Cannabis for Harm Reduction: Study Results and Discussion from the Cannabis Center of Excellence

In an April 9, 2024, webinar, Dr. Marion McNabb, Founder and President of the Cannabis Center of Excellence (CCOE), and guest presenter Dr. Peter Grinspoon weighed in on cannabis as an alternative to harmful substances. A nonprofit research and advocacy organization founded in 2018, the mission of the CCOE is to “integrate citizen-based science and foster community engagement through medical cannabis research, education, and programming,” (1). The purpose of this live-discussion webinar series, Dr. McNabb explained, is to break down CCOE research studies into practical applications for clinical medicine, patients, and policymakers to understand more about integrating cannabis as a harm-reduction therapy and its real-world risks and benefits. Dr. Grinspoon, primary care physician and medical cannabis expert, provided experiences from his own practice and research.

The webinar first focused on opioid epidemic data and on recent cannabis studies. Dr. McNabb stated that she has been the principal investigator on eight different research studies involving cannabis. She discussed in depth a 2019 CCOE cross-sectional survey study titled “Self-Reported Medicinal Cannabis Use as an Alternative to Prescription and Over-the-counter Medication Use Among US Military Veterans,” which was published in Clinical Therapeutics in 2023. In this study, 510 participants were asked about their use of cannabis, medications, and their substance reduction with cannabis. This study used binomial logistic regression output estimating the likelihood that an individual would desire to reduce their medication use with cannabis.

According to Dr. McNabb’s presentation, insights and implications from this study include:

1. Cannabis is non-lethal and in this sample veterans report using more harmful substances less by consuming cannabis daily or more than once per day
2. Clinicians should be mindful of the potential associations between race, gender, combat experience, and the intentions for and frequency of medicinal cannabis use when working with patients to reduce unwanted prescription and medication use

Next, Dr. McNabb explained the iCount Cannabis as An Alternative Study from 2023. The objective of this cross-sectional survey was to understand how patients consume cannabis as a way to reduce unwanted substances including prescription drugs, alcohol, tobacco, opioids, and recreational drugs. Dr. McNabb explained the participant characteristics, responses, the conditions they treated with cannabis, and if they were using cannabis to reduce any medications.

In discussing the takeaways of this study, Dr. McNabb stated, “The opioid crisis is growing, and there really is a need for innovative solutions that are addressed to tailor the individual needs, desires, and medical history of patients. Medical cannabis has been shown in clinical and public health settings to play a harm reduction role. It's not an all panacea. But there is evidence, and supporting and emerging evidence, of at least consideration of this and integration and certain aspects of the journey of opioid recovery.”

The second half of the webinar was a live discussion from Dr. McNabb and Dr. Grinspoon answering questions submitted by attendees. Topics included chemovars and terpenes such as beta caryophyllene and limonene, the possible effects of cannabis rescheduling on cannabis research funding, and dosing of specific cannabinoids such as tetrahydrocannabinol (THC) and (CBD) for reducing opioid use. Dr. Grinspoon also noted the importance of improving quality of life for patients who are suffering, lack of education or presence of bias in medical professionals, and the history of cannabis in the US Pharmacopeia and the War on Drugs.

On cannabis as an alternative to opioid use, Dr. Grinspoon noted, “It’s all about harm reduction. By every metric cannabis is safer than tobacco. It’s safer than alcohol. It’s obviously safer than opiates. So the question is not, ‘is cannabis perfectly safe?’ but rather ‘is cannabis legitimately a safer alternative to some of these other medications?’ And in these studies, we have shown a decrease in other substances when using cannabis."

Find more information on the next installments of this CCOE webinar series here.

Watch Dr. Grinspoon's interview with Cannabis Science and Technology on cannabis truth and policies.

Read our coverage of the second installment of this webinar series.

Reference

1. https://cannacenterofexcellence.org/