Medical Cannabis Shown to Be an Effective Alternative to Opioids

Chronic Pain (CP) is widespread, and, typically, opioids are prescribed for patients who experience CP. Opioids are ineffective for the treatment of CP, notably Fibromyalgia, and the adverse health risks, addictiveness, and side effects make long-term use of opioids a poor choice for this population. This cross-sectional survey of CP patients in Michigan assesses self-reported measures of quality of life, opioid use, pain management, and negative side effects. Among the participants in the survey, 64% reported reduced opioid use and 45% reported incresed quality of life. On the heels of the JAMA study in 2014, which showed significantly lower deaths by accidental opioid poisonings in states with Medical Marijuana laws between 1999-2010 (Bachhuber, et al., 2014), this study warrants additional research.











Boehnke, K., Litinas, E., and Clauwz, D. "Medical cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain." The Journal of Pain. 17.6: 739-744. http://doi.org/10.1016/j.jpain.2016.03.002

1 in 5 patients become long-term users of opioids after 10 days

We know all too well the dangers of opioid misuse in our society. The epidemic has been widely publicized, and the damage caused to communities across our country is staggering. This study puts into a frame of reference just how addictive these substances really are. The data shows that even a one-day supply leads 5% of the sample to use opioids for a year or longer. The probability skyrockets from there. Of the subjects given a 10-day prescription, 20% were shown to continue to use opioids for a year or longer. These numbers are are alarming.





Shah A, Hayes CJ, Martin BC. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use — United States, 2006–2015. MMWR Morb Mortal Wkly Rep 2017;66:265–269. DOI: http://dx.doi.org/10.15585/mmwr.mm6610a1

Massachusetts city makes policy shift on the opioid crisis

Massachusetts State Law has a provision, called Section 35, which gives the Judiciary the ability to court-order treatment for individuals with severe Substance Use Disorders for up to 90 days against their will. This is often a sticking point for many in the recovery world. Many adhere to the belief that non-self-initiated recovery will not achieve positive outcomes. However, from a public policy standpoint, with the old mill towns in Middlesex County being decimated to such a horrific degree, standing by and waiting for individuals to come to change on their own timeline is no longer an acceptable tact. The public health crisis in Lowell, MA, has forced the city and its new harm reduction and outreach program, CO-OP, to take drastic steps. The early data has shown a reduction in opioid overdoses in Lowell by 55%, dropping to 22 in the second half of 2016, compared with 40 in the first six months.

Thoughts?


http://www.fox25boston.com/news/section-35-saving-the-lives-of-addicts-that-dont-want-to-be-saved/496578709

A new therapy model for individuals with co-occurring SUD and PTSD

Researchers at Ryerson University in Toronto, ON, CA are formulating a new therapy model for the treatment of individuals who experience co-occurring SUD and PTSD. This model, RBR (Relationships-based Recovery), is an amalgam of empirically-based models, and employs person-focused counseling with a trauma-informed and harm reduction approach. Primarily a cognitive-behavioral technique, RBR emphasizes interpersonal relationships as integral to the recovery process and encourages a significant figure in the person in recovery's process to engage in the work. This loved one does not attend sessions, nor do they have any contact with the therapist. The person in recovery implements and practices strategies developed in sessions at home with their significant other. 
This paper discusses the framework of RBR and provides a case study into one individual and their measured positive outcomes after the 16-week manualized therapy program, which warrants further study. 


Wanklyn, S.G., Brankley, A.E., Laurence, G. et al. (2017). "Relationship-based recovery case study: An interpersonally empowering approach to recovery from Substance Use Disorder and PTSD." Journal of Contemporary Psychotherapy. 47:41 doi:10.1007/s10879-016-9340-9

http://link.springer.com/article/10.1007%2Fs10879-016-9340-9

Psilocybin shows to be effective treatment for depression and anxiety

In a randomized, double-blind clinical trial, consisting of 56 terminal cancer patients with significant depression and death anxiety, psilocybin has been attributed to an increase in quality of life and mitigation of depressive symptoms. This study, from Johns Hopkins Medical Center, is significant, in that most studies into psilocybin for this purpose have focused on microdoses, whereas this study correlates similar outcomes for those who ingest high doses, in addition to microdoses. 80 % in the study reported fewer depressive symptoms after one treatment, and 78% were reported to be in remission after 6 months from anxiety and 83% in remission from clinical depression diagnosis after 6 months.



Griffiths, R., et al. (2016). "Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial." Journal of Psychopharmacology, 30(12), 1181–1197. DOI: 10.1177/0269881116675513

Study points to possible effectiveness of TMS for treatment of Cocaine Use Disorder

Cocaine-seeking behavior is marked by significant reduction in activity in the prefrontal cortex. This research cohort of scientists in the U.S. and Italy have tested their hypothesis that radial transcranial magnetic stimulation to help activate the prefrontal cortex can be used to mitigate cravings for cocaine among individuals in early recovery from a CUD. Their initial findings show that, within the test group, cravings for the substance were reported 2.5 times more in the control group versus the those who received the TMS treatment. This study warrants further research, as identifying non-therapeutic options for treatment of CUD is needed, and the pilot study's results are positive. 


http://www.europeanneuropsychopharmacology.com/article/S0924-977X(15)00361-2/pdf

Terraneo, A.; Leggio, L.; Saladini, M. et al. Transcranial magnetic stimulation of dorsolateral prefrontal cortex reduces cocaine use: A pilot study. European Neuropsychopharmacology: 2016.  26(1):37-44. Epub 2015 Dec 4. PMD 26655188.

Dutch man euthanized, by his choice, to escape his alcohol use disorder

Euthanasia laws are always a hot topic issue, as much debate exists over the right for a human to choose death as a humane escape route from hopeless and terminal medical conditions. However, in this case, as with the case of another Dutch woman who experienced sexual abuse, anxiety, and depression, the assisted death of Mark Langedijk has raised flags and offended sensibilitites, especially among those in recovery. We do recover, and we do have hope, and Mr. Langedijk did not have to suffer this fate. That being said, it is easy to be indignant and protest his choice or his right to make it, yet this was absolutely his choice and legal, albeit disconcerting and sad.


Embury-Dennis, Tom. "Man in the Netherlands euthanised due to his alcohol addiction." The Independent. Web. 29 Nov 2016.
http://www.independent.co.uk/news/world/europe/man-holland-netherlands-dutch-euthanised-alcohol-addiction-alcoholic-netherlands-a7446256.html