Those of us involved in the marijuana legalization movement have long assumed that those companies that produce and sell competing products — especially alcohol and tobacco — were working behind the scenes to try to maintain marijuana prohibition and to protect their duopoly for legal recreational drugs. These industries have lobbyists who regularly work with state and federal elected officials to keep legal marijuana off the market.
But we now see the pharmaceutical companies are also getting directly involved in political efforts to maintain marijuana prohibition, worried that legal marijuana will undermine their bottom line.
Pharmaceutical company joins the war on marijuana smokers.
Recently, we saw the first direct evidence that pharmaceutical companies are now working to defeat marijuana legalization efforts, acknowledging that their intent is to protect their market in synthetic opioid drugs.
Earlier this month, Insys Therapeutics Inc., an Arizona-based company, donated $500,000 to a group calling itself Arizonans for Responsible Drug Policy, a newly formed organization established to try to defeat Proposition 205, the marijuana legalization voter initiative that will appear on the ballot this November in that state.
Insys currently markets just one product, Subsys, a sublingual fentanyl spray, a synthetic opioid far more potent than heroin (fentanyl is the drug found in Prince's system following his death in April). "Insys Therapeutics made $62 million in net revenue on Subsys fentanyl sales in the first quarter of this year, representing 100 percent of the company's earnings," according to The Washington Post. "The CDC has implicated the drug in a 'surge' of overdose deaths in several states in recent years."
Survey data compiled from medical marijuana patients show that subjects often reduce their use of prescription drug therapies — particularly opioids — when they have legal access to cannabis. According to a 2015 RAND Corp. study, opiate-related abuse and mortality is lower in jurisdictions that permit medical cannabis access, compared to those that outlaw the plant.
Insys has come under scrutiny of law enforcement. According to The Washington Post, a number of states are currently investigating Insys for illegally paying physicians to prescribe their drug in situations in which it was inappropriate. Illinois Attorney General Lisa Madigan filed a lawsuit against the company, claiming the company's "desire for increased profits led it to disregard patients' health and pushed addictive opioids for non-FDA approved purposes."
The smoking gun.
When the company first made its half-million dollar contribution to the group opposing the Arizona legalization initiative — the largest single contribution to the group by a factor of four — the company claimed that its reason for opposing the voter initiative was "because it fails to protect the safety of Arizona's citizens and particularly its children."
But when the company filed a legally required disclosure statement with the Securities and Exchange Commission, it acknowledged to shareholders that it was making the donation because it feared a decline in the sales of its powerful opioid product and that of a second drug it is developing: Dranabinol, a synthetic cannabinoid. Synthetic cannibinoid is a blanket term for an artificial version of tetrahydrocannabinol, or THC — the active compound in the marijuana plant — intended to alleviate chemotherapy-caused nausea and vomiting. The company concedes that the scientific literature has confirmed the benefits of natural marijuana over synthetic THC:
"Legalization of marijuana or non-synthetic cannabinoids in the United States could significantly limit the commercial success of any dronabinol product candidate. ... If marijuana or non-synthetic cannabinoids were legalized in the United States, the market for dronabinol product sales would likely be significantly reduced, and our ability to generate revenue and our business prospects would be materially adversely affected."
The Arizona Republic reported that the company, while publicly claiming to have kids' best interests in mind, is clearly more concerned with ways to "protect its own bottom line."
And the company has good reason for that fear. Recently published studies have found that states that provide for the legal use of medical marijuana had a 25 percent decline in opioid prescriptions. Another recent study from Columbia University found the implementation of medical marijuana programs is associated with a decrease in the prevalence of opioids detected among fatally injured drivers, based on a review of 69,000 fatalities in 18 states, according to data published in the American Journal of Public Health. Where legal marijuana is available, people use far fewer opioid drugs.
So we now have direct evidence that this pharmaceutical company in Arizona is spending large amounts of money to avoid having to compete with legal marijuana, in order to protect its market share for an addictive and dangerous synthetic opioid and a synthetic form of THC, at the expense of public health.
This is not the first instance of pharmaceutical companies pouring money into the "war on drugs." In 2014, The Nation published an article revealing that the makers of Oxycontin and Vicodin were two of the largest contributors to The Partnership for Drug Free Kids and the Community Anti-Drug Coalition of America, two groups that oppose marijuana legalization and support continued prohibition.
Insys will certainly not be the last pharmaceutical company caught putting company profits ahead of concern for public health, but it is the first instance we have seen where a company was caught with its hands in the cookie jar, opposing a marijuana legalization initiative purely for reasons of corporate greed.
Tobacco and alcohol companies have long opposed legal marijuana.
It is understandable that recreational and pharmaceutical industries would not wish to compete with legal marijuana. By any measure, their products are far more dangerous and far more addictive.
For comparison purposes, according to the National Institute on Alcohol Abuse and Alcoholism, excessive alcohol use results in approximately 88,000 deaths per year in this country. And, according to the Centers for Disease Control and Prevention, tobacco smoking results in more than 480,000 deaths each year in this country, about 1,300 people each day.
A 2014 study by Johns Hopkins University found that states that legalized medical marijuana saw a 25 percent decline in overdose deaths from prescription drugs.
Marijuana has never caused an overdose death in the history of mankind. According to a recent report from the World Health Organization, one would have to smoke "between 238 and 1,113 joints a day – or at least 10 joints an hour, for 24 hours straight – before overdose would become a realistic concern" for marijuana.
While one can develop a dependence on marijuana smoking, the threat of dependence with marijuana is far less than with either alcohol or tobacco. Here is what the National Academy of Sciences Institute of Medicine concluded in regard to cannabis' potential dependence liability, in the context of other controlled substances:
"In summary, although few marijuana users develop dependence, some do. But they appear to be less likely to do so than users of other drugs (including alcohol and nicotine), and marijuana drug dependence appears to be less severe than dependence on other drugs."
Here are their dependence ratings:
- Tobacco: 32 percent (proportion of users who ever become dependent)
- Heroin: 23 percent
- Cocaine: 17 percent
- Alcohol: 15 percent
- Anxiolytics/sedatives: 9 percent
- Marijuana/hashish: 9 percent
So if one is electing to use a recreational drug, marijuana is clearly the safest alternative. And if one is using an opioid drug for pain, they should experiment with marijuana as a substitute for the more dangerous and addictive opioids. For many, it is an effective and far less dangerous alternative.
Keith Stroup is a Washington, D.C. public-interest attorney who founded NORML in 1970.