Mac Moore
KU Statehouse Wire Service
he Department of Health and Human Services has declared that the U.S. is facing a opioid epidemic. A record 33,000-plus people died from opioid overdoses in 2015, 329 of whom were in Kansas, according to the CDC.
State lawmakers were swift to pass legislation to combat opioid addiction in Kansas, fearing the types of full-blown crises seen in states such as West Virginia and Ohio might happen here.
West Virginia had 725 opioid-related deaths in 2015, leading the nation with a rate 41.5 per 100,000. Ohio followed with rate of 29.9. Kansas has a rate of 11.8.
A new study suggests one solution to combating the opioid epidemic might be found in legalizing another drug that remains controversial in Kansas.
The National Academies of Sciences, Engineering and Medicine released a comprehensive cannabis study in January indicating there was evidence to suggest cannabis could be used to treat chronic pain in adults. Chronic pain is often treated with an extended use of opioid medications, increasing the chance of addiction.
Kent Hutchison, a professor of psychology and neuroscience at Colorado University and researcher on this study, said cannabis has shown promising signs as a pain management medicine, specifically in regards to neuropathic pain.
“There’s just no doubt in my mind that this is something that people need to look at,” Hutchison said. “Clearly the opioid epidemic has huge negative consequences for society in general.”
A 2014 John Hopkins study on painkiller overdose deaths showed states with medical marijuana laws had a 25 percent lower rate of prescription overdose deaths than those without these laws from 1999 to 2010. The nationwide rate of opioid deaths increased by 200 percent during that time frame.
Hutchison admits the study establishes an indirect correlation, but the results should attract more efforts to compare cannabis and opioids directly. He said more studies need to compare the pain management effectiveness of cannabis versus opioids, particularly when dealing with acute pain such as post-surgery.
“Some laboratories are looking at pain in general, but it’s more chronic pain oriented,” he said.
Hutchison said this type of research is often limited by cannabis being designated as a Schedule I drug at the federal level. Schedule I drugs are classified as having a high potential for abuse with no accepted medical use. Hutchison said this claim is contradictory to evidence found in the study.
“Our research is trying to find ways within the current system to collect the data that we need to collect in order to answer these questions,” he said. “It would make things a lot faster and a lot easier if it was rescheduled.”
House Substitute of Senate Bill 51, signed by Gov. Sam Brownback on April 21, modifies cannabidiol, a specific type of cannabinoid found in cannabis, to a Schedule IV drug if it is the sole active ingredient in a FDA-approved drug product. Epidiolex, a drug fitting that criteria, is currently in clinical testing.
Ed Klumpp, Kansas Association of Chiefs of Police member, supported the bill despite testifying against other marijuana legalization efforts, such as House Bill 2152, the medical hemp bill. Klumpp said any THC or CBD-based medication should be sold through a pharmacy rather than a dispensary. He said pharmacies have better quality control processes than the “head shop” type store fronts proposed in the bill.
“Our organization feels that it should be handled as a medicine through the normal physician and pharmacy route,” Klumpp said. “Not setting up street corner shops that sell product that you aren’t really sure you know what strength it is, what purity it is.”
Only three states require a board-certified pharmacist on-site to dispense medical cannabis; Connecticut, New York and Minnesota. All three states still have these pharmacists operate out of dispensary shops.
Jody Reel, Kansas Pharmacist Association (KPA) chair of government affairs, said the KPA does not have a stance on the legalization of marijuana. She said the KPA would become involved if medicinal marijuana is legalized, as the drug would be considered a medication at that point.
“We we would like to encourage more clinical studies on the potential medical use of marijuana to see it show a more clear benefit as well as understand more of the clinical profile,” Reel said.
Lisa Sublett, founder of cannabis advocacy group Bleeding Kansas, said referring to dispensaries as “head shops” was an effort to unfairly denigrate the growing cannabis industry. She said dispensaries, specifically the compassion shops outlined in Senate Bill 155, the Compassion and Care Act, would be highly regulated.
Sublett said dispensaries communicate in-depth information about the cannabis they provide, including THC to CBD ratios as well as where and how it was grown.
“I dare you to try to get that from Pfizer,” she said.
Pfizer was one of six opioid manufacturers to be sued three years ago by the City of Chicago over the alleged misleading marketing of opioids. According to a report in the Washington Times, Pfizer reached a settlement last year, agreeing not to promote opioids for unapproved uses such as long-term back pain and acknowledging there is no good research on opioids’ effectiveness beyond 12 weeks.
The expanded uses of opioids, as long-term pain treatments, have played a large role in the opioid crisis.
“We know that many of these people that suffer from this did not start out using illegal drugs,” Klumpp said. “They started out using legal prescribed drugs. It’s just so addictive.”
National Institute on Drug Abuse estimates abuse of prescription opioids and other illicit drugs costs $78.5 billion to crime, lost work productivity and health care.
Klumpp said legislators have taken the necessary steps to combat the opioid epidemic in Kansas.
On April 7, Brownback signed House Bill 2217, a law that gives first responders access to opioid antagonists. Opioid antagonists are drugs that block opioid receptors in the brain, acting as antidote during overdoses.
Klumpp also pointed to K-TRACS, or Kansas Tracking and Reporting of Controlled Substances. K-TRACS was implemented in 2011 to unify databases between Kansas pharmacies and doctors.
The program helps prevent patients from “doctor shopping,” a practice used by drug addicts to get a new or multiple prescriptions when their previous doctor might otherwise stop prescribing them.
One possible solution for preventing opioid addiction is by finding an alternative treatment for patients with chronic pain. This is one avenue where medicinal marijuana has seen the most potential.
“In the report, we cover the evidence and clearly there is evidence for cannabis as a treatment of chronic pain,” Hutchison said.
Sublett said the opioid crisis is a clear example of why medicinal cannabis needs to legalized.
“Safer pain management choices are the kind of harm reduction policy that we need to have in place,” Sublett said. “We need this to be implemented now.”
HB 2152 has been tabled until January 2018.
The Senate Committee on Federal and State Affairs stripped SB 155 of its original contents in favor of SB 151. That substituted bill, which would allow medical professionals to prescribe and dispense “non-intoxicating cannabinoid medicine,” has not passed out of the committee.
Mac Moore is a University of Kansas senior journalism major from Lawrence.