Increasing evidence is pointing towards the fact that access to medical cannabis is leading to a decline in opioid-use, Cannabis Health reports.
While the world battles the Covid-19 pandemic, the US and Canada are continuing to fight an epidemic of their own; the ‘Opioid Crisis’.
Declared a public health emergency in 2017 by the US Department of Health and Human Services, an estimated 10.3 million people misused prescription opioids in 2018.
The opioid crisis is thought to date back to the late 1990s when pharmaceutical companies claimed patients would not become addicted to opioid pain relief medications.
Prescription rates soared and, in turn, an increasing number of Americans became addicted to painkillers such as OxyContin. According to the U.S. National Centre for Health Statistics, the death rate from drug overdose more than tripled between 1999 and 2016.
The UK has shown signs of following North America’s footsteps as it faces 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 alternative for opioid-based drugs.
Recent research, for example, found that half of medical cannabis patients stop using opioids for pain management after just 12 months.
A team of Canadian researchers assessed self-reported opioid consumption patterns over time in a cohort of medical cannabis patients who suffered from pain-related issues.
Researchers reported that many subjects tapered their use of opioids following medical cannabis initiation.
The primary outcomes studied were pain intensity and pain-related interference scores assessed at three month intervals for a period of 12 months. The team also assessed anxiety, depression, quality of life, general health symptoms, neuropathic pain, self-reported opioid consumption, and adverse events.
“The proportion of individuals who reported using opioids decreased by half, over a period of twelve months,” they determined.
In addition, the participants’ “pain intensity and pain-related interference” scores were reduced and quality of life and general health improved.
The study came only weeks after a separate Canadian study reported that patients prescribed opioids were able to reduce their opioid dosage by a staggering 78 percent following the consumption of medical cannabis.
Published in the journal of the American Academy of Pain Medicine, the ‘Tilray Observational Patient Study’ analysed 1,145 medical cannabis patients over a six-month period. Patients were monitored from 21 medical clinics across Canada, which is second to America in its opioid consumption.
Conservative MP and member of Conservative Drug Policy Reform Group (CDPRG), Crispin Blunt, told Cannabis Health: “Evidence is very strong on the benefits of substituting opiates for cannabis-based medicines. A 78 percent reduction in opiates within six months is extraordinary.
“Increasing numbers of people worldwide are experiencing the potential benefits of cannabis-based treatment as an opiate alternative that are evidenced so profoundly in this study.”
“As clinicians continue to demonstrate cannabis’ medicinal potential in empirical frameworks, the case for changing public policy to enable widespread medical access to it becomes overwhelming.”
The scientists behind the study say that the observed reductions in opioid use suggests that cannabis has the potential to play a “harm reduction role” in the opioid crisis.
The excessive prescribing of opioids for treating pain in the US has led to a staggering number of deaths linked to overdose. In just one year (June 2019 to June 2020), the US reported just over 48,000 deaths attributed to synthetic opioid overdose.
In parts of the US, this figure is falling and research suggests that this could be in part due to the opening of legal cannabis dispensaries across the country.
Some studies have suggested that increased access to cannabis stores, which are legally authorised to sell medical and recreational cannabis, may help to reduce opioid related deaths, however the evidence so far is mixed.
To explore this further, one group of researchers examined relationships between medical and recreational cannabis stores and opioid related deaths from 2014 to 2018.
Their findings were based on data for 812 counties within the 23 US states that allowed legal cannabis dispensaries to operate by the end of 2017.
Information on state level cannabis legislation was combined with county level data on licensed dispensaries and opioid related mortality rates.
After controlling for population characteristics and other potentially influential factors, the researchers found that counties with a higher number of active cannabis dispensaries were associated with reduced opioid related mortality rates.
According to this estimate, an increase from one to two dispensaries in a county was associated with an estimated 17 percent reduction in all opioid related mortality rates.
An increase from two to three dispensaries was associated with a further 8.5 percent reduction.
This study was the first to examine the association between active cannabis dispensary operations and opioid related mortality rates at the more fine grained county level.
However, the results are observational, meaning that they can’t establish the cause. The researchers stress that while cannabis is generally thought to be less addictive than opioids, it still carries potential harms and public safety risks should not be ignored.
They did, however, say their findings suggest “a potential association between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid related mortality rates.”
In a linked editorial, researchers argued that cannabis liberalisation “cannot be regarded as a remedy to the opioid crisis until a robust evidence base is available.”
Although some may interpret these findings as evidence supporting cannabis liberalisation to address the opioid crisis, they point out that “such conclusions are currently premature without evidence of causality.”
Despite this growing body of research demonstrating the potential of cannabis-based medicine, there remains a lack of clinical data to prove its efficacy and provide clinicians with peace of mind when prescribing the drug.
In an effort to close the knowledge gap, one group of researchers published a paper in the international Journal of Clinical Practice offering clinician’s 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, told Cannabis Health.
“If they choose to prescribe cannabis-based medicines, they will 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 said he would feel confident turning to the consensus if he chose to treat one of his patients with cannabis-based medical products.
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 said.
“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.
Despite demonstrating potential for lessening patients’ dependency on opioids, Dr. Ware stressed that cannabis alone will not solve the opioid crisis.
“Different ways of prescribing and approaching chronic pain have to come into play,” he said.
“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.”
For decades, cannabis has been branded as a ‘gateway drug’; a drug that leads individuals, especially younger users, to harder substances like cocaine, heroin and methamphetamine.
However, some research is disputing this claim.
Since the introduction of laws in Colorado and Washington legalising the sale of adult-use cannabis, research has found that there has been no increase in the number of teens and young adults seeking treatment for substance abuse of either opioids, cocaine, or methamphetamine.
Researchers from Temple University in Philadelphia and the University of Tennessee in Knoxville compared pre- and post-legalisation trajectories of substance abuse treatment admissions rates in Colorado and Washington to a set of other US states that did not legalise recreational cannabis use.
Specifically, investigators assessed treatment admissions for opioids, cocaine, and methamphetamine among those between 12 and 24 years of age.
Additionally, the treatment trajectories in those states did not significantly differ from comparable states that did not liberalise their cannabis laws.
Commenting on the study’s findings in a press release, Norml’s Deputy Director Paul Armentano said: “This data further undermines long standing claims that marijuana acts as any sort of a ‘gateway’ to the abuse of other controlled substances – an allegation that has, historically, largely guided prohibitionist-based marijuana policies in the United States despite a lack of hard evidence.”
Menopause and medical cannabis – how we’re tackling the stigma
A new event will explore how medical cannabis can help women manage symptoms of menopause
Ahead of World Menopause Day on Monday 18 October, Cannabis Health, Integro Medical Clinics and Cannabis Patients Advocacy and Support Services (CPASS) announce a new event exploring how cannabis can help manage symptoms.
The third episode in groundbreaking webinar series exploring the role of medical cannabis in women’s health, will focus on the multi-faceted and often challenging experiences of menopause and perimenopause.
Taking place online on Tuesday 30 November, a panel of expert clinicians and patients will discuss the experiences of women who have found these medicines helpful in managing their symptoms.
Menopause and perimenopause symptoms are chronically poorly treated in the modern healthcare system.
Many women are frequently, simply told to ‘manage their stress better’, ‘lose some weight’ or ‘do more exercise’ when seeking medical treatment for debilitating menopause symptoms which include anxiety, depression, insomnia, low libido, headaches and hot flushes, amongst others.
This lack of recognition can be both cultural and medical. Women often feel ashamed to speak openly about their experiences due to stigma and many doctors lack the training and time to treat symptoms effectively.
Increasingly women are finding cannabinoids helpful in managing some of their menopause symptoms.
Since the legalisation of cannabis-based medicines two years ago, female patients have been able to discover that the rebalancing of their endocannabinoid system can be incredibly helpful in the management of conditions ranging from Endometriosis, bladder and nerve pain, gynaecological pain and PMS to mental health conditions such as anxiety, insomnia and depression.
Aimed at both the general public and caregivers, the event will explore the experiences of women who have lived with perimenopause and menopause symptoms and how they have found cannabis-based medicines helpful.
Dr Sally Ghazaleh
Women’s health consultant at Integro Clinics. She specialises in managing patients with lower back pain, neck pain, neuropathic pain, abdominal pain, cancer pain and complex regional pain syndrome.
Dr Mayur Bodani
A neuropsychiatrist with over 25 years of experience, he has successfully treated many patients with psychiatric disorders such as depression, bipolar disorder, anxiety, psychosis, dementia and many other conditions.
Sarah Higgins CNS
Sarah is a clinical nurse specialist, with over 10 years of experience working in the NHS. She is also the women’s health lead at non-profit organisation CPASS Nurses Arm.
Having been a successful mental health nurse for 30 years, Lauren had to give up her career after being diagnosed with primary progressive MS. She has found cannabis medicines helpful in dealing with her MS symptoms and menopausal symptoms.
Rachel is founder of ‘Our Remedy’, a wellness brand for women. She has found CBD to be very helpful in dealing with her menopausal symptoms.
Lauren worked successfully as a mental health nurse for 30 years before menopause symptoms, alongside the symptoms of her primary progressive multiple sclerosis became so debilitating that she could no longer work and found daily life too difficult to handle.
“When I discovered cannabis medicines (CBMP’s), they completely changed my life. CBMP’s eased my anxiety and meant that I could get a decent night’s sleep. The fact that I was well-rested, meant that I could start to lightly exercise again, which was unthinkable a year ago,” Lauren said.
Medical cannabis has helped Lauren to deal with anxiety, brain fog, and gave her an overall sense of wellbeing. Lauren has found cannabis medicines have given her life back, she can once again exercise and return to her daily routine.
The webinar takes place on Tuesday 30 November at 7pm and is completely free of charge, go to the Eventbrite link here to register.
Integro Medical Clinics Ltd always recommends remaining under the care and treatment of your GP and specialist for your condition while using cannabis-based medicines. The Integro clinical team would always prefer to work in collaboration with them.
Breast milk of THC-positive mothers not harmful to short-term health of infants – study
Researchers reported no differences in short-term health impacts such as breathing difficulties or feeding issues.
According to a new study, the breast milk of THC-positive mothers was not found to be harmful to the short-term health of premature infants.
Researchers compared early pre-term infants who were breast-fed from mothers who consumed THC to those who were fed formula or breast milk from non-THC consuming mothers.
They reported that breast milk caused no differences in short-term health impacts such as breathing difficulties, lung development or feeding issues.
The study analysed the medical records of 763 early pre-term babies from 2014 to 2020. Researchers discovered that 17 per cent of the mothers tested positive for THC at the time of giving birth. They also examined post-natal exposure through breast milk.
Researchers found that overall the babies born to mothers who tested positive for cannabis were similarly healthy at the time of their discharge when fed their mothers breast milk in comparison to those who did not receive their mother’s breast milk.
The authors wrote in the abstract: “In our study, we found no evidence that providing [mother’s milk] MM from THC-positive mothers was detrimental to the health of this early preterm population through hospital discharge. A better understanding of longer-term perinatal outcomes associated with THC exposure both in-utero and postnatally via MM would inform appropriate interventions to improve clinical outcomes and safely encourage MM provision for early preterm infants.”
Breast milk from mothers who consume THC is often restricted by neonatal intensive care units because the effects on early preterm infants are unknown. It is thought that the active ingredient can pass through breast milk. Studies have shown that breast milk is a good way to improve pre-term baby outcomes and reduce infection risk along with intestinal issues.
Researchers cautioned women to abstain as the long term effects are still unknown.
THC-positive breast milk
Natalie L. Davis, associate professor of paediatrics at the University of Maryland School of Medicine said: “Providing breast milk from THC-positive women to preterm infants remains controversial since long-term effects of this exposure are unknown.”
She added: “For this reason, we continue to strongly recommend that women avoid cannabis use while pregnant and while nursing their babies. Our study, however, did provide some reassuring news in terms of short-term health effects. It definitely indicates that more research is needed in this area to help provide women and doctors with further guidance.”
“Teasing out the effects of THC can be very difficult to study,” Dr Davis concluded. “We found that women who screened positive for THC were frequently late to obtain prenatal care, which can have a detrimental effect on their baby separate from cannabis use. This is important to note for future public health interventions.”
The study abstract will be presented at the virtual American Academy of Paediatrics National Conference and Exhibition.
Half of US breast cancer patients use cannabis alongside treatment
A study also revealed that many patients do not share this information with their doctors
New research indicates that almost half of US adults with breast cancer use cannabis alongside their cancer treatment to manage symptoms.
Cancer patients often turn to cannabis for symptom relief alongside their treatment, with symptoms including pain, fatigue, nausea and other difficulties depending on the type of cancer and treatment.
Cancer is also one of the qualifying conditions for a prescription in several different US states. However many doctors feel they do not have the knowledge to discuss it patients, making more education essential for those working in healthcare.
Researchers conducted an anonymous online survey designed to examine cannabis use among adults who had been diagnosed with breast cancer. The participants were all members of the online communities, breastcancer.org and heathline.com.
The results revealed that of the 612 participants, 42 per cent reported using cannabis for symptom relief which included pain, insomnia, anxiety, stress and nausea. Among those, 75 per cent said it was extremely helpful at relieving their symptoms while 79 per cent said they used it during treatment such as systemic therapies, radiation and surgery.
Almost half of the participants who consumed cannabis believed that it can be used to treat cancer itself despite its effectiveness being unclear. Most participants believed that cannabis products are safe.
Patients in the survey used a wide variety of products with various qualities and purities. Half of the participants sought information online. They felt that other patients were the most helpful source of information while doctors ranked low on the list.
Most of the participants who sought information on cannabis use for medical purposes were unsatisfied with the information they were given.
Lead author Marisa Weiss, of Lankenau Medical Center, said: “Our study highlights an important opportunity for providers to initiate informed conversations about medical cannabis with their patients, as the evidence shows that many are using medical cannabis without our knowledge or guidance.”
She added: “Not knowing whether or not our cancer patients are using cannabis is a major blind spot in our ability to provide optimal care. As healthcare providers, we need to do a better job of initiating informed conversations about medical cannabis with our patients to make sure their symptoms and side effects are being adequately managed while minimising the risk of potential adverse effects, treatment interactions, or non-adherence to standard treatments due to misinformation about the use of medical cannabis to treat cancer.”
Introducing our new B2B title
- Menopause and medical cannabis – how we’re tackling the stigma
- ADHD: “I wasn’t naughty, the world just looked different to me”
- British footballer sentenced to 25 years in Dubai jail over CBD
- CBD brand teams up with Welsh artist to highlight emotions of lockdown
- Breast milk of THC-positive mothers not harmful to short-term health of infants – study
- Combining CBD and CBG for the ultimate entourage effect
News11 months ago
Community extends support to cannabis icon Rick Simpson
News1 year ago
NHS lines up cannabis medicine manufacturing
Case Studies2 years ago
CBD oil and fibromyalgia – a case study
News1 year ago
Cancer survivor claims cannabis oil helped her beat brain tumour
Insight1 year ago
I’ve gone from a wheelchair to walking thanks to cannabis
News9 months ago
UK grants second licence to grow high-THC medical cannabis
Feature1 year ago
Medical cannabis could help long-term effects of COVID-19, says David Nutt
News11 months ago
Living with chronic fatigue – my CBD story