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Mind and Body

Treating opioid dependence with marijuana?

Hearing scheduled on whether to add opioid dependency to the list of conditions that can be treated with medical marijuana

File photo, ConvergenceRI

Medicinal marijuana being grown under lights by a registered caregiver in Rhode Island.

By Richard Asinof
Posted 1/7/19
A public hearing is scheduled for Wednesday, Feb.6, by the R.I. Department of Health on whether or not to approve the use of medical marijuana for the condition of opioid dependence adds a new twist to the debate over legalizing recreational marijuana.
In states that have legalized recreational marijuana, such as California and Colorado, what are the demographics by age and gender for purchases? Is there a body of research that has shown that the use of medical marijuana is successful in treating opioid dependence? Are there opportunities for Rhode Island’s research enterprise to become more engaged in such clinical research around marijuana usage, particularly in how cannabinoid receptors in the brain function?
Increasingly, the benefits of medical marijuana have crossed the threshold of clinical acceptance, despite the paucity of medical research, in large part because the federal government still maintains an odious classification of marijuana as a Class One substance, with no currently accepted medical use, making clinical research tightly restricted. [The 2018 U.S. farm bill descheduled some cannabis [hemp] products for the first time.]
Now that 30 states have legalized the use of medical marijuana, the question is when the federal government will take the appropriate action and change the federal laws and drug classification.

PROVIDENCE – The R.I. Department of Health has scheduled a public hearing on Wednesday, Feb. 6, at 10 a.m. to hear comments on whether or not to add opioid dependency to the list of conditions that can be treated with medical marijuana.

The public hearing, which will be held in the R.I. Department of Health’s auditorium, is the result of a petition filed by the B & B Medical Marijuana Center of Warwick on Oct. 24, 2018.

In the petition, B & B Medical Marijuana claimed that: “Studies have shown up to 65 percent of older adults who use medical marijuana significantly reduced their chronic pain and dependency on opioids.”

As part of the petition, B & B Medical Marijuana provided more than 80 pages of documentation supporting its position in the form of studies, articles and research.

Joseph Wendelken, the public information officer at the R.I. Department of Health, provided an overview of the process that will be undertaken in an email sent Friday afternoon, Jan. 4, 2019.

“The team here at the Rhode Island Department of Health will review the public comments that we receive, do a review of the medical literature on the issue, and engage clinicians and researchers to get their input,” Wendelken wrote.

Eventually, Wendelken continued, Dr. Nicole Alexander-Scott, the director of the R.I. Department of Health, will issue a decision on the petition. “Her decision has to come within 180 days of our receipt of the petition,” Wendelken explained. [Because the petition was received in late October, the decision is expected to come sometime before mid-April, according to Wendelken].

In addition, Wendelken provided, as background, that there were two ways a condition can be added to the list of conditions that can be treated with medical marijuana in Rhode Island – either by the R.I. General Assembly or a petition by an individual or a group to the R.I. Department of Health.

Current conditions
The current debilitating medical conditions approved for treatment with medical marijuana in Rhode Island include:

Cancer, glaucoma, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, Hepatitis C, post-traumatic stress disorder, or the treatment of these conditions.

A chronic or debilitating disease or medical condition, or its treatment, that produces one or more of the following: cachexia or wasting syndrome; severe, debilitating, chronic pain; severe nausea; seizures, including but not limited to, those characteristic of epilepsy; or severe and persistent muscle spasms, including but not limited to, those characteristic of multiple sclerosis or Crohn's disease; or agitation of Alzheimer's Disease.

New wrinkle in the marijuana legalization debate
The potential for medical marijuana to be approved as a treatment for opioid dependence adds a new wrinkle to the ongoing debate about whether or not to legalize recreational marijuana in Rhode Island, given the recent move by Massachusetts to do so and the desire to capture a share of the revenues that could be generated as a result.

Such a move may also serve to sharpen the debate around treatment and recovery options, given Rhode Island’s endorsement of expansion of medication-assisted treatment as part of the treatment protocols.

In addition, the public hearing may also engender some discussion around law enforcement policies to be pursued by the new R.I. Attorney General, Peter Neronha.

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