By Paula & Oro Cas
Catch-22: A dilemma or difficult circumstance from which there is no escape because of mutually conflicting or dependent conditions.
I sit looking at this document wondering how to write about the craptastic Catch-22 that has appeared in my husband’s life. My husband is one of the millions of people who suffer with chronic pain. His journey to where he is today began 35 years ago when he worked for a traveling carnival. While working to repair a ride, the clutch holding the ride’s car opposite the repairmen failed sending the cars around the track. Hubby and two other workers fell 50 feet resulting in multiple fractures and life threatening injuries. Combine those injuries with 30 years of commercial truck driving, a near fatal lightning strike resulting in damage to his nerve sheaths and joints, along with degenerative disk disease, stenosis, scoliosis, and osteoarthritis … We have a perfect storm of chronic pain.
Three years ago, the dying disks in his spine drove him to seek medical relief from the pain. Many X-rays, MRIs, Physical Therapy later, he was referred to a pain management clinic. That began a regime of steroid shots, that only offered short periods of relief, narcotics, and a plethora of ‘let’s try this drug for your inability to sleep, and that drug for neuropathy, and this drug for nausea caused by these others’. It was throwing drugs at the problem to see what stuck. All that stuck was the rapid loss of 30 pounds. At 6’1”, 160 pounds, losing that much weight has added other problems into the mix.
The pain clinic started him on a low dose Fentanyl patch. Every few months the dosage had to be increased to receive the same amount of relief from the pain. Though the patch gave consistent pain relief, we like to go camping, and gold mining as physical limitations allow, there was a fear the patch would become wet and release all the Fentanyl at once, so he switched over to oral medication. Hence, we reached our first hurdle.
From past surgeries, he knew his body did well when he took OxyContin or Demerol. It put less stress on his organs and allowed him to function at a near normal level. Insurance company says, ‘due to recent changes in our policies … Blah, blah, woof, woof, we won’t pay for OxyContin for pain management. Pick something else from the formulary’. Not having $400 to pay for a month’s prescription, we ask the pain clinic for their next recommendation.
The next “let’s try” was Morphine. The insurance company will pay for Morphine all day long. He started on a low dose taken once a day, which quickly changed to a higher dosage twice a day. That was where we stayed until his February 2018 appointment where we were told by the pain clinic they could no longer prescribe narcotics for my husband’s pain. I know your next question is going to be, WHY would they do that?
The answer to that question is … My husband is a user of Medical Cannabis. He found that certain strains of indica in combination with his Morphine leveled out his pain where he could begin to move more … Walk the dogs occasionally … Putter around in his shed for an hour. Life was beginning to look better, and we put away thoughts of back or neck surgery.
“This paper, entitled ‘Role of the Cannabinoid System in Pain Control and Therapeutic Implications for the Management of Acute and Chronic Pain Episodes’ explains how cannabis helps manage pain more thoroughly, but to give the gist:
Cannabis regulates nociceptor thresholds. Nociceptors are receptors in the body that detect pain.
Cannabis also acts on non-nervous tissues as well as nervous tissues, which is why it can be so helpful for so many different types of pain, whether physical, mental or emotional.
THC and CBD can help control the pain signals being received by nociceptorsCannabis can inhibit the release of proinflammatory factors by non-neuronal cells.Cannabis Indirectly stimulates opioid receptors, in particular μ-opioid and δ-opioid receptors.Cannabis can also work synergistically with opioids as well.THC works on the endocannabinoid receptors, whereas CBD works on the vanilloid, serotonin and adenosine receptors and the endocannabinoid receptors in a less direct way.” … Cannabis Culture, August 18, 2017
Now, we have always been honest with his medical professionals about his use of Medical Cannabis to help manage his pain. It was not until his appointment in February 2018, to get his prescription for Morphine renewed that we encountered a problem.
The physician’s assistant at the National Spine and Pain Clinic informed us that in order to keep their Federal license issued by the DEA, they could no longer prescribe narcotics to the users of Medical Cannabis even though Medical Cannabis is legal in our state. During past appointments, the pain clinic used urinalysis to check the level of narcotics in his bloodstream. Due to policy changes to retain their narcotics licenses, they would also be testing for presence of Cannabis. Not wanting to give up the relief he received from Cannabis, my husband asked what the treatment plan for him would be if he continue using Medical Cannabis.
He was told he could have one more month’s prescription for Morphine, but they would cut him down from twice a day to once a day as their way to step him down off the narcotics. He was also given Gabapentin. Gabapentin is an anti-epileptic drug, also called an anti-convulsant. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain. There is a long laundry lists of side effects and contraindicators with this drug along with the fact that it blocks the brain from producing new synapsis in the brain.
“A shocking study shows that these two drugs (Gabapentin and Lyrica) block the formation of new brain synapses, drastically reducing the potential for rejuvenating brain plasticity – meaning that these drugs will cause brain decline that apparently robs one of the ability to rebuild. The study demonstrating this type of brain damage with these two drugs came out in 2009 but apparently the media has been very lax in getting any of this information to the public – most likely because they do not want to jeopardize their advertising income from this company.
But the patients are not the only ones not getting this information because the doctors are apparently clueless as well. I say that because first our Facebook group for these two drugs “Neurontin (Gabapentin) & Lyrica (Pregabalin) Should Be Illegal” is growing so quickly.
Neurontin is an anti-seizure medication and that the company had received two huge fines, totaling billions, from the FDA for prescribing it for anything else. And in 2010 they were even found guilty of RICO, yes racketeering, for encouraging doctors to prescribe this drug off label – for things it is not approved for-like pulling a muscle in your back! Then I shared with him the information in this study indicating the brain damage from the drug at which point he understandably decided not to take the drug.
Although I have included the full article on this below this is the link to the article which you need to follow to find the full research study if you want to take it to your doctor to educate him: https://www.wellnessresources.com/news/neurontin-and-lyrica-are-a-death-sentence-for-new-brain-synapses#ref1” … Ann Blake-Tracy
Needless to say, the abrupt withdrawal from the Morphine, the constant hungover feeling caused by Gabapentin and the elevation in his pain levels have curtailed the few improvements we gained in his quality of life. We are now dealing with withdrawal symptoms, (made worse by improper step-down procedures advised by the pain clinic,) increased pain levels, increased number of steroid shots in the spine and neck that are having less and less effect, and have booked appointments with the surgeons.
What I take away from our interactions with the National Spine and Pain Clinic is that they’re only interested in what doesn’t endanger their ability to write prescriptions for narcotics. They have no good plans in place for people that were using Medical Cannabis in order to keep from having to constantly increase their dosages of narcotics and becoming another casualty and statistic in the Opioid Crisis.
It’s time for the Federal Government to show more concern for the citizens of this country who are in need of the benefits of Medicinal Cannabis rather than being influenced by the political power of big pharma and big oil.