Here at Vitality Biopharma, we are at the forefront of creating new cannabinoid pharmaceuticals, which are known to provide substantial pain relief. We believe these drugs will ultimately prove to be very potent and far safer than the options in widespread use today. In part, we aim to deliver this through site-specific delivery, which enables cannabinoids to be delivered directly to the site of disease without THC entering the bloodstream and brain, thereby avoiding its psychoactivity.
Opiates are one of the key classes of drugs we’re seeking to replace, or to make far less necessary, as our proprietary cannabosides could provide a potent alternative form of pain relief and help avoid, or greatly reduce, the use of opiates for the treatment of many conditions including inflammatory bowel disease (where 70% of patients now regularly receive opiates upon hospitalization).
So while it’s with some commercial interest that I write here about the awful effects of the U.S. opioid epidemic and prescription drug abuse, it’s also written as a topic of serious personal interest to me, as a parent, and as someone who lost a young cousin to an overdose within the past few weeks.
Last year, there were 47,055 Americans that died from drug overdoses, and opioids were involved in 61% of these cases. Since 2013, the rates of drug-overdose deaths have exceeded the number of deaths from car accidents. This is not uniquely an American problem, but the U.S. uses an astonishing 80% of the world’s opioids, while representing only 4.6% of the world’s population. The New England Journal of Medicine has just written that the rising death toll has been rivaled in modern history only by that at the peak of the AIDS epidemic in the early 1990s.
Opiates are incredibly potent pain relievers, and that’s why they’re on the WHO List of Essential Medicines. They are a panacea for patients with severe traumatic pain or dealing with end-of-life care. But in recent years there has been widespread use and abuse of them. There has been a 10-fold increase in the medical use of opioids in the last 20 years in a movement towards aggressive management of pain. Opiate addiction is in the news again recently, with the death of famed musician Prince linked to fentanyl, and reports from Cincinnati in the last two weeks where 174 heroin overdoses occurred in 6 days, when street heroin was mixed with powerful synthetic opiates like fentanyl and carfentanil. More than 2.4 million Americans now have a severe opioid-use disorder, which includes dependence on heroin and also prescription opiate drugs that are known by many names including fentanyl, morphine, hydrocodone, OxyContin, Vicodin, Codeine, Percocet, and illicit “street” versions of these same drugs.
In an effort to help reverse this trend, a remake of the 80’s public service announcement showing “Your Brain on Drugs” with an egg and frying pan has been released, along with a variety of resources that describe additional forms of prescription drug abuse. The new version also includes questions that kids are asking their parents these days, which they need to be prepared to answer. The first one is “Prescription drugs aren’t as bad as street drugs, right?”
The incidence of heroin initiation is 19 times higher among those who report prior abuse of pain medications (talk about a “gateway” drug). Studies have shown that today about 75% to 86% of heroin users started with prescription opioid pain relievers. So the first exposure to opiates is far more likely to come not from heroin (as was overwhelmingly true in the 1960’s), but rather from prescription drugs.
Beyond that, there’s startling evidence that opiate addiction may often originate simply by following your doctor’s orders, i.e. not from prescription drug abuse, where the prescription drugs were obtained illegally or misused, but through addiction after receiving and following a legitimate prescription. A 2012 Canadian study showed that 22% of people who were prescribed opioids by their doctors for long-term pain management started abusing the pills. Especially for people at high genetic risk of addiction, giving them even a short dose of prescription opiate medications may be too much for them to handle, like giving them a loaded gun without any training or warning. Doctors are increasingly aware of this, and some are pleading with their physician colleagues to face reality. Think about that the next time your doctor gives you or your kid a seemingly harmless Vicodin, Percocet, or Codeine prescription after a minor surgery (as mine did years ago, when I was about at the age where people often first abuse these drugs, in my early 20s). You may want to throw the prescription away, as I’m thankful I did, and realize a little pain doesn’t mean you’re on your deathbed. What doesn’t kill you makes you stronger.
Both the medical community and the pharmaceutical industry know there’s a desperate and (also never ending) need for safe and effective pain relief — 40% of older adults live with chronic pain. But the rampant abuse of opiates and their questionable efficacy for chronic pain means they are not the answer. It’s a significant reason why our work on cannabinoids is so important. Cannabinoids are already starting to deliver, as clinical studies in IBD have already shown that they can help patients to be weaned off narcotics and corticosteroids. Cannabosides could provide these same therapeutic benefits and more. Through site-specific delivery they can also avoid the psychoactivity and sedation of THC. There is plenty of irony in developing pharmaceuticals derived from what remains an illicit drug by the federal government. That said, this is a drug, and our pharmaceutical solution in particular, where overdoses are near impossible and where the medical community is strongly turning in its favor.