Sunday, May 01, 2005

Cannabis Oral Spray

Article by Aaron Smith from CNN:

"Generally, physicians do not like to use narcotic-based drugs or drugs that have addictive-type characteristics for treatment of chronic pain," said Dr. John Richert, vice president for research and clinical programs for the National Multiple Sclerosis Society.

"There is not yet solid scientific evidence that the cannabis-related drugs are useful for multiple sclerosis pain," he said. "I think if there were solid scientific evidence that this type of drug helped, then that would be the evidence for the FDA to consider in their evaluation for the drug."

I would like to comment:

--We pump people full of drugs (many of which are potentially addictive), without knowing all of the medical risks and/or the respective drug efficacy for each particular individual, on an hourly basis. This is especially common for psychiatric and pain disorders because the potential drug benefits outweigh the costs. We are not talking about targeting blood pressure problems or sinus infections, where we understand the systems involved and for which we have developed specific- and effective-medical treatments --we are talking about targeting biological systems that we know relatively little about and, unfortunately,that vary drastically among individuals.

Pain medications, by virtue of the neurological systems involved in pain perception, have inherent-addictive potential. We still, however, put pain pills in therapeutic-candy dishes next to the Hershey Kisses. We do this because it is the humane thing to do; it's the medically- responsible choice. It's insane that just because we've arbitrarily labeled a drug (all medications are drugs, duh) a "narcotic", we can't harvest that drug's therapeutic properties. If you think cannabis has greater addictive properties than most current pain treatments, you had better educate yourselves. Please tell me that we've moved beyond the "Reefer Madness" days...please.


At 10:56 AM, Blogger Jessica said...

When my 14 year old son recently broke his scaphoid bone, the ER nurse at the hospital called him to the counter and literally blocked me as she directed her instructions to him. As I stood there listening behind her back, I heard her say, "We are prescribing vicodin for you. You should take 1 - 2 every 4 - 6 hours as needed for pain.” “Excuse me”, I interrupted, "is this really necessary?" "Well", she began in the most patronizing voice, "it could throb at night and if he can't sleep, you might not be able to sleep." I was so dumbfounded by the situation that I was at a loss for words and I am NEVER at a loss for words.

When we left the ER, my son said, "Mom, can we just go home, I don't want to fill the prescription tonight." The next day at work, I mentioned the scenario to my co-worker who is a pharmacist by trade and his eyes almost popped out of his head. He said if my son had trouble sleeping, I should offer him a Tylenol PM or something. The thing is, my son never complained about pain (and I continually asked if he was experiencing any) and ended up not taking anything as a result.

I was aghast at how quickly these people prescribed such an addictive pain pill for a 14 year old kid - and insulted at the degree that they didn't involve me in the discussion of it with him and then talked down to me as if they had to explain what was "in it for me" in order for me to comply.

At 12:21 PM, Blogger she falters to rise said...

Your son is lucky that you are an involved parent. Many parents wouldn't have thought twice about it, and your friend is right in telling you your doctor did the wrong thing.

A couple of years ago there was a large movement in the medical field to deal with the problem of "pain management". Many good things came out of this in terms of dealing with chronic and/or neuropathic pain, yet this effort resulted in some negative changes in acute pain management and has led to situations similar to the one you described.

The standard of care is usually to prescribe tylenol with codeine (or equivalent drug) and, if the doctor believes or patient claims the pain will necessitate something stronger, a pain killer such as vicodin. The doctor is to advise the parent, not the child. The doctor usually will advise starting out with OTC drugs and then moving up if necessary depending on the pain source (surgery, injury, disease, etc.).

I'm sorry that the doctor was irresponsible.

My huge concern here is the unwillingness to look at drugs that do not target addiction pathways as heavily as medications such as morphine, vicodin, etc. because we have a societal fear of "narcotics". This an especially valid concern when we are looking at treatments for chronic disease-state pain.


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