Pubdate: Tue, 07 Jun 2016
Source: Globe and Mail (Canada)
Page: A5
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Mike Hager

VETERANS' OPIOID REQUESTS DOWN

Data Show Fewer Are Seeking The Drugs In Recent Years, While
Prescriptions For Medical Marijuana Have Skyrocketed

Fewer Canadian veterans have sought prescription opioids and
tranquilizers in recent years, while at the same time prescriptions
for medical marijuana have skyrocketed.

It is not clear whether the two are related, but the trend echoes what
researchers have found in U.S. states with medical-cannabis laws.

New data provided to The Globe and Mail by Veterans Affairs Canada
show that over the past four years, the number of veterans prescribed
benzodiazepines - with brands such as Xanax, Ativan and Valium - had
decreased nearly 30 per cent. Opioid prescriptions also shrank almost
17 per cent during that same period.

In a report last month, the Auditor-General warned Veterans Affairs to
rein in spending on its coverage of medical marijuana. Government
reimbursements for veterans' pot prescriptions had ballooned from
fewer than a hundred patients costing $284,000 four years ago to more
than 1,700 former soldiers charging the department $20-million last
fiscal year.

This set of statistics is too small and unrefined to prove any
concrete links between the use of the three drugs. But American
research showing significant declines in opioid overdoses where
medical marijuana has been legalized suggests that people may be
substituting these oft-abused medicines with cannabis, according to
Thomas Kerr, a researcher with the B.C. Centre for Excellence in HIV/AIDS.

"This isn't surprising and we're seeing the same effect all over the
place measured in different ways," Dr. Kerr said. (Earlier this year,
Dr. Kerr and his colleagues at the centre urged the Canadian medical
establishment to embrace giving medical marijuana to pain patients
instead of frequently abused opioids.)

The groups organizing hundreds of veterans in Atlantic Canada to take
advantage of the country's most robust medical marijuana coverage have
long argued that the drug was replacing other - more harmful -
pharmaceuticals such as opioids (for pain relief) and benzodiazepines
(for anxiety and insomnia).

Benedikt Fischer, senior scientist at Toronto's Centre for Addiction
and Mental Health, said pain and sleep issues are the most common
reasons medical marijuana is prescribed.

Since 2008, the number of Canadians taking prescription sedatives -
including benzodiazepines, but also sleep aids such as zopiclone - has
remained steady at roughly 10 per cent, according to a bulletin issued
last July by the the government-funded Canadian Centre on Substance
Abuse. While illicit opioid use has skyrocketed in recent years, the
number of Canadians prescribed to this class of heavy painkillers has
dropped from about 21 per cent in 2008 to 15 per cent in 2013,
according to that same bulletin, which provides the latest data available.

Still, Dr. Fischer said newer data from the general population and a
more rigorous analysis of the Veterans Affairs statistics is needed
before any causality can be suggested.

A spokesperson for Veterans Affairs said in an e-mailed statement that
this new "data does not allow the department to make any conclusions
about the use of marijuana for medical purposes and the usage of other
drugs."

Veterans Affairs Minister Kent Hehr declined a request for an
interview on the subject last week, but he previously stated that he
has accepted all of the Auditor-General's recommendations to create
stricter controls on the program. Mr. Hehr has promised an update in
the coming months to an ongoing internal review of medical-marijuana
use among former soldiers.

Last fiscal year, 1,762 veterans used the only publicly funded plan in
the country for medical marijuana. Groups that represent them offer a
small, but lucrative, patient base for Canada's two dozen licensed
producers, which are fighting for their share of a competitive market
while facing pressure from an illegal dispensary sector that has
spread east from Vancouver.

Mike Southwell, co-founder of the controversial New Brunswick-based
Marijuana For Trauma (MFT) organization, said veterans who use his
eight clinics say they much prefer cannabis to the
pharmaceuticals.

"Most of them have been coming off of over 80 per cent of their
[opioid and benzodiazepine] medications," said Mr. Southwell, a
veteran who said he has dropped a handful of other drug prescriptions
and now consumes about seven grams a day of cannabis to treat his
post-traumatic stress disorder and back pain.

On average, last year's marijuana prescriptions cost Veterans Affairs
much more per patient ($11,656) than opioids ($316) or benzodiazepines
($73), according to government data.

Mr. Southwell said these costs are offset by former soldiers regaining
their sex drive and ditching erectile dysfunction prescriptions - also
covered by Ottawa - as well as a myriad of other benefits that come
from using only medical cannabis.

"We've got testimonials rolling every day: 'I got my husband back.' 'I
got my life back.' 'I'm able to feel again.' 'I'm able to love again.'
I'm able to move again.' 'I'm able to sleep again,' " he said. "Those
are amazing statements."

James Grant, a 79-year-old veteran living in a suburb of
Charlottetown, said he has been able to get at least six hours of
uninterrupted sleep and play a full 18 holes of golf since he got a
prescription for cannabis capsules through a Marijuana For Trauma
clinic a month ago. He said his life has become immeasurably better
since using cannabis because he no longer is "gobbling extra-strength
Tylenols" to help fill gaps in his pain medication. 
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