Cannabis is Medicine

   

       Imagine the pain you feel with the flu. Now imagine if that pain never went away, it lasted for months, years, or decades. This is the reality for thousands of chronic pain sufferers in Iowa, including me. How would you feel if you were being denied access to medicine that could potentially change your life? Iowa legislatures are doing just that. Right now Iowa has a bill in place allowing cannabis oil for those suffering with severe epilepsy. However the bill provides no way to obtain the oil. Iowa Legislatures are currently working on a bill that originally included chronic pain under conditions covered, but was cut down to only include MS (multiple sclerosis), epilepsy, and late-stage cancer. The Des Moines Register reports that seventy-eight percent of Iowans are in support of the legalization of medical cannabis, so what is holding legislatures back? Medical cannabis needs to be legalized for chronic pain in Iowa so that the thousands of people with chronic pain can have access to a medication that could alleviate their suffering.

            Chronic pain should be added back to the list of conditions covered in the bill currently under debate by Iowa legislatures. Chronic pain is defined as “pain that doesn’t go away, lasts over six months, or extends beyond the expected recovery time after an accident or medical intervention” (Lucas). Currently chronic pain sufferers are left depending on pain medications with serious health risks, like opiates. The Des Moines Register reports that in 2014, Iowa had 52 fatal opiate overdoses. That is an 80% increase from 2010. One can assume that these numbers will only continue to rise unless something changes. Patients should have the option of trying cannabis to help manage their pain. In states where medical cannabis has been legalized opiate overdoses have dropped by up to 25% (Main). Dr. Gregory Carter says that legalizing medical cannabis could be the answer to stopping the rapid growth of opioid overdoses, especially since cannabis has been found to have no lethal dose. Philippe Lucas, a PhD student at the University of Victoria, adds that cannabis has been shown to prevent the tolerance to and withdrawal from opioids, and can even make a previously ineffective dose of opioids effective again.

            Cannabis has the potential to reduce the suffering of Iowans and improve their quality of life. This positive impact would spread to their caregivers, spouses, and children. A reduction in pain could mean more time with family, being able to work, return to school, and pursue more things in life. In a recent survey sent out to 100 Hawaii residents enrolled in their medical cannabis program, there was an average pain reduction of 64% reported (Webb). That’s equivalent to a 5-point reduction on the 1-10 pain scale. That’s more of a reduction than any pain medication that I have tried. Some patients even reported that they were able to stop or decrease other medications that they were on.

            Legalizing cannabis can also have a positive effect on the economy. Having a comprehensive medical marijuana program would open up a whole new job field. This would create new jobs in farming, transportation, dispensaries, and ones that you wouldn’t think of like accounting and marketing. With starting a program like this there are always costs. However, the State Marijuana Policy Project reports that state medical marijuana programs have had no trouble covering their costs, and some have even produced substantial surpluses. States like Michigan, Arizona, and Oregon have made millions in surpluses. Other states like Vermont and New Mexico have self-sustaining programs.

            Legislatures are hesitant to legalize medical cannabis for various reasons. Most of these reasons are previously held false beliefs about cannabis. One of these beliefs is that cannabis is a gateway drug. That means that the use of cannabis will lead to the use of harder drugs like heroine, cocaine, or methamphetamines. However, cannabis has been proven to do the opposite. It should be considered an “exit drug”, since it can help patients go off other medications. In a study of cannabis patients, many reported using cannabis as a substitute for alcohol (40%), illicit drugs (26%), and prescription drugs (66%). When the patients were asked why they chose cannabis over other prescription medications, they cited less adverse side effects (65%), better symptom management (57%), and less withdrawal potential (34%) as reasons (Lucas).

            Another reason Legislatures may be reluctant to legalize medical cannabis is the possible side effects involved. There are varying reports on the side effects and risks associated with medical cannabis. These results are also dependent on what type of administration was used: smoking, vaping, or ingesting an oil or edible. In a study published by The Journal of Medicine last December; two groups were compared over a one-year time. The first group was cannabis users, and the second group was a control group (did not receive any cannabis).  In this study it was left up to the participants to choose how they wanted to administer their cannabis. Their options were smoking, vaping, or ingesting the medicine. There were no differences between the two groups for serious adverse effects. Though, the cannabis users were at increased risk for non-serious adverse effects. Some were more severe like increased risk for nervous system and psychiatric disorders. However most were mild to moderate including drowsiness (.6%), amnesia (.5%), cough (.5%), and nausea (.5%). It is worth noting that a significant change in average daily pain was reported by the cannabis group, but not in the control group. Also, an improvement of physical function and quality of life was reported in the cannabis group (Ware). Cannabis needs to stop being held to a higher standard than other FDA-approved drugs already on the market. Dr. Juurlink says, “From a pharmacologic perspective, the direct toxic effects of cannabinoids are simply dwarfed by those of opioids and nonsteroidal anti-inflammatory drugs [NSAIDS].”

            The last thing that Legislatures may be concerned about is the chance for people to abuse the system. They may be worried that there will be people claiming to have chronic pain so that they can have access to cannabis. There will always be people who abuse alcohol, opioids, or harder drugs whether it is legal or not. Dr. Carter notes that, “Many currently used medications have the potential for misuse, however this does not diminish their effectiveness in treating patients when used as prescribed by a medical provider.” Also, just because some people abuse the system, doesn’t mean that chronic pain patients should suffer more without access to cannabis. What makes the concerns for the few addicts/abusers more important than the thousands of Iowans suffering from chronic pain?

I have been in pain non-stop for four years. So I am stuck relying on Tramadol, an opioid and NSAID, to function throughout my day. Side effects for Tramadol include some non-serious ones like dizziness and drowsiness, and more serious ones like slowing or stopped breathing, seizures, overdose, and death. You may ask why would I take something with side effects like that? I take it so I can function, so I can wash my hair, get out of bed, go to school, and on good days hang out with people. However, my pain is never below a 3 on the 1-10 scale. I’m constantly functioning at a 6. I deserve to have access to a medicine that could allow me to have a social life, to clean my apartment, and to not have to constantly put my pain into consideration. The decision on whether I can use medical cannabis should be up to my doctor, not to Iowa Legislatures.

            Medical cannabis should be legalized in Iowa for chronic pain. Legislatures, you have the power to alleviate the suffering of the thousands of Iowans with chronic pain. Chronic pain should be put back on the list of conditions in the bill, HF 2384, which is currently in progress. This medicine has the potential to change someone’s life. Please do not continue to believe previously held untrue views of cannabis. “ [The] medicinal use of cannabis holds too much potential to be held back by laws that are not consistent or reflective of the science” (Carter, et al.).

Works Cited

Carter, Gregory T, et al. "Re-Branding Cannabis: The Next Generation Of Chronic Pain Medicine?" Pain Management 5.1 (2015): 13-21. MEDLINE with Full Text. Web. 1 Mar. 2016.

Haly, Charly. “Should Iowa expand use of anti-overdose drug?” The Des Moines Register. www.desmoinesregister.com, 21 March 2016. Web. 30 March 2016.

Juurlink, David N. "Medicinal Cannabis: Time To Lighten Up?" CMAJ: Canadian Medical Association Journal = Journal De L'association Medicale Canadienne 186.12 (2014): 897-898. MEDLINE with Full Text. Web. 1 Mar. 2016.

Leys, Tony. “Iowa Poll: Support growing for medical marijuana.” The Des Moines Register. www.desmoinesregister.com, 2 March 2016. Web. 2 March 2016.

Lucas, Philippe. "Cannabis As An Adjunct To Or Substitute For Opiates In The Treatment Of Chronic Pain." Journal Of Psychoactive Drugs 44.2 (2012): 125-133. MEDLINE with Full Text. Web. 1 Mar. 2016

Main, Douglas. “In States With Medical Marijuana, Painkiller Deaths Drop By 25 Percent.” Newsweek. Newsweek LLC, 25 August 2014. Web. 30 March 2016.

“State Medical Marijuana Programs’ Financial Information.” Marijuana Policy Project. Marijuana Policy Project, 2016. Web. 30 March 2016.

Ware, Mark A., et al. “Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS).” The Journal of Pain 16. 12 (2015): 1233-1242. Print.

Webb, Charles W, and Sandra M Webb. "Therapeutic Benefits Of Cannabis: A Patient Survey." Hawai'i Journal Of Medicine & Public Health: A Journal Of Asia Pacific Medicine & Public Health 73.4 (2014): 109-111. MEDLINE with Full Text. Web. 1 Mar. 2016.