3. The Need for Cannabis Clinical Trials
We need clinical trials to determine the impact cannabis-based medicine can have on opioid addiction. Of course, cannabis is a class 1 controlled substance – so people addicted to opioids will have to wait for clinical trials to answer research questions that could change their lives.
Does cannabis-based medicine, when added to an opioid pain management regimen, significantly:1. Reduce opioid use.2. Reduce opioid overdoses and deaths.3. Improve Quality of Life (QoL).4. Decrease cost to society.
The Multidisciplinary Association for Psychedelic Studies Foundation (MAPS) have paved the way for studying an "illicit drug" with properties proving effective in treating PTSD. MAPS is now doing FDA approved clinical trials and will soon be able to answer the research question: does MDMA improve symptoms of PTSD.
Cannabis and MDMA (aka Ecstasy) were both on the radar screen of researchers - but took a detour in the 60's. So there is an understandable social concern when considering illicit drugs as medications. But medications are simply defined as “substances used for medical treatment.” Rick, Ismail, Leslie and Team are proving that MAPS persistence and patience pays off. They are inspirational.
Does cannabis-based medicine, when added to an opioid pain management regimen, significantly:1. Reduce opioid use.2. Reduce opioid overdoses and deaths.3. Improve Quality of Life (QoL).4. Decrease cost to society.
The Multidisciplinary Association for Psychedelic Studies Foundation (MAPS) have paved the way for studying an "illicit drug" with properties proving effective in treating PTSD. MAPS is now doing FDA approved clinical trials and will soon be able to answer the research question: does MDMA improve symptoms of PTSD.
Cannabis and MDMA (aka Ecstasy) were both on the radar screen of researchers - but took a detour in the 60's. So there is an understandable social concern when considering illicit drugs as medications. But medications are simply defined as “substances used for medical treatment.” Rick, Ismail, Leslie and Team are proving that MAPS persistence and patience pays off. They are inspirational.
2. The Cannabis Option
The challenges of sheltering have been overwhelming for our vulnerable population. People trying to break the chains of opioid addiction are in this group. Medication Assisted Treatments (MAT) are hard enough to get without a pandemic dropping by. With clinics shuddered and medical practitioners running on after-burners, being addicted to opioids and trying to get straight is causing a setback to progress made. Turning to the street may be easier. That’s a really bad thing.
The real-world data, peppered with a few prospective, but still observational studies, suggest cannabis-based medicine may offer an option.
One example comes from The Alcohol and Drug Abuse Institute at The University of Washington. They studied the use of cannabis as a substitute for opioid medication in an online survey of 2897 opioid patients also using cannabis-based medicine. The vast majority of patients (97%) reported using less opioids when using cannabis-based medicine and experienced more tolerable side effects with the combination than with opioids alone (92%).
The real-world data, peppered with a few prospective, but still observational studies, suggest cannabis-based medicine may offer an option.
One example comes from The Alcohol and Drug Abuse Institute at The University of Washington. They studied the use of cannabis as a substitute for opioid medication in an online survey of 2897 opioid patients also using cannabis-based medicine. The vast majority of patients (97%) reported using less opioids when using cannabis-based medicine and experienced more tolerable side effects with the combination than with opioids alone (92%).
1. Buprenorphine and Methadone There are 2 primary medication options to support opioid withdrawal: Buprenorphine and Methadone. This is called medication assisted treatment (MAT). Both are hard to get as they require a physician to be certified to write a prescription. Both work - but there is a 70% failure rate. And both are potentially lethal.
There is mounting real world evidence and numerous anecdotes about using CBD or cannabis-based medicine to support opioid withdrawal. A National Academy of Sciences report in 2017 concluded that there is evidence that cannabis is effective for the treatment of chronic pain in adults.
With no non-opioids to treat severe and chronic pain available, and likely not available for years, it seems an easy decision to give cannabis-based medicine a go. It is available. It is not lethal. And even if cannabis-based medicine works as an adjunct to opioids to manage severe and chronic pain, patients will need less opioids, there will be less overdoses and deaths and, there will be a decrease in cost to society. Finally, if we spend $100million to answer this research question, that is 0.13% of the cost for one year of the opioid epidemic in America (CDC says it cost $76.5B/year).
There is mounting real world evidence and numerous anecdotes about using CBD or cannabis-based medicine to support opioid withdrawal. A National Academy of Sciences report in 2017 concluded that there is evidence that cannabis is effective for the treatment of chronic pain in adults.
With no non-opioids to treat severe and chronic pain available, and likely not available for years, it seems an easy decision to give cannabis-based medicine a go. It is available. It is not lethal. And even if cannabis-based medicine works as an adjunct to opioids to manage severe and chronic pain, patients will need less opioids, there will be less overdoses and deaths and, there will be a decrease in cost to society. Finally, if we spend $100million to answer this research question, that is 0.13% of the cost for one year of the opioid epidemic in America (CDC says it cost $76.5B/year).
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1. Buprenorphine and Methadone There are 2 primary medication options to support opioid withdrawal: Buprenorphine and Methadone. This is called medication assisted treatment (MAT). Both are hard to get as they require a physician to be certified to write a prescription. Both work - but there is a 70% failure rate. And both are potentially lethal.
There is mounting real world evidence and numerous anecdotes about using CBD or cannabis-based medicine to support opioid withdrawal. A National Academy of Sciences report in 2017 concluded that there is evidence that cannabis is effective for the treatment of chronic pain in adults.
With no non-opioids to treat severe and chronic pain available, and likely not available for years, it seems an easy decision to give cannabis-based medicine a go. It is available. It is not lethal. And even if cannabis-based medicine works as an adjunct to opioids to manage severe and chronic pain, patients will need less opioids, there will be less overdoses and deaths and, there will be a decrease in cost to society. Finally, if we spend $100million to answer this research question, that is 0.13% of the cost for one year of the opioid epidemic in America (CDC says it cost $76.5B/year).
There is mounting real world evidence and numerous anecdotes about using CBD or cannabis-based medicine to support opioid withdrawal. A National Academy of Sciences report in 2017 concluded that there is evidence that cannabis is effective for the treatment of chronic pain in adults.
With no non-opioids to treat severe and chronic pain available, and likely not available for years, it seems an easy decision to give cannabis-based medicine a go. It is available. It is not lethal. And even if cannabis-based medicine works as an adjunct to opioids to manage severe and chronic pain, patients will need less opioids, there will be less overdoses and deaths and, there will be a decrease in cost to society. Finally, if we spend $100million to answer this research question, that is 0.13% of the cost for one year of the opioid epidemic in America (CDC says it cost $76.5B/year).
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1. Buprenorphine and Methadone There are 2 primary medication options to support opioid withdrawal: Buprenorphine and Methadone. This is called medication assisted treatment (MAT). Both are hard to get as they require a physician to be certified to write a prescription. Both work - but there is a 70% failure rate. And both are potentially lethal.
There is mounting real world evidence and numerous anecdotes about using CBD or cannabis-based medicine to support opioid withdrawal. A National Academy of Sciences report in 2017 concluded that there is evidence that cannabis is effective for the treatment of chronic pain in adults.
With no non-opioids to treat severe and chronic pain available, and likely not available for years, it seems an easy decision to give cannabis-based medicine a go. It is available. It is not lethal. And even if cannabis-based medicine works as an adjunct to opioids to manage severe and chronic pain, patients will need less opioids, there will be less overdoses and deaths and, there will be a decrease in cost to society. Finally, if we spend $100million to answer this research question, that is 0.13% of the cost for one year of the opioid epidemic in America (CDC says it cost $76.5B/year).
There is mounting real world evidence and numerous anecdotes about using CBD or cannabis-based medicine to support opioid withdrawal. A National Academy of Sciences report in 2017 concluded that there is evidence that cannabis is effective for the treatment of chronic pain in adults.
With no non-opioids to treat severe and chronic pain available, and likely not available for years, it seems an easy decision to give cannabis-based medicine a go. It is available. It is not lethal. And even if cannabis-based medicine works as an adjunct to opioids to manage severe and chronic pain, patients will need less opioids, there will be less overdoses and deaths and, there will be a decrease in cost to society. Finally, if we spend $100million to answer this research question, that is 0.13% of the cost for one year of the opioid epidemic in America (CDC says it cost $76.5B/year).
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2. The Cannabis Option The challenges of sheltering have been overwhelming for our vulnerable population. People trying to break the chains of opioid addiction are in this group. Medication Assisted Treatments (MAT) are hard enough to get without a pandemic dropping by. With clinics shuddered and medical practitioners running on after-burners, being addicted to opioids and trying to get straight is causing a setback to progress made. Turning to the street may be easier. That’s a really bad thing.
The real-world data, peppered with a few prospective, but still observational studies, suggest cannabis-based medicine may offer an option.
One example comes from The Alcohol and Drug Abuse Institute at The University of Washington. They studied the use of cannabis as a substitute for opioid medication in an online survey of 2897 opioid patients also using cannabis-based medicine. The vast majority of patients (97%) reported using less opioids when using cannabis-based medicine and experienced more tolerable side effects with the combination than with opioids alone (92%).
The real-world data, peppered with a few prospective, but still observational studies, suggest cannabis-based medicine may offer an option.
One example comes from The Alcohol and Drug Abuse Institute at The University of Washington. They studied the use of cannabis as a substitute for opioid medication in an online survey of 2897 opioid patients also using cannabis-based medicine. The vast majority of patients (97%) reported using less opioids when using cannabis-based medicine and experienced more tolerable side effects with the combination than with opioids alone (92%).
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3. The Need for Cannabis Clinical Trials We need clinical trials to determine the impact cannabis-based medicine can have on opioid addiction. Of course, cannabis is a class 1 controlled substance – so people addicted to opioids will have to wait for clinical trials to answer research questions that could change their lives.
Does cannabis-based medicine, when added to an opioid pain management regimen, significantly:1. Reduce opioid use.2. Reduce opioid overdoses and deaths.3. Improve Quality of Life (QoL).4. Decrease cost to society.
The Multidisciplinary Association for Psychedelic Studies Foundation (MAPS) have paved the way for studying an "illicit drug" with properties proving effective in treating PTSD. MAPS is now doing FDA approved clinical trials and will soon be able to answer the research question: does MDMA improve symptoms of PTSD.
Cannabis and MDMA (aka Ecstasy) were both on the radar screen of researchers - but took a detour in the 60's. So there is an understandable social concern when considering illicit drugs as medications. But medications are simply defined as “substances used for medical treatment.” Rick, Ismail, Leslie and Team are proving that MAPS persistence and patience pays off. They are inspirational.
Does cannabis-based medicine, when added to an opioid pain management regimen, significantly:1. Reduce opioid use.2. Reduce opioid overdoses and deaths.3. Improve Quality of Life (QoL).4. Decrease cost to society.
The Multidisciplinary Association for Psychedelic Studies Foundation (MAPS) have paved the way for studying an "illicit drug" with properties proving effective in treating PTSD. MAPS is now doing FDA approved clinical trials and will soon be able to answer the research question: does MDMA improve symptoms of PTSD.
Cannabis and MDMA (aka Ecstasy) were both on the radar screen of researchers - but took a detour in the 60's. So there is an understandable social concern when considering illicit drugs as medications. But medications are simply defined as “substances used for medical treatment.” Rick, Ismail, Leslie and Team are proving that MAPS persistence and patience pays off. They are inspirational.
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4. A Few Stark Reminders About the Opioid Epidemic
From 1999 – 2017 in the United States, 400,000 people have died from the opioid epidemic.1On average, 130 Americans die every day from an opioid overdose.2In 2018 there were 68,557 deaths from overdose with 50,000 of those deaths resulting from prescription opioids.3This is more deaths than by guns, car crashes, or HIV/AIDS in one year in the US.4People age 25 – 44 have the highest death rates.5Children and adolescents are not spared as 8986 died between 1999 and 2016 from opioid poisoning – a 268.2% increase in mortality rate.6There was a five-fold increase in babies born with a drug withdrawal syndrome called Neonatal Abstinence Syndrome (NAS) from 2004 to 2014 (last year reported). 7Nearly one in every three people know someone addicted to opioids. 8In 2016, CDC estimated 20.4% of US adults had chronic pain and 8.0% had high-impact chronic pain.9Cost to society is $78.5B/year.10
Something Needs to be Done.
From 1999 – 2017 in the United States, 400,000 people have died from the opioid epidemic.1On average, 130 Americans die every day from an opioid overdose.2In 2018 there were 68,557 deaths from overdose with 50,000 of those deaths resulting from prescription opioids.3This is more deaths than by guns, car crashes, or HIV/AIDS in one year in the US.4People age 25 – 44 have the highest death rates.5Children and adolescents are not spared as 8986 died between 1999 and 2016 from opioid poisoning – a 268.2% increase in mortality rate.6There was a five-fold increase in babies born with a drug withdrawal syndrome called Neonatal Abstinence Syndrome (NAS) from 2004 to 2014 (last year reported). 7Nearly one in every three people know someone addicted to opioids. 8In 2016, CDC estimated 20.4% of US adults had chronic pain and 8.0% had high-impact chronic pain.9Cost to society is $78.5B/year.10
Something Needs to be Done.
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5. The Who Pain Ladder
The World Health Organization (WHO) recommends that analgesics be prescribed following a pain ladder starting at:
Step 1: nonopioid analgesics, (Acetaminophen, NSAIDs…).Step 2: “weak opioids,” with or without a nonopioid alternative or adjunct.Step 3: a “strong opioid,” with or without a nonopioid alternative or adjunct.
The WHO pain ladder kind of says it all: weak opioids and strong opioids. Acetaminophen, NSAIDS, select anti-convulsive and anti-depressant medications, topical agents and interventional approaches don’t seem to cut it when treating serious and/or chronic pain.
The complete elimination of pain is rarely obtainable. Realistic treatment goals include reducing pain, maximizing function, improving quality of life and should incorporate suitable non-pharmacologic and complementary therapies for symptom management. While the psychology of pain and the expectations of pain management need to be re-invented; the epidemic is now.
And the bottom-line is that these patients have a disease. That disease is addiction. Opioids are addictive and lethal. Quality of life for the opioid addict is dismal. The opioid epidemic is out of control. And the process to recover from opioid addiction is wanting.
The World Health Organization (WHO) recommends that analgesics be prescribed following a pain ladder starting at:
Step 1: nonopioid analgesics, (Acetaminophen, NSAIDs…).Step 2: “weak opioids,” with or without a nonopioid alternative or adjunct.Step 3: a “strong opioid,” with or without a nonopioid alternative or adjunct.
The WHO pain ladder kind of says it all: weak opioids and strong opioids. Acetaminophen, NSAIDS, select anti-convulsive and anti-depressant medications, topical agents and interventional approaches don’t seem to cut it when treating serious and/or chronic pain.
The complete elimination of pain is rarely obtainable. Realistic treatment goals include reducing pain, maximizing function, improving quality of life and should incorporate suitable non-pharmacologic and complementary therapies for symptom management. While the psychology of pain and the expectations of pain management need to be re-invented; the epidemic is now.
And the bottom-line is that these patients have a disease. That disease is addiction. Opioids are addictive and lethal. Quality of life for the opioid addict is dismal. The opioid epidemic is out of control. And the process to recover from opioid addiction is wanting.
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6. Potential of Cannabis Medicine for Reducing Harm
For people with the disease that is addiction, the steps to recovery have many challenges. Once in recovery, medication assisted treatment is a daily commitment -- hard enough as an activity of daily living -- harder still in a pandemic.
Harm reduction organizations have long advocated for easier access to medications such as methadone and buprenorphine. This month, SAMHSA and DEA eased restrictions. This had to happen - but it is a double-edged sword for people with the disease that is addiction – especially under pressure. Methadone and buprenorphine are the best medications today to support opioid withdrawal - but they too can be lethal.
Cannabis-based medicine is a real-world solution. There is a volume of real-world data and the safety profile is sufficient. The best cannabis companies are prepared for regulatory oversight and are following GMP. There are formulations that can provide controlled dosing. Cannabis-based medicine needs dose-ranging studies and controlled clinical trials for the indications that appear to show benefit. For pain management, if cannabis-based medicine, as adjunct to opioid treatment, decreases the amount of opioids a patient needs to manage pain, there will be less overdoses, less deaths, better quality of life and less cost to society.
For people with the disease that is addiction, the steps to recovery have many challenges. Once in recovery, medication assisted treatment is a daily commitment -- hard enough as an activity of daily living -- harder still in a pandemic.
Harm reduction organizations have long advocated for easier access to medications such as methadone and buprenorphine. This month, SAMHSA and DEA eased restrictions. This had to happen - but it is a double-edged sword for people with the disease that is addiction – especially under pressure. Methadone and buprenorphine are the best medications today to support opioid withdrawal - but they too can be lethal.
Cannabis-based medicine is a real-world solution. There is a volume of real-world data and the safety profile is sufficient. The best cannabis companies are prepared for regulatory oversight and are following GMP. There are formulations that can provide controlled dosing. Cannabis-based medicine needs dose-ranging studies and controlled clinical trials for the indications that appear to show benefit. For pain management, if cannabis-based medicine, as adjunct to opioid treatment, decreases the amount of opioids a patient needs to manage pain, there will be less overdoses, less deaths, better quality of life and less cost to society.
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7. " A tale of Two Epidemics"
There is a recent Harvard Health Blog – “A tale of two epidemics… Peter Grinspoon, MD is the author and a primary care doctor who has recovered from — and who treats — opiate addiction. Below are the headers to the paragraphs in his article. They say it all.Social determinants of health create greater vulnerabilityTreatments and support systems may be disruptedSocial isolation increases the risk for addictionIsolation may increase the risk of overdose deathsMultiple health crises mean comprehensive solutions
The entire article can be viewed at:https://lnkd.in/drCYchn
People with the disease that is addiction will not have a new normal because they did not have an old normal. Everything for them will be harder. If cannabis-based medicine is a real-world option for pain management and people can take less opioids to manage their pain, they will have a better quality of life, with less chance of overdose or death.
There is a recent Harvard Health Blog – “A tale of two epidemics… Peter Grinspoon, MD is the author and a primary care doctor who has recovered from — and who treats — opiate addiction. Below are the headers to the paragraphs in his article. They say it all.Social determinants of health create greater vulnerabilityTreatments and support systems may be disruptedSocial isolation increases the risk for addictionIsolation may increase the risk of overdose deathsMultiple health crises mean comprehensive solutions
The entire article can be viewed at:https://lnkd.in/drCYchn
People with the disease that is addiction will not have a new normal because they did not have an old normal. Everything for them will be harder. If cannabis-based medicine is a real-world option for pain management and people can take less opioids to manage their pain, they will have a better quality of life, with less chance of overdose or death.
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Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum. Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam veritatis et quasi architecto beatae vitae dicta sunt explicabo.
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Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum. Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam veritatis et quasi architecto beatae vitae dicta sunt explicabo.
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Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum. Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam veritatis et quasi architecto beatae vitae dicta sunt explicabo.
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Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum. Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam veritatis et quasi architecto beatae vitae dicta sunt explicabo.