Cannabis Use in Pts Rx'd Opioids

[DigableCat]

Were any of these MJ in isolation? I would suspect polysubstance overdose in most, if not all cases.

I was actually skimming the report as I was suspecting the same thing.

Drug Abuse Warning Network, 2007:
Area Profiles of Drug-Related Mortality

It's a big file. But from what I've been seeing, it's a multidrug effect phenomenon.

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[Aether2000]

No, these were the cases where MJ was the only drug detected. The idea that MJ does not kill people is a silly urban myth frequently perpetuated by NORML and other groups hell-bent on decriminalizing this potent psychoactive drug that also has cardiovascular and carcinogenic effects.

 

[mille125]

This is a fundamental issue in organized pain medicine.

We can argue standards of care, but we cannot argue the federal law. If the government makes smoking, possessing, etc of MJ a crime, and we are responsible for the oversight of patients (YES WE ARE) that we are prescribing opioids for, then it becomes our responsibility to society to ensure that all safety measures are incorporated. I stand with Algos and believe if a physician threatens to endanger the public by poor prescribing habits, they need to do something else.

Smoke all the weed you want, just not while I am your responsible provider.

i also stand strongly by algos and steve on this issue

 

[DigableCat]

No, these were the cases where MJ was the only drug detected. The idea that MJ does not kill people is a silly urban myth frequently perpetuated by NORML and other groups hell-bent on decriminalizing this potent psychoactive drug that also has cardiovascular and carcinogenic effects.

Now are we talking about THC(i.e. overdose) specifically, or deaths directly attributable to the use of MJ?

 

[Intubate]

Heroin is a schedule I because it has no currently accepted medical use in treatment in the US.

Off topic, but interestingly, diamorphine (heroin) is used extensively in Europe perioperatively, even in obstetrics. It has great properties for perioperative pain.

 

[mid|ine]

Off topic, but interestingly, diamorphine (heroin) is used extensively in Europe perioperatively, even in obstetrics. It has great properties for perioperative pain.

Not only Europe, but most of the rest of the world. There is nothing fundamentally different about diamorphine/heroin vs other narcotics. Its purely a historical issue in the US.

I doubt anyone can show a single case of a THC overdose leading to death. Its a mixed agonist/antagonist with ceiling effects. Yes, driving under the influence is deadly, but no different then EtOH. Its nearly impossible to show if a suicide was due to a person smoking MJ, leading to depression and suicide or if the person is depressed, self medicated with MJ and then still committed suicide. Much like the studies that look at the "gateway theory". X% of heroin users smoked MJ first, therefor MJ leads to heroin use??? 100% of heroin users drank water first, clearly water consumption is more related to heroin abuse!

Personally, I believe in a very limited use of narcotics for treating chronic pain. I am unsure of the role of various THC analogs in medical treatment. I will not Rx opioids to anyone with current MJ use (or any other illegal). Nor will I Rx to anyone with a hx of substance abuse. Very unlikely to for anyone that smokes (substance abuse). I take a hardline when protecting myself and my license, but I am very surprised that anyone here is buying the poor "science" used by the government to justify keeping MJ illegal. Its a waste of our tax payer dollars. Legalize, regulate and tax it.

 

[DigableCat]

Deaths included in the DAWN SURVEY

(1) Drug-related deaths (other than drug-related suicide deaths) include the following:
Natural or accidental deaths with drug involvement These two categories capture deaths involving medical use, nonmedical use, overuse, and misuse of prescription and over-the-counter medications and drug abuse.
Homicide by drug.
This category was designed to capture malicious poisonings; that is, the decedent was administered a drug(s) by another person for a malicious purpose.
Deaths with drug involvement when manner of death denoted by the ME/C was “could not be determined” (CNBD). This manner of death is assigned by the ME/C when a definitive ruling of suicide, homicide, natural, or accidental death is not possible.
(2)Drug-related suicide deaths include suicide deaths with drug involvement. The determination of suicide is made by the ME/C. Because of the broad eligibility criteria for determining DAWN cases, drug-related suicide deaths include more than deaths due to overdoses. A reported drug may not be the cause of the suicide death even if only one drug was involved. Drug(s) must be a contributing factor, though.

Limitations to data
Not every reported substance (drug) is, by itself, the cause of death or even a contributor to the death. DAWN’s broad definition of drug involvement requires only that the drug is related to the death. Therefore, even in single-drug deaths, reported drugs may not be a direct cause of death. Furthermore, incidental reporting (i.e., reporting of drugs unrelated to the death) is unavoidable due to ambiguities and insufficiencies in the ME/C’s records.

 

[lobelsteve]

I agree with legalize, regulate, tax.
And the tax should go for detox/rehab program funding.

But until then....commit a crime that places my license and registration at risk, I'm going to protect myself.

 

[Aether2000]

DAWN is indeed a government survey, but data is data, even with its limitations. The fact that it is a national network sponsored by the US government does not make it automatically a tool of those trying to keep MJ illegal any more than those using the data in an attempt to curtail the use of opioids in the treatment of chronic pain. Unless we have other bona fide data to present, this is as good as it gets, and deference must be given to the data. That being said, I am definitely in favor of developing government licensed fields for growing marijuana, assay the drug for potency and purity, tax the hell out of it, and do the research that would prove its safety and medical effectiveness, and develop delivery systems where the drug cannot be smoked so the effect can be regulated. But until the US government legalizes MJ, we cannot tacitly approve its use in our patients because it is not "medical marijuana", it is a street drug.