To fully understand the opioid crisis that is currently hitting the United States worse than ever before, first we need to take a step back and analyze these prescription drugs with great detail, in order to have a better comprehension on why they are so addictive, and to raise the question can medicinal cannabis really be a worthy replacement for the ailments for whom the doctors are prescribing these aggressive medications.
To properly begin this narrative, we need to acquaint ourselves with all the characteristics of opioids, ranging from possible uses, what they are made of and their chemical structure.
What exactly are opioids?
Opioids are a class of prescription narcotics used for severe pain management. The main issue with all opioids is that they are highly addictive and produce numerous negative side effects that include nausea, itchiness, heavy sedation and even respiratory depression (which basically means that your lungs stop working), which is the number one overdose reason for these substances.
They create their morphine-like effects by binding to the opioid receptors in our bodies, which are mostly located in our brain and spinal cord. The reduction of pain is achieved by diminishing the amount of pain signals that are reaching the brain, which automatically lessens the overall pain sensation we feel.
One of the negative aspects of opioid use is that a strong physical and psychological dependency occurs with prolonged use, followed by a very harsh withdrawal after a patient stops using these medications.
They also produce strong euphoric effects, and because of this they are recreationally misused to a great extent, especially in recent years.
A Brief Overview of Opioid History
The use of the opium poppy plant first started more than two millennia ago which makes it one of the oldest opiates, and at that time opium was mostly consumed for religious practices.
Morphine was first isolated from opium poppy at the start of the 19th century by a german pharmacist named Friedrich Serturner, and this is considered the first successful isolation of an active plant ingredient.
During the 1850s the hypodermic syringe was invented, which led to a boom in morphine use. Serturner named this new substance morphium after the Greek god of dreams, Morpheus.
The general term opioids includes opiates, which refers to all narcotics derived from opium, with morphine being the prime example.
Opioids can also be synthetic and semi-synthetic, and these drugs include hydrocodone, oxycodone and fentanyl.
We’re now going to spend some time getting familiar with the most popular current variations of opioids.
Lean (or Purple Drank)
Mixing prescription strength cough syrup that contains both codeine and promethazine with soft drinks like Sprite is extremely popular in today’s rap culture (which automatically transfers it to the youth cultures of western world), and the dosages found in lean can exceed up to 25 times the recommended dose for consuming cough syrup for medicinal reasons.
The biggest danger of using lean lies in respiratory depression, because promethazine is a depressant of our central nervous system, while codeine acts as a respiratory depressant.
Overdosing on lean causes our lungs to stop working, resulting in quick death. The last celebrity that lost his life to lean is A$ap Yams, the creator of A$ap Mob.
This is a very powerful painkiller, containing a synthetic opioid oxycodone, mixed with acetaminophen (paracetamol). Percocet is mostly used for treating acute anguish, for instance after-surgery pains, because of its expeditious onset.
It’s also frequently used by cancer patients battling chronic pain, and by people who suffer from acute headaches or back pains.
Administering Percocets for eligible reasons is also quite dangerous, mostly because the majority of the population isn’t really familiar with all the addiction and health risks.
This is best described in the lawsuit from 2007 because of unethical marketing, where the pharmaceutical giant Purdue Pharma had to pay 634 million dollars in fines for the claims that their drug OxyContin (which also includes the synthetic opioid oxycodone, same as Percocet) has a lot less potential for addiction and abusement than the other pain medications that were currently on the market.
You can learn more about this in the amazing and hilarious episode of Last Week Tonight.
In 2017, the state of Washington filed another lawsuit against the pharmaceutical behemoth Purdue, once more for deceptive marketing practices, and the claims that their drug OxyContin has a low addiction rate.
This is by far the most powerful synthetic opioid in the world, with potency that ranges about 25 to 50 times more powerful than heroin, and around 50 to 100 times more potent than morphine, according to the DEA.
Because of its extreme potency, it is very difficult to dose properly, and there was even a case of a police officer accidentally touching the substance during an arrest, and consequently overdosing from it.
Besides being created in official pharmaceutical facilities, it is also made illegally, and because such microscopic doses are enough to get someone heavily sedated, it’s extremely hard to accurately dose it without the help of a medical professional.
The famed musician Prince lost his life due to an accidental Fentanyl overdose (which he didn’t have a prescription for), and it was also revealed that he had a very long and serious dependency to Percocet prior to this.
Recently there was another scandal involving an Arizona based pharmaceutical producer Insys Therapeutics, who (still allegedly), bribed doctors to prescribe Fentanyl to patients who don’t require such a medication for their treatment, and falsifying patent files.
The Impact on the Culture
In the recent years there is a massive surge of opioid-related lyrics in rap and trap music. It’s very important to understand that trap and R&B are currently the most popular music genres in the US, and the negative and utterly dangerous influence on today’s youth is directly coming coming from their heroes and role models.
It all started with the codeine-infused drink lean (which is the least potent opioid available), to a full blown invasion of Percocet.
With lyrics like “Pop a Perky (Percocet) just to start it, pop two cups of purple (Lean) just to warm up, I heard your b**** she got that water (Molly Water, a slang term for MDMA)”, it’s evident that the majority of today’s rap stars are heavily promoting almost all really serious drugs, both prescription and illegal ones.
Opioids aren’t the only class of drugs being promoted, as anti-anxiety Xanax, and amphetamine-soaked ADHD drug Adderall are also frequently mentioned in contemporary rap/trap.
This can have (and it already most certainly does) a devastating effect on the prepubescent and teen listeners, who can easily get misguided that these are not extremely hazardous substances, when in fact they really are.
People consuming opioids for fun can expect an euphoric buzz accompanied with heavy sedation, but they will also experience super-strong withdrawal symptoms once they try to kick the habit.
Being properly informed is the most important thing in a situation such as this, and the majority of young people will not stop and think about the possible consequences of opioid use, and the over-acceptance and massive exposure these substances get from mainstream music is only proliferating this horrible epidemic.
Unlike the majority of rappers who are openly promoting opioid use, this correlation between the opioid crisis and all the dangers of using them is wonderfully described in Macklemore’s single entitled “Drug Dealer”.
For recreational users it’s insanely important to understand that consuming opioids is pretty much the same thing as using a synthetic, artificially made ultra-potent heroin.
Where Cannabis Comes Into Play
The connection between marijuana and chronic pain is luckily one of the most studies aspects of medical uses for pot.
Chronic pain is caused either by tissue damage or inflammation, which is called nociceptive pain, and neuropathic pain is caused by a damaged, or a malfunctioning nervous system.
Using cannabis for pain has to be very personalized, because each individual has their own unique chemistry, and for choosing a correct treatment it’s also utterly important to determine the type of pain it is (nociceptive or neuropathic), to determine the best possible strain, dose, and method of ingestion.
A massive Harvard review consisting of 28 studies which were analyzing the adequacy of synthetic cannabinoids (called exo-cannabinoids) for treating chronic and neuropathic pain, positively concluded that it can indeed offer substantial relief, backed by solid scientific confirmation.
From these 28 studies, a considerable lessening of the symptoms was found in six out of six chronic-pain studies, and five out of five neuropathic ones, respectively.
Another relevant study from the University of Michigan showed that cannabis can be of great assistance for managing pain, while lessening the patient’s dependency of opioids.
The data from Michigan shows that cannabis can improve the overall quality of living for those suffering from chronic pain, that it decreases the side effects caused by other medication, and can reduce the consumption of opioids by roughly 64%.
Because of the unique chemical characteristics that every human being has, it’s paramount to find the proper dosage and type of use. For someone it’s going to be smoking, for somebody else edibles, or perhaps vaping or topicals.
Also the strain itself is also very crucial for the desired effect, and the patients should definitely test several different ones before picking their favorite go-to strain. The majority of patients usually prefer potent indica strains, because of their THC-dominance relative to most sativa or hybrid strains.
Most patients prefer low to intermediate doses, because higher doses can possibly amplify the symptoms of pain. To sum it up, start light, and work your way up.
In case you’re currently consuming opioids for pain relief and plan to add cannabis to your regimen, we strongly suggest you use professional medical guidance and general overall alertness.
I hope you found all of this information useful, and for additional info on cannabis and pain relief head to this article of ours.