In Ohio, where the opioid crisis continues to devastate families, could medical cannabis provide a safer, more humane tool for battling addiction than the current options? For decades, cannabis has been labeled a “gateway drug,” accused of leading people into harder substance use. But as research and anecdotal evidence accumulate, a much different story is emerging: cannabis can be an “exit drug” — a plant-based alternative that helps people step away from opioids, alcohol, and other substances.
To understand why this shift matters, we must also confront the shortcomings of the for-profit recovery model that has dominated addiction treatment for years.
The myth of the gateway: War on Drugs
Harkening back to the failed D.A.R.E. program of the 1980s, the “gateway drug” narrative has been widely debunked in recent years. While many people do try cannabis before other substances, evidence shows that most do not go on to use “harder” drugs. Instead, studies show that medical cannabis patients often reduce their reliance on prescription opioids, benzodiazepines, and even alcohol after beginning cannabis therapy.
A 2014 JAMA Internal Medicine study found lower opioid overdose mortality in states with medical cannabis programs, and subsequent patient surveys across the U.S. — including Ohio — confirm that patients turn to cannabis as a direct substitute for pharmaceuticals. We’ve documented dozens of these stories on MedicateOH.com.
The limits of pharmaceuticals
Mainstream addiction treatment in the U.S. often promotes pharmaceutical “solutions” like methadone or buprenorphine. While these medications may reduce immediate overdose risk, they come with significant drawbacks:
- Patients can develop lifelong dependence on replacement drugs.
- Programs are tightly regulated, requiring daily clinic visits in some cases.
- Many patients report side effects and stigma that make recovery harder, not easier.
Over the past two decades, addiction treatment has become a multibillion-dollar industry, driven not merely by public health concern but by private capital, insurance billing, and expectations of return on investment. While some programs deliver genuine care, systemic incentives often reward volume over quality, billing over results, and recruitment over rehabilitation.
Critics and investigative journalism have documented numerous ways in which for-profit and semi-commercial treatment programs exploit vulnerable people:
- Patient brokering / referral kickbacks: Some treatment centers pay so-called “brokers” or “navigators” to refer patients — often by misleading them or exaggerating claims. These brokers may be compensated per admission (a per-head model) rather than per health outcome. (Recovery Research Institute)
- Billing for services not rendered or unnecessary treatments: Reports describe centers billing Medicaid or insurers for services that were never delivered, were not medically necessary, or had insufficient documentation. (ACFE)
- Lavish marketing and misleading promises: Some facilities advertise “luxury rehab” or guaranteed success, using emotionally manipulative messaging to draw in people desperate for relief. (New Jersey Monitor)
- Neglect, underqualified staff, and dangerous environments: In pursuit of profit, staff-to-client ratios are low, licensure is lax, and oversight is minimal. Some programs rely heavily on peer counseling rather than professional clinical care. (NJ.gov)
- Insurance fraud, kickback schemes, and illegal billing: At the federal level, many rehab operators have been indicted and convicted for large-scale fraud, submitting false claims and paying kickbacks. (Department of Justice)
In short, the addiction industry is vulnerable to the same corrupting incentives as any profit-driven health business — especially in an area with weak regulatory oversight and highly vulnerable clients.
The business of addiction
The addiction-treatment industry in the U.S. is worth tens of billions of dollars annually. Large for-profit recovery chains, luxury rehab centers, and pharmaceutical-backed treatment models routinely prioritize revenue over outcomes. Examples abound:
- Florida’s “rehab Riviera”: In the 2010s, unscrupulous sober-living operators lured patients with promises of recovery while billing insurance for unnecessary tests and ineffective care. Many patients relapsed or overdosed while companies profited.
- Ohio’s rehab expansion: As the opioid crisis deepened, new for-profit recovery centers opened rapidly, some charging families exorbitant fees or overbilling Medicaid while providing minimal therapy. Investigations have revealed cases of patient neglect and financial exploitation.
- Pharmaceutical profiteering: The very companies that helped fuel the opioid crisis now profit from selling addiction medications, creating a perverse cycle where corporations benefit at both ends of the epidemic.
This profit-driven model often leaves patients disempowered and families bankrupt, while community-based, non-profit, or plant-based approaches remain underfunded and under-recognized.
How these abuses harm individuals & society
The fraudulent behaviors in the for-profit recovery model inflict concrete harm to the individuals they are “trying to help”:
- Broken trust: Patients enter treatment when most vulnerable. When programs mislead or harm them, it deepens skepticism and damages the credibility of genuine recovery services.
- Resource diversion: Public funds, Medicaid dollars, and philanthropic grants meant for care get siphoned into corporate profits or fraud.
- Poor outcomes: Programs motivated by billing may prioritize enrollment over sustained recovery, neglect aftercare, relapse prevention, or co-occurring mental health support.
- Barrier to innovation: When large, profitable models dominate, less conventional or lower-cost approaches (like cannabis-based substitution) struggle to receive funding or legitimacy.
- Regulatory and oversight strain: Fraud spawns more rules, audits, and red tape — which can discourage nimble, patient-centered alternatives.
In effect, the profit-driven system often perpetuates cycles of dependency, mistrust, and institutional failure, rather than genuinely helping people heal.
Ohio’s reality
The current dispensing rate of 40.7 per 100 people reflects an overall downward trend in opioid prescribing in Ohio. However, it is important to note that a significant portion of Ohio’s fatal overdoses now involve illicit synthetic opioids like fentanyl, not prescription opioids.
At the same time, active medical cannabis patient numbers dropped from 165,746 in May 2024 to 94,294 in July 2025, a decrease of 43%. Of those patients, reports to their MMJ doctors and budtenders show they are successfully using cannabis to taper off or eliminate opioids, avoid relapse, and improve quality of life. So why are they dropping out of the program?
These Ohioans often share a common frustration: traditional treatment paths are either unaffordable or unhelpful, while cannabis — accessible, safe, and holistic — provides real relief. Yet federal law and insurance policies make it difficult to access cannabis as a recognized treatment, pushing patients back into the arms of the very for-profit recovery system that has failed them.
Get Your Ohio MMJ card: altrxmed.com
Toward a new paradigm
In Ohio, patients struggling with opioid dependency often find themselves caught between two unsatisfying options: pharmaceutical maintenance that keeps them tethered to the system, or abstinence-only programs that fail to address chronic pain or trauma. Cannabis offers a third path — one that allows autonomy, symptom relief, and dignity.
The future of recovery must break free from the cycle of pharmaceutical dependence and corporate exploitation. Cannabis-inclusive recovery offers a model that is:
- Non-lethal: No recorded cases of fatal cannabis overdose.
- Patient-centered: Individuals can choose strains, formats, and dosing that meet their needs.
- Cost-effective: Often far less expensive than long-term pharmaceutical maintenance or residential rehab.
- Holistic: Relief for pain, anxiety, insomnia, and PTSD — underlying issues that drive substance misuse.
Emerging evidence of cannabis’s potential for use in decreasing the effects of opiate withdrawal has been available since at least 2018, and yet still no centers exist in Ohio that support patients who want cannabis-aided recovery from other drugs.
Dr. Mark Hurst of the Ohio Department of Mental Health and Addiction Services told the Cincinnati Enquirer many years ago during legislative arguments regarding legalization: “There is no scientific evidence that marijuana is an effective treatment for opioid addiction.” The medical director of the Employee Health Services at the Cleveland Clinic Paul Terpeluk echoed Hurst’s sentiments of the lack of multiple studies that show direct benefits.
But proponents of medical cannabis have heard these arguments before and aren’t having any of it. Paul Armentano of NORML said: “At this point, the data is clear, consistent, and convincing. When legal access to marijuana is available, you will see decline in abuse of and death from opioids. To deny that reality at this point is to deny gravity.”
And Paul must have had a crystal ball because opioid and overall drug overdose deaths have indeed declined significantly in Ohio since their peak in 2021. The state saw its highest number of overdose deaths ever recorded in 2020 and 2021 before reporting consecutive decreases in 2022, 2023, and 2024. Could cannabis have played a role? Could it play a bigger one?
Join Us in Columbus for “Cannabis as and Exit Drug” Saturday, Oct 18th
We invite you to join us as we deepen the conversation at our MedicateOH event on October 18, 2025: “Cannabis as an Exit Drug.” At the gathering we’ll:
- Share Ohio-specific data and personal testimony
- Highlight evidence of substitution
- Contrast the harms of the traditional recovery industry
- Discuss policy strategies, regulatory challenges, and community-based reform
Register for the free program here: https://medicateoh.com/10-18-25-cannabis-as-an-exit-drug/
Can’t make it? Catch it on YouTube.
If your cannabis company would like to sponsor this program, please email us.
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