A new study adds to the growing body of research exploring the potential use of cannabis in reducing opioid dependency.
Following in the footsteps of North America, the UK is facing a growing issue of opioid dependency.
The latest figures show that the number of people dying from opioid-related drug misuse has reached a record high in England and Wales, and last year, the UK government strengthened opioid addiction warnings.
With opioid deaths rising, medical cannabis has become a beacon of hope as a possible replacement for opioid-based drugs. However, there continues to be a lack of research and clinical trials to prove its efficacy and provide clinicians with peace of mind when prescribing the drug.
In an effort to close the knowledge gap, researchers have published a paper in the international Journal of Clinical Practice offering clinicians practical advice for prescribing cannabis for chronic pain.
Supported by one of the world’s leading cannabis companies, Canopy Growth Corporation, and its medical cannabis division, Spectrum Therapeutics, the consensus paper gathered recommendations from twenty-three clinicians from around the world who had experience using cannabis in their practice.
The paper sets out guidance based on these recommendations, explaining when and how to safely prescribe cannabinoids when opioids are a being used for chronic pain. The paper also includes suggestions on how to decrease patients’ dosage of opioids when on a course of cannabis-based medication.
“[The paper] was very much about distilling physicians’ clinical experience into a pragmatic consensus document that clinicians can have in their back pockets,” Dr Mark Ware, Chief Medical Officer at Canopy Growth, tells Cannabis Health.
“If they choose to prescribe cannabis-based medicines, they would have some kind of recipe to follow.
“The general takeaway was that this is an approach to take for patients who are on opioids with chronic pain but aren’t getting the kinds of outcomes that you would want to see.
“The consensus was to start with low doses of CBD-predominant cannabinoid therapies to begin with, and then potentially introducing the THC containing compounds.”
As a pain physician himself, Dr. Ware says he would feel confident turning to the consensus if he chose to treat one of his patients with cannabis-based medical products.
He hopes that the paper will offer fellow clinicians the same confidence in prescribing cannabis despite the absence of evidence and also relieve the suffering of patients who have negative experiences on opioid medication.
Although clinical research remains incomplete, millions of people across the world are self-medicating with cannabis to ease their chronic pain.
“One thing we know is that these cannabinoid compounds, from a scientific background, are remarkable drugs in the way that they act in the human body,” Dr. Ware explains.
“We know that they can co-interact with opioids to improve pain control in animal models, and we know from large-scale follow up studies that people who use cannabis in their self-management of pain are able to reduce their use of opioids.
“It’s not clinical trial data, but it’s very powerful real-world data. With the experience of patients, perhaps we can then start to fill that gap of evidence with pragmatic guidance, which is what this consensus paper was intended to do.”
Despite demonstrating potential for lessening patients’ dependency on opioids, Dr. Ware stresses that cannabis alone will not solve the opioid crisis.
“Different ways of prescribing and approaching chronic pain have to come into play,” he says.
“Cannabis may be part of that toolbox of things that we can use to help shift the course of this very devastating trajectory. But it wouldn’t be right to say that this is the solve – it may just be one part of it.”
Founded in 2013 in Ontario, Canada, Canopy Growth was the first cannabis producer listed on both the Toronto and the New York Stock Exchange. As one of the world’s largest cannabis firms, Dr. Ware believes it is important that the company contributes to research efforts surrounding medicinal cannabis.
“I think we have an obligation to help clinicians understand how to use [our products] safely,” he says.
“We know that, generally, clinicians in Europe, in the UK, and across North America are not very well educated as to what cannabinoids are and how they work.
“We have an obligation to start filling those gaps by doing the clinical research. If we want our products to stand alone from others in the competition, and we want physicians to feel confident prescribing them patients to feel confident using them, we want to be able to provide that kind of support and data that they would expect.”
The full research paper is available from The International Journal of Clinical Practice.
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