Resource

Letter from New Mexico Clinicians, Social Service Providers, and Health Professionals in Support of Medical Cannabis for Opioid Use Disorder (OUD)

Last updated April 17, 2018

For more than two decades New Mexico has suffered from a disproportionate rate of opioid overdoses compared to nearly every other state in the nation. Opioid overdoses are the leading cause of accidental death in New Mexico, far outpacing gun deaths and traffic fatalities. In the midst of the increasing rate of opioid overdose deaths nationally, the U.S lawmakers and the media have increasingly highlighted the need for strategies that treat drug addiction as a health issue. New tools are needed to reduce overdose deaths and the harms associated with opioid addiction. One tool that shows great promise is access to medical cannabis in a regulated system.

This letter, signed by dozens of licensed clinicians, social service providers and health professionals who support the use of medical cannabis for New Mexicans struggling with opioid addiction, was sent to New Mexico Secretary of Health Lynn Gallagher in September 2017. They urge Secretary Gallagher to add opioid use disorder to the list of medical conditions that qualify New Mexicans to access medical cannabis without delay. The NM Medical Cannabis Advisory Board also recommends adding opioid use disorder to the list of qualifying conditions, and both the New Mexico House and Senate passed memorials encouraging the Secretary to add OUD.

Do you agree? We’re asking licensed clinicians, social service providers and health professionals who support the use of medical cannabis for New Mexicans struggling with opioid addiction to sign-on to this letter. Email Jessica Gelay, jgelay@drugpolicy.org, to add your name.


September 30, 2017

 

Ms. Lynn Gallagher,
Secretary of Health
NM Department of Health
1190 S. St. Francis Drive
Santa Fe, NM 87505

 

Dear Secretary Gallagher,

We, the undersigned licensed clinicians, social service providers and health professionals, support the use of medical cannabis for New Mexicans struggling with opioid addiction.

For more than two decades New Mexico has suffered from a disproportionate rate of opioid overdoses compared to nearly every other state in the nation. Opioid overdoses are the leading cause of accidental death in New Mexico, far outpacing gun deaths and traffic fatalities. In the midst of the increasing rate of opioid overdose deaths nationally, the U.S lawmakers and the media have increasingly highlighted the need for strategies that treat drug addiction as a health issue. New tools are needed to reduce overdose deaths and the harms associated with opioid addiction. One tool that shows great promise is access to medical cannabis in a regulated system.

Cannabis helps people at three stages of opioid addiction: 1) by decreasing craving for the opioid, 2) by easing withdrawal, and 3) by assisting with maintenance, in which cannabis replaces opioid use.

Steve Jenison, former Medical Director of the NM Medical Cannabis Program, former chairman of the Medical Advisory Board, and a retired MD provided the following rationale for including opioid use disorder as a qualifying condition in the 2016 petition:

There is mounting evidence that medical cannabis decreases population-level morbidity and mortality related to opioid dependence. In a study published by Bachhuber et al. in JAMA Internal Medicine in 2014, they compared trends in opioid overdose deaths between those states that had enacted medical cannabis programs compared to those states without those programs (Bachhuber 2014). They concluded, “medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates.” Many clinicians who provide care to patients with severe chronic pain report that their patients have been able to significantly reduce or discontinue their use of opioid analgesics with the use of medical cannabis. The findings of Bachhuber et al. support the possibility that this manifests on a population level as a statewide-decline in overdose deaths. Indeed, in a recent paper by Bradford et al. where statewide Medicare Part D prescription rates were examined, it was “found that the use of prescription drugs for which marijuana could serve as a clinical alternative fell significantly, once a medical marijuana law was implemented. National overall reductions in Medicare program and enrollee spending when states implemented medical marijuana laws were estimated to be $165.2 million in 2013. The availability of medical marijuana has a significant effect on prescribing patterns and spending in Medicare Part D.” (Bradford 2016). These population-level findings are corroborated by a survey of chronic pain patients who were enrolled in the Michigan medical cannabis program (Boehnke 2016). Patients using medical cannabis as an adjunct to conventional treatments reported a 64 percent reduction in opioid use and a decrease in medication side effects that affected everyday functioning. A survey of 410 Canadian medical cannabis patients by Lucas et al. (Lucas 2016) showed that 87 percent patients reported substituting cannabis for other drugs that they had been using including prescription medications (80.3 percent), alcohol (51.7 percent) and illicit drugs (32.6 percent)…

Significantly, cannabinoid receptors are sparsely distributed in the lower brainstem regions that control respiratory and cardiovascular functions, accounting in part for the high therapeutic index and low fatal overdose potential that has been observed with the use of exogenous cannabinoids. Activation of CB1 receptors modifies neural transmission and pain perception in both acute and chronic pain through mechanisms that are independent of, but interact and are synergistic with, opioid receptors (Abrams 2011; Kazantzis 2016; Meng 1998; Scavone 2013)….

[T]here are many individuals with opioid dependence who do not have a current diagnosis of chronic pain who could benefit from enrollment in the Program. Many people in New Mexico are opioid dependent because their pain was managed with prescription opioid medications, often inappropriately, and opioid dependence can persist long after the pain has resolved. Many others are dependent because of psychological and sociological influences. …A growing body of information … supports the role of medical cannabis in reducing the individual and population harms related to opioid dependence. The risk-benefit ratio for the use of medical cannabis in selected patients in this context is far more favorable for medical cannabis as compared to continuing opioid use. The addition of opioid dependence to the list of conditions eligible for enrollment in the New Mexico Medical Cannabis Program is entirely consistent with the spirit and the letter of the Lynn & Erin Compassionate Use Act. I urge the Medical Advisory Board to recommend addition of opioid dependence in its report to the Secretary of Health.

We strongly urge you to add opioid use disorder to the list of medical conditions that qualify New Mexicans to access medical cannabis without delay.

Urgently,

 

James

Adams

MD, ABFM, AAHIVS - Family Medicine & HIV Physician Southwest CARE Center

20-Oct-17

Santa Fe, NM

Florian

Birkmayer

Medical Doctor, Psychiatry, The Birkmayer Institute

20-Oct-17

Albuquerque, NM

Anita

Briscoe

MS, Advanced Practice Registered Nurse-BC

3-Oct-17

Taos, NM

Francisco

Bussetti

Ambercare Hospice, Social Worker

4-Mar-18

Albuquerque, NM

Michael

Chartrand

MD, Internal Medicine, Southwest CARE Center

19-Oct-17

Santa Fe, NM

Sheila

Ciminera

LCSW, To Bear Witness Therapy

20-Oct-17

Albuquerque, NM

Julie

Craig

MD, Chief Medical Officer at Las Clinicas Del Norte

2-Nov-17

El Rito, NM

Michael

DeBernardi

PsyD, Director of Behavioral Health, The Life Link

3-Oct-17

Santa Fe, NM

Decy

Devere

CNP, Presbyterian Health Services

4-Mar-18

Albuquerque, NM

Sarah R.

Dolk

Registered Nurse

31-Oct-17

Albuquerque

William

Dougherty

MF, Fellow, American College of Surgeons

25-Oct-17

Santa Fe, NM

Eve

Espey

MPH, Medical Doctor, OB-GYN, Medical Advisory Board Member (2010-2013), NM DOH MCP

5-Oct-17

Albuquerque, NM

Deborah

Foley

MSPAS, PA-C

4-Mar-18

Albuquerque, NM

George

Greer

Medical Doctor, Psychiatry

3-Oct-17

Santa Fe, NM

Brianna

Harrand

PharmD - Director of Pharmacy Services Southwest CARE Center

2-Nov-17

Santa Fe, NM

Mary

Jaco

New Mexico VA, Infection Preventionist, HCS

4-Mar-18

Albuquerque, NM

Steve

Jenison

Medical Doctor (Retired), Director of the Medical Cannabis Program DOH 2007-2009

3-Oct-17

Dixon, NM

Elisa

Kawam

MSW, PhD, Executive Director, National Association of Social Workers, New Mexico Chapter

31-Oct-17

Albuquerque, NM

Carla

Kleefeld

Counselor, PhD

4-Mar-18

Santa Fe, NM

Bryan

Krumm

Psychiatric Nurse Practitioner

10-Oct-17

Albuquerque, NM

Naomi

Landau

Certified Family Nurse Practitioner

3-Oct-17

Santa Fe, NM

Paula

Lane

Albuquerque Integrative Medicine, MD

17-Apr-18

Cedar Crest, NM

Lawrence

Leeman

MPH, Medical Doctor, Medical Director Milagro Perinatal Substance Abuse Program

6-Oct-17

Albuquerque, NM

Bernie

Lieving

MSW, The Lieving Group

20-Oct-17

Santa Fe, NM

Shauni

McClung

Registered Nurse, Seven Clover

4-Mar-18

Albuquerque, NM

Amadea

Morningstar

MA, RPE, RYT Ayurvedic health practitioner

25-Oct-17

Santa Fe, NM

Diane

Polasky

DO, Center for Holistic Health

4-Mar-18

Albuquerque, NM

Rachael

Speegle

Registered Nurse, The Verdes Foundation, COO

30-Oct-17

Albuquerque, NM

Lowan H.

Stewart

MD Emergency Physician, CSV, Department of Emergency Medicine

6-Oct-17

Santa Fe, NM

Bruce

Trigg

Medical Doctor, Former Public Health Physician NM DOH

6-Oct-17

New York, NY

Vicki

Ventura

Albuquerque Integrative Medicine, NP

4-Mar-18

Albuquerque, NM

Jacob

Vigil

PhD, Psychology, Director Medical Cannabis Research Fund, UNM

20-Oct-17

Albuquerque, NM

Mike

Wallace

MSN, Family Nurse Practitioner-BC, Spine and back specialist

13-Oct-17

Albuquerque, NM

 

Citations – Jenison Testimony

Abrams DI, Couey P, Shade SB, Kelly ME, Benowitz NL. Cannabinoid-opioid interaction in chronic pain. Clinical Pharmacology & Therapeutics 90:844-851 (2011).

Boehnke KF, Litinas E, Clauw DJ. Medical cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain. Journal of Pain 17:739-744 (2016).

Bradford AC, Bradford WE. Medical marijuana laws reduce prescription medication use in Medicare Part D. Health Affairs 35:1230-1236 (2016).

Kazantzis NP, Casey SL, Seow PW, Mitchell VA, Vaughan CW. Opioid and cannabinoid synergy in a mouse neuropathic pain model. British Journal of Pharmacology, 173:2521-2531 (2016).

Lucas P, Walsh Z, Crosby K, Callaway R, Bell-Isle L, Kay R, Capler R, Holtzman S. Substituting cannabis for prescription drugs, alcohol and other substances among medical cannabis patients: the impact of contextual factors. Drug and Alcohol Review 35:326-333 (2016).

Scavone JL, Sterling RC, Van Bockstaele EJ. Cannabinoid and opioid interactions: implications for opiate dependence and withdrawal. Neuroscience 248:637-654 (2013).

 

Medical Marijuana
Letter
New Mexico