Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Friday, November 27, 2015

Therapeutic Recreation

"Gone is the day where a patient says, 'I smoke cannabis recreationally and I continue to do this for my pain' — and I have to shy away from that. I can say, medically, I have a prescription pad and I can actually bring [cannabis] to the table as part of their pain regimen."
"Right now we’re not really using it [marijuana] as a medication. We’re giving people permission to experiment with it."
Dr. Hance Clarke, Toronto General Hospital

"We’re kind of conditioned in society to look down on marijuana, because of all the propaganda we’ve been fed all our lives. [But] it’s basically given me my life back."
Bob Deslauriers, 58, hepatitis C sufferer

Bob Deslauriers' medial marijuana joints contain high-potency pot which has lessened his dependence on a type of morphine for pain control.
Chris Roussakis for National Post   Bob Deslauriers' medial marijuana joints contain high-potency pot which has lessened his dependence on a type of morphine for pain control.
"We have a statewide epidemic of opioid deaths. As soon as we can get people off opioids to a nonaddicting substance — and medicinal marijuana is nonaddicting — I think it would dramatically impact the amount of opioid deaths."
Dr. Gary Witman of Canna Care Docs, Fall River Canna Care clinic
In Canada, a multi-hospital research project is underway for the purpose of testing the wisdom of substituting a non-addictive drug for a hugely addictive one. The idea is to overcome a social problem that is both debilitating and deathly. When physicians prescribe opioids for their patients for short-term use in controlling pain, the end result is often addiction. And opioids, though they fulfill the objective of dulling pain, create an additional, worse problem; addiction leading to death.

And even while this research is being pursued, surveys suggest that medical-cannabis users are taking the initiative of their own accord and substituting pot for prescription pharmaceuticals. Canada is recognized to be second only to the United States in the use of opioids through prescription. The result has been hundreds of Canadians dying annually, from overdoses. And it's not because they are overdosing themselves necessarily, but merely using what their doctors have prescribed.

Of course huge numbers of people caught in the addiction cycle are there because they have spiralled from its legitimate, prescribed use to over-consumption because they have become heavily addicted, adding to the death toll. A case study was recently made public by Dr. Hance Clarke out of Toronto General Hospital, who co-authored it as part of his association with Ontario's Transitional Pain Service, provincially funded to aid post-operative patients who become dependent on medication.

One patient in particular was the subject of the study, and the outcome appears to point the way through to making opioids redundant with the simple substitution of a far less harmful drug which can achieve the positive effects that opioids are known for, without burdening users with their negatively harmful consequences. That patient was a man from Eastern Ontario whose back operation in 1987 left him with a hepatitis C infection transmitted by tainted blood in a transfusion.

Eventually his liver was destroyed and a transplant required. As a result of his health condition and the surgeries this engineer and former corporate CEO was dependent on so much painkiller he was unable to function. And then marijuana was provided for his use and that made it possible for him to be gradually weaned away from most of the opioids he had been dependent on; the exception being a small dose of morphine.

The result was the return of his intellectual capacity and his ability to function again as he normally would. His dependence on the legal but debilitating drug was alleviated by the introduction of a once-illicit drug and a medical-prescriptive war was won. Or potentially gained, since Dr. Hance points out with all due caution that one problem solved simply is one problem solved.

The results could be reflected in other patients with similar problems, but until numerous patients are studied under a rigorous, randomized controlled trial, celebration is somewhat premature. But this kind of experimental exchange of prescribed drugs is happening elsewhere, too.

A number of clinics and physicians in Boston, Massachusetts have launched a program of drug substitution, finding the new protocol far more beneficial to their patients. Canna Care Docs operates in seven States of the Union as a network of facilities whose doctors issue medicinal marijuana cards, including to their patients in the nine clinics they operate in Massachusetts. 

On the other hand, for every enthusiast about enlisting the aid of marijuana and rejecting harder drugs, there is an opposing view that holds that any time additional drugs are added to the situation, problems ensue and it is drugs themselves and their addiction potential and how that affects people's lives that is the problem. These are people who view marijuana as a 'gateway' drug leading users to harder drug use, and the downward spiral that results.

For Bob Deslauriers that substitution saved his life, transforming him from someone who merely existed with no quality of life left to him under the pain-killing for life-numbing effect of opioids, to being able to resume his former work schedule with the use of a marijuana strain high in the compound cannabidiol (CBC) to treat his pain, and another with plenty of tetrahydrocannabinol (THC) to control chronic nausea.

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