In an article from earlier this year, the New York Times estimated1 the number of Americans who lost their lives to overdose in 2016 rose nearly 19% over 2015. Between 59,000 and 65,000 people lost their lives to drugs, with a majority due to prescription medications, and many due to legally prescribed opioid pain killers. With these death statistics climbing so rapidly in the United States, it leaves little question as to why pain patients are frantically searching for alternative treatment options.
Cannabis to the Rescue?
Recently, results of an online survey published in the Journal of Cannabis and Cannabinoid Research2 show patients with chronic pain or other pain-related conditions such as fibromyalgia, back pain, and arthritis are finding relief from their symptoms by using cannabis and taking less pain medication than they would without cannabis.
Of almost 3000 survey respondents, nearly 63 percent stated they use marijuana to help ease symptoms of pain or other pain conditions. 30 percent of respondents were currently using or had used an opiate-based pain medication in the last six months, with an astounding 97 percent claiming cannabis helps reduce the number of opiates they take. Ninety-two percent said they prefer using cannabis to opiates, and 93 percent said with better access, they’d choose cannabis over opiates.
User surveys are not the only source for convincing evidence of patients’ preference for medical marijuana. One study published in Journal of the American Medical Association: Internal Medicine3 back in 2014 showed states with legal marijuana had seen a 25 percent decline in the number of opiate-related overdoses. Another, more recent survey, published in 2016 in the journal of Health Affairs4 shows that doctors in legal cannabis states wrote an average of 1,800 fewer doses of prescription pain medications than their counterparts in non-legal states.
Opiates Have Serious Side Effects
Although the fear of overdose is certainly a valid reason for seeking alternatives, many patients report other serious side effects and complications of both short-term and long-term opiate use.
At onset, opiates create a feeling of euphoria, pain relief, drowsiness, and sedation because of the flood of dopamine they cause. The extreme highs that these powerful opiates generate cause them to become extremely addictive. DrugAbuse.com states5, “Because of the intense high produced by the interaction of several opiates and the brain, the drugs remain extremely addictive, sometimes causing measurable symptoms of addiction in under three days.”
The National Safety Council6 recently published their findings in a twelve-page white paper concerning the safety of opioid medications in general which listed out many of the side effects of the drugs. It also called on prescribing physicians and dentists to stop prescribing these medications. Some side effects they warned of:
- Gastrointestinal Issues: Severe constipation, nausea and vomiting, and intestinal bleeding are all common side effects of opioids.
- Impaired Recovery: Opioids have been found to delay recovery and increase the risk of permanent disability.
- Respiratory Depression: Simply stated, opioids can slow or stop the lungs from functioning, causing users to suffocate.
- Endocrine Changes: Causing loss of libido, infertility, fatigue, depression, anxiety, and other sexual dysfunction.
- Increased Pain: Ironically, long-term use can cause increased sensitivity to pain.
- Changes to the Brain: Chronic opioid use has been shown to cause permanent changes to critical brain mass.
- Withdrawal: Symptoms include extreme muscle pain, chills, sweats, anxiety, increased pain, rapid heartbeat, diarrhea, and nausea.
- Death: More than 20,000 Americans died7 as a direct result of prescription opiates in 2015.
Cannabis Has Minimal Side Effects
It would be false to say cannabis doesn’t come with its own set of side effects; however, in comparison to the list above, it is easy to understand why patients would want to seek out an alternative. Cannabis does produce adverse side effects for some users, but not all patients will experience the same effects because everyone’s endocannabinoid system and biochemistry are different — much like a fingerprint — so how cannabis affects each patient is individual to them.
Minor side effects: dry mouth, dry eyes, and increased appetite.
Moderate side effects: short-term memory impairment, change in time perception, cloudiness, lack of coordination, enhanced sensory perception (brighter lights, louder sounds, stronger smells)
Serious side effects: increased heart rate, anxiety, paranoia, increased lung problems in smokers, addiction (however, marijuana is the least addictive drug on the market), and an increased risk of psychosis, in rare cases.
Most importantly, one side effect never listed with cannabis: Death. There has never been a single recorded case of a fatal cannabis overdose.
Though not inconsequential, many of these side effects can be prevented through proper dosing, new product formulations, and education. As an example, many users have had experiences where cannabis has caused anxiety. However, several studies have shown that cannabis products that are high in CBD can actually relieve anxiety.
As further research is conducted and the anecdotal stories of millions of legal consumers are spread, a different image of marijuana is starting to come to light. Through an understanding of the science behind cannabinoids, consumers are starting to learn that different strains have distinct cannabinoid profiles and create different effects. Through education, tailoring a specific outcome or preventing a particular side effect can be easily achieved through minor adjustments. Examples include increasing the CBD ratio to negate the psychoactive effects of THC, or changing from a sativa strain (which is more cerebral and can cause anxiety), to an indica strain (which is better known for relaxation and calming effects).
In an era when so many people are suffering from the effects of such devastating diseases as chronic pain, fibromyalgia, multiple sclerosis, and many other debilitating conditions, it seems almost inhumane to force people to also live with serious complications from the medicines that are supposed to help them. Compassion tells us there is room for both solutions.
References:
1 Katz, Josh. Drug Deaths in America Are Rising Faster Than Ever. New York Times. June 5, 2017.
2 Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report. Reiman, Amanda, Welty, Mark and Solomon, Perry. June 1, 2017, Cannabis and Cannabinoid Research.
3 Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010. Marcus A. Bachhuber, MD, et al. October 2014, JAMA: Internal Medicine.
4 Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D. Bradford, Ashley and Bradford, W. David. July 2016, Health Affairs, Vol. 35, pp. 1230-1236.
5 DrugAbuse.com. The Effects of Opiate Use. DrugAbuse.com. [Online] http://drugabuse.com/library/the-effects-of-opiate-use/.
6 Teeter, Donald MD. The Psychological and Physical Side Effects of Pain Medications. National Safety Council. [Online] http://www.nsc.org/RxDrugOverdoseDocuments/900006497-ADV-Rx-Side-Effects-WhitePaper.pdf.
7 American Society of Addiction Medicine. Opioid Addiction 2016 Facts and Figures. American Society of Addiction Medcine. [Online] 2016. https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf.