The elephant in the room: Why do we overlook medical marijuana for addictive painkillers?

By Becky DeKeuster, Special to the BDN
Posted Feb. 05, 2014, at 1:46 p.m.

Last month, the Maine attorney general’s office announced troubling news — that heroin overdoses in Maine quadrupled between 2011 and 2012. This had state leaders and policy experts frantically playing the blame game pointing to the economy, to MaineCare cuts and to recent restrictions on obtaining prescription opiates as the explanations for why more Mainers are turning to the street drug heroin to manage pain, addiction, or perhaps both.

The elephant in the room has never been more visible: The medical community needs to begin seriously considering medical marijuana as a viable treatment option to manage chronic pain and move away from opiates.

Chronic pain is clinically defined as pain lasting more than six months that doesn’t respond to standard medical or surgical procedures. Once diagnosed with chronic pain, patients move from treatment to pain management. Treatments include acupuncture, electrical stimulation, physical therapy, psychotherapy and steroid injections. The most common pain management treatment, however, is the use of opiates. In fact, an international study done in 2010 revealed 80 percent of the world’s opiates are consumed by Americans.

Diagnosed, chronic pain is a qualifying condition for the use of medical marijuana in Maine. Promising studies here and abroad have concluded that marijuana plays an important role in reducing addiction to, and abuse of, opiates, while providing similar analgesic benefits with far fewer physical and social risks.

To emphasize this point, the Center for Disease Control says that 38,329 people died of drug overdoses in 2010. Sixty percent of these overdoses were caused by pharmaceutical opiates. Meanwhile, there is no record of anyone overdosing on medical marijuana.

It defies reason that we regularly prescribe patients a six-month course of opiate pharmaceuticals, which carries a grave risk of physical dependency, and that we ask patients to use a drug that is responsible for thousands of overdose deaths each year, before we offer the alternative of a natural substance that will effectively manage pain without the same threats of addiction or overdose.

Anyone who has found it necessary to use medications such as Vicodin or oxycodone knows that six months is more than enough time to develop a serious physical dependency on it, if not a full-blown addiction. Such addiction has, in many cases, ultimately led to severe withdrawal symptoms or, worse still, overdose and death.

Some may argue that the cause of the increase in overdose deaths is directly related to the loss of MaineCare funding due to the state’s failure to expand Medicaid. This position fails to recognize that this isn’t an issue of money or politics. It’s about providing the best patient care available. There is an existing treatment at our disposal that is, tragically, being overlooked.

Yet many physicians are unwilling to certify patients to use medical marijuana. Some cite fear of losing federal funding; some point to a lack of studies proving the medical efficacy of the natural plant; and others simply have no framework other than to view medical marijuana as a drug of abuse.

The tragic spike in heroin-related deaths prompts an overdue discussion: Instead of leading people down the path to opiate addiction, overdose and possible death, shouldn’t we be leading them to the least-harmful treatment and recovery option? Medical marijuana should be on the front line of treatments for chronic pain.

Becky DeKeuster is executive director of Wellness Connection of Maine, which operates four of Maine’s eight licensed, nonprofit medical cannabis dispensaries.

 

http://bangordailynews.com/2014/02/05/opinion/the-elephant-in-the-room-why-do-we-overlook-medical-marijuana-for-addictive-painkillers/ printed on September 20, 2014