Pubdate: Fri, 24 Jun 2016
Source: Minneapolis Star-Tribune (MN)
Copyright: 2016 Star Tribune
Author: Gary Starr
Note: Dr. Gary Starr is chief medical officer and co-founder of 
LeafLine Labs, one of two companies authorized to grow and sell 
medical cannabis in Minnesota.

Pain Relief


Opioid deaths are down 25 percent in states where medical marijuana 
is legal. On July 1, it will be legally available to many more 
Minnesotans, if doctors and patients are willing to pursue it.

Last December, the Star Tribune reported that in Minnesota deaths 
from prescription and illegal opioids had risen sixfold since 2000, 
with 317 lives claimed in 2014 alone. Chronic pain doesn't 
discriminate - prescription opiates and heroin both metabolize to 
morphine in our bodies. Rich, poor, unknown or superstar: All are 
vulnerable to these risks when escalating doses of prescription 
opiate medication are their bridge to temporary relief.

When I was trained as a doctor in the 1990s, opiate painkillers like 
OxyContin, Percocet and Vicodin were paraded in front of us as 
potential good treatments for pain. We didn't foresee the beginning 
of the terrible opiate crisis we find ourselves in now.

None of us thought we'd effectively be pushing heroin, but from the 
body's viewpoint, this is what we were inadvertently doing by 
normalizing prescription opiate use.

Now, as an emergency room physician, I witness the devastation caused 
by prescription opioid overuse and abuse in Minnesota. Perhaps you 
know someone in this trap. One of our state's greatest artists, 
Prince, may have fallen victim to the same pattern of chronic pain, 
escalating opioid use and accidental overdose experienced by so many 
others. This wasn't a moral misjudgment or a suicidal gesture - it 
was the tragic outcome of what can happen when your body learns to 
need opiates to numb chronic pain. There is a risk that the same 
opiate level may one day stop your breathing - the potentially deadly 
spiral of prescription opiate use for chronic pain.

I have hope that physicians and patients are at a turning point - 
seeking an alternative to these potentially deadly painkillers. On 
July 1, the Minnesota Department of Health will add "intractable 
pain" to the list of conditions that qualify a patient for access to 
medical cannabis - making this safe, alternative remedy available to 
many more Minnesotans.

Opioid-related overdoses and deaths continue to rise because healing 
professionals, trained to prescribe these medicines, recognize few 
other choices. Many physicians and patients carry opinions about 
medical cannabis based on the rhetoric of fear and the connotation of 
moral impairment rather than learning the truth. Our training didn't 
include centuries of forgotten experience with cannabis. We didn't 
learn that our bodies have a whole system of compounds - like those 
found in the cannabis plant.

Medical cannabis potentially could save lives that might otherwise be 
lost to chronic opioid use. A 2014 study in the Journal of the 
American Medical Association Internal Medicine found that states with 
laws allowing access to medical cannabis had almost 25 percent fewer 
incidences of opioid-overdose deaths than those without.

These opioid medications that allow patients with chronic pain to get 
by day by day are also putting them at mortal risk. I could not stand 
by and watch this twisted paradox. Dr. Andrew Bachman and I cofounded 
LeafLine Labs as mounting evidence showed how effective medical 
cannabis could be for many patients - while remaining much safer and 
less addictive than opiate painkillers used today.

A week from now, physicians willing to have this conversation with 
patients may begin certifying Minnesotans with intractable pain for 
participation in the state's medical cannabis program. Current 
observational data from the state Health Department show that a 
majority of patients are benefiting from medical cannabis. It can 
effectively treat pain - without risk of death from respiratory 
arrest. It is far less addictive than opiate medications, and it has 
been shown to reduce the severity of opiate withdrawal for those 
attempting to quit an opiate painkiller addiction. One patient at 
LeafLine Labs started opiate painkillers to treat painful and 
unrelenting muscle spasms from a motorcycle accident. Certified for 
medical cannabis as an alternative in 2015, he now is free of opiate 
painkillers. "I'm more functional," he says. "It's a very clean 
product that works better than the opiates that were prescribed to me before."

Our state is at a crossroads. The Health Department has recognized 
the potential of medical cannabis for intractable pain. Now it's time 
for physicians and patients to move toward medical cannabis as a 
valuable, tightly regulated alternative to opiates. For Prince, it 
comes too late. But for thousands of others, there's a better way to 
help those in chronic pain - without risking tragedy.
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MAP posted-by: Jay Bergstrom