The New Treatment for Opioid Addiction: Marijuana
By Sam Wood
The price of medical marijuana could fall dramatically for some patients by mid-summer. And the drug will soon be used to treat opioid withdrawal in Pennsylvania, which will become the second state after New Jersey to allow it for that purpose.
At a news conference in Harrisburg, Secretary of Health Rachel Levine said she had approved the sale of cannabis flower, the traditional smokable or vaporizable form of the plant.
"It's another tool," Levine said. "The whole idea of this program is to provide another tool in the toolbox of physicians to treat these conditions."
Since the launch of the state medical marijuana program in February, dispensaries in Pennsylvania have sold only pricey marijuana oils and extracts. Flower, also known as leaf or bud, needs no processing and is less expensive to produce.
"For some patients, the cost of their medical marijuana could drop by 50 percent with the addition of flower," said Chris Visco, owner of TerraVida Holistic Centers, a chain of dispensaries with shops in Sellersville and Abington. "It offers the lowest price per milligram of THC, the active ingredient."
Marijuana producer Charlie Bachtell, CEO of Cresco Yeltrah, said being able to sell plant material will streamline a large part of his production. "We just have to weigh it and put it in a container," he said. "There's no manual labor turning it into something else, whether it's filling a capsule or filling a vape pen. Every time someone touches it, it makes it more expensive."
Though smoking cannabis is prohibited by Pennsylvania law, the difference between lighting up and vaporization is literally a matter of degrees. Vaporizing requires less intense heat and a specialized electronic device so that the marijuana doesn't combust, but the method delivers the same psychoactive and physical effects as smoking. (To discourage smoking, dispensaries are forbidden from vending pipes, bongs and rolling papers.)
Nearly all of the 29 states that have legalized marijuana in some form allow for the distribution of plant material. Minnesota and West Virginia are among the last weed-legal states with laws banning its sale.
Levine accepted more than a dozen recommendations made last week by the state's medical marijuana advisory board. With her decision, doctors will still need to register but will be able to opt out of the published registry. Terminal illness, neurodegenerative diseases, and dyskinetic and spastic movement disorders are now qualifying conditions.
Allowing the use of cannabis to help wean people off of opioids may have the greatest impact on the state. New Jersey was the first to approve "addiction substitute therapy for opioid reduction" last month. By adding treatment for opioid withdrawal to the list of approved uses, Levine opened up the possibility for clinical research on the two drugs at state health systems.
"This is major news," said physician Sue Sisley, founder of the Scottsdale Research Institute, where she researches medical marijuana's effects on PTSD in veterans. "We have all these opioid task forces in so many states, and almost none of them even mention cannabis as a substitution for opioids as part of the treatment strategy."
Sisley called Levine's decision "courageous" but warned it could be politically "radioactive."
"It's a very conservative medical environment you have in Pennsylvania," said Sisley, who serves on the steering committee of Jefferson's Lambert Center for the Study of Medicinal Cannabis and Hemp in Philadelphia. "But Dr. Levine recognizes she needs to solve the problem and start preventing all these deaths that are all so preventable."
Advocates applauded the evolution of the state marijuana program.
"I am ecstatic today," said State Sen. Daylin Leach (D., Montgomery), who helped drive the legislation that became the state's medical marijuana law. "Allowing the whole plant will dramatically expand the number of patients who benefit from medical cannabis and will go a long way toward guaranteeing that this huge new industry survives and prospers."
Becky Dansky, legislative counsel of the Marijuana Policy Project, said that allowing the sale of flower represented more than a cheaper option for patients, many of whom are on disability.
"For many patients, it's the best form to treat their symptoms," Dansky said. "The key now is to get it on the shelves as soon as possible."