Study Shows: Opioid Addicts who use Cannabis will do Poorly in Methadone Treatment

In light of Canada’s recent move towards the legalization of cannabis, authors of a new study published in Biology of Sex Differences, that investigated the association between cannabis use and methadone treatment outcome, discuss their findings and the implications.

Legalizing cannabis

There is a growing popular belief that cannabis is natural and therefore harmless to use. In fact, many people who are addicted to opioids believe that cannabis use is a substitute to methadone and can help them control opioid withdrawal symptoms. In addition, there are an increasing number of studies advocating for the use of cannabis instead of opioids for chronic pain. Is cannabis harmless for everyone as claimed? Will making cannabis legal and eventually more accessible do harm or good?

Public perception of cannabis is that it is a harmless substance, mainly because it is unlikely to lead to death due to overdose. While there are no documented reports of fatal overdoses from cannabis, other adverse consequences have been noted, including cognitive impairment, respiratory problems, and psychotic symptoms. Vulnerable populations, such as those with existing addictions, are at greater risk of experiencing these adverse events.

Opioid addiction

Opioid addiction (or opioid use disorder) has skyrocketed around the globe and is especially pervasive in Canada where it was declared a public health crisis. Deaths from opioid overdoses have become commonplace in Canada; the urgent need for adequate treatment options for those with opioid addictions has been emphasized by clinicians and the public.

Methadone maintenance treatment is currently the oldest and most widely used pharmacological treatment for opioid addiction. Those in treatment receive a daily dose of methadone, a long-acting synthetic opioid, to reduce cravings and relieve withdrawal symptoms without producing the same euphoric effects of other opioids.

Current study

Previous research has found differences in clinical profile and treatment outcomes between men and women, and therefore our study aimed to explore sex differences in cannabis use.

777 participants in this study (414 men and 363 women). About 60% of men and 44% of women reported using cannabis. After controlling for age, methadone dose, and length of time in treatment, we found women were 82% more likely to also use illicit opioids while on methadone treatment if they were cannabis users.

A recent study found the motivation for using cannabis varied between men and women, whereby women tended to report the primary purpose for using it was for self-medication, whereas men more often reported using cannabis was for recreational purposes. However what we see in this study is that women who use cannabis are not faring well compared to men. Cannabis has not helped women and was associated with worse health outcomes for them.

BioMed Central

Lactuca Virosa: Another Plant Used as Alternative Painkillers

Known as the “poor man’s opium”, wild lettuce is an excellent and natural painkiller. Lactuca Virosa can be used as an alternative to traditional and often addictive prescription painkillers. The power of this vegetable – a cousin to the lettuce we buy at the grocery store – is found in the white substance produced in its leaves and stem. The Latin prefix “lac” means milk and is meant to describe the plant’s bitter white sap.

The pain-relieving properties of wild lettuce were already being utilized as early as the 19th century, however, it was only during the 1970s that it gained popularity.

There are two popular ways of enjoying wild lettuce. The first is to cook the plant in a sugar-water mix until it reaches a syrup-like consistency; the solution is then drunk as medicine. This has been found to be quite effective, although the bitter taste remains.

Looks can be deceiving

Wild lettuce is often overlooked because of its weed-like appearance. Still, several studies point to the numerous health benefits of the plant. Studies have also found that people with asthma respond better to the wild lettuce treatment than to opiates. This is because patients tend to undergo an opiate withdrawal which can be more challenging than their actual condition.

The need for pain relief

Pain is a major public health problem. In America, between $560 billion and $635 billion is spent on pain treatment annually; this translates to each American spending around $2,000 just for pain relief. The National Academy’s Institute of Medicine notes that 100 million Americans currently suffer from chronic pain.

There are two caveats to note: Since wild lettuce manipulates the function of the central nervous system, it should not be taken for at least two weeks prior to any major surgery.

Asia Cruise News

Florida Lawmakers Push for Marijuana Decriminalization

Now that Florida has legalized marijuana for medicinal use, a couple of state lawmakers want to ensure that law enforcement doesn’t put more people in jail for pot possession.

Democratic Representative Carlos Guillermo Smith and Democratic Senator Jeff Clemens recently introduced bills in the state legislature aimed at eliminating the criminal penalties associated with marijuana possession. These bills would allow anyone caught with up to an ounce of weed to simply repay their debt to civil society through a small fine and/or community service rather than through the criminal justice system.

Last year, a number of local jurisdictions across Florida passed decriminalization ordinances – giving police the freedom to issue citations for petty pot possession when the offense was not connected to violent crime. As it stands, 14 cities and counties in the Sunshine States have adopted these policies, including Miami-Dade County and Orlando.

There were almost 40,000 people busted in Florida for this offense in 2016, according to the West Orlando News.

A report from the American Civil Liberties Union shows that Florida spent $228 million in 2010 enforcing marijuana laws – a large majority of these arrests were for minor pot possession.

Merry Jane

Cannabis oil legislation: This makes sense how?

The state Legislature recently approved a bill that would give parents the ability to try a drug derived from marijuana to help children with severe seizures.It’s a good and important measure that got the support it deserved. It was approved unanimously in the Assembly and with only one no vote in the Senate (Duey Stroebel). Legislators justifiably patted themselves on the back with Assembly Speaker Robin Vos (R-Rochester) proclaiming that “Today is a day that I could not be prouder.”

“This is not the fix we are looking for,” said Rep. Jill Billings (D-La Crosse). “You’re setting families up saying they can possess it but they can’t get it.” Good point.

Sen. Chris Larson’s office said he has a bill to allow manufacture of the drug, and Rep. Scott Krug’s office blamed it on the feds, saying all would be well if and when they reclassify cannabis oil; something the sponsors of the bill thought would happen months ago.

Journal Sentinel

Cannabis Investors: Could the Opioid Crisis Derail the Recreational Marijuana Train?

Investors in Canadian medical marijuana producers are betting that Ottawa will deliver on its plan to legalize the sale of recreational pot and open a massive new market.

Is the plan at risk?

Canadians are generally perceived as having open minds when it comes to giving people the option to legally use cannabis for recreational purposes. Whether or not they are comfortable having dispensaries set up in their communities is another question.

While the discussion surrounding the legalization of marijuana continues, a surge in the use of opioids by Canadian teens is once again bringing the entire drug problem out into the open.

Reports continue to emerge of young teens overdosing and sometimes dying due to the use of drugs containing fentanyl, a potent synthetic opioid. The death of a 14-year-old girl in an Ottawa suburb recently made national headlines.

Should you own cannabis stocks?

Medical marijuana suppliers, such as Canopy Growth Corp. (TSX: WEED) are trading at extreme valuations right now based on investor expectations that a legal recreational marijuana market is coming soon.

The government may well see the plan through, but there is a risk that Ottawa could drag its feet, especially if MPs start to take heat from voters who think the Liberals should focus on stamping out the opioid problem first.

If Ottawa decides to backtrack on the marijuana file, cannabis stocks could get hit hard.

As such, I would avoid the sector today.

The Motley Fool

Feds ‘Just Say No’ to Marijuana at High Times Cup on Tribal Lands

Case in point: the 2017 High Times Cannabis Cup on the Moapa Band of Paiutes reservation in Nevada near Las Vegas. The most recent update on this particular Cup is that despite receiving two warning letters from U.S. Attorney David Bogden, the Tribe is moving forward this Saturday with the Cup as planned.

Given the Wilkinson statement regarding Tribal cannabis and the Cole Memo regarding federal enforcement of its cannabis laws, it’s easy to see why the Moapa Indians are trying their hand at hosting this Cup. Nonetheless, tribes that have tried to legalize or “medicalize” marijuana on their lands have been met with mixed reactions and enforcement by the federal government (see here, here, here, here, and here). The Moapa are no exception.

On February 16th and 23rd, U.S. Attorney Daniel Bogden sent “warning letters” to the Tribe concerning this upcoming cannabis cup, reiterating that marijuana remains federally illegal and that the Tribe has an “incorrect interpretation” of the Cole Memo and Wilkinson statement. Bogden’s letters also reminded the Tribe that neither the Cole Memo nor the Wilkinson statement alters the power of the federal government to enforce federal laws on tribal lands. At no point in his February 16th letter did Bogden threaten to shut down the Cup. But Bogden’s February 23rd letter states that his office communicated with tribal officials and his understanding is that no cannabis or cannabis products will be present at the Cup.

Since Bogden’s warning letters come on the heels of White House press secretary Sean Spicer’s comments about the likelihood of increased federal enforcement in states with recreational marijuana programs, many are wondering if Bogden’s actions are the beginning of what “increased enforcement” may look like.

Above the Law

Just how mainstream is Marijuana? There’s now a “Congressional Cannabis Caucus.”

Earlier this month, Rohrabacher introduced a measure called the Respect State Marijuana Laws Act of 2017, which would protect people from marijuana-related prosecutions under the Controlled Substances Act, provided that they were acting in compliance with state laws. The bill has drawn bipartisan co-sponsorship.

Voters and lawmakers in many states have been liberalizing their marijuana laws since the 1990s, sometimes drastically so. Most have opted to scale back the strict marijuana prohibitions of an earlier era, adopting regulatory structures that allow for everything from limited access to certain marijuana-derived chemicals for medical use all the way up to full-blown commercial legalization and regulation.

The disconnect between state and federal laws leaves many marijuana users, patients, businesses and researchers stuck in an uncomfortable gray area between the two. Federal authorities could technically sweep in at any minute, shutting down businesses and arresting marijuana users even in places where it’s legal under state law.

That this hasn’t happened on any significant scale since Colorado and Washington’s state legalized marijuana in 2012 is partly because federal authorities lack the manpower to do so. Most drug enforcement is handled at the state level, by state and local police. This fact was explicitly acknowledged by Obama’s Justice Department in what came to be known as the Cole Memo, which laid out a federal policy of noninterference with state marijuana laws provided certain guidelines, like preventing underage people from using marijuana, were adhered to.

But a memo is just a voluntary statement. It doesn’t have the force of law, and the new administration could choose to adhere to it or ignore it, depending on its own enforcement priorities.

The Washington Post

Kava Legal in Relaxation of WA’s Drug Laws

Changes to the State’s medicines and poisons laws last month mean a ban has been lifted on the plant product, bringing WA into line with other States.

Kava, also known as Piper methysticin, is made from the root of a shrub and in small doses in herbal preparations can relax muscles and help with sleep. The WA Health Department said yesterday kava would be a closely regulated substance in WA.

Low-dose products labeled as a complementary medicine are available over the counter.

The department said patients should still seek expert advice before starting a treatment, and any mental health condition required the advice of a qualified medical professional.

Professor Jerome Sarris, who is deputy director of the NICM integrative medicine institute at Western Sydney University and has done clinical trials into the effectiveness of kava, said it was a sensible step forward.

“Anxiety disorders are complex and can significantly impact people’s day-to-day lives, and research has shown kava compares favorably to the efficacy of existing medications for the treatment of chronic anxiety,” he said.

“However, unlike some other options, it has less risk of dependency and less potential for side-effects such as lethargy and memory impairment.”

The West Australian

State Senate Approves Marijuana Oil Legalization

The vote is another step toward increasing access to cannabidiol, also known as CBD oil, by making changes to the state law that governs it. CBD-oil has been used to treat medical conditions including seizure disorders in children.

The state Senate voted 31-1 in support of the bill, which would make it legal for individuals to possess the oil in Wisconsin, as long as a doctor has signed off on it. Sen. Duey Stroebel, R-Saukville, was the only dissenting vote.

In 2014, lawmakers passed a bill called Lydia’s Law, which made the oil available to certain populations. However, some patients have said it’s difficult to access the oil because that law requires the U.S. Food and Drug Administration to approve prescriptions.

A similar bill passed the state Assembly during the last legislative session but failed to pass the state Senate after opponents expressed concern about the oil being a gateway to marijuana legalization in the state.

The bill would not legalize the manufacture or sale of CBD oil in Wisconsin. Users would need to travel to adjacent states to procure it.

The bill now goes to the state Assembly, where Assembly Speaker Robin Vos, R-Rochester, has shown support.

Wisconsin Public Radio

DEA Asked Public’s Comment On Its Proposed Kratom Ban: 99 Percent Opposed It

When the Drug Enforcement Administration formally backed off plans last year to ban the ability to buy kratom, the agency announced it would accept input from the public to help determine how to proceed.

Kratom is a herb made from the leaves of Mitragyna species, a Southeast Asian tree related to coffee. Often taken in powder form, kratom contains the alkaloids mitragynine and 7-hydroxymitragynine, which appear to activate opioid receptors in the brain and reduce pain. And although most opioids have sedative qualities, low to moderate doses of kratom actually serve as a mild stimulant.

A diverse coalition of supporters appears prepared to stand firm against that move. Of the 2,416 comments submitted to the DEA with profession-related information, nearly half self-identified as either veteran, law enforcement officials, health care professionals or scientists. The overwhelming majority of these were in favor of keeping kratom legal, with veterans supporting by a margin of 448 to 1 and medical professionals supporting by a margin of 569 to 7.

Despite having received overwhelming support in favor of keeping kratom legal, it’s not yet clear how the DEA will proceed. The agency is still awaiting the results of a U.S. Food and Drug Administration analysis of the potential harms and health benefits of the herb, which will determine if kratom truly poses an “imminent hazard to the public safety,” as the DEA initially claimed last year.

“What we found is a kratom community of responsible consumers who look just like your family and the people who live next door,” they said. “The face of kratom consumers is the face of America today.”

Huffingpost

Cyprus Set to Provide Cannabis Oil to Cancer Patients

Alongside announcing the cannabis oil provisions, Pamboridis said that legislation has been drafted to legalize medical cannabis more broadly. According to Greek-language newspaper Politis, the draft bill will be open for public consultation prior to being entered into parliament for debate and approval.

These announcements come two months after Pamboridis tweeted that he wanted to have a frank and open public conversation about the potential benefits of medical cannabis use.

Although these plans are groundbreaking for Cyprus, medical cannabis provisions for cancer patients are well-established in certain other countries.

Cannabis use, sale, and cultivation have been prohibited in Cyprus since 1977 when the Narcotic Drugs and Psychotropic Substances Law was introduced. This legislation, which deems cannabis to be a Class B drug, offers harsh penalties for related offenses.

According to the European Centre for Monitoring Drugs and Drug Addiction (EMCDDA), possession of fewer than 30 grams of cannabis can garner a prison sentence of up to eight years. Possession of more than 30 grams is presumed to be a supply offense and can be punished by up to life in prison.

In December 2016, the Irish parliament’s lower house passed a bill to legalize and regulate cannabis products for medical use. One month later, the lower house of the German parliament passed a bill to legalize cannabis for medical use “in very limited exceptional cases”.

Both bills are expected to pass their respective parliaments’ upper houses without obstruction.

Talking Drugs

New England hospitals will help women, babies affected by opioid abuse

Dartmouth-Hitchcock’s Perinatal Addiction Treatment Program is using a grant from the March of Dimes to create an online toolkit for hospitals and health centers that want consistent guidelines and a systematic approach to care. For example, the toolkit includes consent forms that enable a patient’s addiction treatment provider and medical care team to share information and work together.

“Providers were saying, ‘I feel like my patients have two different health care teams — they have their addiction treatment provider and they have their perinatal health care team, and the two don’t talk to each other. This is not a safe situation,'” said project coordinator Daisy Goodman.

Officials estimate about 10 percent of newborns in New Hampshire’s Upper Connecticut Valley region are exposed to opioids before birth. While that number has increased, knowledge about how to treat them also has significantly improved, Goodman said.

Participating sites include Dartmouth-Hitchcock clinics in Lebanon, Claremont and New London; Cheshire Medical Center in Keene, Catholic Medical Center in Manchester, Memorial Hospital in Conway, Manchester Health Center and Maine’s Waldo County General Hospital.

NBC

Marijuana Has Medical Benefits According to National Academy of Sciences

The committee who conducted the review concluded that patients who were treated with cannabis or cannabinoids are likely to experience a huge decrease in pain symptoms. In adults suffering from multiple sclerosis-related muscle spasms, temporary use of oral cannabinoids led to a marked improvement in their condition, according to a news release.

The first attempt by the government to control the use of pot was commissioned by then New York mayor Fiorello La Guardia in response to the Marijuana Tax Act of 1937. The LaGuardia report concluded that pot did not have any effect on a person’s sensibilities or decision-making ability.

Former U.S. President Richard Nixon also commissioned a scientific assessment of marijuana in the early 1970s. Commissioned by Nixon, the Schaefer Report came up with the conclusion that cannabis does not rank high in social problems in contemporary America.

There is a huge difference in the landscape of cannabis in 1999 and 2016. Currently, medical marijuana is legal in 28 states (as of this writing), while 16 states have CBD laws. Last summer, the DEA did not reschedule marijuana, which means that it has no medical value.

Testing It Up

Guest column: Lessons of the Opioid Addiction Epidemic

Opioids, which include Oxycontin, Percocet, Vicodin, and morphine, are powerful painkillers. In the past, opioids were mainly used for patients with cancer pain, at the end of life, or after major surgery. But starting about 20 years ago, there was a big push for doctors to prescribe opioids for acute and chronic pain of all types, such as headaches, fibromyalgia, arthritis and back pain.

At the same time, doctors were told, incorrectly, that these medications were not addictive. As a matter of fact, doctors were told that less than 1 percent of patients on long-term opioid therapy became addicted or dependent on the medications. Furthermore, starting patients on these medications, doctors were told, would return them to normal function. They would get their lives back.

If you are a young person (younger than 25) and take an opioid for any reason — after a surgery, tooth extraction, etc. — you are 50 percent more likely to become addicted in your lifetime. The young brain should not be exposed to opiates unless absolutely necessary.

Now, pain is very personal and emotional for many people. There are many people whose lives have been changed for the better because of opioid therapy, but the above statistics are sobering.

Because of the evolving understanding of opioid pain medications and the drastic increase in people living with addiction, and overdose deaths, providers are becoming more cautious about prescribing these medications. We will explore this and the community response to the opioid crisis in an article in this space next month.

Citizen-Times

How Psychedelic Mushrooms Change Cancer Patients Dealing With Anxiety

With medical marijuana now legalized in 28 states and the District of Columbia, the debate over when, and if, a previously illegal and often stigmatized drug should be used to treat serious symptoms will likely carry on through the foreseeable future. However, new research shows that another illegal, and far more psychedelic, the substance may also have certain health advantages as well.

According to the results of two studies released last year, psilocybin, the active ingredient in magic mushrooms, can help ease feelings of anxiety and depression in cancer patients.

In both studies, one conducted at NYU and the other at Johns Hopkins University, 80 percent of cancer patients reported a decrease in anxiety and depression for at least six months. Psychiatric evaluators also supported their patients’ claims, noting an increase in optimism as well as overall quality of life. In the NYU-led research, 70 percent of participants said taking psilocybin was one of the five most important experiences they’d ever had.

That being said, it shouldn’t come as a surprise that psilocybin is still considered a Schedule 1 substance under the Controlled Substances Act, meaning psychedelic mushrooms are legally considered to have no legitimate medical use and possess a high potential for abuse. Additionally, the treatment given in both studies was conducted under the care of medical professionals, meaning it isn’t recommended as some sort of catchall, home remedy for anxiety and depression.

Other, smaller studies have even found evidence that psilocybin may be beneficial in alcoholism, smoking addiction and obsessive compulsive disorder, meaning there may be even more reasons to call mushrooms “magic.”

Paste Magazine

Magic Mushrooms: Scientists Warn Against Psilocybin Use

In a study published in the Journal of Psychopharmacology, the researchers conducted a survey of nearly 2,000 people who said they encountered a past negative experience when taking psilocybin-containing “magic mushrooms”. In fact, more than 10 percent believed their worst “bad trip” could put themselves or other at risk for physical harm.
Another 2.5 percent of the respondents said that behaved aggressively after taking magic mushrooms while 2.7 percent had to seek medical help. The researchers, however, warned that the survey they conducted dud not apply to all psilocybin use because the questionnaire used wasn’t designed to study the “good trip” experiences.

Positive Experiences Too

According to PsychCentral, despite the risk of psilocybin use, most of them still reported the experience to be “worthwhile” and “meaningful”. About half of the positive responses by users of magic mushrooms claimed that it was one of the top most valuable experiences in their life.

What Are Magic Mushrooms And Psilocybin?
The U.S. Department of Justice reports that psilocybin is a hallucinogenic substance obtained from magic mushrooms which are indigenous to tropical and subtropical regions of Mexico, South America and the United States.

Though many studies have shown that psilocybin could be used to treat anxiety and depression, the use of this substance is associated with negative psychological and physical consequences. The physical effects of magic mushrooms usually take place within 20 minutes of ingestion. These could last for about 6 hours and include muscle weakness, drowsiness, lack of coordination, nausea and vomiting.

On the other hand, psychological effects of magic mushrooms include hallucinations and an inability to discern reality from fantasy. In large doses, however, panic and psychosis may occur.

Counsel & Heal

Magic Mushroom: Caution Is The Word

Psilocybin, the main active ingredient in magic mushrooms, is responsible for the hallucinogenic effects. In the U.S, the magic mushroom is considered a Schedule I substance, which means that it has a high potential for abuse.

In 2014, an estimated 22.9 million people in the U.S. reported lifetime use of Psilocybin, according to the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health.

Recent studies have documented a wide range of positive effects of Psilocybin on the human brain, say easing depression or anxiety. But it is equally important to inform consumers about the risks associated with its use.

According to the survey data, 39% of the respondents rated acute and enduring adverse effects of Psilocybin among the top five most challenging experiences of his/her lifetime. Eleven percent put self or others at risk of physical harm during their difficult or challenging experience (i.e., a “bad trip”). There were also three cases of attempted suicide.

But, that said the rates of adverse effects after psilocybin use have been fund to be very low relative to adverse effects associated with other psychoactive drugs, according to the survey data.

RTT News