Cannabis and Fentanyl- The Fentanyl Crisis in Canada
British Columbia, and the rest of the country, has struggled with the fentanyl crisis since 2016 when it was labelled a public health emergency. At the end of November 2020, there were more than 1,300 overdose deaths in British Columbia alone – which is approximately 5 people every day. Chief Coroner Lisa Lapointe told CBC that COVID-19 is preventing people from accessing harm reduction services while also making the street drug supply more toxic than ever with “extreme concentration[s] of illicit fentanyl.” New studies suggest cannabis could reduce fentanyl use.
The most common treatment for opioid addiction, including fentanyl, is methadone. Methadone is a prescribed medication that aims to help with withdrawal symptoms. As with many treatments, there are a few problems with methadone. First, it needs to be taken strictly as prescribed, which often means visiting a pharmacy every day to get their daily dose. This can be a challenge for folks who experience other barriers. Second, it’s also addictive. And third, according to a recent news release, a number of people taking methadone are also intentionally or inadvertently using fentanyl. In many cases, this increases a person’s likelihood of experiencing an overdose.
New Research on Cannabis and Fentanyl
We’ve talked about cannabis’s role in supporting addictions previously, but the research around this topic is continuing to be explored.
A recent UBC study found those who had consumed cannabis (ie. had THC present in their urine) were 10 per cent less likely to have fentanyl positive urine. This significantly decreased their risk of overdose. Dr. Eugenia Socías, a clinician-scientist at BCCSU and lead author of the study, said “these new findings suggest that cannabis could have a stabilizing impact for many patients on treatment, while also reducing the risk of overdose.”
More research is necessary to fully understand the mechanisms involved in cannabis’s contribution to opioid use but the results are promising.
What we know about Cannabis and Opioids
Initial studies of CBD, verified CBD is safe and well-tolerated when co-administered with fentanyl to healthy non-opiate dependent individuals. This indicates, in some cases, it’s safe for individuals to simultaneously consume CBD and opiates. Therefore, CBD has potential therapeutic benefits for those experiencing withdrawal symptoms and may be vulnerable to relapse. Though people should always be cautious when using more than one medication as there is always a potential for unknown interactions.
In Vancouver, there are safe consumption sites that can help decrease the adverse impacts of drug use, including potential drug interactions. Find safe consumption sites in Vancouver, here.
Read more about cannabis and drug interactions on our blog.
A 2015 study conducted in opioid-dependent individuals found a single dose of CBD decreased cravings as well as feelings of anxiety. A 2019 study adds to these findings by demonstrating that the FDA-approved Epidiolex can reduce cravings in individuals who were previous heroin users. These individuals also reported a reduction in their feelings of anxiety, and blood levels of cortisol were also reduced (cortisol is a hormone known to increase under conditions of stress and anxiety).
Fentanyl, as an opioid, is also used for pain management. Both cannabis and CBD have long-term therapeutic benefits for chronic pain. When given access to cannabis, individuals currently using opiates for chronic pain decrease their use by 40–60% and report that they prefer cannabis to opiates. Patients in these studies reported fewer side effects with cannabis as well as a better quality of life.
Read more about using cannabis for treating chronic pain on our blog.
The fentanyl crisis is an issue that impacts a number of Canadians. The number of overdoses in Vancouver alone is alarming and should be something that’s concerning to all Canadians. That being said, Vancouver has shown harm reduction is effective in preventing overdose deaths. Harm reduction refers to a range of public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviours, both legal and illegal. Cannabis has a number of therapeutic benefits and could be seen as a method of harm reduction for fentanyl users. With more research, we may be able to more confidently say that cannabis is a safer treatment method than methadone.