Cannabis studied as opioid replacement
Medical pot viewed as safer, less addictive than painkillers; health officer cautious
A Nanaimo-based researcher believes cannabis could help reduce opioid overdoses and help people overcome addiction.
Philippe Lucas, who works for medical-marijuana producer Tilray, published an academic paper in the Harm Reduction Journal that explores cannabis as a substitute for opioids.
Lucas said doctors should consider prescribing cannabis as a safer, less addictive alternative to opioids for treating chronic pain.
“The evidence is clear at this point that medical cannabis is far less addicting and has … zero risk of overdose compared to opioids,” said Lucas, who has been researching the therapeutic use of cannabis for more than a decade. In a case where an opioid addiction has already taken hold, cannabis can be used alongside opioid-replacement therapies such as methadone or suboxone to improve results, Lucas’s research suggests.
B.C. reported 972 drugoverdose deaths in 2016, and is on pace for more than 1,500 this year. Most have involved fentanyl or another opioid.
Lucas called it “an escalating health emergency that needs action and merits novel interventions. I think medical cannabis can play a real role in reducing the harm of opioids.”
However, deputy provincial health officer Dr. Bonnie Henry said more research is needed.
“I think there’s a lot of things we still don’t know about cannabis,” Henry said, particularly when it comes to the medical use of different strains of cannabidiol (CBD) and the psychoactive component tetrahydrocannabinol (THC).
“I’m optimistic and I’m hopeful there will be some benefit from cannabis that will help people who have an addiction to opioids and those with chronic pain,” she said.
“But I think we still need quite a bit more science to help us understand exactly where it’s going to work and how it’s going to work.”
Tilray, which is based in Nanaimo, is funding a study that will compare the treatment outcomes for 250 people who use methadone or suboxone alongside cannabis and 250 people who use the opioid replacement therapies alone. The clinical trials will take place at five medical clinics in B.C. and Ontario, and Lucas hopes the results will be released in 2018.
Because he works for Tilray, a business that benefits from the proliferation of medical marijuana, Lucas will remain at arm’slength from the study. He said the administration and data collection will be conducted by medical staff at the clinics.
Lucas said government funding for cannabis-based research is limited, so funding comes from the marijuana industry.
“But study design and independent ethics reviews ensure these studies are being done in a way that does not compromise the patients or the data that’s being collected,” he said.
Henry said she has concerns about Tilray, one of the country’s largest licensed producers of medical marijuana, funding a study into medical cannabis when it has a huge financial stake.
“I always have concern about that,” she said. “We see that with other drug trials, where pharmaceutical companies are sponsors and we know there’s a bias toward a positive study.
“I do think we need to make sure we have that distance between the manufacturers and the scientific studies that are being done.”