States with medical marijuana laws were associated with significantly lower state-level opioid overdose mortality rates, which could be a useful tool for states with high levels of opioid abuse.

Authored by Marcus A. Bachhuber, a study published in 2014 in the Journal of the American Medical Association examined medical marijuana laws and state-level death certificate data in all 50 states from 1999 to 2010. Before 1999, only three states had legalized medical marijuana, which rose to 10 states by 2010.

The study found that states with medical cannabis laws had a 24.8 percent lower annual opioid overdoses on average than states without them. In 2010, this translated to roughly 1,729 fewer overdose deaths in total.

According to the Center for Disease Control, West Virginia was the state with the highest drug overdose rate in 2015, followed by New Hampshire, Kentucky, Ohio and Rhode Island.

West Virginia is one of 22 states that does not have a medical marijuana law on the books.

“I would contend that West Virginia is a great place to have (medical marijuana),” said Del. Mick Bates, (D-Raleigh, District 30). “We could be leading the conversation for an alternative to opioids and narcotics as a part of treatment, as an alternative to what people are doing now.”

Bates, a physical therapist for 23 years, continued, “Clearly, how we’ve been treating many of these conditions, pain in particular, has not been effective. West Virginia is killing its future, and I think this could be part of the solution.”

New Hampshire, Kentucky, Ohio and Rhode Island all allow some form of legal medical marijuana. In Kentucky, it is only available for the treatment of epilepsy and in Ohio dispensaries are currently not operational.

Sales of prescription opioids in the U.S. nearly quadrupled from 1999 to 2014, according to the Center for Disease Control and Prevention. As sales quadrupled, so have opioid overdose deaths. CDC reported opioids were involved in 33,091 deaths in the United States 2015.

The Bachhuber study showed that the longer medical marijuana was available, the lower the rate of overdose deaths.

Dr. Ethan Russo, a board-certified neurologist and psychopharmacology researcher in Washington who has completed extensive research on the medical uses of cannabis, said this is a “striking illustration” of what can happen.

“It could be advantageous in dealing with the opioid epidemic,” Russo said.

Another study conducted by the University of Michigan in 2015 indicated that chronic pain patients, who often become dependent on prescription painkillers, could also benefit from the availability of medical marijuana.

In the U.S., an estimated 100 million adults suffer from chronic pain. According to a 2014 Express Scripts’ report, America claims less than 5 percent of the world’s population but it consumes roughly 80 percent of the world’s opioid supply.

“I’ve been treating patients for 23 years,” Bates said. “I see people every day, and pain is one of their major complaints.”

When he first started his practice, he didn’t hear these complaints.

“I used to treat successfully a huge number of patients without pills. But I’ve watched them take over and destroy communities and families, and here we are.”

Patients in the Michigan study reported a 64 percent reduction in their use of opioid pain medications and a 45 percent improvement in their quality of life since using cannabis to manage their chronic pain. They also reported they were using less medications overall, and therefore experiencing fewer side effects.

Russo explained that cannabis, a botanical medicine, taps into a natural pain suppressing piston in the body, the endocannabinoid system.

The authors of the Michigan study wrote, “Although we caution against using this study to change clinical practice toward cannabis, this study provides intriguing hints of the value of cannabis, as an effective pain medication and as an effective agent against opioid overuse and overdose.”

Chronic use of other pain relievers, such as oxycodone or opioid-based drugs, cause brain abnormalities, which leads to addiction, according to Drs. Thomas R. Kosten and Tony P. George, in their paper, “The Neurobiology of Opioid Dependence: Implications for Treatment.”

Medical marijuana advocates argue the drug offers increased benefits without the risks associated with opioids.

For example, certain strains of marijuana contain different levels of cannabidiol (CBD) and tetrahydrocannabinol (THC). As Dr. Russo explains, “CBD does not produce a high. It is not intoxicating.”

Studies have shown medical benefits from strains with variant levels of both CBD and THC, but a lot of attention in the medical community is paid to CBD.

“Assumptions are made about the kind of people who use the product for recreational reasons,” Bates said. “It’s fear of the unknown. You have to educate before you can advocate.”

Bates hopes to see West Virginia continue the conversation during this legislative session. He anticipates the introduction of a few marijuana-related bills, some for medical purposes, others for recreation. 

“We can’t continue to just ignore the need. There is a need,” Bates said.

He pointed to surrounding states who are rapidly moving forward with the issue and fears West Virginia will once again be last in line.

“If we get ahead, we could see some benefit of it. We could lead in some areas in terms of use, such as the area of addiction management and treatment. There could be research money that could come our way, but until we have that conversation, we won’t know.”

Holdren writes for the Beckley, West Virginia Register-Herald.