Ex­perts say cannabis can help fight opi­oid epi­demic

The Southern Berks News - - LOCAL NEWS - By Eric Devlin ede­vlin@21st-cen­tu­ry­media.com @Eric_Devlin on Twit­ter

Ed­i­tor’s note: This is the third in a se­ries of sto­ries on med­i­cal cannabis and how its le­gal­iza­tion will im­pact Penn­syl­va­ni­ans.

PITTSBURGH » As the opi­oid epi­demic con­tin­ues to dec­i­mate com­mu­ni­ties here at home and across the coun­try, ex­perts at the first-ever World Med­i­cal Cannabis Con­fer­ence and Expo in Pittsburgh re­cently looked at what role med­i­cal mar­i­juana can play in help­ing to bring it to an end.

The hour-long Opi­oids to Cannabis panel looked at re­cent sta­tis­tics show­ing states that have reg­u­lated med­i­cal cannabis mar­kets see a de­crease not only in opi­oid re­lated over­doses, but the to­tal num­ber sold as well. The panel dis­cussed the rel­e­vant re­search avail­able and fu­ture treat­ment op­por­tu­ni­ties.

In­cluded in the dis­cus­sion were Dr. Matthew Ro­man, founder of Na­ture’s Way Medicine, based in Wilm­ing­ton, Del.; Dr. Thomas Whit­ten, a pain man­age­ment spe­cial­ist based in Greens­burg, Pa.; Kevin Boehnke, a doc­toral can­di­date at the Univer­sity of Michi­gan School of Pub­lic Health in Ann Ar­bor; Kirk Reid, founder of Cap­tain Kirk’s Edi­bles, and Nate Jack­son, a cannabis user and a former NFL tight end, who played most of his ca­reer with the Den­ver Bron­cos. Dr. Bryan Doner, a prac­tic­ing emer­gency physi­cian and CEO and co-founder of Com­pas­sion­ate Cer­ti­fi­ca­tion Centers, a med­i­cal mar­i­juana mar­ket­ing and con­sult­ing com­pany, mod­er­ated the dis­cus­sion.

Re­cent stud­ies into med­i­cal cannabis have found a link be­tween states that le­gal­ized med­i­cal mar­i­juana and a de­creased num­ber of pre­scrip­tions for pain killers. Ac­cord­ing to the Centers for Dis­ease Con­trol, since 1999 opi­oid deaths have quadru­pled and opi­oid abuse has been es­ti­mated to cost over $72 bil­lion in med­i­cal costs alone.

First-hand ac­counts

Doner sees it ev­ery day. “I deal with this type of thing ev­ery day, ev­ery shift,” he said. “From over­doses, to ad­dic­tion, to chronic pain, this is some­thing that’s in­trin­si­cally im­por­tant to me not only pro­fes­sion­ally but per­son­ally.”

Through his work at a detox cen­ter, Whit­ten saw that many pa­tients ad­dicted to opi­ates “were ad­dicted by their doc­tors not treat­ing their pain ap­pro­pri­ately.”

Ro­man has been prac­tic­ing with med­i­cal mar­i­juana now for a few years and said the ma­jor­ity of his pa­tients suf­fer some kind of pain and re­sorted to pain-re­liev­ing nar­cotics.

“Many in heavy doses, and Delaware is es­pe­cially bad for that,” he said. “What I’ve been find­ing is that [med­i­cal mar­i­juana] works. It does so and I know so be­cause their nar­cotics are go­ing down. What they’re get­ting pre­scribed is go­ing down.”

He said cannabis can help pa­tients with­draw from opi­ates and can as­sist with the symp­toms of those try­ing to go cold turkey off of methadone.

Re­li­able re­search

The re­search avail­able on the pos­i­tive ef­fects of med­i­cal mar­i­juana pro­vides strong ev­i­dence that it could play a large role in com­bat­ing the opi­oid epi­demic.

Boehnke has re­searched how cannabis af­fected opi­oids and other med­i­cal use among pa­tients suf­fer­ing from chronic pain. He cited a re­port per­formed by the National Acad­e­mies of Sci­ences, En­gi­neer­ing and Medicine, that shows ev­i­dence that cannabis is ef­fec­tive for the treat­ment of pain in adults.

“That’s one of the few con­di­tions where there’s that body of ev­i­dence in the pub­lished, peer-re­viewed sci­en­tific lit­er­a­ture fo­rum,” he said. “So when it comes to chronic pain there seems to be this clear ev­i­dence that this is ex­tremely use­ful.”

How­ever, be­cause mar­i­juana is clas­si­fied as a Sched­ule 1 drug by the United States Drug En­force­ment Ad­min­is­tra­tion, it’s dif­fi­cult to do stud­ies to prove the drug is an ef­fec­tive re­place­ment to opi­oids for pa­tients suf­fer­ing chronic pain, he said.

“There haven’t been al­most any stud­ies like that that have been done,” Boehnke said. “But there have been a lot of things done at statewide lev­els and in in­di­vid­u­als.”

In 2014, he said, a study pub­lished in JAMA In­ter­nal Medicine found that opi­oid deaths were down by about 25 per­cent in states with med­i­cal cannabis com­pared to those with­out.

“Statewide that’s a pretty sig­nif­i­cant find­ing,” Boehnke said. “That’s a lot fewer deaths.”

Like­wise, he said, hos­pi­tal­iza­tion rates for opi­oid painkiller de­pen­dence and abuse dropped 23 per­cent on av­er­age in states af­ter mar­i­juana was per­mit­ted for medic­i­nal pur­poses and 13 per­cent on av­er­age for opi­oid over­dose hos­pi­tal­iza­tions, ac­cord­ing to a re­port pub­lished in Drug and Al­co­hol De­pen­dence.

“We’re also see­ing that this is eco­nom­i­cally po­ten­tially go­ing to save money as well,” he said.

A re­port pub­lished in Health Af­fairs, shows in states with med­i­cal mar­i­juana laws, doc­tors are pre­scrib­ing about 1,800 few pain killer doses per year, sav­ing on av­er­age about $165 mil­lion among Medi­care Part D en­rollees.

“So this is a sub­stan­tial eco­nomic sav­ing,” Boehnke said.

Boehnke con­ducted his own study in Michi­gan sur­vey­ing pa­tients who went to a med­i­cal cannabis dis­pen­sary with chronic pain. He and his team asked them how their qual­ity of life and med­i­ca­tion use changed.

“We found that they de­creased their opi­oid use by about 64 per­cent,” he said. “At the per­sonal level we’re find­ing that peo­ple are de­creas­ing their use. We found that this was be­cause many of them said they had fewer med­i­ca­tion side ef­fects and they had a bet­ter qual­ity of life.”

Qual­ity of life

Among former opi­oid ad­dicts like Reed and Jack­son, switch­ing to cannabis helped them get off of opi­ates.

Reed, who was di­ag­nosed with mul­ti­ple scle­ro­sis in 2004 and is slowly go­ing blind, ad­mit­ted that he grew up a mis­guided teen and be­came a drug ad­dict.

“There’s not a drug I haven’t tried,” he said.

Af­ter his di­ag­no­sis, he would com­plain enough that hos­pi­tals would “hand me pills like cot­ton candy.”

Dur­ing one MS at­tack, a lo­cal mar­i­juana com­pas­sion club gave him a mar­i­juana muf­fin to help ease the pain. The hos­pi­tal called him a drug seeker be­cause he had THC in his sys­tem and kicked him out af­ter his health in­sur­ance pol­icy ran out.

“No­body would do any­thing for me be­cause I had THC in my sys­tem,” he said.

He was able to slowly ween off most of his med­i­ca­tions thanks to cannabis, he said. While it’s not a cure-all, he’s been able to man­age his pain and found a suc­cess­ful busi­ness sell­ing mar­i­juana edi­bles.

Jack­son used cannabis in high school and col­lege and found it more use­ful for pain man­age­ment than pills and he healed faster, he said. He de­scribed the NFL as “pill city” with many of his team­mates ad­dicted to pills.

“I never be­came ad­dicted, I didn’t like them,” he said. “I had with­drawal symp­toms. I used cannabis and was able to move on.”

While cannabis alone may not be the panacea to end the opi­oid epi­demic, Boehnke and oth­ers said it needs to be part of the con­ver­sa­tion. “It’s a tool in the tool box.”

“What I’ve been find­ing is that (med­i­cal mar­i­juana) works. It does so and I know so be­cause their nar­cotics are go­ing down. What they’re get­ting pre­scribed is go­ing down.” — Dr. Matthew Ro­man, founder of Na­ture’s Way Medicine

The Opi­oid to Cannabis panel at the first-ever World Med­i­cal Cannabis Con­fer­ence and Expo in Pittsburgh re­cently looked at what role med­i­cal mar­i­juana can play in help­ing to bring it to an end.

Nate Jack­son, a cannabis user and a former NFL tight end; Kevin Boehnke, a doc­toral can­di­date at the Univer­sity of Michi­gan School of Pub­lic Health in Ann Ar­bor; and Kirk Reed, founder of Cap­tain Kirk’s Edi­bles, par­tic­i­pated in the Opi­oid to Cannabis panel at the first-ever World Med­i­cal Cannabis Con­fer­ence and Expo in Pittsburgh re­cently.

PHO­TOS BY ERIC DEVLIN — DIG­I­TAL FIRST ME­DIA

Dr. Matthew Ro­man, founder of Na­ture’s Way Medicine, based in Wilm­ing­ton, Del., said the ma­jor­ity of his pa­tients that use med­i­cal mar­i­juana are able to slowly lower their pre­scrip­tion opi­oid dosage.

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