Pubdate: Sun, 04 Oct 2015
Source: Boston Herald (MA)
Copyright: 2015 The Boston Herald, Inc
Contact:  http://news.bostonherald.com/
Details: http://www.mapinc.org/media/53
Note: Prints only very short LTEs.
Author: Chris Villani

DOCS PIONEER POT AS AN OPIOID SUBSTITUTE

Lobel: Medical Marijuana Saved Me From Addiction

Boston sportscasting icon Bob Lobel is one of the hundreds of 
patients in Massachusetts who say they have found an effective 
substitute for opioids by using medicinal marijuana.

The 71-year-old longtime television reporter and anchor has dealt 
with chronic pain for years, the result of numerous surgeries: He's 
had two knee replacements, two rotator cuff surgeries, four back 
surgeries and, in separate accidents, fractured the tops of both femurs.

"That was brutal," Lobel told the Herald, referencing the femur 
breaks. The constant pain left him taking a variety of opioids.

"My issue was strictly pain," he said. "I didn't want to take any 
more OxyContin or oxycodone or Percocet, for a variety of reasons. 
The biggest thing I was worried about was addiction. But they also 
made me tired and it was hard to function and I couldn't go on TV all 
drugged up."

Lobel said pure curiosity led him to check out a medical marijuana 
event several months ago at the Castle at Park Plaza in Boston. It 
was there he met Dr. Uma Dhanabalan of the Uplifting Health and 
Wellness clinic in Natick. Dhanabalan recommends patients for 
medicinal marijuana certificates in Massachusetts and has been a 
strong advocate for using cannabis as a way to treat those who might 
otherwise find themselves hooked on opioids.

"She told me medical marijuana could be used for pain reduction and I 
said, 'Hey, sign me up,' " Lobel said, adding that he had been trying 
to manage his pain with over-the-counter meds after committing to no 
longer taking opioids. "I wanted to at least try it. I wasn't 
interested in getting high, that's not the goal, believe me. It was 
really about helping with the pain, and it did."

Lobel's daughter lives outside of Portland, Ore., and set up an 
appointment for him to consult with a doctor there this summer. He 
flew out and met the qualifications for receiving a medicinal 
marijuana card. After getting his card, he was able to buy the 
cannabis. He said the whole process in Oregon took three days, but he 
is still waiting to get his medical marijuana card in Massachusetts.

"I don't want to have to fly across the country and deal with 
drug-sniffing dogs at the airport, I want to do everything legally 
here," Lobel said. "I just have to wait and get my card."

In the meantime, Lobel says, he has been using the medical marijuana 
he got in Oregon to "take the edge off" of his pain. He doesn't 
smoke, but instead prefers to use cannabis oil, which can be orally 
ingested, vaporized into the lungs, or applied topically. He also has 
tried forms of edible cannabis, such as candies or cookies, and says 
he doesn't need to take the drug every day.

Getting past the stigma of the word "marijuana" has been part of the 
learning process, he said.

"It's more than a reasonable alternative (to opioids) once you get 
past the stigma like you're under a railroad bridge smoking pot," 
Lobel said. "It's not perfect, and I still need to learn more about 
what works best for me. I just feel like it's a positive once you get 
past the word 'marijuana.'

"I am not saying it's the be-all and end-all," he added. "But, in 
terms of pain relief ... it really helps."

Lobel spent many years as a sports anchor and reporter for WBZ-TV and 
has called games for the Celtics and Bruins as well as the Boston 
Marathon and numerous other events. He's retired, but still teaches a 
few days a week at Salem State University and hosts a show called 
"Sports Legends of New England." He said he will continue to learn 
more about medicinal marijuana and use his daughter as a caregiver 
and resource.

"The whole range of what's available is incredible," he said. "When 
(former Red Sox pitcher) Bill Lee was talking about marijuana and his 
brownies back in the '70s, he wasn't kidding. He was just ahead of his time."

Hundreds of opioid addicts are being treated with medical marijuana 
in Massachusetts, with advocates touting the new therapy as a 
life-changing alternative to a deadly epidemic - and facing down 
critics who contend they are peddling junk science.

"We have a statewide epidemic of opioid deaths," said Dr. Gary Witman 
of Canna Care Docs, a network of facilities that issue medicinal 
marijuana cards in seven states, including nine clinics in 
Massachusetts. "As soon as we can get people off opioids to a 
nonaddicting substance - and medicinal marijuana is nonaddicting - I 
think it would dramatically impact the amount of opioid deaths."

Witman, who works out of a Fall River Canna Care clinic, says he has 
treated about 80 patients who were addicted to opioids, muscle 
relaxers or antianxiety medication with cannabis using a one-month 
tapering program. More than 75 percent of those patients stopped 
taking the harder drugs, Witman said.

Cannabis, Witman said, can treat the symptoms patients had been using 
opioids to manage, such as chronic pain or anxiety - and treat them 
far more safely.

Dr. Harold Altvater of Delta 9 Medical Consulting in Malden says he 
has also seen success with medical marijuana as a substitution therapy.

"You are basically taking something that can be very harmful for an 
individual, and substituting with another chemical, just like you 
would any other drug, that has a wider safety margin," he said. "So 
if the goal is to decrease the body count ... the goal would be to 
get them on to a chemical that was safer."

"What we are seeing is that, in follow-up visits, patients have 
decreased and even eliminated their opioids," said Dr. Uma Dhanabalan 
of Uplifting Health and Wellness in Natick, adding marijuana works 
far better than other substitutes. "It's a problem when we are 
replacing one synthetic opioid with another synthetic opioid because, 
guess what .. synthetic opioids kill, cannabis does not."

On a neurological level, medical marijuana works on what is known as 
the "endocannabinoid system" and binds to neurological receptors 
involved in appetite, pain sensation, mood and memory. Opioids work 
on a different, similar system - but less effectively, Witman said.

"Endocannabinoids are even more powerful and the therapeutic benefits 
are even better," he said.

Other doctors say the process is not as simple as substituting 
cannabis for opioids. Dr. Anil Kumar of Advanced Pain Management 
Center in Stoneham is wary of the idea of giving medical marijuana to 
opioid addicts without extensive follow-ups.

"It might be an exit drug for some, or an entry drug for others," he 
said. "If you don't have a way of monitoring this patient who is 
saying 'give me marijuana and I will stop taking narcotics,' they may do both."

Joanne Peterson - founder of Learn to Cope, a network of 20 support 
groups for addicts and their families - calls the idea of using 
medical marijuana as a safer substitute for opioids "total (expletive)."

"I am not a doctor, but coming from someone who is on the front lines 
with people we are burying every week, adding another drug into the 
mix is probably a bad idea," she said. "They are already a zombie on 
the opiates, do they have to be a zombie on pot?"

The Massachusetts Department of Public Health has no official 
position on using medicinal marijuana as an alternative for opioids.

"DPH is committed to effectively administering the medical marijuana 
program in order to best serve patients safely and continues to work 
with the administration and stakeholders on developing strategies to 
curb the opioid epidemic in the commonwealth," DPH spokesman Scott 
Zoback told the Herald, declining to comment further.

Patients who have had success with the treatment sing its praises.

Howard Bart, a patient at Dhanabalan's clinic, knew very little about 
medicinal marijuana before his wife researched the topic online. He 
says it has been a life-changer for him:

After four back surgeries, he had been on various painkillers for 
more than 20 years - until he started taking cannabis this year. He 
has not had a pill in seven weeks.

"The marijuana saved my bacon from discomfort and pain every time," 
he said. "My doctor told me it has something to do with receptors. 
All I know is, it works."
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MAP posted-by: Jay Bergstrom