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An Alternative Solution to the Opioid Crisis

Topic: Canada's Opioid Overdose Crisis

Chronic pain is rarely isolated; it is frequently linked with sleep disturbances and emotional distress, forming the well-known “Pain Triad”. These three interconnected ailments can affect a person’s quality of life. For example, a high level of pain can lower your mood and reduce your quality of sleep.

Medications typically used to treat the Pain Triad

The drug classes that correlate to the three pillars of the pain triangle are listed below1. Medical cannabis is a promising alternative for all, and it is likely to avoid the negative side effects associated with these drugs, particularly opioids.

Medical cannabis as an alternative solution to the opioid crisis

Medical cannabis is a promising alternative to opioids for the treatment of chronic non-cancer pain2, which is the most common indication for its use. Other areas where cannabis has showed promise to date are in fact covered by drug classes overwhelmingly used to the three pillars of the pain triad. Moreover, cannabis may well spare patients many of the side effects associated with opioid use3.

For those interested in using medical cannabis as an adjunct therapy option to opioid, Starseed offers several product options that maybe helpful for patients. Starseed’s clinic partner ‘North Star Wellness’ is also available for medical cannabis consultations free of charge. With 9 clinics across Ontario and a team of expert health care professionals, North Star Wellness offers in-person and telemedicine consultations for patients in need of education and medical authorization for cannabis.

Register and book your appointment today.

References:

[1] National Pain Centre (2017). The 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain. Hamilton, ON: McMaster University. Retrieved from http://nationalpaincentre.mcmaster.ca/documents/Opioid%20GL%20for%20CMAJ_01may2017.pdf

[2] Benedict, G., Sabbagh, A., & Conermann. (2022). Medical cannabis used as an alternative treatment for chronic pain demonstrates reduction in chronic opioid use – a prospective study. Pain Physician Journal, 25, E113-E119. Retrieved from https://www.painphysicianjournal.com/current/pdf?article=NzQwOA%3D%3D.

[3] Ergisi, M., Erridge, S., Harris, M., Kawka, M., Nimalan, D., et al. (2022). An updated analysis of clinical outcome measures across patients from the UK medical cannabis registry. Cannabis and Cannabinoid Research, X(X), 1-10. Retrieved from https://www.liebertpub.com/doi/epdf/10.1089/can.2021.0145.

Previous Article
A Brief Overview on Canada’s Opioid Overdose Crisis
In Canada, the ongoing public health crisis of opioid overdose and deaths is worsening. Between January 2016 and June 2021, 24,626 persons died in Canada because of opioid overdoses, with latest figures indicating a frightening increase of 19 deaths per day. With a 66 % increase in death year over year, the COVID-19 pandemic in Canada has exacerbated the opioid problem, and we are still learning about the causes and risks that contribute to these terrible overdoses, which involve both prescribed and non-prescribed opioid use. Why is there an increase in opioid-related harms? The following reasons may have led to the rise in opioid-related harms: • Social isolation and pandemic-related stress1 • Erratic unregulated drug supply due to border and travel restrictions1 • Restricted accessibility of healthcare services1 The pandemic has affected virtually all services and therapies accessible to people suffering from chronic pain, addiction, and mental illness. Anxiety alone is a huge cause for drug use, and what could be more stressful than the current pandemic? People who formerly used drugs with a friend are now doing so alone, with no one to contact 911 or administer naloxone. COVID-19 overburdened emergency rooms and hospitals, and they may not have had the time or resources to address addiction. Opioids are undeniably effective in the treatment of certain types of pain, such as post-operative, palliative, and cancer pain. However, the fact that around 10% of those who are prescribed opioids go on to develop an opioid use disorder (OUD) is cause for concern2. Furthermore, problematic opioid usage isn't just an individual issue; it's also a 'proximity' issue for friends, family, and communities. Who are most likely affected by the opioid crisis? The opioid issue affects some communities and populations disproportionately, such as males aged 20 to 49 who work in the construction industry3. Chronic pain is a major issue in the trades and construction industry, with 32% of workers over-indexing for chronic back pain alone. Construction workers are estimated to account for 30% of all opioid-related deaths. Additionally, workers with a substance use disorder (SUD) miss an average of 14.8 days per year, while workers with OUD miss an average of 29 days per year4. This points to a rise in the number of construction workers seeking treatment for chronic pain and OUD. Chronic pain, however, is rarely isolated; it is frequently linked with sleep disturbances and emotional distress, forming the well-known "Pain Triad." Opioids are currently the most used drug to treat the Pain Triad. Because no single medication can target all three arms of the pain triad, prescribers frequently turn to multiple high-risk drugs, including opioids, that together increase the abuse potential and worsen symptoms. As a result, there has been a lot of interest in potential alternatives. The opioid overdose crisis is worsening during the COVID-19 pandemic with many communities across Canada reporting record numbers of opioid-related deaths, emergency calls and hospitalizations. We can all play a role in supporting those who use substances. If you or someone you care about is in need of assistance – Get help now. References: [1] Special Advisory on the Epidemic of Opioid Overdoses.  Opioid and Stimulant-Related Harms in Canada. Ottawa: Public Health Agency of Canada; Sept 2021. [2] Angus Reid Institute. (2021). Canada’s other epidemic: as overdose deaths escalate, majority favour decriminalization of drugs. Retrieved from https://angusreid.org/wp-content/uploads/2021/03/2021.02.24_Opioid_Dependence.pdf [3] Gomes, T. et al. Changing Circumstances Surrounding Opioid-Related Deaths in Ontario During the COVID-19 Pandemic. Ontario Drug Policy Research Network / The office of the Chief Coroner of Ontario / Ontario Forensic Pathology Service / Public Health Ontario. May 2021. [4] Xiuwen, D., Wang, X., Fujimoto, A., & Dobbin, R. (2013). Chronic back pain among older construction workers in the United States: a longitudinal study. International Journal of Occupational and Environmental Health, 18(2), 99-109.
Next Article
Understanding Chronic Insomnia and its Cause and Effects
Chronic insomnia is a long-term pattern of difficult initiating or maintaining sleep. Sleep disorders, like insomnia, are problems with the quality, timing, and amount of sleep, which result in daytime distress and impairment in functioning.1 Our sleep-wake cycle is controlled by the body’s internal clock known as circadian rhythm. Circadian rhythms are physical, mental, and behavioural changes that follow a 24-hour cycle. It can influence important functions in our body, such as hormone release, digestion, body temperature, and sleep cycle. Usually, our circadian rhythm closely follows the daily pattern of day and night. However, many people have sleep schedules that cause misalignment of their circadian rhythm. Shift work is one example of a situation in which individuals are unable to get the sleep they need. Travel is also a common cause of disturbed sleep. In some people, circadian rhythms can be shifted forward or backward without a clear cause, resulting in persistent difficulties in sleep timing and overall sleep quality. Poor sleep can also trigger or worsen other health conditions, creating a complex chain of cause-and-effect of insomnia. Sleep quality can be hampered by a demanding work schedule and high level of stress, but the contrary is also true. It's difficult to perform well when you're nodding off at your desk, fatigued, have poor energy, and lack creativity. Many medical conditions, such as PTSD, pain, and sleep apnea, have the potential to disrupt sleep. Can medical cannabis help with sleep? A recent high-quality human clinical trial demonstrated that giving cannabis, specifically THC 10mg-20mg in oil form, one hour before bed improved sleep quality and insomnia significantly. The research implies that mixing THC with CBD can help people who are new to THC or who are sensitive to it avoid or lessen the unpleasant psychoactive effects of THC.2 References: [1] Qaseem, A., Kansagara, D., Forciea, M., Cooke, M., Denber, T.D., et al. (2016). Management of chronic insomnia disorder in adults: a clinical practice guidelines from the American College of Physicians. Annals of Internal Medicine, 165(2). 125-133. [2] Walsh, J.H., Maddison, K.J., Rankin, T., Murray, K., McArdle, N., et al. (2021). Treating insomnia symptoms with medicinal cannabis: a randomized, crossover trial of the efficacy of cannabinoid medicine compared with placebo. Sleep Research Study, 44(11), 1-8.

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