Article by Richard Cowan, former NORML National Director and author of Breaking Down The Label Of CBD Gummies.
Vancouver, British Columbia, is truly one of the world’s most beautiful cities. It also has the best weather of any major Canadian cities. Faint praise, but homeless people are much less likely to freeze to death there. That fact may partly explain why its Downtown Eastside has a very visible street population, and substance abuse problems.
The excellent website MedicalExpress.com has published two studies by the University of British Columbia about the therapeutic use of cannabis in reducing the problems with opiates by these people.
The first study from May 26, 2020, Majority of cannabis use in Vancouver’s Downtown Eastside for therapeutic purposes found that:
“Most people at high risk of overdose in Vancouver’s Downtown Eastside who use cannabis do so for pain relief and other therapeutic reasons—and they may be at lower risk of overdosing on opioids as a result…”
“We’re seeing more and more in our research that people are using cannabis for therapeutic reasons,” says Stephanie Lake, a doctoral candidate at UBC’s School of Population and Public Health and the lead author of the study. “We’re also seeing that, for some individuals in our study, this therapeutic use corresponds with either less use of illicit opioids or a reduced risk of overdose…”
Additionally, cannabis users in the group characterized by using cannabis for pain relief had lower odds of experiencing a recent non-fatal opioid overdose and injecting heroin every day in comparison to other groups. Previous research from the BCCSU found that many people at risk of overdose, particularly those living with pain, may be using cannabis to reduce their reliance on illicit opioids, a key driver of the opioid overdose public health emergency.
Another key finding of the study was that therapeutic cannabis users rely on the unregulated market to supply their cannabis use—and that access to legal cannabis for all people who use cannabis in the study remains a challenge. Participants in the current study reported that illegal dispensaries were the most important source of cannabis in approximately half of all study interviews; legal sources of cannabis (i.e., through the medical cannabis system or recreational cannabis stores) accounted for less than one per cent.
“The mounting evidence related to the motivations behind people’s cannabis use strongly suggests that improving access to cannabis for therapeutic purposes could help reduce overdose risk associated with illicit opioid use,” says Dr. M-J Milloy, a research scientist at BCCSU, the Canopy Growth professor of cannabis science at UBC and the senior author of the study. “Unfortunately, our results also tell us that medical cannabis users from the Downtown Eastside do not have equitable access to legal sources of cannabis, either through the medical cannabis system or the new recreational market. Authorities should pause their efforts to close unregulated sources of cannabis and eliminate the illicit market until barriers to legal cannabis are addressed, especially during the overdose crisis.”
Another study from December 21, 2020 found that “Cannabis could reduce fentanyl use, reduce overdose risk” by the University of British Columbia.
“New research… found that 53 per cent of the 819 study participants in Vancouver’s Downtown Eastside were intentionally or inadvertently using fentanyl, despite being on opioid agonist treatments (OAT) like methadone or buprenorphine/naloxone…
However, researchers found that those in the study who had urine tests positive for THC (the primary psychoactive component of cannabis) were approximately 10 per cent less likely to have fentanyl-positive urine, putting them at lower risk of a fentanyl overdose.
“These new findings suggest that cannabis could have a stabilizing impact for many patients on treatment, while also reducing the risk of overdose,” said Dr. Eugenia Socías, a clinician scientist at BCCSU and lead author of the study. “With overdoses continuing to rise across the country, these findings highlight the urgent need for clinical research to evaluate the therapeutic potential of cannabinoids as adjunctive treatment to OAT to address the escalating opioid overdose epidemic…”
The findings… add to an emerging body of research suggesting cannabis could have a stabilizing impact for many patients on treatment, while also reducing the risk of overdose.
“Scientists are only just beginning to understand the role cannabis might play in supporting people’s wellbeing, particularly those who use other substances,” says Dr. M-J Milloy, study co-author and the Canopy Growth professor of cannabis science at UBC, who will lead the new study with Dr. Socías. “This study will help us understand if and how cannabis might have a role in addressing the overdose crisis.”
Two added points here. First, I salute Canopy Growth for its support for academic research.
Substantively, it is important to recognize— as these two studies do — that any cannabis regulations must understand that the people with serious mental and/or substance abuse problems will not be served by the same distribution systems for either recreational or medical cannabis.
Every city has similar problems with a subset of the homeless and/or mentally ill populations, and there is no neat dividing line between the recreational and medical use of marijuana. A refuge where they could buy and use cannabis and get food and/or coffee could be an important part of reducing the chaos of their lives. (Sounds a lot like a Dutch “coffee shop.”)