conventional therapies.

Possible Implications

  1. New Treatment Options: Introduction of novel medications for psychiatric conditions.
  2. Further Research: Increased interest in studying the therapeutic potential of psychedelics.
  3. Regulatory Changes: Potential adjustments in drug regulations to accommodate new treatment options.
  4. Healthcare Integration: Integration of psychedelic-based therapies into mainstream mental health care.
  5. Patient Outcomes: Improved outcomes for patients with treatment-resistant mental health disorders.

What to Follow

  • Clinical Trials: Ongoing and future trials to validate and expand on these findings.
  • Regulatory Developments: Changes in policies regarding the use of psychedelics in medicine.
  • Market Trends: Adoption and commercialization of LSD-based medications.
  • Patient Experiences: Feedback and results from patients using these new treatments.

Conclusion

The study on LSD-based medication offers a promising new avenue for treating mental health disorders. With rapid and durable responses, this medication could significantly impact the field of psychiatry, providing new hope for patients and healthcare providers.

Source: Medscape, The study



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Veterans with PTSD Experience Benefits from Service Dogs

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A study published in JAMA Network Open reveals that service dogs significantly improve mental health outcomes for veterans with PTSD. The presence of service dogs helps reduce PTSD symptoms, including depression and anxiety, and enhances overall well-being. This research supports the therapeutic benefits of service dogs in providing emotional support and improving the quality of life for veterans struggling with PTSD.

Service Dogs as Therapeutic Allies for Veterans with PTSD

Introduction to the Study

A new study has revealed that veterans with PTSD gain significant mental health benefits from having service dogs. This finding emphasizes the therapeutic potential of service animals in managing PTSD symptoms.

Key Findings

The study found that veterans with service dogs reported reduced PTSD symptoms, including lower anxiety and depression levels, compared to those without service dogs. Additionally, these veterans experienced improved overall well-being and quality of life.

Therapeutic Benefits

Service dogs provide various forms of support that can help mitigate PTSD symptoms. These include:

  • Emotional Support: Helping veterans feel calmer and more secure.
  • Physical Assistance: Assisting with daily tasks and providing a sense of routine.
  • Social Interaction: Encouraging socialization and reducing feelings of isolation.

Importance of the Findings

These findings highlight the potential of service dogs as a complementary treatment for PTSD. They underscore the need for increased access to service dogs for veterans and further research into their benefits.

Why This Is Important

Understanding the benefits of service dogs for PTSD can inform treatment approaches and policies, improving support for veterans. It also highlights the need for broader recognition and funding for service dog programs.

Possible Implications

  1. Enhanced Access: Increased provision of service dogs to veterans in need.
  2. Policy Support: Development of policies to support service dog programs.
  3. Further Research: More studies to explore and validate the therapeutic benefits of service dogs.
  4. Public Awareness: Greater awareness and acceptance of the role of service dogs in mental health care.

What to Follow

  • Program Developments: Initiatives to provide more service dogs to veterans.
  • Policy Changes: Legislative support for service dog programs.
  • Research Studies: Ongoing research into the benefits of service dogs for PTSD.
  • Veteran Feedback: Reports from veterans on their experiences with service dogs.

Conclusion

Service dogs offer significant therapeutic benefits for veterans with PTSD, enhancing their mental health and quality of life. Continued support and research are essential to maximize these benefits and improve veterans’ access to service dogs.

Source: JAMA Network Open



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Anxiety Diagnosis Linked to Increased Risk of Parkinson’s Disease

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A recent study suggests that individuals diagnosed with anxiety may have a higher risk of developing Parkinson’s disease later in life. The findings highlight the importance of monitoring anxiety symptoms and exploring their potential link to neurological conditions. This research could lead to improved early detection and preventive strategies for Parkinson’s disease.

Study Links Anxiety Diagnosis to Parkinson’s Disease Risk

Introduction to the Study

A study has revealed a potential link between anxiety diagnoses and an increased risk of developing Parkinson’s disease. This discovery emphasizes the need for heightened awareness and monitoring of anxiety symptoms as potential early indicators of neurological conditions.

Key Findings

Researchers found that individuals diagnosed with anxiety are at a higher risk of developing Parkinson’s disease. The study suggests that anxiety could be an early symptom or a contributing factor to the onset of Parkinson’s.

Implications for Early Detection

Understanding the connection between anxiety and Parkinson’s could lead to earlier detection and intervention. Healthcare providers might start screening for Parkinson’s in patients with chronic anxiety to identify those at risk sooner.

Importance of the Findings

These findings underscore the importance of considering mental health conditions like anxiety in the broader context of neurological health. Addressing anxiety may not only improve mental well-being but also potentially delay or prevent the onset of Parkinson’s disease.

Why This Is Important

Early detection of Parkinson’s disease is crucial for managing symptoms and improving patient outcomes. Recognizing anxiety as a risk factor can lead to more proactive and preventive healthcare strategies.

Possible Implications

  1. Early Screening: Implementing routine screening for Parkinson’s in patients with anxiety.
  2. Preventive Care: Developing strategies to manage anxiety and potentially reduce the risk of Parkinson’s.
  3. Research Expansion: Encouraging further studies to explore the link between anxiety and neurological conditions.
  4. Integrated Healthcare: Promoting a holistic approach to treating mental and neurological health.

What to Follow

  • Future Studies: Ongoing research into the relationship between anxiety and Parkinson’s disease.
  • Clinical Guidelines: Updates in clinical practices for screening and managing at-risk patients.
  • Patient Outcomes: Monitoring the impact of early detection and intervention strategies on patient health.

Conclusion

The study linking anxiety to an increased risk of Parkinson’s highlights the need for integrated healthcare approaches. By addressing anxiety early, healthcare providers may improve both mental and neurological health outcomes.

Source: Washington Post, The study



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