The Biology of Cannabis vs. Opioids for Pain Relief – Leafly

Cannabis and opioids are both known for their analgesic, pain-relieving effects. However, opioids are highly addictive—between 1999 and 2014, sales of prescription opioids in the United States quadrupled, with staggering increases in overdoses. In the healthcare system, 49% of patients seeking treatment for pain leave with a prescription. Because the risk of addiction and overdose associated with opioids is so great, finding a drug substitute with less abuse potential is critical.

Amanda Reiman, manager of Marijuana Law and Policy at the Drug Policy Alliance, defines substitution as a “conscious choice to use one drug (legal or illicit) instead of, or in conjunction with, another due to issues such as: perceived safety; level of addiction potential; effectiveness in relieving symptoms; access and level of acceptance.”

It’s important to take these factors into consideration when determining the substitution potential of cannabis. The ideal substitute will perform better than the previous medication by being more safe, effective, and accessible, while also being less addictive.

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There is already evidence that cannabis is used to substitute opioids. In the United States, total prescription drug spending in Medicare for both program and enrollee spending fell by $165 million per year in 2013 after the implementation of several state medical cannabis laws. The most common reported drug substitution was opioids (32-36% of total substitutions), followed by benzodiazepines and antidepressants.

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Data from self-reported studies show that cannabis is already being used to substitute some prescription drugs, and states with legalized medical cannabis have seen decreases in prescription drug rates. Biologically speaking, though, what makes medical cannabis effective for pain relief and a possible substitute

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