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On 23 February 2017, White House Press Secretary Sean Spicer, in response to a question about the Trump Administration’s policy regarding states that have legalized marijuana in defiance of federal law, suggested that there would likely be greater enforcement of recreational cannabis in coming years. To defend this claim, he cited America’s opioid addiction crisis as a reason the government should not encourage people to do drugs: Implicit in this statement is the claim that recreational marijuana will lead individuals to other, harder drugs, in this case a class of prescription painkillers called opioids that are closely related to heroin. That the United States is suffering through a serious crisis with opioid addiction and overdose is well accepted by the federal government. From the Centers for Disease Control and Prevention: While these drugs can be both addictive and deadly in their own right, numerous studies have demonstrated an association between non-medical (i.e. recreational) prescription drug use and illicit drug use such as heroin, which has similar chemical properties to opioids: The cause of this epidemic is not controversial — researchers almost universally attribute it to legal prescriptions from medical doctors that are either used by a patient legally, or illicitly diverted from a doctor to another individual. A 2016 review in the New England Journal of Medicine is unequivocal on this point: The increase in opioid painkillers prescriptions stems, most argue, from an increased demand for better pain medication in the early 1990s, a campaign that misrepresented their danger, and heavy marketing and drug development by pharmaceutical companies. Liberalization of cannabis policy, one will note, is not mentioned as a driving force behind the opioid crisis. Perhaps just as pernicious as the falsehood implicit in Spicer’s press conference regarding the potential link between cannabis and opioids is his omission (or ignorance) of the fact that studies increasingly suggest that cannabis legalization results in a reduction of opioid overdoses. The most exhaustive study on this topic, published in JAMA Internal Medicine in October 2014, analyzed the cause of death data from all states between 1999 and 2010, including states that had legalized medical marijuana during that period. These researchers found that states with medical marijuana programs had fewer opioid related deaths, and that these decreases happened in concert with marijuana reform: The data predates the legalization of recreational marijuana in any state, and therefore cannot test the relationship to full legalization — a distinction that Spicer did make in the press conference. It is unclear, however, if this distinction holds any relevance to the opioid epidemic. In January 2017, the National Academies of Sciences, Engineering and Medicine released a comprehensive review of academic studies concerning cannabis use published since 1999. Importantly, they found no individual study or credible meta-review linking cannabis use to increased opioid use. While the concept of marijuana as a gateway drug remains controversial, there is a near-universal agreement that the opioid crisis was caused by an influx of legal prescription painkillers and is thus unrelated to marijuana use. Spicer A) would be therefore hard-pressed to find evidence to support his implied connection between recreational cannabis and opioid addiction, and B) would have to find a way to get around an increasing number of studies suggesting that less strict marijuana laws result in fewer opioid deaths. However, as noted in the the National Academies of Sciences review, the recent adoption of recreational marijuana laws and therefore the dearth of high quality studies make it impossible (at this time) to fully reject a connection between recreational pot and opioid addiction. In this respect, we rate the claim as Unproven.
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