Cannabis for back pain puts him in a pickle
Dear Dr. Zorba: I enjoy your radio show. I’m a 56-year motorcycle guy. I had an accident when I was much much younger, and the result has been years of back pain every day — some days good, some days bad.
I don’t like prescription pain killers because of side effects. That’s why I’m using cannabis. It doesn’t fog me up; it doesn’t constipate me. But it’s illegal in my state. What to do? — RK from Milwaukee
Dear RK: You are in a pickle aren’t you? Our state is not like 23 others that have approved this for medical use.
If you get marijuana, then you do so illegally. If you’re caught, you might get prosecuted. And besides that, when you buy illegal drugs, you are interacting with a dealer and probably supporting a Mexican drug cartel.
Awful, isn’t it?
Now, if a doctor wrote you a letter saying marijuana use is OK for medical purposes, that wouldn’t matter. We can write for a prescription narcotic that can kill you, but not a substance that just gets you stoned.
How many people die from marijuana? Outside of car crashes, I venture very, very few — unless you happen to be texting while driving.
Many of my physician colleagues say that if a patient is taking any illegal substance while on a prescription narcotic, they’ll toss them from their practice. I completely understand that when it comes to heroin or cocaine, but marijuana? It’s closer to a couple of drinks than it is to shooting up.
A lot of back pain is neuropathic, caused by misfiring nerves. Recent research out of Alberta, Canada, showed that many patients given opioids for back pain may have a reduction in their pain but they don’t function any better.
We have other drugs that work for this type of pain — the seizure medication Gabapentin, for example — but we should be testing marijuana to see if that works. The reason we’re not doing so is because of old-fashioned, outdated federal and state laws that are not patient-oriented.
My spin: Pain is complex. One drug may not work for all. Sometimes society’s laws can get in the way of the best treatment.
More on e-cigs
Many radio listeners have chimed in that e-cigarettes are useful to quit smoking. They have helped them kick butt. In my regular practice I haven’t seen that. I have seen patients cut down, but I have seen few stop. It’s become more of a crutch than a cure.
Recent research out of California published in the prestigious journal The Lancet bears this out. They found that e-cig users were 28 percent less likely to quit than smokers who went cold turkey or used nicotine gum or prescription drugs.
This confirms the opinion of the U.S. Preventive Services Task Force, which found insufficient evidence to recommend e-cigarettes as a device to quit smoking.
Smoking is clearly one of the worst things you can do to your body. I was a smoker in college so I know how hard it is to quit. I have never completely lost the desire, though it rarely surfaces. But give me a cheese-and-sausage thin-crust pizza and a Coke and I can taste a Marlboro — and I quit in 1969.
So anything that will help people quit smoking should be available. I think e-cigarettes do help some, but for others they just draw out the misery.
Combine that with recent research that shows some e-cigs have heavy metal toxic chemicals and I would think before I’d use them. Buyer beware. Stay well.
Dr. Zorba Paster is a family physician, professor at University of Wisconsin School of Medicine and Public Health, and host of the public radio program “Zorba Paster on Your Health,” which airs at noon Wednesdays on 91.1 FM, and noon Sundays on 91.9 FM. His column will appear twice a month in The Spokesman-Review. He can be reached at askzorba@doctorzorba.com.