CANNABIS USE & THE DECLINE IN PRESCRIPTION MEDS

Thursday, April 20, 2017

The dialogue around cannabis is changing and the once long-held beliefs are being dispelled.

As the battle for access to cannabis continues, general society is now beginning to speak differently about the world's most used and sought after illicit (soon-to-be/somewhat legal) drug. In recent years science is moving at an unrelenting pace to better understand cannabis. Cannabis is now considerably referred to and recognized for its medical and therapeutic purposes and as a result many people are reducing their dependence on pharmaceuticals because of the positive benefits of cannabis.
 

In the last four years (2014-2017)...

...multiple large scale studies have been published highlighting the highly medical benefits & economically promising effects of cannabis. In 2014, scientists in the USA looked at the how medical cannabis laws in all 50 states were associated to opioid analgesic overdose mortality between 1999 to 2010. It was discovered that states with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws. In 2016, researchers looked at Medicare prescription costs from 2010 to 2013 and found that states which legalized medical cannabis saw declines in the number of Medicare prescriptions for drugs used to treat those conditions, such as chronic pain, anxiety or depression. Those declines equated to about $165 million US in Medicare savings in 2013 and was estimated that, if medical cannabis were available nationwide, spending could be reduced by about $470 million. The mounting evidence of subsituting cannabis for pharmaceutical drugs is undeniable!
 

But what is happening in Canada?

Since Canada's first medical cannabis program in 2001 Canadians have seen and fought for their legal rights to use, grow and access cannabis safely. The recent Liberal government has even set out a list of recommendations for the legalization process, estimated to be shown in parliament spring of 2017. For more information visit our: CANADIAN CANNABIS HISTORY
 

While Canadians await regulation change important research is being completed to shape Canadian laws and the knowledge around the benefits of cannabis use in Canada.

 
In our very-own okanagan backyard, researcher Dr. Zach Walsh has been tackling the many stigmas of cannabis. In 2013, Dr. Walsh and collegues published Cannabis for therapeutic purposes: Patient characteristics, access, and reasons for use with the intent of reporting the demographic characteristics, medical conditions and symptoms, reasons for use, perceived effects, and authorized and unauthorized modes of accessing cannabis for therapeutic purposes among Canadians.  The largest study of its type at the time showed Canadians explicitly reported using cannabis to effectively address pain, sleep disturbance, and anxiety. In 2014 and 2015 the Walsh lab published two more studies addressing; 1. Barriers to medical cannabis access for Canadians and 2. Substituting cannabis for prescription drugs, alcohol and other substances. Both of these studys held a significant impact on the Allard v. Canada, 2016 federal court case. Dr. Walsh testified at the Allard court case and his lab's research was highlighted throughout the case. Inline with those previously mentioned findings in the USA, Dr. Walsh and collegues discovered that 87% of Canadian respondents using medical cannabis were substituting cannabis for one or more of alcohol, illicit drugs or prescription drugs, with 80.3% reporting substitution for prescription drugs, 51.7% for alcohol, and 32.6% for illicit substances, They also found that patients under 40 years of age were more likely to substitute cannabis for all three classes of substance than older patients. Furthermore, those who reported substituting cannabis for prescription drugs were also more likely to report difficulty affording sufficient quantities of cannabis.
 
Most recently, in 2017 the Walsh lab in collaboration with the LP (Government Approved - License Producer) Tilray published a survey of 271 authorized medical cannabis patients, defining the different classes of prescription drugs that are being substituted for cannabis. A total of 63% of medical patients of this survey reported cannabis use as a substitute for general prescription drugs, specifically 30% for pharmaceutical opioids, 16% for benzodiazepines, and 12% for antidepressants. These medical patients also reported substituting cannabis for other substance use aswell; including 25% of patients substituting for alcohol use, 12% for cigarettes/tobacco use, and 3% for illicit drug use. 
 
Research is showing why Canadians are using cannabis, their movement away from prescription drugs and why they will continue to do so.
 
This research is highlighting trends in how people are moving away from pharmaceutical medications and substituting with cannabis. It shows how governments and society in general are benefiting from cannabis both economically and in the sense of personal healthcare. Research will continue to progress, and Canadians will continue to use cannabis in-lieu of alcohol, illicit, or prescription drugs. Just imagine what the future of cannabis will be in Canada!
 
Canadians have known what cannabis can add your health and well-being,
Now, we are grateful that research is starting to catchup to what many
longtime cannabis users have understood for decades.


FURTHER READINGS OF INTEREST:

Cone et al. 2008. Urine drug testing of chronic pain patients: licit and illicit drug patterns. Journal of Analytical Toxicology 32: 532-543.

Ryan-Ibarra et al. 2014. Prevalence of medical marijuana use in California, 2012. Drug and Alcohol Review 34: 141-146.

Abrams et al. 2007. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology 68: 515-521.

Ellis et al. 2008. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. Neuropsychopharmacology 34: 672-80.

Wallace et al. 2007. Dose-dependent effects of smoked cannabis on Capsaicin-induced pain and hyperalgesia in healthy volunteers Anesthesiology 107: 785-796.

Wilsey et al. 2008. A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain. Journal of Pain 9: 506-521.

Ware et al. 2010. Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. CMAJ 182: 694-701.

Cooper et al. 2013. Comparison of the analgesic effects of dronabinol and smoked marijuana in daily marijuana smokers. Neuropsychopharmacology 38: 1984-1992.

Wilsey et al. 2013. Low-dose vaporized cannabis significantly improves neuropathic pain. The Journal of Pain 14: 136-148.

Eisenberg et al. 2014. Pharmacokinetics, Efficacy, Safety, and Ease of Use of a Novel Portable Metered-Dose Cannabis Inhaler in Patients With Chronic Neuropathic Pain: A Phase 1a Study. Journal of Pain and Palliative Care Pharmacotherapy 28: 216-225.

Wallace et al., 2015. Efficacy of inhaled cannabis on painful diabetic neuropathy. Journal of Pain 7: 616-627.

Wilsey et al. 2016. An exploratory human laboratory experiment evaluating vaporized cannabis in the treatment of neuropathic pain from spinal cord injury and disease. The Journal of Pain.

Lynch and Campbell. 2011. Cannabinoids for treatment of chronic non-cancer pain; a systematic review of randomized trials. British Journal of Clinical Pharmacology 72: 735-744.

Sunil Aggerwal. 2012. Cannabinergic pain medicine: a concise clinical primer and survey of randomized-controlled trial results. The Clinical Journal of Pain.

Lynch and Ware. 2015. Cannabinoids for the treatment of chronic non-cancer pain: An updated systematic review of randomized controlled trials. Journal of Neuroimmune Pharmacology 10: 293-301.

Ware et al. 2015. Cannabis for the Management of Pain: Assessment of Safety Study. Journal of Pain.

Comelli et al. 2008. Antihyperalgesic effect of a Cannabis sativa extract in a rat model of neuropathic pain. Phytotherapy Research 22: 1017-1024.

Johnson et al. 2009. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety and tolerability of THC: CBD extract in patients with intractable cancer-related pain. Journal of Symptom Management 39: 167-179.

Abrams et al. 2011. Cannabiniod-opioid interaction in chronic pain. Clinical Pharmacology & Therapeutics 90: 844-851.

Haroutounian et al. 2016. The effect of medicinal cannabis on pain and quality of life outcomes in chronic pain: A prospective open-label study. The Clinical Journal of Pain.

Boehnke et al. 2016. Medical cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain. The Journal of Pain 17: 739-744

Powell et al. 2015. Do medical marijuana laws reduce addictions and deaths related to pain killers?

Bachhuber et al. 2014. Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010. Journal of the American Medical Association 174: 1688-1673.

Mark Collen. 2012. Prescribing cannabis for harm reduction. Harm Reduction Journal 9: 1.