While college health professionals have been warning students about the dangers of marijuana being a gateway to even more dangerous drugs, there has been a building conversation about helping people who are dependent on opioids and other prescription drugs ease out of their substance use disorder using marijuana. In states where marijuana is medically legal, researchers have found declines in opioid-related mortality. They looked at thirteen states in total, all which had medical marijuana laws go into effect over a period of time. States with medical marijuana laws in place had a significantly lower average number of opioid overdoses compared to states without legal medical marijuana.
But let’s be clear, this is not evidence that legalizing marijuana is causing the decrease in opioid deaths – the finding is correlational and does not prove causation. More research is needed to determine how marijuana laws may interact with policies aimed at preventing opioid overdoses. Cannabis is a Schedule I controlled substance, which makes it extremely difficult for researchers to get approval to use it in a clinical study; however, the National Institutes of Health recently awarded a five-year, $3.8 million grant to researchers for the first long-term investigation to see if medical marijuana reduces opioid use among adults with chronic pain.
As college administrators are grappling with how the opioid epidemic impacts their institution, and more and more states move to legalize marijuana, college and universities struggle to understand how it all fits together. Survey data from Vector Solutions (formerly Everfi's Campus Prevention Network) Prescription Drug Abuse Prevention course show that the overwhelming majority of college students are not misusing or abusing prescription opioids, so perhaps there is not a huge need for medical marijuana on campus? The conversation about using medical marijuana as an “exit drug” for students who are dependent on opioids has yet to make a big splash on college campuses, but using medical marijuana to ease opioid withdrawal symptoms could have its place.
It is important to point out that any discussion about this issue on campus must include the recognition that marijuana is still a Schedule I drug under federal law. This means that regardless of changes to state laws, institutions of higher education are expected to follow the regulations outlined in the Drug Free Schools and Campuses Act (Edgar Part 86). This includes upholding federal laws and statutes prohibiting marijuana possession, use, or distribution by students, staff, and faculty. Not doing so puts an institution at risk of losing or being required to repay federal funds. Some mistakenly believe that exceptions are made for medical marijuana, but that is not the case. Those with a legitimate marijuana prescription in a state where it is medically legal still cannot use or possess the substance on a federally-funded campus.
Because the federal law prohibits medicinal marijuana use, schools have to be thoughtful in how they handle students with legitimate medical marijuana needs. They also have to consider how to work with students in the recovery community who may use marijuana as an exit drug as described above, or to minimize the debilitating side effects of opioid withdrawal. This type of situation could require schools to work within the law to identify outside the box solutions, such as assisting students with locating appropriate off-campus housing options or helping students find alternative solutions to address withdrawal without creating further stigma for those experiencing a substance use disorder.
The federal law is quite clear as to the expectations for how an institution should respond to marijuana use and possession, but the reality is that administrators at each institution must navigate their way through these complex issues in a way that best meets the needs of their student community.