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Opioid Dependence & Role of Cannabis in Treatment

Opioid Dependence

Opioid abuse and overdose has spiked in the last five years. Opioid overdoses increased by 65% from 2012 to 2014. Recent figures show that the average number of fatal overdoses per year in the United States is around 33,000, but in 2016 a government report showed 64,000 deaths from drug overdose overall and more than 50% of those deaths were from opiates. A dramatic increase in fatal overdoses has caused many to find an alternative to opiates for pain relief and alternative treatment methods.
 

Opiate vs. Opioid: What Are They & What’s The Difference?

 
An opiate refers to the chemical compound taken from opium (opium poppy) while an opioid refers to the synthetic drugs derived from opiate compounds – for example, heroin is an opioid. However, the term “opioid” has been used to describe all opiate and opioid compounds in recent culture.

Opiate Compounds:
  • Morphine
  • Codeine
  • Thebaine
  • Papaverine
  • Narcotine
  • Narceine

 

Opioid Dependence

 
An opioid dependence is created when the body becomes accustomed to the presence of opioid induced dopamine that it becomes desensitized to the effects of the drug. More drugs are needed to achieve the same effect which increases the risk of an overdose.

How We Become Opioid Dependent
  1. Opioids attach to receptors in the brain, spinal cord and gastrointestinal tract (gi tract).
  2. Body releases dopamine (responsible for pain relief)
  3. Long-term production or large quantities of dopamine produced in a short-term, makes the body accustomed to certain dopamine levels requiring individuals to increase their opioid dose to maintain these levels.

Opioids prevent the body from interpreting pain – you still have pain, but the drug disrupts the channel of communication that signal your brain to recognize the pain. The problem is that opioids take away your body’s ability to manage pain with nociceptors, the sensory receptor for painful stimuli.
 

Current Treatment: Opioid Withdrawal

 
The current acceptable treatment for opioid dependence to wean patients off of opiates while minimizing withdrawal in opiate abusing patients is Methadone Maintenance Treatment (MMT). The problem with this method is that Methadone is an opioid. This is equivalent to moving an alcoholic from liquor to beer. It doesn’t treat the addiction. Using another opioid to treat opioid addiction leaves a high risk of abuse in methadone treatment. The risk is mitigated through a required daily clinic visit to obtain the methadone. However, this increases the chance of relapse as patients lose motivation to travel to a clinic or low income patients with barriers to transportation abandon treatment all together.
 

Cannabis and Opioid Withdrawal: Why Natural Makes Sense

 
Cannabis has become a common course for treating the symptoms of withdrawal because of its quality as a natural analgesic, mood booster and anti-inflammatory agent. Cannabis is also a safe option because there is a zero risk of fatality. Why? It takes 40,000 times the normal amount of cannabinoids to be considered a fatal dose – making this risk “impossible”

Symptom Relief with Cannabis:
  • Nausea
  • Diarrhea
  • Muscle spasms/shaking
  • Insomnia
  • Anxiety
  • Cramping
  • Goosebumps/ body chills
  • Intense sweating
  • Mood swings
  • Depression
  • Severe aches and pains

 

Pain Management & Cannabis

 
The most common prescription for medical cannabis is for pain management. Many doctors and nurses are prescribing cannabis to help wean their patients off of opioids.

Cannabinoids prevent opiate tolerance build up that causes opioid dependence. This helps doctors wean patients by allowing them to take fewer opioids for pain. This eventually turns into a treatment that replaces opioids with cannabis or uses a combination of opioids and cannabis to manage pain. Always consult with a naturopathic doctor or holistic nurse to help navigate the proper treatment path for you.
 

Microdosing & CBD: Products That Eliminate Fear of Psychoactivity

 
Microdosing is beneficial in pain management treatment because it maintains a minimum dose of cannabis in your system that yields the maximum relief. This eliminates the “high” feeling that can induce anxiety in many patients. Likewise, CBD is the non-psychoactive compound in marijuana that has pain relieving properties perfect for novice cannabis users or for patients that do not desire the “high” associated with high doses of THC.

Medicinal cannabis products like edibles or tinctures also make microdosing easier to manage as most of these products are pre-dosed or come with syringes to measure out precise dosage. Edible and tinctures produce longer lasting effects of the cannabis because they are metabolized differently than an inhaled cannabis product. Because both are ingested either sublingually or in the gi tract, these methods of consumption are inherently more bioavailable than smoking cannabis.
 

Microdosing Products Preferred by NDs
  • Myriam’s Hope
  • The CBD formula tinctures are easy to measure out and are made with high quality cannabis oil. Different formulas provide patients with high levels of CBD per ml dose. Formula A packs a 25 mg/ml punch while Formula B and C provide users with 50 mg/ml and 100 mg/ml respectively.

  • Veda Chews
  • The pre-dosed cannabis infused high CBD “medibles” are easy and convenient. The CBD formulas (gold 1:1 and silver 3:1) offer a non-psychoactive to minimally psychoactive effect with powerful and effective relief of pain, nausea, and inflammation.

 
Cannabis should be considered as a viable and effective way to deal with opioid addiction and withdrawal. Work with a trusted naturopathic doctor or homeopathic nurse who is trained in clinical cannabinoid medicine and/or chronic pain management with cannabis.


Microdosing & CBD Products to Try

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Topical Cannabis – More Than Localized Pain Relief

Topical Cannabis

Topical cannabis is not a new concept. Rubbing cannabis as a localized method of treating pain and finding superficial relief from tension and muscle soreness has been used by ancient civilizations including ancient China, Egypt and Greece. The resurgence of topical cannabis is helping many treat ailments without the psychoactive effects commonly associated with consuming cannabis.
 

Traditional Treatments Using Topical Cannabis

 
The most common use for topical cannabis, as well as medically prescribed cannabis, is pain. The modern cannabis user applies topical cannabis as a supplement to other forms of consumption for the treatment of sore muscles, inflammation, tension, and localized pain relief.
 

Topical Cannabis for Skincare

 
Besides treating tension and sore muscles topical application of cannabis is helpful for headaches and cramping too. Furthermore, skincare benefits through the topical method of consumption comes from its anti-inflammatory and antioxidant properties. Because of these properties, cannabis has proven a good ally for treating skin conditions including:

  • Psoriasis
  • Dermatitis
  • Itchy skin

How do they work to treat your skin? While THC has antioxidant properties, CBD is the real powerhouse of the cannabinoids. CBD, in a 1998 study, was found to have more powerful antioxidants than vitamin E and C. What does that mean? Antioxidants protect skin from free radicals, which are unstable molecules that harm cells and cause damage on a spectrum that ranges anywhere from early aging to cancer. Another way cannabis helps protect skin is by aiding with the aging process – cannabis can become the new hero in the fight against wrinkles and aging skin. There are a few reasons for its rejuvenating properties, but can mainly be attributed to the moisturizing and sun protection provided through the seed oil.

Different topicals interact differently with skin conditions depending on the cannabinoid content (THC versus CBD) and the composition of its other ingredients. Work with an experienced naturopathic doctor or holistic nurse to make sure you are choosing the right product for your condition.

Pro-Tip

If you plan on using topical cannabis as part of your skincare routine we suggest applying after a hot shower – your pores will be open and absorption will be more effective. Be generous with it and don’t be shy about a second… or third application.
 

Getting Intimate with Topical Cannabis

 
Cannabis and sex is not a new concept – the history behind it extends into ancient history and cannabis topicals is just one method of consumption to consume to improve sex. By now most people have seen or heard of topical cannabis products lines that include personal lubricants and suppositories, and we know you may have some questions.

How do they work?

Because of the increased bioavailability found in mucus membranes in the genital region, cannabis topicals designed for personal pleasure are able to target a zone and minimize the psychoactive effects.

What do they do?

These lines of products all aim to do one thing – relax the region so you can focus on feeling good. However, some might work better for your biochemistry or needs.

Personal Lubricants: FORIA Pleasure led the pack with personal lubricants. This topical cannabis awakens your libido, makes you more sensitive and relaxes the region for maximum enjoyment. When your body is relaxed and nerve endings are brought on-line, you are more likely to achieve and maintain a state of orgasm.

Suppositories: Much like the personal lubricants, anal suppositories can serve as a good way to explore new horizons. Anal suppositories help relax the region and enhance sensations to reach another level of euphoria with your partner.

What are the benefits?

Besides feeling good, cannabis can have a benefit beyond the physical when used during intimacy. Whether you are using cannabis topicals for massage or play, they aide in partner bonding and increasing connectivity. They help keep things interesting which ultimately helps maintain chemistry and sexual attraction in your relationship.

Are there risks?

Always check products for ingredients you may be allergic to, but the main risk involved with using cannabis topicals for sex is that most are made with an oil or wax based binder for the cannabis oil – this means that they are NOT latex friendly, but if you use alternative forms of protection you should be fine.

Whether you decide to use cannabis topicals to treat localized pain, for skincare, or for play – topical cannabis is a good method to try for novice users or to supplement other consumption methods. It is all the benefits of cannabis without adding the psychoactive commitment that comes with other methods of consumption.


Try Cannabis Topicals

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Cannabis Topicals: What They Are & How They Work

Cannabis Topicals

Cannabis topicals are gaining popularity and ridding a lot of public opinion regarding the use of cannabis and its effectiveness. Cannabis infused topicals are proving that you don’t have to get high for cannabis to be effective.
 

What Are Cannabis Topicals?

So what are they? Cannabis topicals are cannabis infused lotions, balms and oils that are absorbed through the skin and used as a localized treatment of ailments like pain, muscle soreness and inflammation.
 
Types Available:

  • Lotions
  • Creams
  • Balms
  • Oils
  • Sprays
  • Patches
  • Lubricants
  • Suppositories

 
CANNABIS TOPICALS
 
Don’t just think of these topicals as a medical treatment. Cannabis topicals have come a long way and many manufacturers have included in there lines topicals for play. Which fits with the historical use of cannabis as an aphrodisiac, but don’t take our word for it.
 

How Cannabis Topicals Work

Cannabis infused topical products work through transdermal absorption. The cannabinoids found in the topicals bind to a network of CB2 receptors that are found all over the body – they can be activated naturally through the natural course of your endocannabinoid system or by introducing cannabinoids such as THC and/or CBD to the system.
 

Patients Who Use and What Are Its Uses?

The rise in topical popularity among cannabis users largely comes from patients who want the therapeutic benefits of marijuana without the cerebral euphoria from a high. It is a safe method of consumption for those that not only want to avoid the high, but for those who prefer not to smoke or consume edibles to get the healing found through cannabis use.
 
Commonly Treated Ailments Using Cannabis Topicals

  • Pain
  • Muscle soreness
  • Tension
  • Inflammation
  • Psoriasis
  • Dermatitis
  • Itching
  • Cramping

Different topicals have different benefits and target a variety of ailments depending on the specific cannabinoids they deliver and other ingredients used in the product.
 

Why Don’t Topicals Get You High?

Most cannabis infused topicals, even with active THC, cannot breach the bloodstream when absorbed transdermally and won’t cross the blood brain barrier as a result. Although feeling the relief from pain or surface level aches and inflammation might be euphoric, it isn’t a psychoactive effect from the topical product used.
 
Everything Has An Exception

Transdermal patches are the only exception to the non-ability to get you high. Why? Patches do deliver cannabinoids to your bloodstream and if there is enough THC in the product, it can yield psychoactive effects often associated with cannabis use.

Now that recreational use is legal in the state of California, it can be expected that we will only see a rise in innovation with consumption methods and for advancement in the effectiveness of existing consumption methods to happen.


Try Cannabis Topicals

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California, Cannabis & What is Legal Use

legal use of weed in CA

Now that California has opened up to recreational sales and legal use of cannabis, many may be left wondering – what does this mean? What exactly does legalized cannabis mean? Below is a basic guideline to help you navigate the complicated arena between medical cannabis and recreational or adult-use cannabis.

Who Can Buy Cannabis?

The age and legal requirement for people that want to buy cannabis is different depending on whether it is for medical use or adult-use.

Medical Use Cannabis
  • Persons 18 years and older in possession of either a VALID county issued MMIC or valid physician rec
  • Be a primary caregiver of a person possessing either rec – section 11362.7(d) or 11362.5(e)
Legal Use of Recreational Cannabis
  • Persons 21 or older can buy cannabis from a licensed dispensary or delivery service

Benefits to Medical Rec

Now that recreational cannabis is legal to buy in California some may want to toss out their medical rec and save on the cost of renewing their current medical rec. NOT SO FAST! If you have a county issued medical rec you do not have to pay sales and use taxes on medical cannabis products – other taxes may apply, but you’d be saving at least 7.75% from sales tax.

So What Exactly is Legal & What is NOT: Adult-Use Cannabis?

The list for legal use and illegal use may be extensive, but we have highlighted some of the guidelines you can expect:

Legal Use

  • Persons 21 and older can buy cannabis products
  • Persons 21 and older can grow and cultivate up to six (6) cannabis plants for personal use provided that they be locked up and out of public view
  • Consuming cannabis on private property is allowed

LEGAL USE OF WEED IN CA
Illegal

  • Cannot consume in public or within 1,000 feet of a school, rec center, or youth center
  • Cannot consume while you drive or operate a vehicle or boat
  • Cannot have an open container in your vehicle
  • Cannot consume on federal lands such as national parks (still federally illegal)
  • Cannot transport across state lines even if traveling to another state that has legalized cannabis

For a more comprehensive list of what is legal, check out the California Department of Public Health website.

Final Note – Jobs & Cannabis Consumption

Remember, even though the recreational use of cannabis is now legal use of cannabis, employers can still prohibit its use by their employees. This is still true if you are a medical cannabis user in many states – know the law and your rights under ADA in your state and locally. An informed decision to consume cannabis is always recommended.

Driving High: Enforcement & Penalties of Cannabis DUI

driving high - cannabis DUI

Is a cannabis DUI really a thing? Adult use of cannabis may be legal in California, but driving under the influence of cannabis is not. Like alcohol, if you are found to be under the influence of cannabis while driving, you are guilty of DUI under Vehicle Code 23152(e)VC which states that a person is guilty if he or she drives while mental abilities are impaired by cannabis to the extent that he or she is unable to drive with the caution of a sober person using ordinary care.

Bottom line is any amount of cannabis consumption, whether that is ADULT USE or medical marijuana, puts you at risk of a DUI.

How is a Cannabis DUI Measured?

There is currently no standardized amount that has been widely accepted to be a reliable measure for the effect of cannabis on the brain. Why? There hasn’t been a chemically based test created that standardizes the effect of cannabis because everyone’s biochemistry is different.

In the meantime, California may adopt DUI standards that have been in place in other states that have decriminalized cannabis and is legal for adult use. For example, Colorado’s standard for DUI is having more than five (5) nanograms of THC per milliliter (ml) of blood. However, scientifically that doesn’t tell us much. Does not tell officers if a detained person is still intoxicated and it does not conclusively tell officers if someone is impaired or not.

Why Is It So Hard to Tell If Someone Is High?

Let’s take alcohol as an example. Ethanol, alcohol in beverages, is water soluble. We are made up of a lot of water – up to 60% in adults. Because we are made up of water, ethanol is flushed out of our bodies in hours.

THC on the other hand is fat soluble. It gets trapped in our fat stores in our bodies making the length of time that THC spends in the body variable from person to person. Its fat soluble qualities makes THC leech out of our fat stores over time and is the reason you can still test positive for THC up to 30 days after consuming cannabis.

Cannabis DUI - what is the penalty, enforcement and criteria

What is a Cannabis DUI Based On?

Law enforcement will use many factors in determining whether a person is driving while impaired. Some factors may include:

  • Circumstantial evidence (open containers, cannabis paraphernalia, etc.)
  • Roadside sobriety tests
  • Dilated pupils
  • Odor of cannabis on body
  • Red eyes
  • Cottonmouth
  • Slowed reaction time
  • Officer’s best guess

What Are The Penalties: 1st time Cannabis DUI

Penalties for a first time cannabis DUI offense may vary from case to case, but the basic guidelines may include:

  • Informal probation with a three to five year duration
  • Anywhere from four days to six months in county jail
  • A fine that could range anywhere from $390 – $1,000 plus any legal and court fees that you may incur during the process
  • Six month suspension of a driver’s license
  • Required attendance of DUI school for three to nine months

Any or all of these penalties may be augmented if the detained person on suspicion of DUI refuses to cooperate or refuses the chemical test.

Additional Penalties to DUI
  • Up to two (2) extra days in jail
  • A one year suspension of a driver’s license
  • Nine months of required DUI education courses

Avoiding A Cannabis DUI

Ultimately if the arresting officer decides that someone is driving high, they will be going to jail. Since there is no reliable way to measure the effects on the brain it is up to the full discretion of the arresting officer.

Driving High - Driving High: Enforcement & Penalties of Cannabis DUI

The only way to avoid a cannabis DUI is to not drive while consuming, and to not drive while you are impaired. Consume cannabis responsibly – there are too many options available as means of transportation to put your rights, freedoms, and the lives of you and others in jeopardy.