Opioid Crisis

Florida governor Rick Scott recently signed a Bill HB21 which will make it more difficult for some physicians to prescribe narcotics to certain patients. Specifically, this new law limits prescription of schedule 2 narcotics (OxyContin, Percocet, dilaudid, morphine, methadone and fentanyl plus some others) for acute pain to 3 days worth of meds, or in exceptional cases 7 days. Additionally, physicians are required to take a special course now to prescribe narcotics and will also have to access a data base for every patient they prescribe to and report their prescriptions to the state. This will affect surgical patients and anyone who finds themselves with an acute pain situation. It is not supposed to affect cancer patients and chronic pain patients who are already in the system.

There are some critics in the physician community that say this is burdensome and too restrictive for certain things. For instance, total knees and back surgeries often require a month or more of post operative narcotics. There is also concern among patients with chronic pain and their physicians who are now feeling scrutinized. I have heard of some pain clinics are now refusing new patients and cutting off existing ones.

Medical cannabis physicians have noticed an increased number of patients coming to them because they have heard that cannabis can be substituted for narcotics. It has the added benefit that it is not physically addictive nor do people die from overdoses with it. And data from states that have legalized marijuana show a marked decrease in opioid drug overdose deaths and also a decrease and violent crimes. Some states like California who have had legal medical marijuana for over 20 years do not seem to have the same opioid crisis as states that don’t allow medical marijuana.

Florida definitely has an opiate crisis and in fact 16 Floridians die every day from opiate overdose. Nationally about 60,000 people die each year. The large majority of these patients started their addiction legally with medically prescribed opiates from doctors.

Medical marijuana was voted on in Florida in 2016 and was overwhelmingly approved by 71 plus % of voters. We now have over 100,000 patients who are on the state registry to use medical marijuana (cannabis) and that number is rapidly rising. Considering the lack of support from organized medicine and efforts within the state and federal government to derail medical cannabis, it has been found to be as a very useful medicine by Floridians.

There are many entities that are actively lobbying or at least resisting the liberalization of medical marijuana which makes it difficult and expensive to get in Florida.The pharmaceutical industry is by far the biggest lobbying group in the country and they poured over a quarter billion dollars into the hands of politicians over the last decade. Much of this money has been a resistance to the expansion of medical marijuana. Some of their biggest profits have been from narcotics. In 2007 the pharmaceutical company Purdue was fine by the feds $634.5 million for influencing doctors to inappropriately prescribe the opiate OxyContin. But considering that company is making over $16 billion a year selling narcotics (2016) such fines are considered just the price of doing business. It is also interesting that the pharmaceutical company that makes the life saving antidote Narcan has increased the price 5 fold since the narcotic epidemic has become recognized.

There have been some resistance from law enforcement to further liberalize the concept of medical marijuana because they have a financial interest also. Keeping marijuana illegal enhances their options for arrest and prosecution and maintain authority for search and seizure. The for-profit prison system really opposes decriminalizing marijuana because they want to keep their prisons full.

Cannabis has been around forever as a medicine except for that time between the 1930s to 1996 when it was effectively banded by the federal government. They categorized it as a schedule 1 drug which means it is highly addictive and there is known medical use for it, but then they hypocritically allowed a pharmaceutical company to produce a synthetic THC and sell it as Marinol. Then in 2003 the feds also took out their own patent (#6630507) on another component of marijuana called CBD because they recognized it was useful as an antioxidant and neuroprotectant. They now are trying to allow another pharmaceutical company to produce a purified version of this.

In the midst of an opiate crisis killing thousands of Americans every year, One wonders why the government and the medical establishment don’t look at what is becoming apparent to physicians who have been substituting cannabis for opioids. No, there are no clinical studies on this because the federal government has not allowed any funding of research on this. But states that have medical marijuana and the physicians who are knowledgeable in it’s use know that this can be a big part of the solution of the opioid crisis.

I encourage people to learn about the benefits of medical cannabis and become educated. Support the struggle to make it more easily available for people with chronic pain and other maladies for which it is a better substitute than many of the pharmaceutical drugs with high cost and dangerous side effects.