“Of all the things that cannabis can potentially do for humankind, the impact on the opioid crisis is by far the best and biggest thing it could do for humanity.”
Dr. Adie Wilson-Poe was a straight edge kid. She grew up in Arizona then moved to the northwest at 19–first to Seattle and later to Portland–and found her home there. She wasn’t into drugs or drug culture; she was a punk rock kid who moved to Seattle for the music and ended up in science. While getting her psychology degree, Dr. Wilson-Poe became interested in drug use and addiction. She started studying neuroscience, specifically the neurobiology of psychology.
The first time Dr. Wilson-Poe smoked weed, she was 25 and well into grad school. Although at the time there was scant scientific literature about marijuana, she studied whatever data she could find and came to understand that cannabis had medicinal properties. She also started studying the basic mechanisms of addiction and how different drugs affect the brain in unique ways.
Dr. Wilson-Poe is an accomplished neuroscientist whose work is regularly funded by the National Institute on Drug Abuse.
Why do you think so many pain-relieving drugs are addictive and what does the future hold in terms of cannabis-based pain relief?
The whole reason that most people are using opioids or cannabinoids is because they’re trying to relieve pain. There is a very complex interaction between pain relieving drugs that are also addictive. That dynamic interaction between pain relief and drug abuse or drug misuse is something that we spent a lot of time working on. There’s a big gap between what we do in the lab and what we would do in the clinic and I’m trying to narrow that gap for cannabis and opioid interaction.
We know that inhalation is a very common method that people use to relieve pain. We know it’s a very effective method for relieving immediate pain. Oral products and edibles are great for nighttime when you can wait for them to kick in and then work overnight. But for relief when you’re in pain, you need something that works right away, and we know that the lungs are a great method of doing that.
How do you think cannabis can solve the opioid epidemic?
Of all the things that cannabis can potentially do for humankind, the impact on the opioid crisis is by far the best and biggest thing it could do for humanity. There are a number of places where cannabis can interact with opioids. If we just follow one person, let’s say you get injured at work, you throw out your back, and you have pain. You have a choice at the time that you’re experiencing pain. You could start using cannabis right away and never even use an opioid at all. All of the side effects, all of the risks, all of the dependence potential. You can prevent it entirely by managing pain with cannabis. Cannabis has been used for pain relief on this planet for 5,000 years.
The other thing we know from the evidence and my work has contributed to this as well, is that when they are used together, cannabis and opioids provide synergistic pain relief. So synergy means greater than additive effects. Rather than two plus two equals four you have two plus two equals seven or something. We know that this is a very robust effect, we see it in people, we see it in all other mammals, we see it whether you use a synthetic cannabinoid or delta-9, you see it whether you use codeine and morphine. When you use the drugs together, you get better pain relief and what that means–the outcome of that better pain relief–is that you don’t need as many opioids.
Can you explain how cannabis can also be used for addiction treatment?
Let’s say again: you have your injury on the job and your doctor prescribed opioids. You took them as directed and get to a point where your injury has resolved, but now you’re physically dependent on opioids. There’s a role for cannabis here. Part of the science is a little bit more messy than the others, but there’s some preliminary results showing that people who are physically dependent on opioids have some withdrawal relief from cannabis. During withdrawal you feel restless, you can’t sleep, you’re irritable. Those symptoms are very well treated with cannabis.
People have always talked about weed as a gateway drug, but now we’re hearing that marijuana is the exit drug. What are your thoughts?
The gateway hypothesis came out of some evidence that was produced in the 70s, 80s, and 90s, which showed that there’s a correlation between using cannabis and using harder drugs like opioids. But that correlation is also true for people who use nicotine and alcohol. Just because those things are correlated with the use of harder drugs doesn’t mean that they cause a person to use harder drugs. That gateway hypothesis has been thoroughly refuted in more recent work. We now know that cannabis is not necessarily the gateway to causing someone to use other drugs. We’re in this new time where we see that cannabis is not the gateway drug to opioid use, but rather it’s an important tool for exiting from dependence on opioids.
How has our government ignored the evidence that cannabis is less dangerous than alcohol?
In the early seventies, President Nixon assigned a bunch of scientists and doctors the task of analyzing cannabis’ effects on people and making a determination about how safe or how dangerous it was. This was the Shafer Commission. They wrote up this exhaustive report and gave it back to him. The report said, “This is a very innocuous substance, it shouldn’t be regulated, it’s even less dangerous than alcohol.” But Nixon ignored the evidence and allowed cannabis to persist as a schedule one drug.
Through the history of prohibition there’s been a blatant disregard of the evidence. We saw this even as recent as the current administration. Jeff Sessions is probably the worst at this. Everything that comes out of his mouth about cannabis is directly in contradiction to the evidence. The evidence has always been there to support cannabis as a relatively safe substance, especially compared to other drugs.
Can you talk about what you’re doing with the business Smart Cannabis?
We’re really interested in what the effects of cannabis in people are and how we can use that information to both better support the people using cannabis and help to support the people who are cultivating or producing cannabis. We have to study it in people and ask them, how did this make you feel? Knowing what people actually find enjoyable, not just intoxicating because there’s really a difference there, right? Like just because something has 30% THC and it got you really high doesn’t mean that was necessarily an enjoyable experience. Maybe you’d have a better time on Friday night if you had had a 17% flower, but we don’t know that until we actually test it in people.
Do you have an opinion on the recent vaping controversy?
Oil cartridges are not going anywhere. This is an incredibly convenient and very popular way for people to consume cannabis. But what we really need to focus on is what’s the safest possible way to consume. Propylene Glycol and Vitamin E Acetate are probably never going to be allowed to be in these cartridges again. Obviously, all of these flavors and additives that break down into really nasty chemicals, those are going to be outlawed.
We’re going to need to have some regulation around.
We’re probably going to see some change in the technology also. You can’t have a battery that’s over this amount of voltage. You can’t have a ceramic coil or a fiberglass coil that gets hotter than this temperature, because we know at that temperature, that’s when things start to break down and even if we don’t have the FDA or some other regulators telling us that this is what we need to do, it’s on us, it’s on the industry to be able to make those decisions for the health of our consumers.
Cannabis events help to educate people about cannabis, what do you see as your role in all this?
I feel incredibly grateful that this is what I get to do with my time on planet earth. It just so happened that legalization and the opioid crisis was happening when I was going to grad school. I get to participate in something that could leave a very long-lasting mark on humanity. It’s also interesting that a lot of my colleagues–a lot of doctors, a lot of healthcare professionals–because of the federal prohibition, there’s a lot of conservative thinking. There are a lot of people who are afraid to talk with their patients about cannabis or a lot of people who are afraid to speak about these things in public.
I believe in doing no harm and it’s very clear to me from the evidence that cannabis is a medicine and opioids, although useful for certain things, are dangerous. I feel very privileged that I get to participate in these really important conversations at a really important time. But one component of that is my not fearing what the National Institutes of Health are going to do or what the DEA is going to do. There’s some inherent risk for me in openly talking about these kinds of ideas because so many of my colleagues would just rather hide in the laboratory because it’s too much of a risk for them. But the right thing to do is to reduce harm and keep people alive and I feel very privileged that I get to play some part in that.