Research supports the potential to replace some pharmaceuticals with cannabis.
Modern-day medications have done much to advance and protect human health, but these are not without controversy. It’s true we are living longer than ever before thanks, in large part, to the achievements of modern medicine. Yet, there are serious detrimental side effects to many pharmaceuticals that keep patients looking for alternatives. This is especially true for people needing medicinal support over the long term. So, these are the drugs that we may one day replace with cannabis.
Cannabis may replace certain prescription drugs, especially opioids, but research is playing catch-up. With limited governmental approval for access for research purposes and few human clinical trials, we’re a little behind the anecdotal reports. However, in several cross-sectional surveys (USA and Canada), the most common prescription drugs patients replace with cannabis are for pain, depression, and anxiety.
Further, a 2021 survey [1]Sinikka L Kvamme, Michael M Pedersen, Kristine Romer Thomsen, Birgitte Thylstrup. Exploring the Use of Cannabis as a Substitute for Prescription Drugs in a Convenience Sample. Harm Reduction Journal … Continue readingof nearly 3000 people was published in Harm Reduction Journal, indicating that, “More than half (65.8%) found [cannabis] much more effective compared to prescription drugs, and 85.5% that the side effects associated with prescription drug use were much worse compared to use of [cannabis].”
Finally, it is important to recognize that the long term impacts of using medical cannabis, including high THC products, is not known. Some studies suggest mental health consequences. Researchers and healthcare professionals are keeping an eye on these over time.
Prescription Painkillers Replaced with Cannabis (Oxycontin, Tramadol)
Medical cannabis has become a valuable intervention strategy to combat the opioid epidemic. It is effective in managing chronic pain. Additionally, acute pain may be lowered when used in conjunction with opioids (to lower risk) for acute pain. Cannabis is safer as there is no effect on the respiratory system, and thus no deaths from overdose. It is non addicting for most of the population. Some studies indicated that no more than nine per cent of patients are at risk for addiction, compared to opioid risk of addiction at nineteen per cent.
Alarmingly, opioids can lead to physical addiction in as little time as four to eight weeks. Further, for long time patients, whom abruptly stop, there are severe symptoms including, increased pain, cramping, chills, diarrhea, anxiety, nausea, vomiting, insomnia, and intense cravings. It is these withdrawal symptoms that often lead patients to seek illegal drugs. In fact, according to the AMA, forty-five per cent of heroin abusers started on prescribed opioids. Interestingly, a component of cannabis, CBD, has been found to help patients overcome opioid addiction.
Lowered Opioid-Related Deaths in Legalized States
Research from the University of Georgia (2018), it was found that, “In states with medical cannabis dispensaries, the researchers observed a 14.4 percent reduction in use of prescription opioids and nearly a 7 percent reduction in opiate prescriptions filled in states with home-cultivation-only medical cannabis laws.”
In a study published in the journal Frontiers in Pharmacology (2021),[2]Caroline A MacCullum, Lauren Eadie, Alasdair M Barr, Michael Boivin, Shaohua Lu. Practical Strategies Using Medical Cannabis to Reduce Harms Associated with Long Term Opioid Use in Chronic Pain. … Continue readingconcluded that, “When low dose THC is introduced as an adjunctive therapy, we observe better pain control clinically with lower doses of opioids, improved pain related outcomes and reduced opioid related harm.”
In conclusion, some chronic pain patients have able to fully get off prescription and replace with cannabis, while others participate in harm reduction by using both to manage pain.
Can Cannabis Replace ADHD Meds (Ritalin, Adderall)?
There are conflicting reports about cannabis use for the treatment of ADHD. Some studies have identified a higher risk of cannabis dependency for people who have an attention disorder, while other studies and personal anecdotes indicate that people with ADHD tend to use cannabis to treat their symptoms (which is the real reason why a high majority of ADHD patients regularly consume cannabis).
Cannabis may be a suitable alternative to Adderall. The latter works by blocking reuptake of dopamine. Dopamine is a feel good, calming, chemical that improves attention span in the brain. Cannabis works by increasing levels of dopamine. This means different mechanisms make the same result.
A qualitative survey, published in PLoS ONE (2016), did a lot to advance the anecdotal reports about the potential of cannabis to help manage the symptoms of ADHD. Researchers randomly selected fifty-five online forums and surveyed these for how people were managing adult ADHD symptoms. The results indicated that, “despite no clinical recommendations or systematic research supporting the beneficial effects of cannabis use for ADHD, online discussions indicate that cannabis is considered therapeutic for ADHD.” In fact, 25% reported positive benefit in the management of ADHD symptoms while using cannabis. [3]John T Mitchell, Maggie M Sweitzer, Angela M Tunno, Scott H Kollins, F Joseph McClernon. “I Use Weed for my ADHD”: A Qualitative Analysis of Online Forum Discussions on Cannabis Use and … Continue reading
It’s important that randomized clinical trials catch up to what patients are trialing outside of medical care.
Will Cannabis Manage Insomnia Better Than Ambien?
In America, it is estimated that almost 70 million suffer from sleep deprivation brought on by dysfunction in sleep patterns, including insomnia. The nervous system absolutely needs sleep – to maintain homeostasis, energy, and cognitive strength. Prolonged problems with sleep will lead to psychiatric disorders, including substance abuse.
The top prescription sleep aids include: Restoril (with Temazepam), Halcion (with Triazolam), Sonata (with Zaleplon), and Ambiem (with Zolpidem). Each has a different active ingredient. Restoril is exclusively reported to help with both falling asleep and staying asleep. These pharmaceuticals work on the GABA receptors in the brain, which control alertness levels.
People find success with short term use of prescription aids, but these are seriously habit forming and patients quickly become dependent on them. Worse, as tolerance increases, so does the dosage. This can lead to substance abuse problems.
Can Cannabis Keep You Asleep?
Interestingly, one of the most popular uses for medical cannabis is to achieve a full night’s sleep. The top consumers are patients managing sleep disturbances related to Post Traumatic Stress Disorder (PTSD), anxiety, and/or pain.
A study published in Frontiers in Molecular Neuroscience (2020), reviews the hypnogenic effects of THC, but little is still known about the how and why at the level of the Endocannabinoid System. The sleep-promoting effects of cannabis are long known. THC is known to reduce the time needed for onset of sleep and decrease the frequency of waking once asleep.
A 2017 survey published in the journal Psychopharmacology [4]Piper et al.Subsitution of Medical Cannabis for Pharmaceutical Agents for Pain, Anxiety, and Sleep. Psychopharmacology (2017);31(5):269881117699616. DOI:10.1177/0269881117699616.found that over 2/3rds of patients were about to decrease (or stop altogether) their prescription sleep aid habit by switching to cannabis.
Still, despite the massive popularity of cannabis as a treatment for insomnia, the science is still in very early stages. Over the short term, cannabis supports sleep, but there is evidence it also disrupts REM. This can its own health implications, including non-restorative sleep.
Considering the issues associated with long-term Ambien use, including dependence and influence over mood, cannabis has good sleep benefit. More research will give scientists a better understanding of which cannabinoids provide a healthy night sleep. It will also help with dosing information.
Should You Replace your Medication with Cannabis?
As a final note, always speak with your doctor before starting a new medication, even if it’s one you consider to be ‘all-natural.’ Cannabis has its own contraindications with certain pharmaceuticals, as these share the same metabolic pathways. This can reduce the effectiveness of the prescription you are taking. Timing things out can be a simple solution for this. But, you’ll need the guidance of a health care professional to navigate it.
Additionally, your doctor will have the knowledge required to evaluate your personal history. They’ll look at your medical condition, and current medications before you introduce a new one. In some cases, cannabis may not be appropriate.
Finally, cutting out your current medications cold turkey can be dangerous. This is especially true in the case of mood-stabilizers and opioids; going cold turkey can lead to dangerous withdrawals. Basically – talk to your doctor first.
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