Opioid Tapering With Cannabis: A Regimen



Tapering Off Opioids for Pain Relief with Dr. Gregory Smith a Green Flower Media class

Decreasing or quitting opioid medications using medical cannabis.

We're all aware by now, aren't we, that our medical profession has created a nightmare of addiction by overprescribing opioid medications? I recently took a class at Green Flower Media on using cannabis to taper down the opioid dose with the hope of getting completely away from these medications that were only meant for short-term use of around two weeks.

Some Perspective

The US has 5% of the world's population but uses 80% of the opioid medications prescribed. There's been a four-fold increase in prescription opioid deaths since the year 2000, causing over 40 deaths a day, most as a result of a patient taking too much of the opioid medication. Research shows that opioids are ineffective for the long-term treatment of chronic pain. The epidemic is caused by prescription-writing practices of physicians stimulated by the marketing practices of pharmaceutical companies.

All of the studies done on opioids were done for two weeks, the length of time the medications are most effective. All of the research on cannabis was done using cannabis with around 25% THC and negligible CBD. The doses were 20-30 mg of THC, multiple times a day

Any negative effects presented by research were done with questionable science. The data of the effectiveness of cannabis as a healing herb overwhelmingly overshadows any parinoid percieved problems that've never really materialized.

There's no correlation between the studies done by our government and how cannabis is used in the real patient world.

The medical community created this opioid dilemma. This is a step towards repairing the damage.

It wasn't until a decade ago that the prescribing practices of physicians began changing. Previously opioids were for end-of-life conditions or for post-surgery. It wasn't until the last couple years, when they were doing studies to show that the opioids could be effective long-term that they discovered the tendency to increase pain perception, the opposite of what they were marketed to do. Long-term opioid use causes increased pain

Pain signalling can be modulated by simply using the power of your mind. After a few weeks the tissues are healing, so the cells are quieting. Pain isn't sharp and knife-like, but dull and achy. This is when opioids can begin to ramp up the pain signal.

Research has shown the severe problems inherent in current opioid use practices. Long-term use actually increases the patient's perception of pain, leading to higher and higher doses of opioids. Patients are regularly being terminated by their pain doctors for testing positive for "illicit substances," usually cannabis.

These opioid-addicted patients end up seeking street opioids to feed their cravings. The cheapest street solution, unfortunately, is heroin. Overdoses of herion add another 26 deaths a day to the climbing numbers of opioid failure.

Opioid tolerance and enhanced pain perception

Opioids are useful following surgery or trauma, and in the beginning, that was how they were used, for short-term pain relief. When used long-term you bring new concerns into the healing space. After a few months patients develop an addiction to the opioids. Their perception of pain is enhanced, so that minor pain is perceived as major pain. The patient's mind calls for more opioids. The harsh reality is that long-term opioid use leads to marked magnification of the pain response.

This is not what you envisioned when your doctor said "Take these every day and come back to see me in three months" was it?

Tolerance comes into play because over time the opioid receptors become desensitized. Now you need more opioids and more frequent dosing times to achieve the same level of relief. After a few months the patient can become so addicted to the opioid medication that discontinuing, or even delaying the taking of a dose, can result in the onset of severe withdrawal symptoms - sickness, pain, undeniable cravings for opioids

Early symptoms of opioid withdrawal
* Anxiety/Agitation
* Muscle aches (profusely, throughout the body)
* Increased tearing for no reason
* Insomnia
* A clear, runny nose
* Sweating for unknown reasons
* Craving opioids

Later symptoms of opioid withdrawal
* Intense abdominal pain
* Diarrhea
* Dialated Pupils
* Nausea and vomiting

These sick patients crave the opioids to make the sickness go away, making it difficult for an individual to make the break from opioids on their own. If a patient stops and then restarts an opioid regimen they typically require a higher dose to begin again.

A patient who stops opioids successfully and then later starts again on that same dose can end up dead. During the time away from opioids the tolerance levels are reset. You won't need as much, so if you take that much it could be fatal.

The side effects no one likes to talk about
- Severe, intractable constipation, associated with abdominal bloating, nausea, and colic.
- Decreased testosterone in males to the point where it's common for a long-term patient to need hormonal replacement therapy.
- Depression, a common occurance with long-term use.

These side effects call for the use of other prescription medications that can further complicate the treatment of chronic pain.
 


The Social Setting

There are a million and a half legal medical cannabis patients in the US right now. About 80-90% of them use medical cannabis for chronic pain. Chronic pain is a subjective condition, easily faked to get the prescription, which makes you wonder how many of that number where really pain patients. We believe cannabis should be available freely to all, so I'm not bothered by this, but Dr. Michele Sexton has an ongoing cannabis use survey with Bastyr University.

Of participants identified as medical cannabis users only, 61% used cannabis to manage pain. The second and third noted reasons for using cannabis were anxiety and depression, significant because pain patients often have anxiety and depression.

They did another analysis of this data, asking if patients substituted cannabis for prescribed medications. The survey included 2864 people, and 46% responded "Yes!"

The top medications they were substituting for were narcotics and opiates. The next two types of medications they were substituting for were anti-anxiety and anti-depression medications.

Medical cannabis patients were 4.6 times more likely than non-medical cannabis users to substitute cannabis for pain medications, and women were 6 times more likely to be substituting cannabis for their prescribed pain medications.

I'd say the patients have spoken and it's time someone listen.ped.

Data shows that 10-15% of chronic pain patients are actually using cannabis, in combination with other pain control medications, to reduce the opioid medications. About 80% of medical cannabis users report regular substitution of cannabis for other prescription pain meds, without their doctor's advice, and it's working for them.

With the tide of change concerning cannabis in our country a number of studies have contrasted medical states with non-medical states. Study of years between 1999 - 2010 showed a 30% reduction in opioid overdoses in states with medical cannabis laws. Another study found 28-30% fewer hospitalizations for opioid addiction in medical cannabis states. A study of Medicare and Medicaid patients found a reduction in prescribed pain and anxiety medications in the states with medical cannabis laws.

Studies suggest a patient can expect a 30% reduction in chronic pain using cannabis. This is the same effect one can expect from opioids. A study of patients already taking opioids found a nearly 30-35% reduction in pain perception when cannabis was added to the regimen.

Another study in 2016 showed that using cannabis resulted in a 65% reduction in the use of opioids, fewer side effects, and a remarkable 45% improvement in quality of life.

Yet another study of over 550 pain patients showed a 39% reduction in opioids used and 35% quit using prescription pain medications altogether with the addition of cannabis.

The biggest roadblock to using cannabis to reduce or eliminate opioid use is resistance from the medical community. Over 90% of doctors practicing in this country have never taken a class on or have any experience recommending cannabis. They're clueless to the biology and chemistry. They're concerned about recommending a recreational drug, and their most concerned about repeatable results. Getting cannabis to play by pharma rules isn't the neat transition everyone was hoping for.

In Dr. Smith's experience, doctors prescribing the opioids and benzodiazepines won't be open to the conversation on cannabis. If your doctor won't work with you there are a couple websites that can connect you to qualified, compassionate medical personnel that can work with you and your doctor.

These sites can help you in your search for a cannabis-friendly doctor. They may also be able to help you find a dispensary.
- WeedMaps.com
- MarijuanaDoctors.com
- Leafly.com

You'll need to sign a new opioid contract with your pain Doctor as well as possibly one with the cannabis doctor.

OK, let's learn some basics of the biology. I'll try to be gentle.
 

Some basic biology

Cannabis is an excellent opioid-sparing medication, in Dr. Smith's opinion, better than the standard medications (mostly OTC) typically prescribed or recommended. Cannabis, along with being opioid-sparing, will treat a number of symptoms that accompany chronic pain and opioid use, like joint pain and inflammation, muscle spasm, anxiety, depression, nausea, constipation, and poor appetite

The goal of an opioid-sparing medication is to
- reduce the level of pain
- reduce the side-effects associated with opioids
- decrease the development of opioid tolerance and the constant need to increase opioid doses
- decrease the number of accidental overdoses, hospitalizations, and death associated with opioids

After successfully introducing cannabis as an opioid-sparing medication the goal is to get the patient completely off opioids. So far, in the clinical world, that seems to be only 60% of those patients. I'd hope we can beat those numbers, but I'll take any percentage. :hug:

Your ECS is the braking system for most other systems in the body. It puts the brakes on how much pain we percieve in our brain and how much inflammation, swelling, and muscle spasm is generated when we're sick or injured.

Cannabis helps to spare opioids and to control chronic pain through several mechanisms other than the ECS. There are hundreds of compounds found in cannabis, and they're all working in synergy to heal the stressed system.

In Dr. Smith's regimen dosing is controlled to no more than 10 mg of THC per dose to limit euphoria. You read that right, his patients typically control their pain and taper off opioids on 10 mg or less of THC per dose.

CBD is not euphoric, and doesn't cause dependency that we know of, allowing doses of hundreds of milligrams of CBD numerous times a day. CBD in proper ratio with THC will soften the euphoric effects of THC.

Chronic pain dosing is 1:1, THC:CBD. More on this important point below.

THC modulates the way we percieve pain and may help reducing muscle spasm.

CBD works in the periphery, turning down the inflammatory response and reducing the amount of painful swelling and inflammation at the site of injury.

CBD is an important part of the pain regimen because the entourage effect potentiates the cannabinoids when they're used together. Even small doses of either CBD or THC will enhance the other's performance. Take them together in a ratio that works for you, but take them together.

CBD enhances the ECS by blocking the action of the enzymes charged with degrading cannabinoids, allowing the cannabinoids to circulate. CBD helps create a more balanced endocannabinoid tone in the brain, and also counteracts the euphoric effects of THC, in a high enough ratio.

Cannabinoids make opioids process more efficiently in the brain. Opioid medications mimic endorphins, and by attaching to endorphin receptors in the brain they diminish pain perception. Both THC and CBD work to magnify the effects of opioids

By including cannabis you get reduced pain perception and increased relief from opioids at a reduced dose.. Less opioid used with cannabis = greater relief.

Opioid receptors are in the brain stem, where life can be swiftly terminated. Opioids, in overdose, will depress your breathing, and you'll die. Cannabinoids can't attach to those receptors and there are no endocannabinoid receptors on the brain stem, so there's no chance of respiratory depression and possibly death.

An interesting point about Tylenol

Tylenol, once ingested, is metabolized in the liver to become another component that attaches to the CB1 receptors in the brain and decreases pain perception, the same way THC does. Isn't that fascinating?

It also blocks an enzyme that degrades endocannabinoids, increasing the availability of your endogenous signalling molecules. If the enzymes don't get them torn apart they're free to go in search of cells in need of signaling.

Tylenol is also opioid-sparing and potentiates the opioids. It has no GI, cardiac, or renal side-effects. However, high doses, particularly when taken with alcohol, can cause severe liver damage

Because so many opioids are made with Tylenol included in the formulation, and the fact that many opioid patients take numerous doses a day, Federal regulations cut the upper doses of Tylenol OTC from 500 to 325 mg per capsule, but many pain patients take up to 8 combination pills a day. Too much Tylenol is being consumed by too many people. Eight extra-strength capsules would be 2600 mg a day.

It's been determined that B-Caryophyllene attaches to CB2 receptors, reducing inflammation and inflammatory response, much the same way CBD does. Some believe it's really a cannabinoid, not a terpene at all. When looking for a canna med for inflammation, it's a good idea to find one high in B-Caryophyllene. It shows up in high concentrations in many of the purple flowering cannabis plants.

Fun to grow and great meds. :slide: I'd appreciate some input as to what chemovars have worked for you.
 

Opiod tapering using cannabis: the basics

We're looking for a gradual tapering off of the opioids as you systematically increase THC and CBD. A slow tapering minimizes the withdrawal effects, and using cannabis reduces tolerance concerns. Cannabis can also lower the opioid dose, if they have to be reintroduced.

A recent study showed that patients taking opioids for as little as a month will still be using them three years later. Any prescribed use of opioids for longer than two weeks needs to be questioned. There are a number of pain meds available that will do at least as good as the opioids, if not more effective.

Because opioids and benzodiazepines cause euphoria they're pleasant for the patient initially, so they keep taking them. Too soon that fades into dependance.

The typical medical approach to opioid withdrawal is detoxification, which requires close medical supervision only available in a hospital setting. Potent meds are used to counteract the withdrawal symptoms. Such drastic measures are often used for herion withdrawal.

A more gradual approach is used for most opioids, dropping off 20-30% per month, until the patient can't tolerate the pain without opioids or stops using opioids altogether. The hopeful goal is a 10% drop per week, with the understanding that many patients will need to go slower than that. This takes time. Give yourself the gift of that time.

This approach usually takes 3-6 months and can be very effective.

The most difficult part of the opioid loop is taking that first step of getting the doctors lined up and on the same page. The three of you - cannabis doctor, pain doctor, and you - get the best results if you work as a team. The lingering stigma of cannabis makes this step more challenging than it need be, but that's the world we live in.

If you bring something from the Internet to back up your ideas it might go better. If it doesn't, look for another doctor. This really isn't something you want to go through on your own.

The nitty-gritty

It's best to have two types of cannabis, slow release and quick release. Examples of a slow release will be extracts in edibles, tinctures, etc, introduced through the gut and lasting up to 6 hrs or longer. Quick-acting cannabis would be inhalation with a vaporizer, or a tincture used sublingually, as a spray or smoked (for breakthrough pain), taking effect within 20 minutes and only lasting about an hour.

Again, look for a chemovar high in b-caryophyllene. A-pinene may add to the analgesic effects and soften some side effects of THC.

Before starting this withdrawal a cannabis user is recommended to do the Six-Day Sensitization Protocol to clear the receptors and reset tolerance levels. We have a thread dedicated to Dr. Sauk's protocol. You're welcome to join us there and let us help you get through the 6 days.

6-Day Sentizitation Protocol: Resetting The Tolerance Levels
 

THE REGIMEN

Getting Pain Relief: Setting your personal dose of THC

The initial goal is to find the dose of THC and CBD necessary to get adequate pain relief. If you're able to get good pain relief without opioids, all the better. This is a good indicator of future success. If you've been taking frequent opioid doses over a long time you don't want to discontinue the opioids cold turkey.

Do a gradual withdrawal over weeks or months using daily doses of slow-release cannabis.

If the slow-release cannabis dose isn't giving enough relief after 90 minutes take half the opioid dose.

This approach will usually give you the same relief you were getting from a whole opioid dose alone. Taking the opioid dose along with cannabis in this way three times a day can usually eliminate any withdrawal effects.

The Details

Beginning doses are 2.5 mg each of THC and CBD, taken through the gut so it's long-acting. Although they try to limit THC to 10 mg doses to control euphoria, some patients in Dr. Smith's clinical practice patients going as high as 15 mg of THC to get the relief they sought.

But a good starting point is 2.5 mg of THC and 2.5 mg of CBD, slow-release, 3 times a day.

After two or three days, if you're not getting enough relief, increase the cannabinoid dose to 5mg each of THC and CBD.

Increase every 2 - 3 days in 2.5 mg increments until you're at 10 mg each.

After reaching 10 mg THC/CBD doses the next step is increase the CBD content to 2:1 CBD:THC, then 3:1, and finally 5:1.

If you get to 5:1 and you're not getting the relief you seek, begin to increase THC slowly until you hit the sweet spot. Then stay there.

* The goal here is to increase the cannabinoid doses to be able to control the pain with no more than half the original opioid dose.

Once you've enjoyed several days of consistent pain control, cut the opioid dose in half again, gradually decreasing both the dosing times and dose concentrations. You're unlikely to have any severe withdrawal symptoms or craving of opioids. Your physican can help you by prescribing the opioids in smaller dose tablets. It's easier to drop off small quantities when the pills are 5 or 10 mg instead of 25 or 30 mg.

If you find it difficult to get pain relief without opioids, try substituting a 500 mg Tylenol instead of the opioid. You'll get the "THC effect" without increasing the THC dose. Don't take Tylenol if you're also taking opioids or drinking alcohol. Combining them can damage your liver. We want your liver healthy and strong.

Countering Breakthrough Pain

Cannabis lasts longer in the body than opioids. Following this regimen breakthrough pain may not happen. You'll be using long-acting cannabis. If you have intolerable breakthrough pain in between doses of your long-acting cannabis, take a small dose of a fast-acting cannabis, such as 1 or 2 inhallations of a vaporizer, a couple hits of a joint, or 2.5 mg of a tincture, applied sublingually.

Give this 20 minutes to work before taking a fast-acting opioid pill to counter the pain. If you need the opioid, try breaking it in half and only taking that much. You might be surprised to find that's enough.

The higher your opioid dose, and the more frequent you're dosing, the longer this process will take, but there's an end in sight. :love:

Problems and Pitfalls

The worst symptom of opioid withdrawal is opioid craving. A patient will do almost anything to get the opioids to feed that craving. Cannabis blocks the reward signal triggered by opioids. This works with cocaine, opioids, and gambling. Anything that triggers the reward system in this way can be tempered by cannabis. A healthy ECS does this all the time.

Cannabis tones down the reward response which cuts back on cravings. Cannabis also cuts back on nausea and vomiting, anxiety and agitation when used at the 1:1 ratio.

Countering the argument that using cannabis as a substitute for opioids is simply substituting one addictive drug for another, the GW Pharma studies are indisputable. It tracked several thousand patients on Sativex for a year.
* no dependant behavior was found
* no uncovering of psychosis
* some mild euphoria (we call that a sense of wellbeing)

Some conditions never respond to cannabis or non-opioid medications. The goal is to reduce the opioid need as far as is comfortably tolerable for the patient.

Including cannabis in the regimen will decrease the chance of overdose, improve your mood, and reduce the incidence of constipation and other opioid side effects.

If you stop taking opioids or benzodiazepines and then later get a craving for them, see your doctor. Taking a dose level you used to take before can cause accidental fatal overdose.

Dr. Smith recommends you get an app to track your
- pain level
- cannabis use
- opioid use
- side effects

You can get a printout of the records to take with you for doctor appointments. Consider how much easier this would make life for you and your doctor. Someday our doctors will all have testing facilities so they'll know precisely what's in the medicine you're using, but we're not there just yet.

Consider a support group of others going through the same process. Social support is an important part of strengthening a healing endocannabinoid system.

Let's have a discussion about "getting high." If you're getting high you're flooding your endocannabinoid receptors. This doesn't happen in nature, so the supposition is that you're throwing the system out of balance.

Tolerance buildup explained:

The cells have endocannabinoid receptors, and when you flood the system with phytocannabinoids they can hang around for long stretches of time. After a couple weeks the receptor sites harden (they start off soft and pliable) and sink into the cells (going offline).

It takes about six days, without any external cannabinoid surface activity for the receptors to regenerate, clean themselves up, and resurface. Your endocannabinoid system continues to spontaneously heal you with its signaling work, it's the lack of phytocannabinoid activity that needs to occur to reset those receptors.

In the ECS cannabinoids are created, activate the receptors, and are deconstructed by the attendant enzymes in the blink of an eye, a fraction of a second. When you take cannabis to get high you have a flood of THC attached to receptors throughout the brain causing euphoria for up to hours.

Because this doesn't happen in nature Dr. Smith believes it's wrong to subject the ECS to heightened euphoria. In his own words, "This is not pain relief by intoxication."

It's pain relief because we turned down the volume on the pain perception. To do this most effectively it helps to have all your receptors available.

When you're taking cannabis for pain management you want to avoid euphoria during your treatment phase. This is done by either continuous micro-dosing or balancing the CBD and THC to at least an even ratio. To fully counter the euphoric effects of THC you may need to get to a 4:1 CBD:THC ratio. Everyone is individual.

If you're treating chronic pain and you take too much THC you're working against yourself. Dr. Smith believes patients are using the euphoria to treat emotional pain. Physical pain, from injury or surgery, is a special category. His conclusion is that if you're only treating physical pain, without emotional pain, avoid euphoria.

My personal take-away on this is that if you use cannabis to treat chronic pain, choose your euphoric experiences carefully. Overindulgence for you may result in increased pain perception. No one wants that.

Our community has a better relationship with using suppositories for chronic pain. We may be able to get away with higher THC doses in this manner. This is something we as a community will explore in days ahead.

The most common mistake Dr. Smith sees is the timing of the long-term doses. It takes up to 90 minutes before you're going to feel the desired effects. When you're in pain, 90 minutes can seem intolerably long and there's a great temptation to take an opiod. As an example: If you know you usually take your opioid at 9 AM, take the cannabis dose by 7:30. In this way the cannabis is active when you'd typically be taking the opioid and you might be able to reduce or possibly skip that opioid dose.

Take 1/2 the planned opioid dose if pain is not reduced to comfortable levels.

Most pain patients on opioids have both slow-release and fast-release pills. You mirror this with slow-release cannabis edibles for the base-line meds and fast-release tinctures, bud, or concentrates for breakthrough pain. Two hits from a joint or vape, or 2.5 mg of a tincture under the tongue qualifies as a fast-release dose for breakthrough pain. Pain relief will come within 9 to 23 minutes.

Dr. Smith recommends a CBD only vaporizer. Get your 30 mg of THC through the edibles in three 10 mg doses and use the CBD vaporizer for breakthrough pain. Keep an open mind. CBD has not been shown in trials to moderate pain, but we have members among us who can testify that it does indeed offer a level of relief. We even have one that I just located that used a high CBD chemovar to get away from a long-term opioid regimen. With the rest of this regimen in place you have a good chance of having it work for you, in my opinion.

Don't forget the value of the 500 mg tablet of Tylenol. It'll stimulate the CB1 receptors in the same way THC will. Taking 3 a day is only 1500 mg of Tylenol, a workable dose. No alcohol when using Tylenol.

Pain control is the goal. If you can't function as the member of society your life demands - grocery shopping, caring for the children, going to work, etc...you're not getting pain control. If you're still in pain and you've reached the 10 mg threshold for THC begin increasing the CBD ratio to 2:1, then 3:1, then 5:1 before you increase THC concentrations.

The goal isn't to get to 10 mg of THC, but rather to use it as the upper threshold.

The majority of Dr. Smith's pain patients are using 5 mg in balance 3 times a day. Every patient is individual. You'll have to find your own sweet spot. No one can do that for you.

At 10 mg of THC you begin to feel euphoric. Dr. Smith's contention is that euphoria is a disruption to functionality. My presence proves him wrong to use this as a blanket statement. Lol!

How long will this withdrawal process take?

Your opioid doctor is the main player in this game. The cannabis doctor is assisting the opioid doctor. You and the opioid doctor need to agree on a quit date. This scheduling will depend on how long you've been on opioids, how high the doses are, and what type of opioid you're taking. That date can be as close as a month, more likely to be three months, and in some cases will be six months off.

In Dr. Smith's experience 40% of opioid patients may never be able to get completely free of the drugs. They will, however, be able to dramatically reduce the opioid dose and mitigate the nasty side effects associated with opioid medications.

I believe that the experience of our community supports the idea that by using BioBomb suppositories one can get over that final threshold. This is merely conjecture on my part, garnered from my studies and the interactions I've had with members that have tried them for chronic pain management. It just may be what's needed to break that craving. It certainly is worth the try.
 

SUMMARY

*The initial goal is to decrease the frequency and dose of opioids, with an eye to quitting opioids altogether.

* Work closely with your doctor that prescribes the opioids.

* You may need to get a separate doctor for your cannabis regimen.

* Gradual tapering off of the opioids can spare you the withdrawal symptoms and cravings that usually come with discontinuing opioids.

* You want to reduce the risk of accidental overdose if restarting opioids after they've been stopped.


A personal note :love:

Pulling this information together was an emotionally grueling project for me. I have such a strong connection to this community and I know many are struggling with opioid dependance, an unexpected hangover of injury made worse by the medication meant to give relief.

We now know that cannabis is as effective as opioids, with small exception, and without any of the dangerous side effects that come hand-in-hand with opioid use. With the knowledge we're getting now we have a gateway drug out of the opioid nightmare.

This is a labor of love, from me to you. Even if I never know you, this was my gift, in hopes that it will help you find your way home.

:hug::hug::hug::hug::hug:


Resources from Dr. Smith:

Cannabis-MD is a collection of educational materials for medical professionals.
- The site teaches you about the plant, the ECS, how cannabis interfaces with the ECS, and classes on particular disease states and their treatment with cannabis.


"Medical Cannabis: Basic Science and Clinical Applications" by Dr. Gregory Smith. A textbook for physicans on what cannabis is and why it's an important therapeutic tool.

"CBD (Cannabidiol): What You Need To Know"

 
There..... I think I caught all the mistakes. Lol!
 
Ok now that I read thru everything I want to thank Sue for all she does on this site. It's journals like this that will one day make people more aware of cannabis and hopefully make it legal and put a stop to big pharma's killing network. We now have more and more information to talk sensibly to others so they too can see what the drug companies don't want you to find out.
Thanks for all you do
Derbybud
 
This is such amazing work and compassion, Sue. I think we've talked before about my experience with opioids. The truth is that this has become such a problem that it touches the lives of practically everyone, from the people who become addicted, to the people who love those addicts. I've done a lot of research into pain management and the so called "opioid epidemic" and I can see a lot of the research I found mirrored in this, so I know the amount of work that you poured into this.

When I began my research, I never imagined that pain itself would be such a convoluted topic, and perception of pain is something that people do not really take into account. I think that physical recover is hard to achieve when so many people walked down this road to cope with some kind of emotional issue, and as time went on, the stigma and the rigors of addiction just made both the physical and emotional troubles worse, like a snow-ball rolling down the hill. I can't say I've experienced this process personally, I can't claim that kind of insight; I'm a pretty empathetic person, and I've watched the closest people to me I've known walk down that road, and in the end it took their lives. It sucks to watch someone suffering with pain, knowing the relief they're turning to is poisoning them all the same, and not being able to do anything about it. You want them to stop, but at the same time you don't want them to suffer in pain. If this kind of information had been available to me 15 years ago to help the people I love, it might have changed my life.

What's done is done though. Now days I just want to do my part to turn the tide of this opioid epidemic, to try to stop other people from feeling the kind of pain and lament it brings to everyone from the people taking the drugs, to the people who have to deal with the fallout. I don't really have the type of personal insight of addicts to know what they're going through, but I've watched enough of them go through it, listened to them enough, pondered on it long enough, and loved enough addicts to know it doesn't make anyone a bad person. I think the bare minimum I can do to help others avoid that type of euphoric-chase to cope with emotional distress, is to remind people addicted that they're not monsters, and that there shouldn't be a stigma behind the word 'addict'. I try to remind everyone I know, if they spit the word out in disgust, that it could just as easily be them, or someone they loved. There's always someone that believes their shit doesn't stink, or that they'd never succumb, and they're usually the most vocal about it, so I feel a bit of an obligation to yell just as loud that it is not your fault, that it's not all about will-power, morality, or any of that non-sense.

I'll keep a link to this thread handy, and share it with the people I know that need help. Thanks again, Sue.
 
Thank you all. Now spread this far and wide please. I think we have a charge, don't we?

:circle-of-love:
 
Fertilizer, I'll be doing another thread on pain and the ECS and how that keys into this epidemic. Would you be willing to preview it to see if there's anything you'd want to add? It's not going to be ready for a week or so, possibly longer. This one and the one on surgery were the priority.
 
SweetSue,

Thank you for all your time and efforts. Excellent posts. I will take time to study info here. Count me in for this study. I am tapering opioids, have been for years. Using cannabis for almost one year after starting very low CBD doses. Was terrified of THC at first, makes me smile to remember. Still working to find best profile, percentages,.... Preference is tinctures but not limiting methods. Encouragement felt, appreciate.
 
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