Pubdate: Thu, 26 Nov 2015
Source: National Post (Canada)
Copyright: 2015 Canwest Publishing Inc.
Author: Tom Blackwell
Page: A6


Research Project: Limited Study Finds It's Safer, Fewer Side Effects

The routine back operation Bob Deslauriers had in 1987 was supposed 
to fix damage wrought by a rugby-playing youth. Two decades after the 
fact, it nearly killed him.

The 58-year-old unknowingly received a tainted blood transfusion 
during the surgery, and 18 years later discovered the resulting 
hepatitis C infection had virtually destroyed his liver.

A transplant last year saved Deslauriers' life, but by the time he 
left hospital, the engineer and former corporate CEO had another 
problem: He was on so much opioid painkiller, he could do little but 
blankly stare at the TV.

His salvation, surprisingly, came from marijuana. Pot helped wean him 
off all but a small dose of morphine - and made his intellectually 
demanding work possible again, according to a unique case study 
published this month.

A multi-hospital research project has now been launched to test the 
novel idea of using a historically illicit drug to curb dependence on 
a legal - but potentially debilitating - one. Meanwhile, a recent 
survey suggests many medical-cannabis users are already substituting 
weed for prescription pharmaceuticals.

Deslauriers is convinced of the benefits.

"We're kind of conditioned in society to look down on marijuana, 
because of all the propaganda we've been fed all our lives," says the 
Eastern Ontario resident. "(But) it's basically given me my life back."

The case also underlines the complexity of using cannabis as an 
emerging medicine, with Deslauriers using one strain high in the 
compound cannabidiol (CBD) to treat his pain, and another with lots 
of tetrahydrocannabinol (THC) to control his chronic nausea.

The concept could have wide application if proven effective, given 
Canada's massive prescription opioid habit - per-capita consumption 
here is second only to the United States.

Hundreds of Canadians die yearly from overdosing on prescription 
narcotics - many simply taking what doctors recommended for chronic 
pain - while others spiral into addiction.

Dr. Hance Clarke, who co-authored Deslauriers' case study, heads 
Ontario's Transitional Pain Service, set up last year with provincial 
funding partly to help post-operative patients who become dependent 
on the medications.

The Toronto General Hospital physician stressed that one case does 
not prove the effectiveness ofmarijuana to phase out narcotics. But 
Clarke and colleagues have begun an observational study involving 
numerous patients, and a more rigorous randomized controlled trial is 
eyed for the future.

There is already some evidence that cannabis can treat certain types 
of pain, with the brain's cannabinoid receptors known to be involved 
in pain modulation.

"Gone is the day where a patient says, 'I smoke cannabis 
recreationally and I continue to do this for my pain' - and I have to 
shy away from that," said Clarke. "I can say, medically, I have a 
prescription pad and I can actually bring (cannabis) to the table as 
part of their pain regimen."

The case study sounded familiar to Dr. Norm Buckley, director of the 
National Pain Centre at McMaster University in Hamilton, Ont., who 
has had patients tell him they were going to smoke marijuana to get 
off narcotics - and succeed.

Cannabis would appear to be safer than opioids - unlikely, for 
instance, to cause life-threatening symptoms in excessive doses, he 
noted. The problem is a lack of science to indicate what strains and 
what doses are appropriate for which patients, the kind of 
prescribing guidelines that come with pharmaceutical medicines, Buckley noted.

"Right now we're not really using it as a medication," he said.

"We're giving people permission to experiment with it."

Still, a recent study at the University of British Columbia, based on 
an online survey of medical-marijuana patients, found that 80 per 
cent used it to replace prescription drugs for conditions ranging 
from pain to depression and HIV.

The most common reason was fewer negative side effects.

The athletic, entrepreneurial Deslauriers lived a full life until 
about 10 years ago, playing on Canada's national rugby team, 
competing in other sports and later heading a "conglomerate" whose 
businesses stretched from oil and gas to TV production.

Then he collapsed after a charity run in 2005, learning that he had 
advanced cirrhosis of the liver - triggering burst veins and internal 
bleeding - and would likely be dead within a week.

He survived the initial crisis and finally underwent a liver 
transplant, thanks to the organ part his sister donated.

Desluariers had already been on hydromorphone - a semi-synthetic 
morphine derivative - because of chronic abdominal pain beforehand. 
With the acute pain related to the surgery, the dose soared to almost 
40 milligrams a day.

Though no longer running the company, he still does research work on 
robotics at home, but found the narcotic-induced fog made that impossible.

After beginning to smoke a CBD-rich cannabis strain, he was able to 
reduce his intake of hydromorphone almost immediately, and has now 
reduced his dosage down to two to eight mg per day, Deslauriers said.
- ---
MAP posted-by: Jay Bergstrom