Pain Management, Part III: The Cannabis Solution


In the final part of his series on pain management, the author argues that cannabis should be available as an alternative to opiates in treating pain.

In the past two installments, we have talked about America's addiction to opiates (which has gotten to the point where preventable fatalities due to prescription medication abuse exceed those related to automobiles) and the dubious, and sometimes shady, practice of treating said addiction with buprenorphine-naloxone sublingual agents. I can kill two gorillas with one bullet on this one. All we have to do is legalize cannabis for medical use. It really is that simple.

Inhaled cannabis provides so many medical benefits. I know patients who have been able to take a lot less oxycodone after a surgery because they added cannabis to their drug regimen. I know long-term pain-management types who are taking lower dose range opiates due to cannabis supplementation. I have seen adult ADHD patients stabilize without amphetamines and bipolars get in a more stable mood range, both thanks to cannabis. The herb has a potential that has only begun to be explored.

If I could get a hardcore shooting-up heroin addict down to inhaling cannabis, I would call it a win and move on. I would applaud him for making such a smart choice of drug. The advantages to cannabis over opiates are massive. I'll focus on 2.

First, cannabis is all natural. I believe everything was put on this Earth for a reason. (I’m still looking for an explanation for poison ivy and the pickerel, but that's another story.) Cannabis was created to serve as a medicinal herb and a social lubricant. Second, the analgesic effect of cannabis is not fraught with the crippling stupor that high-dose opiates bring. Patients on cannabis are far more productive and lucid. The side-effect profile compared to opiates is very gentle. Not to mention, the liver is preserved.

While my home state of Pennsylvania is not quite as progressive as California, where cannabis is already legal for medical uses, we are at least talking about it. Pennsylvania House Bill 1393 was drafted and debated but never voted on in the last legislative session. Pennsylvania Senate Bill 1003 is on the docket in the upper house as we speak. Hopefully, it will be passed sooner rather than later.

Under this bill, cannabis would be distributed through a state-run program, not through a shop on every corner, as in California. If this program were not put under the control of pharmacists, it would be nothing short of a crime. If I were CEO of any of the chain pharmacies, I'd have my lobbyists talking the ears off the legislature for the exclusive rights to run the cannabis centers in the state. Some might say it's a dirty business, but we're already knee deep in the dirt with heroin needles and, some might argue, emergency contraception. The advantages that would be offered to patients and the tax revenue that would be generated for the state more than justify the legalization of cannabis for medical use. Peace.

Jay Sochoka, RPh, thinks both sides can agree this one.

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