By Ruth A. Hill R.N.
If you are wondering why your physician is reducing your oxycodone blame it on the government. In the federal government’s wisdom to abate the opioid crisis the Centers for Disease Control (CDC) put out mandatory guidelines for prescribing opioids and benzodiazepines. The Medical Board of California (MBC) mimic the CDC guidelines with the addition of explicit patient populations.
CDC guidelines recommend caution when needing to “increase the opioid dosage to ≥50 morphine milligram equivalents (MME)/day and should avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to ≥90 MME/day.”
https://www.cdc.gov/drugoverdose/pdf/Guidelines_Factsheet-a.pdf
The law of unintended consequences are actions of people, and especially of governments, that always have effects that are unanticipated or “unintended.” Eighty percent of my clients coming to try medical cannabis come because their physician is reducing their Norco oxycodone or ativan they are taking for chronic pain. These guidelines caused insurance companies to arbitrarily deny coverage to patients trying to renew their prescriptions. Patients care coming home from day surgery with only a three-day supply of oxycodone as surgeons wash their hands of the need. This scenario is repeated across the country from CA to FL.
It is established scientific fact that opioids are best for acute pain. Immediate post-operative patients certainly qualify for acute pain. The internet is replete with physician reports in medical journals that refute the CDC guidelines as grossly misinterpreted and not meant for chronic pain users. Instead the guidelines are meant for patients new to pain medications not for the “50 million Americans (or 20% or population) who have chronic pain. About 20 million of them have “high-impact chronic pain” — pain severe enough that it frequently limits life or work activities.” Per https://www.painnewsnetwork.org
Unfortunately, opioid madness is mimicking reefer madness. Once the federal government in conjunction with insurance companies try to mandate medical treatment the unintended consequences are years of suffering for chronic pain patients as they wait for common sense to show its head.
In the meantime, what is a patient to do when sent home from the ER or outpatient surgery without adequate pain medications. One safe option is to ask assistance from a friend/family member who can visit a local marijuana/cannabis dispensary to purchase a “whole flower CBD tincture to take under the tongue”. You can usually fine a good one-ounce bottle of a CBD tincture that will give 10mg/ml. Do not let the budtender sell you an edible if you are new to marijuana. Tinctures are more precise for determining your dose without the high.
If your adventure into finding a natural plant medicine is unsuccessful than visit www.holisticcaring.com and make an appointment with a qualified cannabis nurse who helps clients navigate through the maze of cannabis products.
Cannabis is not like taking a pill. It is highly individual, netting immediate results or requiring much trial and error. This navigation can be costly. Nurses have been in the forefront of educating the public with science and not myths. You can get relief without the high, but it takes patience and commitment. There are many patients who are on benzodiazepines for relief of air hunger from chronic lung disease (COPD), anxiety from post-traumatic stress disorder (PTSD). These medications are also being tapered to zero. The scientific literature demonstrates the benefits of cannabis for COPD and PTSD.
As we celebrate Cinco de Mayo this coming week, we also celebrate National Nurses Week. Nurses are in the forefront of change in health care innovation. Nurses in the 50’s paved the way for natural childbirth when the National College of Nurse Midwifes was established to facilitate the movement away from Twilight Birth. Education mothers on the Lamaze method allows childbirth to proceed on its own naturally without anesthetizing the mother.
Nurses embrace a holistic caring philosophy. We educate clients on the benefits of yoga, meditation, spiritual, cultural, and social connections that blend eastern and western medicine. Treating the mind and spirit adds exponential benefits to pharmaceutical, medical, or surgical interventions. If you see a nurse this coming week wish her a Happy Nurse’s Day. An Happy May Day.
Ruth A Hill RN consults clients on safe cannabis use without the high. hillruth@gmail.com
