Adding Reason to Rhetoric

How the war on opioids and RESTRICTED access to cannabis is hurting chronic pain patients

Around three years ago, I chartered a cannabis education non-profit organization.  At the time, I had been using cannabis for seizure control for about a year. I was using CBD which was legal in my state.  I had met a few patients who told me that I might have success with using THC (which is still illegal in my state) to control the excruciating pain that I experienced as a result of Trigeminal Neuralgia.  There was a lot of information available online but it was difficult to determine fact from fiction. I began researching and speaking to cannabis professionals. I took CMU classes through the Medical Cannabis Institute and Patients Out of Time.  On January 6, 2015 Cannabis Forward received our 501c3 tax exempt non-profit status which made us the first cannabis related non-profit in South Carolina.

I found success in THC for pain control that I never found with opiates.  I noticed that many cannabis advocates were using the analgesic properties of cannabis as a way to get legislators to agree to medical cannabis programs for their state, many of which were seeing an astounding number of ‘opioid related deaths’. The common rhetoric was that chronic pain patients were the leading cause of the opioid epidemic.  Statistics from the CDC and NIH were often used as the basis on which this issue was pushed. The National Institute of Health statistic we often see used is from a report regarding opiate related deaths, but this statistic failed to remove deaths caused by illicit drugs like street heroin and street fentanyl. In fact, charts showing deaths related to ALL drugs were commonly used by cannabis advocates as so-called “proof” of how chronic pain patients were overdosing due to lack of access to medical cannabis.  You may have seen this chart in your local newspaper:

It is true that pharmaceutical companies solicited doctors while providing false information about opioids during the 1990’s and early 2000’s.  It is true that many doctors wrote large and unnecessary prescriptions based on this false information.
It is also true that the government’s response to handling the “opioid epidemic” is killing chronic pain patients.

I am in an online support group of patients who suffer with cranial neuralgias.  Over the past two years, I have seen many patients share their stories of how their doctor reduced their opiate prescriptions, how their pharmacy would no longer fill their prescriptions, and how they were turned away at the ER for being “pill seekers”.  I have also seen where patients in the group have sadly reported that a member committed suicide because they had received restrictions on their medication and could not take the pain anymore. This has happened three times in the past year. The National Center for Health Statistics reports that an estimated 20,000 chronic pain patients commit suicide each year.  That is more than the estimated number of deaths due to heroin overdoses.  If things keep going this way, we risk replacing the opioid epidemic with a suicide epidemic.

That is where cannabis should come in.  I no longer push for cannabis as a complete replacement to opioids.  I have learned over the years that each pain patient will find relief in different medications and health care modalities.  Opioids didn’t work for my nerve pain but it does for countless others. For some chronic pain patients, cannabis exacerbated their pain.  Cannabis can certainly be used successfully to help patients overcome opioid and other drug and alcohol addictions. Cannabis should definitely be available for anyone who wants to utilize its analgesic properties.  It is safer than opiates. After all, you cannot die from a cannabis-related overdose. Additionally, cannabis can be used in conjunction with opiates and can allow for lower narcotic dosing, thus reducing the negative side effects from opiates and synthetic opioids.

Two years ago, the New England Journal of Medicine reported on several published stories which concluded that less than 8 percent of patients receiving opioids for chronic pain became addicted to their prescribed medication.  According to CDC data, at least half of all prescription deaths are associated with illicit drug use such as benzodiazepines, alcohol, and cocaine. Clearly the numbers aren’t matching up and chronic pain patients are paying the price.  The CDC has begun to issue new data that better clarifies the opioid-related death statistic of prescription drugs from illicit drugs, but, unfortunately, the damage to chronic pain patients’ ability to receive their medication has already been done.  

Some possible solutions to this crisis are:

  • limit prescription writing for acute pain
  • address mental health and previous substance abuse issues with patients before writing new pain medication prescriptions
  • remove the Fifth Vital Sign protocol
  • increase availability to naltrexone
  • legalize cannabis on a federal level

Someone recently asked me why I push for opioid access if I am a cannabis advocate.  My answer was simple: I am not a cannabis advocate. I am a patient advocate.

Emily McSherry is the founder of Cannabis Forward.  She lives her life with Left Temporal Lobe Epilepsy, Trigeminal and Geniculate Neuralgia, and Acute Intermittent Porphyria.  

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