Cannabis vs. Opioids

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James Feeney, a surgeon in Connecticut, heard it from his patients. A few actually turned down his prescription for oxycodone, the popular opioid painkiller that has also gained notoriety with the opioid epidemic. His patients, Feeney recalls, would say, “Listen, don’t give me any of that oxycodone garbage. … I’m just going to smoke weed.” “And you know what?” says Feeney. “Every single one of those patients doesn’t have a lot of pain, and they do pretty well.” Marijuana has worked well enough, anecdotally at least, that Feeney is following his patients’ lead and conducting a trial at Saint Francis Hospital and Medical Center in Hartford, Connecticut. The self-funded study will compare opioids and medical marijuana for treating acute pain, such as that from a broken rib.* That distinction—acute pain from an injury—is also an important one. A small body of evidence suggests that medical marijuana is effective for chronic pain, which persists even after an injury should have healed and for which opioids are already not a great treatment. But now Feeney wants to try medical marijuana for acute pain, where opioids have long been a go-to drug. “The big focus from my standpoint is that this is an attempt to end the opioid epidemic,” he says. Overdoses from opioids, which includes heroin as well as prescription painkillers like oxycodone and morphine, killed more than 30,000 people in 2015.
Marijuana might have a bigger role in curbing this drug abuse than previously thought. Its potential uses are actually threefold: to treat chronic pain, to treat acute pain, and to alleviate the cravings from opioid withdrawal. And it has the advantages of being much less dangerous and addictive than opioids.

The big roadblock? Marijuana’s status under federal law as a Schedule I drug—the most tightly restricted category—which makes it very difficult for researchers to study.
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