The cannabis antidote to the opioid epidemic? Patient education, good doctors, and tight controls
After retiring from the Drug Enforcement Administration a few years ago as a senior investigator focusing on controlled substance compliance, I founded a private consulting firm to provide guidance to clients in the pharmaceutical industry on the proper ways to adhere to U.S. laws and regulations governing the handling of controlled substances.
As you might expect, the U.S. pharmaceutical industry faces strict product registration, record keeping, security and reporting requirements called for by the federal Controlled Substances Act and its corresponding Code of Federal Regulations. The point of this closed system of distribution between manufacturers, distributors, retail pharmacies and doctors is to ensure that controlled pharmaceutical substances are not diverted into the illicit drug market.
Unfortunately, many of the companies and individuals authorized to handle controlled substances have ignored or purposely circumvented these laws and regulations over the years. The sad and unfortunate outcome of this reality is that billions of dollars of legitimate prescription drugs have been diverted into the consumer marketplace and an entire generation of hopeless and lost drug addicts has been spawned in every corner of our nation.
There are important lessons here for the medical cannabis industry, which is gaining momentum and scale in jurisdictions all over the world, including here in the U.S. where cannabis is still treated as a controlled narcotic by the federal government, though legalized in certain states.
Some important background on the current opioid epidemic, which has become one of the most significant healthcare crises the United States has ever known:
In the late 1990s and early 2000s, a number of unscrupulous physicians and pharmacies recognized the potential to exploit the newly emerging Internet to illegally authorize and ship controlled substances – specifically hydrocodone combination products - to customers across the country. Customers could simply order and pay for such products on a website, which would, in turn, fax a doctor’s prescription for the drug to a pharmacy that would then ship the product to the customer by courier. In the matter of just a couple of days, the customer would receive the controlled substances at their door without ever stepping foot in a doctor’s office or a pharmacy.
In 2007, legislative changes forced individuals to move from illegally obtaining controlled substances via the Internet to visiting pain management clinics in person. Unfortunately, with this shift from the Internet to pain management clinics, the DEA saw a significant rise in shipments of controlled substances to Florida, in particular, oxycodone and hydrocodone products.
The DEA did, in fact, target a number of drug distributors and one particular manufacturer responsible for supplying hundreds of millions of opioid narcotics to a number of pharmacies in Florida.
Having been on the ground as a DEA Special Agent through those investigations in the Sunshine state – parking lot surveillances, and all – I was able to get an up close and vivid view of how the opiate epidemic was evolving, growing and adversely affecting so many people – mostly normal, average Americans – all across the U.S.
Boarding the plane home to Boston from Orlando International Airport at the conclusion of that investigation, I remember being struck by how starkly the squeaky clean tourist mecca image portrayed by Orlando contrasted with the unseemly and vile reality of greedy corporate players in the pharmaceutical industry using the area as an operational base to push highly addictive drugs onto the American public. It made my stomach turn, but I left Florida with a much better understanding of how the opiate epidemic could, in fact, be stopped once and for all.
Aggressive DEA administrative and civil actions stemming from those investigations did, in fact, lead to substantial corporate fines being levied, forcing some significant changes in how pharmaceutical companies distribute and dispense controlled substances. Unfortunately, regardless of the actions taken by the DEA against the pharmaceutical industry, opioid addiction is still a widespread epidemic across the country.
Ultimately, the key to getting a handle on this problem is a balanced approach that includes not just law enforcement efforts but education and training for the pharmaceutical industry, physicians and patients, as well as better, more universal access to treatment for patients addicted to opioids.
In fact, it’s the same approach that the legalized medical cannabis industry is largely implementing of its own accord.
As an illustration of the approach some companies in the medical cannabis industry are taking, Khiron Life Sciences Corp., a medical cannabis company operating in Colombia where I accepted a position as Vice President of Compliance, is developing and implementing a three-pronged go-to-market approach that includes scientific research, physician training and patient education to ensure that practitioners and patients, alike, have their eyes wide open to what cannabis treatment options can offer, and what they can’t.
Under the direction of a renowned cannabis researcher and medical practitioner who specializes in analyzing and testing medical cannabis as a treatment option for patients suffering from pain from cancer and other diseases, Khiron is committed to ensuring that any medicinal cannabis products it dispenses are patient-centric and are prescribed for legitimate medical reasons only.
The company is also implementing and developing compliance standards that mirror or exceed those in the U.S. pharmaceutical supply chain to ensure that its cannabis product supply chain operates above the level mandated by the Colombian government. This includes implementing a closed loop of distribution to ensure full seed to sale compliance, track and traceability, and security.
In short, the medical cannabis company I now work for is dedicated to the health and wellbeing of its patients and will easily avoid any of the scenarios I described above with regard to the pharmaceutical industry.
Fortunately, while the specifics will vary from company to company and while there will always be outliers that take the wrong path, I believe the global medical cannabis industry is naturally well positioned to avoid the mistakes and transgressions of the opioid makers and that it won’t do anything to jeopardize the widespread goodwill it has deservedly earned to this point.
I’ve seen what can happen otherwise, but my law enforcement instincts tell me the medical cannabis industry is in good hands.
Matt Murphy, an internationally recognized security expert in the fields of drug law enforcement, risk assessment and systems development, regulatory compliance, and training, is Vice President of Compliance for Khiron Life Sciences Corp. (KHRN-TSXV), a Canadian integrated medical cannabis company with its core operations in Colombia.