Why Doctors Need a Third Pain Management Solution

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By Steele Clarke Smith III

While the legalization of cannabis continues to be a hot topic, its origin in the United States is speculative at best. The issue wasn’t really an issue until 1910, when refugees of the Mexican Revolution began bringing it across the Mexico-US border. 

Four years later, the US federal government approved the Harrison Narcotics Act of 1914 to tax and regulate the distribution of opioids. A string of increasingly rigorous laws followed, including the Marijuana Tax Act of 1937, the Boggs Act of 1952, and the Controlled Substances Act of 1970. The Controlled Substances Act placed substances that Congress deemed hazardous or medically suspect into a category known as Schedule 1. This criminalized the use of cannabis, heroin, and LSD and made these substances difficult for physicians and scientists to obtain for research purposes. 

The criminalization of cannabis continued throughout the ‘70s, ‘80s, and early ‘90s, despite the fact that the Nixon-appointed Shafer Commission recommended removing it from Schedule 1 in 1972. It wasn’t until California Proposition 215 (also known as the Compassionate Care Act of 1996) that the regulation of medical marijuana started to change. In 2014, Colorado and Washington became the first states to legalize recreational cannabis and California legislation followed two years later. As of 2018, medical marijuana is legal in thirty states and recreational marijuana is legal in nine.

Of the nine states that permit both medical and recreational cannabis, California has the largest population of users.

To understand why the decriminalization of cannabis is important, it’s necessary to examine the role of pain relievers in the medical community. Briefly, “low-level” pain relievers (aspirin, ibuprofen, etc.) are only effective at pain levels one through two, while “high-level” painkillers (hydrocodone, oxycodone, etc.) are only safe for pain levels seven through ten, though they are often prescribed for lower-level pain. This means that, until the decriminalization of cannabis, there were no safe, legal alternatives for pain levels three through six. Patients whose pain fell within that range had only three options: to risk the dangers of opioids, to cope with the pain as best they could, or to buy cannabis illegally. Even now, with the legalization of cannabis, many people are understandably hesitant to self-medicate on unregulated doses of marijuana, legal or otherwise. The stigma of visiting a pot shop to buy dope, even from the most respectable dealer (a.k.a., “budtender”), is enough to make most people think twice about it. Doctor-regulated doses that are proportional to each patient’s need are as important for medical marijuana as for any other prescription drug.

Unfortunately, because of America’s “war on drugs”, organizations like the National Institute of Health (NIH) and the National Institute on Drug Abuse (NIDA) tend to focus more on the abuse of cannabis than on its benefits. Despite these setbacks for the scientific and medical communities, research on the subject has managed to progress. Recent studies reveal that the human body produces receptors known as Cannabinoid #1 (CB1) and Cannabinoid #2 (CB2). When these receptors aren’t functioning properly, it leads to a variety of health conditions collectively referred to as Clinical Endocannabinoid Deficiency (CECD). CECD can result in serious, persistent health concerns and psychological disorders such as anxiety, depression, insomnia, migraines, nausea, fibromyalgia, irritable bowel syndrome (IBS), and other chronic aches and pains.

Fortunately, research confirms that cannabis can reproduce the benefits of CB1 and CB2, while minimizing the negative side effects of opioids, including dependency, depression, euphoria, incoherence, constipation, and/or loss of appetite. The ability to administer cannabis in measurable doses is a major innovation. That’s why cannabis pharmaceuticals are making so many waves in the health community. Thanks to prescription-only cannabinoids, healthcare professionals finally have a safe, holistic way to monitor and alleviate “mid-level” health concerns between levels three and seven. These primarily fall into one of four categories: chronic pain, nausea (specifically related to oncology and chemotherapy), insomnia, and psychological disorders like anxiety and depression.

Thus, prescription cannabinoids effectively treat a wide range of health concerns caused by CECD and fill a gap in the healthcare community. As a prescription-only medication, administered orally in tablet form, patients are guaranteed safe, reliable doses that can be easily divided into smaller amounts, eliminating the stigma and the dangers of smoke-inhaled cannabis. As ongoing healthcare reforms again restructure US health services, pharmaceutical cannabinoids have the potential to become the next generation of prescription medications.

Steele Clarke Smith, III is CEO of Idrasil®, the first standardized form of medical cannabis available as a prescription.

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