According to the Center for Disease Control and Prevention, between 1999 and 2016, more than 200,000 people died from overdoses involving prescription opioids. With this many people losing their lives to prescription painkillers, natural, alternative forms of pain relief are beginning to enter the market. However, with big pharmaceutical companies grossing astronomical profits from opioids, the patenting and production of these lethal drugs continues to dominate – with no end in sight.
Now, doctors and pharmacists are becoming hesitant as to what they prescribe to their patients to manage their pain due to the possible repercussions. This has left patients who are undergoing rigorous treatment regimens for diseases – such as cancer – worried about falling victim to prescription opioid addiction. The race to find a non-addictive alternative has begun, and patients are waiting for relief without the fear of dependency.
Despite the damaging effects opioids have on the health of those who use them for medicinal purposes or for recreational use, doctors continue to prescribe these dangerous and highly-addictive drugs. This has led to a painkiller gold rush with pharmaceutical giants, such as Purdue Pharma, cashing in on the well-being of others. Purdue is the manufacturer of the well-known prescription opioid OxyContin. According to Forbes, Purdue has reported around 3 billion dollars in annual revenue, with speculators attributing that a large portion of this gross amount is due to the sale of OxyContin.
With opioids being prescribed to patients for cases ranging from minor to chronic pain, the epidemic has grown into an unstoppable wrecking ball. The National Institute on Drug Abuse reports that in 2013, 78 billion dollars were spent on opioid-related disorders and overdoses, with only 2.8 billion dollars of this sum being allocated for treatment programs. This total amount is derived from activities including the costs of criminal justice, lost work productivity, injuries caused by intoxication, and treating babies who have been born opioid dependent.
While all doctors should practice health and wellness ethically, this is unfortunately not always the case. According to CNN, Dr. Aathirayen Thiyagarajah, a pain specialist operating out of South Carolina, had received more than 200,000 dollars in kickbacks from the producers of Subsys. This drug is an oral spray form of fentanyl, being nearly 100 times stronger than morphine. Users of Subsys have reported feeling “zombie-like”, often blacking out and not being able to remember what happened to them while they were under the effects of the drug. With such dangerous side effects, it is frightening that some doctors will not provide non-addictive options for patients who do not want to continue their prescription of a drug with this strength.
Opioids and the Human Body
When considering the high number of patients who fall victim to these drugs, it is important to understand why this issue has become so widespread. Opioids are a form of pain relief that tricks the body into feeling a reduction of pain. When an individual takes an opioid, prescribed or not, the opioids attach to the brain’s opioid receptors, blocking the pain signals being sent from the brain to other areas of our body. Unfortunately, while this is occurring, the opioids also target the reward system of the brain, flooding neurotransmitters with dopamine, a chemical compound known for causing feelings of euphoria and senses of pleasure.
This dopamine excess is what causes addiction, as more dopamine is needed over time for the patient or user to feel the same effects of their initial usage. This leads users to take more than the prescribed dosage of the opioid, potentially leading to an overdose. If a doctor is unwilling to increase the dosage of the prescription or provide a larger fill of the prescription, this causes users to seek alternatives such as heroin, which puts them at a much greater risk of overdosing.
Worried Cancer Patients
For people battling life-threatening illness, such as cancer patients, the amount of pain they experience is debilitating. From invasive surgeries to rounds of chemotherapy, these warriors are going through quite possibly the hardest times of their lives. Relief from pain is vital, as the recovery process is typically prolonged. However, while the simple route would be to give a cancer patient morphine or prescribe them with a traditional painkiller such as Vicodin, patients have become hesitant to use these forms of relief, and oncologists are taking notice. According to Dr. Judith Paice in an interview with The National Institute on Drug Abuse, oncologists are still providing opioid prescriptions, but are very anxious about doing so in fear that legal action could ensue.
With an already compromised immune system, chronic pain, and medication side effects, many cancer patients would not be able to also overcome an opioid dependency. For patients who have a short life expectancy, such as those with late stage mesothelioma cancer, the primary goal is to make the patient as comfortable as possible. This has led to a push of natural alternatives being created to ensure that cancer patients, especially those with terminal cases, are able to feel as much relief as possible without adding more complexities to their lives.
Despite political scrutiny and a long history of stigmatization, Cannabis sativa is being explored as a means to relieve symptoms of pain naturally. One of the main compounds that researchers are focusing on is cannabidiol (CBD). Let’s take a look at the effects this compound has on our bodies, and why it may prove to be an alternative to prescription opioids.
The human body contains an endocannabinoid system that helps in regulating certain bodily functions, such as endocrine system responses, sleep, and pain. CB1 and CB2 receptors are found throughout the immune system and interact with CBD, which is what causes relief to be felt throughout the body. Unlike prescription opioids, cannabidiol does not create an excess of dopamine. Instead, CBD promotes other compounds in the body from being absorbed, such as anandamide. As the decomposition of anandamide is slowed, pain relief is experienced. Also, CBD is a non-psychoactive, allowing the user to avoid the feelings of euphoria that come with using THC while still feeling relief.
CBD can be consumed in a number of ways, including:
- CBD oil
- Encapsulated CBD
- CBD edibles
- Dissolvable CBD powder
- CBD-infused drinks
- CBD ointment
One benefit of CBD use is that building up a tolerance is not likely. This means that a patient can take a consistent dose without having to increase the amount in order to reap the benefits. Opioids make the user want more as they build up a tolerance, forcing them to overmedicate, potentially causing a dangerous addiction.
Recently, the National Center for Biotechnology Information conducted a study proving the effectiveness of Nabiximols, a spray form of CBD. This form of CBD was used on patients with cancer who were responding poorly to opioids for pain relief. While this trial was small, consisting of just 263 participants, patients reported feeling mild relief from their symptoms from low doses of Nabiximols, setting the stage for more trials to be conducted.
Symptoms that CBD may help in relieving for cancer patients going through chemotherapy are:
- Reduced swelling
- Reduced nausea & vomiting
- Increased appetite
- Reduced bodily pain
While the legalities of marijuana and tetrahydrocannabinol (THC) continues to be discussed, CBD has been cleared for usage for all of the United States, with 46 states allowing for prescription CBD usage.
The End of Addiction
With the possibility of addiction to prescription opioids, cancer patients must explore other available options. We must continue to spread information about non-addictive forms of pain relief and allow the data gathered from clinical trials to back medical claims. As regulations around cannabis begin to be lifted across the world, more research about CBD and its benefits will become more streamlined, and hopefully medicinal uses will arise for patients who suffer from chronic pain.