Rebelling Against Pharmacism: Subbing Cannabis for Opioids
Note: this is a work of creative non-fiction. While the events and activities are factual, a few different people contributed their medical cannabis experiences to this story. It is not meant to encourage nor recommend to anyone to do what is described here. The author is not liable for any actions readers may take as a result of reading this article. By proceeding to read, the readers agree to abide by this Do Not Try This At Home caution. The hope is that there will be more interest and robust discussions in how we use pharmaceutical products and criminalize ethnobotanical medicine such as cannabis and mushrooms except when pharmaceutical companies use them as ingredients in their products.
In April of 2019, I was crunching away on pistachios when I heard crunching in my skull instead of between my teeth. I knew this was trouble, so I called my friend, our friendly neighborhood dentist. He confirmed my fears as dentists often do and sent me to the oral surgeon next door, one of two maxillodental surgeons in town. If any of you have had the experience of getting a dental implant, which was what I chose over bridges and other more old-fashioned methods that would compromise my other good teeth, then you can believe that I laughed, actually laughed out loud when I saw the estimate.
I’m not going to go over the details of this exciting, latest, and beautiful thing in the history of dentistry. I want to tell you about the medications that were prescribed to me for pre- and post-op use. Let me explain first that my family was never much into medical anything. We hardly took any meds to the headache of the family physicians who prescribed them for high blood pressure and such. After all, what guilt trip would my mother have over me if her blood pressure was under control? The hospital was a place where we went to die. So when the dental surgeon’s office handed me the prescriptions for the pills, I was naturally skeptical.
For one, I was wary of opioids having known people who lost friends and family members to the scourge of opioid addiction. At that time, I did not know that a friend of mine would die from an overdose about a year later. Her husband had OD’ed and died two years earlier, and now their orphan kid would be raised by the grandparents. Naturally, I felt a sense of unease seeing two opioids on my prescription list. One was the pre-op relaxant and another for post-op pain control. A normal and reasonable patient would have trusted the doctor and filled them, but me, not so much. I did go to a pharmacy and, yes, the nurse had called in the prescription, and I could pick them up in 15 minutes. I asked the pharmacist if they were opioids, and he confirmed that they were. He told me that everyone reacts differently to medication. A reasonable thing to say. Some become addicts while many others would not. It might also help you understand my hesitation when I tell you that my mother was so afraid of drugs that she once told me that she would kill me herself if I ever touched drugs and that she brought me into the world and could also take me out. I still believe that she would reach out of her grave to do just that. I never went back to pick up the meds.
This left me in a bit of a quandary. I figured drilling into my skull, maxilla to be precise, would require some form of sedation especially, since I turned down the happy gas. The pain, I was not really worried about because I had dental surgery with anesthesia before getting my braces. In that procedure, the guy pulled eight teeth including four wisdom teeth, and I ended up throwing out the pain meds when they made me sick. Fortunately, marijuana was legal for medical and recreational use in California, and this seemed like the way to go. My grandfather was a compound chemist/pharmacist back when they made their own medicine as needed. My grandmother was an amateur horticulturist who foraged and brought home plants. When she used to visit over the summer, she would explain to me what medicinal qualities those humble weeds offered, the knowledge we were beginning to forget in favor of pills and tablets.
It was a natural progression that marijuana came up as alternative medicine. The next issue was how to obtain and figure out the dosage since I never really got into it before. Once my coworker and I split a brownie. While he was off to points unknown in his mind, I had felt nothing. I never developed any handy contact with the official medical cannabis providers, either. There were a few boutique dispensaries, but I was not ready to spend that kind of cash, a lot more than the cost of generic opioids. But living in California so close to Santa Cruz, I had a handful of friends who knew something about it. Someone gifted me a small amount of dried cannabis as a kind and generous favor, and my ethnobotany guide and I got to work.
We decided brownies would be the appropriate carrier. It’s easy to make and use if you can figure out how to make the green butter without burning or under-extracting it. We did some research and measured out a few things for the slow cooker. It was quite an experience like nothing I have ever cooked in a kitchen before or since. For one, there is a strong vegetal and medicinal odor to it. Then there is just this green and greasy mud. We froze it to make it easier to measure since that is important. It could have gone pear-shaped at any point, but about 24 hours later, we had some home-baked medicine. For many, it is just easier to go pick up pills, and why not. But there is a deep sense of gratification and even communal support when we do something like this together in cooperation. Popping pills alone in a bathroom just does not offer that. And this sense of connection is therapeutic on its own.
From my previous experience, I knew that I would have to eat a fair amount to get any effect. The result was that I fell asleep, and two hours later, my eyes opened to the ceiling over my bed liquidly cascading across the room. I was also groggy as I pulled my body into my friend’s passenger seat on my way to the surgeon’s office at crack of dawn.
The reception nurse went through the pre-op checklist.
“Did you get all the prescriptions filled? Did you take the pre-op antibiotics and relaxer med?” I answered yes to all of them while this was patently untrue. My consultation with recent research and recommendations on pre-op antibiotics strongly suggested that they were unnecessary (science classes are useful just so you know how to read medical journals and research papers.) I certainly did not take the opioid. I lied to the nurse because the possibility was high that the dental surgeon would refuse to operate on me if he knew that I failed to follow his instructions. Did I mention that I had to pay him the full amount before the procedure? I was not about to go looking for someone who would work with me on the no-opioid policy.
“You took just one?” She was referring to the pre-op relaxant because I must have looked deeply out of it. I answered in a short affirmative and shut my mouth before blabbing further. The nurse was looking at me, and I felt a touch of anxiety wondering if she knew I was under the influence of THC rather than opioids. Was she onto me? At the same time, it was in my favor that everyone would respond differently to a medication. If I was lying poorly, the pharmaceutical party line covered me well.
The procedure itself was a non-event, although it required drilling into my maxilla, drilling into my skull. My body required some weeks to recover fully. I kept a few medicinal brownies as backup pain management, but they were never needed. I gave them back to the person who donated the cannabis to my therapeutic needs.
I know that some people would say this was stupid, and I took an unnecessary risk for nothing. The prescription medications are supposed to be safe and efficacious and meet the standards set by a body of scientific professionals. It was my risk to take, and I chose to forego what I considered less salubrious. Medication has its time and place, but I also have the choice to take them or not. American Medical Association has a body of ethics regarding the patients’ rights. Honesty between the patient and physician is one of them. I did not feel that I could be candid with the doctor and the staff. I never felt that my decision to forego opioids would be respected.
Another consideration that stopped me was the widespread opioid addiction. The Center for Disease Control has a web page about opioid use disorder (it is a medically recognized condition now). While we debated the legitimacy of cannabis as medicine and its recreational use, people have been dying from opioids. According to the CDC, 841,000 people died from drug overdoes between 1999 and 2019. Out of 70,630 people who died from a drug overdose in 2019, over 70% died from an opioid overdose, and in July of 2021, the CDC released a report for 2020. In the year that was marked by severe quarantine, isolation, fear, and uncertainty, the deaths due to opioids increased by a whopping 30%. And my friend died in 2020 about two weeks into the lockdown. She was a single mother in recovery. She could not get to see her kid who was with the grandparents. In that dark place with no in-person support available to her, she overdosed.
That is why I am telling you my story now. We have a medical system reliant on pharmaceutical merchandise that creates addiction, and our society also treats the people who are addicted to them as if they are disposable. I do believe that pharmaceutical medicine has its use in a world full of complicated illnesses and conditions, but we ought to question what is prescribed to us. Any physician, family practice or obstetrics, can prescribe a psychiatric medication like anti-depressants without referring their patients for psychological evaluation. Our medical care delivery system has much to re-evaluate and improve. Many of us want the system to change, but for that to happen, patients have to take charge of their own health and judge what they want in their medical care. It’s about time medical science catches up with the legitimate efficacy of cannabis.
P.S. There is another story of corporate cannabis take-over, but that is for another time.
Resources
AMA Code of Medical Ethics: https://www.ama-assn.org/delivering-care/ethics/patient-rights
CDC Drug Overdose, Opioid: https://www.cdc.gov/drugoverdose/deaths/index.html
CDC OD Death Up 30%: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20210714.htm
