Testimony for the President's Commission on Combating Drug Addiction and the Opioid Crisis

Innovative Pain Management and Prevention Measures for Diversion

September 27, 2017

Governor Christie and members of the Commission. Thank you for the opportunity to testify on this incredibly important issue.

My name is Beth Collins and I represent Americans for Safe Access. The mission of Americans for Safe Access is to ensure safe and legal access to medical cannabis for therapeutic use and research. Americans for Safe Access is comprised of patients, medical professionals scientists and concerned citizens.

First, Americans for Safe Access recommends that the Commission urge President Trump to formally declare the opioid crisis a national health emergency in order to make Public Health Funds available to the state's most affected by this issue. Second, we hope the Commission will work with the Department of Health and Human Services (HHS) so that states can be eligible to use Medicaid to supplement their medical cannabis programs to assist individuals suffering from chronic pain. Third, we recommend the Commission work with the DEA, HHS and lawmakers on Capitol Hill to take the steps necessary to remove cannabis from Schedule I to make it a more accessible therapy for pain management.

Members of the Commission, while we may disagree on some policies, we can certainly agree that America is in the midst of an epidemic. But this epidemic is not just the opioid epidemic that formed this important Commission, but also an underlying national epidemic of chronic pain. One in three Americans suffer from chronic pain and one in ten have experienced severe pain every day for three months or more. ¹ In dealing with this national pain epidemic, many have been prescribed opioids. Between 1999 and 2012, the Centers for Disease Control (CDC) estimates that the number of opioid prescriptions quadrupled without a significant increase in patients presenting with chronic pain.²

We have all heard the number. 91. 91 individuals a day lose their lives to prescription opioid use.  Drug overdoses are now the leading cause of death for Americans under 50, surpassing car accidents, gun homicides, and a variety of illnesses.³ Public health experts estimate that for every fatal overdose, there are 30 nonfatal overdoses.⁴ When we talk about the opioid crisis, it always seems that we talk about how many lives are lost.  If we truly want to end this crisis, we must shift the discussion to how many lives can be saved. And Members of the Commission, lives can be saved with medical cannabis.

The subject of today’s meeting is innovative pain treatment. Innovation is typically associated with new ideas or creativity in application.  Although medical cannabis has been used as a treatment around the world for thousands of years, the innovative part comes in by using medical cannabis to help fight the opioid crisis.

Why should medical cannabis be considered a tool to fight the opioid crisis? 29 states and Washington DC, including those most negatively impacted by the opioid crisis such as West Virginia, New Hampshire, and Ohio all have medical cannabis programs. Many of these states allow medical cannabis to be used to treat chronic pain. A study in the Journal of the American Medical Association indicated that in states with medical cannabis programs, there has been a 25% reduction in opioid related deaths.⁵ This study also showed a 13% decrease in hospitalizations from opioid related causes. In a survey of nearly 3,000 pain patients, 93% preferred medical cannabis over opioid therapies for pain management.⁶ In addition to the data, there are thousands of personal stories of patients who have been able to reduce the number of opioids they take or come off opioid therapies altogether by using cannabis.

The National Academies of Science, Engineering, and Medicines revealed strong clinical evidence that cannabis is highly effective in treating chronic pain.⁷ The National Institute on Drug Abuse (NIDA) has indicated that medical cannabis legalization might be associated with decreased prescription opioid use and overdose deaths.⁸ A NIDA funded analysis showed that a areas with a greater number of medical cannabis dispensaries were associated with decreases in opioid prescribing,  in self-reports of opioid misuse, and in treatment admissions for opioid addiction.  This past week the National Institutes of Health (NIH) indicated that medical cannabis “might be effective for chronic...primarily for neuropathic pain patients.”⁹

It is not our position that cannabis alone will end the opioid crisis. Cannabis will not and should not replace the prescribing of opioids. And we recognize, that cannabis, like any other medicine has side effects. But we can not continue to ignore the usefulness of medical cannabis in reducing our nation's pain epidemic. Cannabis is one of many tools that can help fight this epidemic. And it is a tool that this Commission should consider carefully and seriously. We must work together to End Pain, Not Lives.

Thank you for your time.