Colorado once again has the opportunity to lead on the cannabis front. Currently, there is an interim committee within the Colorado General Assembly called the Opioid and Other Substances Use Disorders Interim Study Committee, and they will be reviewing six proposed bills to address the growing opioid problem in Colorado that claimed 329 lives due to overdose, which made up 38.8% of all drug related deaths. And while heroin use is on the rise, there is more data that links opioid use leading to heroin use than there is for cannabis being a gateway drug. The latter has been debunked.
The Opioid and Other Substances Use Disorders Interim Study Committee is a bipartisan committee consisting of lawmakers from both the house and senate. On the committee are 10 representatives and senators, five Republicans and five Democrats. Chair Rep. Brittany Pettersen, Majority Whip (D- Jefferson County, District 28), Vice Chair Sen. Colonel Kent D. Lambert (R– El Paso County, District 9), Sen. Irene Aguilar (D- Denver County, District 32), Sen. Cheri Jahn (D- Jefferson County, District 20), Rep. Chris Kennedy (D- Jefferson County, District 23), Rep. Clarice Navarro (R- Fremont, Otero and Pueblo County, District 47), Sen. Kevin Priola (R- Adams County, District 25), Rep. Kim Ransom (R- Douglas County, District 44), Rep. Jonathan Singer (D- Boulder County, District 11) and Sen. Jack Tate (R- Arapahoe County, District 28).
The six bills seek to create a myriad of strategies to combat the opioid epidemic. The first proposed bill is to authorize the creation of the Opioid and Other Substances Use Disorders Interim Study Committee to study and develop intervention, treatment and prevention methods for the growing opioid epidemic in Colorado. The second bill changes prescriptive authority for professional with authorization to provide prescription pain pills. The third bill allows for the creation of supervised injection facilities and safe needle exchanges, absolves people using opioid antagonists responding to someone who is overdosing and specifies synthetic opioids. The fourth bill seeks to use $2.5 million from the marijuana tax fund to repay loans and award scholarships for addiction counseling training, which is designed to address the shortage in behavioral health providers. The fifth bill adds residential and inpatient assistance program to the Colorado medical assistance program through a federal financial program that the state has identified. The sixth bill prohibits individual and group health benefit plans from requiring prior authorization for medicated-assisted treatment, requires the authorization for the reimbursement of Narcan, and requires health insurance companies to provide coverage for alternative pain management therapies, such as acupuncture, physical therapy and chiropractic services that are not less favorable than applicable services provided by primary care services.
These are all forward-thinking measures to address the opioid crisis in Colorado, however, none of the proposed bills include using cannabis as an exit drug, or as an alternative solution for pain management that is less addicting with no known overdose deaths even though it is the most used “illicit” drug in the United States. And while these are proposed bills, the first one mentions studying available medication options available by prescription. Medical marijuana has been legalized for medicinal use in 28 states, and Washington, DC, and in Colorado, chronic pain it is listed a qualifying condition for using medical marijuana. In a state where medical marijuana has been legal for 17 years with most registered patients using cannabis for treating chronic pain, it seems odd that cannabis would not be consideration. The only mention of marijuana is to use tax dollars for addiction counseling.
There is plenty of data and research available now to support that there is a link between states that have legalized medical marijuana and both a reduction in the use of opioid pain medications, as well as a reduction in the overall use of prescription medications. Some studies were conducted from self-reporting surveys of current medical marijuana patients in legal states, which can be impacted by selection and recall bias. However, there does exist a growing body of clinical research showing that cannabis in reducing and treating opioid and heroin addiction, and that cannabinoids work synergistically with opioids to increase their effect, therefore reducing the amount of opioid-based pain medication needed to decrease pain.
A week ago, several articles were published online about cannabis has being helpful in reducing opioid use in Colorado. This echoes studies that have been conducted on using cannabis for pain management and for curbing opioid abuse. Despite this research, Dr. Larry Wolk, Executive Director and Chief Medical Officer of the Colorado Department of Public Health and Environment did not support the correlation to cannabis and the decrease in opioid abuse, stating “It just hasn’t been in place long enough. Anything that does get published at this point should be considered preliminary data.” While he has a good point in that this is preliminary data, his peers are already advocating using cannabis as an exit drug as well as a therapy for treating chronic pain. Medical doctors are also seeing the value of cannabis as an exit drug for opioid and heroin addiction. Dr. Uma Dhanabalan, a Harvard trained physician, is well known in the cannabis community and has been treating pain patients successfully with cannabis over opioids, and she advocates across the globe for using cannabis as an exit drug.
None of this is surprising to me. I myself have spoken about the issue at multiple conferences attended by medical professionals. As someone who has been in the cannabis space for over 16 years, and having owned a dispensary, I have spoken thousands of people throughout the world who have been using cannabis over opioids for managing pain. I have also met people who have stopped using opioids and heroin with the assistance of cannabis. The same goes for tobacco. I myself use cannabis for chronic and severe pain management, and I have also used cannabis to successfully stop smoking tobacco. It is a very powerful tool for managing pain and also for overcoming all addiction.
The committee will have a final meeting to vote on the proposed legislation on Tuesday, October 31, 2017. Addressing this opioid addiction crisis is going to take real leadership and the ability to embrace nonconventional methods that are showing to be effective, especially cannabis because it is readily available and already legal in Colorado. In addition to the suggestions made in these proposed bills, Colorado can create affordable access to cannabis through tax breaks and discounts, insurance coverage for addiction treatment using cannabis similar what is provided for alternative healthcare as well as coverage for those who chose medical marijuana over opioid-based pain medications and funding for medical professionals to learn the endocannabinoid system and how cannabinoids work on pain receptors.
Fortunately, this is an interim committee and there are opportunities to create amendments to add cannabis as a viable treatment option for pain management and to reduce opioid addiction and death. Most importantly, lawmakers can add an amendment to allow doctors to write recommendations for acute short-term pain. Currently, doctors can only recommend for chronic long-term pain, by allowing for recommendations for short-term acute pain, patients can opt to use cannabis instead of opioids or in conjunction with in lower dosages for time. This is helpful for when a person is going to have surgery or was in an accident, or anything that would require just short-term pain management that opioids would otherwise be used for. As mentioned earlier, studies have shown that cannabinoids are effective in reducing the need for opioids when introduced in conjunction with opioids, resulting in the need for less opioid-based pain medication. This is because some cannabinoids act on opiate receptors, which means that less opioids are needed. This lowers the chance of becoming addicted to opioids and potentially heroin.
Contacting your local representatives and committee members mentioned above can help facilitate meaningful and life-saving results for Coloradans struggling with chronic pain or addiction. We all know the saying about doing the same thing repeatedly trying to achieve different results, and while well-meaning, these bills are still sticking to traditional harm-reduction measures that will take time to implement when we have the tools right here in Colorado that can save lives now. Cannabis is effective and safe, and Colorado can take the lead on putting a major dent in the opioid epidemic here, and nationwide.