The Colorado legislature recently passed Senate Bill 13, which would allow physicians to recommend medical marijuana for any “condition for which a physician could prescribe an opioid.” This language is overly broad and could threaten the health of Coloradans, particularly those with opioid-use disorder.

Consider all of the medical conditions for which an opioid, in one form or another, may be prescribed. For example, a severe, painful cough can be treated with codeine. Pregnant women with opioid use disorders are often treated with buprenorphine. After a painful child birth, a new mother may be given hydromorphone. Not only is there no medical evidence to support the use of marijuana for these health conditions, but it is specifically and strongly recommended that pregnant or breast-feeding women not use marijuana. 

This legislation may be even more dangerous for patients struggling with addiction. The most effective treatment for opioid use disorder is a comprehensive approach, providing psychosocial support and medication-assisted treatment (MAT). MAT can include treatment with full or partial agonist opioids. It is entirely conceivable, under this bill, that patients with opioid use disorder could be recommended medical cannabis instead of MAT. 

MAT has been demonstrated to reduce withdrawal cravings, risk of infectious diseases, and overdoses. Patients receiving MAT are more likely to be successful in their recovery, rebuild their lives, and maintain gainful employment and personal relationships.

Indeed, the Journal of the American Medical Association (JAMA), has recently weighed in on the use of medical marijuana to replace opioids. The authors conclude that “it would be irresponsible for medicine to exacerbate [the opioid addiction crisis] by encouraging patients… to rely instead on unproven cannabis treatment.”

Given these health threats, addiction medicine physicians recommended that our state legislators consider amendments or reforms to require screening for patient substance use disorders before recommending marijuana. Based on the clinician’s judgment, medical marijuana may still be appropriate. But we recommended documentation of the risks/benefits of medical marijuana, specific to that patient. These common sense, medically prudent suggestions were unfortunately not incorporated into legislation this session.

The hasty expansion of medical marijuana to allow its use for virtually anything is irresponsible and may create more public health problems. Despite the good and honorable intentions of its sponsors, SB 13 is not the answer to the opioid crisis and should be vetoed by Gov. Polis for the protection of public health.

Stephanie Stewart, MD, MPHS is a board-certified public health and preventive medicine physician and an addiction medicine fellow.