Chronic Pain? Substitute Marijuana for Opioids

Charles P. Vega, MD


October 02, 2018

Hello. I'm Dr Charles Vega, and I am a clinical professor of family medicine at the University of California at Irvine. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

The state of Illinois is attempting a first-in-the-nation experiment to address the nation's opioid epidemic.

A new law—the Alternatives to Opioids Act—encourages patients who might otherwise use opioids to consider marijuana instead. In states where medical use of marijuana is permitted, the substance is often used to treat chronic pain. But Illinois is going a step further and explicitly suggesting that marijuana could be used as a substitute for opioids.

Under the pilot program, which begins immediately, patients (who must be at least 21 years of age) can obtain a physician's certification stating that they have a condition for which an opioid could be prescribed. They may then receive medical cannabis for up to 90 days while the state completes the full certification for each user.

The program is not without its critics, who voice concern about the potential for users to move on to require or abuse opioids.

Is an initiative like this evidence-based? Or is it the result of lobbying by medical marijuana business interests? The jury is out. And this state-based program bears watching nationwide.

Share your thoughts with me, and our colleagues, in the comments section.


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