HARRISBURG — Some Pennsylvania cannabis companies are using incomplete or misleading claims to promote marijuana as a treatment for opioid addiction, potentially putting patients’ lives at greater risk, a Spotlight PA investigation has found.
The most alarming examples, according to several of the experts, were online statements made by two companies that help patients become certified to buy medical marijuana at state dispensaries. New York addiction psychiatrist Adam Bisaga, an author of one of the scientific articles cited, warned of the risk of using marijuana instead of one of the federally approved opioid use disorder drugs, saying in an email that “advocating substituting cannabis for buprenorphine, methadone, or naltrexone is not based on any research and it may be dangerous.”
And while the state’s 2016 medical marijuana law requires the Department of Health to restrict the advertising and marketing of cannabis, it does not specifically mention the certification companies that often play a crucial role in connecting patients with physicians. A department spokesperson said the agency doesn’t “have any regulatory authority” over those companies.
“That’s terrible,” said Erin Zerbo, an addiction psychiatrist in New Jersey and an associate professor at Rutgers New Jersey Medical School, as she reviewed Spotlight PA’s findings. “‘A viable substitute?’ No, that’s bad.”Seven websites cited a 2014 study that found medical marijuana laws were associated with lower rates of fatal opioid overdoses. But they ignored a later study that showed the trend didn’t hold up over time and, in fact, reversed.
Keith Humphreys, an addiction researcher and professor at Stanford University School of Medicine, said medical cannabis companies should be held to a higher standard than nonmedical businesses. When the agency did take enforcement action, the issue often was whether medical marijuana dispensaries failed to follow the required approval process for submitting advertising and marketing materials to the Department of Health, or whether they made references to recreational use.
In sections of their websites focused on opioid addiction, each displayed identical statements: “Research suggests that medical marijuana can be a viable substitute for opioids such as buprenorphine and other prescription drugs.” Neither webpage included a link to said research. Beth Wiese, a neuroscience doctoral candidate at the University of Arizona and an author of the article, said she supports having opioid use disorder as a qualifying condition for cannabis but she still sounded a note of caution.
That report did not compare outcomes for patients who use cannabis instead of buprenorphine, which is not mentioned at all. It also lumped together several conditions, saying 99.62% of patients surveyed “were able to reduce pain, better sleep, less anxiety, less seizures, appetite increase, less vomiting, nausea, addiction withdrawal symptoms, decrease with muscle spasms, improved energy and less seizures.
The Wolf administration says opioid use disorder should only be a qualifying condition for medical marijuana in certain circumstances, but sections of at least 13 websites — including one promoting Compassionate Certification Centers — left out those caveats. Amanda Berg / For Spotlight PA Neuroscientist Yasmin Hurd, a leading CBD researcher and an author of the second article Hawks cited, called Compassionate Certification Centers’ online statements about cannabis and opioid use disorder “blatantly incorrect” and “beyond misleading.”Hurd, director of the Addiction Institute at the Icahn School of Medicine at Mount Sinai, hopes the cannabis compound CBD will one day become a federally approved medication for opioid use disorder.
An April report from that year written by the state’s Medical Marijuana Advisory Board cleared the way for the change, but did not cite any specific research to support it. Instead, the report said cannabis had “been reported by patients to ease the symptoms and process of opioid withdrawal. It has been used by patients as an ‘exit drug’ to get off of heroin and other opiates.”
The state’s health secretary at the time, physician Rachel Levine, also didn’t cite any specific research when she formally added opioid use disorder as a qualifying condition. Levine said opioid use disorder should only be a qualifying condition in certain circumstances: when conventional therapies are contraindicated or ineffective, or if cannabis is used alongside another primary therapy.
It might help you endure some of the worst symptoms of withdrawal when stopping opioid use, but the truth is, if cannabis wasn't treated like nuclear material by this gov't, you would have just consumed cannabis instead and we wouldn't be having this conversation.
What’s really to blame here? Federal marijuana prohibition.