Spicer Misspeaks on Cannabis and Opiates

February 24 - Asked about state marijuana laws yesterday, Press Secretary Sean Spicer said that while medical marijuana was "very different than recreational use," he opined, “When you see something like the opioid addiction crisis blossoming around so many states … the last thing we should be doing is encouraging people.”

It is widely understood that overuse of prescription opioids, not marijuana use, is what's driving the opiate crisis in the US. In fact, states with medical marijuana laws are seeing positive trends regarding opiates, as people are often able to substitute cannabis for pain relief.

The National Academy of Sciences’ Institute of Medicine found in 1999, “there is no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” The new NAS report found, "The committee did not identify a good- or fair-quality systematic review that reported on the association between cannabis use and the initiation of use of opioids."

“States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws,” reported a team of investigators from the University of Pennsylvania, the Albert Einstein College of Medicine in New York City, and the Johns Hopkins Bloomberg School of Public Health in Baltimore in the Journal of the American Medical Association (JAMA) Internal Medicine.(1)

- Chronic pain patients with legal access to medicinal cannabis significantly decrease their use of opioids, according to data published in The Journal of Pain after investigators at the University of Michigan, Ann Arbor conducted a retrospective survey of 244 chronic pain patients.(2)

- A study published in Health Affairs examined data from Medicare Part D from 2010 to 2013 and found that states that legalized medical marijuana — which is sometimes recommended for symptoms like chronic pain, anxiety or depression — saw declines in the number of Medicare prescriptions for drugs used to treat those conditions and a dip in spending by Medicare Part D, which covers the cost on prescription medications.(3)

- Columbia University's Mailman School of Public Health analyzed federal crash data in 18 states over the period from 1999 to 2013. States that passed a medical marijuana law during this period saw a reduction in opioid involvement in fatal car accidents, relative to states without such a law. The reduction was greatest among drivers aged 21 to 40, the age group most likely to use medical marijuana where it's available.(4)

Last year, then-Attorney General Loretta Lynch said, “When we talk about heroin addiction, we unusually, as we have mentioned, are talking about individuals that started out with a prescription drug problem, and then because they need more and more, they turn to heroin. It isn’t so much that marijuana is the step right before using prescription drugs or opioids...It’s not as though we are seeing that marijuana is a specific gateway.”

"A growing body of scientific research – including four published studies by California's own Center for Medicinal Research – shows that marijuana is effective in treating chronic pain," said Cal NORML director Dale Gieringer. "Knowledgeable specialists therefore regard medical marijuana as an exit, rather than a gateway, to narcotic abuse."

Also see:

Lt. Gov. Newsom tweets on the topic.

Sean Spicer Wrongly Links Recreational Marijuana with Opioid Crisis Forbes

Sean Spicer seemed to tie marijuana use to opioids. The evidence isn’t on his side Washington Post

Trump administration signals a possible crackdown on states over marijuana LA Times

1. Marcus A. Bachhuber, MD; Brendan Saloner, PhD; Chinazo O. Cunningham, MD, MS; Colleen L. Barry, PhD, MPP. Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010, JAMA Intern Med. 2014;174(10):1668-1673.

2. Kevin F. Boehnke, Evandelos Litinas, Daniel J. Clauw. Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain. Journal of Pain, June 2016; Volume 17, Issue 6, Pages 739–744.

3. Ashley C. Bradford and W. David Bradford. Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D. Health Affairs July 2016 35:71230-1236

4. June H. Kim, MPhil, MHS, Julian Santaella-Tenorio, DVM, MSc, Christine Mauro, PhD, Julia Wrobel, MS, Magdalena Cerda`, DrPH, Katherine M. Keyes, PhD, Deborah Hasin, PhD, Silvia S. Martins, PhD, and Guohua Li, MD, DrPH. State Medical Marijuana Laws and the Prevalence of Opioids Detected Among Fatally Injured Drivers. American Journal of Public Health, November 2016; Vol. 106, No. 11, 2032-2037.