NJ Cannabis Media -
February 11, 2019

Cannabis and stigma: Opioid crisis changing outlook

Written by Marc Schwarz

Much of the stigma regarding cannabis can be tied to its classification as a Schedule I drug by the Drug Enforcement Agency.

Cannabis is considered, along with heroin and LSD as substances that “have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.”

And yet, it’s a drug that depending on its form can be classified anywhere from Schedule II to V that may be the reason cannabis ultimately is rescheduled or de-scheduled and loses the stigma surrounding its use.

“I think the stigma is starting to reduce and a big part is that people don’t want to be on opioids if they don’t have to be,” says Jeff Brown, assistant health commissioner in charge of the medicinal marijuana program. “For many, particularly those with chronic pain, medical cannabis can be a really good alternative to opioids.”

Part 1: How stigma affects everything in the cannabis industry

Part 2: Why words matter

Part 3: How N.J. can address the issue

Part 4: Business implications

State data shows at least 3,100 residents likely died of drug overdoses in 2018, setting a record for the fourth straight year.

One of the actions Governor Phil Murphy took in January to combat this problem was to announce that the state’s medical marijuana program will allow all patients who suffer from opioid addiction to use medical cannabis as an adjunct to medically assisted treatment (MAT).

During the announcement, State Health Commissioner Dr. Shereef Elnahal noted two studies in 2018 that showed a lower overdose death rate and lower rate of opioid prescribing in states where medical cannabis is legal.

Studies and research are key to overcoming the stigma and increasing participation in the medical program, Brown says.

“We see more skepticism on the part of physicians,” Brown says. “What is most common in terms of communications that we get from patients or potential patients is, ‘I have chronic pain. Why won’t my physician recommend me for medical marijuana?’ ”

Brown acknowledges there are several obstacles.

One is that because cannabis is a Schedule I drug, there’s been limited research in  the U.S. When a new pharmaceutical is introduced to the physicians, it’s gone through rigorous random trials, Brown explains.

“When a new migraine treatment comes to market, it’s accompanied by a lot of literature from the random control trials that they did, the clinical team … It’s all provided to the doctors, including proper dosing. We’re not we’re not quite there yet with cannabis.”

The other issue is that physicians are uncomfortable with the process of ordering medical marijuana for patients. There’s two points of care, Browns says, the physician and then the dispensary, where the cannabis is provided.

Elnahal has been engaged in a year-long effort to overcome some of the obstacles by holding eight Grand Rounds at hospitals and medical schools across the state – reaching more than 2,000 docs and other clinicians. The session help educate physicians about the benefits of medicinal marijuana, and the changes the Department of Health has made to make it easier for patients and physicians to participate. The number of physicians participating in the program has more than double since Murphy took office in January 2018.

“I think you’ll start to see more best practices being shared among physicians,” Brown says. “I do think as we get more more manufactured products on New Jersey’s market,  those that clearly delineate the milligrams of the cannabinoid profile – that you know milligrams per serving or per dose of THC, CBD and other cannabinoids – you might start to see it become more accessible. I think that format is easier for physicians to understand versus I think you need to take an eighth of Death Star every two weeks.”


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