Research undertaken by the University of British Columbia and University of Victoria has shown that given the choice, those suffering from chronic pain, and those taking medication for mental health conditions, would choose cannabis over their medication. Lead author of the study, Associate Professor Zach Walsh, notes that although it was previously known that those taking meds for pain and mental illness often used cannabis as a substitute, the study is the first ever to show which medications (and to what extent) are being substituted. It is also the first to track medical marijuana under the new system of multiple licensed producers; all participants were authorized by their health care professional to acquire cannabis in addition to their prescription medications.
In the study, 270 patients registered to obtain cannabis from federally licensed producer, Tilray, were asked to complete an online survey containing 107 questions, focusing on patterns of use, the effect of substituting cannabis for medications, demographics, etc. The results showed that in general, patients felt that cannabis was effective to treat pain and mental health difficulties. Cannabis was used to substitute for prescription meds in 63 per cent of cases: pharmaceutical opioids in 30 per cent, benzodiazepines in 16 per cent, and antidepressants in 12 per cent of cases. Participants also stated that they used cannabis as a substitute for illicit drugs (3 per cent), cigarettes (12 per cent) and alcohol (25 per cent).
In the case of illicit drugs, cigarettes, and alcohol, reasons for the switch to cannabis often include avoiding the severe withdrawal symptoms which can be faced when quitting. Alcohol withdrawals, for instance, can cause seizures, an irregular heartbeat, and tremors. Opioids and tobacco are also highly addictive, and difficult to quit; cannabis, on the other hand, is only mildly habit forming, meaning that individuals can cease use of this substance without having to face withdrawal symptoms such as those encountered when quitting heroin or cocaine.
In the study, researchers also discovered that some patients obtained their cannabis from unregulated sources. Moreover, many were charged money for recommended medical cannabis. These findings highlight the need for policy changes at a federal level. Ideally, all cannabis should be obtained from licensed providers, to ensure quality and compliance with regulations. Licensed providers often provide a wide variety of products, and can advise patients on the most suitable products and doses.
Cannabis enables patients to avoid many of the particular side-effects caused by the above-mentioned medications. Health authorities have consistently warned the public regarding the spike in painkiller prescriptions and overdose deaths. In Canada, approximately $93 million was spent on medications to treat addiction to illicit opioids and prescription painkillers in 2014, compared to just $57.3 million in 2011. Experts state that the problem started two decades ago, when doctors, prompted by the pharmaceutical industry, began prescribing opioids for moderate or severe pain. A recent Globe investigation found that in Canada, 53 prescriptions were written for every 100 people, and spending continues to increase as doctors take to prescribing Suboxone to treat opiate addiction.
Benzodiazepines, meanwhile, are prescribed for a host of conditions including anxiety disorders. In fact, they continue to be one of the most commonly prescribe medications for this condition, despite efforts to promote antidepressants as a first-line treatment. Benzodiazepines are successful in the short term because they quell anxiety symptoms quickly (within minutes of ingestion), they are relatively safe, they are consistent, and there are few side-effects. However, there are several issues associated with long-term use, including ‘benzodiazepine withdrawal syndrome’, which can manifest itself in sleep disturbance, irritability, numbness or tingly sensations, and feelings of depression.
As for antidepressants, both Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs) can cause a number of side effects, including nausea, insomnia, headaches, shakiness, poor appetite, and erectile dysfunction. Tricyclic antidepressants (TCAs), meanwhile, can cause constipation, a slight blurring of vision, and weight gain. Some people who take antidepressants experience a desire to self-harm, and harbour suicidal thoughts; others who take SSRIs and TCAs for prolonged periods of time face an increased risk of Type 2 diabetes; elderly people who take antidepressants, meanwhile, can suffer from hyponatraemia (an extreme drop in sodium levels).