Medical Marijuana Musings –
It’s Painfully Clear
Medical marijuana remains controversial despite its well-documented safety and efficacy for a broad range of medical conditions.
The focus here, however, is the powerful role it could play in managing one of our most intractable healthcare problems – chronic pain that affects an estimated one-third of Americans.
The FDA just approved the expanded use of a drug called lubiprostone (Amitizia) for the often severe constipation caused by the use of opioid drugs for chronic pain.
And here we go again with another example of compounding America’s over-medicated condition by prescribing ever more drugs to offset the ill effects of the drugs that are currently being over-prescribed.
According to this report, the newly-expanded drug of choice can cause more pain in the form of headaches, abdominal pain, and nausea – not to mention the discomfort of diarrhea, abdominal distension, and flatulence. It may also cause shortness of breath (dyspnea) – an anxiety-provoking condition that can increase sensitivity to pain. Both nausea and shortness of breath have been found in a clinical study to result in higher levels of pain – by a whopping 61% and 49% respectively.
I’ve posted before about the dangers of long-term use of opioids themselves for chronic pain (see “Understanding Chronic Pain & How Best To Manage It“) – including their potential to spread cancer tumors throughout the body. I’ve also posted previously about the folly of the debate about the relatively harmless use of medical marijuana for chronic pain management (see “Medical Marijuana vs. Prescription Opioids – Misplaced Perceptions and Priorities“).
Distraction and Acceptance –
Pot Can Help
A recent study in The Journal of Pain and reported on in Science Daily invites elaboration. This study was about the roles of distraction and acceptance in effective pain management. According to this report.
“As an adjunctive (supplementary) pain treatment, acceptance is intended to disrupt the link between thoughts and behaviors so patients are willing to tolerate pain. The majority of experimental studies have shown that acceptance strategies are more effective at increasing pain tolerance than other pain regulation strategies…
“In the study sample, distraction was used to shift attention away from pain stimulation to lessen pain intensity. With cognitive behavioral structuring, patients are trained to alter their appraisals of pain dysfunction in order to improve their ability to cope with pain. Proponents believe that restructuring pain-related thoughts may affect disability-related behavior, such as avoiding work or recreational activities in fear of pain…
“Results of the study showed that acceptance led to increased pain tolerance relative to cognitive restructuring and distraction lowered pain intensity compared to acceptance.(emphases added).”
Anxiety and Pain
Here’s where I add my take on the role that medical marijuana may legitimately play in managing chronic pain more effectively – and safely – than our current reliance on dangerous opioid medications.
First, a disclaimer. No medication works the same for everyone, which is why prescribing medications is at best a 50-50 proposition. Different people respond to marijuana differently, as they do to every medication. Some get paranoid or anxious, and for them this won’t apply.
But anxiety relief is one of the better documented applications for medical marijuana, so it’s probable that the majority of patients would experience relief from anxiety rather than an exacerbation of it.
And anxiety is a core element in how we cope – or fail to cope – with chronic pain. I speak from experience on this count, as I endure daily neuropathic pain from a series of injuries and ill-advised medical interventions.
Many people suffering with chronic pain are afraid to attempt physical activities for fear of triggering more pain. This, of course, is counterproductive since physical activity is a powerful antidote to all kinds of pain – from osteoarthritis to chronic depression and much in between.
What the study in The Journal of Pain addresses is our perception of pain, how we mentally frame it as a factor in our daily living. And how we frame it mentally can influence how willing we are to accept the risks of masking our pain with dangerous medications that may cause much worse pain down the road.
Where medical marijuana offers some hope is its ability to help many people suffering with chronic pain to reassess their pain – and their pain thresholds. Doing so may lead many to greater acceptance of their pain as unavoidable and something they need to learn to manage better, especially if it’s supplemented with some cognitive therapy or counseling to raise self-awareness and acceptance.
I call this pain reconciliation – learning to reconcile with your pain rather than mask it with painkillers that, as I like to say, kill more than pain. More people die every year in America from prescribed opioid medications than from heroin, cocaine and all street drugs combined.
Maybe it’s time we shifted the focus of our “war on drugs” to the real battlefront – over-prescribed medications.
Worth Risking Your Life?
Medical marijuana may allow those who benefit from it to lower their dosage of other, more dangerous opioid – and NSAID – medications. This would seem an entirely laudable goal. Yet the medical profession continues to wring its hands about medical marijuana while ignoring, and enabling, the continuing reliance – their reliance – on far more dangerous opioids.
Once again, so much for “First, do no harm” (see Our Healthcare Sucks for more examples of how many current medical practices would have Hippocrates rolling over in his grave).
If you understand the risks of taking painkillers on a long-term basis, you should welcome anything that might help lower those risks by lessening your dependence on them.
And if the idea of medical marijuana raises some kind of moral resistance in your mind, maybe you should ask yourself whether that antiquated notion is worth risking your life for.
Because opioid drugs – once reserved for only temporary and acute pain – are now the default for chronic pain as well. And as noted earlier, they’ve been shown in animal studies to promote the spread of tumors. Some anesthesiologists – specialists in pain management – have grown sufficiently concerned to stop using them (see this report on the University of Chicago Medicine website).
Maybe you should, too.
Or at least maybe you should try whatever means you can muster to do so. And if you’re in one of the 18 states in which medical marijuana is legal, try it as well.
And if you’re not, try cognitive therapy – talk therapy – that may help you reframe your perception of your pain, with or without the medical marijuana.
Because learning to accept pain into your life as a permanent fixture may free you to be more easily distracted from your pain without relying on opioids or other risky painkillers.
And marijuana has certainly proven to be a great distracter. And pain management is one area where distraction can play a positive role, freeing you to engage in other pursuits and not be held hostage to your pain.
Time to Move?
Whatever state you live in – physically and mentally – talk with your doctor about ways to better manage your chronic pain that minimize your need for high-risk medications.
The goal is to take charge of your pain, not eliminate it. You can set limits on how much you’re willing to let it interfere with, and dictate, your daily activities.
In the process, you’re likely to find your tolerance for pain will increase, your ability to do things you’d otherwise be fearful of will improve, and your need for medications of any kind will diminish.
And that’s likely to leave you healthier, happier, and more likely to maximize your longevity.
And if you happen to get a little buzz in the process, well – that’s not so bad, is it?
Who cares what the puritans among us may think?
They’re not the ones living with your pain, after all.
Benefits of cognitive pain relief methods.