According to recent studies every day, more than 115 Americans die after overdosing on opioids.  The misuse and addiction to opioids include prescription pain relievers, heroin, and synthetic opioids such as fentanyl. This has become a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and Prevention estimates that the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.

WHAT ARE OPIOIDS?

Opium is a plant containing opioids which reduce pain by binding to opioid receptors.

HOW DO OPIOIDS WORK?

People are usually familiar with opioids such as fentanyl, oxycodone, hydrocodone, codeine, and morphine. These are a class of drugs that interact with opioid receptors on nerve cells in the brain and body which produce pain relieving and euphoric effects. Prescriptions for drugs such as these have been on the rise along with overdoses from taking them.

According to the Centers for Disease Control and Prevention, both the sale of prescription opioids and prescription opioid overdose deaths in the U.S. nearly quadrupled from 1999 to 2014! The reason death with an opioid overdose is common is due to the areas of the brain and body that have the highest densities of opioid receptors. The three major locations of these high density areas are the spinal cord, limbic system, and brainstem. The brainstem includes the medulla, the part of the brain that controls the autonomous, non-voluntary functions of the body like breathing and heart rate. In the event of an overdose, areas of the brain with the highest densities of opioid receptors become depressed, causing heart failure and/or respiratory failure. There is a high risk of opioid dependence, and once addicted, it can be difficult to stop.

HOW DOES MEDICAL CANNABIS WORKS?

Cannabis contains cannabinoids: chemical compounds that bind on cannabinoid receptors located in the brain and body to regulate the communication of cells. The most highly concentrated cannabinoid receptors in the brain are located in the basal ganglia, the hippocampus, and cerebellum. These areas are responsible for managing several faculties such as emotion, memory, motor control, and the autonomic nervous system. In the event of an overdose of cannabinoids, the affected areas are not responsible for autonomic function. This means that if an overdose occurs, side effects may include headache, nausea, vomiting, and/or paranoia, but there has never been a recorded case of death by overdose of cannabinoids.

WHY CHOOSE CANNABIS OVER OPIOIDS FOR PAIN TREATMENT?

So, what is the difference between opioids and cannabis, and why would someone choose to treat their pain with one over the other?

While both cannabis and opioids are effective in pain management, cannabis has never been linked to death by lethal dosage, while the CDC reports that more than three out of five drug overdose deaths involve an opioid. So why use opioids to treat pain? The legal availability and the widespread cultural acceptance make opioids easier to obtain and use. Most opioids listed as a schedule II drugs by the DEA, a variety of these can be marketed to you and prescribed by healthcare professionals at their discretion. Cannabis and cannabinoids are listed as a schedule I drugs, making all cannabis or cannabis derived medications illegal federally, even medications that don’t cause a “high” like CBD. This of course means that, regardless of local or state law, the federal government sees cannabis as having no medicinal value.