Pot and Pain, Part 1

It seems there are still some misconceptions about pain being an “excuse” for Medicinal Marijuana (MMJ), I have overheard on talk back radio old folks complaining that it didn’t work for them etc. There are several reasons why Cannabis is useful, and preferred by patients, it is to much for 1 post,  I got to 1200 words on the first attempt, so I will break it down,

  • Neuropathic Pain vs Nociceptive pain.  Part 1
  • Side effect profile vs Opiates.   Part 1
  • Synergestic effect with Opiates.  Part 2
  • Hyperalgesia.   Part 2
  • Anti Inflammatory effects.  Part 2

 

First of all, MMJ will not work for Nociceptive pain  It is well established in the scientific literature that is is effective for Neuropathic pain.  In Laymans terms, this means that it wont work if you break  a bone,  but if you happened to crush a nerve…….. then it offers good results. The Germans managed to compile a list of high quality cannabis studies in 2012, and show those with postive vs negative results.  There tallies were 26 studies for chronic/neuropathic pain, with 23 having positive results in favor of MMJ. There are also many other studies since 2012 supporting the benefits, and even getting measurable results out of tiny doses.  Some of these studies also go into secondary benefits, such as improved sleep, which anecdotally, is what a lot of older MMJ users in the USA find, it relieves some pain from sciatica or similar, and allows them to sleep through the night better.

The second nugget of knowledge is in regards to the conventional alternatives.  Many of the members of my chronic pain group have debilitating diseases, it is not a case of a bunch a people with a dodgy knee, we have 10+ people with Complex Regional Pain Syndrome (CRPS),  which is widely considered the most painful condition in existence. We also have a young woman who has been on Morphine since age 12 for Juvenile Arthritis that had so much inflammation the nerves were damaged,  several failed back surgeries, people with Lupus, MS, and Allodynia,  which is when the nerves a basically fried in a permanent state of over excitement, where even the lightest touch is severely painful.  Because this group is at the extreme end of the scale, Doctors feel the urge to “do something” and this invariably involves the Morphine family of drugs (Opiates) and the Valium class of drugs (Benzodiazepines, “Benzos”) Both classes are addictive, and while they work short term, or as a rescue medication for flares, there is actually little evidence that opiates work long term.   Many of the community have had to battle the label of addiction, when taking the medications exactly as prescribed by the GPs and specialists. I myself have seen it first hand with the 40+ Emergency Department visits my wife has made, in the cities, the doctors treat you as a junkie, as seeking relief from excruciating pain looks very similar to seeking a “fix” that the substance abusers seek.  I would go so far as to say Christchurch hospital was disgusting in that regard, yet the St Johns crew could make an estimate of a patients pain based on blood pressure and heart rate, and showed nothing but compassion, Gold Star for them!

Opiates are widely over prescribed, although it is not as bad as in the USA, where estimates are 17k people die from prescription overdoses per anum, we still have problems with it here, I have an OIA request in to get some harder numbers on deaths and near misses in NZ.  The side effects often experienced with Opiates and or Benzos are….

  • Constipation, (who doesn’t love a fleet enema )
  • Depression, (as if people in chronic pain aren’t depressed enough already)
  • Respiratory depression, (that is how it kills, you stop breathing, even if your mind is completely aware, as my wife’s was when St Johns overdosed her)
  • Aggression
  • Dizzyness, prone to falling over, causing more pain..
  • Cognitive impairment, unable to spell 5 letter words, delayed reactions, patients often feel unsafe to drive, especially at night and more so when Opiates and Benzos are combined
  • Tolerance build up, after a few weeks or months, you will need to double it
  • Nausea, though generally this side effect fades over a week or so, in some cases it is a violent reaction and the medication cannot be tolerated
  • In extreme cases heart issues, I’m aware of 1 patient on 120 mg of Methadone morning and night, and his Heart rhythm/QT Intervals went out of whack leaving him unable to walk to his letterbox.
  • Hyperalgesia – more on that later..

In comparison,  the most reported side effects, when used medcinally for Cannabis use are,

  • Dry eyes
  • Improved mood
  • Improved Sleep
  • Cognitive impairment (mild in comparison to Opiates and Benzos)

From personal experience with the wife, the cognitive deficit from Opiates and Benzos can be huge, there is an entire year of her life she barely remembers, which is just as well, as that year had the most pain and hospital visits as ACC tried to shirk their responsibilities. The aggression she displayed that year at points was enough for a social worker to become involved during one hospital visit. I also had a neighbor with a failed back surgery that would have a family intervention due to aggression after less than a week on Morphine.  I also have a contact from who had a respectable job, and on being prescribed Methadone,  “lost the plot”  and resulted in 2 Tresspass orders, of which he can barely remember the events.

More to follow,  in part 2 next week!

 

 

One drug addict to another

Phil Ure knows about drug addiction from his own experience. He has reservations about Darien Fenton’s “openness”, as he comments at The Standard.

and i feel fenton deserves no kudos..

..she is one who has the platform/experience to talk of this issue..

..of the madness of prohibitions..

..she has said nothing..

..and this piece from her doesn’t call for the changes needed to prevent those 50 accidental deaths each year..

..it is more an exercise in self-aggrandisement..piggy-backing on the common-sense being spouted by others/the (accidental) death of hoffman..

..than anything else..

..fenton is still mirroring the (criminal) silences of all her fellow-politicians..

..(and i hafta say..if there is one thing i know about that vile muck that is methadone..

..that is it is so addictive..that users get down to small amounts daily..

..but that this nazi-smack has such a grip on them..

..that they are unable to do that final ‘kick’…

..and that many..20 years after taking methadone..are still trapped in/by it..

..and seeing as fenton herself raised this subject..

..i think it is fair to ask her if she too is an example of the utter fucken madness of getting people addicted to a drug more addictive than the one they were addicted to..

..(think about that for a minute..!..eh..?..)

..is fenton still hooked on methadone..?

..has she too..like so many others..been unable to make that final ”kick’..?

..and why won’t she come clean..

..and start talking some commonsense on narcotic-addiction..

..i mean..f.f.s..!..if not her..who..?

phillip ure..

I was tempted to reformat this into something more readable but decided to leave it in Phil’s unique and often  infuriating style to leave his message as he intended it.

Darien Fenton “opens up” but with mixed messages

There’s been a lot of praise for Darien Fenton “opening up” about her historic drug addiction and fair enough, good on her for being a little bit open about it.

See NZ Herald: Darien Fenton: ‘It’s a miracle I survived’MP Darien Fenton speaks out for the first time about her battle with heroin.

But it’s an odd message. I can understand some defensiveness and self protection, but Fenton plays down her addiction…

So I’m well and truly passed it. It was decades ago, so I’m one of the lucky ones I guess.

… and provides scant details. It comes more as a carefully crafted PR political self promotion rather than a heartfelt revelation.

A comment on Facebook:

The words “public health services, work place accidents, poverty and struggle” appear in the article. This is a Labour Party propaganda article put together by their Comms unit to get publicity after Hoffman’s death.

That’s a fair point, although it isn’t known if it was done by Fenton alone (it doesn’t sound like her language) or by a PR team.

But what really changed me was a job where I experienced first-hand workmates who lost their lives through workplace accidents and coming face to face with families who were struggling.

That is a rather curious explanation for kicking her habit. A workplace death could impact on someone significantly, but it sounds unusual that an addict would give a toss about “families who were struggling”. It’s common for an addict’s own struggles to rule their life.

And it’s not a surprise revelation, I’ve heard it mentioned for years. Ian Wishart revealed Fenton’s addiction and subsequent methadone treatment in his Investigate Magazine in 2008 – Labour MP’s Class-A drug addiction battle.

Fenton has not opened up, she has admitted a little, played down it’s current significance and clammed up – “declined to give further details of her drug use”.

By being vague and not in fact opening up Fenton leaves questions unanswered, so leaves doubts. Should she at least be specific about when she completed her methadone treatment?

This all raises another question – is this just a private issue that Fenton has chosen to reveal a little about? Or is it relevant to Fenton’s job as an MP?

For example in her first term in Parliament Fenton served on the Health Select Committee – was her drug addiction past relevant? Was there any potential conflict of interest?

If Fenton is praised for admitting her past problems and it’s left at that does that show a double standard?

David Garrett got blasted and hounded out of Parliament because of the revelation he had illegally obtained a passport using a false identity – decades ago.

The use of heroin is also illegal, and addicts are often involved in other illegal activities to fund their addiction. Is that a more acceptable breaking of the law than what Garrett did? Garrett claimed his misdemeanour was victimless. Drug addicts impact on more than just themselves, including aiding and abetting other addicts, and making the drug market possible.

Fenton’s experiences with drugs may have been long in the past and could have ended up making her a worthwhile contributor to Parliament. But the same could be said of Garrett. His past, and his failure to be publicly open about his past, were his political downfall and it also severely impacted on the credibility of the Act Party.

I’m in two minds about whether Fenton should actually be open rather than giving a little information along with what seemed like a self serving political promotion – there were mixed messages for sure.

Fenton hasn’t “opened up”, she has confirmed what was already known, with a hint that it’s with political motives, and then clammed up.

And there’s also a very mixed message when a belated slight admission about past misdemeanours is highly praised while the misdemeanour of others were used to destroy their political career due to the impact on their family, with attempts to also destroy their party.