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Can medical cannabis decrease Ark. opioid deaths?

A recent study concludes it will take a combination of medical cannabis and prescription drug monitoring programs to decrease opioid overdoses

By John Lovett
Times Record

LITTLE ROCK, Ark. — Will implementation of medical cannabis in Arkansas reduce the use of potentially deadly opioid painkillers?

Several medical studies indicate it will, but the conclusion of a recent study published by the National Center for Biotechnology Information concludes it will take a one-two punch of medical cannabis and prescription drug monitoring programs to decrease opioid-related mortality.

That same study, titled “Implications of prescription drug monitoring and medical cannabis legislation on opioid overdose mortality,” also showed opioid-related mortality rate was slower in states with medical cannabis laws than those simply with prescription drug monitoring programs.

The Arkansas Prescription Drug Monitoring Program was amended this year to “mandate prescribers check the prescription drug monitoring program when prescribing certain medications.”

Dr. Joe Goldstrich, an Iowa-based physician who works with those in Arkansas creating medical cannabis guidelines, has become a vocal proponent of cannabis as an alternative to opioids. He says he has seen its benefits first hand: In 2014 at an Oakland, Calif., clinic he saw “a majority of patients reduce opioids to safer levels” and many reduced opioids enough with medical cannabis to completely wean themselves off drugs like oxycontin.

At 392 drug overdose deaths, Arkansas saw a 9.5 percent increase from 2014 to 2015. Oklahoma, on the other hand, had a 6.4 percent decrease, dropping from 777 deaths to 725. Oklahoma had 790 overdose deaths in 2013 and Arkansas had 319 that year, indicating a steady rise in Arkansas with a low but steady drop in Oklahoma.

Goldstrich pointed out another study published in 2014 by the Journal of the American Medical Association that found “States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.”

The doctor said he hopes to be able to provide continuing education courses to physicians in Arkansas this spring to teach the science behind cannabis and explain how various strains of cannabis can be used to treat a variety of different ailments, from cancer and Crohn’s Disease to multiple sclerosis and Parkinson’s Disease.

Goldstrich said major prescription drug manufacturers have fought medical cannabis legislation and the use of the word “marijuana” began in the 1930s to “disparage Mexicans” and discredit the plant’s benefits.

Dr. John Swicegood of Advanced Interventional & Pain Diagnostics in Fort Smith noted in a recent email to the Times Record that “the narrative of over-prescribing is real but needs clarification.” He explained that in the 1980s, Purdue Pharma introduced oxycontin as “safe and effective for chronic pain” with “little addictive or abuse potential.”

“Data that had been sent through the FDA was essentially unsubstantiated ‘junk science’ and through tremendous lobbying pain became the ‘5th vital sign,’” Swicegood wrote.

To adhere to Medicare and Joint Commission, Swicegood adds, doctors “had to offer pain relievers to patients, to the point of physicians scoring reimbursement tied to patient satisfaction with pain scores.” This practice is still going on, Swicegood adds, but “finally being phased out.”

Swicegood, trained in the 1970s at the University Medical School at San Antonio, adds that because the addictive nature of opiates have been known for several hundred years, the drugs were “never intended to be given regularly except in dire non-operative crippling pain.”

“When the Purdue (Pharma) narrative began, I knew it was a bad idea,” Swicegood wrote. “Unrelieved chronic pain is very real. I have spent my entire life trying to relieve pain. The bad idea was the way the Federal government allowed Purdue and other big pharma companies to turn their drugs lose on the public.”

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