Is Cannabis Harm Reduction?

Article by Dessy Pavlova, GrowWise Health

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Medical cannabis is often used to help break the cycle of chronic pain for various conditions, and its overall therapeutic effects can help meet many health goals, including something as simple as getting a good night’s sleep. Cannabis is also sometimes used as a safer alternative for or in conjunction with pharmaceutical medication as a form of harm reduction.

In the case of improving your quality and duration of sleep, using cannabis in lieu of highly addictive pharmaceutical sleep aids limits the likelihood of side effects like dependence or withdrawal, which reduces harm. Some individuals may use cannabis in order to limit the use of other legal recreational substances such as alcohol, or illegal substances obtained from unregulated sources. Cannabis is safer than many medical and recreational substances, and in itself can act as an agent of harm reduction. There are, though, potential harms of using cannabis itself. With an upcoming legal cannabis market, it’s important all individuals considering trying cannabis are as aware of the risks as well as the benefits of cannabis use, and especially how best to reduce any potential harms.

What is Harm Reduction?
Harm reduction is a public health strategy that acknowledges people use drugs in various ways and works to decrease negative consequences, dangers, and damage caused by use.

An example of harm reduction for illicit drug use are Safe Injection Sites, legal facilities that allow for people who use intravenous drugs to safely administer them in the presence of healthcare professionals without the fear of arrest or accidental overdose. An example of harm reduction for cannabis use could be finding an alternative to exposing yourself to the harms of smoking, such as ingesting or vaporizing. There are many other harm reduction strategies that can be implemented for pharmaceuticals, for legal substances like tobacco or alcohol, and for illegal drugs obtained from unregulated street sources, and cannabis may play a significant part.

How Cannabis is Harm Reduction
Cannabis is being studied in relation to the substitution effect because of its large safety margin. The substitution effect is a method of harm reduction that provides a less harmful alternative to a more harmful substance. Cannabis has the potential to replace multiple substances as it provides limited risk in relation to other drugs. In one study, 40% of the sample of patients from a medical cannabis dispensary used cannabis as a substitute for alcohol, 26% used it as a substitute for illicit drugs, and 65% used it as a substitute for prescription drugs. The reasons for using cannabis as a substitute varied from fewer adverse effects and less withdrawal potential, but 57% of patients claimed that cannabis provides better symptom management. This is promising, considering opioid-related overdoses are currently a regular occurrence in Canada, with a widespread fentanyl epidemic.

Evidence shows that endocannabinoid and opioid receptors may interact in a way that enhances the pain-relieving effect of opioids when combined with cannabis. This allows for patients to reduce the number of opioids they need to take, while simultaneously reducing their pain, thereby lowering the potential for overdose. Interestingly, patients are recommended to use whole plant cannabis as opposed to chemical derivatives that may not have the cannabinoids and terpenes needed. CBD is the main cannabinoid known to help treat dependency issues, as well as mental health conditions like depression, anxiety, and PTSD.

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