Terry Lake, the former British Columbia health minister who oversaw the declaration of a public-health emergency amid the deadly fentanyl crisis, is urging more research on the effects of marijuana on opioid addictions.
Now a vice-president at a medical cannabis company, Lake said there is preliminary evidence that shows marijuana can help people with addictions reduce their use of hard drugs and ease the painful symptoms of withdrawal.
"I'm not saying it's the answer to the opioid crisis. I'm saying it's one of the options we should explore," said Lake, who chose not to run in last spring's provincial election.
"It's very promising and deserving of further research and there's no better place to do that than in British Columbia."
Lake, who was hired last August by Quebec-based Hydropothecary, will join a researcher, an activist and others for a discussion of pot as an opioid substitute at the Lift Cannabis Expo in Vancouver on Sunday.
There have been "intriguing" early studies that have suggested cannabis might play a beneficial role in lowering the risk of overdose deaths, said M-J Milloy, a research scientist with the BC Centre on Substance Use.
A 2014 study in the peer-reviewed Journal of the American Medical Association Internal Medicine found that states with legal cannabis had an opioid death rate that was 25 per cent lower than states where pot was illegal.
A Canadian paper, published last year in The International Journal of Drug Policy, surveyed 271 medical cannabis patients and found 63 per cent used pot as a substitute for prescription drugs and 30 per cent used it as a substitute for opiates.
Milloy conducted a study that showed marijuana may help wean people off crack cocaine. His team tracked 122 Vancouver-area crack users over a three-year period and found they reported using the harder drug less often when they opted to consume pot.
He said there's a need for more formal, controlled trials on the effect of cannabis on opioid use, and he and fellow scientists at the B.C. centre plan to undertake some of that work.
"We certainly have reports from people who are suffering from opioid use disorder that cannabis helps them mitigate the feelings of withdrawal," said Milloy, who will participate in the talk with Lake on Sunday.
"We also know that many people suffering from things like trauma and chronic pain, which are often the roots of opioid addiction, that they also report that cannabis is useful for them."
Some addictions specialists are skeptical of the idea, Lake noted, as they're concerned about simply substituting one drug for another. More study is needed, and Lake said he hopes Canada will become a hub for marijuana research after it legalizes pot.
While Lake may have a financial interest in promoting medical cannabis, he said he thinks companies must be cautious about "overhyping" the benefits of the drug.
"It's not a panacea. It's not a cure-all. It very much is dependent on the individual, the condition they are dealing with and their individual response," he said.
British Columbia's public-health emergency, declared in April 2016, is still underway. Between January and November last year, 1,208 people died of illicit drug overdoses in the province, exceeding 2016's total of 985 fatalities.
Lake said he's come to believe Canada should adopt the approach of Portugal, which decriminalized all drugs and aims to help people dealing with addiction from the perspective of a health concern rather than a criminal problem.
Sarah Blyth, an activist who will join Lake and Milloy for the panel discussion, co-founded the High Hopes Foundation, which provides dried cannabis and oil to opioid users in Vancouver's Downtown Eastside.
Blyth said a lot of people who have received marijuana through the foundation have stopped using opioids or cut back, though she said she didn't have concrete numbers.
"It helps them go to sleep. It helps them ease physical pain. It helps them ease some of the tension they're dealing with," she said. "They know it's properly dosed. They know what they're taking."
For several years, the Eden Medicinal Society dispensary chain has also offered cannabis to opioid users to help ease the pain of withdrawal. The chain recently partnered with University of British Columbia psychologist Zach Walsh to deliver a more formal study, which is ongoing.
Eden gathered its own data prior to joining forces with Walsh, and found there was a 50 per cent reduction in opiate use among people accessing the program, said Tyler James, the chain's director of communications.
"It was really just to stave off some of the withdrawal symptoms, which can be very debilitating," he said.