Thursday, February 2, 2017
The title of this post is the headline of this notable new Atlantic article, and here are excerpts:
James Feeney, a surgeon in Connecticut, heard it from his patients. A few actually turned down his prescription for oxycodone, the popular opioid painkiller that has also gained notoriety with the opioid epidemic. His patients, Feeney recalls, would say, “Listen, don’t give me any of that oxycodone garbage. … I’m just going to smoke weed.”
“And you know what?” says Feeney. “Every single one of those patients doesn’t have a lot of pain, and they do pretty well.” Marijuana has worked well enough, anecdotally at least, that Feeney is following his patients’ lead and conducting a trial at Saint Francis Hospital and Medical Center in Hartford, CT. The state-funded study will compare opioids and medical marijuana for treating acute pain, such as that from a broken rib.
That distinction — acute pain from an injury — is also an important one. A small body of evidence suggests that medical marijuana is effective for chronic pain, which persists even after an injury should have healed and for which opioids are already not a great treatment. But now Feeney wants to try medical marijuana for acute pain, where opioids have long been a go-to drug.
“The big focus from my standpoint is that this is an attempt to end the opioid epidemic,” he says. Overdoses from opioids, which includes heroin as well as prescription painkillers like oxycodone and morphine, killed more than 30,000 people in 2015.
Marijuana might have a bigger role in curbing this drug abuse than previously thought. Its potential uses are actually threefold: to treat chronic pain, to treat acute pain, and to alleviate the cravings from opioid withdrawal. And it has the advantages of being much less dangerous and addictive than opioids.... Yasmin Hurd, a neuroscientist at Mount Sinai who has a license to study marijuana and its derivatives...in a small pilot study ... has found that cannabidiol can reduce the cravings of people addicted to heroin. “They relapse because they are in conditions that induce craving,” says Hurd. By controlling their anxiety, cannabidiol also seems to be controlling their cravings.
Hurd is now running a larger trial to investigate if the substance could help people addicted to heroin, and she published a recent review on cannabidiol’s role in curbing substance abuse....
Interestingly, patients already seem to be replacing opioids with marijuana for chronic pain. A handful of observational studies have also found correlations between states legalizing medical marijuana and a drop in painkiller prescriptions, opioid use, and deaths from opioid overdose. And in 2016, Dan Clauw and his colleagues published a survey of patients with chronic pain who started patronizing a medical marijuana dispensary. They cut their previous opioid use by two-thirds....
Clauw, who runs a pain lab at University of Michigan, says he would to like understand how marijuana quells pain on a molecular level, but getting the license has proved too big a hurdle.
Meanwhile, Feeney’s hospital trial for acute pain is able to get around the logistics issue of marijuana as a scheduled substance. Medical marijuana is legal in the state of Connecticut, but neither Feeney nor his hospital provides it directly to patients. Rather, a doctor certifies a patient to use marijuana, and the patient then picks it up at a dispensary or pharmacy. “The strains I have to select from are so pure and so potent that the stuff they get from the University of Mississippi pales in comparison,” says Feeney.
The trial, which was just got started, will enroll 60 patients with rib injuries in total—30 on marijuana, 30 on opioids. The doctors chose rib injuries to study because the pain lasts a predictable six weeks. Because of the study’s design, patients get to choose whether they use opioids and marijuana to control pain. So far, the hospitals has enrolled a handful of patients. They’ve all chosen marijuana.
Some prior related posts:
- Given latest opioid death data, should Ohio officials be fast-tracking access to medical marijuana?
- "The Case for Pot in the Age of Opioids: Legalizing medical marijuana could save lives that may otherwise be lost to opioid addiction."
- "Can medical marijuana be used to treat heroin addiction?"
- "Elizabeth Warren Urges CDC To Consider Cannabis To Solve Opioid Epidemic"
- Yet another study suggests link between medical marijuana availability and decreased opioid use
- "Could medical marijuana solve Ohio's opioid problem?"
- "Legalize marijuana and reduce deaths from drug abuse"
- "Obama’s Opioid Offensive Again Ignores the Cannabis Solution"