Clinical Research Coordinator, Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, MA, USA.
University of Virginia School of Medicine, Clinical Professor, University of Virginia School of Nursing , Charlottesville, VA, USA.
Expert Rev Pharmacoecon Outcomes Res. 2020 Oct;20(5):423-429. doi: 10.1080/14737167.2020.1807944. Epub 2020 Aug 31.
The opioid epidemic has resulted in the deaths of millions of Americans and was declared a public health emergency in 2017. In response, many states have enacted policies and analyzed various interventions for harm reduction and overdose prevention, which have embraced limited success. With more states legalizing medical marijuana, another intervention of interest in pain management, much research has since focused on the potential for medical marijuana laws (MMLs) to curb the opioid epidemic. Nonetheless, marijuana legalization and its use for medical purposes has been a polarizing debate from ethical, social, and clinical perspectives.
We examine evidence on the merits of medical marijuana to address its potential as a diversion from prescription painkillers. Additionally, we review the impact of MMLs on opioid-related outcomes. Furthermore, we provide multi-layered recommendations for future directions in the evaluation of medical marijuana and MMLs as potential mitigators of the opioid epidemic.
Despite limited and mixed evidence of efficacy, medical marijuana may still play an important role in addressing the opioid epidemic in the United States. Furthermore, we believe coordinated responses among the federal government, states, researchers, and patients are crucial in producing more robust evaluations of medical marijuana and MMLs.
阿片类药物泛滥已导致数以百万计的美国人死亡，并于 2017 年宣布为公共卫生紧急事件。作为回应，许多州已经制定了政策并分析了各种减少伤害和预防过量用药的干预措施，这些措施取得了一定的成功。随着越来越多的州使医用大麻合法化，另一种在疼痛管理中具有潜在作用的干预措施，因此，许多研究都集中在医用大麻法规 (MML) 遏制阿片类药物泛滥的潜力上。尽管如此，从伦理、社会和临床角度来看，大麻合法化及其用于医疗目的一直是一个两极分化的辩论。
我们研究了医用大麻的优点的证据，以探讨其作为处方止痛药替代品的潜力。此外，我们还回顾了 MML 对阿片类药物相关结果的影响。此外，我们还为评估医用大麻和 MML 作为阿片类药物泛滥的潜在缓解因素提供了多层次的未来发展建议。
尽管疗效的证据有限且存在分歧，但医用大麻在美国应对阿片类药物泛滥问题上仍可能发挥重要作用。此外，我们认为，联邦政府、各州、研究人员和患者之间的协调应对对于更有力地评估医用大麻和 MML 至关重要。
