Tryp Therapeutics announced on Wednesday that it had “submitted an Investigational New Drug (IND) application to the U.S. Food and Drug Administration (FDA) for its planned Phase 2a clinical trial investigating the effects of psilocybin-assisted psychotherapy in the treatment of patients aged 21+ suffering from Irritable Bowel Syndrome (IBS) at Massachusetts General Hospital (MGH).”
The Canadian company said in the announcement that the “planned open label study in collaboration with Harvard Medical School/Massachusetts General Hospital will evaluate the effect of psilocybin-assisted psychotherapy in patients with treatment-resistant IBS who experience chronic abdominal pain and other debilitating gastrointestinal symptoms.”
“Many of these patients also suffer from fibromyalgia, anxiety and fatigue. The primary efficacy endpoint of the study will be improvement in abdominal pain. The proposed study will also explore changes in brain connectivity and responses to pain at baseline and at four weeks, six months and twelve months post the psychedelic drug sessions, along with numerous other secondary endpoints,” the announcement said.
“Tryp and our collaborators at Harvard/MGH believe there is tremendous potential for the treatment of debilitating IBS symptoms by utilizing the combined administration of psilocybin and psychotherapy. The clinical study will examine how psilocybin-assisted psychotherapy may alter brain networks involved in chronic abdominal pain and gastrointestinal-specific anxiety in patients with IBS to improve their symptoms. Submission of IND 163994 is an important step in advancing our program,” said Jim Gilligan, the chief executive officer of Tryp Therapeutics.
Gilligan told Green Market Report that the “most important thing is a clinical data – to be able to not just assume or hypothesize that we’re going to have a benefit, but to actually demonstrate that we can do something positive for patients.
“We’re looking at things a little bit differently than the big guys, looking at unique areas where we can have first-mover advantage. But we’re judicious in selecting areas where we really think that we’ll have a positive outcome,” Gilligan said.
“Using an IV to induce and subsequently awaken the patient from the psychedelic state, the approach might also allow for the use of serotonin antagonists to terminate the psychedelic experience, if necessary,” the outlet said, which noted that TRP-8803 will be “central” to the company’s approach to the therapy.
TRP-8803 is “Tryp’s lead program,” the company says, describing it as “a proprietary formulation of IV-infused psilocin (the active metabolite of psilocybin) that alleviates numerous shortcomings of oral psilocybin including: significantly reducing the time to onset of the psychedelic state, controlling the depth and duration of the psychedelic experience, and reducing the overall duration of the intervention to a commercially feasible timeframe.
“The Company has an ongoing Phase 2a clinical trial for the treatment of Binge Eating Disorder at the University of Florida, an upcoming Phase 2a clinical trial with the University of Michigan for the treatment of fibromyalgia and a planned Phase 2a trial for the treatment of irritable bowel syndrome at Mass General Hospital, all of which are utilizing TRP-8802 (synthetic, oral psilocybin) to demonstrate efficacy in these indications. Where a preliminary clinical benefit has been demonstrated, subsequent studies are expected to utilize TRP-8803 (IV-infused psilocin) which has the potential to further improve efficacy, safety and patient experience,” Tryp said in Wednesday’s announcement.
A new study led by a team of Irish, American and Canadian researchers has determined that medical cannabis is a safe and effective treatment for pain caused by cancer when combined with other drugs. The researchers, who are affiliated with the Royal College of Surgeons, Dublin, and the Medical Cannabis Programme in Oncology at Cedars Cancer Centre in Canada, McGill University and Harvard Medical School, concluded that medicinal cannabis is “a safe and effective complementary treatment for pain relief in patients with cancer.”
The study, which was published this week by the peer-reviewed journal BMJ Supportive & Palliative Care, sought to investigate the effectiveness of medical cannabis in reducing pain in cancer patients. The research also examined the effectiveness of medical cannabis in reducing the use of other medications in patients with cancer.
“Our data suggest a role for medicinal cannabis as a safe and complementary treatment option in patients with cancer failing to reach adequate pain relief through conventional analgesics, such as opioids,” the authors of the study wrote.
In their introduction, the researchers note that approximately 38% of cancer patients experience moderate to severe pain. The rate is even higher for some groups of patients, with 55% of patients undergoing anticancer treatment and 66% of patients with advanced, metastatic or terminal disease experiencing pain. Painkillers, often powerful opioids, are the standard treatment for cancer pain, but about a third of patients who use the drugs still experience pain.
To conduct the study, the research team surveyed 358 adult cancer patients over a period of three years to collect real-world data on cancer pain and its treatment. The average age of participants in the study group was 57, and 48% of patients were men. The most common cancer diagnoses were genitourinary, breast and bowel cancers.
About a quarter of the patients were given medical cannabis products rich in THC, 17% were given CBD-dominant formulations and 38% were given a balanced mix of the two products. Every three months for a period of one year, study participants were surveyed and asked how much pain they were experiencing. Patients were also asked how many drugs they took to treat the pain.
Medical Cannabis Reduced Cancer Pain
At three, six and nine months into the study, patients experienced a significant reduction in pain, as measured by factors including pain severity, average pain intensity and overall interference with day-to-day life. Additionally, the research revealed that medical cannabis formulations with a balanced mix of THC and CBD were most effective at reducing the pain experienced by patients during the study.
The researchers also observed a reduction in the number of medications taken by participants during the study period and concluded that medical cannabis was a safe and effective complementary option for patients.
“The particularly good safety profile of [medicinal cannabis] found in this study can be partly attributed to the close supervision by healthcare professionals who authorized, directed, and monitored [the] treatment,” the researchers wrote.
Overall, the medical cannabis products were well tolerated by the patients in the study group. The most commonly reported side effects of the medical cannabis treatments were fatigue and sleepiness, but only by two and three patients, respectively.
The team of researchers recommended further study into using cannabis as a treatment for pain caused by cancer, writing that their “findings should be confirmed through randomized placebo-controlled trials.” They also recommended continued research “particularly to understand any benefits and risks of these medicines for children and young people.”
It’s a horrible topic that we can’t stop talking about because it doesn’t stop being a horrible topic. One of the biggest issues in the world of health and drugs is the opioid epidemic, and the large and growing number of overdose deaths from these doctor-prescribed medications. Research on different fronts point to the use of weed as a way to lower opioid use, with a recent study related to payments once again backing up that idea.
The research
The opioid issue is huge, and the medical industry is constantly commenting on it, and how to deal with it. In a recent study, investigators showed a monetary connection which indicates that places with legalized weed, also have lower opioid prescription and use rates. However, the study comes with some concerning points.
The study, entitled Using Penalized Synthetic Controls on Truncated data: A Case Study on Effect of Marijuana Legalization on Direct Payments to Physicians by Opioid Manufacturers, was put out by researchers from the University of Florida, University of Southern California, and Purdue University.
In the study, investigators assess data from drug transactions of direct payments from opioid manufacturers, directly to physicians. In this case, specifically between 2014-2017. The purpose? To identify if these payments are affected by the inclusion of medical cannabis policies. In order to do this, the researchers used a “a novel penalized synthetic control (SC) method that accommodates the zero-payment related latent structures inherent in these payments.”
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The paper makes this statement, “Physicians are the primary gatekeepers for deciding medication for patients needing pain management.” This is important to remember as death numbers spiral out-of-control. As medical marijuana is employed in more places and for more things, more doctors might be driven to switch up how and what they write for pain.
Study findings
The study results indicate a “a significant decrease in direct payments from opioid manufacturers to pain medicine physicians as an effect of [medical marijuana law] passage.” It found that “physicians in states with an MML are prescribing fewer opioids.” The thought is that this is “due to the availability of medical marijuana as a substitute.”
To get more specific, this “substitution effect is comparatively higher for female physicians and in localities with higher white, less affluent, and more working-age populations.” This could indicate that female doctors might be friendlier in general to the idea of medical marijuana, or it could speak to females having less powerful relationships with opioid producers. It’s hard to say which.
The study found that in 2015, doctor’s prescribed 49% more opioid treatments than non-opioid treatments in terms of 30 day prescriptions, as well as prescribing 49% more days of prescribed medication for opioid vs non-opioid treatments. In states where no legalization measure was applied, the ratio remained about the same for opioid vs non-opioid prescription, at about 1.38:1.
For states that did apply a medical marijuana legalization within the years 2015-2017, the study found that the same ratio decreased from 1.57:1 to 1.52:1. The same decrease in ratio was likewise seen when looking at the number of days of medication prescription when comparing opioid to non-opioid medications, in states that passed a medical legalization.
These numbers imply something weird though, which the researchers don’t talk about. They imply that states without medical weed policies, automatically prescribe less opioids. After all, a 1.38:1 ratio is lower than either 1.57:1 or 1.52:1, indicating non-legal states prescribe less before and after a legalization. This, to me, seems suspect, or at the very least, very much in need of some sort of explanation. Nothing of the sort is given.
Opioid medications
Realistically, according to this data, researchers could say that states with medical weed policies, have uniformly higher opioid prescribing, and likely higher use. And that seems a big enough point that it deserves expansion, which it didn’t get. In fact, all the researchers say after presenting the information, is “We leave further analysis of the possible effect of MML passage on patient care for future research.” What this means, is impossible for me to say based on what is provided. But it’s an odd thing not to address.
Wait a second, how did they put this together?
The thing about a lot of research, is that its not exactly direct. Meaning its not about counting heads in a group. It can’t be when researchers want to study large populations. When trying to assess something on a country-wide level, it means making estimates about larger numbers, often using models to generalize information to a greater level. While this is necessary, it can create questions of effectiveness in specific situations.
In this case, the investigators created a “novel penalized synthetic control method.” They describe it as such: “This method estimates an average treatment effect from a longitudinal dataset on multiple treated and control individuals. We create a synthetic counterpart of each treated and control unit by closely matching on the target unit’s and their groups’ average pre-treatment outcome history using the pooled synthetic 27 control strategy. Further, we use a novel penalty so that the resulting estimators are adaptive to the latent groups in the data whose members have similar quarterly non-payment patterns.”
They go on to explain it further, but the point in me quoting it, is to show it’s a bit more complicated than counting up the prescriptions or payments by themselves. So can there be error in models? Of course. Am I saying there is one here? Not exactly. I’m just pointing out a strange piece of data, which was spoken about only partially, and which works to ask more questions than it answers.
Another reality to consider, is that researchers looked at payments from opioid manufacturers to physicians; something often looked at as a corrupt way to get more prescriptions written. The researchers in the study overlook this idea, and actually say “interactions between these manufacturers and physicians are critical to advance existing pain management protocols.” And that “Direct payments from opioid manufacturers to physicians are established conduits to facilitate such interactions.”
In fact, the researchers seem concerned about less money flowing from opioid producers to doctors. They say, “The finding that the opioid manufacturers in states that passed MML are stepping away from this particular form of interaction is concerning, for such activity can significantly affect the opioids ecosystem.”
Does medical weed affect opioid prescription and use?
Do we really want doctors taking payments from opioid manufacturers?!?
The researchers in the study sound concerned about a possible erosion of the opioid market. But…isn’t that we want? Something like weed to affect the current opioid eco-system and lower the amount of use? And don’t we want to see less of them prescribed, and doctors paying less attention to opioid manufacturers?
Perhaps the biggest issue with this study, beyond making an implication about legalized states uniformly prescribing more opioids vs non-opioids than non-legal states, is that it seems to be written by researchers who fully support payments made from opioid producers directly to the doctors who prescribe them. Which has already caused tons of controversy in that those who accept such payments, tend to write more prescriptions.
This can be seen in an investigation into pharmaceutical payments directly to doctors in the state of New York. In this 2018 report by New York Health Foundation, it found that among other things, “Physicians who received payments from opioid manufacturers prescribed more opioids to Medicare patients than physicians who did not receive any opioid-related payments.”
How much money are we talking about, and how frequently did it seem to have this effect? According to the report, “More than $3.5 million in opioid-related payments were made to physicians in New York State by pharmaceutical companies; about one in ten physicians who prescribed opioids to Medicare patients received a payment.”
It said that, “Moreover, a higher number of opioid prescriptions was associated with more opioid-related payments to physicians.” However, it also found that these payments were concentrated among a choice few doctors, “Opioid-related payments from industry were concentrated within a small proportion of physicians, who tended to prescribe a large quantity of opioids. The top 1% of physicians in New York, in terms of the amount received in opioid-related payments, received more than 80% of total payments.”
So perhaps the finding of the current report that less money is going to doctors from opioid producers, is actually an indication of a lessening of these seemingly corrupt payments, which have led to more prescribing. Which is technically what we want in this climate. And which therefore strongly calls into question the motives of the researchers and why this information makes them concerned.
Effects of legal weed on opioid payments to doctors
Conclusion
I admit I’m slightly confused. The study talks about medical weed bringing down opioid use as seen through payments, which in the middle of a crisis like this, is optimal. Then it backhandedly turns this around and essentially questions if this is a good idea. Perhaps this study is an example of how research is often funded for a purpose, and not always with the best of intentions. I can’t say this for sure, as no funding information is given. Maybe a problem in and of itself.
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The healthcare industry is constantly evolving, with new technologies emerging every year that promise to revolutionize patient care. One area of innovation that is gaining momentum is digital drug delivery, which refers to the use of technology to improve the delivery of medications to patients. The latest advancements in this field are transforming the way we think about patient care, offering new and exciting possibilities for improving medication adherence, accuracy, and efficacy.
In this article, we will take a closer look at the latest technologies in digital drug delivery, including wearable devices, smart pills, and other cutting-edge medical devices. We will examine the potential benefits of these technologies for patients and healthcare providers, as well as the challenges and considerations that come with implementing them in clinical practice.
Beyond the Pill: How Digital Drug Delivery is Transforming Patient Care
Wearable Devices for Digital Drug Delivery
Wearable devices have become increasingly popular in recent years, with a wide range of devices available that can track everything from heart rate and blood pressure to activity levels and sleep patterns. In the field of digital drug delivery, wearable devices are being used to monitor vital signs and drug levels in real-time, providing healthcare providers with valuable data to improve patient care.
VitalPatch RTM (Image Credit: vitalconnect)
One example of a wearable device for digital drug delivery is the VitalPatch, a wearable patch that can monitor vital signs such as heart rate, respiratory rate, and body temperature. The VitalPatch can also monitor drug levels in the blood, providing healthcare providers with valuable information about how a patient is responding to a medication. This information can be used to adjust dosages, improve medication adherence, and prevent adverse reactions.
Another example of a wearable device for electronic drug delivery is the SmartCap, a bottle cap that can monitor medication usage and remind patients when it is time to take their medication. The SmartCap uses Bluetooth technology to sync with a patient’s smartphone, providing alerts and reminders when it is time to take medication. The SmartCap can also monitor medication usage and provide healthcare providers with valuable data on medication adherence.
Wearable devices have the potential to greatly improve patient outcomes by enabling real-time monitoring of vital signs and drug levels, enhancing medication adherence, and increasing patient engagement in their own care. However, there are also challenges and considerations to be aware of when implementing wearable devices in clinical practice, such as ensuring data privacy and security, patient compliance with device usage, and integration with existing healthcare systems.
Smart pills are another exciting development, offering a way to deliver medication directly to targeted areas of the body. Smart pills contain tiny sensors that can track the pill’s progress through the body, providing healthcare providers with valuable information on how the medication is being absorbed and metabolized.
One example of a smart pill for digital therapeutics is the Proteus Discover, a pill that contains a sensor that can track the pill’s location in the body and provide data on medication adherence. The Proteus Discover system also includes a wearable patch that can monitor vital signs and track medication usage, providing a comprehensive view of a patient’s health status and medication regimen.
Another example of a smart pill is the PillCam, a pill-shaped camera that can be swallowed to provide images of the digestive system. The PillCam can help diagnose conditions such as Crohn’s disease and colorectal cancer, and can also be used to monitor the effectiveness of medication in treating these conditions.
PillCam SB 3
(Image Credit: Medtronic)
The potential benefits of smart pills are significant, including targeted drug delivery, improved medication adherence, and enhanced diagnostic capabilities. However, there are also challenges and considerations to be aware of when implementing smart pills in clinical practice, such as ensuring patient comfort and safety, managing data privacy and security, and navigating regulatory hurdles.
Other Digital Drug Delivery Technologies
In addition to wearable devices and smart pills, there are a wide range of other digital drug delivery technologies that are currently being developed and tested. These include:
Implantable drug delivery devices, which can deliver medication directly to targeted areas of the body and provide long-term treatment for conditions such as chronic pain and diabetes.
Electronic skin patches, which can be used to deliver medication through the skin and monitor vital signs such as blood glucose levels.
3D-printed drug delivery devices, which can be customized to a patient’s specific needs and deliver medication in unique ways.
While these technologies are still in development and testing, they offer exciting possibilities for the future of digital drug delivery and the healthcare industry as a whole.
Electronic skin patches
Benefits and Challenges of Digital Drug Delivery
The potential benefits of digital drug delivery are significant, including improved medication adherence, targeted drug delivery, and enhanced diagnostic capabilities. By leveraging the latest advancements in wearable devices, smart pills, and other smart drug delivery technologies, healthcare providers can more effectively monitor patient health and improve patient outcomes.
However, there are also challenges and considerations to be aware of when implementing digital drug delivery in clinical practice. One of the biggest challenges is ensuring patient comfort and safety, particularly when it comes to devices that are implanted in the body or require patients to swallow sensors or cameras. Another challenge is managing data privacy and security, as these technologies can collect sensitive patient data that must be protected from unauthorized access or use.
Regulatory hurdles are also a consideration when it comes to digital drug delivery, as new technologies must undergo rigorous testing and approval processes before they can be used in clinical practice. Healthcare providers and device manufacturers must navigate complex regulatory frameworks to ensure that such technologies are safe, effective, and compliant with all relevant regulations.
What Countries Are Currently Leading The Industry?
The US, UK, and Germany lead the development and adoption of digital drug delivery systems due to their strong healthcare and technology industries. Japan and South Korea are also at the forefront of developing related medical devices. China and India’s growing healthcare industries provide opportunities for innovative solutions, while Israel and Singapore’s focus on healthcare innovation may also emerge as leaders.
Collaboration and innovation among healthcare providers, technology companies, and regulatory bodies will be necessary for global adoption.
Potential Adoption Rates Of Digital Drug Delivery Systems
To predict potential adoption rates for digital drug delivery systems, we can look at other industries that have successfully integrated digital technology, such as digital health, fintech, e-commerce, transportation, and edtech. These industries have all seen strong growth potential, driven by advances in technology, increased consumer awareness, and the potential for improved outcomes.
Despite unique challenges, such as patient comfort and safety, data privacy and security, and regulatory hurdles, it’s reasonable to predict that digital drug delivery systems will continue to be adopted at an increasing rate in the coming years as they offer similar benefits in terms of convenience, safety, and efficacy.
Digital drug delivery doesn’t have a direct relationship with recreational drugs (such as cannabis, THC, HHC, LSD, MDMA, Psilocybin, Ketamine, Magic Mushrooms, Amanita Mushrooms, etc.) but it could have potential implications. Wearable devices and other digital health technologies could be used to monitor drug use in patients, prevent drug diversion and abuse, and help with addiction treatment. Future advances could also have implications for the development of new treatments for substance use disorders. Overall, digital health technologies could play a role in the safe and effective delivery of medications used in addiction treatment.
Potenctial For Abuse
Digital drug delivery technologies have the potential to be abused, similar to any technology that impacts human health and behavior. Potential abuses include diversion, hacking, inappropriate use, privacy violations, and addiction. It is crucial that healthcare providers, technology companies, and regulatory bodies collaborate to address these risks and ensure safe and appropriate use of such systems. Safeguards could include measures to prevent diversion and hacking, training for healthcare providers and patients, and implementing data privacy and security measures.
As digital drug delivery technologies continue to evolve, there are exciting possibilities for the future of healthcare. From improving medication adherence to enabling targeted drug delivery and enhancing diagnostic capabilities, it has the potential to transform the way we deliver healthcare to patients.
In the future, we can expect to see further advancements in wearable devices, smart pills, and other digital drug delivery technologies. We may also see the development of new technologies that leverage artificial intelligence, machine learning, and big data analytics to improve patient care and outcomes.
Main Takeaway Points
Digital drug delivery technologies, including wearable devices and smart pills, are transforming the way we think about drug delivery and patient care.
Wearable devices are becoming increasingly sophisticated, offering targeted drug delivery and real-time monitoring of vital signs and other health metrics.
Smart pills, such as the Proteus Discover system and the PillCam, offer improved medication adherence and enhanced diagnostic capabilities.
Other technologies, including implantable devices, electronic skin patches, and 3D-printed devices, are currently in development and offer exciting possibilities for the future of healthcare.
While digital drug delivery offers many potential benefits, there are also challenges and considerations to be aware of, including patient comfort and safety, data privacy and security, and regulatory hurdles.
As these technologies continue to evolve and become more widely available, they have the potential to transform the way we deliver healthcare and improve patient outcomes.
While the west is currently leading the industry, we can see other coutries, especially from Southeastern Asia, entering the race.
Looking at other industries with similar growth patterns, we can predict that digital drug delivery systems will continue to be adopted at an increasing rate in the coming years.
The future of digital drug delivery is bright, with new technologies emerging every year that offer exciting possibilities for improving patient outcomes and the overall healthcare experience. From wearable devices and smart pills to implantable devices and 3D printing, the latest advancements in this fields are transforming the way we think about patient care and offering new solutions to longstanding healthcare challenges.
As these technologies continue to evolve and become more widely available, it is important to consider the potential benefits and challenges of implementing them in clinical practice. While digital drug delivery offers many potential benefits, there are also considerations around patient comfort and safety, data privacy and security, and regulatory hurdles that need to be addressed.
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The legal weed industry is going down. Or if not actually down, it’s certainly not reaching its projected highs. And there are good reasons. Beyond the ability to grow the plant at home, the black market has always existed, and always been able to offer cheaper prices. People don’t like paying higher prices than they have to. This is now seen in the ketamine industry, where expensive pricing has led to clinics closing; in light of patients taking the cheapest option possible.
The cost of treating your mental health
One of the most messed up things about the idea of mental health treatment, is that it means taking people already suffering from things like depression and anxiety, and forcing often huge price tags as a means to get better. How many people are willing to go to therapy, or take action, if they feel it’ll burn a hole in their wallet, and possibly make their situation worse by affecting their feelings of monetary (and therefore life) security?
The legal weed industry is a greedy place. Legislators were so greedy they instituted ridiculous taxes to try to squeeze as much tax money into their own coffers as possible. And there wasn’t a lot of logical thought or reality that went into it. We can know this because the whole idea was to divert from an already existent and strong black market, which always required lower pricing to be competitive with. While industry people are disappointed at the current state of layoffs and closures, it’s not surprising. People don’t like paying more than they have to, for something that should cost less.
Yet, without paying attention to this, new legalizations often seek to impose the same mess of taxes and regulatory laws, which caused the problems in the first place. And not only that, they’re applying the same lack of logic to even newer industries, like mushrooms. It’s speculated Oregon is going to have some pretty high session costs; and that’s to use a plant that can be grown at home, for which there’s a strong black market, and for which no actual therapy is given in a session. Actual therapy might be a reason for increased pricing, but lets be honest, who wants to pay out hundreds for a random trip sitter?
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I’ve been behind the ketamine industry since it started. Mainly because it’s a way for people to get help, and without dealing with standard medical channels. But the same problem permeated this industry from the get-go – super high prices. Ketamine is produced generically. And the sessions (at home or in-person) aren’t like psychedelic sessions which can take hours. Why are people charged so much? Probably because the thought of how popular such an industry could be, made those running it get a little greedy.
What’s going on in the ketamine industry now?
Right now, the ketamine industry is experiencing the same thing as the weed industry, which will likely be the same as what happens with the legal psychedelics industry if the same path of greed isn’t diverted from. Essentially, clinics are closing. And while some, like the writer for this Guardian article, want to put it on an industry ‘moving too quickly’, that reasoning makes no sense. It could have sprouted out even faster, and still done better than today; if people were charged relevant pricing.
I did a couple ketamine treatments in Mexico. My experience wasn’t the best, either because I really am a non-responder (and more specifically, an anxiety responder), or because of the crappy doctor, and the not-great-experience he created. Either way, the ketamine treatments were very expensive even in Mexico (though better than the US), and the idea of trying it further under the circumstances, didn’t make financial sense.
I find it a little funny that despite watching it happen with weed, there’s still confusion on the topic. People don’t have money. The majority of us are fighting to survive, and its often the people from the worst financial situations that have the biggest issues. The expensive nature of the ketamine industry indicates its only meant for the rich among us. If that’s the case, there shouldn’t be any expectation of its survival long term, and not because it doesn’t work.
Just like the weed industry, tons of crazy projections were made for ketamine, with no thought to reality. How can such a high-priced service appeal to those without money? In a great showing of exactly this point, clinics that offer at-home services at lower prices, have a greater influx of users for those low prices. And while that in and of itself should answer the question of how to handle this, and provide incite into why its happening; confusion seems to continue. With lines like above – that the industry moved too quickly, instead of the logic answer that the industry charges too much. Period.
The fallout
Who is being hit? A lot of places, including two of the bigger providers: Field Trip Health and Ketamine Wellness Centers (KWC), both of which operate chains of clinics in the US. According to KWC’s site, “Delic announces the pending acquisition of Ketamine Wellness Centers by Peter/PetraMD, the largest online mens and women’s health clinic covering 47 states nationally.” Which means it was bought out.
Ketamine therapy
While KWC was bought out, and Field Trip closed about four locations, other providers like Actify Neurotherapies, had to close shop entirely. According to the Guardian article, “Premature expansion, delays to health insurance coverage payments and investor impatience have been key to these closures,” but I’m not onboard with that explanation. If pricing had been decent from the beginning, none of this would matter.
And for that matter, let’s look at pricing. When I wrote about this close to two years ago, I quoted pricing as per TMS & Brain Health as $400-800 per session; with usually six ketamine treatments (or more in the case of TMS); that’s a lot of money. At that time, yet another clinic – Revitilist Clinic, put the cost at $474- $800 per session, depending on the exact service. Even if a person from lower financial means manages some treatments, the likelihood they’ll continue is lowered by the extreme cost.
On the other hand, some clinics started offering at-home services which bring down costs. It was reported within the last year, that Mindbloom clinic charged $193 per session as part of an introductory package of six sessions with a total price of $1,158. This is much lower than the thousands it costs to do the same amount of sessions in-person.
Lets go back to those big chains for a second, which are having problems and closing locations. KWC charges $125 just for pre-screening, and then charges $449 per session for mental health issues, and a whopping $899 per session for pain treatments. For 4-6 mental health treatments sessions, that’s $1,921 – $2,819, without considering ongoing treatment. For pain, its $2,822 – $4,620. Think about people who want to get away from opioids through ketamine, and how difficult this makes it at such expensive prices.
Field Trip for its part has different options. If you want in-person, but without all the bells and whistles (now simply having the therapist in the room is considered ‘extra’), it costs $219 per session, and goes up to $302 for everything including the therapist. However, this is misleading, as the sessions are packaged together, meaning that $219, is really $5,250 over 24 months, and the $302 is really $7,250 over 24 months. Bundling generally means not paying for single sessions, and might require continued payment when treatments aren’t effective.
Field Trip also provides at-home treatments. In the FAQ it states these sessions have a base rate of $150; but can only be done for New York residents. Whether this is only done as a package deal, like above, is hard to say, as its not formally stated. My expectation is that it does come as part of a package deal with a higher final price. Even so, the price is much lower, so its not surprising that clients prefer this model. And it says a lot if you pay attention. It says that the treatments never needed to cost more than this anyway, and even this might be an inflated price.
Ketamine might be useful, but is it too expensive?
What does this mean?
According to Natalie Ginsberg, the global impact officer at MAPS, via the Guardian, “I live in LA and there are ketamine clinics everywhere. Telehealth is not killing the clinic business but many people will opt for both cheaper and more convenient ways of doing this work.”
Ben Spielberg, the CEO of Bespoke Treatment, a clinic that offers ketamine infusions, had this to say via the Guardian, “A lot of people see ketamine clinics as this great business to go into to make huge margins, because ketamine itself is so cheap. But it really couldn’t be further from the truth: the cruel absurdity is that the people who benefit the most from ketamine therapies can rarely afford it. Many of them are on disability due to their mental health conditions and $400-$600 per infusion is an insurmountable obstacle.”
When looking at Oregon’s magic mushroom industry plans, the same idea of overly expensive pricing is set to be employed, with apparently no thought to the weed or ketamine situations, and what they tell us. According to OPB.org in an article from March 2023, expected costs could be between $2,000 and $3,000 for a treatment course, though this is speculation at the moment. It does, however, go in line with pricing in places like the Netherlands, where treatment can range from $4,160 – $7,750 for the whole cycle. That begs the question of who would do this when you can buy mushrooms for ~$32 an eighth.
How expensive is ketamine outside formal treatments? According to drugs.com, you can get 200ml for $167.80, with 10mg per ml. Most patients receive .1-.5mg/kg for a treatment, so if you weigh 160 lbs, that’s 72.5kg. On the high end, it means a treatment using 36.25mg, which is roughly 3.5 ml. 200ml is therefore good for many, many usages (upwards of 50), meaning the costs of these in-person and at-home treatments are wildly expensive.
Conclusion
The reality is that the future of ketamine therapy is either in at-home treatments; these companies losing the greed, and offering less expensive prices that go in line with the actual cost of ketamine; or continuing as is, with the understanding it’ll be a niche market for the small percentage who can afford it.
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The opioid problem isn’t getting any smaller, and thus far, no tactics employed, are helping things out. If a new Texas bill goes through, it will officially make cannabis an opioid alternative in the state; giving a much needed replacement to these death-causing drugs. Will it pass, and what else would this new bill change?
Texas and cannabis
Texas is not historically one of the more lenient states when it comes to cannabis; although as a southern state, its made great leaps and bounds in the last few years. Prior to 1973, Texas had the most strict cannabis policy in the US, with all possession garnering a felony charge. In fact, such possession came with two years to life in prison. Luckily, things have loosened up on several fronts, starting with the passage of House Bill 447 in 1973, which changed the penalty scheme for cannabis crimes.
Even so, recreational cannabis is still illegal in the state, and possession of up to two ounces counts as a class B misdemeanor. It comes with a penalty of up to 180 days prison time, and up to $2000 in fines. This applies to state law, though several individual locations have enacted less severe punishment measures.
In 2015 Texas passed medical legislation that allowed the use of cannabis oil with no more than .5% THC, (since updated to 1%). This is applicable with a doctor’s prescription; and happened through Senate Bill 339 aka the Texas Compassionate Use Act. At the time of passage, cannabis oil was specifically meant for epilepsy patients. Since that time, Texas passed a range of bills to cover more illnesses, and loosen cannabis restrictions in general.
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Despite making progress on some fronts, like medical usage, Texas has had a back and forth pattern of progress. For example, as late as 2020, the state banned smokable hemp. In fact, as per Texas drug policy, “Smoke a joint, lose your license” applied, whereby part of the punishment for a drug infraction, was temporary loss of a drivers license. This was officially overturned in 2021. In term of smokable hemp, though the ban was overturned in 2021, in 2022, the State’s Supreme Court reinstated the ban on manufacture and processing of smokable hemp. This still stands.
Interestingly, in 2015, a Texas lawmaker introduced a recreational bill, under a religious pretense. Said Representative David Simpson who created the bill, “I don’t believe that when God made marijuana, he made a mistake that government needs to fix.” The bill, however, never cleared either side of the State’s Congress, and no subsequent effort of this nature was made.
New Texas bill to expand medical industry
Texas passed a couple updates since its original medical passage, in 2019 and 2021. And now, once again, legislation is on the table that would expand it out even further, and which introduces the ability to use cannabis as an opioid alternative. Originally filed at the end of January 2023 by republican Rep. Stephanie Klick, HB 1805 was officially passed by the Texas House of Representatives on April 12th, 2023. The vote was 127-19.
What does this bill do? It’s a cannabis bill meant to expand medical services. This time around, a couple things would come out of it. For one, it would replace the 1% THC cap with a 10 milligram volumetric dose. As per the wording of the bill, it redefines the term ‘low-THC cannabis’ to mean “the plant Cannabis sativa L., and any part of that plant or any compound, manufacture, salt, derivative, mixture, preparation, resin, or oil of that plant that contains not more than 10 milligrams of tetrahydrocannabinols in each dosage unit.” Thus, it removes “one percent by weight”, replacing it with the 10mg max instead.
The other big thing it would do, is allow cannabis to be prescribed as an alternative to opioid medications for patients with chronic pain issues. As per the wording of the bill, the inclusion would be made for “a condition that causes chronic pain, for which a physician would otherwise prescribe an opioid.” Right now, qualifying conditions are epilepsy, seizure disorders, multiple sclerosis, spasticity, amyotrophic lateral sclerosis, autism, cancer, neurodegenerative diseases (incurable), PTSD, and medical conditions approved for research.
Another addition aside from cannabis as an opioid alternative, is that the Department of State Health Services could designate any issue seen as a debilitating medical condition, for cannabis treatment. This would make it so that more conditions could be treated by cannabis, regardless of whether they’re officially stated in the law.
New law to update medical legislation in Texas would make cannabis an opioid alternative
The bill isn’t out of the woods yet, and passed over to the Texas Senate after approval by the House. Should it pass through the Senate, its expected to be enacted in September, 2023. But its already known that making it through the Senate, will be much harder than making it through the House. The Senate is presided over by Lt. Gov. Dan Patrick, a staunch anti-legalization supporter.
An example of this disconnect between government entities related to cannabis was seen prominently in 2019, when the House passed a cannabis decriminalization measure, which stalled out in the Senate. Several other legislative measures concerning cannabis have gone the same way since that time.
Texas and opioids
Perhaps what will ultimately give this bill a good push forward, is that its specifically related to opioids. Opioids have become an incredible problem throughout the US, and beyond. 2021 saw close to 100,000 opioid overdose deaths in just the US, with nothing done on a substantial level to get rid of the problem.
In fact, despite the deaths, and despite every state having some kind of lawsuit against big pharma giants and retailers, opioids are still allowed through government regulation, and doctor’s are still most certainly allowed to prescribe them. While alternatives like ketamine exist (which would realistically prove more useful than cannabis), this is literally pushed down so far, its not a part of the conversation.
What’s the deal in Texas specifically with opioids? According to the Texas Workforce Commission, there were 2,506 opioid-related deaths in 2021, which was an 80% increase from 2020. In 2020, 92% of opioid deaths were from synthetic opioids, in the age range of 0-17. In 2021, the average monthly death rate was 209, up from 114 in 2019. And since 2017, 52% of all unintended deaths from overdose, included use of an opioid.
When comparing Texas to the rest of the US, in 2020, the Texas rate of opioid use was 7.2%, while in America overall, the rate was 5.6%. The top five counties in the state hit hardest by opioids in 2020, were: Harris, Dallas, Tarrant, Bexar, and Travis; with deaths of 489, 217, 165, 125, and 109, respectively. It’s fair to say that Texas has a bit of a problem with opioids.
Texas has higher opioid use rate than rest of US
Enough to be a part of lawsuits against 11 different entities. These include four with manufacturing companies: Johnson & Johnson, Endo, Teva, and Allergan. It’s a part of a separate suit with the following distributors: AmerisourceBergen, Cardinal Health, and McKesson. One against retailers: CVS, Walgreens, and Walmart. And one with manufacturer and distributor Mallinckrodt, which is now bankrupt. It’s expected that all told (Texas and beyond), these companies are paying in the neighborhood of $50 million in these, and other, suits; and that’s not accounting for future lawsuits.
There’s no saying if this medical expansion bill will pass. However, that it attempts to facilitate some kind of help to opioid users in the way of using cannabis as an alternative for opioid medicines; indicates it might get more traction than other cannabis-related bills. In a state with growing opioid damage, even anti-cannabis holdouts, will eventually have to cave to voter will for help and change.
Conclusion
Cannabis might not be the overall best opioid alternative, but its certainly something at a time when something is needed. What might be a better showing of support for the people, however, is laws that eliminate the legal ability to prescribe and sell these medications. And if you’re thinking we could never as a population handle life without them; its best to remember that not only are there non-addictive alternatives like ketamine, but that we as a species survived thousands of years without synthetic opioids. Just a thought.
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Johnson & Johnson and friends are paying out a lot of money for their misdeeds; even if they refuse to admit to doing anything wrong. In fact, every state in the US has at least one opioid lawsuit; with the question now of, where does all that settlement money actually go?
How much must be paid & by who?
There isn’t a finite answer to this question, as not every case against the major players like Johnson & Johnson has been settled. And we’re only talking about America right now anyway. So far, over 3,000 suits have been filed by different states and local governments over the pills which have caused a major death toll in America, Canada, and beyond.
The biggest payout comes in the form of a $26 billion settlement that was made between 46 US states and Johnson & Johnson, AmerisourceBergen, Cardinal Health, and McKesson. It was brokered in 2021, and dubbed the ‘National Settlement.’ This settlement does not include the four states that didn’t sign on, or anything previously decided or still ongoing. The number also doesn’t include separate lawsuits that have been waged against retailers like Walgreens.
Another of the big settlements has to do with the Native American population of America, a population hit very hard by opioids. This lawsuit was also against the four companies involved in the National Settlement, with a total of $590 million to be paid out to federally recognized tribes. It started as a settlement between AmerisourceBergen, Cardinal Health, and McKesson and just the Cherokee tribe for $75 million. This was then increased to $440 million, with a stipulation that it can be accessed by any federally recognized tribe member.
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For its part, Johnson & Johnson was also included and has two years to pay out $150 million in this particular case. Of that, $18 million is specifically for the Cherokees. To give an idea of the brazen ego of these companies; upon making this settlement, Johnson & Johnson said in a statement that “This settlement is not an admission of any liability or wrongdoing and the company will continue to defend against any litigation that the final agreement does not resolve.” I guess the company just likes paying out big sums of money.
Even more opioid lawsuits
It’ not just the pharma companies and distributors that are set to pay a lot of money. Even retailers got hit with lawsuits. CVS, Walgreens, and Walmart were staring down over 300 lawsuits over opioids, and settled for $13 billion in late 2022.
And what of Purdue specifically? The company that skyrocketed this whole issue with the creation of Oxycontin, and all the lies surrounding the usefulness and addictiveness of this drug? It also is in the process of dealing with the fallout of its blatant disregard for humanity. This company isn’t a corporation, and is privately owned by the Sackler family. The family was made to pay out $6 billion in a 2022 settlement, which goes mostly to local and state governments. And this as a part of a revised bankruptcy settlement, just to give an idea how much these little pills are hurting everyone…including those who made them.
Opioid lawsuit money
Even the federal government, which allows the opioids through regulation, is a part of it. The US Justice department made an $8 billion settlement with Purdue, which was reported in October 2022. And who gets this money? It goes to the Treasury Department, which is allocating $1.775 billion for states, tribes, and local governments for the future. And only $225 million for a “public benefit trust” to state and local communities now. It’s thought that once its all told, approximately $50 billion will be paid out from opioid lawsuits altogether on the state and local level.
Opioid lawsuit money: How is it split?
The whole point of these lawsuits is that the drugs hurt (and are still hurting) a lot of people. Now, sure, you can also say the disability damages affect a wider audience, including governments, but the thing to really remember in this, is who the victims are. And that’s primarily people who started opioids for pain issues. When you think about it, these lawsuits have less to do with people who decided to take up the drugs on their own.
So how does the money get to them? Or does it even? States are bringing in millions and billions of dollars from these opioid lawsuits, so where does the money go? This is where things get a bit complicated. And where we have to hope that the created systems, actually use the money appropriately.
The National Academy for State Health Policy is interested in this question, and compiled data to help elucidate the situation by looking at “state legislation, opioid settlement agreements and spending plans, advisory committees, and other entities charged with disbursing state funding”. According to the agency, all the states are setting up regulated structures for money dissemination; some related to the settlements themselves, and some as a part of new policy.
As the biggest payout as of yet, the National Settlement includes both the ability for states to create their own policies, while also defining some aspects of the payment structure. For example, this settlement includes a timeline for payouts, which stipulates 18 months. The money is split due to factors like overall population; how many overdoes deaths the location had, as well as how many active use cases there are now; and how much of the medications made their way into the location.
What about once a state has the money? The settlement agreement goes on to stipulate a standard rate for dissemination past that point, with 15% of the payment going to a State Fund, 70% to an Abatement Accounts Fund, and the last 15% to a Subdivision Fund. Should a state want to change this policy, it can challenge it. While all this applies to the biggest lawsuit, many settlements have similar instructions.
Lawsuits over opioids
The ’State Fund’ is money which is “awarded directly to the state, with final spending authority residing with legislative appropriation, attorneys general, the Department of Health, or the state agencies responsible for substance use services.” The Subdivision Fund (Local Share) is money paid “directly to participating political subdivisions, including participating cities and counties.” And the Abatement Fund is to “distribute funding across the state.”
Essentially, each state is tasked with coming up with “unique process and administrative structures for allocating funding across state and local entities, identifying abatement needs, obtaining input from the public and experts, providing guidance on priorities and spending activities, and promoting transparency around the use of funds.” And these processes can be used for any opioid lawsuit money from future or already on-going cases.
Opioid lawsuit money, and how it can be used
With the National Settlement as the example, there are some stipulations as to how the money can be used once a state takes it in. This is where we need to make sure that these avenues lead to something useful; and that they don’t get corrupted. Which means watching over the process from beginning to end.
The main point is that at least 70% of this money must be used for ‘opioid remediation efforts,’ which essentially means policies that target the problem and attempt to solve it. As per the wording of the agreement:
“Care, treatment, and other programs and expenditures (including reimbursement for past such programs or expenditures except where this Agreement restricts the use of funds solely to future Opioid Remediation) designed to (1) address the misuse and abuse of opioid products, (2) treat or mitigate opioid use or related disorders, or (3) mitigate other alleged effects of, including on those injured as a result of, the opioid epidemic.” It’s not, however, more specific than this, leaving the individual locations to figure out what these measures should be.
The money must also be used to set up Opioid Settlement Remediation Advisory Committees. These committees are designed to provide some guidance for the remediation process; they only deal with the 70% allocated to the Abatement Accounts Fund.
Lawsuit money allocation
The problem is that such systems have shown to be corruptible time and time again. To combat this (in some form) there is a guideline set up to try to deter unrelated spending. It stipulates a requirement to report all use of the funding money, including unrelated costs like payments to lawyers, investigation costs, court fees, and administrative fees. However, a requirement to report, doesn’t mean the funds won’t still be used for these purposes. If reported unrelated costs are still covered, the simple action of reporting does not mean the funds won’t be misused. We’ll have to keep an eye out.
Moving forward
Will any of this work, or are we simply filling government coffers, to be blown like so much other government money? The way I see it, there are two ways to look at progress. The first is if those who have been hurt, get repaid for their losses. And the second is in how it works to change the current landscape. Considering most new regulation focuses on decriminalizing drugs and setting up safe use sites, instead of looking at alternatives like ketamine; its certainly hard to see a path for positive change. And realistically, so long as the doctor is the dealer, can we actually expect this problem to go away?
It’s best to remember that no state pursuing an opioid lawsuit has barred the sale of opioids in the state; even with lawsuit money rolling in. Not even one made a guideline for making them harder to get. Kind of a contradiction, and one that shouldn’t be ignored if people really expect that governments are working on their behalf.
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Welcome to TheCannadelics Sunday Edition, our weekly newsletter, sent to you every Sunday morning at 11am est with the main articles of the week. This week we look into DIY mushroom grow kits, and DIY mushroom spores, as well as other drugs your can grow on your own.
If you happen to like mushrooms, we have a great newsletter for you!
But first thing first, Prof. Raphael Mechoulam, the ‘godfather’ of cannabis research passed away this weekend. We would like to honor and celebrate his life and groundbreaking work on Cannabis and cannabis research. Rest in peace dear payoneer.
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Welcome to the Cannadelics Sunday edition, going out every Sunday with the top stories from the cannabis and psychedelics industries. This week we have an interesting selection of stories, as well as an exciting deal on magic mushroom spores. Scroll down to learn more.
Before moving forward, let us take a moment to honor and celebrate the life and groundbreaking work of Professor Raphael Mechoulam, who recently passed away on Friday. Widely regarded as the “godfather” of cannabis research, Professor Mechoulam made significant contributions to the field and helped pave the way for a better understanding of the potential benefits of cannabis.
We extend our heartfelt condolences to his loved ones and colleagues. May he rest in peace and be forever remembered as a beloved pioneer in the field of cannabis research.
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One of the great things about psilocybin is, much like cannabis, the mushrooms it comes from, can be grown in home. So, here are some basic instructions to highlight the general process. Prospective growers should do further research, and remember, these instructions are for growing all mushrooms.
Growing mushrooms does not have to be some intimidating and complicated endeavor. It should be fun and relatively hands off. In my opinion, the best cultivation products combine the elements of affordability, convenience, and ease of use. If a product is well-priced, user-friendly, and makes your life easier in some way, what could really be better? With that in mind, I made the following list of what I think are some of the best magic mushroom grow kits on the consumer market.
Everyone knows that you can grow weed at home, regardless of how much of a hassle it may be. But did you know you can also grow many other “drugs” at home? Psilocybin, mescaline, DMT, salvia, ibogaine, and many other hallucinogens are plant-based, and some can easily be grown in a personal garden space.
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Professor Raphael Mechoulam. Image credit: Wikipedia
Professor Raphael Mechoulam, an award-winning Israeli chemist, instructor of Medicinal Chemistry at the Hebrew University of Jerusalem, and esteemed medical cannabis researcher, has passed away on Thursday, March 9th, 2023, at 92 years of age. Professor Mechoulam was a respected intellectual, a visionary, and a true leader in his field. His contributions to science and medicine will continue to have a lasting impact on the cannabis industry and society as a whole. RIP dear Mechoulam, you will forever be in our hearts.
First and foremost, it’s not good to smoke anything while pregnant – point, blank, period. However, it can be safer than alternative medications when you’re at a loss for treatment options, so many women choose to self-medicate. Recently pregnant women have been checked for the compound THCM, to see if they’ve smoked weed while pregnant. What exactly is THCM? And what are the implications of the test?
We all know that pharmaceutical pain medications are much stronger than most natural alternatives. Think cannabis vs oxycontin, it’s no comparison. So why are a growing number of people turning away from opioids in favor of milder treatment options? Aside from obvious safety issues with the former, the answer to this question lies in part in how we, as a society, view pain in the first place.
To kick off the summer, Zach Leary, son of renowned psychedelic researcher Timothy Leary, is hosting a tight knit event called the Basement Tapes, during which he will share with attendees numerous different never-before-seen videos, documents, and articles that will give the public a much better understanding of psychedelic therapy. Leary is working in partnership with the Psychedelic Institute, a non-profit organization dedicated to spreading knowledge and improving access to “medically-safe and evidence-based” psychedelic therapies.
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Best, The Cannadelics team
*** Disclaimer: As the legality of cannabinoids and psychedelics changes between state to state, you should always check with your local authorities first.
Patients with tinnitus commonly seek symptom relief via cannabis use, according to new research.
The study, published last month in the Journal of Otolaryngology – Head & Neck Surgery, is being called the first “to assess perspectives and usage patterns of cannabis in patients experiencing tinnitus.”
The findings, based on interviews with 45 individuals suffering from tinnitus, showed “that 42% (19/45) of patients had never used cannabis, 36% (16/45) previously used cannabis at some point in the past, and 22% (10/45) reported current cannabis use at the time of questionnaire completion.”
“Of the 10 patients currently using cannabis, 80% (8/10) reported that it helps with tinnitus-related symptoms. Patients reported that it helped with dizziness/unsteadiness/disequilibrium (3/8, 38%), auditory symptoms (3/8, 38%), emotional difficulties (anxiety, depression, feeling upset, fear) (6/8, 75%), pain (headache, neck pain/aches) (7/8, 88%), sleep disturbances (7/8, 88%), and functional difficulties (concentration, fatigue, work disturbances) (4/8, 50%),” the study said.
“Overall, 96% (43/45) of patients responded that they would consider cannabis as a treatment for their tinnitus. Patients also considered cannabis as a viable treatment for their tinnitus-related symptoms,” it continued.
Here is more on the findings:
“Patients considered cannabis use for auditory symptoms (91%), and symptoms related to their tinnitus, such as emotional complaints (60%), sleep disturbances (64%), and functional disturbances (56%). 36% of patients had previously used cannabis and 22% of patients reported cannabis use at the time of the study. 80% of patients that were actively using cannabis reported that it helped with tinnitus-related symptoms, such as dizziness, anxiety, bodily pain, and sleep disturbances. Most patients would prefer to use edibles (62%), tablet (58%) and cream (47%) formulations of cannabis. Patients were concerned about the cost (29%), potential physical health implications (53%) and psychosocial side effects (60%) of cannabis. Over half of patients learned about cannabis from a friend or family member and only 22% of patients learned about cannabis from a physician or nurse.”
The authors of the study believe that the findings could serve as the groundwork for more research, and perhaps even clinical trials that assess the effectiveness of cannabis for tinnitus treatment.
“The results of this study demonstrate an active interest amongst patients with tinnitus to consider cannabis as a potential adjunctive treatment for symptom management. Moreover, cannabis use is both common and can be beneficial in this patient population. An understanding of patient attitudes towards cannabis use is a prerequisite to exploring its potential use in clinical practice,” they wrote in their conclusion.
“Cannabis use is common amongst patients with tinnitus and most participants would consider cannabis as a treatment option to manage their symptoms. Almost all patients were interested in learning more about cannabis if proven to help with symptoms of tinnitus, but physicians must be aware that most patients receive their information on cannabis from non-medical sources. This data may lay the groundwork for future research and clinical trials on cannabis use for tinnitus alleviation. Otolaryngologists can develop an understanding of patient attitudes and usage patterns to guide patient counseling on the use of cannabis for symptoms associated with tinnitus,” they added.
Those who suffer from this are often vexed by the lack of an effective treatment.
The authors noted that “antiepileptic drugs, such as lamotrigine and gabapentin, have been studied as pharmacological treatment for tinnitus, given their inhibitory effect in the central nervous system,” but “there is insufficient evidence to support the use of antiepileptic drugs for tinnitus and it has not shown to be beneficial compared to placebo.”
We all know that pharmaceutical pain medications are much stronger than nearly anything you can find in nature. There’s no comparing cannabis, cloves, or magic mushrooms to powerful drugs like fentanyl and isotonitazene. So why are a growing number of people turning away from opioids in favor of milder treatment options? Aside from obvious safety issues with the former, the answer to that lies in part in how we, as a society, view pain in the first place.
Is pain something that should be immediately and completely masked, or are there some healing components to allowing our bodies to feel discomfort? Is our culture of hiding from anything that feels bad, keeping us in a perpetual state of illness?
Pain & pain medications throughout history
Pain is not a condition in and of itself, but rather a symptom of many other diseases or disorders, indicating something is wrong with our bodies. Pain is incredibly complex and can vary significantly between people, even those who share similar illnesses or injuries. Pain can also range in severity, as well as in the way it’s felt. Some variations of pain can include pricking, tingling, stinging, burning, soreness, aching, and many other unpleasant sensations.
The entire spectrum of pain consists of hundreds of different types of disorders and syndromes. For instance, you can experience pain following an injury, or chronic pain related to aging. Pain can also be neurological, like migraines. Heart attacks, cancer, and childbirth all cause different forms of pain. When it comes to clinical diagnoses, healthcare providers typically group pain into one of two categories: acute or chronic. Acute pain comes on suddenly and intensely, and is usually the result of a traumatic injury or surgery.
Chronic pain persists over a longer period of time, and can be difficult to manage. Chronic pain affects very 50 million American adults, and it’s one of the most common reasons people seek medical care. Although some medical professionals consider chronic pain to be its own medical disease, there is always an underlying cause.
Again, pain is our natural warning sign that something is not right. The purpose of feeling pain is to change our course of actions – be it limiting certain activities, eating different foods, doing certain exercises, and so on. It’s remarkably specific in letting us know what activities will further aggravate an area, and in preventing us from doing said activities.
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What the research says
Pain is something that has long-confused physicians, so in an effort to better understand it, they started tracking their patients’ discomfort at all times. For a while, pain was even referred to as “the fifth vital sign”, officially declared so in 1999, but the move was met with great controversy and continues to be a point of contention in the healthcare industry to this day.
Regardless, the goal was for doctors to take more cognizance of pain because it can be an important factor in determining the overall health and mental state of a patient. The problem was that, the quest to gain a better understanding of pain eventually turned into a mission to mask pain entirely, not necessarily treat its root causes.
Some issues come along with pain medications, the most obvious being that if you don’t feel any pain, you may not take the correct actions to manage and heal your ailment, leading to further injury. Another problem that is rarely discussed, is the role of pain management medications in the actual treatment of pain. For a long time, it was commonly believed that pills helped, but recent studies show that many frequently used pharmaceuticals actually hinder the healing process.
It is well established in scientific literature that NSAIDs can impede the healing of broken bones, damaged ligaments, and other musculoskeletal tissues. Many surgeons many avoid suggesting or prescribing these medications because of the growing concern in how they negatively impact callus formation and decrease the activity of COX isoenzymes that decrease the synthesis of prostanoids.
Another drug of great controversy – opioids. How much are these incredibly dangerous drugs that have caused hundreds of thousands of overdose deaths over the last decade, even aiding in the healing process? Short answer, not very much at all – according to recent studies.
A study published in 2017 found that patients who were treating wounds with opioid doses over 10mg per day exhibited slower rates of healing than patients who took less than 10mg or none at all. Other studies have also suggested that opioid use may negatively impact wound healing by reducing immune activation, impacting tissue oxygenation and angiogenesis, and altering myofibroblast recruitment as well as impacting keratinocyte cytokine production, endothelial proliferation and angiogenesis.
Other drugs that can slow wound healing are cytotoxic antineoplastic and immunosuppressive agents, corticosteroids, and anticoagulants. Additionally, all drugs in the pain relief category can theoretically interfere with healing by masking pain and thus allowing you to continue to hurt yourself without immediately realizing it.
My personal experience with pain & pain medications
To not sound completely tone-deaf here, I do understand that certain levels of pain can make life unbearable. I’ve been blessed in not having to experience chronic, debilitating pain personally, but I have had a handful of injuries and surgeries in my life that left me in pain or discomfort for a few weeks to a few months at a time.
I also suffer from frequent migraines and cluster headaches, which come on strong and fast. Normally, I try to take it easy, drink a lot of water, eat food, and avoid smoking until it goes away. Admittedly, I’ll pop an Excedrin occasionally if I don’t have time to tend to naturally, but I try to avoid that as the regular use of any acetaminophen-based drug can cause significant damage to the body, particularly the liver.
Right now, I’m drawing from my experience of giving birth, comparing how it went when I received epidural versus a natural birth. First, it’s important to note that babies whose mothers receive an epidural are more likely to develop respiratory distress syndrome once the child is born. Epidural anesthetic is sometimes combined with opioid drugs as well, which can cross the placenta and add to the risk of developing respiratory depression.
Babies who have are exhibiting such problems likely end up going to the hospital’s neonatal intensive care unit (NICU). While staying in the NICU may not seem harmful on the surface, it means that mother and baby are separated immediately after birth. And when you use epidural, you can’t move your legs for a couple of hours after giving birth, so if the baby is not in the same room with you, that’s even longer spent away from them during their first moments on this earth, and this can have profound effects on the emotional and physical well-being of both baby and mom.
This is what happened to me when I gave birth to my first son with epidural. The labor was about 10 hours, I had to be put on oxygen at numerous points during the process, and my baby was born with some breathing issues that made it difficult for him to breathe through his nose while eating. He was taken to NICU right away, but even while there he had issues for a couple of weeks. At one point during a feeding, he stopped breathing completely for a few seconds and turned blue, it was the most terrifying thing I’ve ever experienced.
Were these issues causes by the epidural? It’s hard to say, but very possible. Especially when comparing that ordeal to the birth of my second son, which was done completely naturally. No problems during the labor which last less than one hour from start to finish, baby had absolutely no issues, and we were discharged in about 1 day.
In my opinion, that’s very telling of the types of complications that can arise when unnecessary medical intervention is at play.
Pain medications – Final thoughts
Pain medications and pain management is a complicated and sensitive subject for many people, patients and medical professionals alike. Pharmaceuticals have their place in modern medicine, but it’s important to take a closer look at their overall role in treating pain over the long term. These recent discoveries place greater importance on treating the root causes of pain, in order to get patients off their medications as quickly as possible.
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