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Administrator Michele Leonhart has created quite a controversy with her comments on medical marijuana made last Wednesday during a Drug Enforcement Administration (DEA) House oversight hearing. From her bumbling response to Rep. Jared Polis (D-CO) on the issue of addiction and comparing medical marijuana to the harmful effects of other Schedule I substances like heroin or methamphetamine, to her commonsense response to Rep. Steve Cohen (D-TN) on leaving the question of medical marijuana treatment, “between [a patient] and his doctor,” Leonhart illustrated her illogical approach to medical marijuana as a public health issue.
Notably, toward the end of Rep. Polis’s examination, he asked Leonhart if she was “willing to look at the use of medical marijuana as a way of reducing abuse of prescription drugs,” given that reducing prescription drug abuse is the DEA’s top priority. Leonhart candidly responded:
We will look at any options for reducing drug addiction.
Well, Administrator Leonhart, you’re in luck. There is indeed evidence that shows patients using medical marijuana to reduce or eliminate their addictive and often-harmful pharmaceutical drug regimen.
Just this month, eminent medical marijuana researcher Philippe Lucas, M.A. published an article in the Journal of Psychoactive Drugs called, “Cannabis as an Adjunct to or Substitute for Opiates in the Treatment of Chronic Pain.” According to Lucas, “Evidence is growing that cannabis [medical marijuana] can be an effective treatment for chronic pain, presenting a safe and viable alternative or adjunct to pharmaceutical opiates.”
As if directly addressing Leonhart’s statement to Rep. Polis, and her concern over prioritizing prescription drug addiction, Lucas notes that:
Addiction to pharmaceutical opiates has been noted by the medical community as one of the common side-effects of extended use by patients (such as those suffering from chronic pain), and a growing body of research suggests that some of the biological actions of cannabis and cannabinoids may be useful in reducing this dependence.
Lucas further argues that, “[R]esearch on substitution effect suggests that cannabis may be effective in reducing the use and dependence of other substances of abuse such as illicit opiates, stimulants and alcohol.”
As such, there is reason to believe that a strategy aiming to maximize the therapeutic potential benefits of both cannabis and pharmaceutical cannabinoids by expanding their availability and use could potentially lead to a reduction in the prescription use of opiates, as well as other potentially dangerous pharmaceutical analgesics, licit and illicit substances, and thus a reduction in associated harms.
Another article on the effects of medical marijuana “substitution” was published in December 2009 by the Harm Reduction Journal. Researcher Amanda Reiman MSW, PhD notes that medical marijuana patients have long been engaging in substitution by using it as an alternative to alcohol, prescription and illicit drugs. In a study Reiman conducted with 350 medical marijuana patients, she found that 40 percent reported using medical marijuana as a substitute for alcohol, twenty-six percent reported using it as a substitute for illicit drugs, and nearly 66 percent use it as a substitute for prescription drugs.
[S]ixty five percent reported using cannabis as a substitute because it has less adverse side effects than alcohol, illicit or prescription drugs, 34% use it as a substitute because it has less withdrawal potential…57.4% use it as a substitute because cannabis provides better symptom management.
If Leonhart is serious about combating prescription drug abuse, she should heed the conclusions of researchers like Lucas and Reiman and pay attention to the evidence. Answers to two important public health concerns -- medical marijuana and prescription drug abuse -- lie at her feet waiting to be addressed.