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Medical Marijuana

Story at-a-glance -

  • In states where medical marijuana is legal, overdose deaths from opioids like morphine, oxycodone, and heroin decreased by an average of 20 percent after one year, 25 percent after two years and up to 33 percent by years five and six
  • While prescription painkillers were responsible for 16,600 deaths in 2010, one study found “little, if any effect of marijuana use on… mortality in men and… women”
  • There is a wealth of research linking marijuana with pain relief; in one study, just three puffs of marijuana a day for five days helped those with chronic nerve pain to relieve pain and sleep better
  • Marijuana is classified as a Schedule 1 controlled substance and labeled as a drug with a "high potential for abuse" and "no accepted medical use," which clearly is not an accurate description
  • Oxycodone, fentanyl, and meperidine (Demerol), which are among the most commonly abused opioids and leading causes of opioid overdose deaths, are Schedule II drugs, meaning they should technically be less dangerous than marijuana, which is not the case
 

Prescription Painkiller Deaths Fall in Medical Marijuana States

September 10, 2014 | 67,767 views

By Dr. Mercola

A new study found that deaths from opioid overdoses have fallen sharply in the 23 US states where medical marijuana is now legal. Coincidence? Not likely.

For those with chronic pain, medical marijuana can be life changing, allowing a safer, natural form of treatment than the conventionally recommended pain-relieving drugs called opioids.

There is a wealth of research linking marijuana with pain relief. In one study, just three puffs of marijuana a day for five days helped those with chronic nerve pain to relieve pain and sleep better.1

Meanwhile, deaths from prescription opioid overdoses are skyrocketing with little sign of stopping… except in areas where people in pain have access to marijuana instead.

Medical Marijuana States See Significant Drop in Opioid Deaths

In states where medical marijuana is legal, overdose deaths from opioids like morphine, oxycodone, and heroin decreased by an average of 20 percent after one year, 25 percent after two years and up to 33 percent by years five and six.2 As the researchers explained:3

"Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates. Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain.

Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them…"

According to 2010 data, there were enough narcotic painkillers being prescribed in the US to medicate every single adult, around the clock, for a month.4 By 2012, a whopping 259 million prescriptions for opioids and other narcotic painkillers were written in the US, 5 which equates to 82.5 prescriptions for every 100 Americans. And those narcotics are responsible for 46 deaths each and every day...

While critics of medical marijuana (which, by the way, are in the minority, as 85-95 percent of Americans are in favor of medical cannabis, and 58-59 percent are in favor of legalizing marijuana) point out its risks, they pale in comparison to those of opioids. While some do become addicted, or at least dependent, on marijuana, it is far less addictive than prescription opioids.

Many people find themselves addicted to painkillers before they even realize what's happened, often after taking the drugs to recover from surgery or treat chronic back, or other, pain.

The drugs work by binding to receptors in your brain to decrease the perception of pain. But they also create a temporary feeling of euphoria, followed by dysphoria, which can easily lead to physical dependence and addiction.

This may drive some people to take larger doses in order to regain the euphoric effect, or escape the unhappiness caused by withdrawal. Others find they need to continue taking the drugs not only to reduce withdrawal symptoms but to simply feel normal. Large doses of the painkillers can cause sedation and slowed breathing to the point that breathing stops altogether, resulting in death.

Marijuana is also said to be a "gateway" drug for more dangerous drugs like heroin, which is ironic since opioids – not marijuana – are chemically similar to heroin, and virtually indistinguishable as far as your brain is concerned. And, prescription painkillers – not marijuana – have recently been tagged as gateway drugs to heroin

Why Was Marijuana Declared a Schedule 1 Substance in the First Place?

Marijuana was a popular botanical medicine in the 19th and early 20th centuries, common in US pharmacies of the time. By the mid-1930s, cannabis was regulated as a drug in every state.

In 1970, the Controlled Substance Act was enacted and changed its classification to a Schedule 1 controlled substance. This act labeled cannabis as a drug with a "high potential for abuse" and "no accepted medical use," which clearly is not an accurate description.

Other Schedule 1 drugs include heroin, LSD, Ecstasy, methaqualone, and peyote. In 1973, the Drug Enforcement Agency (DEA) was formed to enforce the newly created drug schedules, and the fight against marijuana use began.

Even in states where medical marijuana use is legal, such as California, the DEA has raided medical marijuana suppliers and even arrested patients, because on a federal level, possessing or distributing marijuana is still considered a criminal offense.

Oxycodone, fentanyl, and meperidine (Demerol), which are among the most commonly abused opioids and leading causes of opioid overdose deaths, are Schedule II drugs, meaning they should technically be less dangerous than marijuana, a notion that is easily dismissed.

While prescription painkillers were responsible for 16,600 deaths in 2010, one study found "little, if any effect of marijuana use on… mortality in men and… women."6 Meanwhile, until recently certain opioid prescription drugs such as Vicodin were classified as Schedule III substances, which are defined as "drugs with a moderate to low potential for physical and psychological dependence."

The US Food and Drug Administration (FDA) only recently recommended tighter controls on painkiller prescriptions, and has announced its intention to reclassify hydrocodone-containing painkillers from Schedule III to Schedule II drugs. The reclassification will affect how hydrocodone-containing drugs can be prescribed and refilled.

Doctors will only be allowed to prescribe a 90-day supply of the drug per prescription, and they will no longer be permitted to phone in refills. Rather, the patient has to bring the prescription with them to the pharmacy. The new regulations are expected to take effect sometime this year.

Ironically enough, while talking about the need for stricter controls and less addictive painkillers, the FDA recently approved the first drug containing pure hydrocodone for the US market, called Zohydro ER (Zogenix). All other hydrocodone-containing painkillers on the market are mixed with other non-addictive ingredients.

Marijuana Treatment Is Likely Far Safer Than Heroin/Opioid-Based Drugs

There's no doubt that marijuana needs to be rescheduled, and Dr. Allan Frankel, a board-certified internist in California who has treated patients with medical cannabis for the past seven years, actually thinks marijuana should be de-scheduled altogether, as a plant really does not belong on any schedule of a controlled substance.

The federal government, meanwhile, wants to get rid of all medical use of marijuana, which of course begs the question: Why? According to Dr. Frankel, the answer is simple. "They want it. This is a huge market," he says. And yes, medical cannabis is clearly competition to the pharmaceutical industry, as the cannabis plant can take the place of a wide variety of synthetic drugs, especially for mood and anxiety disorders. The last thing they want is a therapy that's going to take away from their bottom line.

Certain forms of cannabis are very potent medicine, with few or no psychoactive effects, courtesy of high amounts (about 10-20 percent) of cannabidiol (CBD), critical levels of medicinal terpenes, and flavonoids, as well as tetrahydrocannabinol (THC) in varying ratios for various diseases (the higher the THC, the more pronounced its psychoactive effects). In his medical practice, Dr. Frankel treats a wide variety of patients with medical cannabis, which has become his specialty.

Despite the many claims of cannabis performing miracles, he's reluctant to think of it as a cure for anything. Occasionally, however, patients will experience very dramatic results. For example, he has seen tumors virtually disappear in some patients using no other therapy except taking 40 to 60 milligrams of cannabinoids a day. The most common thing he sees in cancer patients, however, are tumors shrinking, or a metastasis disappearing. Sometimes tumors will shrink or vanish, only to reemerge in other areas, months later, and then shrink or vanish again... Other common ailments being treated with cannabis include:

Mood disorders Pain disorders Degenerative neurological disorders such as dystonia
Multiple sclerosis Parkinson's disease PTSD
Seizure Disorders

Focus of Marijuana Debate Should Be on Developing Dose-Consistent Medicine

Dr. Frankel is very focused on trying to develop accurate dose-consistent medicine. The Patient Access Centers he consults with create a diverse collection of dose-consistent oral-buccal sprays. He also believes it's very important to open up and start talking about dosing—what works, what doesn't. It is his belief that some patients, in large part due to lack of education about the medicine, may be taking 10, or even 100 times, higher dosage than is really needed to treat their ailment. Unfortunately, many doctors in this still highly controversial field are afraid to recommend dosages, for fear of the repercussions.

"There's this false notion (I think I can very safely say it's false) that doctors cannot recommend dosage because of this federal [law against] aiding and abetting with cannabis. It's not true. It's just not true," he says. "There are no [cannabis] medications that we dose by body weight. We now have about 120 kids with seizure disorder, and if you look at the surveys, across the board, the average dose is 37 milligrams [of whole-plant CBD] per day, and there's no relationship with body size."

As far as what is known, when marijuana is inhaled, smoked, or vaporized, its effects are rapid and short lasting. Orally, it's the most unpredictable and delayed. When ingesting it, it can take up to two hours to take effect, but if dosed appropriately, you can achieve once-a-day dosing with an edible medicine. When smoked, as little as 10 mg of CBD acts as a major appetite suppressor. CBD is also an excellent painkiller, particularly for tooth pain when the cannabis oil is applied sublingually or directly onto the tooth. Cannabis oil can also help heal sunburn overnight. CBD is also very effective for anxiety disorders.

Just a couple of milligrams of whole-plant CBD can effectively subdue anxiety without causing any kind of mental deficiency or high. In fact, to determine how much THC in an oral dose would be required to get high, they made liquid edibles with 5mg, 10mg, and 20mg of THC. The lowest dose, 5mg, did not produce a high. The upper two—10 and 20 mg—did. Taking 50-100 mg of oral THC could get you into serious trouble. Paranoia is the most common side effect. Overdosing can also produce nausea and vomiting.

Beware of Synthetic Marijuana

As recently reported by Forbes, "the demand for a 'legal high' has been so great in recent history that it's set the stage for the synthetic market to take off."7 Unfortunately, the synthetic version of marijuana is nothing like its natural counterpart, and aside from offering no medicinal properties can be deadly. Whereas a person using marijuana tends to be "interactive, mellow, and funny," people using synthetic marijuana tend to be "angry, sweaty, and agitated."

With synthetic marijuana, there is no end to the potentially deadly combinations of laboratory-fabricated chemicals. Various versions are being imported, mostly from Asia, under the guise of potpourri, herbal incense, and even "plant food." The rate at which poisonings are escalating argues in favor of the legalization of marijuana. Unlike natural marijuana, synthetic marijuana can cause a number of severe symptoms, including:

Hallucination TremorSeizure
TachycardiaChest painCardiac problems
StrokeKidney problemsAcute psychosis
Brain damageDeathHypokalemia

According to a Time Magazine feature, synthetic marijuana is now the second most popular drug among teens and young adults, behind pot itself.8 Most people don't realize how dangerous synthetic marijuana can be. The synthetic powder is mixed in a lab and shipped to the US, where retailers spray it onto a leaf—often an herb or a spice—that can be smoked, just like pot. It binds to cannabis receptors in your body up to 1,000 times more strongly than real marijuana, as well as producing gripping effects on serotonin and other receptors in your brain. You can't overdose on real pot, but you CAN overdose on synthetic versions—and it doesn't take very much.

Earlier this year, more than 100 people were treated in Louisiana emergency rooms after smoking synthetic cannabis products, many suffering life-threatening reactions—so many that the state of Louisiana recently banned the sale and use of eight of them.9 Colorado has experienced a similar escalation in ER visits.10 There are several reasons why synthetic marijuana is far more dangerous than the natural plant, which were recently summed up by Forbes:11

  • It's much more efficient at binding and acting in your brain, so it takes much less to produce maximal, sometimes life-threatening, effects
  • It's capable of going to lots of different areas in your brain, which is why it can cause so many different effects, from memory problems to seizures, cardiac, respiratory and gastrointestinal effects, and psychosis
  • Your body doesn't know how to deactivate synthetic marijuana, allowing its effects to persist
  • It lacks cannabidiol, which is present in natural marijuana and helps to blunt some of THC's adverse effects
  • It's produced in underground labs, so there's no way to know what you're actually getting

Are You in Pain? Weighing Your Options for Relief

If you're in pain, especially if it's severe, I realize that you may be desperate for relief. Prescription painkillers do have their place in medicine, especially for short-term relief of severe pain (such as after surgery or serious injury). In certain cases, such drugs can be a great benefit when used cautiously and correctly with appropriate medical supervision. However, it's also quite clear that these drugs are being overprescribed, and can easily lead you into addiction and other, more illicit, drug use.

I strongly suspect that the overreliance on them as a first line of defense for pain is a major part of this problem. So if you are struggling with severe or chronic pain, my first suggestion would be to see a pain specialist who is familiar with alternative treatments and the underlying causes of pain. Ideally, it is best to find a knowledgeable practitioner who can help you attack the pain from multiple angles, giving you both relief and healing. As mentioned, CBD in marijuana is an excellent painkiller and has been used successfully to treat a variety of pain disorders. If your pain is severe enough, it might even be worth moving to one of the many states where medical cannabis is legal, as it can be a real life changer.

In states where medicinal marijuana is legal, such as California, Washington, or Colorado, you can join a collective, which is a legal entity consisting of a group of patients that can grow and share cannabis medicines with each other. By signing up as a member, you gain the right to grow and share your medicine. I do, however, still recommend working with a health care practitioner who can guide you on the most effective dosage and form of use.

That being said, even with this natural plant, there are potential downsides that need to be addressed (and particularly if you are thinking of smoking it for recreational purposes). Marijuana use can be addicting, and no doubt families have been broken up and jobs lost over its use, just as they have been with opioid addiction. In the short-term, marijuana use can cause trouble with your ability to think clearly and may impair short-term memory.

Marijuana also leads to motor skill impairment and affects alertness, coordination, and reaction time, which is why it should never be used prior to driving. There is also some evidence that marijuana use can exacerbate psychotic symptoms in those with schizophrenia or other psychotic disorders. Finally, if you are in pain that is bearable, please try these 19 non-drug alternatives for the treatment of pain first, before resorting to prescription painkillers of any kind. These options may even be used in addition to such drugs, and may allow you to at least reduce your dosage.

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