Pope Francis, the Golden Rule, and marijuana reform

GUEST POST BY MIRIAM BOERI, PHD

Last month, to great fanfare and some protest, Pope Francis made history by being the first Pope to address a joint meeting of Congress. Frequent standing ovations interrupted his talk, delivered in English, slowly and deliberately, with one of the most moving turns in the Pope’s speech being a reference to the Golden Rule: “Do unto others as you would have them do unto you.”

While Pope Francis was referring to immigrants and refugees, his words apply to all who are disenfranchised by their situations. He appealed to all of us to listen their stories. As a sociologist who listens to the stories told to me by people who use drugs, the Pope’s words led me to reflect on the possibility of bridging our differences of opinion to make medical marijuana available to those who need it to relieve their suffering.

After many years of political debate, marijuana prohibition is now being challenged by public outcry and popular vote. Yet those who oppose it say we need more research. Research on the benefits of marijuana has been stifled, yet a growing number of studies show marijuana’s medicinal purposes for a host of debilitating conditions.

On another front, recent epidemiology studies show that medical marijuana laws are associated with significantly lower opioid overdose mortality rates, while clinical studies show that marijuana use does not harm recovering drug users. This research provides evidence supporting the stories I hear from many hard drug users about how marijuana helps stop or reduce their use of other drugs.

Meanwhile, I meet women who have weaned themselves off methadone treatment by secretly using pot, and who had to hide their cannabis out of fear that they could be expelled from their program. In another case, a young man told me he used marijuana to stop a twitching caused by a prescription medication he was given for a mental health condition. All of these people were using marijuana illegally and could be charged and convicted if caught, all were homeless or living in public housing, and some were in this situation because of a felony conviction for selling marijuana.

These stories show how past offenses that resulted in a criminal justice record or unaddressed mental health conditions were the cause of their poverty. As poor patients in a state with public healthcare, they were often given a variety of expensive prescription pills for free. Many of these medications were addictive, or had debilitating side effects that pot or concentrates can help relieve. Yet in a commonwealth where medical marijuana is legal, people can’t afford to use it legally. And since it wasn’t recommended by the Governor’s Opioid Working Group as a strategy to combat the heroin and Oxycontin crisis, cannabis cannot be legally used to treat addiction.

Healthcare professionals in Boston have been at the forefront of integrating behavioral and medical care with policy, with naloxone (Narcan), buprenorphine, and methadone being used as primary solutions in addressing overdoses. Naloxone is an effective antidote, but not a cure or a preventative therapy. Buprenorphine is a narcotic agonist and antagonist and used as a substitute for heroin. It has abuse potential and is addictive. Methadone, the most widely used substitute for opioids, is not only extremely addictive, but also has a very narrow therapeutic index, which is the ratio between the toxic dose and the therapeutic dose of a drug. In contrast to the approved but addictive substitutes for opioids, marijuana has one of the widest (and safest) therapeutic ratios of all drugs.

Perhaps the Pope’s words will influence the hearts and minds of policymakers in Mass, the state with the highest percentage of Catholics. Or maybe if we moved to “listen to their stories,” like one told to me by a homeless young man who spent the last five years in and out of treatment homes and jail for opioid addiction. He now uses marijuana illegally to help relieve his craving for opioids, and says, “I think that medical marijuana would be a great thing, especially in treatment. Obviously you have to try something else ‘cause not a lot of it worked so far, and I’ve seen a lot of death in my life.”