Dr. Donald Abrams Compares Cannabis To Opiate-based Medicines
Donald Abrams, M.D. explains he first learned how medical marijuana helped patients in various ways through many studies – dating back through the 90’s. Dr. Donald Abrams is the Chief of Hematology-Oncology at San Francisco General Hospital, as well as Professor of Clinical Medicine at the University of California, San Francisco.
Transcript: So the next research that we did was to answer what I think is probably one of the more interesting questions and that is, is there an interaction between opioids and cannabinoids in pain relief.
So we took a group of patients who were on a stable dose of either long acting oxicodone or long acting morphine and we measured the level of the 12-hour release drug in their blood stream before and after 5 days of vaporizing cannabis 3 times a day. And what we found there was, interestingly, that the plasma levels of the opioids, either oxicodone or morphine, were actually decreased in the patients after exposure to the cannabis. But their pain relief was increased. So that’s somewhat paradoxical.
But my colleague who is a pharmacologist, says that what we are seeing is a so called a phamaco dynamic effect as opposed to a pharmaco kinetic effect. If the cannabis had boosted the plasma levels of the opiods and lead to decrease in pain, that would have been a pharmaco kinetic effect. But instead, by some other mechanism, the cannabinoids allowed for more pain relief at lower plasma levels.
So what does this mean?
It means for people who have pain who are on opioids, they may be able to take lower dosages, the same dosage for a longer period of time and they may have decreased side effects. Because as you know, opioid side effects include nausea, which cannabis can help, constipation, may people think cannabis also helps constipation.
For me I think one of the tricky parts about this , that I am aware that in some of the government hospitals, the VA hospitals for example or other military facilities. That patients that are on chronic opioids have to have a negative urine test for cannabis before they can get their drugs. And that seems a little short sighted because people may actually be boosting the effect of their pain medication by using cannabiniods in conjunction. YouTube Video