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Cannabis: Putting the Pot in Pain Management PotentialNovember 2, 2018
Disclaimer: Keep out of reach of children. For use only by adults 21 years of age and older.
"I feel as though I should clarify something," my father begins our interview, "I was physically, though never mentally, addicted to narcotics from around 2007 until 2017." The gravity of a statement that had never been so plainly articulated by my father or anyone else in my family came garbled from my speakerphone and settled in the air of my chilly apartment. My father, a mid-50s retiree who fled to Florida to avoid the pain he is caused by Reno’s winters, is now one year clean of any prescription drugs. I remember my childhood as being punctuated by orange pill bottles. They were on the kitchen counter, on his nightstand, in the glovebox of our car. They were an inescapable and yet normalized reality that's underlying weight was shirked by the simple fact that "dad needs these pills to feel better." My father hurt himself when he was eighteen and in the Navy. He was dropped eighteen feet off the side of a ship onto a steel deck, an injury that never truly healed. This ultimately led to three ruptured discs in his spine and pain that has no foreseeable end. With chronic pain, there is no getting better—there is only pain and pain management.
Pain management for my father began with a prescription for four to six 7.5 mg of Vicodin per day that escalated in dosage and type of narcotic as his tolerance to the medications grew. As the dosage grew, so did his dependency. My father’s situation is not unique; reports from 2015 indicated that “Nearly 92 million U.S. adults, or about 38 percent of the population, took a legitimately prescribed opioid like OxyContin or Percocet in 2015”. This over prescription of opiates has resulted in a national crisis—one that has, since 2000, killed around 500,000 people in the United States. This crisis feels insurmountable in the way that most large-scale issues do. However, scientists in medical fields have been researching an alternative to narcotics to treat chronic pain: cannabis.
When I was 15 and cleaning out the shed in our backyard, I bumped the shelf behind me and heard something crash to the ground. That was when, in an unanticipated role reversal, I discovered my father’s bong. I questioned him about it, and after initially sheepishly dismissing the object as something else and telling me not to worry about it, he eventually sat my sister and I down and told us that he had begun smoking weed as a way to help manage his pain.
Cannabis as pain management is an under-researched field, one that has shown a lot of promise but has yet to be studied to the extent of yielding conclusive results. Although the evidence regarding cannabis alone as pain treatment has yet to be conclusive, the ways in which legalization and thus increased access to weed has impacted the use of opiates is not marginal. Statistics surrounding opiate use in states where medical cannabis is legalized suggest that the usage rates of opioids are going down. It was reported in 2018 that based on Medicaid prescription data from 2011-2016, "both medical and recreational cannabis laws were associated with annual reductions in opioid prescribing rates of 5.88% and 6.38%, respectively".
Additionally, while the full extent of weed’s analgesic properties remain to be studied, there are studies that suggest that cannabis used in tandem with narcotics may bolster the effectiveness of narcotics. Researchers have reported findings that state, “cannabis enhances the analgesic effects of sub-threshold oxycodone, suggesting synergy, without increases in cannabis’s abuse liability”. This potentially means that the use of cannabis as well as narcotics may slow a person’s ability to build a tolerance to narcotics, thus reducing the amount of narcotics that they would need to take in order to feel an effect, potentially reducing the risk of dependence.
Furthermore, it is important to consider the fact that most pain management plans are not structured in accordance with an individual's unique experience of pain in mind. More specifically, prescription narcotics are not as one size fits all as they are typically prescribed to be, and there are many pain-adjacent experiences, such as disturbed sleep, sensory loss vs sensory gain, anxiety, and depression, that simply cannot be helped by narcotics and could even potentially be worsened by them. Cannabis, however, is proving to help with these pain-adjacent symptoms.
My father’s experience corroborates this idea, as his inability to sleep is one of the worst aspects of his experience with chronic pain and something that potentially exacerbated his dependence on narcotics. He told me, “Well, if I’d have been able to smoke [weed] and go to sleep and wake up and smoke and go back to sleep rather than take the pills, I think that probably would have been better physically, and I probably wouldn’t have become as dependent on [narcotics] as I was.” My father goes on to say that he believes his disrupted sleep and resultant sleep deprivation are partly why it took him so long to be able to advocate for himself, get the surgery that he needed to help reduce his pain, and to get off those drugs faster. Being able to sleep is one thing that weed afforded him that narcotics could not.
My father smokes weed regularly now. It helps him sleep, it helps with his pain, it helped him stop using opiates. Prolonged use of narcotics changed his perception of reality, his brain chemistry, the ways in which he treated people—his family included. Towards the end of our conversation, I asked him if he had any fears associated with continued use of narcotics. He told me that he was afraid that he would “turn into a miserable wretch and that his family wouldn’t love him anymore.” I understand where that fear comes from, and ultimately, it comes from a place of pain. Weed, however, has given my father a new way to cope with his pain in a capacity that he feels does less harm to himself and to those who love him. For him, weed is the ultimate alternative, and it has the potential to be for others as well.