Fact check: Does medical cannabis reduce need for opioid painkillers by up to 75%?

事实核查:医用大麻是否能减少阿片类止痛药的需求高达75%?

2020-11-30 21:26:40 mySA

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The claim: “Studies have shown up to 75 percent reduction in opioid dosage for medical cannabis users.” — State Rep. Lyle Larson, R-San Antonio. Rep. Larson made the claim in a tweet as he announced legislation he has filed. If approved by more than two-thirds of both legislative chambers, a proposal would be added to the November 2021 ballot that would amend the state constitution to legalize the possession, cultivation and sale of cannabis strictly for medical use. PolitiFact rating: Mostly True. Preliminary studies suggest a correlation between medical cannabis usage and a reduction in opioid dosage among chronic pain patients, but researchers note the results are inconclusive and more rigorous testing should be done to know the full effects. State lawmakers so far have filed more than a dozen bills related to marijuana and medical cannabis for consideration during the 2021 legislative session, coming on the heels of a record-breaking 65 marijuana bills filed last legislative session. Proponents of loosening the state’s marijuana prohibitions hope that momentum generated by legalization efforts around the country could carry into Texas, riding on arguments that legalization would be a boon for the economy and an important pillar of criminal justice reform. Rep. Lyle Larson, R-San Antonio, made a different case for medical marijuana when he filed House Joint Resolution 28. TEXAS TAKE: Get political headlines from across the state sent directly to your inbox The intersection of medical cannabis and opioid use as treatments for chronic pain is an emerging field of research as more states loosen regulations on medical and recreational use of marijuana. Larson’s aides pointed to a report published over the summer by researchers at the University of Arizona that assessed the effectiveness of medical cannabis in reducing opioid dosage for the treatment of chronic pain in non-cancer patients. The analysis looked at nine separate studies involving a total of 7,222 participants across the U.S., Canada and Australia that “found a much higher reduction in opioid dosage, reduced emergency room visits, and hospital admissions for chronic non-cancer pain by (medical cannabis) users, compared to people with no additional use of” medical cannabis. Those studies confirm Larson’s assertion: There was a 64 percent to 75 percent reduction in opioid dosage when patients supplemented their chronic pain treatments with medical cannabis, and 32 percent to 59 percent of cannabis users reported a complete end to opioid use. But University of Arizona researchers note several caveats to these findings. There has generally been “a dearth of empirical studies” about the use of cannabis versus opioids in chronic pain treatments. In order to include a large sample size, the researchers “relaxed inclusion criteria” in their analysis to allow for the inclusion of observational studies, which are not systematic enough to be considered empirical evidence. For instance, in each of the nine studies, patients were self-reporting their reduction of opioid dosage, implying a degree of uncertainty in the findings. And in several of the studies, patients didn’t report the amount of cannabis used to achieve a reduction of opioid dosage. Furthermore, researchers noted how cannabis can slow a person’s metabolism, thereby causing an opioid medication to absorb into their bloodstream more slowly. This effect can give a patient the impression that their opioid dosage may need to be increased. While studies suggest that cannabis could be used to reduce opioid dosages when treating chronic pain, researchers suggest the findings be interpreted with caution due to limitations in the evidence. The intent of the study is to suggest to the wider medical field that more systematic tests should be conducted, said Dr. Babasola Okusanya of the University of Arizona, who was involved in the study, and the severity of the opioid epidemic should heighten the urgency of these tests. “Given the current opioid epidemic in the USA and medical cannabis’s recognized analgesic properties, (medical cannabis) could serve as a viable option to achieve opioid dosage reduction in managing non-cancer chronic pain,” researchers wrote. “Unfortunately, the evidence from this review cannot be relied upon to promote (medical cannabis) as an adjunct to opioids in treating non-cancer chronic pain.” It would be premature to base legislation on this study’s findings, Okusanya said. “Although some evidence points to the potential use of medical cannabis for opioid dose reduction in people with non-cancer chronic pain, it is not sufficient to support a legislative bill to make medical cannabis available to people with non-cancer chronic pain,” he said. While the effects of cannabis on decreasing opioid usage may be inconclusive, other studies have shown that increasing access to marijuana can lead to a reduction in opioid-related deaths. Last year, researchers found that the legalization of recreational marijuana reduced annual opioid mortality between 20 percent and 35 percent. “Recreational marijuana laws affect a much larger population than medical marijuana laws, yet we know relatively little about their effects,” said Nathan Chan of University of Massachusetts Amherst, who co-authored the study. “Focusing on the recent wave of recreational marijuana laws in the U.S., we find that opioid mortality rates drop when recreational marijuana becomes widely available via dispensaries.”
声称:“研究表明,医用大麻使用者的阿片类药物剂量减少了75%。”--圣安东尼奥州众议员莱尔·拉森。 众议员拉森在推特上宣布他已经提交的立法时提出了这一主张。如果获得两院三分之二以上的赞成票,2021年11月的投票将增加一项提案,修改州宪法,使拥有,种植和销售严格用于医疗用途的大麻合法化。 政治事实等级:基本正确。初步研究表明,医用大麻的使用与慢性疼痛患者阿片类药物剂量的减少之间存在相关性,但研究人员指出,结果尚不确定,需要进行更严格的测试以了解其全部效果。 到目前为止,该州立法者已经提交了十多项与大麻和医用大麻有关的法案,供2021年立法会议审议,此前上次立法会议提交了创纪录的65项大麻法案。 支持放松该州大麻禁令的人希望,全国各地大麻合法化努力所产生的势头能够传到德克萨斯州,他们的理由是,大麻合法化将有利于经济,也是刑事司法改革的重要支柱。 圣安东尼奥共和党众议员Lyle Larson在提交众议院第28号联合决议时,对医用大麻提出了不同的观点。 得克萨斯州采取:获得政治头条从全州直接发送到您的收件箱 随着越来越多的州放松对医疗和娱乐使用大麻的管制,医用大麻和阿片类药物用于治疗慢性疼痛的交叉是一个新兴的研究领域。 拉森的助手提到了亚利桑那大学的研究人员在夏季发表的一份报告,该报告评估了医用大麻在减少非癌症患者慢性疼痛治疗中阿片类药物剂量方面的有效性。 该分析研究了美国,加拿大和澳大利亚共7222名参与者参与的9项独立研究,“发现与没有额外使用医用大麻的人相比,(医用大麻)吸食者在减少阿片类药物剂量,减少急诊室就诊次数,减少因慢性非癌症疼痛住院的人数方面要高得多”。 这些研究证实了拉森的断言:当患者在慢性疼痛治疗中补充医用大麻时,类阿片剂量减少了64%至75%,32%至59%的大麻使用者报告说完全停止了类阿片的使用。 但是亚利桑那大学的研究人员对这些发现提出了几点警告。关于在慢性疼痛治疗中使用大麻和类阿片的情况,通常“缺乏实证研究”。为了纳入大样本量,研究人员在他们的分析中“放宽了纳入标准”,以允许纳入观察性研究,这些研究不够系统,不足以被认为是经验证据。 例如,在九项研究中的每一项研究中,患者都自我报告他们减少了阿片剂量,这意味着研究结果存在一定程度的不确定性。在几项研究中,患者没有报告为减少阿片类药物剂量而使用的大麻数量。 此外,研究人员还注意到大麻如何减慢人的新陈代谢,从而导致阿片类药物更慢地吸收到血液中。这种效应会给患者一种印象,即他们的阿片类药物剂量可能需要增加。 虽然研究表明大麻可以用来减少治疗慢性疼痛时的阿片类药物剂量,但由于证据的局限性,研究人员建议对这些发现的解释要谨慎。参与研究的亚利桑那大学的Babasola Okusanya博士说,这项研究的意图是向更广泛的医学领域建议,应该进行更系统的检测,阿片类药物流行的严重程度应该提高这些检测的紧迫性。 研究人员写道:“鉴于目前阿片类药物在美国的流行以及医用大麻被认可的止痛特性,(医用大麻)可以作为一种可行的选择,在治疗非癌症慢性疼痛时实现阿片类药物剂量的减少。”“不幸的是,这篇综述的证据不能被依赖于推广(医用大麻)作为阿片类药物的辅助物治疗非癌症慢性疼痛。” Okusanya说,根据这项研究的结果制定立法还为时过早。 他说:“尽管一些证据指出医用大麻可能用于降低非癌症慢性疼痛患者的阿片剂量,但这不足以支持一项立法法案,使非癌症慢性疼痛患者能够获得医用大麻。” 虽然大麻对减少类阿片使用的影响可能尚不确定,但其他研究表明,增加获得大麻的机会可导致减少与类阿片有关的死亡。去年,研究人员发现,消遣大麻的合法化将每年的阿片类药物死亡率降低了20%到35%。 这项研究的合著者,马萨诸塞大学阿默斯特分校的内森·陈说:“娱乐性大麻法比医用大麻法影响的人口要多得多,但我们对其影响知之甚少。”“聚焦于美国最近一波消遣性大麻法律,我们发现当消遣性大麻通过药房广泛供应时,阿片类药物死亡率会下降。”

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