Currently, opioid-based pharmaceutical drugs are the main prescription for those that suffer from chronic pain. The most popular of these being hydrocodone, oxycodone (also known as OxyContin and Percocet) oxymorphone, morphine, tramadol, codeine and fentanyl. Although these medicines are effective in the treatment of pain, it is strongly advised that these drugs are taken for short time periods due to their highly addictive and dangerous nature.
In the US alone the increasing numbers of people who have opioid dependencies are now at a critical level, with some states claiming opioid addiction to be at epidemic proportion. Although most high strength opioids are prescription only, with physicians needing a licence to prescribe, not all opioid users are in it for the for pain management.
Highly potent opioids like oxycodone (OxyContin) and fentanyl are a type 2 controlled substance and therefore illegal without a prescription. The abuse of opioids for recreational use is a trend that saw over 64,000 opioid-related deaths in 2016, of which 20,000 were fentanyl-based. Due to opioids highly addictive quality, even medications like codeine that are used for mild pain relief, and can be bought over the counter at a pharmacy, are still cautioned as being highly addictive.
What are Opioids?
Opioids and opium use dates back to as early as 3400 B.C- derived from the opium poppy and nicknamed the ‘joy plant’ by those that cultivated it, it is known for its pain relieving and sedative effects- and not to mention its ability to create intense euphoria. It was acknowledged in approximately 460-357 B.C by Hippocrates ‘the father of medicine’ himself, as a helpful drug that could be used for severe pain. Over the years this powerful pain reliever has seen many facing a balancing act between medicine and pleasure and thought-out history it has been severely abused.
Opioids work by activating the opioid and nerve receptors in the brain and in turn, causes the ‘opioid effect’ which is effective pain relief. Opioids are effective because as the receptor is stimulated it mimics the natural opioids found in the body. When Opioid receptor stimulation occurs, its effective in blocking pain, slowing breathing and having a general calming and anti-depressing effect. Opioids are also produced naturally by the body, but not in enough amounts to be able to combat severe pain or chronic pain.
Aswell as triggering pain relief opioids target the brain's reward system which triggers the release of dopamine. The neurotransmitters that are stimulated by dopamine regulate emotion, motivation and happy feelings. When these neurotransmitters are overstimulated it creates a euphoric effect in our bodies, this triggers a reward signal that makes us want to recreate that same feeling over and over which is why the addictive quality of opioids is so high.
The effect of opioids in the short term is pain relief, euphoria and relaxed happy feelings. However, these qualities don't come without some harmful side effects. The most common side effects of taking opioids are drowsiness, confusion, seizures, depression, nausea, constipation and slowed breathing which can lead to hypoxia and even result in death.
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CBD vs Opioids
CBD (Cannabidiol) is one of hundreds of cannabinoids found naturally in the cannabis plant. The most commonly known cannabinoids are CBD and THC, which both have potential pain relieving qualities. CBD is one of the non-psychoactive therapeutic components of cannabis and does not produce a high.
CBD works by stimulating the production of cannabinoids in your endocannabinoid system (ECS) which is responsible for appetite, mood, memory and pain reactions.
CBD is thought to be effective for chronic pain due to its analgesic effects, which works by blocking pain signals in your nervous system. CBD also stimulates the production of anandamide, but also keeps it in your bloodstream and inhibits absorption, increased anandamide levels in the bloodstream are effective in pain relief.
Studies have found there to be potential for CBD to be effective in helping relieve the symptoms of chronic pain and reducing inflammation. CBD could potentially help with pain related to cancer, multiple sclerosis, rheumatoid arthritis, peripheral neuropathic pain and other chronic pain disorders.
Unlike opioids, CBD has none of the addictive qualities that are problematic with opioid use, and can, in fact, be effective in fighting addiction to opioids. CBD could potentially be effective in weaning addicts off opioids and help break the cycle of dependency. By slowly taking lower amounts of opioids and replacing them with CBD it has been found that users found the same effects and in fact over time replaced opioids with CBD altogether.
There are very few side effects to taking CBD some find that they experience dry mouth, low blood pressure, lightheadedness, and drowsiness when taken in large amounts. There are no known risks of death or addiction.
CBD for pain relief and can be used alongside opioids in order to fight addiction cravings if there is an opioid dependency, but in many cases, users have found themselves using CBD as a viable substitute to opioids all together and have been able to break their addiction.
CBD is still in its infancy when it comes to research, but there have been a number of high profile cases in which CBD has been used as a replacement for opioids and has been seen as effective. The laws on CBD in the US are rapidly changing and CBD is set to be in the very near future accessible to all. Currently, CBD derived from cannabis is a schedule 1 substance, which is confusing and disappointing because of its non-psychoactive properties.
There are some states where cannabis-derived CBD products are legal and available for medical use. However, CBD that is derived from hemp is legal in all 50 states. Also, the other advantage of hemp-derived CBD is that the THC (the psychoactive compound) levels are almost non-existent at 0.3%.
As the opioid epidemic rages across the US, many are looking for other options, in order to regain control of their pain and not allow their opioid dependency rule them. In the coming years with more research and acceptance towards CBD, it is the hope of many advocates and users that CBD could be the pain reliever of the future.