Expanding legal access to marijuana is not the solution to America's opioid crisis

Expanding legal access to marijuana is not the solution to America's opioid crisis, according to a new research analysis published by the nonprofit Hazelden Betty Ford Foundation.

Hazelden Betty Ford's latest Emerging Drug Trends report—produced in collaboration with the University of Maryland School of Public Health—highlights a lack of robust scientific evidence to support the oft-cited claim that increasing access to marijuana, also known as cannabis, would help reduce addiction to opioids and other drugs. The report aims to clear up confusion about the known science on this topic, concluding that the strongest existing research points to marijuana use actually increasing people's risk for misusing opioids and other substances.

"The notion that increased access to marijuana will help the country shed its current addiction crisis does not have scientific merit, and distracts from planning and implementing a longer-term and broader set of evidence-based strategies," the report states.

This conclusion aligns with the recent advisory issued by the U.S. Surgeon General, which emphasized that "adolescent marijuana use is often also associated with other substance use," including opioid use.

"The dialogue around marijuana legalization has been muddied by the desperate desire for solutions to the nation's opioid crisis," said Nick Motu, vice president and chief external affairs officer for Hazelden Betty Ford the nation's leading nonprofit addiction treatment provider. "We must continue taking aggressive steps nationally to increase access to effective interventions, treatment and wrap-around supports for people with opioid use disorder, but it's irresponsible—given the research available—to cite the opioid crisis as grounds for advancing the commercialization of marijuana."

The report cautions that research findings at the individual level—showing how marijuana use affects individual people, including their use of opioids and other drugs—should be considered by policymakers before making marijuana more accessible.

"There is an increasing trend across the U.S. and worldwide to downplay the risks associated with marijuana use. This is particularly problematic given the substantial evidence of marijuana's harmful effects on mental health and substance use disorders, pregnancy outcomes and brain functioning among a youth and young adults," said Kate Gliske, PhD, a research scientist with Hazelden Betty Ford's Butler Center for Research.

The new paper is the eighth edition of Hazelden Betty Ford's Emerging Drug Trends report, designed to provide frontline treatment and research perspectives on America's No. 1 public health problem: addiction. The latest report includes the following findings and conclusions:

  • Studies using strong scientific methods show that marijuana use increases the risk for starting to misuse prescription opioids, rather than lowering the risk;

  • Individuals with addiction to prescription opioids often have a history of using other drugs including marijuana and need comprehensive addiction intervention and treatment;

  • Marijuana use to manage pain does not appear to be related to decreases in pain (meanwhile, other pain management approaches are evidence-based and effective), and evidence that marijuana is an effective treatment for opioid use disorder is even weaker;

  • When dealing with the addiction and overdose crisis facing the U.S., policymakers should make decisions that have a strong scientific justification.

Because the strongest available research reflects that marijuana might actually exacerbate subsequent opioid addiction and because much more research on marijuana is needed overall, the report urges caution around any efforts to increase access to legal marijuana.

"We need to study cannabis and derivatives like CBD to determine which health conditions could benefit and how such products would work. As important, we need to determine the limitations—what cannabis and its derivatives do not affect or help," said Hazelden Betty Ford Chief Medical Officer Marvin D. Seppala, MD. "We've jumped the gun and allowed relatively indiscriminate use by a large portion of the population without adequate scientific study."

The full report is available here.