Pubdate: Sat, 02 Jul 2016
Source: Ottawa Citizen (CN ON)
Page: A4
Copyright: 2016 Postmedia Network Inc.
Contact:  http://www.ottawacitizen.com/
Details: http://www.mapinc.org/media/326
Author: Paula McCooey

WHEN CANNABIS IS AN ALLY IN PAIN FIGHT

Pot Has Helped Gillian Fitzgibbon Find Relief and Kick Opioid Use

When Gillian FitzGibbon's doctor suggested she try cannabis to reduce 
her chronic knee, hip and ankle pain, she figured anything was better 
than the cocktail of opioids she had been prescribed for years, 
medication that she said left her in an "abyss".

As health-care providers sound the alarm over rising opioid addiction 
and the lack of available pain management alternatives, some patients 
like FitzGibbon - along with their physicians - are turning to 
cannabis derivatives for relief.

Ottawa physician Hillel Finestone co-authored an article published on 
June 14 in the journal Canadian Family Physician that calls opioid 
use in Canada an epidemic and links it to the lack of options offered 
by doctors for pain management. The authors say this is happening, in 
part, because non-medical pain management services - like 
physiotherapy to address physical tension and psychologists and 
social workers to address stress - are not covered by government 
health insurance plans, and therefore typically not considered part 
of a pain management plan.

And while Finestone says medical marijuana may have a role to play in 
the holistic approach to pain management, he cautioned it shouldn't 
be considered a "silver bullet."

"Cannabis is definitely used by some people for pain but it is still 
a small aspect of the multidisciplinary approach (of how) we want 
physicians to treat it, and the way we want people to think about 
it," said Finestone, who is director of stroke rehabilitation 
research at Elisabeth Bruyere Hospital and a professor of physical 
medicine and rehabilitation at the University of Ottawa. "No one is 
going to say that marijuana is a one-stop pain treatment."

Nevertheless, FitzGibbon, 56, whose pain stems from multiple sports 
injuries and recent falls, was willing to take that chance. She had 
been on a cocktail of pharmaceuticals, including opioids, to treat 
anxiety, depression and osteoarthritis. Her inactivity contributed to 
weight gain and her family doctor suggested she undergo bariatric 
surgery - an operation to reduce the size of her stomach - so she 
would eat less. While reluctant, she was considering it because she 
was desperate to regain her health and mobility.

"I found myself lying in my hospital bed (after a serious knee injury 
two years ago) in my living room, where I lived for six months, 
wondering why I was still alive," FitzGibbon said. "I had no idea 
that there were such severe side-effects (from the drugs). You get so 
trapped in the abyss of opioid side-effects that you just can't (see) 
your way out of it."

According to the Centers for Disease Control and Prevention in the 
United States, regular opioid use can lead to addiction or overdose. 
Deaths involving prescription opioids have quadrupled since 1999, and 
so have sales of these prescription drugs. From 1999 to 2014, more 
than 165,000 people died in the U.S. from overdoses related to 
prescription opioids.

There are currently no national-level data for prescription 
opioid-related mortality in Canada. However, the Canadian Centre on 
Substance Abuse has provincial data that shows the overall rate of 
opioid-related mortality increased by 242 per cent between 1991 (12.2 
per 1,000,000) and 2010 (41.6 per 1,000,000). In 2010, 12.1 per cent 
of all deaths among those ages 25 to 34 in Ontario were 
opioid-related, an increase from 5.5 per cent in 2001

Dr. Mary Lynch, a pain specialist and professor at Dalhousie 
University in Halifax, is currently researching the use of medical 
marijuana in pain management. While she acknowledges there is a role 
for opioids in certain cases, her research has found that 25 of 30 
randomized controlled trials done as part of her study in Canada have 
shown that cannabinoids have "a significant analgesic effect" and are 
safe in the management of chronic pain. She admits the research is 
still in its infancy and more research needs to be done. Until then, 
she says, the government needs to address the problem of long wait 
times to get into pain clinics.

"We have a terrible situation across the country where people with 
chronic pain conditions wait for very long periods of time to get 
into pain clinics," said Lynch. "Many have absolutely no access 
because there are no pain clinics in vast areas of Canada. They are 
mostly in the urban centres."

FitzGibbon waited a couple of years after her knee injury to get into 
the Chronic Pain Management clinic, part of the AIM Medical Group at 
the Trainyards. When she met with Dr. Marc Engfield for the first 
time, he told her he was open to cannabinoids to help control her pain.

"I really just sat and bawled my eyes out, saying please help me," 
said FitzGibbon, who admits she had been struggling with suicidal 
thoughts. "I said I am so tired of being prescribed medication with 
such severe side-effects."

The doctor suggested she try synthetic cannabis, along with a strain 
of cannabis oil that helps her address all her ailments at once. One 
dose of oil is the size of a piece of rice, which she puts under her 
tongue. She also went to National Access Cannabis, a for-profit, 
membership-based consultation centre in Hintonburg where she learned 
about strains and the many ways - including cooking - cannabinoids 
can be ingested. When she walked into the clinic last fall, she was 
100 pounds overweight and barely mobile. Since then she been able to 
manage her pain, get off four medications and become mobile. Another 
byproduct of better health is more than a 100-pound weight loss.

"I can do the stairs better, I'm moving better, my blood pressure 
went down," said FitzGibbon "All I've ever wanted to do is emerge out 
of hibernation a healthier person and this is my year."
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MAP posted-by: Jay Bergstrom