Louisville Medicine Volume 65, Issue 3 | Page 17

T he Alliance for Innovative Medi- cine (AIM) is a 501(c)(4) nonprof- it organization that serves as the voice for professionals who believe that medical cannabis should be legalized in the Commonwealth of Ken- tucky. AIM’s diverse network of contributors includes health care, law enforcement and legal professionals. The mission of AIM is to fuse the talents of like-minded professionals into a powerful advo- cacy effort to persuade Kentucky executive, legislative and judicial branch leaders to legalize medical cannabis as soon as possible. I volunteered as the medical liaison for AIM after a thorough review of the relevant social science and medical literature con- firmed a scientific basis for the anecdotal positive benefits of can- nabis reported by patients during my 12-year radiation oncology career. For example, medical cannabis has been proven effective in the treatment of a multitude of debilitating medical conditions (particularly pain, decreased appetite, weight loss, nausea and drug-resistant seizures). 2,3 Due to the national opioid epidemic, I was also pleased to learn that state medical cannabis laws have been correlated with an approximately 11 percent decrease in the annual number of daily opioid doses prescribed per physician. 4 In addition, states that have legalized medical cannabis — compared to states that have not legalized medical cannabis — have an approximately 25 percent lower average opioid overdose death rate, a 23 percent reduction in hospitalizations related to opioid dependence, and a 13 percent reduction in hospitalizations related to opioid pain reliever overdose. 5,6 Furthermore, emerging scientific evidence suggests that cannabis is an “exit” drug rather than a “gateway” drug, helping people decrease or eliminate their use of much more dangerous drugs such as opiates (and alcohol). 7,8 And, unlike pre- scription drugs (especially opiates), cannabis has relatively minor negative side effects, does not increase or contribute to the likeli- hood of death, and is non-lethal. 9 Allaying my concern that legalization of medical cannabis might increase teen abuse of cannabis, I discovered that, for persons aged 12-17 years between 2002 and 2013 (a time period during which 13 states enacted medical cannabis laws), the prevalence of canna- bis use disorders fell by approximately 24 percent, 10 the prevalence of past-year cannabis use fell by approximately 17 percent, the prevalence of past-month cannabis use fell by approximately 10 percent, the prevalence of daily or almost-daily past-year cannabis use fell by approximately 29 percent, the prevalence of daily or al- most-daily past-month cannabis use fell by approximately 33 per- cent, and the prevalence of past-year cannabis initiation among persons at risk for initiation fell by approximately 15 percent. 11 Medical cannabis may save the lives of our patients in indirect ways also. For example, state legalization of medical cannabis has been associated with an approximately 11 percent reduction in the suicide rate of men aged 20-29 years and an approximately 9 per- cent reduction in the suicide rate of men aged 30-39 years. 12 And FEATURE state legalization of medical cannabis has been correlated with an approximately 10 percent reduction in traffic fatalities the first full year after coming into effect. 13 Finally, my research revealed unexpected economic benefits, for medical cannabis laws at the state level have been associated with statistically significant decreases in health care spending by the U.S. federal government and the relevant state governments. 14 In conclusion, AIM is a nonprofit professional organization that advocates for the legalization of medical cannabis in the Com- monwealth of Kentucky. Medical cannabis alleviates symptoms from a variety of serious medical conditions without significant side effects and reduces opioid use/hospitalization/overdose death rates, state and national health care spending, traffic fatalities, teen cannabis initiation/use/disorders, and male suicide rates. Join the movement! Don Stacy, MD is a physician-activist. He practices radiation oncolo- gy in Louisville, KY and Jeffersonville, IN. REFERENCES: Institute of Medicine, Marijuana and Medicine: Assessing the Science Base (Washington, D.C.: National Academy Press, 1999). 2 Institute of Medicine, The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research (Wash- ington, D.C.: National Academy Press, 2017). 3 Devinsky, O. et al., “Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome,” New England Journal of Medicine 376, 2017: 2011-2020. 4 Bradford, A. and Bradford W., “Medical Marijuana Laws Reduce Prescrip- tion Medication Use in Medicare Part D,” Health Affairs 35, 2016: 1230-1236. 5 Bachhuber, M. et al., “Medical Cannabis Laws and Opioid Analgesic Over- dose Mortality in the United States, 1999-2010,” JAMA Internal Medicine 174(10), 2014: 1668-1673. 6 Shi, Y. et al., “Medical Marijuana Policies and Hospitalizations Related to Marijuana and Opioid Pain Reliever,” Drug and Alcohol Dependence 173, 2017: 144-150. 7 Lucas, P. et al., “Cannabis as a Substitute for Alcohol and Other Drugs: A Dispensary-Based Survey of Substitution Effect in Canadian Medical Canna- bis Patients,” Addiction Research and Theory 21(5), 2013: 435-442. 8 Gruber, S. et al., “Splendor in the Grass? A Pilot Study Assessing the Impact of Medical Marijuana on Executive Function,” Frontiers in Pharmacology 7(Article 355), 2016: 1-12. 9 Sidney, S. et al., “Marijuana Use and Mortality,” American Journal of Public Health 87(4), 1997: 585-590. 10 Grucza, R. et al., “Declining Prevalence of Marijuana Use Disorders Among Adolescents in the United States, 2002 to 2013,” Journal of the Amer- ican Academy of Child & Adolescent Psychiatry 55(6), 2016: 487-494. 11 Azofeifa, A. et al., “National Estimates of Marijuana Use and Related Indi- cators – National Survey on Drug Use and Health, United States, 2002-2014,” MMWR Surveillance Summaries 65(No. SS-11), 2016: 1-25. 12 Anderson, D. et al., “Medical Marijuana Laws and Suicides by Gender and Age,” American Journal of Public Health 104(12), 2014: 2369-2376.13 Anderson, D. et al., “Medical Marijuana Laws, Traffic Fatalities, and Alcohol Consumption,” The Journal of Law and Economics 56(2), 2013: 333-369. 14 Bradford, A. and Bradford W., “Medical Marijuana Laws May Be Associ- ated with a Decline in the Number of Prescriptions for Medicaid Enrollees,” Health Affairs 36(5), 2017: 945-951. 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