They called it the gateway drug. In my adolescent mind, marijuana was no different than cocaine or heroin or angel dust (though I’m still not completely sure what that stuff was). I am a product of generation D.A.R.E., made even more insular by my Catholic schooling and reasonably sheltered upbringing. When Scruff McGruff talked, I listened: I didn’t drink before I was 21, and I’ve never smoked or taken a pill that was not prescribed to me. So when I found my mom passed out with a bong in her hand, I freaked out, shaking her until she woke up and proceeded to freak out herself. Our relationship was never the same.
Having grown up with a chronically ill mother, I spent most of my childhood witnessing her body’s little failures and, as a result, unconsciously waiting for the Big Failure, the inevitable event that would steal her from me for good. My instincts were right, but it didn’t happen until the fall after I graduated college. And it wasn’t marijuana — it was a prescription painkiller, a drug no one warned me about.
Since my mom died, opioid abuse has evolved into a full-blown epidemic, arguably the most prominent conversation in the public health news cycle. In 2015, six years after my mom’s death, 12.5 million people misused opioids, a class of drug including heroin and prescribed medicines like Oxycontin. That same year, opioids killed over 33,000 people in the US alone.
Though opioid use and abuse transcends demographics, medical literature has interesting insights on women’s relationships with prescription painkillers. For instance, between 1999 and 2010, death by prescription painkillers increased more than 400 percent among women, compared to a 237 percent growth rate among men, according to the Office on Women’s Health.
Studies also link opioid use among women to psychological and emotional distress, often brought on by a history of violence in intimate relationships or traumatic childhood events. Research has found that history of trauma was present in at least 55 percent of women who misused substances.
But like other drug abuse cases, my mom’s situation is far too nuanced to reduce to one particular event or emotion. She certainly experienced childhood trauma and emotional distress — her twin brother drowned when they were nine years old — but she also had a very real chronic illness, which is why her doctors prescribed prescription painkillers in the first place. The accompanying high may have just been a convenient cherry on top.
Dr. Eric Weintraub, Director of the Division of Drug and Alcohol Abuse at the University of Maryland School of Medicine, tells me that addiction to opioids often occurs when users seek to numb both physical and emotional pain. “Some people just don’t feel good about themselves and have a chronic dysphoria,” he said. “Then they take drugs and it takes care of their anxiety. They want to keep recreating that feeling.”
Weintraub says most addicted individuals aren’t chasing euphoria. Instead, they’re trapped in a cycle of suffering and temporary relief.
“I’ve never met someone addicted to opioids who is having a really good time,” he said. “It’s usually not irresponsible, partying people. These people are really held captive to their addictions.”
In response to the thousands of lives bound by opioid addiction, the federal government is doubling down to combat the epidemic. The FDA commissioner recently called for stronger measures in preventing opioid addiction, such as including stronger warnings on medicine labels, developing new abuse-deterrent opioids, and re-scheduling prescription painkillers to a stricter category. Still, the World Health Organization argues that pain management is a human right. Could marijuana be a safer and less addictive alternative?
The night I found my mom with the bong in her hand, she was adamant about one thing. She wasn’t using marijuana for fun. Plagued by physical pain, she was smoking to feel better.
“There is some suggestion that marijuana could be an effective alternative to prescription painkillers for some people,” Weintraub said. “It’s not always used in evidence-based ways, but marijuana has been proven to help with chronic pain, multiple sclerosis, and for nauseousness from chemotherapy. It can also help those who aren’t able to eat due to an illness like HIV or cancer.” In addition to its pain-management potential, Weintraub points out that marijuana seems to be much safer than opioids, and not addictive in the same way.
But while evidence shows marijuana can be individually effective for pain and other conditions, the verdict is still out on whether or not it could profoundly affect the opioid crisis as a whole. Dr. Keith Humphreys, an addiction researcher and psychiatry professor at Stanford University, said that although there is a link between medical marijuana legalization and lower opioid prescription rates in some states, that doesn’t necessarily imply a causal relationship. In fact, Humphreys says that the volume of US marijuana consumption has gone up 80 percent in the last decade, right alongside the opioid epidemic.
In light of the numerous other non-addictive options, Humphreys believes marijuana shouldn’t be treated as a cure-all miracle drug. “If marijuana is going to save us from opioids, how far does it have to go before it starts to have an effect? There are hundreds of non-addictive medications that can be used for pain, like Gabapentin or Ibuprofen.”
Though he believes marijuana has a place as an alternative for pain management, Weintraub admits there are inherent risks involved. Daily marijuana users can experience withdrawal, which can lead to anxiety, insomnia, and dysphoria. Those who use marijuana are more likely to be in car accidents, and individuals with predispositions to certain illnesses can experience psychotic behavior while using marijuana. There is also a link between marijuana use and the use of other illicit drugs, along with the risk of using marijuana to self-medicate, just like people do with opioids.
For this reason, Weintraub cautions against jumping ahead of the scientific research when it comes to marijuana. “There is no scientific literature to support some uses of marijuana, like treating anxiety. People should get professional help and talk about their problems,” he said. “Research shows us what’s effective and safe, and we should stick with that.”
Whether or not marijuana is likely to make a dent in the opioid crisis on a broad scale, responsible use as a safer, less-addictive remedy for certain conditions seems like a reasonable alternative to opioids. Like Weintraub said, both marijuana and opioids have their own risks, but in the midst of a problem so expansive and deep, perhaps we need to leverage the lesser of two evils.
My mom used marijuana because she saw therapeutic value in it. I might never know whether she used it to deal with her emotional or physical pain, or maybe a combination of both. And I may not ever understand the pain that led her to use marijuana or abuse opioids in the first place. What I do know is there’s an epidemic stealing parents and children from families around the country — and if there’s a better way forward, it’s time to explore it.
Do you think more research should be done on medical marijuana? Tell us @BritandCo.
(Illustrations by Rosee Canfield and Sarah Tate / Brit + Co)