Over 100 million Americans currently suffer from chronic pain, leading many to use addictive and potentially fatal opiates. Now, some are wondering if a bit of chronic could be the cure for chronic pain.
We note that the subject contained in this article represents illegal activity in certain jurisdictions. Whilst we do not condone any acts which are contrary to any such laws, we understand that readers in those jurisdictions which have decriminalised cannabis may find this article of interest.
Chronic pain is defined as any pain which lasts beyond three months, potentially as the result of other symptoms such as arthritis, diabetes, or a sporting injury.
With 1.5 billion people estimated to suffer from chronic pain globally, a number which is higher than those that suffer from cancer, heart disease, and diabetes combined, chronic pain is one of the world's biggest health burdens.
Roughly one in three Americans and one in five Australians suffer from chronic pain.
Aside from the obvious pain itself, there are many negative externalities that befall those suffering from chronic pain, such as depression, sleep disturbance, and fatigue. Additionally, chronic pain sufferers will often have to spend more on healthcare while spending less time at work, placing a financial strain on top of their current issues.
And not only does chronic pain affect a large number of individuals, but it also has huge ramifications for the economy. In Australia alone, chronic pain is estimated to cost $66.1 billion each year – a number which could be set to climb to roughly $215.6 billion by 2050.
Chronic pain becomes more prevalent as we age, which doesn't paint a pretty picture given that most of the world has an ageing population. People are living longer, and having fewer children, which means that in a few decades we may see a huge spike in chronic pain numbers.
Though the pain itself is only part of the larger issue. Chronic pain sufferers frequently find themselves unable to stop taking their pain medication – often opioids – which can be both highly addictive and potentially fatal.
The Opioid Epidemic
In attempts to alleviate chronic pain, many find themselves depending on opioids, which can often become addictive and in many cases can be fatal.
In the 1990s in the United States, medical professionals increasingly began to prescribe opiates for a growing list of health issues. Prescriptions for opioid painkillers leapt from 76 million to 207 million between 1991 and 2013.
Coinciding with this increase in opioid prescriptions, were deaths due to opioid misuse, eventually leading to 47,600 deaths in 2017 – that's over 130 deaths a day.
That same year, 1.7 million Americans reported suffering from substance misuse issues relating to prescription opiates. There were 58 opioid prescriptions per 100 Americans in 2017, with rates higher in cities with greater unemployment.
And when you combine the aging population, the chronic pain crisis, and the opioid epidemic, you can start to see some real impacts on the economy.
A study from the School of Economics found that an increase in Asian elderly population share will significantly lower economic growth due to decreased labour participation in the region. On top of this, population aging will likely lead to a rise in the demand for health care, with fewer working taxpayers to support this rise.
Though it isn't just the elderly who find themselves suffering from chronic pain. Another group that frequently reports chronic pain is, unsurprisingly, athletes.
Sports are physical and often lead to injury, whether it be a serious injury or repetitive minor injuries, and both can take their toll on one's body over time. Though for an athlete, an injury could mean having to stop engaging in their sport for weeks or months at a time, which is something nobody wants to go through.
As a result, it can be easier for athletes to simply pop a pill, and numb the pain. For this reason, opioid addictions can disproportionately affect athletes more than their non-athletic counterparts.
According to a study published online in the journal Drug and Alcohol Dependence, 7 percent of the former NFL players were currently using painkilling opioid drugs. This works out to be 3 times the rate of the general population.
Cannabis For Chronic Pain
Evidently, chronic pain is a serious, and growing issue, with many societal ramifications. As long as societies have ageing populations and athletes, there will continue to be chronic pain. And as it stands, as long as there's chronic pain, opioid misuse isn't far off either.
So where does cannabis fit in?
Well, increasingly, athletes are coming out in support of CBD and cannabis as a way to treat their sporting injuries and reduce inflammation.
From professional UFC fighter Nate Diaz to professional skateboarder Matt Miller, many athletes are starting to bring out their own lines of CBD products, designed to reduce inflammation and pain without the need for addictive drugs.
Say you have a sore shoulder, or any part of your body, you rub the topical CBD on it and within ten minutes, there's a substantial decrease in pain.Matt Miller, Professional skateboarder and founder of MillerHealer
As this anecdotal data piles up, clinical research is also beginning to report similar findings. For example, in a study involving 2897 medical cannabis patients, patients overwhelmingly reported that cannabis provided equal relief to their other medications, but without the unwanted side effects.
Another study involving 274 participants found that upon taking cannabis, their pain severity score improved together with most social and emotional disability scores. Not only that, but opioid consumption at follow-up decreased by 44%.
And perhaps most interestingly, this wasn't a one-off. It's been consistently found that in states where marijuana is legal, opioid prescriptions go down.
Due to the pain-relieving effects of cannabis, many are now questioning if it may be used as a substitute to opiates, and whether it can help alleviate both chronic pain and the current opioid epidemic.
Other early studies have confirmed these suspicions, with one study published in the American Journal of Psychiatry and Neuroscience finding that "After 6 months, 156 patients (26%) had ceased taking opioids," the paper states. "An additional 329 patients (55%) had reduced their opioid use by an average of 30%. One hundred fourteen patients (19%) neither increased nor decreased their opioid use."
Adie Wilson-Poe, a neuroscientist and the advisor to Weedmaps, stated that "when patients have access to cannabis, they fill fewer opioid prescriptions, consume fewer opioids, overdose less and stay alive."
Wilson-Poe's comments are in relation to a documentary created by the ancillary cannabis company WeedMaps, which explored this potential for cannabis to help ease people off of harsher drugs.
No other policy, clinical intervention, law or pharmaceutical therapy has the kind of impact that cannabis does when it comes to opioid use.Adie Wilson-Poe
And here in Australia, as we recently wrote, there are many companies similarly exploring the benefits of cannabis on certain physical ailments.
Medlab Clinical (ASX: MDC), for example, is developing a series of cannabis-derived medicines, one of which is NanaBis, designed to serve as an alternative to opioids for those suffering from chronic cancer pain.
NanaBis is already being prescribed by doctors for chronic cancer pain, and several doctors have said to Medlab that the drug is successfully decreasing patients' reliance on opioids for pain management.
You can read more about MedLab and their cannabis medicines in our recent report here.
In conclusion, while studies on cannabis are admittedly in their early stages, the evidence seems to be piling up that cannabis can indeed help reduce different types of pain and ease people off of opioids.
And the beauty of it? Cannabinoids such as CBD have been deemed by the World Health Organisation to "exhibit no effects indicative of any abuse or dependence potential. To date, there is no evidence of public health-related problems associated with the use of pure CBD."
Could cannabis truly be the next exit drug? Only time will tell.
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