Opioid and Cannabinoid Interactions: A Novel Harm Reduction Approach To Reduce the Risk of Overdose

Abstract

Opioid overdose fatalities total over a half a million lives lost to date, most often the result of respiratory arrest, was recently proclaimed a national emergency and is a serious public health concern. This epidemic has highlighted many of the ways our current failed policies have created barriers and negative attitudes around substance use and the people who use substances. The evidence laid out in this body of work highlights the importance of continued cannabis and cannabinoid research to fully understand the impacts of these compounds and how the endocannabinoid system interacts with the other biological systems. This work highlights the potential of cannabinoid and opioid interactions to increase the safety profile of opioid therapies, through coadministration of a central CB2 agonist or peripheral CB1 agonist alongside morphine as a preventative to opioid induced respiratory depression, as well as highlights the necessity to consider sex differences when developing new drug discoveries. Despite the variety of intervention approaches to curb the escalating death toll of opioid therapies, success has not been achieved. Additionally, while attitudes around cannabis-based medications have begun to shift, more work still needs to be done to ensure that everyone who stands to benefit from cannabinoid-based therapies has access to them. Focus on policies and interventions aimed at reducing harm to people who use drugs, instead of shaming and punishing them, and including these same individuals in conversations around future research and therapies will be the only way that we can put an end to the opioid epidemic for all individuals who consume substances, regardless of gender, socioeconomic status, race, or geographical location.