Legalizing cannabis may have a role to play in decreasing opioid mortality rates. “It’s an evolving idea that was thrust into the forefront when U.S. states legalized cannabis,” says Clarke. “Opioid mortality dropped in those states.”
One U.S. study, published this summer in Economic Inquiry, showed that recreational marijuana laws reduced annual opioid mortality between 20 and 35 per cent, particularly in people addicted to synthetic opioids such as fentanyl.
There is a lot of skepticism in the Canadian medical community about cannabis, including using it as a treatment for pain. According to Clarke, only one per cent of doctors prescribe it, despite Canada’s legalization of medical cannabis in 1999 and the establishment of a commercial medical cannabis industry in 2013.
“We know that there is something there,” says Clarke, “but so far, every patient has been trial and error.” Doctors are reluctant to prescribe cannabis without unbiased, peer-reviewed research to support its benefits, he explains.
Clarke says researchers currently aren’t certain which component of cannabis may make it effective in treating pain: THC (the main psychoactive compound found in cannabis), CBD (another compound found in cannabis that does not cause a high) or a combination of both.
While CBD impacts the dopamine and serotonin systems in the central nervous system and may have some anti-inflammatory effects, Clarke says, “the story on CBD is certainly not clear-cut.”
The pot industry is selling pain patients on the merits of CBD oil without research to back up their claims, he adds. And generally, says Clarke, “people probably aren’t taking enough of it to work, so it’s not as effective as it’s claimed to be.”