The medical ethics of denying cannabis as medicine while allowing opiates

Currently the United States is experiencing the worst drug epidemic in its history.

  • Each day at least 60 people die from opioid pain medications.
  • Drug poisoning is the number one cause of unintentional death.
  • 75% of new heroin users start on prescription painkillers.
  • 70% of people abusing prescription painkillers report getting them from friends or relatives.
  • There are 4.3 million nonmedical users of prescription painkillers.
  • Almost 2 million people have prescription painkiller substance use disorders.
  • There are over 400,000 emergency room visits for prescription painkillers annually.
  • Research indicates 4% to 6% of prescription painkiller abusers will transition to heroin use.
  • Prescription painkiller overdoses kill more citizens than car accidents.
  • Opioid prescriptions have tripled over the past 20 years.
  • 12 states have more opioid prescriptions than people.
  • The opioid epidemic has an estimated total economic burden of $78.5 billion annually.

The United States leads the world in prescription opioid consumption. In 2009, the United States consumed 99% of the world’s hydrocodone, 81% of the world’s oxycodone and 60% of the world’s hydromorphone. In 2007 Purdue Pharma paid a $634m penalty for misrepresenting OxyContin’s addictiveness.  In 2015 the company reached a $24m settlement with Kentucky after the state claimed Purdue cost it “an entire generation” to OxyContin.

Opium is derived from poppies and contains both codeine and morphine, which are also made by the human body.  Heroin (diamorphine) is a semi-synthetic opioid that is up to 5 times stronger than morphine.  Fentanyl is a semi-synthetic opioid that is 50 times stronger than heroin.  Carfentanil is a semi-synthetic opioid 100 to 1,000 times stronger than fentanyl used to tranquilize large animals like elephants where 2 mg can knock out a 2,000-pound animal.  1 kilogram from China, where it is legal to manufacture, costs $3,000. $3.00 worth of carfentanil from China can easily kill 5,000 people ($0.06/person) and it is doing so as heroin is being cut with fentanyl and carfentanil to boost profits leading to waves of overdoses.

Studies have shown that in states where medical cannabis is available (now 28 states), opiate overdoses, use, dependence, deaths and hospital admissions are all down.  There were declines in the number of Medicare prescriptions for drugs used along with a dip in spending by Medicare Part D, which covers the cost on prescription medications.  Medical marijuana saved Medicare about $165 million in 2013.  If medical marijuana were available nationwide, Medicare Part D spending could have declined in the same year by about $470 million.

Medical ethics require doctors to follow the Hippocratic oath of first do no harm.  Since opiates are powerful but also dangerous, harm reduction necessitates the availability of cannabis as both replacement and adjunct to therapy with opiates with a position as a first line therapeutic for pain. When used in conjunction with opiates, cannabis leads to a greater cumulative relief of pain, resulting in a reduction in the use of opiates and associated side-effects. Additionally, cannabis can prevent the development of tolerance to and withdrawal from opiates, and can even reset opiate efficiency after a prior dosage has become ineffective due to tolerance.

Opiates can and do kill.  Cannabis has never killed anyone as a person cannot overdose on cannabis.  Why are dangerous and addictive opiates available for doctors’ prescription and recommendation but not cannabis?

It’s not like we have never used cannabis as medicine in this country.  In 1850 cannabis was added to the US Pharmacopeia (an official public standards-setting authority for all prescription and over-the counter medicines), which listed marijuana as treatment for numerous afflictions, including: neuralgia (nerve pain), tetanus, typhus, cholera, rabies, dysentery, alcoholism, opiate addiction, anthrax, leprosy, incontinence, gout, convulsive disorders, tonsillitis, insanity, excessive menstrual bleeding, and uterine bleeding, among others. Patented marijuana tinctures were sold by Big Pharma companies such as Parke-Davis and Eli Lily.  From 1850 to 1937 cannabis was one of the top 3 prescribed medicines in the US.

In 1889, an article by Dr. E. A. Birch in The Lancet, still one of the world’s leading medical journals, described the utilization of cannabis for the treatment of opium withdrawal symptoms: “the mixture reduced the opium craving and acted as an anti-emetic [drug that is effective against vomiting and nausea].”

Please don’t tell me that there isn’t enough science to back up cannabis as medicine as cannabis is the most studied drug in history and Big Pharma, the FDA and the US Patent Office think otherwise (US Patent 6,630,507 Cannabinoids as Antioxidants and Neuroprotectants).  There are already ten cannabinoid-based drugs courtesy of Big Pharma- Marinol, Nabilone, Dexanabinol, CT-3 (ajulemic acid), Cannabinor, HU 308, HU 331, Rimonabant (Acomplia) and Taranabant, four of which are already FDA approved.

The head of the class is Sativex, a cannabis-based mouth spray developed by UK-based GW Pharmaceuticals. Sativex contains cannabis extracts that are rich in THC and CBD. The spray is used for neuropathic pain and spasticity in patients with multiple sclerosis.

The company’s most recently granted patent (No. 9,205,063) covers the prevention and treatment of neural degeneration with a full plant spectrum pharmaceutical formulation of cannabis obtained by running the plant through a common carbon dioxide (CO2) extraction method. The patent lists all the usual active components of cannabis that come from a full plant extract: THC, CBD, terpenes, sterols, triglycerides, alkanes, flavonoids, etc.  GW Pharma is claiming ownership of cannabis as a drug in the prevention and treatment of Alzheimer’s disease, Parkinson’s disease and multiple sclerosis.

Patent No. 9,168,278 granted for the use of the cannabinoid THCV as an appetite suppressant in a weight loss medication. Patent No. 9,017,737 granted for the use of CBD and other cannabinoids to prevent or treat psychotic disorders.  Patent No. 8,771,760 granted covers with the use of cannabinoids for constipation.  Patent No. 8,790,719 filed in 2013 makes claim for the use of plant-derived cannabinoids in the treatment of prostate cancer, breast cancer, and colon cancer.

Jesus said “What goes into someone’s mouth does not defile them, but what comes out of their mouth, that is what defiles them.”  Someone illegally self-medicating with cannabis by putting it in their bodies to heal themselves does not defile themselves.   However, someone speaking words out of their mouths that cannabis is not medicine is beyond ridiculous at this point in the debate and is a denial of science and plain evidence in the historical record.

In 1988 US Drug Enforcement Agency, Chief Administrative Law Judge Francis Young determined: “Marijuana, in its natural form, is one of the safest therapeutically active substances known to man. By any measure of rational analysis marijuana can be safely used within a supervised routine of medical care.  It would be unreasonable, arbitrary and capricious for DEA to continue to stand between those sufferers and the benefits of this substance in light of the evidence in this record.”

As Thomas Jefferson said, “If people let the government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny.”

It is time to assert the ownership and dominion we have over our own bodies and our own health.  The truth we learned in elementary school is more valid than ever today that we are what we eat.  Our bodies are our temples and we don’t need the government, the medical establishment or Big Pharma to defile them.

Let’s chase the money changers out of our temple and reconsecrate the kingdom within with some of that good old natural holy anointing oil, you know the kind with kaneh bosm in it!  😉  I mean come on folks Messiah literally means the anointed one.

christ-weed (1)

“Jesus Healing the Blind”  from 12th Century Basilica Catedrale di Santa Maria Nouva di Monreale in Sicily.

 

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About Ian Benouis

Ian Benouis is a West Point graduate, former Blackhawk helicopter pilot, US Army officer and combat veteran who participated in Operation Just Cause in the Republic of Panama. This operation was the largest combat operation in US history focused directly on the War on Drugs. He was a pilot-in-command and his aviation brigade flew more night vision goggle hours than any unit in the military except for the Task Force 160 Special Operations which his unit was ultimately rolled up into when the Fort Ord, California military base was shut down. Ian grew up in Hawaii in the 1970’s where cannabis was decriminalized and fully integrated in to the culture. He has been healing himself of trauma for over 25 years with sacred plants, a spiritual practice, and being a student and practitioner of ethnobotany. Ian was a pharmaceutical representative for Pfizer after he got out of the Army witnessing firsthand the meteoric rise of the SSRI’s and synthetic opioids in the early 1990's. He is a casualty of the drug war having been busted for a friend’s cannabis while in law school. Ian is an intellectual property attorney who has been working in the corporate world for over 20 years in the primary roles of VP of Sales and Marketing and General Counsel. He is a political activist in the cannabis and natural plant medicine space nationally and locally in Texas. Ian has also been the Chairman of the Board for a public policy foundation in Texas for over seven years. Ian was featured in the Spike Jonze produced episode Stoned Vets on Weediquette the cannabis focused series on Viceland on HBO with a number of other veterans protesting the VA’s policy on medical cannabis and trying to end the veteran suicide epidemic. In 2016 Ian organized a trip for six veterans with PTSD to Peru in May for a 10-day plant diet including ayahuasca and other plant medicines with three Shipibo shaman brothers that are third generation plant medicine healers. Ian also took some of the same veterans to Mexico for treatment with iboga and 5-Meo-DMT. This experience was captured on video and was released as a documentary on March 16, 2017 entitled Soldiers of the Vine. He is member of the team working on the movie From Shock to Awe a feature-length documentary that will chronicle the journeys of military veterans as they seek relief from Post-Traumatic Stress Disorder with the help of ayahuasca, MDMA and cannabis.