STEAMBOAT SPRINGS \u2014 Twenty-five years ago, when Dr. Brian Siegel began his career in medicine, he had a liberal policy when it came to prescribing opioids to his patients.<\/p>\n
As he remembers, almost everyone did. <\/p>\n
In 2012, doctors wrote a total of 255 million<\/a> prescriptions for opioids, the most ever recorded, according to the Centers for Disease Control and Prevention.<\/p>\n Siegel followed the recommendations of fellow doctors and pharmaceutical companies. They had the same message: \u201cIf they need more, you give them more,\u201d Siegel said. <\/p>\n Experts in Colorado, including Siegel, a pain management physician at UCHealth Pain Management Clinic in Steamboat Springs, now believe the frequent and free-wheeling approach to opioid prescriptions contributed to the state\u2019s current opioid crisis. The impacts in Routt County have been among the worst in Colorado.<\/p>\n The rate of drug overdoses increased six-fold from 2014 to 2016<\/a>, with more than 65% of those deaths attributed to the abuse of prescription opioids.<\/p>\n To combat the epidemic, state lawmakers have passed several pieces of legislation in recent years aimed at reducing opioid prescriptions. <\/p>\n The most recent among them was Senate Bill 19-013<\/a>, which went into effect Aug. 2. It allows doctors to recommend medical marijuana in cases where they would otherwise prescribe opioids. New Jersey and Pennsylvania, where drug overdoses are the leading cause<\/a> of accidental death, have similar laws. <\/p>\n Siegel and other health care professionals are skeptical about the bill. Marijuana is still a federally illegal substance, and it does not have the approval of the U.S. Food and Drug Administration. They argue more research needs to be done before replacing opioids with marijuana to treat pain, particularly for acute injuries.<\/p>\n Finding a solution to the opioid epidemic<\/strong><\/p>\n Under current laws, doctors may authorize people to use medical-grade marijuana for a number of disabling and debilitating conditions, including cancer, seizures, severe pain and PTSD \u2014 or post-traumatic stress disorder. <\/p>\n The bill expands the qualification to allow a person to receive a state-issued medical marijuana card for \u201cany condition for which a physician could prescribe an opioid,\u201d according to the Colorado Department of Public Health and Environment.<\/p>\n It received bipartisan support from lawmakers who saw it as a way to reduce the number of patients who take opioids. They argue it can curb the number of people with an opioid use disorder, many of whom became addicted after a doctor temporarily prescribed them painkillers to treat pain. <\/p>\n \u201cI believe in medical marijuana helping a lot of people,\u201d Sen. Joann Ginal, a state Democrat and one of the sponsors of the bill, told KUNC<\/a>. \u201cI\u2019ve seen it in helping people with PTSD, with autism and now using it for acute pain may be one of the ways that we can also help cut down on opioid addiction.\u201d<\/p>\n In 2017, prescription opioids were involved in more than 35% of all overdose deaths \u2014 nearly 17,000<\/a>, according to the CDC.<\/p>\n Siegel has seen that downward spiral among his own patients.<\/p>\n \u201cA lot of the people who become addicted to opioids generally start out as a ski racer kid who has broken their leg,\u201d he said as one example. \u201cThey lose their identity, are treated for an acute injury, start on opioids and progress to a chronic opioid-type of regimen.\u201d<\/p>\n Lack of research on marijuana<\/strong><\/p>\n Despite the toll painkillers have taken, Siegel does not believe medical marijuana is the panacea to pain relief, or even a better alternative.<\/p>\n \u201cI don\u2019t personally prescribe it,\u201d he said. \u201cThere have been no good studies.\u201d<\/p>\n Some supporters of using medical marijuana in place of opioids cite a 2014 study, published by the American Medical Association. Between 1999 and 2010, according to the study, states that legalized medical marijuana reported a 25% reduction in opioid overdose deaths. <\/p>\n A 2019 study, published in the National Academy of Sciences, challenged those findings. By expanding the timeframe to 2017, researchers found that states with medical marijuana reported almost a 23% increase in overdose deaths. <\/p>\n Of course, as the old statistics adage warns, \u201ccorrelation does not imply causation.\u201d Yet the potential, under-researched side effects of marijuana give a local addiction expert her own reservations about the bill. <\/p>\n Nancy Beste, executive director of Road to Recovery, a substance abuse treatment center in Steamboat, treats many people with opioid use disorders.<\/p>\n She and her colleagues gained statewide notoriety<\/a> for her implementation of a medication-assisted treatment program, which has allowed many with substance use disorders to stay sober.<\/p>\n When it comes to treating people who already have an opioid addiction, as many of her patients do, she says medical marijuana could exacerbate the problem if a patient switches from painkillers to cannabis.<\/p>\n \u201cI feel like people jump from one substance to another often when struggling with substance use disorder,\u201d she said. \u201cI want people to learn to be healthy and happy without any chemicals, if possible.\u201d<\/p>\n Patients younger than 18 also may receive medical marijuana instead of opioids as long as they have the approval of two physicians, according to the bill. When consuming medical marijuana at their school, on the school bus or at a school-sponsored event, it must be in a form that cannot be smoked, according to the most recent bill text. <\/p>\n