Trump Administration’s First National Drug Control Strategy Emphasizes Opioid Crisis, Makes No Mention of State-Legal Cannabis Regimes

The Trump Administration’s White House Office of Drug Control Policy released its first National Drug Control Strategy on Thursday, January 31, 2019. The document outlines President Trump’s priorities regarding drug trafficking and drug use and provides strategic direction to federal agencies involved in preventing initiates to illicit drug use, treating those suffering from substance abuse disorder, and enforcing laws regarding illicit drug production, trafficking, and distribution.

The strategy clearly states that the opioid crisis is the president’s top priority, which Americans for Safe Access (ASA) believes is appropriate given the troubling data regarding opioid overdoses and deaths. As is noted on the strategy’s first page, Centers for Disease Control and Prevention (CDC) figures show that there were more than 47,500 opioid overdose deaths in the U.S. in 2017. With more than 130 people dying every day in America from opioid-related causes, it is critically important that the country identify and embrace alternatives to opioids in the treatment of pain and provide appropriate, evidence-based treatments for those suffering from opioid use disorder.

Encouragingly, the National Drug Control Strategy calls for better prescribing practices and the expansion of alternatives to prescription drugs that come with a high risk for addiction and abuse. The available data indicate that medical cannabis is one such alternative. Opioid overdose and death rates are lower in states that have a legal medical cannabis program, especially in those states with active medical cannabis dispensaries. Studies have shown that many pain patients are able to reduce or completely eliminate their use of opioids after commencing treatment with medical cannabis. It is clear that medical cannabis can be an important tool in the effort to prevent addiction to opioids, and it should be a frontline treatment option for patients and their health care providers.

With regard to substance use disorders, while the National Drug Control Strategy does not address these elements comprehensively, it does contain positive references to increasing the number of peer recovery support workers, reducing stigma, misunderstanding, and legal and regulatory barriers to treatment, expanding medication-assisted therapy (MAT), and increasing employment opportunities for people in recovery across the federal government and in the private sector. Here, too, medical cannabis can play a role. It was long argued that cannabis was a “gateway drug” that would lead to addiction to hard drugs, but it is becoming increasingly clear that cannabis is actually an exit ramp. With the understanding that compounds within cannabis may reduce cravings and can treat the pain and discomfort associated with opioid withdrawal, several states have already made opioid use disorder a qualifying condition for medical cannabis.

The lack of explicit reference to medical cannabis as a prevention and treatment modality within the strategy is entirely unsurprising given cannabis’ Schedule I status. It is, however, important to note that specific references to cannabis within the strategy relate to the trafficking of illicit cannabis across our borders and illicit cultivation on U.S. public lands. The document is mum on state-legal medical cannabis and adult-use programs.

ASA will continue to work at the federal and state levels to make cannabis a frontline treatment option for pain and to ensure safe, legal access to cannabis for all who may benefit from it, including those attempting to recover from opioid use disorder. To learn more about ASA’s efforts to address the opioid epidemic, please visit our End Pain, Not Lives campaign page.