By Daniel Matthews
Oftentimes, we don't know the answer even when it's right in our face.
There has been a torrent of news about fentanyl, the deadly opioid that killed Prince. Our country is awash in this stuff, and it's killing us.
Here's the skeleton narrative: drug manufacturers use opioids to create addictive drugs such as Fentanyl. The FDA's Center for Drug Evaluation and Research evaluates these drugs to make sure they "work correctly and that their health benefits outweigh their known risks". (A quick aside--if Fentanyl is so deadly, how do its benefits outweigh its risks? It kills pain, but aren't there other drugs that do, too? More on this soon.) Pharmaceutical companies then go to work on selling approved drugs to consumers.
Here's the kicker: the hardcore killer, Fentanyl, is a Schedule II drug, meaning doctors can prescribe it through pharmacies. Cannabis, on the other hand, which has never killed a soul, is a Schedule I, right up there with heroin.
This also means it's tough to do research. In order to study cannabis, researchers have to get Schedule I research registration from the DEA and a research license from the state-controlled drugs agency. What's more, they have to get the cannabis from the NIDA (National Institute on Drug Abuse). The stuff from the NIDA is a lot less potent than what is out there right now. Studies on it are limited in relevancy.
It's all coming to a head. Scientists and lawmakers are watching the opioid crisis rage, and calling for the DEA to reclassify cannabis as a Schedule II. If that happens, more research could go into cannabis' potential as a painkiller. It also has anti-nausea and sleep-inducing effects, because cannabis interacts with the body's endocannabinoid system.
The endocannabinoid system helps regulate a variety of functions, including immune function, pain management and sleep. If research proves what we already know about cannabis, and the FDA subsequently approves it for medical use, we could see doctors prescribing it instead of opioids in the future.
Less people would get addicted, less would die. According to a study reported by the Journal of the American Medical Association, states with medical cannabis have experienced lower opioid overdose fatality rates.
But the implications of making cannabis a Schedule II are complex. Right now, twenty-three states have some sort of medical marijuana program in place. The pharmaceutical companies and manufacturers don't have their grubby, gigantic hands in the mix. Once it's a Schedule II, and if the FDA approve it, these companies will scramble to capitalize on it. We could see the price of prescription cannabis skyrocket. We could see drugs with THC in them that don't remotely resemble cannabis sold to poor people for exorbitant prices.
But here's the interesting thing: that doesn't have to be the case, because people can grow this stuff in their backyards. A situation in which the traditional system for prescription drugs applies to cannabis would be a dark one. Big pharma would have to lobby our lawmakers to rig the market, making recreational cannabis illegal across the board, obliterating state dispensaries, and putting the manufacture and sale of cannabis squarely in the hands of the zeitgeist.
This is unlikely to happen because so many states already have medical marijuana. Four states have legalized recreational cannabis. Once it becomes federally legal to prescribe the stuff, manufacturers and pharmaceutical companies will have to compete with the people who are already growing, and the dispensaries that are already selling.
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To be clear, I think it's only a matter of time. Cannabis will disrupt the opioid market and the pharmaceutical industry. Along the way, it will be interesting (if that's the right word) to see what kind of tricks the pharma PACs have up their sleeves.
It will be interesting to see what kind of regulation the federal government tries to pass. Will there be a cannabis regulation face-off between the federal government and the states? A scenario of that sort isn't hard to imagine.