By Susan L Kupiec

I am writing in response to a recent article, “Waterbury may opt in for retail marijuana market.” In this article, Waterbury resident Glenn Anderson promotes himself as a patient resource to help patients on opioids, using cannabis to cease or decrease opioid use. In the state of Vermont, it is legal to work with only one patient as a registered medical marijuana caregiver, so this not only advocates for nonmedical professionals helping patients taper off prescribed and possibly fatal medications, but alludes to the black-market culture and inappropriate cannabis procurement.

To quote the article:

Waterbury resident Glenn Anderson pointed out that access to marijuana can even help people stay off harder drugs. “I work with a number of patients, and we’ve helped a number of people off of opioids in significantly harmful situations through cannabis therapy,” said Anderson. “I accept what you’re saying about the concerns about the degrading quality of life and the degenerate side of what we see of drug use, but I would say we can use cannabis on so many more lifting levels, and in ways that are very positive as far as helping people receive the medicine that keeps them from opioid addiction.”

I am a member of the Vermont Cannabis Nurses Association and American Cannabis Nurses Association and specialize in opioid use and multi-substance use disorders. Myself and my colleagues have many concerns about a layperson helping and assisting patients taper and withdraw from opioids. Opioid medication adjustments and withdrawal can be severe and needs to be monitored by a health care professional team. The Vermont standard is a team of professionals including a doctor, nurse and social worker for the additional and much-needed mental health and emotional support. As I mentioned, I work in what we call the medication- assisted treatment field and am witness to the daily struggles and unfortunate dangers that can come with opioids. Patients need to be closely monitored for their physiological needs and concerns, such as blood pressure, heart rate, temperature, sleep, appetite and pain level just to name a few. We need to understand that it is not only physical symptoms that need to be monitored but also the mental and emotional concerns. Anxiety, depression, increase in suicidal thoughts and actions and the risk of relapse are common and serious concerns we see daily in this field. A field of professionals, not laypeople.

Withdrawal from opioids can be dangerous and symptoms severe, to state it simply. It is absolutely necessary to be under the supportive care of a medical professional or team so they can make appropriate plans with the patients, whether medication-assisted treatment, as in taking methadone or suboxone, supportive medications for the withdrawal and tapering process and/or many other varied needs and concerns. I am not promoting one treatment course over another, but I am promoting safe, monitored treatment and care plans by professionals who are licensed and educated in this field. The way it needs to be, and the only way it should be. Keeping patients safe.

The Vermont Cannabis Nurses have offered to support Glenn Anderson and his patients, as he does not work within recommended and safe parameters, nor have any medical staff or professionals that he is working with. We are in the middle of an opioid epidemic that has been growing at alarming rates during the COVID-19 pandemic. Opioid overdoses have increased exponentially over this past year. Promoting a cannabis therapy without the medical background to “keep people from opioid addiction” is a game we as a society should not be playing with. This game is people’s lives and livelihood.

There is unfortunately just not quite enough evidence-based research to say that cannabis therapy can be used to treat opioid addiction or enough to recommend specific dosing or safe care. My professional opinion, and that of VTCNA, a person prescribed opioids or who is struggling with opioid addiction should meet with an accredited provider, stop in to a medication-assisted treatment center or look for support at rehabilitation centers specializing in opioid use disorder. Vermont has many treatment options and supportive resources. Please, leave this to the professionals and remind our readers not only to work within the confines of a legal medical marijuana program in our state, but that work within this patient population without proper education can be a danger to our community.

Susan L. Kupiec, RN, is a member of the Vermont Cannabis Nurses Association and the American Cannabis Nurses Association.