BY RUTH HILL R.N.                                                                            

According to the US Centers for Disease Control, ninety-one people die from prescription opiate abuse in the US every day. In West Virginia, the state hardest hit by the epidemic, 41 of every 100,000 residents died from drug overdoses in 2015. North Dakota was ranked the lowest (2.6 per 100,000). California, ranked seventh-lowest in the nation (11 per 100,000). Oxycodone ranked first in 2010 and 2011 among drug overdose deaths. Heroin ranked first from 2012 through 2014.

In the 80’s evidence based practice theorized opiates were nonaddictive if the patient had legitimate pain. Now in 2016 we find this study had too few subjects and did not look at long term use. In other words, we were duped. So, what now?

Pain is still not being treated effectively with or without opioids. The favorite sound bite is: The US writes 90% of the Vicodin prescriptions and we are only 5% of the world’s population. Dr. Forest Tennant, the renowned pain specialist out of West Corona, CA, would remind us the above statistic shows how compassionate we are. The second sound bite is: to sue the makers of opiates. It’s comforting to sue the pharmaceuticals just like it is easy to sue gun manufactures. But that ignores treating the epidemic.


Hospitals are touting their comprehensive policies. That too is more blah blah blah. Their focus is discharging the patient with less pills to a physician who has no knowledge of how to replace the opiate with another effective treatment. Fear of raising a suspicious flag to the FDA, the community physician, more often than not, refuses to refill the prescription.

In states where cannabis is legal the opiate deaths are lower proving cannabis can lead us out of the opioid epidemic. More people are reducing or totally stopping their use of opioids, anxiolytics, anti-insomnia, and tricyclic drugs all taken to relieve pain and insomnia.

However, getting to that set point takes a trial and error approach. Cannabis failure can be high if the user is not willing to commit with money and patience. The first step is to take both CBD, the nonpsychoactive molecule, and THC, the psychoactive molecule. Users are instructed to start with 1 mg dose of both and increase daily, by 1mg increments until effective.

When the user requires more than 10mg of THC and/or 10mg of CBD, the cost rises. Most products come in 15 ml bottles which last for 8 or 10 doses or (5-7) days.  A 10mg capsule comes in a bottle with only 14 capsules. A 30mg capsule can cost $8 per capsule. If a user needs 30mg three times a day, that is $24/day just for the CBD.

The negative propaganda, that marijuana is a gateway drug, fear of being stoned, and increasing costs, all lead to loss of faith and resultant cannabis failure. A new user can spend $300 in the first week through trial and error before settling on a stable dose for maintenance.

Edibles can be dangerous in the naive user as there is no way to determine how much THC or CBD is present in the gummy or honey or brownie, or chocolate they are eating. Purchasing the more safe and efficient methods of inhalation, such as vaporizers, is also an expensive choice. The machines can range from $80 to $600.

My question to the cultivators is why is medical cannabis so expensive? Your mark ups are outrageous. Will cannabis be for the middle class or the wealthy? Will the President’s push to fix the opioid crisis lead to rehabilitation centers providing cannabis? Will back yard growers flourish as regulations become more stringent?

Cannabis can stop or reduce, the dose requirements of opiates, anti-anxiety and anti-psychotic drugs used for pain, without the side effects of pharmaceuticals. Cannabis can treat so many diseases, but success only comes with trial and error. Each user investigating medical cannabis needs to decide for themselves if the cost is worth the rewards.

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