New Illinois Law Encourages Marijuana as Opioid Alternative

Alicia Ault

September 10, 2018

The state of Illinois has amended its medical marijuana law to encourage patients who might otherwise use opioids to consider marijuana instead.

In other states with medical marijuana, the substance is often used to treat chronic pain. Illinois State Senator Don Harmon (D-Oak Park), who sponsored the legislation, claimed that his state is the first in the nation to explicitly suggest that marijuana could be used as a substitute for opioids.

The law creates a pilot program allowing anyone over age 21 years with any condition for which opioids might be prescribed to apply for temporary access to the state's medical cannabis program.

Governor Bruce Rauner (R) signed the Alternative to Opioids Act into law on August 28, saying he hoped it would help address the opioid epidemic in the state. In 2017, Illinois had 2100 overdose deaths in which an opioid was a contributing factor.

"This law will give thousands of Illinoisans who struggle with the negative side effects of opioids, including harmful addiction, another choice to manage their pain," said Rauner, in a statement. "This is not about personal opinions about cannabis. It's about giving people more control over their own health care and pain-relief options."

Illinois is 1 of 31 states with medical marijuana but has had what many consider to be a somewhat restrictive law. Even before the new law, any physician could prescribe marijuana for one of the approved conditions; however, patients first had to be fingerprinted by the local sheriff, and those with felony drug convictions were prohibited from accessing marijuana.

The new law eliminates fingerprinting, lifts the prohibition against individuals with a criminal history, and allows access to marijuana for 90 days while the state completes the full certification for each user. Patients still must register with the state's Cannabis Tracking System, which records every transaction at a dispensary.

Less Opioid Use or More Abuse?

Chris Lindsey, senior legislative counsel for the Marijuana Policy Project (MPP), which advocates for legalization, said the nonprofit organization "is pretty excited" about the changes in Illinois. "There is compelling evidence that when patients in a state have access to medical cannabis, we don't see as much opioid use," Lindsey told Medscape Medical News.

But Kevin Sabet, PhD, president and CEO of Smart Approaches to Marijuana (SAM), a group that urges a science-based approach to the drug, is not as enthusiastic. "The marijuana industry continues to push pot as a cure-all for everything from eliminating morning sickness to stopping the abuse of opioids," Sabet told Medscape Medical News.

Sabet said evidence that marijuana can replace opioids is scant and adds that "studies have shown marijuana use actually increases the chances a user will move on to abuse opioids."

He cited a study published in the Lancet in July, which he said concluded that "people using marijuana had more pain over time, and did not reduce their opioid use."

Both Sabet and Lindsey said they were not aware of other states that were explicitly looking to marijuana as a way out of the opioid crisis. On election day this year — November 6 — voters in Michigan and North Dakota will consider initiatives legalizing marijuana for adults, and voters in Utah and Missouri will decide whether to approve medical marijuana. This year, 23 state legislatures considered bills to legalize for adults, and 14 weighed creating a medical marijuana program, according to MPP.

According to Sabet, there are "misguided lawmakers who are using faulty studies to support the idea that marijuana can replace opioids."  He claimed that is the case in Illinois.

"All of this is being driven by Big Marijuana and the lobbyists they employ," he said.

The Marijuana Policy Project reports that it receives donations from the marijuana industry. SAM receives funding mainly from individuals who have been affected by drug addiction and the commercialization of marijuana; SAM also gets funds from a small number of small family foundations. SAM receives no funding from opioid, alcohol, tobacco, or other similar commercial entities.

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