Is marijuana a narcotic?

In the ever-evolving world of drugs, medicine, and the law, is marijuana a narcotic? Please note that this debate doesn’t change the fact that cannabis is a powerful tool to enhance wellbeing, but the classification of drugs can come into question as public opinion shifts. 

Recent changes to the term “narcotic” in relation to cannabis and CBD offer an excellent example of how this can play out in the real world. 

In this post, we’ll explore what it means to call a substance a narcotic and whether marijuana is considered a narcotic. We’ll also engage in a discussion about how cannabis, which has been shown to alleviate pain and help consumers sleep, might be used to treat similar symptoms of disorders physicians might otherwise use pharmaceutical narcotics to treat.

Is marijuana a narcotic?

Physicians have historically called any drug that can dull pain and make you feel sleepy, including cannabis, a narcotic. 

“Narcotic is now a term that has more legal implications than it does pharmacologic ones,” an FAQ included in the book Pain Management Secrets explains. 

The FAQ adds that the term’s definition has expanded to include any “drugs of abuse that are controlled by government agencies.” This has created some confusion regarding what substances are technically considered narcotics as drug laws continue to evolve.

Currently, the answer to whether marijuana is considered a narcotic (in the legal sense) seems to depend on who you ask. According to the International Narcotics Control Board, an intergovernmental organization with ties to the World Health Organization (WHO) established by the Single Convention on Narcotic Drugs of 1961, cannabis is a narcotic and falls under the organization’s purview. 

In recognition of the potential therapeutic uses for cannabis, however, the WHO has started to reconsider how it views cannabis and explored changes to the anti-cannabis stance established by the 1961 convention.

Despite the changing tune of the international community, cannabis plants and products containing more than 0.3% THC remain illegal under federal law in the United States. It's interesting to note, however, that the U.S. Drug Enforcement Administration doesn’t call cannabis a narcotic on its fact sheet and specifies on another fact sheet that “narcotic” refers primarily to opioids.

As of this writing, 23 states and the District of Columbia have legalized cannabis for recreational and medical use, while an additional 17 have legalized only medical use. 

What does that mean for cannabis’ status as a narcotic? For one thing, it may eventually lead to a change in the plant’s regulatory status or even legalization at the federal level. In the short term, however, the changing public image of cannabis might simply lead us to ask whether the question of whether marijuana is a narcotic, with all its cultural baggage, even matters beyond the scope of the legal system.

Can marijuana replace common narcotics?

While the definition and legal connotations of the term “narcotic” might be a little unclear, individuals who would otherwise turn to pharmaceutical narcotics to aid sleep or relieve pain may be able to use cannabis instead.

As a 2023 literature review states, “high-quality evidence to support cannabis use for sleep remains limited” due to a range of factors impacting the replicability of studies, including differences in “cannabis types, doses, timing of administration, and sleep outcome measures.” 

This lack of high-quality evidence makes it difficult for physicians to suggest best practices for individuals who use cannabis as a sleep aid. Two conclusions reached by the review’s authors, however, are that THC is more likely to help with sleep relative to CBD, and the sleep of patients with pain-related disorders is more likely to improve compared to the sleep of patients with other disorders.

A 2023 study, which notes that sleep disturbances affect between 40% and 70% of older adults, highlights the popularity of the use of cannabis as a sleep aid among Americans over the age of 65 — especially those experiencing pain that keeps them awake.

“Sleep disturbance is often comorbid with other conditions (such as pain), and cannabis may play a palliative role as part of an integrative treatment strategy, offering an explanation for why these sleep users indicated cannabis was used to address more health conditions,” the authors suggest.

Even if pain isn’t interfering with an individual’s sleep, cannabis has been used to manage general pain for thousands of years. 

Contemporary evidence generally supports the use of cannabis for pain, especially chronic pain, despite sharing similar issues to studies of cannabis and sleep regarding the type of product or strain of cannabis used, dose levels, and so on.

“Clinicians around the globe often note relief of pain and accompanying symptoms (i.e. depression, anxiety, sleep disturbances) in patients with chronic non-cancer pain who did not respond to established non-pharmacological and pharmacological therapies,” one 2022 literature review explains.

Can marijuana help treat narcotics addictions?

While cannabis might be used to treat similar symptoms to those that would otherwise be treated with pharmaceutical narcotics, there is mixed evidence supporting the idea that cannabis can be used to replace other narcotics (especially opioids) when users are addicted to those narcotics.

A 2019 letter written in light of legislative changes to allow physicians to prescribe cannabis as a substitute for opioids published by the Journal of the American Medical Association, for example, argues that the currently limited evidence providing guidelines for physicians to recommend cannabis “meets the standards of rigor desirable for medical treatment decisions.”

“Cannabis and cannabis-derived medications merit further research, and such scientific work will likely yield useful results,” the authors add.

Cannabis advocates have historically argued that the potential for cannabis products to reduce opioid use as part of a broader pro-legalization platform, but a 2023 study of Colorado residents found mixed evidence in support of this idea. 

For context, the state legalized recreational cannabis use in 2014, and has experienced lower opioid-related deaths relative to the national average. The study looked at how the availability of cannabis affects the use of opioids in different counties in Colorado. The results are a bit mixed. On one hand, in places where recreational cannabis became available, there was a noticeable drop in the number of 30-day opioid prescriptions and fewer hospital stays related to opioids. However, there wasn't a significant change in the total amount of opioids used or in emergency room visits related to opioids.

Interestingly, the counties that only started allowing cannabis for recreational use (and didn't have medical cannabis before) saw bigger drops in 30-day opioid prescriptions compared to those that already allowed medical cannabis.

In summary, the study concluded that making cannabis more widely available doesn't consistently lead to less opioid use or fewer opioid-related hospital visits across the board.

The study’s authors state “while cannabis may have therapeutic benefits to patients suffering with particular ailments, it is not the panacea for solving the opioid crisis.”

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