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How Marijuana Legalization is Affecting Prescription Painkiller Use and Abuse

Reading Time: 7 min 22 sec

The opioid epidemic in the USA is an issue that plagues our society and tears apart communities and families.

The opioid epidemic, by definition, is the widespread abuse of painkillers, and it's estimated that 10 million Americans are misusing or abusing prescription painkillers. However, that number is down from 11.4 million just a few years ago.

But what caused this decline in painkiller abuse? Part of the answer is legal recreational and medical cannabis.

There is a clear connection between cannabis legalization and falling painkiller use and abuse. Join us as we dive into how cannabis is helping fight the opioid epidemic in America.

marijuana legalization

The Problem With Painkillers

"What starts as a medicine to help manage pain becomes a dangerous addiction."

Pain is not something that anyone wants to go through. Imagine having to go to the dentist or get an operation without painkillers.

Sometimes we truly need painkillers for a set amount of time, like after a surgery or when you get a tooth pulled. The problem with painkillers arises when the pain doesn't go away.

When pain doesn't go away, it's called chronic pain. Chronic pain is pain that lasts longer than six months, usually resulting from illness or injury.

In the United States alone, nearly one in five people suffer from chronic pain. Usually, chronic pain is treated through the use of painkillers.

When people use painkillers for a long time, they start to rely on them. This is a big problem because prolonged use creates a dependence on painkillers.

Dependence on painkillers is what makes them extremely addictive. What makes the problem even worse is that a tolerance can be built up from using painkillers.

That means that the longer someone uses painkillers, the less effective they become. As a result, people will need to take more and more painkillers to get the same effects.

This leads to a vicious cycle of needing more painkillers or needing to switch to a stronger type. In turn, a slippery slope of addiction that can be deadly often becomes a reality.

marijuana legalization

When people start abusing painkillers, they can easily overdose on them. It's especially dangerous because there's no easy way to know when someone has had 'too much’.

It's a very thin line between enough to 'get high' and overdosing, especially when someone is addicted. During an overdose, opioids suppress areas in the brain responsible for lung and heart function.

Breathing and heart rate both slow down until they eventually stop. At that point, the brain doesn't receive any more oxygen.

Death is likely, but those who survive may face lifelong organ or brain damage. What starts as a medicine to help manage pain becomes a dangerous addiction.

How THC and CBD Fight Pain

"When THC connects to the CB1 receptors on pain cells, they stop sending signals. Fewer pain signals sent to the brain means that the pain gets reduced."

One of the best alternatives for pain medication is cannabis. It's no secret that cannabis can help fight and manage pain naturally.

Cannabis has been used as a pain medicine since the times of ancient China, but it wasn’t until the modern age that people found out HOW it can fight pain.

What is the Endocannabinoid System?

Cannabis works against pain by acting on the endocannabinoid system (ECS). The ECS was only discovered in the 1990s, but it has changed our understanding of pain forever.

The ECS is a complex biological system in our body that handles the regulation of memory, mood, appetite, and pain. It is a network of endocannabinoid (EC) receptors found on particular cells all around our bodies.

Receptors are small proteins that sit on the surface of cells. When a chemical or compound connects to the receptor - something happens to the cell.

In the EC system, there are two main types of EC receptors, CB1 and CB2. Cannabinoids either connect with the receptors or act as agonists, stimulating them.

marijuana legalization

CB1 receptors can be found mostly in the brain and the central nervous system, while CB2 receptors are located mainly in the immune system.

When we eat THC gummies or have CBD oil, the cannabinoids are “connected” to the EC receptors. When that happens, the ECS becomes activated and starts having an effect on pain.

Activated Endocannabinoid System Stops Pain

But how exactly does an activated ECS affect pain? As stated previously, it is through the effects the cannabinoids have on the cells that they're connecting to.

For instance, CB1 receptors can be found in some pain cells (called nociceptors). Our feeling of pain comes from the electrical signal pain cells send to our brains.

When THC connects to the CB1 receptors on pain cells, they stop sending signals. Fewer pain signals sent to the brain means that the pain gets reduced.

Another way cannabis stops pain is through the immune system. CB2 receptors are found on immune cells.

The immune system is our best friend against infection and diseases. But sometimes, our immune system can work against us.

The immune system can mistake our own cells or harmless things (like pollen) as enemies. Not only that, but the immune system causes inflammation.

Inflammation is a part of healing from an injury or disease, but too much inflammation causes pain. When CBD connects to the immune cells, it slows down the inflammation response, which also lowers pain.

That's just a few small pieces of the entire EC system and what it's capable of. The best part about using cannabis to fight pain is that it's generally not as addictive as prescription painkillers and does less long-term damage to the organs. 

How Cannabis is Fighting Painkiller Use and Abuse

"...a study released in January 2020 showed the decrease of painkiller use of all states with cannabis laws."

Since cannabis is so effective at fighting pain, why isn't it used more often? The answer is the slow rate of marijuana legalization.

Now, more states have legalized medical and recreational cannabis than ever. This is excellent news, and we can see its direct effect on painkiller use and abuse.

A case study released in March 2020 shows the effect that cannabis legalization has on opioid use. In the study, the researchers wanted to compare marijuana legalization and painkiller use.

They looked at three states before and after legalization - Colorado, Utah, and Maryland. They focused on Colorado because it has had recreational cannabis laws since 2014.

Maryland has only had medical cannabis legalization since 2012. Utah had cannabis prohibition until 2018.

marijuana legalization

The researchers gathered the data of all the painkillers prescribed each year in each state. Those painkillers were oxycodone, morphine, fentanyl, and many more.

Then, the scientists compared the total painkillers prescribed in each state with the years before and after marijuana legalization. They discovered that Colorado had the sharpest decline in painkiller use after 2014.

Maryland also had a significant decrease in painkiller use after its cannabis legalization laws in 2012. Utah has not had a substantial decline in painkiller use, and basically nothing changed.

This study proves that having legal marijuana laws decreases painkiller use. Another exciting discovery from this study is that recreational marijuana laws may work better.

It's possible that only having medical marijuana laws like Maryland restricts some people. But, it's clear that having no cannabis laws is not helpful, like in Utah.

It's easy to see that access to cannabis reduces the need for painkillers. But, another question is, does cannabis help reduce illegal opioid use?

Part of the big problem of painkiller abuse doesn’t just apply to people suffering from pain. Some are addicted to pain medication from recreational use or as a coping mechanism.

A study from May 2018 looked at veterans' drug of choice with access to medical marijuana. Veterans often abuse opioids as a way to cope with post-traumatic stress disorder (PTSD).

PTSD is a mental disorder that causes constant emotional and physical stress from a traumatic event. Those with the condition often become very anxious and depressed.

Often, veterans and others with PTSD will turn to drug use. Opioids are commonly used because it helps calm and subdue their emotional stress.

In the aforementioned study, the researchers focused on 93 American veterans. Most of them reduced their opioid use when they had access to medical marijuana.

marijuana legalization

Not only that, but the researchers found that the veterans also replaced alcohol and other illegal drugs with cannabis. Many of the veterans said it helped them both mentally and physically. 

Lastly, a study released in January 2020 showed the decrease of painkiller use in all states with cannabis laws. It didn't matter if the state had recreational or medicinal laws.

States that still had cannabis outlawed didn't have a decrease in painkiller use. The study also found that, again, recreational cannabis laws decrease opioid use more than medical cannabis laws.

Cannabis Can Help Stop the Opioid Epidemic

From 1999 to 2018, hundreds of thousands of Americans have overdosed on prescription opioids. The opioid epidemic is a massive problem that often gets swept under the rug.

Current and ongoing research shows that cannabis can help treat pain and mental disorders, which can prevent people from becoming addicted to opioids. It's about time that America decides to move away from extremely addictive and dangerous opioids and focuses on the holistic qualities that cannabis can provide instead.

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