December 5, 2009 – Cannabis, otherwise known as marijuana (or marihuana), has been a topic of debate for many years, not only in Canada, but also in several other countries including the U.S. and the U.K. However, while marijuana for recreational use has not been legalized in Canada, medical marijuana use can be granted for medicinal needs.

The Definition of Chronic Pain

Although “chronic pain” seems all encompassing and thus easily used as a reason for medical marijuana use, the organization of Health Canada very clearly defines what can be considered severe enough pain for medical marijuana. With that said, there are many suffering from chronic pain – due to a variety of reasons – with grants for the medical use of cannabis.

Arthritis, headaches and back pain are the most common, but fibromyalgia, carpal tunnel syndrome, neuropathy and phantom limb pain are also common reason for chronic pain. Continuing pain can also be caused by debilitating illnesses such as MS (multiple sclerosis), scoliosis, osteoporosis and others.

Original Treatments for Chronic Pain

For many, medical marijuana use is a “last resort”, used only after several pharmacologic treatments fail. Typically, the first treatments include pain relievers such as aspirin or ibuprofen. Unfortunately, long-term use can cause serious side effects; even if there is pain relief, it can only be in short periods due to the need for short-term use of the “first line” of treatments.

Should the first treatments fail, narcotic opioids such as codeine, morphine and oxycodone are generally prescribed. Although often highly affective, the concern for these types of narcotics is that they have a high possibility for addiction and abuse. As well, their use is also limited, due to possible side effects in higher doses. The withdrawal symptoms for addictive pharmaceuticals can be mild to painfully severe.

Medical Marijuana for Chronic Pain

For those that don’t respond to the first or second line of treatments, medical marijuana may be prescribed. As well, there are those who prefer not to use man-made pharmaceuticals that have a high rate of addiction or serious side effects.

According to Health Canada, “Dependence is unlikely to be problematic when cannabis is used therapeutically, although withdrawal affects may be uncomfortable. These include restlessness, anxiety, mild agitation, irritability, tremor, insomnia and EEG/ sleep disturbance, nausea, diarrhea and cramping.”

Relief from chronic pain, however, far outweighs the possibility of addiction for many:

– Migraines – Severe, incredibly painful and often lasting as long as 72 hours, migraines can cause serious debilitating issues such as nausea, vision changes, vomiting and a high sensitivity to light and sound. Many of the pharmaceuticals used to either stop or lessen the amount of migraines cause the same issues as the onset of the migraines themselves. Often, sufferers stop treatment because it doesn’t work or because the side effects are too severe.

Medical marijuana, on the other hand, has been a well-documented treatment for many years – even throughout the nineteenth century. Cannabinoids have often demonstrated anti-inflammatory effects, as well as dopamine blocking. It is believed by some that one of the causes of migraines is the lack of natural endocannabinoids in the body, which might explain why cannabis works to decrease the pain as well as the symptoms.

– Multiple sclerosis (MS) – MS is a degenerative disease that attacks myelin in the brain and spinal cord. If you imagine nerves to be like electrical wires, myelin is the insulating, protective sheath around the nerves. The autoimmune system treats myelin as a foreign invader, destroying patches of it and leaving nerve fibers exposed, interrupting their normal function. It is debilitating and painful, causing such symptoms as tingling and numbness, painful muscle spasms, tremors, paralysis and more.

Prescribed pharmaceuticals can cause severe, debilitating medical issues such as seizures, abdominal cramps, dizziness, mental disturbances and other problems. Many MS sufferers prefer to self-medicate with marijuana, and have noticed that cannabis helps them control tremors, spasms and bladder control. Tests have also shown that THC helps reduce pain intensity and sleep disturbance significantly.

Although these two illnesses are common for the use of medical marijuana in relieving chronic pain sufferers, the same can be said for rheumatoid arthritis, spinal cord injuries and even phantom limb pain. While more studies need to be performed to explain exactly how cannabinoids and medical marijuana work, the fact that they do work is clear. Source.

Over the last several years, without many people realizing it, the U.S. government has changed the focus of its anti-drug efforts, deemphasizing marijuana in favor of prescription drugs.

A CBS News survey of government and nonprofit anti-drug groups has found a retreat from anti-marijuana campaigns over the past several years as prescription and over the counter drug abuse has grown amongst teens.

In fact, the Partnership for a Drug Free America, the nation’s largest creator of anti-drug messages, hasn’t produced a single anti-marijuana public service advertisement since 2005. Picture 2

The change comes as a result of the decline in marijuana use amongst teens, and growing worry over the abuse of prescription drugs. Marijuana use has been declining for 10 years and past-month use is down 25 percent since 2001 according to the largest tracking study in the U.S., “Monitoring the Future” by the University of Michigan.

Meanwhile prescription drug abuse has held steady over the past five years according to the Partnership for a Drug-Free America, with nearly one in five teens (19 percent) abusing prescription medications to get high.

“There is a new threat in town,” Robert Dennisoton of the Office of National Drug Control Policy said.Picture 3

The concern about pills has been highlighted by a string of high profile deaths like that of Heath Ledger, Anna Nicole Smith, and possibly Michael Jackson — all tied to the abuse of legal prescription drugs.

In an effort to spread awareness about the dangers of the misuse of prescription drugs, the Partnership for a Drug-Free America even refers to young people today as “Generation Rx” in TV advertisements that point to the dangers of misuse of those drugs.

“For this generation, high prevalence of prescription drug abuse was kicking in… there was a dawning, and a number of us began to feel that we need to do something about it,” said Sean Clark, executive vice president with the Partnership for a Drug-Free America.

The Office of National Drug Control Policy, the government’s drug policy wing, now dedicates all of its campaign resources directed at parents – some $14 million dollars since 2008 – to the abuse of prescription and over the counter drugs.

“The issue of prescription drug abuse, which the Office of National Drug Control Policy has been shouting about from the rooftops, it is a significant problem in this country,” National Drug Control Policy Director Gil Kerlikowske said on “The Early Show” last week.Picture 4

Advocates for marijuana legalization argue that the shift from anti-marijuana to anti-pill messages has come at least in large part because prescription and over the counter medicines are far more deadly than marijuana.

“While it is the most widely used illicit drug, it is much less dangerous than prescription drugs,” said Bruce Mirken of the Marijuana Policy Project, a group that supports marijuana legalization.

“The government is talking about the dangers of acetaminophen – this stuff is given out like candy and can kill,” he said. “When you put it in that context, marijuana almost looks benign.”

The addictiveness of marijuana – or lack thereof – compared to other drugs is also cited by supporters.

“The bottom line is the Opiates and Stimulates are much more addictive than marijuana, those that try it are likely to return to them after first use.” said Mitch Earleywine, associate professor of psychology at the State University of New York. “Maybe 9 percent of marijuana users develop problems but 14-23 percent of prescription drug abusers end up saying can’t quit or report withdrawal when they want to stop.”

Advocates also point to recently-released data obtained by the Web site ProCon.org which indicates that prescription drugs are responsible for far more deaths than marijuana.

The report compared data on deaths due to marijuana with FDA-approved medications. It found that the approved drugs — which included anti-psychotics, Attention Deficit Disorder medications, painkillers and other prescription drugs — were suspected as the primary cause of 10,008 deaths and as a secondary cause in 1,679 more.

Marijuana, on the other hand, was the primary suspect in zero deaths and a suspected secondary factor in 279 deaths.

Another report recently issued by the Florida Department of Law Enforcement indicated that prescription drugs caused more deaths than illicit drugs – even including alcohol-related automobile accidents. Prescription drugs were the cause of more than 25 percent of drug related deaths in the state. Marijuana was not listed as a cause of death last year in Florida.

There are now more new abusers of prescription drugs each year than there are abusers of marijuana, according to the National Survey on Drug Use and Health from the Department of Health and Human Services. About 2.15 million people started using prescription pain relievers to get high in 2007, while 2.09 million people started using marijuana that year. By Elizabeth Sprague.

June 29, 2009 – We must learn how to reduce the harms associated with our drug use, including reducing easily preventable deaths from overdose.prescription

As the world continues to mourn the death of Michael Jackson and the details of his final hours emerge, it appears that it may be another in a long line of celebrity drug overdoses. Jackson is reported to have taken a number of painkillers known as opioids on a regular if not daily basis.

Michael Jackson inhabited his own rarified world, and we are used to hearing about drug overdoses in the context of fast-lane inhabiting music and film stars, like Jackson and Heath Ledger, who died of an opioid overdose last year. But even among average Americans, deaths from drug overdoses have been rising and have reached crisis levels in our country. A recently-released report by the Drug Policy Alliance documents the extent of the problem: drug overdose is now the second-leading cause of accidental death in America, surpassing firearms-related deaths. Many of those affected are young people. Among teenagers there has been a steep rise in misuse of prescription drugs. A December 2008 survey of high school seniors reported that more than 15 percent of high school seniors reported using prescription drugs for non-medical reasons. But it’s not just young people who are dying of overdoses: overdose is the number-one injury-related killer among adults in Michael Jackson’s age group: 35-54.

This spike in overdose deaths is almost entirely attributable to increasing numbers of people overdosing on legal, prescription drugs; overdose deaths from heroin and other illegal drugs have leveled off in many places as a result of harm reduction efforts. Most of these drugs are opioids, which can include both opium-derived drugs like morphine and codeine, and synthetics like Oxycontin and Vicodin, both of which were allegedly used by Michael Jackson, and Demerol, with which he reportedly was injected just before he died. Other commonly prescribed opioids include Percodan and Percocet. Some of the drugs involved in overdoses have been diverted to the black market and sold illegally, while others are obtained through legal prescriptions. Pain patients can misunderstand their doctors’ instructions and accidentally exceed their prescribed doses of painkillers.

But in Michael Jackson’s case, if it was caused by an opioid overdose, his death might have been averted had people close to him had access to a simple and reliable antidote: naloxone, otherwise known as Narcan.

Naloxone, if administered to someone who has stopped breathing as a result of an opioid overdose, can reverse the effects of the overdose and restore normal breathing in two to three minutes. Naloxone has been used effectively in emergency rooms to reverse overdoses for over 30 years. Tens of thousands of lives could be saved if naloxone were more widely available and more people (including doctors, pharmacists and other health care professionals, as well as law enforcement professionals, many of whom are currently unfamiliar with naloxone), were trained in its use.

Cities with programs that increase the availability of naloxone, among them Chicago, Baltimore and San Francisco, have seen their overdose rates decline dramatically. New Mexico, which for years had a high number of deaths from drug overdoses, saw a 20 percent decline in such deaths after the state’s Department of Health began a naloxone distribution program in 2001. Naloxone itself has no abuse potential, making it a good candidate for over-the-counter availability. If people who are prescribed an opioid were also be given a prescription for naloxone, with instructions for them and their caregivers on how to administer it, this spike in overdose deaths could be reversed.

But our country’s drug war mentality prevents this safe and effective remedy from being made more widely available. Fear that doing so will encourage drug use causes the government to restrict naloxone’s availability. This “abstinence only” mindset is the same one that for years has prevented the federal government from funding syringe exchange programs — proven to reduce the spread of HIV, hepatitis C and other blood-borne diseases — for injection drug users. Just as the “abstinence only” model has proven a failure at preventing unwanted pregnancy and sexually transmitted diseases, it has been a failure at reducing drug use or the harms associated with drug use. Rather than continuing these failed policies, we need evidence-based solutions to the problems of drug misuse and drug overdose.

Fortunately some attention is now being paid to the overdose crisis. A bill known as the Drug Overdose Reduction Act was recently introduced in Congress by Rep Donna F. Edwards (D-MD). The bill would create a federal grant program to provide cities, states, tribal governments and community-based groups with funding to prevent and reduce overdose deaths; task the Centers for Disease Control and Prevention with responsibility for reducing overdose deaths; commission studies on the efficacy of various strategies to reduce overdose deaths; and create a nationwide surveillance system for monitoring overdose trends. A Facebook group called Purple Ribbons for Overdose Prevention now has nearly six thousand members across the country and is growing daily.

Another part of the solution to the overdose crisis are “Good Samaritan/911” laws, which provide immunity from arrest and prosecution for drug use or possession to anyone who calls 911 to report an overdose. Many lives could be saved if friends of overdose victims weren’t afraid of being prosecuted if the police are called to the scene. New Mexico last year became the first state to pass such a law, and similar legislation is now pending in several states.

We need to accept the reality that people will always use drugs, whether legal or illegal, prescribed or sold on the street, mood or performance enhancers, pain killers or stress reducers or sleep-enablers. We are a nation of drug users. We must learn how to reduce the harms associated with our drug use, including reducing the unconscionable and unnecessary number of deaths from overdose. By Jill Harris. Source.