Medical Cannabis Can Be Substituted for Pharmaceutical Drugs

How Can Medical Cannabis Be Used As Substitution for Pharmaceutical Drugs?

Prescription drugs must be extensively studied through a series of clinical trials before they can reach the market.  These studies first involve animal and then human studies.  Efficacy and safety are weighed against the risks and costs of treatment to determine if the the pharmaceutical should be used in the treatment of symptoms of disease.  However, most all prescription drugs come with side effects and the risk of addiction.

For example, opioid drugs have been prescribed at an alarming, increasing rate causing a public addiction crisis.  The drugs are known to be highly addictive, with side effect profiles that cause drowsiness, poor judgement, lethargy, nausea, and confusion.  As awareness of this crisis has increased, the perception of marijuana and cannabinoids has shifted away from it as a gateway drug to that of an effective medication with less abuse potential and few side effects than many pharmaceutical drugs used to treat similar conditions.

Recent studies have shown that the opinion of the public has shifted.  This is evidenced by the swift changes in legalization of marijuana and medical cannabis in many states throughout the US.  Many experts agree that cannabis is a safe alternative to pharmaceutical drugs used to treat opioid addiction.  These opioid addiction drugs are chemically similar to the opioids themselves, although the atomic substitutions made in the drugs lower the high, they are themselves equally if not more addictive than the opiates themselves.  This is not the case with cannabis, which works on an entirely different neurochemical system within the body. 

The same is true for a new health crisis that is starting with increasing addiction problems with benzodiazepines - a class of drugs used to treat anxiety, PTSD, and panic disorder.  These drugs are also highly addictive, with side effects of fatigue, impaired judgement, and memory loss.

Substituting cannabis use for drugs like opioids and benzodiazepines is a process called harm reduction - meaning that some drug addicts cannot break the cycle of use.  They can, however, use cannabis to self-medicated in place of the drugs with much less harm to themselves (and others through violence and car accidents).  This kind of harm reduction should always be done under the supervision of a doctor, as one drug is tapered down in place of the less harmful drug.  Interactions between drugs also need to be monitored by a physician to avoid complications and/or unknown side effects.


Cannabis Substitution for Prescription Drugs

Many people have already started to switch from their commonly used pharmaceutical drugs to over the counter CBD products - available online and in pharmacies and grocery stores.  These products are not regulated by the FDA, and are whole-plant and hemp-derived cannabidiol supplements.  Other consumers choose to use recreational and medical cannabis from dispensaries and online stores throughout the country - including Texas.

As the benzodiazepine crisis grows, it opens an obvious window for medical marijuana to step in and help once again with the harm reduction method, as it has done for the opioid epidemic.  Benzodiazepines (valium, xanax, klonipin) are usually prescribed to reduce anxiety through their action on GABA receptors (the same receptors activated by alcohol).  They are prescribed for many different conditions, including but not limited to, anxiety, panic disorder, PTSD, spasticity, alcohol withdrawal, and seizure disorder. 

CBD and THC have been shown to treat all of these disorders as well.  Unfortunately, due to the Schedule 1 status of cannabis, research studies are highly restricted - slowing our ability to gain knowledge about the power of substituting a holistic treatment with medical cannabis for a known addictive drug class like benzodiazepines.  All evidence clearly indicates that CBD is NOT addictive. Benzodiazepines are highly addictive (and overly prescribed).

Substituting THC and/or CBD products for prescription drugs often occurs by accident initially.  For example, a chronic pain patient suffering through steroid injections and taking daily opiates might try cannabis during a visit to a legal state, where he or she discovers that medical cannabis is just as if not more effective treatment for their pain than opiates, and come with fewer side effects and the added benefit of classification as a holistic treatment from a plant.

Alternatively, a patient suffering from anxiety or PTSD might also try cannabis in a legal state and discover the benefits of exchanging medical marijuana for benzodiazepines. 

Sleeping pills like Ambient are slowly beginning to reveal their abuse potential and harmful side effects of amnestic driving and eating.  THC is known to be an excellent aid for insomnia - taken with an edible at night.


Pharmaceutical Substitution with Medical Cannabis

When drugs like opioids, benzodiazepines, and sleeping pills are added with marijuana, they can act synergistically - amplifying the effect of each drug.  This can be dangerous when it causes drowsiness and decreased drive to breath.  Therefore, all attempts at pharmaceutical substitution or harm reduction with cannabis should be done under the guidance of a physician so the patient does not accidentally overmedicate.  Benzodiazepines in particular need to be slowly tapered down over weeks to months in order to avoid complications with seizures from withdrawal. Other complications of rapid withdrawal from benzodiazepines include heightened anxiety, insomnia, flu-like symptoms, tremors, and depression.

Physicians are also informed about the interactions between drugs.  For example, if CBD and Xanax are taken together, the liver uses some of the same enzymes to process both drugs - so taking the two together can lead to elevated levels of Xanax in the bloodstream, making the same dose last for a longer period of time (and putting more stress on the liver).  When done properly, this interaction can be used to lower the dose of valium needed to have the same anti-anxiety effect as the drug is slowly tapered off.


Medial Cannabis Helping with Harm Reduction

Cannabis treatment is being broadly studied as a partial or full substitution for opioids, but research is just beginning on its possible use in reducing benzodiazepine use.

One study evaluated feedback given by patients new to medical marijuana treatment who had been taking benzodiazepines.  Almost a third of the subjects stopped their benzodiazepine use within 2 months, while almost 45% ended use  within four months.  This result shows an association rather than causation - however it is a promising illustration of the efficacy of medical cannabis in harm reduction for drug abuse and addiction.

Another study done in Canada showed high trends of cannabis substitution across multiple types of prescription drug use, using a survey of 2032 medical cannabis patients.  Cannabis was substituted for alcohol in 45% of those surveyed, 31% substituted it for tobacco, and 26% substituted it for illicit drugs.  Most impressively, 69% reported substituting medical marijuana for prescription drugs.  Opiates were the most common of these pharmaceutical substitutions (35%).  Antidepressants and anti-anxiety prescriptions came in a close second with 21% of people surveyed successfully switching from those drugs to cannabis. 

Chronic pain and mental health issues were the two most common reasons for the patients choosing to switch to medical marijuana and CBD treatment. 

Unfortunately, issues of chronic pain are often accompanied by mental health issues due to long term struggling with discomfort.  Then the over use of pharmaceuticals to relieve the pain lead to the addition of abuse and addiction to the problem list.  Insomnia also joins in, creating a cycle of pain, mental suffering, addiction, and drug dependence that can be difficult to break.

Medical marijuana has the potential to break this cycle at the root cause by stopping the pain, while having the added benefit of treating the co-morbidities that come with chronic pain conditions - making it a holistic alternative to overmedicating with multiple pharmaceuticals.

Best Approach to Staying Healthy with Cannabis

It is always best to consult with your doctor when beginning a new medication or stopping an old one.  The doctors at Compassionate Telemedicine are here to help guide you through the optimal use of medical cannabis for your medical conditions.




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Dr. Allison Kendrick

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