Opiates Proven Ineffective For Treatment Of Pain…Medical Cannabis Proven Efffective and Safe
Many of us have known for years that medicinal cannabis is a safe and effective treatment for many types of pain. Yet, doctors continue to prescribe over the counter (OTC) medications or worse, opiates. Suffering from chronic pain can be debilitating and prevent people from engaging in everyday activities. At their wits end, they beg their doctors for opiates thinking that they are the only solution. Unfortunately, many doctors still stigmatize medicinal cannabis and continue to prescribe opiate medications. Others, won’t prescribe anything at all leading patients to suffer or turn to dangerous street drugs.
Opiates Don’t Treat Pain
Hyperalgesia – Opiates Make Pain Worse
Unfortunately, opiates do not help alleviate chronic back pain rather they can make the pain worse in many cases. This double edged sword phenomenon in which the opiates make the pain worse thus requiring more opiates is called opiate induced hyperalgesia. This is a condition in which a patient experiences of paradoxical response when receiving opiates for the treatment of pain. So instead of feeling the “normal” pain from the underlying condition, such as from a pinched nerve, the pain is much more severe than it should be. Yet, despite evidence describing this phenomenon, many doctors don’t even know that this condition exists and continue to stigmatize medicinal cannabis and prescribe opiates.
Opiates – No More Effective Than Placebo
For years studies have been suggesting that opiates are not effective at treating chronic pain, especially that in the neck and back that plague millions of people globally. This year The Lancet published the first randomized placebo-controlled trial that demonstrated that opiates provided no better relief for acute neck and back pain than placebo. The opiad crisis has killed hundreds of thousand of Americans, many of whom were started on pain medication with good intentions that turned deadly. In addition, hundreds of thousand more remain addicted to opiate medications destroying lives and families. Now we have even more evidence that opiates are not only dangerous, but that they do not work. A placebo pill is just as good as Percocet!
Alternative Medications for Pain
Over The Counter Medications
I often hear patients say I tried Tylenol or ibuprofen and nothing worked. And my job was emergency position, I hear this very frequently as people, again struggling with severe pain, or looking for relief and feel that opiates are the only solution. However a study published in JAMA looked at participants with pain Presenting to the emergency departmentwho received 400 milligrams of ibuprofen and 1000 milligrams of acetaminophen versus patients who received 5 milligrams of oxycodone and 325 milligrams of acetaminophen and patients receiving 5 milligrams of hydrocodone and 300 milligrams of acetaminophen or 30 milligrams of codeine and 30 milligrams of acetaminophen. There was no clinical significant difference in pain scores after two hours. What does this mean? The combining ibuprofen and acetaminophen is as effective as percocet, vicodin and Tylenol #3.
Just kidding….tramadol, also known as Ultram, is an opiod. How often I see doctors prescribing tramadol thinking that it’s a safe alternative to opiates. Although it is a weaker opioid, there are serious concerns about abuse and addiction potential and it is not very effective for severe or chronic pain. Additionally, it has dangerous side effects that include respiratory depression and seizures. Much of the metabolism of tramadol depends on an enzymes that patients either have different quantities of or different activities of. This means that you cannot predict the metabolism in any given patient. For some, it may not work at all. For others, it may work so well that they may develop a respiratory depression, seizures, and potentially overdose. And finally, it can have serious interactions with other drugs. Tramadol – just don’t.
Medical Marijuana – Safe and Effective for the Treatment of Pain
Even as a medical cannabis physician, I would recommend all my emergency department patients to try acetaminophen/ibuprofen combination first. But I understand that there are many patients with very severe and debilitating pain. I’ve just outlined why opiates are not the answer, now i’ll explain why medical cannabis is a safe and effective treatment for pain. The CDC reports that there have been studies that show that medical cannabis is effective for treating neuropathic pain. Additionally, a large meta analysis published in JAMA found that half of adults who use cannabis to manage their chronic pain reported that the use of medical cannabis lead them to “decrease the use of prescription opioid, prescription non opioid, and over the counter medications.” Furthermore, another comprehensive review published by the National Academy of Sciences showed that adult patients with chronic pain who are treated with cannabis we’re more likely to experience a clinically significant reduction in pain symptoms. From severe pain experienced bye patience struggling with cancer and its treatment, patients with such severe pain they are on disability, or everyday soccer moms who have chronic pain playing them at every hour of the day, medical marijuana can help. So often I hear from my patients that they are now able to “live again.” Many of them were unable to even perform basic activities of daily living secondary to the pain. After starting medical cannabis, they were able to function, many even report significantly less anxiety. The anxiety was due to the thought of going out or performing activities that would exacerbate their pain. Overall their lives are significantly improved.
If you are suffering from pain and have tried alternative forms of treatment whether medication, physical therapy, chiropractic procedures that have not worked, you may benefit from medical cannabis. Cannabis care consultants is not a medical card factory, we provide holistic and personalized care for our patients. You will always see the same doctor each year. We are there to help guide you on your journey to living well again.
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Lancet VOLUME 402, ISSUE 10398, P304-312, JULY 22, 2023
Chang AK: A Randomized Clinical Trial. JAMA. 2017;318(17):1661–1667. doi:10.1001/jama.2017.16190Bijur PE Esses D Barnaby DP Baer J. Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department
Bicket MCStone EM McGinty EE. Use of Cannabis and Other Pain Treatments Among Adults With Chronic Pain in US States With Medical Cannabis Programs. JAMA Netw Open. 2023;6(1):e2249797. doi:10.1001/jamanetworkopen.2022.49797