Pubdate: Sat, 02 Jul 2016
Source: Ottawa Sun (CN ON)
Page: 8
Copyright: 2016 Canoe Limited Partnership
Contact: http://www.ottawasun.com/letter-to-editor
Website: http://www.ottawasun.com/
Details: http://www.mapinc.org/media/329
Author: Paula McCooey

CANNABIS A NEW WEAPON IN PAIN-RELIEF ARSENAL

When Gillian FitzGibbon's doctor suggested she try cannabis to reduce 
her chronic knee, hip and ankle pain, she figured anything was better 
than the cocktail of opioids she had been prescribed for years, 
medication that she said left her in an "abyss."

As health-care providers sound the alarm over rising opioid addiction 
and the lack of available pain management alternatives, some patients 
like FitzGibbon - along with their physicians - are turning to 
cannabis derivatives for relief.

Ottawa physician Hillel Finestone co-authored an article published on 
June 14 in the journal Canadian Family Physician that calls opioid 
use in Canada an epidemic and links it to the lack of options offered 
by doctors for pain management. The authors say this is happening, in 
part, because non-medical pain management services - like 
physiotherapy to address physical tension and psychologists and 
social workers to address stress - are not covered by government 
health insurance plans, and therefore typically not considered part 
of a pain management plan.

And while Finestone says medical marijuana may have a role to play in 
the holistic approach to pain management, he cautioned it shouldn't 
be considered a "silver bullet."

"Cannabis is definitely used by some people for pain but it is still 
a small aspect of the multidisciplinary approach (of how) we want 
physicians to treat it, and the way we want people to think about 
it," said Finestone, who is director of stroke rehabilitation 
research at Elisabeth Bruyere Hospital and a professor of physical 
medicine and rehabilitation at the University of Ottawa. "No one is 
going to say that marijuana is a one-stop pain treatment."

Nevertheless, FitzGibbon, 56, whose pain stems from multiple sports 
injuries and recent falls, was willing to take that chance. She had 
been on a cocktail of pharmaceuticals, including opioids, to treat 
anxiety, depression and osteoarthritis. Her inactivity contributed to 
weight gain and her family doctor suggested she undergo bariatric 
surgery - an operation to reduce the size of her stomach - so she 
would eat less. While reluctant, she was considering it because she 
was desperate to regain her health and mobility.

"I found myself lying in my hospital bed (after a serious knee injury 
two years ago) in my living room, where I lived for six months, 
wondering why I was still alive," FitzGibbon said. "I had no idea 
that there were such a severe side effects (from the drugs). You get 
so trapped in the abyss of opioid side effects that you just can't 
(see) your way out of it."

According to the Centers for Disease Control and Prevention in the 
United States, regular opioid use can lead to addiction or overdose. 
Deaths involving prescription opioids have quadrupled since 1999, and 
so have sales of these prescription drugs. From 1999 to 2014, more 
than 165,000 people died in the U.S. from overdoses related to 
prescription opioids.

There are currently no national-level data for prescription 
opioid-related mortality in Canada. However, the Canadian Centre on 
Substance Abuse has provincial data that shows the overall rate of 
opioid-related mortality increased by 242 per cent between 1991 (12.2 
per 1,000,000) and 2010 (41.6 per 1,000,000). In 2010, 12.1 per cent 
of all deaths among those ages 25 to 34 in Ontario were 
opioid-related, an increase from 5.5 per cent in 2001

Dr. Mary Lynch, a pain specialist and professor at Dalhousie 
University in Halifax, is currently researching the use of medical 
marijuana in pain management. While she acknowledges there is a role 
for opioids in certain cases, her research has found that 25 of 30 
randomized controlled trials done as part of her study in Canada have 
shown that cannabinoids have "a significant analgesic effect" and are 
safe in the management of chronic pain. She admits the research is 
still in its infancy and more research needs to be done. Until then, 
she says, the government needs to address the problem of long wait 
times to get into pain clinics.
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MAP posted-by: Jay Bergstrom