Medicinal Cannabis: A Therapeutic Alternative for Management of Chronic Pain in older Australians

 

Pain has been described as a fundamental and universal human experience, and thus access to effective pain relief should be regarded as an essential and universal human right.1

Chronic unremitting pain has become a grave problem in modern civilization.

The human toll associated with chronic pain is massive, and is linked to considerable economic impact, including an enormous Health Service utilisation burden. 2-3

It could be perceived as perhaps quite paradoxical that people who do not have a condition that is life restrictive, but who suffer chronic pain, receive lesser efficient and effective means to successfully manage their pain. Hence the permanent nature of their pain creates enduring suffering and debility, which may, in some cases, encompass a period of time that could feasibly be decades.

With respect to the incidence of chronic pain among the older population, there are abundant indications confirming older Australians continue to suffer considerably, and this has a drastic impact on their future and quality of life. 4-7

‘Duty of care’ is considered an area never to be compromised as per the code outlined by the Hippocratic oath that all medical professionals are supposed to uphold.

The foundation of this oath is: “DO NO HARM”.

Thus, every person has an integral right to the provision of the finest treatment possible to alleviate any form of suffering endured from chronic, relentless, excruciating pain.

Potent opioid analgesics, are widely prescribed for older Australians in chronic pain, yet these agents are associated with the highest degree of drug-related harm.

It has been surmised that up to 73% of older people on opioid regimes are NOT receiving effective pain management!!!!!

It is therefore illustrated, there is an urgent need for an alternative approach.

Given the high prevalence of chronic unrelieved pain in the aged, this should be regarded as a matter of “high priority and focus”, of which we are duty bound to honour.

The potential benefits of medicinal cannabis in treating poorly managed intractable chronic pain is considered a beneficial alternative approach to enhancing quality of life, and maximizing comfort and well-being in Australia’s older population!!!!!!!!!!!!!

Otherwise are we not condoning neglect?!?!

In supporting the concept of a compassionate and empathetic culture, it is time for us to avoid and negate the subjective views based purely on stereotypical interpretations of street cannabis.

Bureaucratic law is enabling a gross injustice to transpire against our population in need, by continuing to construct negative viewpoints related to outdated, propagated rigid regulations, intentional barriers and stigma.

This is institutionalised bias at its worst and should not be tolerated!!!!!!!!

Is it fear of the unknown stopping Australia’s Government from legalising a natural medication, that exhibits less risks than countless prescribed drugs handed out daily, or is it fear that some of the public may judge political decisions of this nature as a negative because of their own rigid views??

This topic really should not be creating such division in society due to political correctness.

The bottom line is, we ought to be analysing the product only in relation to its efficacy in alleviating suffering for specific conditions, hence basing it on the necessity of promoting a civilised and humane philosophy of care for our society.

If preferred pharmaceuticals and other methods of treatment have demonstrated persistently, to be unsuccessful in treating a person regarding their specific conditions, it seems again, neglectful not to consider and utilise a medicine that may alleviate the issue and ensure comfort and relief.

Well-being of our older population should ultimately dominate all decisions.

Thus, it is crucial we examine the genuine medicinal usefulness, (currently being ignored), and embrace the numerous and substantial benefits of medicinal cannabis as a viable alternative.

Excruciating, relentless, debilitating chronic unmanaged pain cannot be condoned!!!!!!

The frequent and significantly hazardous and destructive adverse effects associated with opioids are detrimental to living risk free, as they habitually and predominantly affect mood, conscious thought, judgement, may create hallucinations and delusions, alter cognition, and affect mobility.

Although all medications have adverse effects, medicinal cannabis is unlikely to be associated with side effects of the dangerous severity of those arising from opioid use, so cannabis may be considered to be a safer and less harmful option than heavy and extended use of opioids.

Furthermore, withdrawal symptoms may be considerably less than with heavier compounds such as opiates, may limit and prevent the probability of accidental death/fatality, and consequently should be considered a beneficial alternative.

Side effects are evident in majority of mainstream drugs in the current market, just as there are people who exhibit allergic reactions, intolerance, and/or have the predisposition of an addictive background.

These factors are managed and reviewed ongoing during the commencement of any pain management regime, and have long been a regulated method of monitoring medications, understanding hazard management and avoiding any circumstance that may pose risk of abuse or misuse to the patient.

Precise strains, developed as a medicine, in specific measured doses and reproducible formulas, are also reinforced with all medicine, as the aim is to avoid or prevent elements of high risk.

Thus, it seems quite simple to consider that when prescribing medicinal cannabis for chronic pain, the same existing frameworks and regulatory compliance methods could easily be implemented, and utilised to minimise peril.

Consequently, the argument in regard to safety and risk of medicinal cannabis is ultimately void.

It should not be this complex!!!!!!!!!

It is essential we prioritise those who require urgent management of their suffering, thus reinstate a meaningful life to those who live in chronic, unremitting, daily agony.

In accordance with the introduction of any new medicine, an educational scheme needs to be instigated for all Medical Practitioners and Specialists who shall prescribe medicinal cannabis.

Adequate knowledge is crucial in providing information regarding the most superior available cannabis medicine best used for the treatment of chronic pain in the older population, prescription methods and preferred forms of administration.

Then prescribers may easily regulate and monitor as per proper process and regulatory compliance.

Furthermore, there can be no excuses based on ignorance once people are well educated.

It seems that the law continues to complicate an issue that admittedly requires careful consideration, but is not as intricate as it seems.

The negative impact current rigid ideals have on this area, remain evident.

Australians cannot ignore the progression of other countries, since by disregarding this evidence, we postpone the capacity to assist our older population in the present, and therefore prolong their suffering if we do not act accordingly.

Surely if Australians are not bound by old archaic ideals, we can initiate a successful strategy that enables us to follow in the footsteps of other forward-thinking countries who have successfully introduced the use of medicinal cannabis as a therapeutic pharmaceutical to benefit the population who require it.

There can be no excuses in permitting the continuation of a system that disregards the needs of those who deserve the benefits of medicinal cannabis to assuage pain and misery.

Time is not always on the side of those who agonize, thus we do not have the right to ignore this potentially lifesaving treatment, disregarding the unending suffering of older Australians.

The harsh ramifications of these decisions are discriminating and negligent.

This argument is so compelling it cannot be ignored.

We must challenge why people continue to waste valuable time overthinking and demonising the healing properties of cannabis.

Let us make a stand and give a voice to and advocate for more empathetic approaches that will benefit our population, alleviate suffering and maximise dignity, value, and quality of life.

We cannot tolerate this unacceptable ongoing cruelty to humanity!!!!!!!!!!!!!!

“Consider, the present alternative, which is, we continue ignoring the significant benefits of cannabis, and refuse to contemplate the countless areas where traditional medicine is ineffectively managing critical conditions. We must provide a united front in advocating medicinal cannabis as an innovative solution and way forward within the convoluted realms of modern medicine by challenging and dispelling the myths and attitudes associated with cannabis, and reinforcing, what we have recognised as the beneficial attributes associated with this natural plant”.

© Leah Bisiani – Uplifting Dementia: Oct.2017

 

Leah Bisiani – MHlthSc/Dementia Consultant/RN.1

“Uplifting Dementia” 30.10.2017

Uplifting Dementia

 

 

References:

  1. Brennan F, Carr DB, Cousins M. Pain management: a fundamental human right. Anesth Analg. 2007; 105: 205 – 21
  2. Dworkin RH, Panarites CJ, Armstrong EP, Malone DC, Pham SV. Health care utilization in people with postherpetic neuralgia and painful diabetic peripheral neuropathy. J Am Geriatr Soc. 2011;59(5): 827–836
  3. Breivik H, Eisenberg E, O’Brien T. The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care. BMC Public Health 2013; 13: 1229
  4. CK Tan E, Jokanovic N, PH Koponen M, Thomas D, N Hilmer S, Simon Bell J. Prevalence of analgesic use and pain in people with and without dementia or cognitive impairment in aged care facilities: a systematic review and meta-analysis. Curr Clin Pharmacol 2015; 10: 194 – 203
  5. Teno JM, Weitzen S, Wetle T, Mor V. Persistent pain in nursing home residents. JAMA 2001; 285: 2081
  6. Fox PL, Raina P, Jadad AR. Prevalence and treatment of pain in older adults in nursing homes and other long-term care institutions: a systematic review. CMAJ 1999; 160: 329 – 333
  7. Takai Y, Yamamoto-Mitani N, Okamoto Y, Koyama K, Honda A. Literature review of pain prevalence among older residents of nursing homes. Pain Manage Nurs 2010;11: 209 – 23

 

 

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