IF THERE’S ANYTHING Jeff Sessions hates more than answering rapid-fire questions in front of a packed Intelligence Committee hearing, it’s a bag of stinky bud. The Attorney General’s distaste for marijuana is well documented. His Reefer Madness-era alarmism is so anachronistic it’s almost quaint. Or at least it would be if he weren’t using its outdated data to launch an attack on states’ rights to authorize medical marijuana.
In May, Sessions asked congressional leaders to roll back federal protections for the drug that have been in place since 2014, according to a letter that became public Monday. Known as the Rohrabacher-Farr amendment, these protections prevent the Justice Department from using federal funds to block states from crafting their own medical marijuana regulations. In his letter, Sessions complained that the amendment was keeping his department from enforcing other federal laws—namely, the Controlled Substances Act—citing the country’s “historic drug epidemic and potentially long-term uptick in violent crime” as justification.
Let’s put aside for a moment the fact that Session’s position directly contradicts the will of the American people; as of an April Quinnipiac poll, medical marijuana hit its highest levels of support in history, with 94 percent of voters approving of doctor-prescribed weed. Instead, let’s jump straight into why this is a totally bogus way to justify a new national drug enforcement policy.
While it’s true that yes, the US is in the midst of a “historic drug epidemic,” marijuana is not the drug that kills 91 Americans every single day. It is also not responsible for the quadrupling in overdose deaths in the US since 1999. In fact, according to the US Drug Enforcement Administration—which Sessions oversees—no deaths from marijuana overdose have ever been recorded. The epidemic the AG referred to is, of course, the deadly opioid sort—drugs like oxycodone, methadone, heroin, and fentanyl. No one is losing family members to some THC oil.
Using this very real public health crisis to justify cracking down on medical marijuana isn’t just disingenuous, it’s irresponsible. Because marijuana, it turns out, is actually pretty great at managing chronic pain. In January, the National Academies of Science, Medicine and Engineering conducted the most thorough review of marijuana research to date. Across numerous trials and experiments, the report found strong evidence that people treated for pain with marijuana were “more likely to experience a significant reduction in pain symptoms,” compared to a placebo.
That was pretty huge, because marijuana’s legal status as a Schedule 1 drug has severely limited the ability of researchers to test whether it can help patients deal with crippling pain, anxiety, insomnia, and nausea. It’s a classic, bureaucratic Catch-22: The DEA won’t change the legal status of marijuana unless the FDA determines its medical usefulness. The FDA can’t make that determination because the legal restrictions on the drug prevent researchers from running gold-standard clinical trials with it.
A meta-analysis published last year in the Journal of the American Medical Association found just 28 randomized clinical trials evaluating cannabis for chronic pain. Part of the reason for the paucity of pot trials is because whole plants and natural extracts aren’t patentable, so pharmaceutical companies have little incentive to pursue them. Plus the FDA doesn’t have an approval process for whole plants or other botanicals, just single molecules.
So instead, scientists are having to rely on observational, real-world data to form a picture of how marijuana might actually help solve the opioid epidemic, rather than contribute to it. So here are a few things Sessions might want to note:
States that permit medical marijuana have fewer opioid overdose deaths. According to a 2014 study in JAMA Internal Medicine, the 13 states that enacted medical cannabis laws before 2010 had a 25 percent lower average annual opioid overdose mortality rate. Painkiller prescriptions go way down after introducing medical marijuana laws. In a 2016 Health Affairs study, researchers found that doctors in states where medical MJ was permissible, prescribed (on average) 1,826 fewer painkiller doses for Medicare patients between 2010 and 2013. Chronic pain patients who use pot don’t need as many painkillers. A 2015 study in the Journal of Pain found that patients in Michigan who visited local dispensaries were 64 percent less likely to report opioid use, which suggests weed could actually substitute for some painkillers.
All of these studies looked at correlation, not causation, so it’s impossible to say for sure that access to medical marijuana will drive down opioid use and abuse. Marie McCormick, a public health researcher at Harvard who chaired this year’s NAS committee report says more research is needed to understand whether or not marijuana could be a substitute for serious painkillers. But it shouldn’t take a PhD or an MD to understand that cutting off people’s access to pot won’t make their symptoms go away. And pot, unlike opioids, doesn’t have a fatal dose.
McCormick says that’s something that states are starting to understand. “We’ve gotten really good feedback that our report is helping them set policies,” she said. “And at the end of the day it’s states that are basically running this thing.”
Well, they are for now. But not if Sessions gets his way. And that’s where researchers like McCormick start to get a little worried. “Once you’ve made up your mind about something, presenting alternative evidence only reinforces what you already think,” she says. Sessions thinks pot is ruining this country, not helping patients. “I really doubt whether this report or any other could convince the AG otherwise.”
credit:wired.com
