The drugs that killed nearly 14,000 people in 2006 are, of course, legal medicines. They have been approved for sale by the same federal government that bars medical use of marijuana – for which the count of medically confirmed overdose fatalities remains zero.

This gets even crazier when you consider that – as we’ve pointed out before – there is evidence that use of medical marijuana can help some pain patients reduce their doses of these dangerous and addictive narcotics.

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Okay, let me say right up front that a) I know that headline is provocative, and b) neither I nor anyone can answer the question with any certainty given what we know and don’t know so far about Michael Jackson’s death. But the question needs to be asked.

It needs to be asked because suspicions that prescription painkillers may have been involved in Jackson’s death are strong enough that the federal Drug Enforcement Administration has been brought into the investigation. And we know that he had a documented history of battling pain and at least some acknowledged problems with prescription painkillers.

We don’t know yet what pain drugs Jackson was on or what they were prescribed for. But if he was addicted to prescription painkillers, that addiction almost certainly started with legitimate and needed treatment for real pain. And that’s where medical marijuana might have helped.

We know — repeat, we know — that marijuana can be effective against certain types of pain. As The Lancet Neurology put it a few years ago, “cannabinoids inhibit pain in virtually every experimental pain paradigm.” We know that human clinical trials such as this one have found marijuana to be effective, particularly for neuropathic pain.

And there is considerable evidence that marijuana and cannabinoids can act synergistically with opioid painkillers, providing better pain relief at lower doses than either class of drugs by itself. For example animal studies such as this one have reported that such combination therapy avoids the development of tolerance and allows effective relief with lowered opioid doses — avoiding the pattern of escalating doses that can lead to addiction and overdose risk.

And there is evidence that this same effect occurs in people. For example, in a series of cases reported in the Journal of Pain and Symptom Management (which, alas, you can only access by paying for it — sorry!), patients on morphine and other narcotics were able to cut their doses roughly in half when smoked marijuana was added to their regimen.

At MPP, we hear similar stories from patients all the time: Again and again, patients tell us that use of medical marijuana allows them to cut back or eliminate the heavy doses of narcotic painkillers they’d been taking, while obtaining equal or better relief. There is enough science corroborating these accounts that they deserve to be taken seriously.

We can’t yet say that medical marijuana could have saved Michael Jackson, and we may never know that for sure. But there is simply no reasonable doubt that marijuana can help some chronic pain patients reduce both their suffering and their consumption of addictive and potentially deadly narcotics. If the U.S. government acknowledged that reality instead of denying it, lives could be saved — maybe lots of them.

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