In order to have a complete understanding of the opioid crisis that is currently plaguing the United States and Canada, we first need to take a step back and analyze these prescription drugs in greater detail.
This will allow us to understand their addictive nature much better, and it will also help us answer if medical cannabis can really be an adequate replacement for ailments for which the doctors are prescribing these aggressive medications.
To start this topic off on the right foot, let’s first acquaint ourselves with the most important characteristics of opioids.
What are opioids?
Opioids are a class of prescription narcotics used for severe pain management. The biggest issue with all opioid-based medications is that they are highly addictive and produce numerous negative side effects.
The main unwanted secondary effects of opioids include nausea, itchiness, heavy sedation and respiratory depression. Hypoventilation (also known as respiratory depression) happens when the amount of oxygen decreases and the concentration of carbon dioxide increases.
This insufficient ventilation can lead to respiratory arrest, which quickly becomes lethal if not medically treated. Respiratory depression is the most frequent cause of death for opioid-related overdoses.
How opioids work?
The way all opioid medications work is by binding to the opioid receptors in the body, which are mostly located in our brain and spinal cord.
The morphine-like effects of opioids are achieved by decreasing the amount of pain signals that are reaching the brain, which automatically lessens the overall pain sensations.
Besides the high risk of overdose, the biggest negative aspect of opioid consumption is the powerful physical and psychological dependence, which occurs with prolonged use of these medications.
Also, very harsh withdrawal symptoms happen after a patient ceases to use them, making opioids very dangerous even when their use has been discontinued. There is a staggering number of former opioid addicts that have turned to heroin after experiencing horrible withdrawal symptoms.
Like all of this isn’t troublesome enough, opioids also create very strong euphoric effects, which led to a great increase of recreational misuse in recent years.
A brief overview of opioid history
Opioids have been used by humans for an extremely long time, and the first record human use of opium poppy is found at the archeological sites in the Iberian and Italian Peninsula, dating to the Neolithic period, or about 5,500 years before Christ.
It has been proven that both ancient Sumerians and Egyptians used poppy, primarily for medical, but also for religious and recreational purposes.
Fast forward to Ancient Greece, Hippocrates was recorded for valuing opium for its pain relieving and sleep inducing characteristics, and ancient Romans also knew about the powerful effects of this plant.
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, leading to a boom in morphine use. Morphine is a medication used for pain, and is a member of the opiate family, isolated from opium poppy.
The German pharmacist named this substance after the Greek god of dreams Morpheus.
The general term opioids includes all of the opiates, which refers to all narcotics derived from opium, with morphine being the prime example.
Most popular opioids in use today
Opioids can also be synthetic and semi-synthetic, and these drugs include hydrocodone, oxycodone and fentanyl. Here are the most popular opioids in use today.
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.
Codeine is a mildest form of a morphine based opiate and a respiratory depressant, while promethazine is an antihistamine, which acts as a depressant of our central nervous system.
The biggest danger of using lean lies in respiratory depression. Consuming excessive doses of lean causes the lungs to stop working, resulting in quick death.
The last celebrity to lose his life because of lean was A$ap Yams, the mind behind A$ap Mob.
Percocet is a potent painkiller, containing a very powerful synthetic opioid oxycodone, combined with acetaminophen (paracetamol), which is a non-opioid pain reliever. It is usually prescribed for treating acute anguish like after-surgery pains, because of its expeditious onset.
This medication is also frequently used by cancer patients battling chronic pain, but also people who suffer from acute headaches and back pains.
Besides the extremely dangerous recreational use, administering Percocets for actual medical reasons is also quite hazardous, mostly because the majority of the population isn’t really familiar with all the severe 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.
This of course was completely untrue, and to learn more about this case watch this amazing and entertaining episode of Last Week Tonight.
Ten years later In 2017, the state of Washington filed another similar lawsuit against the pharma colossus Purdue, once again 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. It is 25 to 50 times more powerful than heroin, and around 50 to 100 times more potent than morphine, according to the DEA.
This is truly an insanely dangerous opioid, and it’s very hard to comprehend why the pharmaceutical companies decided to create it in the first place, because this potency can become hazardous and deadly quite easily.
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.
Being 50 times more potent than heroin, I can only imagine how easy it can be to get hooked on this opioid, especially if you’re completely unaware of the potential hazards it can bring about, and what it’s actually made of.
How opioids influence the Western culture
In 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.
This creates a very negative and dangerous influence on today’s youth, and it’s coming directly from the artists that these kids look up to and revere.
The biggest threat of this type of indoctrinating campaign are the youngest listeners (and you can bet that there’s a staggering number of very young listeners in these music genres), who still don’t have the appropriate rationale to objectively determine how malicious these substances really are.
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 modern music.
Even the name for this new version of rap music is tightly entangled with narcotics. Trap is the short version of the full phrase “trap-house”, which is a location where addicts come to get their product.
It’s also connected to how both the dealers and the customers are “trapped” in this vicious cycle.
This can have (and it already most certainly does) a devastating effect on the prepubescent and teen listeners, who can easily get misguided and deceived that these are not extremely unsafe substances, when in fact they really are.
People consuming opioids for recreational purposes can expect a strong euphoric buzz accompanied with heavy sedation, but they will also experience awfully 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 pathways of medical cannabis.
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.
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 that it 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.
The majority of chronic-pain patients usually prefer soothing indica strains, because of their uniquely sedative cannabinoid and terpene profile, in comparison to the more energizing sativa or hybrid strains.
Most patients prefer low to intermediate doses, because higher doses can potentially amplify pain, and also high levels of THC without the appropriate levels of its “counterpart” cannabidiol (or CBD), can cause THC-induced anxiety and paranoia.
To avoid these negative sensations you should start light, and slowly work your way up to determine the best possible dose for you.
Are cannabis concentrates the newest replacement for opioids?
Hitting the cannabis world by storm, the pure and incredibly potent canna-concentrates are the next big thing in both the recreational and medicinal realms of marijuana consumption.
The thing that separates these extracts from other cannabis derivatives is the really high concentration of both cannabinoids and terpenes, and these extracts most likely have a much more beneficial effect in comparison to consuming only bud material or hash.
What’s troubling about proving these claims is that no scientific studies have been performed on the effects of concentrates so far, which will surely change as cannabis continues to become more and more mainstream.
The same issue also plagues Rick Simpson Oil (or RSO), which is also another variation of a cannabinoid-packed extract.
The main anecdotal benefit of RSO has always been the anti-proliferative and apoptosis-inducing effects for fighting cancer cells, but according to Rick, using RSO can also bring about a whole plethora of differing effects.
RSO is very similar to these new methods of cannabis extraction like BHO and rosin, because the end product of all these extracts has a concentration of cannabinoids between 80% and 90%.
Hopefully, science will soon start analyzing the effects that these powerhouse concentrates can bring, and I’m certain that we’ll see a lot more beneficial attributes of cannabis, for severe and chronic pain but also for much more.