The United States is suffering from an epidemic that is estimated to have claimed 400,000 lives. In what is now known as the opioid crisis, drug manufacturers have been raking in huge profits over the past two decades by mass prescribing a diverse class of addictive painkillers known as opioids.
Now, about 130 people in the United States die every day after overdosing on opioids, making it the nation’s biggest accidental killer, while millions more continue to suffer from the dependence and addiction that the drugs cause.
Things reached a boiling point this week after drug-maker Purdue Pharma filed for bankruptcy and agreed to a $12bn settlement for its role in fuelling the crisis.
Before that, a landmark case saw pharmaceutical giant Johnson & Johnson pay $572m in compensation for its role in the epidemic of addiction in Oklahoma alone.
It’s a crisis that has been described as a “uniquely American problem” – a phenomenon that could only really emerge from the US healthcare system, where insurance companies seek out cheap solutions and many doctors who prescribe the drugs receive payments from the manufacturers to do so.
In 2012, this crisis peaked, when more than 255m opioids were prescribed, at a rate of 81 prescriptions per 100 Americans.
The trouble is that many aspects of the problem have a wider relevance too, and not least in the UK, where a government review recently revealed that almost 12m people (about one in four adults in England) are now taking medicines that are addictive for pain, depression, or insomnia.
The majority of these are antidepressants, which doctors issued nearly 71m prescriptions for in 2018, a 97 per cent increase compared to 2008. What’s also worrying is that prescriptions of opiates have risen 22 per cent from a decade earlier to 40m. Both of these medicines can be difficult to withdraw from and are easy to abuse.
Also consider that both countries have been engaged in a longstanding war on drugs that has led to a widespread denial of the medical properties that exist in banned substances.
We know that medical cannabis creates important pain-relieving molecules that are 30 times more powerful than aspirin, but that crucially, offers relief without the risk of addiction and fatal overdose that prescription painkillers do.
While opioids work by blocking the brain’s receptors, the cannflavins in medical cannabis target pain with a different approach, by reducing inflammation.
If you look first at CBD-dominant strains that have very little or no THC, the World Health organisation has said that “in humans, CBD exhibits no effects indicative of any abuse or dependence potential” and that “to date, there is no evidence of public health-related problems associated with the use of pure CBD”.
This is crucial because patients now report many benefits of CBD, which include relieving insomnia, anxiety, and chronic pain.
So if CBD can be an effective, non-addictive, and a safe substitute for opioids, then what of medical cannabis that also contains the psychoactive compound THC?
Critics of the drug say that this type of cannabis is itself addictive. While decades of global conservatism towards cannabis has resulted in a shortage of medical trials, recent studies show it can be particularly effective for the severe chronic pain that plagues millions, and is still far safer than opiates because it’s impossible to overdose on and far less addictive.
Health Canada, the Canadian version of the NHS, found that while cannabis addiction does exist, the risk is far lower than in tobacco, alcohol, and opioids, while the NHS states that 10 per cent of regular cannabis users are at risk of addiction.
Pre-clinical studies are also uncovering that certain cannabinoids may even alleviate opioid withdrawal symptoms. In fact, striking recent statistics suggest that prescribing medical cannabis instead of opioids has the potential to prevent around 25 per cent of deaths associated with opioid addiction each year.
Also bear in mind that in American states where cannabis is legal for medical uses, prescriptions for opioids and anti-depressants has fallen on average by an extraordinary 30 per cent, a rate still strengthening with time.
The financial burden that these health care crises have on British society each year already runs into billions of pounds, including the cost of lost productivity in the workforce.
Medical cannabis is an inexpensive and effective alternative to many treatments, that is now widely viewed as a non-toxic and non-addictive substitute for pricey prescription drugs.
This alone should be a good enough reason for the NHS to consider CBD or medical cannabis both as a substitute to prescribing opioids, and as means to alleviate the opioid withdrawal symptoms addiction that already afflicts so many.