Search Results for: opioids

Can Opioids Be Replaced By CBD Oil?

Perhaps one of the more compelling arguments for legalizing medical cannabis is the fact that evidence heavily suggests that it is able to provide most of the benefits of widely-used opioids without the potentially lethal side effects that come from misuse.

Opioids are currently the most-abused type of prescription drug in the United States. In 2017, 47,000 Americans died as the result of opioid abuse, from drugs sourced from both legal and illegal sources. However, it’s difficult for many American medical professionals to avoid prescribing opioids due to the effectiveness of these drugs at managing pain.

This is exacerbated by the fact that pharmaceutical companies have been found complicit in lobbying for the wider use of these classes of drugs, which has led to unnecessary prescriptions and an increased potential for abuse. A number of cities have even sued the pharmaceutical industry for causing the crisis.

However, we already have a powerful equivalent to opioids for pain management that carries fewer side effects and reduced potential for abuse in medical cannabis – specifically cannabidiol, better known as CBD oil.

While medical cannabis, in general, has been found to have uses for the type of pain management normally treated by opioids, adoption has been slow thanks to fears and misconceptions about the psychoactive effects of cannabis, specifically its active ingredient tetrahydrocannabinol, also known as THC.

In the course of decades of medical cannabis research, it has been found that CBD has most of the benefits of THC, without the strong psychoactive effects that normally come with it. The potential for abuse is also much reduced from regular cannabis with THC, which in itself is already lower than the abusive potential of most opioids used for pain treatment.

CBD Oil and FibromyalgiaReasons CBD Oil hasn’t replaced opioids

So why hasn’t CBD oil been more widely adopted? Ultimately it has to do with the incredibly complicated nature of cannabis. Cannabis plants contain more than 500 chemical compounds. Isolating these compounds can be difficult and expensive, and it’s hard to recreate findings of previous studies create controls for studies involving cannabis due to the sheer complexity of the plant. Different strains of cannabis and varying levels of different chemicals in each strain can also affect different people in different ways.

There are also new discoveries made about cannabis that may dissuade its more widespread use. For instance, it was found that even relatively small doses can irreversibly alter the brains of teens, which may mean that in the near future, doctors may not prescribe cannabis for teens and young adults.

Conclusion

Even with these setbacks, however, it’s safe to say that CBD oil will likely have a role to play in helping solve the opioid crisis, though not by itself. The crisis is multifaceted, with economic and social angles to consider, which make it unlikely that any single solution will be workable.

Instead what is more likely to work might be a multi-pronged solution that involved weaning opioid abuse victims off drugs with different types of therapy as well as preventing the potential for abuse by substituting opioids with CBD when possible for pain management.

 

 

Study: Majority Of Chronic Pain Patients Replace Opioids With Cannabis

OHIO: More than two-thirds of chronic pain patients registered to legally access medical cannabis products substitute marijuana for prescription opioids, according to data published in The Journal of Headache and Pain.

Investigators from the United States and Canada assessed the use of medical cannabis and prescription drugs in a cohort of over 2,000 Canadian patients licensed to access marijuana products. Among those patients with a primary diagnosis of chronic pain, 73 percent reported substituting cannabis in place of opioids. Among those patients diagnosed specifically with headache/migraine, cannabis was frequently reported as a substitute for other medications – including opiates (43 percent), anti-depressants (39 percent), NSAIDS (21 percent), triptans (8 percent), and anti-convulsants (8 percent).

“Most patients in the pain groups reported replacing prescription medications with medicinal cannabis, the most common of which were opiates/opioids across all patient groups,” authors concluded. “This is notable given the well-described ‘opioid-sparing effect’ of cannabinoids and growing abundance of literature suggesting that cannabis may help in weaning from these medications and perhaps providing a means of combating the opioid epidemic.”


For more information, contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, “Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort,” appears in The Journal of Headache and Pain. NORML’s fact-sheet highlighting the relevant, peer-reviewed research specific to the relationship between cannabis and opioids is available online.

Oregon Marijuana Company Launches Cannabis For Opioids Swap

OREGON: Kaya Holdings has announced it will be holding talks with Oregon state and local law enforcement authorities and compliance officials to launch “Kaya Cares,” a Cannabis-for-Opioids swap program whereby people dependent on opioids and wishing to explore cannabis as a safe alternative can exchange their prescription opioids for cannabis products at no cost.

“We decided to step up and do our part after President Trump announced the war on the opioid epidemic,” commented Kaya Holdings CEO Craig Frank, “Numerous studies, including those reported by Newsweek, NBC News, US News and World Report, CNN and others, have shown that states with legal marijuana programs have declining rates of opioid addiction, with some states reporting a decrease in deaths as high as 25%. We want to help people in the communities we serve, as well as demonstrate that cannabis companies can be part of the President’s solution to the crisis.”

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KAYS presently operates three Kaya Shack marijuana retail stores to service the legal medical and recreational marijuana market in Oregon, with a fourth retail outlet scheduled to open shortly. Additionally, KAYS recently acquired a 26 acre parcel in Lebanon, Oregon, on which it plans to develop the Kaya Farms medical and recreational marijuana grow and manufacturing complex, at which it plans to explore development of  opioid-free cannabis infused pain relief alternatives.

Adds KAYS Senior Advisor, W. David Jones, “The opioid epidemic kills an average of 91 Americans a day. Beyond the human cost in lives and devastated families, the epidemic disrupts our economy with reduced productivity and increased healthcare costs. We realize this administration has been reviewing its stance on legal marijuana and we appreciate US Attorney Jeff Sessions’ clarification to Congress regarding the Cole Amendment. We wish to heed President Trump’s call to create constructive, private sector based initiatives with high probabilities of success. We believe a program like Kaya Cares and other initiatives to be undertaken by KAYS will help transition people away from dangerous opioids, making the government’s war on opioids a little more successful.”

Patients Use Fewer Opioids Following Enrollment In Medical Cannabis Program

NEW YORK:  Patients enrolled in New York state’s medical cannabis program reduce their use of opioids and spend less money on prescription medications, according to data published online in the journal Mental Health Clinician.

Investigators from GPI Clinical Research labs in Rochester and the University of Buffalo assessed trends in patients’ medical cannabis and prescription drug use following their enrollment in the state’s marijuana access program.

On average, subjects’ monthly analgesic prescription costs declined by 32 percent following enrollment, primarily due to a reduction in the use of opioid pills and fentanyl patches. “After three months treatment, medical cannabis improved [subjects’] quality of life, reduced pain and opioid use, and lead to cost savings,” authors concluded.

The study’s findings are similar to those reported among enrollees in other states’ medical cannabis programs, including the experiences of patients in IllinoisMichiganMinnesotaNew Mexico, and elsewhere.


For more information, contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, “Preliminary evaluation of the efficacy, safety, and costs associated with the treatment of chronic pain with medical cannabis,” appears in The Mental Health Clinician. NORML’s fact-sheet highlighting the relevant, peer-reviewed research specific to the relationship between cannabis and opioids is available online.

85% Of U.S. Doctors Suspect Their Patients Abuse Opioids

Survey shows 77% list medical marijuana as least preferred alternative

MASSACHUSETTS:  The opioid epidemic causes more than 100 overdoses daily in America and fewer than 1 in 5 treating physicians approve of the government’s handling of the crisis. These findings are from a new survey of 501 physicians conducted by InCrowd and McLean Hospital.

“The doctors we surveyed showed incredible passion for this topic—they had significant insight into fixing it,” says Danielle Schroth, InCrowd’s Director of Crowd Development. “They’re frustrated that they can’t do enough for their patients’ wellbeing.”

“Part of what got us into this current crisis was physician behavior, well-meaning physician behaviors,” says Rocco Iannucci, MD, of McLean Hospital’s Division of Alcohol and Drug Treatment. “The survey uncovered physicians’ pressures towards treating pain and addiction.”

The survey fielded by InCrowd, pioneer of real-time life science market intelligence, and McLean Hospital’s Division of Alcohol and Drug Treatment Programming, also found:

  • Nearly half (47%) disapprove of the federal government’s response
  • Forty-four percent called for stricter regulations to curb opioid abuse, while 18% wanted to discontinue opioid prescriptions all together
  • Ten percent wanted to end patient satisfaction surveys, which put pressure on physicians for positive patient ratings
  • Nonsteroidal anti-inflammatory drugs (NSAIDS) are the most preferred treatment alternative (68%), followed by lifestyle changes.

“There is limited education historically on treatment of pain,” says Dr. Iannucci. “So, doctors may only be familiar with a few things—perhaps Tylenol, ibuprofen, and then they move to opioids. More systematic education of medical students and residents in all specialties, and not just in pain specialization, is really important.”

Infographic: Cannabis Vs. Opioids

Cannabis has been used to treat ailments since 4000 BC. Despite its abilities to offer relief for those in pain, this drug became demonized and criminalized beginning in the early 20th century.

Conversely, in the 1990s, opioid prescriptions took off, leading to an epidemic of dependency and overdoses. Until this time, chronic pain was severely untreated.

Cannabis has been proven to alleviate chronic pain without the health risks posed by opioids. Our team at Apollo Cannabis Clinic created the below infographic, “Cannabis Vs. Opioids,” to offer an in-depth comparison between these two drugs – and ultimately offer an alternative to opioids.

cannabisvopiods

Poll: Marijuana Safer Than Opioids, But Moms Shouldn’t Use

By Kristen Wyatt, Associated Press

COLORADO: Americans think it’s safer to use marijuana than opioids to relieve pain, but they were less comfortable with children and pregnant women using pot to treat medical conditions, according to a new Yahoo/Marist poll released Monday.

Two-thirds of the respondents in the telephone survey said opioid drugs such as Vicodin or OxyContin are “riskier” to use than pot, even when the pain pills are prescribed by a doctor.

Only one in five said marijuana was riskier than opioids. The rest weren’t sure.

Every day, an overdose of prescription opioids or heroin kills 91 people, and legions more are brought back from the brink of death. Some 2 million Americans are thought to be hooked on the pills.

Last month, President Donald J. Trump appointed an opioid commission to look into the problem.

Marijuana by itself is not fatal. Doctors technically don’t prescribe it for pain or other purposes but most states that allow medical marijuana do require patients to get a doctor’s written recommendation to purchase it to treat their conditions.

Among those answering the Yahoo/Marist poll, 83 percent said the drug should be legal nationally for medical treatment.

But 70 percent said it is not acceptable for pregnant women to use marijuana to reduce nausea or pain. And the survey respondents were about evenly divided on whether marijuana should be recommended for children if it were legal.

The survey respondents were deeply divided on how Trump should approach pot: 38 percent said he shouldn’t be as tough about enforcing federal laws against recreational pot use as President Barack Obama, whose policy generally was to leave states alone.

Another 30 percent said Trump should take a harder line than Obama, while the rest weren’t sure or said Trump should treat it about the same as Obama did.

Trump’s administration has sent mixed messages to the 28 states and Washington, D.C., in violation of federal drug law when it comes to pot.

Trump said as a candidate that states should be allowed to tinker with marijuana laws. But new U.S. Attorney General Jeff Sessions has said marijuana is dangerous and marijuana changes by states should not be allowed.

There has been no action yet by the U.S. Justice Department or any other federal agencies to crack down on states violating the Controlled Substances Act, which bans pot for any use.

The Yahoo/Marist telephone poll of 1,122 adults was conducted last month and had a margin of error of plus or minus 2.9 percentage points.

Mentor Capital Discusses Opioids Vs. Cannabis at Congressman Rohrabacher Reception

CALIFORNIA: Mentor Capital  met with Congressman Dana Rohrabacher of Newport Beach at his reception by the Cannabis Host Committee in San Diego, March 6th, 2017. Mentor CEO Chet Billingsley, nicknamed “The Doc” by the Congressman, outlined in discussion how 20% of the opiate crises and 6,000 annual deaths could be avoided by the projected 20% substitution to legal cannabis from other illegal drugs that would follow a national marijuana legalization. Too much cannabis puts the user to sleep, but too much opiate, heroin or even alcohol can “relax” breathing to zero and overdose death. An additional 6,000 lives are saved by an observed 7% shift from alcohol.

Congressman Rohrabacher spoke to the exclusive group of major cannabis leaders on freedom as a cornerstone American value that is violated whenever a peaceful cannabis user is dragged off to be caged. He jokingly held a Moscow Mule drink in hand and asked how even in this time of Russian hysteria how could this rowdy alcohol be accepted and mellowing cannabis not be. The Congressman also railed against the practice of asset forfeiture being applied against legal cannabis firms without trial or even charges being levied. Reporting on his own Washington, DC cannabis prognosis, he felt that the campaign promise by now President Trump that cannabis use should be governed by the choices of each state, would prevail.

Following the political overview by Congressman Rohrabacher, the founders of the larger cannabis companies met with CEO Billingsley to explore how Mentor may provide public market liquidity and funding for their long-established medical marijuana and adult use cannabis enterprises.

Study Finds Patients Choosing Cannabis Over Opioids

Research shows people with chronic pain or mental health issues prefer taking cannabis over prescription opioid medications to treat symptoms

By Amy Wallace

CANADA: Researchers from the University of British Columbia and the University of Victoria have found patients prefer cannabis over opioid medication to treat chronic pain and mental health issues.

“This study is one of the first to track medical cannabis use under the new system of licensed producers, meaning that all participants had physician authorization to access cannabis in addition to their prescription medicines,” Associate Professor Zach Walsh of UBC and co-author of the study, said in a press release.

Researchers studied more than 250 patients registered to purchase cannabis from Tilray, a federally licensed producer, with prescribed medical cannabis for the treatment of chronic pain, mental health and gastrointestinal issues. Participants responded to an online survey on cannabis use.

Results showed nearly 63 percent of patients reported using cannabis instead of their prescription medication, which included opioids, sedatives and anti-depressants.

Results showed the main reason for the preferred use of cannabis over opioid medications was due to the reduced side effects, better symptom management and a feeling that cannabis is safer.

“Further research into how well cannabis works compared to the accepted front-line treatments is warranted,” Walsh said. “Additionally, long-term research into the potential impact of the cannabis substitution on the quality of patient’s lives is ongoing.”

The study was lead by Phillippe Lucas, a graduate fellow at the University of Victoria Center for Addictions Research of British Columbia and vice president of Patient Research and Access at Tilray, a federally authorized medical cannabis production company.

The study was published in the International Journal of Drug Policy.

Justice Department Announces Global Resolution of Criminal and Civil Investigations with Opioid Manufacturer Purdue Pharma and Civil Settlement with Members of the Sackler Family

DISTRICT OF COLUMBIA: Today (10/21/2020), the Department of Justice announced a global resolution of its criminal and civil investigations into the opioid manufacturer Purdue Pharma LP (Purdue), and a civil resolution of its civil investigation into individual shareholders from the Sackler family.  The resolutions with Purdue are subject to the approval of the bankruptcy court.

“The abuse and diversion of prescription opioids has contributed to a national tragedy of addiction and deaths, in addition to those caused by illicit street opioids,” said Deputy Attorney General Jeffrey A. Rosen.  “With criminal guilty pleas, a federal settlement of more than $8 billion, and the dissolution of a company and repurposing its assets entirely for the public’s benefit, the resolution in today’s announcement re-affirms that the Department of Justice will not relent in its multi-pronged efforts to combat the opioids crisis.”

“Today’s resolution is the result of years of hard work by the FBI and its partners to combat the opioid crisis in the U.S.,” said Steven M. D’Antuono, Assistant Director in Charge of the FBI Washington Field Office.  “Purdue, through greed and violation of the law, prioritized money over the health and well-being of patients.  The FBI remains committed to holding companies accountable for their illegal and inexcusable activity and to seeking justice, on behalf of the victims, for those who contributed to the opioid crisis.”

“The opioid epidemic remains a significant public health challenge that impacts the lives of men and women across the country,” said Gary L. Cantrell Deputy Inspector General for Investigations at the U.S. Department of Health and Human Services’ Office of Inspector General.  “Unfortunately, Purdue’s reckless actions and violation of the law senselessly risked patients’ health and well-being.  With our law enforcement partners, we will continue to combat the opioid crisis, including holding the pharmaceutical industry and its executives accountable.”

“This resolution closes a particularly sad chapter in the ongoing battle against opioid addiction,” said Drug Enforcement Administration (DEA) Assistant Administrator Tim McDermott.  “Purdue Pharma actively thwarted the United States’ efforts to ensure compliance and prevent diversion.  The devastating ripple effect of Purdue’s actions left lives lost and others addicted.  DEA will continue to work tirelessly with our partners and the pharmaceutical industry to address the damage that has been done, and bring an end to this epidemic that has gripped the nation for far too long.”

Purdue Pharma has agreed to plead guilty in federal court in New Jersey to a three-count felony information charging it with one count of dual-object conspiracy to defraud the United States and to violate the Food, Drug, and Cosmetic Act, and two counts of conspiracy to violate the Federal Anti-Kickback Statute.  The criminal resolution includes the largest penalties ever levied against a pharmaceutical manufacturer, including a criminal fine of $3.544 billion and an additional $2 billion in criminal forfeiture.  For the $2 billion forfeiture, the company will pay $225 million on the effective date of the bankruptcy, and, as further explained below, the department is willing to credit the value conferred by the company to State and local governments under the department’s anti-piling on and coordination policy.  Purdue has also agreed to a civil settlement in the amount of $2.8 billion to resolve its civil liability under the False Claims Act.  Separately, the Sackler family has agreed to pay $225 million in damages to resolve its civil False Claims Act liability.

The resolutions do not include the criminal release of any individuals, including members of the Sackler family, nor are any of the company’s executives or employees receiving civil releases.

While the global resolution with the company is subject to approval by the bankruptcy court in the Southern District of New York, one important condition in the resolution is that the company would cease to operate in its current form and would instead emerge from bankruptcy as a public benefit company (PBC) owned by a trust or similar entity designed for the benefit of the American public, to function entirely in the public interest.  Indeed, not only will the PBC endeavor to deliver legitimate prescription drugs in a manner as safe as possible, but it will aim to donate, or provide steep discounts for, life-saving overdose rescue drugs and medically assisted treatment medications to communities, and the proceeds of the trust will be directed toward State and local opioid abatement programs.  Based on the value that would be conferred to State and local governments through the PBC, the department is willing to credit up to $1.775 billion against the agreed $2 billion forfeiture amount.  The department looks forward to working with the creditor groups in the bankruptcy in charting the path forward for this PBC so that its public health goals can be best accomplished.

The Criminal Pleas

As part of the plea, Purdue will admit that from May 2007 through at least March 2017, Purdue conspired to defraud the United States by impeding the lawful function of the DEA by representing to the DEA that Purdue maintained an effective anti-diversion program when, in fact, Purdue continued to market its opioid products to more than 100 health care providers whom the company had good reason to believe were diverting opioids and by reporting misleading information to the DEA to boost Purdue’s manufacturing quotas.  The misleading information comprised prescription data that included prescriptions written by doctors that Purdue had good reason to believe were engaged in diversion.  The conspiracy also involved aiding and abetting violations of the Food, Drug, and Cosmetic Act by facilitating the dispensing of its opioid products, including OxyContin, without a legitimate medical purpose, and thus without lawful prescriptions.

In addition, Purdue will admit to conspiring to violate the Federal Anti-Kickback Statute.  Between June 2009 and March 2017, Purdue made payments to two doctors through Purdue’s doctor speaker program to induce those doctors to write more prescriptions of Purdue’s opioid products.  Similarly, from approximately April 2016 through December 2016, Purdue made payments to Practice Fusion Inc., an electronic health records company, in exchange for referring, recommending, and arranging for the ordering of Purdue’s extended release opioid products – OxyContin, Butrans, and Hysingla.

The Civil Settlements

The department’s civil settlements resolve the United States’ claims as to both Purdue and its individual shareholders, members of the Sackler family.

The civil settlement with Purdue provides the United States with an allowed, unsubordinated, general unsecured bankruptcy claim for recovery of $2.8 billion.   This settlement resolves allegations that from 2010 to 2018, Purdue caused false claims to be submitted to federal health care programs, specifically Medicare, Medicaid, TRICARE, the Federal Employees Health Benefits Program, and the Indian Health Service.  The government alleged that Purdue promoted its opioid drugs to health care providers it knew were prescribing opioids for uses that were unsafe, ineffective, and medically unnecessary, and that often led to abuse and diversion.  For example, Purdue learned that one doctor was known by patients as “the Candyman” and was prescribing “crazy dosing of OxyContin,” yet Purdue had sales representatives meet with the doctor more than 300 times.  It also resolves the government’s allegations that Purdue engaged in three different kickback schemes to induce prescriptions of its opioids.  First, Purdue paid certain doctors ostensibly to provide educational talks to other health care professionals and serve as consultants, but in reality to induce them to prescribe more OxyContin.  Second, Purdue paid kickbacks to Practice Fusion, as described above.  Third, Purdue entered into contracts with certain specialty pharmacies to fill prescriptions for Purdue’s opioid drugs that other pharmacies had rejected as potentially lacking medical necessity.

Under a separate civil settlement, individual members of the Sackler family will pay the United States $225 million arising from the alleged conduct of Dr. Richard Sackler, David Sackler, Mortimer D.A. Sackler, Dr. Kathe Sackler, and Jonathan Sackler (the Named Sacklers).  This settlement resolves allegations that, in 2012, the Named Sacklers knew that the legitimate market for Purdue’s opioids had contracted.  Nevertheless, they requested that Purdue executives recapture lost sales and increase Purdue’s share of the opioid market.  The Named Sacklers then approved a new marketing program beginning in 2013 called “Evolve to Excellence,” through which Purdue sales representatives intensified their marketing of OxyContin to extreme, high-volume prescribers who were already writing “25 times as many OxyContin scripts” as their peers, causing health care providers to prescribe opioids for uses that were unsafe, ineffective, and medically unnecessary, and that often led to abuse and diversion.

The civil settlement also resolves the government’s allegations that from approximately 2008 to 2018, at the Named Sacklers’ request, Purdue transferred assets into Sackler family holding companies and trusts that were made to hinder future creditors, and/or were otherwise voidable as fraudulent transfers.

Today’s resolution does not resolve claims that states may have against Purdue or members of the Sackler family, nor does it impede the debtors’ ability to recover any fraudulent transfers.

Today’s announcement was made by Deputy Attorney General Jeffrey A. Rosen; Acting Assistant Attorney General of the Civil Division Jeffrey Clark; U.S. Attorney for the District of Vermont Christina Nolan; and First Assistant U.S. Attorney for the District of New Jersey Rachael Honig.  The criminal investigation was conducted by the U.S. Attorney’s Offices for the Districts of New Jersey and Vermont, the Consumer Protection Branch of the Department of Justice’s Civil Division, and the FBI’s Washington, D.C. and Newark Field Offices, with assistance by DEA.  The civil settlements were handled by the Fraud Section of the Commercial Litigation Branch of the Department of Justice’s Civil Division, and the U.S. Attorney’s Offices for the Districts of New Jersey and Vermont, with assistance from the Department of Health and Human Services, Office of General Counsel and Office of Counsel to the Inspector General; the Defense Health Agency; and the Office of Personnel Management.  The Purdue bankruptcy matter is being handled by the U.S. Attorney’s Office for the Southern District of New York and the Civil Division’s Commercial Litigation Branch, Corporate/Finance Section.

Except to the extent of Purdue’s admissions as part of its criminal resolution, the claims resolved by the civil settlements are allegations only.  There has been no determination of liability in the civil matters.