Cannabis dispensaries opened for business this month in Ohio amid a continuing debate over medical marijuana’s benefits.
More Dead in Ohio.
The headline above sounds similar to a passage from Crosby, Stills, Nash, and Young’s anti-war song “Ohio,” which chronicled the shooting deaths of four students at Kent State University nearly 50 years ago.
But it’s actually a description of what is happening today in the Buckeye State, where opioid overdoses are killing people in large numbers.
Ohio is among the top five states with the highest rates of opioid-related overdose deaths. In 2016, there were 3,613 opioid-related overdose deaths in Ohio — a rate of almost 33 deaths per 100,000 people.
That’s more than double the national rate of 13 deaths per 100,000, according to the National Institute on Drug Abuse.
A medical marijuana bill in Ohio passed and signed into law in 2016 was enacted two weeks ago.
Ohio residents with at least one of 21 qualifying conditions can now get a doctor’s recommendation to purchase marijuana at state-licensed dispensaries.
While chronic and severe pain are qualifying conditions for medical marijuana in Ohio, opioid addiction is not. State regulators are still debating that topic.
So far, only a handful of medical marijuana dispensaries in Ohio are open for patients. About 60 locations are expected to open by mid-March.
And it can’t happen too soon for many Ohio residents and advocates of the program.
Betty Cox says she would be dead if not for marijuana.
In 2016, Cox, 58, a widow, mother, and grandmother from Cincinnati, was sick and believed she was dying from her opioid medications.
She’d been taking them for 15 years for severe pain from serious injuries, fibromyalgia, and more.
Her daily regimen included high doses of morphine and Percocet.
Cox believed her daily intake was excessive, but she trusted her doctor at a pain management clinic.
“My doctor said opioids would benefit me more than hurt me. He never told me they were addicting,” Cox told Healthline.
She was helped by the meds for a while, but she made a life-changing decision when her pharmacy made her sign a document stating she knew the drugs were addicting.
“That’s when I knew I had to get off these drugs,” she said. “But I had to keep working, and keep the pain down, and take care of my kids. I didn’t know how I was going to do this.”
So she turned to marijuana, hoping it would help.
“It saved my life. Because of the marijuana, I was able to taper slowly off the opioids. It took more than two years and it was very hard, but I did it,” she said.
Cox is in far less pain now than she was when she was taking the prescription drugs. But she still is forced to purchase marijuana illegally.
“I was alive during the ’70s. I know how to find it,” she quipped.
But soon she won’t have to buy it on the streets. She has an appointment next week to get set up for medical marijuana in Ohio.
Debate over the merits of medical marijuana to address this emergency continues in Ohio and nationwide.
Multiple studies from across the nation show a direct correlation between the legalization of medical marijuana and a decrease in opioid use, overdose, and death.
A in the journal JAMA Internal Medicine looked at the association between state implementation of medical cannabis laws and opioid prescribing under Medicare Part D.
The study found that prescriptions filled for all opioids decreased by “2.11 million daily doses per year from an average of 23.08 million daily doses per year when a state instituted any medical cannabis law.”
And it found that prescriptions for all opioids decreased by 3.7 million daily doses per year when medical cannabis dispensaries opened.
The study concluded that medical cannabis policies “may be one mechanism that can encourage lower prescription opioid use and serve as a harm abatement tool in the opioid crisis.”
According to data from the Minnesota Department of Health, 63 percent of patients known to be taking opiate painkillers who enrolled in the state’s medical cannabis program “were able to reduce or eliminate opioid usage after six months.”
conducted in New Mexico showed that medical cannabis enrollees, compared to nonusers, “were more likely either to reduce daily opioid prescription dosages between the beginning and end of the sample period (83.8 percent versus 44.8 percent) or to cease filling opioid prescriptions altogether (40.5 percent versus 3.4 percent).”
In Michigan, collected from patients enrolled in the state’s cannabis program showed that marijuana treatment “was associated with a 64 percent decrease in opioid use, decreased number and side effects of medications, and an improved quality of life.”
Dr. William Sawyer is an old-fashioned doctor from Cincinnati who still makes house calls and even gives out his personal cellphone number to his patients.
He is in many ways a refreshing reminder of a bygone era in family medicine.
When it comes to medical marijuana, he is more modern. He adamantly supports it.
“I’ve seen the benefits of marijuana in my patients over the last 32 years,” Sawyer told Healthline.
He has many patients, including some who are more than 70 years old, who’ve moved from opioids to marijuana on their own to address pain and other health issues.
While Ohio residents continue to debate the topic, many in the state like Sawyer believe medical marijuana will save countless lives and be a positive step in addressing the opioid epidemic that has ravaged the state.
Sawyer, who is certified to recommend medical marijuana but not allowed to prescribe it, feels medical marijuana is simply another tool for those dealing with opioid addiction.
He believes what has happened in other states where medical marijuana legislation has been implemented will happen in his state.
“From Colorado to Washington state to California, there is plenty of evidence for physicians and patients who believe there could be a better way to address this opioid addiction issue,” he said.
Sawyer gets frustrated when people criticize medical marijuana and say more randomized clinical trials are needed.
“I remind them that it is still not proven that hand-washing at a newborn ICU prevents infections,” he said. “So why do you wash your hands? Citizen science tells us that medical marijuana obviously will help. As a physician, I know it will.”
Critics of medical marijuana in Ohio insist the substance is potentially harmful, that it is a gateway drug to harder drugs, and that more randomized clinical trials of the side effects of marijuana need to be initiated.
Dr. Mark Hurst, director of the Ohio Department of Mental Health and Addiction Services, has stated publicly that he doesn’t believe medical marijuana is a viable treatment for opioid addiction because of the lack of scientific data.
Hurst told the Cincinnati Enquirer last summer, “There is no scientific evidence that marijuana is an effective treatment for opioid addiction.”
The Cleveland Clinic won’t be recommending medical marijuana to its patients.
On the medical center’s website, Paul Terpeluk, DO, medical director of the Employee Health Services at the clinic, said:
“In the world of healthcare, a medication is a drug that has endured extensive clinical trials, public hearings and approval by the Food and Drug Administration (FDA). Medications are tested for safety and efficacy. They are closely regulated, from production to distribution. They are accurately dosed, down to the milligram. Medical marijuana is none of those things.”
But proponents of medical marijuana scoff at this way of thinking.
Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws (NORML), is the co–author of “Marijuana Is Safer: So Why Are We Driving People to Drink?,” and the author of “The Citizen’s Guide to State-By-State Marijuana Laws.”
“At this point the data is clear, consistent, and convincing. When legal access to marijuana is available, you a see decline in abuse of and death from opioids. To deny that reality at this point is to deny gravity,” he told Healthline.
According to Armentano, the rollout of medical marijuana in Ohio has been slow because public officials have largely ignored the sentiment of the voters.
“The Ohio medical marijuana program is a very narrow, limited program that is not patient-centric. It is indicative of politicians and regulators being dragged to the table as opposed to actually supporting the idea,” he said.
Ohio’s two most recognized political figures — former Ohio Gov. John Kasich and former Speaker of the House of Representatives John Boehner — were both vehemently opposed to medical marijuana while they held public office.
Despite signing the medical marijuana law in Ohio, Kasich didn’t believe marijuana could have any positive impact on the opioid crisis in his state.
When asked at a press conference what role it could play, Kasich said, “I know it’s not recreational marijuana, not recreational use, but I don’t see a role for it in this at all.
Boehner, too, denigrated the idea of marijuana as medicine while in Congress, stating that he was “unalterably opposed” to the idea.
But Boehner’s tune has changed.
He now sits on the board of directors of Acreage Holdings, a cannabis firm whose mission is to “become the world’s leading cannabis company, bringing safe, affordable cannabis to everyone who needs it.”
Boehner told Time magazine that his perspective shifted after he saw how marijuana helped a good friend deal with debilitating back pain.
Marijuana’s potential use as a treatment for veterans also reportedly convinced him to change his mindset.
“I’m joining the board of #AcreageHoldings because my thinking on cannabis has evolved. I’m convinced de-scheduling the drug is needed so we can do research, help our veterans, and reverse the opioid epidemic ravaging our communities,” Boehner announced on Twitter last year.
Acreage Holdings, which is based in New York and has an office in Ohio, was in the news last week when CBS announced it was rejecting Acreage Holdings’ ad for medical marijuana in the upcoming Super Bowl.
The 30-second spot reportedly featured a veteran who treats his service-related pain with medical cannabis and a child with Dravet syndrome whose symptoms were eased by cannabis.
Both Boehner and Kasich declined a request from Healthline to discuss the issue of medical marijuana in their home state.
Mark Farrar, 27, who lives in East Cleveland, grew up in a physically and emotionally abusive household. In his despair, turned to heroin at age 19.
“It wasn’t a pleasant childhood. My father was abusive,” Farrar, who has been diagnosed with post-traumatic stress disorder (PTSD), told Healthline.
He started using in 2011.
“From there it just grew, and it became all I could focus on,” he said.
But after an eight-year battle to get off heroin, he’s been clean for nearly a year. All because of medical marijuana, he said.
Farrar regularly drives with a friend to a marijuana dispensary in Michigan to get his medical marijuana prescription.
He hopes to get his medicine in Cleveland soon so he will no longer have to make the trek.
Farrar is working now and has a girlfriend.
“I feel great. I’m living a normal life now and I do not feel opioid withdrawal. I feel better about myself,” he said.
Farrar just put down a deposit for an apartment and is saving up for a car.
“I still live in East Cleveland, the poorest part, where there is nothing but drugs and druggies. I can’t even walk down the street without getting offers for drugs. I am moving to a better part of town at the end of the month,” he said.
Farrar tried Alcoholics Anonymous, but it didn’t work for him.
“With AA, you can’t do anything else,” he said. “But I found along the way that low doses of THC help me tremendously. It has given me my life back. It balances me and takes away the craving for opioids. Cannabis is my anti-drug.”
Farrar believes medical marijuana will help many more opioid addicts in his home state.
“I am all for it,” he said. “I have my medical card, but the prices are really high in the Ohio dispensaries. I am hoping the prices will go down as the demand increases.”
When asked what he would tell someone else who reads this story who is still addicted to opioids, Farrar said:
“I would tell that person that there is a better life out there and this way worked for me. Medical marijuana may not work for you, but it is worth trying. If you want a better life, there is help out there, there are agencies and resources. You just have to take the initiative.”
It appears the U.S. public now overwhelmingly supports medical marijuana.
In an April 2018 Quinnipiac poll, 93 percent of respondents said they support the use of marijuana for medical purposes. Another 70 percent said they “oppose the government enforcing federal laws against marijuana in states that have already legalized” either its medicinal or recreational use.
A majority of mayors in the United States appear to support it as well.
A 2018 survey from Boston University asked 110 mayors from cities nationwide about their position on legalizing marijuana.
In the survey, a slight majority of the current mayors across the United States said they are in favor of legislation that would legalize marijuana.
Fifty-three percent of mayors said they support marijuana sales in their cities while 35 percent were opposed to the idea.
Meanwhile, Betty Cox is counting the days until she begins her new journey with Ohio’s state-sanctioned medical marijuana program.
The wait has been far too long for Cox, but she’s grateful that the program is finally up and running.
And not just for herself.
“It kills me to think all the stuff people have had to go through in order to get something that we know saves lives,” she said.
Cox is looking forward to spending more time with her children and her grandchildren, and just getting her life back.
“I’m getting older. It’s hard to work and I walk on a cane. I’m really looking forward to the day next month when I will no longer have to worry,” she said.