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So, my roommate’s been completely MIA for the last week and a half solid…
His girlfriend, who he’d like to marry, went through surgery and he’s been taking care of business. His big fear isn’t that she’ll have a hard time recovering physically (although apparently it looks pretty brutal), it’s that she’ll have trouble with her pain meds…hydrocodone, or Vicodin.
Well, to be more specific, coming OFF her pain meds is the issue he’s stressin’on…
Last time he stopped by he expressed this to me in animated fashion, but was relieved she’s down to one pill a day instead of two. I guess in his past a man he greatly admired, one of the stoutest most brilliant captains he’d ever known, withered to pain-med addiction which led him to a heroin addiction that eventually took his life.
Sadly, stories like his are all too common.
While the mainstream conversations are centered on other issues like the 2nd Amendment in the first quarter of 2018, people forget about President Trump’s Declaration of Emergency (which was extended for 90 days in Jan) in relation to opioid deaths where more than 3, 4, 5 times as many people are perishing than to guns.
In fact, according to U.S. Government numbers, about as many people died in 2016 (64,000+!!!) to opioid addiction as American soldiers in the Vietnam, Iraq and Afghanistan wars combined.
That shocked me to my core.
And it freaks me out because one of my brothers, a Vietnam Vet in his 60’s, is abusing Fentanyl patches…I think, well, he’s on them!
But there’s little I can do…
I’ve already watched (from afar) as opioid addiction demolished my older sister and her family.
When I was a youngster – my mom had me much later in life @48 – I remember she was beautiful, with two healthy kids and a husband. Thanks to opioid addiction, by the time I turned 19 her husband who I loved was dead, her daughter, my niece, dead, both from overdoses and my nephew is forever scarred.
So yes, supporting cannabis-based therapy research and spreading this information as far and wide as I can…is personal. Let’s dig in, and we’ll begin by briefly looking at two systems as they relate to addiction – a complex brain disease.
The Opioid & Endocannabinoid Systems
A quick refresher so you get up to speed on two human physiological systems involved with addiction. I searched and found an interesting study from 2015 to pull from named, Interactions of the Opioid and Cannabinoid Systems in Reward: Insights from Knockout Studies.
The following three quotes are from that study, which you could consider reading if you have time and interest. It’s slightly outdated, but there’s a fair amount of nuggets.
The Opioid System
“Opioid receptors and endogenous opioid peptides are largely expressed throughout the nervous system, noticeably within areas of the neurocircuitry of addiction associated with reward, motivation, or learning and stress. Besides its key role in many aspects of addiction, the opioid system also plays a part in a diverse range of physiological functions including nociception, mood control, eating behavior, or cognitive processes.“
You might be wondering about Nociception – a sensory nervous system response. Simply put, in this context we’re talking about a system that expresses itself to negative stimuli. Like, if you touch a hot stove, nociception is responsible for producing all the negative or unpleasant things you experience afterwards.
With addiction, if I understand correctly, it’s partly responsible for the unpleasantness of withdrawals – the lack of endorphins being the negative stimuli.
Opiates cause a rush of artificial endorphins to seige your nervous system, producing both pain relief and a deep sense of euphoria. The issue is through continued use the brain stops producing its own endorphins and…dun dun dun…the reward system becomes dependent on an outside source.
Without them, the body produces light, moderate to severe withdrawal symptoms depending on the level of addiction.
Reminds me of a lecture on porn addiction I listened to through Stefan Molyneux’s YouTube channel. Turns out the dopamine-reward that a man’s brain produces when he orgasms while watching porn videos, is exactly the same neurologically as when a heroin addict shoots up.
Internet porn is essentially a digital heroin of sorts.
We’ll save that discussion for another article. Point here is, the brain’s reward system is POWERFUL enough without any help.
Meanwhile some opioid/opiates can inject up to 100 times more than what these men’s brains are producing on their own! If you believe in evolution, look what this reward system has done to every species in response to winning a fight, securing food, getting a mate, acquiring power, etc.
The Endocannabinoid System (ECS)
“The endocannabinoid system plays a key role in energy balance, modulation of pain response, with processing of central and peripheral pain signals, learning and memory, reward and emotions. It has also been shown to be involved in neurogenesis and would play a neuroprotective role in some pathological conditions.”
When we’re talking about super-THC dominant products alone, that’s more of a ‘Get Stoned” kind of thing with various therapeutic benefits and a different kind of euphoria (for a portion of the population high-THC can be frightening though).
CBD on the other hand is 100% non-addictive, non-psychoactive, and has been found to be especially effective in certain applications when combined with other natural phytocannabinoids like CBG, CBN, and THC. By itself, you can safely take up to 1500 mg of clean plant-based CBD per day.
In essence, it seems to modulate addictive neurological mechanisms and restore balance.
This is, after all, what the ECS is designed to do throughout the human body – maintain homeostasis on the cellular and neurochemical levels – energy, psychology, pain relief, memory, mood control, etc.
If you’re interested, I wrote The Human Endocannabinoid System 101 as a basic summary.
Cross Talk Between Systems
“Many neurotransmitter systems are involved when addiction develops, and both opioid and endocannabinoid systems are major players in addictive disorders. In addition to their specific ligands, both systems have also been implicated in the action mechanism of several other addictive drugs, like ethanol, nicotine, or psychostimulants [meth, caffeine, etc.].”
Man…sometimes I really wish I were a doctor.
Obviously we’re discussing complex human physiology here, but suffice it to say the ECS mingles with, or works with the opioid system on a number of levels.
Based on a limited amount of official human studies and a growing number of animal studies, CBD helps to regulate not just the uptake of the three neurochemicals in Leafly’s nifty graph below, but addresses potential damage that could be caused by having way too much present within the brain.
Source: America’s Opioid Crisis: Can High-CBD Cannabis Combat Pain and Reduce Addiction Rates?
CBD literally ‘sees’ potential damage being caused by addictive/anxious/depressive thoughts – for example a sound or smell triggers panic – and blocks receptors from giving them as much, or any attention.
From Leafly’s article – it’s another great read,
“Scientists have found CBD can help dissolve these associations through interactions with the serotonin system. Serotonin is a neurotransmitter commonly associated with mood, but it also plays a role in addiction. Preclinical research shows CBD can reduce drug-seeking behavior, diminish withdrawal symptoms, and limit cravings.”
Oddly enough, published more recently in March, 2018, in the journal Planta Medica, they found that (in their mice) Cannabidiol blocked, or attenuated, morphine opioid reward, and when administered alone there was no “rewarding or aversive properties.”
There’s no evidence CBD triggers the reward system, at all, in fact it works as a modulator. So you’ll never stop taking CBD and then get cue-induced cravings to chase down a reward or go get more CBD – it doesn’t cause artificial euphoria either.
The Clinical & Anecdotal Evidence
Months. That’s how long it would take you to read a good chunk of the personal testimonials and reviews of both marijuana and hemp-based CBD usage online…talking about how it’s led to a decrease is opioid usage.
I remember saying that a couple years ago and can’t imagine what it must be like online nowadays. These come from people of all walks of life dealing with a massive list of physical and psychological issues. Everything from soccer moms and retired folks, to kids and veterans.
As a Washingtonian I’m already surrounded by it. I could go on and on with the things I’ve seen and heard in relation to both the opioid epidemic and how cannabinoids are helping.
We’ve had limited clinical research going on behind the scenes for years though, with the rise of state-level marijuana legalization.
One example would be the landmark study published in 2014, Medical Cannabis Laws & Opioid Analgesic Overdose Mortality in the United States, 1999-2010, which clearly shows:
“Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.”
In 2018, you think that has become more or less true?
As CBD (vs. ‘marijuana’ as a product) continued to skyrocket in popularity, some researchers got together in 2015 to survey the landscape and see what was going on. How much was hype and how much was based on clinical vs. anecdotal evidence?
Here’s a quote from their work entitled, Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence,
“CBD is an exogenous cannabinoid that acts on several neurotransmission systems involved in addiction. Animal studies have shown the possible effects of CBD on opioid and psychostimulant addiction, while human studies presented some preliminary evidence of a beneficial impact of CBD on cannabis and tobacco dependence. CBD has several therapeutic properties on its own that could indirectly be useful in the treatment of addiction disorders, such as its protective effect on stress vulnerability and neurotoxicity.”
I remember when this came out, and CBD is still being hailed by many today (anecdotally) to be reducing alcohol and tobacco sales…to the chagrin of many DC lobbyists.
Then we can skip forward to a 2017 study of 3000 medical marijuana patients through UC Berkeley and Hello MD where they found:
- 97% could decrease opioid usage.
- 92% preferred cannabinoids.
- 80% said cannabinoids more effective.
Source: Study: Pain Patients Prefer Cannabis Over Opiates
But what would this look like on a nationwide scale to really combat the opioid crisis?
We must begin with the CTP.
CTP & ‘The Substitution Effect’ Rationale
In the summer of 2017, one of the most powerful papers on the subject was published in the Harm Reduction Journal, August, 2017, entitled, Rationale for Cannabis-Based Interventions in the Opioid Overdose Crisis.
Not going to lie, it’s mind blowing!
Based on research and clinical data, the suggestion is to introduce cannabis-based interventions (the substitution effect), during three windows of opportunity to reduce the opioid crisis, and I’ll use their words to paraphrase.
- Prior to opioid introduction in the treatment of chronic pain. 4 out of 5 heroin users report opioid use begins with pharmaceuticals. Cannabis can supplement as an analgesic and reduce the supply of ‘pills’ on the black market. There’s ‘significant’ population-level evidence cannabis substitution is taking place across North America (like in my town).
- As an opioid reduction strategy for those already using opioids. To help ensure treatment success without progression to dependence or overuse – cannabis can be a useful adjunct therapy. The aim’s to slowly introduce cannabis into the care continuum, while subsequently reducing dosage & frequency of prescription opioid use.
- As an adjunct therapy to methadone or Suboxone treatment to increase treatment success rates. Intermittent cannabis users show superior retention in naltrexone treatment, cannabis reduces opioid withdrawal symptoms (especially CBD) during methadone stabilization, and CBD reduces heroin-seeking behavior in mice.
And remember, no one has to take illegal amounts of THC here. They could, and it could help, but it can be highly curated for the individual now with the amount of variety out there – different marijuana strains and products. Then there’s hemp-based which erases the THC issue.
Speaking of which. If you’re still with me, let’s assume you’re ready.
How to Get Started
Let’s say you clearly see the evidence, both clinical and anecdotal, and decide you’d like to experiment with cannabinoids yourself to ease opioid use, or for someone you care about.
Great, the first question is, do you have access to legal Marijuana Dispensaries? If so, do your homework on nearby dispensaries, or those in a nearby state, and go get yourself some products (and consume them in the state where they’re legal of course…).
If you opt for marijuana sources of CBD that will include higher THC levels, a good place to begin approaching from a therapeutic perspective is Project CBD’s Cannabis Dosing suggestions:
Here’s the big three:
- Delivery Method: Would you prefer edibles? Flower to smoke? Candies? Drinks? Each one will impact you different depending on the specific THC/CBD and other cannabinoid/terpene levels.
- Find Your Ratio: Ideally, you find a local brand you know and trust will label ethically, so you can get to a strain or product with the right CBD to THC ratio to suit your needs.
- Start Low: With THC it’s best to start low. What’s low? Good question, it’s going to be a little different for everyone so when it comes down to it, you have to experiment. There’s a 70% chance you already have, so now it’s a matter of blending in CBD.
If you don’t have access to legal dispensaries, or you would prefer a source you can buy online, that’s where hemp-based CBD comes into play.
These Pills Aren’t Addictive
On HempforFitness.com you can get CBN capsules and three different kinds of full-spectrum hemp capsules with high levels of CBD (hard to get these levels in dispensaries) and legal levels of THC.
- Remedium Hemp Oil Capsules 300mg -1800mg
- Hemp CBD Capsules with Myrrh, Frankincense, Turmeric 100mg – 600mg
- The Other Lab-Tested Hemp Oil Capsules are 460mg – 2760mg
I checked the nearest dispensary to my house and the largest CBD doses I can find in edibles are 25mg (per piece), so as you can see these are highly potent – completely derived from industrial hemp plants.
Another example would be, I can walk half a block and go get marijuana-derived oils with high percentages of THC and CBD, but it’s almost impossible to get something like Lady Blanca Full Spectrum Hemp Extract that lab tests at 58.33% and legal amounts of THC.
I’m not a doctor, or a psychologist, just a writer. But listen, if you begin using CBD and supporting the American cannabis industry, in reality you’re also helping combat the opioid crisis.
3 Steps to Stop the Opioid Crisis
Step #1: Decriminalize All Drugs in America on the Federal Level
There’s really no more debate. Plenty of on-the-ground evidence exists for all to see in areas across the globe.
One of the most recent would be Portugal’s lessons where after 15 years of decriminalization (along with Step #2) in 2017 it was reported they produced:
- Portuguese on Heroin down to 25,000 from 100,000.
- Number of people dying from overdoses down 85%
- Drug mortality rate dropped to the lowest in Western Europe.
They won the war on drugs by ending it!
Step #2: Treat Drug Abuse & Addiction as a Disease
Once it’s no longer a crime to be addicted to opioids, or use or abuse opiates, we can treat it like the disease it is. We can also dramatically reduce the street-level need. Opioids aren’t the bad guys. They have their place in medicine. Legalization and decriminalization takes all the wind out of the black market’s sails.
Step #3: Make Cannabinoid-Based Treatments Widely Available
A good percentage of the things people take opioids for, they could use cannabinoids for, or supplement cannabinoids and likely experience better results. Cannabinoids can also be used to help with addiction treatments.
Here’s for hoping and thanks for reading!