Opiate pain killers vs medical marijuana

Opioid prescription deathsBecause of its low toxicity, marijuana gives patients suffering from chronic pain an intelligent choice to help cope with their suffering.  Medical cannabis not only helps patients using opiate painkillers to get better pain relief, it also helps them reduce their use of this very dangerous type of medication. Cannabis is low toxic, and does not have to cause a head high for patients to experience relief. Also medical cannabis does not have to be smoked and there are plenty of good non-smoking options available for folks who prefer alternative methods to smoking. Low-toxic cannabis is an intelligent low cost option for folks in chronic pain, as it helps patients get off of their far more toxic opiate pain killers.  These facts are supported by sound science.  I have compiled a list of science from peer reviewed journals supporting below the video.  Because of its safety and effectiveness for pain, our legislators have a moral, ethical obligation to make sure that cannabis is legally available to patients who suffer from chronic pain.

More science below to help combat the lack of quality information about medical cannabis in today’s media

One of the big criticisms of proposed cannabis legalization is the idea that legal cannabis might increase teen use.  These claims are not based in science.  The most up to date science from the great states of Washington and Colorado show that teen use rates for cannabis have not increased with cannabis legalization.  Basically, the prohibitionists’ non-scientific argument is that young folks are so dumb that they’ll be tempted to use cannabis unless we spend millions of dollars locking them up and destroying their lives.  Young people have been very effectively messaged that tobacco use is a bad choice without making tobacco illegal and there’s no reason to believe that cannabis would be different in this regard.  Prohibition is not the best tool for informing people about how to make intelligent choices.

120926092633Below are several peer reviewed studies showing that medical cannabis helps opiate pain medications work better

Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010. JAMA Intern Med. 2014 Aug 25. doi: 10.1001/jamainternmed.2014.4005. [Epub ahead of print] PubMed PMID: 25154332.  “…States allowing the medical use of cannabis have lower rates of deaths resulting from opioid analgesic overdoses than states without such laws”.   

—Did you know that there are 25% fewer overdose deaths from opiate pain killers in states with legal medical cannabis? That’s right folks, the science has been clear for a long time.  And now there’s even more evidence that low-toxic medical cannabis saves lives for folks in chronic pain.  This time it’s the heavy hitting Journal of the American Medical Association stating “states allowing the medical use of cannabis have lower rates of deaths resulting from opioid analgesic overdoses than states without such laws”.  Below are a few more of the many, many, many studies on cannabis and chronic pain:

Cannabis as an Adjunct to or Substitute for Opiates in the Treatment of Chronic Pain, Lucas, P., Journal of Psychoactive Drugs, 44 (2), 125–133, 2012  “When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects)”….

Cannabis in Palliative Medicine: Improving Care and Reducing Opioid-Related Morbidity, Gregory T. Carter, MD, MS1, Aaron M. Flanagan, MD2, Mitchell Earleywine, PhD3, Donald I. Abrams, MD4, Sunil K. Aggarwal, MD, PhD5, and Lester Grinspoon, MD, American Journal of Hospice & Palliative Medicine 000(00) 1-7, 2011  “…long-term drug safety is an important issue in palliative medicine. Opioids may produce significant morbidity. Cannabis is a safer alternative with broad applicability….”

Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain, Johnson, JR, Burnell-Nugent, M, Lossignol, D, Ganae-Motan, ED, Potts, R and Fallon, MT,MB Journal of Pain and Symptom Management Vol. 39 No. 2 February 2010 167-179  “This study shows that THC:CBD extract is efficacious for relief of pain in patients with advanced cancer pain not fully relieved by strong opioids.”

Cannabis as an Adjunct to or Substitute for Opiates in the Treatment of Chronic Pain, Lucas, P., Journal of Psychoactive Drugs, 44 (2), 125–133, 2012  “Novel research suggests that cannabis may be useful in the treatment of problematic substance use. These findings suggest that increasing safe access to medical cannabis may reduce the personal and social harms associated with addiction, particularly in relation to the growing problematic use of pharmaceutical opiates. “

Cannabinoids against pain. Efficacy and strategies to reduce psychoactivity: a clinical perspective.  Karst, M and Wippermann, S (2009).  Expert Opin Investig Drugs, Feb. 18, No. 2,125-133

“There is a growing body of evidence to support the use of medical cannabis as an adjunct to or substitute for prescription opiates in the treatment of chronic pain. When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects) by patients in a clinical setting. Additionally, cannabinoids can prevent the development of tolerance to and withdrawal from opiates, and can even rekindle opiate analgesia after a prior dosage has become ineffective. Novel research suggests that cannabis may be useful in the treatment of problematic substance use. These findings suggest that increasing safe access to medical cannabis may reduce the personal and social harms associated with addiction, particularly in relation to the growing problematic use of pharmaceutical opiates.”

Cannabinoid–Opioid Interaction in Chronic Pain, Abrams, DI, Couey, P, Shade, SB, Kelly, ME and Benowitz, NL, Clinical Pharmacology & Therapeutics, 90 (6) 2011, 844-851  “We therefore concluded that vaporized cannabis augments the analgesic effects of opioids without significantly altering plasma opioid levels. The combination may allow for opioid treatment at lower doses with fewer side effects.”

Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain, Johnson, JR, Burnell-Nugent, M, Lossignol, D, Ganae-Motan, ED, Potts, R and Fallon, MT,MB Journal of Pain and Symptom Management Vol. 39 No. 2 February 2010 167-179  “This study shows that THC:CBD extract is efficacious for relief of pain in patients with advanced cancer pain not fully relieved by strong opioids.”

Patients and Caregivers Report Using Medical Marijuana to Decrease Prescription Narcotics Use, Peters, D.C., Humboldt Journal of Social Relations, 35, 2013, 25-40  “All patients and producers who were taking opiate pain killers claimed they reduced overall drug use, especially opiates, by using medical marijuana. Patients and caregivers also claimed medical marijuana was preferred over opiates, eased withdrawal from opiates, and in some cases was perceived as more effective at relieving pain.”

Cannabinergic Pain Medicine A Concise Clinical Primer and Survey of Randomized-controlled Trial Results, Aggarwal, SK, Clin J Pain  Volume 29, Number 2, February 2013, 162-171  “Cannabis and other cannabinergic medicines’ efficacies for relieving pain have been studied in RCTs, most of which have demonstrated a beneficial effect for this indication, although most trials are short-term. Adverse effects are generally nonserious and well tolerated. Incorporating cannabinergic medicine topics into pain medicine education seems warranted and continuing clinical research and empiric treatment trials are appropriate.”

Cannabinoid-opioid interactions during neuropathic pain and analgesia, Bushlin, I, Rozenfeld, R and Devi, LA, Curr Opin Pharmacol. 2010, 10(1): 80.

Impact of Cannabis Use during Stabilization on Methadone Maintenance Treatment. Scavone JL, Sterling RC, Weinstein SP, Van Bockstaele EJ.  Am J Addict 2013;22(4):344-51.

Cancer PatientBelow are more peer reviewed references demonstrating that medical cannabis helps patients use less of their prescription opiate pain killers

Cannabis not only helps opiate medications work better, it also helps patients use less of this highly toxic class of drugs. There is positive synergy between opiate medications and cannabis.

Cannabinoid–Opioid Interaction in Chronic Pain, Abrams, DI, Couey, P, Shade, SB, Kelly, ME and Benowitz, NL, Clinical Pharmacology & Therapeutics, 90 (6) 2011, 844-851 “We therefore concluded that vaporized cannabis augments the analgesic effects of opioids without significantly altering plasma opioid levels. The combination may allow for opioid treatment at lower doses with fewer side effects.”

Synergistic interactions between cannabinoid and opioid analgesics

Life Sci. 2004 Jan 30;74(11):1317-24. Review. PubMed PMID: 14706563. http://www.ncbi.nlm.nih.gov/pubmed/14706563

Synergy between THC and morphine in the arthritic rat

Eur J Pharmacol. 2007 Jul 12;567(1-2):125-30. Epub
2007 Apr 20. PubMed PMID: 17498686. http://www.ncbi.nlm.nih.gov/pubmed/17498686

Cannabis reduces opiate use in the treatment of non-cancer pain

J Pain Symptom Manage. 2003 Jun;25(6):496-8. PubMed PMID:
12782429.  http://www.ncbi.nlm.nih.gov/pubmed/12782429

Synergistic and additive interactions of the cannabinoid agonist CP55,940 with mu opioid receptor and alpha2-adrenoceptor agonists in acute pain models in mice.

Br J Pharmacol. 2005 Mar;144(6):875-84. PubMed PMID: 15778704; PubMed Central PMCID: PMC1576059. http://www.ncbi.nlm.nih.gov/pubmed/15778704

Cannabinoid-opioid interactions during neuropathic pain and analgesia, Bushlin, I, Rozenfeld, R and Devi, LA, Curr Opin Pharmacol. 2010, 10(1): 80.

Additionally, there is a lot of good science showing synergistic effects between the molecule CBD and THC.

Feel free to comment at CannabisMatrix.com or email me at DrJake@DrJakeFelice if you have any questions regarding these synergistic effects.

Jake w Hatch surf photoBelow is essential data for citizens to consider which puts into perspective the magnitude of the scope of drug toxicities for our citizens, and why low toxic cannabis can be such an excellent option for patients suffering from even mild to moderate chronic pain.  

 No other pain relieving medication is less toxic than cannabis, not even aspirin or Tylenol. If deaths from toxic effects from NSAIDs such as ibuprofen and Aleve were tabulated separately in the National Vital Statistics reports, these drug toxicities would constitute the 15th most common cause of death in the United States. This is why cannabis as medicine can be an excellent choice as a substitute for more toxic pain-killers such as opiates and NSAIDs.

The July 1998 issue of The American Journal of Medicine stated the following: “Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures of all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated.”

And again in June 1999 the prestigious New England Journal of Medicine issued a similar statement:  ”It has been estimated conservatively that 16,500 NSAID-related deaths occur among patients with rheumatoid arthritis or osteoarthritis every year in the United States. This figure is similar to the number of deaths from the acquired immunodeficiency syndrome and considerably greater than the number of deaths from multiple myeloma, asthma, cervical cancer, or Hodgkin’s disease.

If deaths from gastrointestinal toxic effects from NSAIDs were tabulated separately in the National Vital Statistics reports, these effects would constitute the 15th most common cause of death in the United States. Yet these toxic effects remain mainly a “silent epidemic,” with many physicians and most patients unaware of the magnitude of the problem. Furthermore the mortality statistics do not include deaths ascribed to the use of over-the-counter NSAIDS.”

A recent study in Therapeutics and Clinical Risk Management notes that the number of deaths and hospitalizations from GI bleeding due to NSAIDs has remained unchanged since the 1999 study.  Again, medical cannabis has never killed a single patient.

Yours truly,

-Dr. Jake Felice

Seattle, WA

Naturopathic Medicine is a holistic approach to health care. Recent advances in medical science continue to demonstrate that today’s chronic diseases can be prevented and treated with naturopathic medicine protocols. Naturopathic physician Jake Felice, N.D, blends nutrition, therapeutic exercise, bodywork and a variety of modalities to prevent health problems and to treat chronic pain and disease.  Patients frequently benefit by using less of their conventional pain medications including opiates such as Percocet and Oxycontin. Opiates kill twice as many people as automobile crashes in Washington state and there has been a tripling of opiate related deaths in the US since 1998.

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5 Responses to Opiate pain killers vs medical marijuana

  1. Josh Geary says:

    Thanks for the suggestion of the topical cream, tonight is the first time that I have used it and it works great. Also thank you in general for your excellent service and your very easy to understand suggestions for treatment. Dr. Felice will come highly recomended from me.

    • admin says:

      Thanks Josh! In order for patients to get the most pain relief, the best type of topical cannabis for pain contains high THC, CBD, plus high levels of terpenes. Studies show that high levels of THC are important for pain control and that cannabis topicals work best due to synergy between THC and CBD. Even though a topical contains high THC levels, it does not cause a head high when it is applied to the skin. I am currently writing a book on topical cannabis and will be posting a new video on topical marijuana sometime over the next month. -Dr. Jake Felice

  2. Lorna says:

    Would love to get the recipe for making the topical treatment for pain. I have the oil just need to know what to mix it with….

    PS …will it be messy?

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