A $3.8 million five-year grant has been awarded by the National Institutes of Health to New York researchers at Albert Einstein College of Medicine to conduct the first long-term investigation into the question of whether medical marijuana reduces opiate use in adults with chronic pain. The study is significant in that it will use real medical cannabis available to patients from dispensaries rather than the notoriously low-quality weed grown in Mississippi by the National Institute on Drug Abuse.

Marijuana has long been considered a gateway drug to opiates like heroin. Many, on the other hand, claim it has helped them get off their reliance on opiates for the control of chronic pain. Convincing long-term research for either argument has been lacking.

chronic pain

 Does marijuana increase the risk of fatal car crashes?

Along with the concern that marijuana use may lead to harder stuff is the possibility of danger to society such as producing more fatal automobile accidents. Colorado – one of the first two states to decriminalize cannabis and allow its use for recreation and medicine – has investigated this very question. They found that there was no increase for a crash risk or in fatalities associated with cannabis use compared to alcohol use.
Chronic Pain

The principal investigator Chinazo Cunningham, associate chief of general internal medicine at Einstein and Montefiore said, “There is a lack of information about the impact of medical marijuana on opioid use in those with chronic pain. We hope this study will fill in the gaps and provide doctors and patients with some much-needed guidance.”

Chronic pain patients with HIV will be the special focus of this study. They plan to investigate 250 HIV-positive and negative chronic pain patients on opiates who are medically certified to use medical marijuana dispensed through approved outlets in New York state.

Scientists have never studied whether the long-term use of medical cannabis actually reduces the use of opioids in any population. Neither are there any studies on the specific compounds found in marijuana such as THC and CBD (tetrahydrocannabinol and cannabidiol) and their effects on medical outcomes like pain, activities of daily living, and quality of life. Most of the studies reporting negative long-term effects have focused on illicit rather than medical cannabis. Evidence-based recommendations based on research are badly needed to help officials craft reasonable and effective healthcare policy.

 Chronic pain in HIV

Opiate use for chronic pain is much more common in people with HIV than in the general population. Up to 90 percent of patients with HIV have chronic pain. Despite the risk of misuse, opiate pain relievers are often prescribed. Marijuana presents a promising alternative in that in addition to reducing pain, it reduces anxiety and improves appetite, to daunting issues that accompany AIDS. Cannabis is legal in twenty-nine states, plus the District of Columbia. Chronic pain and HIV are qualifying conditions for the application of medical marijuana.

The study will ask subjects to do web-based questionnaires every two weeks to assess pain levels. Blood and urine samples will also be taken every three months.