Monday, 19 December 2016

Researchers think cannabis can help solve opioid crisis

By Ed Stannard,

Researchers at St. Francis Hospital and Medical Center believe medical marijuana can help solve the epidemic of opioid addiction in Connecticut.


The Hartford medical center has been given the go-ahead to conduct the first study in the state on cannabis, which they will use to treat pain from multiple rib fractures.


“It’s really hard to overstate that this could change everything for the good,” said Dr. James Feeney, director of trauma services at St. Francis, on Friday. “We believe that this will help reduce the opioid usage and therefore reduce opioid abuse and dependence in our communities.”


Deaths from drug overdoses, many of them because of highly addictive opioids such as oxycodone and fentanyl, may reach 900 in Connecticut this year, according to an October report by the state’s chief medical examiner, Dr. James Gill. People who become addicted to prescribed opioids may turn to cheaper and more dangerous and illegal heroin.

Patients with at least three rib fractures will be invited to participate in the pilot study. Broken ribs are usually not treated with surgery, but the patient is given painkillers, Feeney said. “We typically would treat this pain with oxycodone,” he said.


Feeney said patients are told, “It’s going to hurt for six to eight weeks … try to get back to work as well as you can and, when you’re in pain, take a pain medication.”


He said Dilaudid also can be prescribed for severe pain, but “substituting one for the other doesn’t do us any good,” because it too is addictive.


Feeney said the hope is that “we can just reduce their usage overall by substituting with a medication that is not addictive, it doesn’t interact with other medications and has a very mild side-effect profile.”


Feeney added, “Very, very few places have the opportunity to do this research … If this works, it could be a solution to a problem that’s plaguing our families.”


The cannabis given to the research subjects will be in the form of capsules that contain equal amounts of two cannabinoids, THC and CBD. For severe “breakthrough pain,” a nasal spray will be offered.


When it passed the state’s medical marijuana law in 2012, the General Assembly approved research, which has been limited in the United States because marijuana growing and use is illegal under federal law. However, the federal government has not enforced the law against state-approved programs. Medical cannabis is now legal in 28 states and the District of Columbia; several states approved it in the November elections.

The state Department of Consumer Protection put out a call for research proposals earlier this year and St. Francis’ proposal was the first one accepted. Consumer Protection Commissioner Jonathan Harris said three other research proposals are under consideration, including one from Connecticut Hospice in Branford.


Dr. Laura Lamb, a research fellow at St. Francis who is involved with the research, said they hope to have 30 patients in the study, with another 30 in a control group. “We’re planning to proactively approach people as they have the criteria to enroll,” she said.


After the pilot study is completed, the researchers plan a larger trial. “We’ve already designed that study and we’ve already applied for funding,” Feeney said.


Monica DiFiori, research coordinator, said they hope to expand use of medical cannabis to include fractures of the pelvis, spine and elbow that are not repaired surgically. One advantage to taking part in the research is that patients don’t have to register with the state as typical medical marijuana patients do, DiFiori said. Registration includes a $100 fee.


Feeney said the six trauma surgeons at St. Francis “believe so strongly in this” that they donated from their shares of the Anthony S. Morgan Trauma Research Fund to underwrite the $30,000 cost.


Harris said his department was not looking specifically for a study comparing effects of cannabis and opioid use. “We want to provide a platform, a framework to show how medical cannabis works.”


He said other studies may examine the effect of marijuana on other types of pain, such as that associated with cancer. Cancer is one of the 22 conditions for which patients can register in the medical marijuana program. Others include post laminectomy syndrome with chronic radiculopathy and complex regional pain syndrome.


As of last week, the Consumer Protection Department had registered more than 15,000 patients in Connecticut, along with 584 doctors who are registered to recommend the drug. Harris said at least 259 jobs have been created because of the program. There are eight dispensaries across the state and four growing facilities.


“Research is key to understanding how the medicine really works best … and what it works best for,” Harris said.


He said the program “has the potential of making Connecticut … the mecca for marijuana research, creating more good jobs and supplementing biotech research and other health-care research that’s being done in the state.”

No comments: