The Human Face of The Opioid Epidemic And How Cannabis Can Help

You [expletives] still didn’t get the job done! Just let me die!”


Those were the words of 43-year old Timothy Dillon, as he lay bleeding on the ground after being shot by police, following a five-hour long standoff where he threatened to shoot the officers, goading them to kill him “Let’s get this over with.” Instead of getting it over with and killing him, as Dillon had hoped in an attempted ‘suicide by cop,’ deputies administered first aid and saved his life, allowing him to “still hold [his] wife, hug [his] daughter and [his] son.”

Dillon suffers from severe chronic pain caused by injuries to his back and neck from being hit in two car crashes, in 2008 and 2010. While surgery can be beneficial for some, it did not help relieve Dillon’s pain. As a result, a doctor prescribed him highly-addictive opioid painkillers, such as Oxycodone, but soon even they could not help with Dillon’s intense pain. Dillon was desperate and tried to use alcohol and cannabis to wean himself off of the “far more dangerous” opioids he had been prescribed. Unfortunately, Florida’s medical cannabis program only allows for CBD-rich cannabis and is still dysfunctional, leaving Dillon no choice but to violate both state and federal law in pursuit of a less harmful medicine.

Eventually, Dillon “became desolate and wanted to die because he felt like he was failing his family and friends and could no longer bear the pain.” That was when he took to drinking heavily one fateful Saturday afternoon, threatening to take his own life while “friends tried helping.” Dillon alternated between having a “revolver pointed to the side of his head” and “shooting rounds into the floor,” a very threatening display given that he is known to be an excellent marksman and is a member of the National Rifle Association (NRA). Despite his firing numerous rounds, Dillon was the only person injured during the stand off. When interviewed at the hospital the next day, he had little memory of the day before, indicative of him being black-out drunk or otherwise not in a sober state of mind.

During trial, Senior U.S. District Judge Kenneth Ryskamp referred to Dillon as being suicidal and “totally out of his mind” at the time of the altercation, calling the whole ordeal “very unusual circumstances.” Though Dillon admitted to using cannabis and alcohol to wean himself off opiates Judge Ryskamp was understanding as they are much less dangerous and addicting than opiates. In the end, Judge Ryskamp ruled that nothing “about this case that warrants incarceration,” and instead gave Dillon three years of probation, a hefty $10,000 fine, and mandatory mental health and substance abuse counseling.

When he recently spoke to the Sun Sentinel, Dillon told them he has been clean of drug abuse for nearly three years and “now uses yoga and other non-pharmaceutical methods to deal with his pain.” While the leniency shown by Judge Ryskamp in Dillon’s case is admirable, and also scientifically accurate as opiates are unarguably more deadly than cannabis, it is worth noting that judges are not doctors and perhaps we should not advice on the relative safety of drugs from people who are not medical experts.

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Photo credit: Tim Pierce, via Flickr

Senator Elizabeth Warren to the Rescue:

Elizabeth Warren recently penned a letter to Dr. Thomas Friedan, Director of the Centers for Disease Control, alerting him to the harsh reality of the opiate abuse epidemic, and discussing cannabis as a potential alternative treatment for pain. In her letter, Warren called for the CDC to collaborate with the NIH, SAMHSA, and the DEA to fill in the gaps in our knowledge regarding five main areas. First, what is “the long term impact of opioids have on children treated at a young age?” Second, investigate the “use, uptake, and effectiveness of medical marijuana as an alternative to opioids for pain treatment in states where it is legal.” Third, find out “the impact of the legalization of medical and recreational marijuana on opioid overdose deaths.” Fourth, explore why there is an “increased use of fentanyl” and figure our the sources for its distribution. Finally, determine “how fentanyl may be contributing to opioid overdoses and deaths.”

According to the Centers for Disease Control, “In 2014, 61% (28,647) of drug overdose deaths involved some type of opioid, including heroin,” making opioids the most lethal type of drug commonly prescribed and illegally used. Since it is practically impossible to overdose on cannabis, it should then come as no surprise that deaths from opioids are down by 25% in medical cannabis states. Cannabis doesn’t just lead to less overdoses, it also leads to a better quality of life free from chronic pain. A 2016 study found that using cannabis for treating chronic pain “resulted in improved pain and functional outcomes, and significant reduction in opioid use.” That same study drew attention to the numerous side effects caused by opioid use, including increased risks of “endocrinopathy, bowel dysfunction, cognitive decline, hospitalization and death from overdose.” This study came one year after a massive meta-analysis of the available research on cannabis use for treating pain found “moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity.” Clearly, Senator Warren has some solid factual grounds for calling for the CDC to investigate the use of cannabis for chronic pain.

Much of Senator Warren’s letter has to do with the legally prescribed and often illegally used opioid fentanyl. For those who don’t know what fentanyl is, it is an opioid like heroin, but it is “up to 40 times more powerful than heroin.” That means it is much easier to overdose on fentanyl than on heroin; especially if the user isn’t aware that their heroin is actually fentanyl and takes their normal dose, leading to an overdose. A batch of heroin tainted with fentanyl is believed to be what led to Portland seeing 14 overdoses in only 24 hours, resulting in two deaths. More recently, a homeless black man named Jeffrey Pendleton was arrested for possession of cannabis and was being held on $100 bail in debtor’s prison, only to be found dead several days later from a fentanyl overdose. One can only suspect how a man with no known history of fentanyl abuse would obtain such a drug while in police custody.

Senator Warren Makes an Impact:

After receiving Senator Warren’s letter, the CDC has already acted to implement new opioid prescription guidelines to family practice doctors. Jacob Sullum, senior editor at Reason Magazine, has a sage analysis of the new rules finding them to include “some sensible precautions, such as warning patients against mixing opioids with other depressants, avoiding dual prescriptions of opioids and benzodiazepines when feasible, and providing naloxone, an opioid antagonist that reverses the effects of an overdose, to patients taking large amounts of painkillers.” Sullum’s analysis is not all positive and includes a strong warning to anyone using medical cannabis with opiates to treat their pain, “The CDC … recommends interrogation and urine testing aimed at discovering illicit drug use, ostensibly to inform clinical decisions.”

Illicit drug use can also include cannabis use; remember the unfortunate story of Norman Smith, the medical cannabis patient who was recommended cannabis by his Cedar Sinai doctor only to have his surgeon remove him from the transplant list for his drug use, leading to his untimely death. Norman’s death was one of the many human stories that moved the California legislature and Governor Jerry Brown to pass AB 258 last year, making California the only state to give medical cannabis patients protection against discrimination in receiving organ transplants. It’s still too early to tell if the CDC’s new rules will be enough to fend off America’s opioid epidemic. One thing is certain, their new rules mention nothing about medical cannabis, so it seems that part of Senator Warren’s letter fell on deaf ears.

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