Alternative Treatment

The Problem

Treatment for opioid dependence, as well as healthcare policy designed to address the epidemic proportions of suffering individuals, has been monopolized by an industry with enough capital to create brilliant marketing and promotion strategies that have created a $1.4 billion opioid addiction treatment industry in the U.S. as of 2014 (Manalo, 2017).

“Interestingly, the pharmaceutical industry’s response to this drug addiction crisis is more drugs.” (Manalo, 2017)

Due to a lack of equally proportional funding for high profile marketing and lobbying strategies, other equally viable or promising alternative treatments, like Ibogaine therapy, have either struggled to gain a foothold in the treatment arena or remain virtually unheard of. This is simply unconscionable given the degree to which this problem is devastating our families and communities across Maryland, and hemorrhaging our hard-earned tax dollars in a futile attempt to meet the burgeoning capacity needs of our overwhelmed healthcare and justice systems.

The Solution

Although medical use of ibogaine is currently not legal in the United States, it is currently used to treat opiate addiction in other countries, including Canada and Mexico. While 9 of the 28 countries presently in the European Union have similar classifications as the U.S., it is unregulated (neither officially approved nor illegal) in much of the rest of the world. New Zealand, Brazil, and South Africa have classified ibogaine as a pharmaceutical substance and restrict its use to licensed medical practitioners.

This has led Americans who struggle with addiction to seek out international clinics or underground providers to receive treatment.

Recent legislation proposed funding allocations for an Ibogaine Treatment Study Program, which could move the needle forward in remediating the spiraling overdose death rate caused in part by insufficient efforts to address this healthcare crisis.  Despite a plethora of scientific research-based evidence to support this alternative therapy, this initiative has yet to gain enough legislative support to pass.

See Ibogaine Treatment for further information on risks and benefits.

The Problem

Because Opioid-Use Disorder is not currently listed as a condition for treatment with medical cannabis in the Maryland regulations, programs that currently treat individuals with an opiate-use disorder have been reluctant to allow medical cannabis to be used within their programs, in lieu of, or in conjunction with buprenorphine or methadone, despite research supporting its efficacy as a harm reduction alternative.  Additionally, pain-management patients that have successfully switched from a prescription opioid to medical cannabis, are disallowed from using medical cannabis in Maryland’s treatment facilities, even when they have a prescription for medical cannabis written by a medical practitioner for chronic pain unrelated to their addiction.

The Solution

In Maryland we have had a law since 2014, and regulations since 2015, which allows providers to recommend cannabis for chronic and/or severe pain without limitation. Providers can also recommend cannabis products as a replacement option for patients wishing to reduce or replace traditional pharmaceutical opiates to reduce and/or eliminate pain originating from illness or injury. Since opioid withdrawal is often managed with other prescribed opiates –buprenorphine and methadone, it stands to reason that the treatment of an opiate-use disorder meets every criterion for inclusion in the regulations as a condition that could be treated with medical cannabis, and that medical cannabis could replace prescribed opiates such as buprenorphine or methadone. Therefore, it should be included as a listed condition in the cannabis regulations. In Maryland, the current law states that the Commission may approve applications from providers that include any condition that is severe and for which other medical treatments have been ineffective. Additionally, anyone can submit a petition to the Commission to formally add new conditions. Adding opioid use disorder to the title 13-3301 of the current medical cannabis law, would quickly allow treatment providers to permit their patients to choose medical cannabis, instead of, or in conjunction with, buprenorphine or methadone.

Evidence shows that states with medical cannabis laws have a 25% lower annual opioid overdose mortality rate compared with states without medical cannabis laws. The Surgeon General’s 2016 report, Facing Addiction in America, states that there is a “growing body of research suggesting the potential therapeutic value of marijuana’s constituent cannabinoid chemicals in numerous health conditions including pain…addiction…and other conditions…”

Maryland must adopt measures to prevent treatment providers from discriminating against addiction patients when they refuse to allow them to benefit from medical cannabis.  The same laws that apply to patients with other diagnoses for whom medical cannabis has replaced more dangerous use of opioid medications, must be equally applied to those dependent on opioid-maintenance therapies.  The rights of addiction patients to choose medical cannabis to reduce or eliminate their chronic opioid dependence associated with opioid maintenance therapies must be protected and enforced.

See Medical Cannabis Treatment for further information on risks and benefits.