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Are Pain Medications Preventing You from Healing?

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We all know that pharmaceutical painkillers are much stronger than nearly anything you can find in nature. There’s no comparing cannabis, cloves, or magic mushrooms to powerful drugs like fentanyl and isotonitazene. So why are a growing number of people turning away from opioids in favor of milder treatment options? Aside from obvious safety issues with the former, the answer to that lies in part in how we, as a society, view pain in the first place.

Is pain something that should be immediately and completely masked, or are there some healing components to allowing our bodies to feel discomfort? Is our culture of hiding from anything that feels bad, keeping us in a perpetual state of illness?

Pain defined throughout history

Pain is not a condition in and of itself, but rather a symptom of many other diseases or disorders, indicating something is wrong with our bodies. Pain is incredibly complex and can vary significantly between people, even those who share similar illnesses or injuries. Pain can also range in severity, as well as in the way it’s felt. Some variations of pain can include pricking, tingling, stinging, burning, soreness, aching, and many other unpleasant sensations.

The entire spectrum of pain consists of hundreds of different types of disorders and syndromes. For instance, you can experience pain following an injury, or chronic pain related to aging. Pain can also be neurological, like migraines. Heart attacks, cancer, and childbirth all cause different forms of pain. When it comes to clinical diagnoses, healthcare providers typically group pain into one of two categories: acute or chronic. Acute pain comes on suddenly and intensely, and is usually the result of a traumatic injury or surgery.

Chronic pain persists over a longer period of time, and can be difficult to manage. Chronic pain affects very 50 million American adults, and it’s one of the most common reasons people seek medical care. Although some medical professionals consider chronic pain to be its own medical disease, there is always an underlying cause.

Again, pain is our natural warning sign that something is not right. The purpose of feeling pain is to change our course of actions – be it limiting certain activities, eating different foods, doing certain exercises, and so on. It’s remarkably specific in letting us know what activities will further aggravate an area, and in preventing us from doing said activities.


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What the research says

Pain is something that has long-confused physicians, so in an effort to better understand it, they started tracking their patients’ discomfort at all times. For a while, pain was even referred to as “the fifth vital sign”, officially declared so in 1999, but the move was met with great controversy and continues to be a point of contention in the healthcare industry to this day.

Regardless, the goal was for doctors to take more cognizance of pain because it can be an important factor in determining the overall health and mental state of a patient. The problem was that, the quest to gain a better understanding of pain eventually turned into a mission to mask pain entirely, not necessarily treat its root causes.

Some issues come along with masking pain, the most obvious being that if you don’t feel any pain, you may not take the correct actions to manage and heal your ailment, leading to further injury. Another problem that is rarely discussed, is the role of pain management medications in the actual treatment of pain. For a long time, it was commonly believed that pills helped, but recent studies show that many frequently used pharmaceuticals actually hinder the healing process.

It is well established in scientific literature that NSAIDs can impede the healing of broken bones, damaged ligaments, and other musculoskeletal tissues. Many surgeons many avoid suggesting or prescribing these medications because of the growing concern in how they negatively impact callus formation and decrease the activity of COX isoenzymes that decrease the synthesis of prostanoids.

Another drug of great controversy – opioids. How much are these incredibly dangerous drugs that have caused hundreds of thousands of overdose deaths over the last decade, even aiding in the healing process? Short answer, not very much at all – according to recent studies.

A study published in 2017 found that patients who were treating wounds with opioid doses over 10mg per day exhibited slower rates of healing than patients who took less than 10mg or none at all. Other studies have also suggested that opioid use may negatively impact wound healing by reducing immune activation, impacting tissue oxygenation and angiogenesis, and altering myofibroblast recruitment as well as impacting keratinocyte cytokine production, endothelial proliferation and angiogenesis.

Other drugs that can slow wound healing are cytotoxic antineoplastic and immunosuppressive agents, corticosteroids, and anticoagulants. Additionally, all drugs in the pain relief category can theoretically interfere with healing by masking pain and thus allowing you to continue to hurt yourself without immediately realizing it.

My personal experience with pain

To not sound completely tone-deaf here, I do understand that certain levels of pain can make life unbearable. I’ve been blessed in not having to experience chronic, debilitating pain personally, but I have had a handful of injuries and surgeries in my life that left me in pain or discomfort for a few weeks to a few months at a time.

I also suffer from frequent migraines and cluster headaches, which come on strong and fast. Normally, I try to take it easy, drink a lot of water, eat food, and avoid smoking until it goes away. Admittedly, I’ll pop an Excedrin occasionally if I don’t have time to tend to naturally, but I try to avoid that as the regular use of any acetaminophen-based drug can cause significant damage to the body, particularly the liver.

Right now, I’m drawing from my experience of giving birth, comparing how it went when I received epidural versus a natural birth. First, it’s important to note that babies whose mothers receive an epidural are more likely to develop respiratory distress syndrome once the child is born. Epidural anesthetic is sometimes combined with opioid drugs as well, which can cross the placenta and add to the risk of developing respiratory depression.

Babies who have are exhibiting such problems likely end up going to the hospital’s neonatal intensive care unit (NICU). While staying in the NICU may not seem harmful on the surface, it means that mother and baby are separated immediately after birth. And when you use epidural, you can’t move your legs for a couple of hours after giving birth, so if the baby is not in the same room with you, that’s even longer spent away from them during their first moments on this earth, and this can have profound effects on the emotional and physical well-being of both baby and mom.

This is what happened to me when I gave birth to my first son with epidural. The labor was about 10 hours, I had to be put on oxygen at numerous points during the process, and my baby was born with some breathing issues that made it difficult for him to breathe through his nose while eating. He was taken to NICU right away, but even while there he had issues for a couple of weeks. At one point during a feeding, he stopped breathing completely for a few seconds and turned blue, it was the most terrifying thing I’ve ever experienced.

Were these issues causes by the epidural? It’s hard to say, but very possible. Especially when comparing that ordeal to the birth of my second son, which was done completely naturally. No problems during the labor which last less than one hour from start to finish, baby had absolutely no issues, and we were discharged in about 1 day.

In my opinion, that’s very telling of the types of complications that can arise when unnecessary medical intervention is at play.

Final thoughts

Pain management is a complicated and sensitive subject for many people, patients and medical professionals alike. Pharmaceuticals have their place in modern medicine, but it’s important to take a closer look at their overall role in treating pain over the long term. These recent discoveries place greater importance on treating the root causes of pain, in order to get patients off their medications as quickly as possible.

Thanks for joining us! Welcome to Cannadelics.com; where we work daily to bring you the very best in cannabis and psychedelics news reporting. Head our way frequently to stay in-the-loop, and sign up for the Cannadelics Weekly Newsletter, so you’re never late to get a story.



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Senate Leadership Pushes End of Federal Prohibition Of Cannabis

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In a big week for the marijuana industry and a surprise to most of the industry, Senators Schumer (D-NY), (Murray D-WA), Wyden (D-OR), Cory Booker (D-NJ) and 14 others have deduced to follow the public and make a change.  As of today, Senate leadership pushes end of federal prohibition of cannabis.

Senator Patty Murray, a senior member and former Chair of the Senate Committee on Health, Education, Labor, and Pensions (HELP) has long been a champion of veterans.  This falls in line with PTSD treatments and with the American Medical Association’s backing of rescheduling and more medical research to see how the cannabis plant can help more patients.

RELATED: California or New York, Which Has The Biggest Marijuana Mess

They have reintroduced the Cannabis Administration and Opportunity Act (CAOA), legislation that would end the harmful federal prohibition of cannabis by removing cannabis from the list of federally controlled substances and empowering states to create their own laws. This legislation would be a historic step toward rectifying the failed policies of the War on Drugs and would help federal law better reflect the will of the vast majority of Americans, 91% of whom believe that cannabis should be legalized for either adult or medical use.

“It is far past time that the federal government catch up to Washington state when it comes to cannabis laws. This legislation is about bringing cannabis regulations into the 21st century with common-sense reforms to promote public safety and public health, and undo deeply unjust laws that have for decades disproportionally harmed people of color,” said Senator Murray.  “The Cannabis Administration and Opportunity Act will help set us on a safe and responsible pathway to legalization—I’ll keep working to secure the necessary support to get it done.” 

Sen. Patty Murray
Photo by Anna Moneymaker/Getty Images

The Cannabis Administration and Opportunity Act establishes a federal regulatory framework to protect public health and safety, prioritizes restorative and economic justice to help undo harm caused by the War on Drugs, ends discrimination in the provision of federal benefits on the basis of cannabis use, provides major investments for cannabis research, and strengthens worker protections. By decriminalizing cannabis at the federal level, the CAOA also ensures that state-legal cannabis businesses or those in adjacent industries will no longer be denied access to bank accounts or financial services simply because of their ties to cannabis.

The Cannabis Administration and Opportunity Act:

  • Protects public health by:
    • Establishing a Center for Cannabis Products to regulate production, labeling, distribution, sales and other manufacturing and retail elements of the cannabis industry.
    • Instructing the FDA to establish standards for labeling of cannabis products, including potency, doses, servings, place of manufacture, and directions for use.
    • Establishing programs and funding to prevent youth cannabis use.
    • Increasing funding for comprehensive opioid, stimulant, and substance use disorder treatment.
  • Protects public safety by:
    • Removing cannabis from the Controlled Substances Act and eliminating federal prohibitions in states that have chosen to legalize medical cannabis, or adult-use cannabis.
    • Retaining federal prohibitions on trafficking of cannabis in violation of state law; establishing a grant program to help departments combat black market cannabis.
    • Requiring the Department of Transportation (DOT) to create standards for cannabis-impaired driving.
    • Directing the National Highway Traffic Safety Administration (NHTSA) to collect data on cannabis-impaired driving, create educational materials on “best practices,” and carry out media campaigns.
    • Incentivizing states to adopt cannabis open container prohibitions.
  • Regulates and taxes cannabis by:
    • Transferring federal jurisdiction over cannabis to the Alcohol and Tobacco Tax and Trade Bureau (TTB).
    • Eliminating the tax code’s restriction on cannabis businesses claiming deductions for business expenses, and implementing an excise tax on cannabis products.
    • Establishing market competition rules meant to protect independent producers, wholesalers, and retailers and prevent anti-competitive behavior.
  • Encourages cannabis research by:
    • Requiring the Government Accountability Office (GAO) to study and report on metrics that may be impacted by cannabis legalization.
    • Requiring the Department of Health and Human Services (HHS) and National Institutes of Health (NIH) to conduct or support research on the impacts of cannabis.
    • Requiring the VA to carry out a series of clinical trials studying the effects of medical cannabis on the health outcomes of veterans diagnosed with chronic pain and post-traumatic stress disorder.
    • Requiring the Bureau of Labor Statistics to regularly compile and publicize data on the demographics of business owners and employees in the cannabis industry.
    • Establishing grants to build up cannabis research capacity at institutions of higher education, with a particular focus on minority-serving institutions and Historically Black Colleges and Universities.
  • Prioritizes restorative and economic justice by:
    • Using federal tax revenue to fund an Opportunity Trust Fund to reinvest in communities and individuals most harmed by the failed War on Drugs.
    • Establishing a Cannabis Justice Office at the Department of Justice’s Office of Justice Programs
    • Establishing a grant program to provide funding to help minimize barriers to cannabis licensing and employment for individuals adversely impacted by the War on Drugs.
    • Establishing expedited FDA review of drugs containing cannabis manufactured by small businesses owned by socially and economically disadvantaged individuals.
    • Directing the Secretary of Housing and Urban Development to establish a grant program to provide communities whose residents have been disproportionately affected by the War on Drugs with additional funding to address the housing, economic, and community development needs of such residents.
    • Initiating automatic expungement of federal non-violent cannabis offenses and allows an individual currently serving time in federal prison for nonviolent cannabis offense to petition a court for resentencing.
    • Disallowing the denial of any benefits or protections under immigration law to any noncitizen based on their use or possession of cannabis.
    • Prevents discrimination in the provision of federal benefits against people who use cannabis.
  • Strengthens workers’ rights by:
    • Removing unnecessary federal employee pre-employment and random drug testing for cannabis
    • Ensuring worker protections for those employed in the cannabis industry.
    • Establishing grants for community-based education, outreach, and enforcement of workers’ rights in the cannabis industry.

RELATED: Cannabis Industry Employs The Same As These Companies

The Cannabis Administration and Opportunity Act is co-sponsored by U.S. Senators Jeff Merkley (D-OR), Kirsten Gillibrand (D-NY), Elizabeth Warren (D-MA), Ed Markey (D-MA), Michael Bennet (D-CO), Gary Peters (D-MI), Tina Smith (D-MN), John Hickenlooper (D-CO), Ben Ray Luján (D-NM), Alex Padilla (D-CA), Peter Welch (D-VT), Rev. Raphael Warnock (D-GA), John Fetterman (D-PA), and Laphonza Butler (D-CA).

Senator Murray has been a leader on common-sense cannabis reforms. She helped introduce the Cannabis Administration and Opportunity Act last Congress, and in 2017, she first introduced the Secure and Fair Enforcement (SAFE) Banking Act which would allow state-legal cannabis businesses to access banking services. She has reintroduced the bill multiple times and is pushing hard for its passage. An updated version of the legislation—the Safe and Fair Enforcement Regulation (SAFER) Banking Act of 2023, which Murray also cosponsored—passed through committee after a bipartisan markup last fall.



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Off To The Horse Races With Cannabis

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House racing is highly popular sports with over 45,000 races run in the US and Canada last year.  The Kentucky Derby is the pinnacle of horse racing in North America, but most major metro hubs have some type of opportunity. Globally it is a $400 billion industry with tens of millions of people watching. But are they off to the horse races with cannabis?

RELATED: How To Be Discreet When Using Weed

The biggest horse racing party is the Kentucky Derby and the Infield (the area inside the track) is a huge one with beer trucks, Mardi Gras bead shenanigans, and maybe a little whiff of weed.  While Churchill Downs, where the race is run, bans all smoking, vapes, gummies and more make the way in. The same is true across the realm.  But what about those in the race?

The signature beverage of the Kentucky Derby is the Mint Julep

Horse racing is an intense activity for the animal, and increasingly, horse owners are adapting human products (either medical marijuana or hemp) for their athletes.  Recovery, hydration, inflammation and pain management are all benefits for the horse if done with the correct dosage.  Additionally, it is seen as a potential for calming a horse.

Like the human mass market, CBD is leading the way. But the efficacy and safety of some products is questionable, due to very little research and supervision. Until the passage of the 2018 Farm Act, it was illegal to possess or conduct research on hemp as well as marijuana. Like the NFL, owners should be aware CBD and THC cannot be used in when competing, and if CBD shows up on a drug test that horse may be disqualified.

RELATED: The Most Popular Marijuana Flavors

With rescheduling, there should be more research done regarding CBD and THC’s benefits to animals, especially pets and horses. Before administering CBD to horses, horse owners should first consult with a veterinarian.

Additionally, jockeys are banned from using cannabis while racing. This falls inline with the current global sports guidelines.  CBD has been used in helping with recovery, but it can not be used prior to the race, especially if you are looking at winning.



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The Future Of Cannabis After Rescheduling

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The Cannabis world is going through another big change with the potential of rescheduling – but what does it really mean?”

The Fresh Toast – The cannabis world is going through another major change, so what is the future of cannabis after rescheduling?

The Drug Enforcement Administration (DEA) is moving for cannabis to be rescheduled. The anticipated rescheduling follows the Department of Health & Human Services’ (HHS) August 2023 recommendation, based on scientific support for the rescheduling from the FDA, that cannabis be rescheduled under Schedule III of the Controlled Substances Act. Cannabis has remained a Schedule I substance since it was originally “temporarily” classified as such by the Controlled Substances Act of 1970. Schedule I drugs are defined as having no currently accepted medical use and a high potential for abuse, with other Schedule I drugs including heroin and LSD (despite cocaine, fentanyl, and other potentially dangerous drugs being in less restrictive drug schedules). The status of cannabis as a Schedule I drug has long been criticized, particularly as more and more U.S. states legalized cannabis for medical and recreational use.

RELATED: Beer Sales Flatten Thanks To Marijuana

From a consumer standpoint rescheduling will not actually legalize cannabis. At least not in a way forcing States in which cannabis is currently prohibited to immediately change course as a direct result of rescheduling. Instead, those States are likely to continue cannabis prohibition (though this momentous step may influence further states to legalize). Similarly, states with state-legal cannabis programs will likely not immediately change from a consumer perspective, although further regulation or even a reduction in product pricing due to cannabis no longer being subject to section 280E of the Internal Revenue Code (discussed in detail below) may soon follow.

Photo by 2H Media via Unsplash

There is more going on the business side with rescheduling. Falcon Rappaport & Berkman LLP has reviewed the process and outcomes.

Taxes

The most significant consequence of cannabis rescheduling will be the immediate removal of cannabis from the reach of I.R.C. Section 280E, which is arguably the greatest burden on state-legal cannabis operators. Section 280E prohibits cannabis businesses from writing off many business expenses when calculating their net profit, which has resulted in vastly higher taxes as compared to similar non-cannabis businesses. Instead, section 280E only permits a deduction for the Cost of Goods Sold (COGS) for any business trafficking in any controlled substances (i.e., drugs listed on Schedule I or Schedule II). Despite cannabis businesses operating under state-legal programs, they are considered “trafficking” and cannot take ordinary business deductions. Allowing cannabis businesses to deduct all ordinary and necessary business expenses, and not just COGS, will help to even the playing field with nearly every other legal business.

Federal Illegality

As discussed from a consumer standpoint, rescheduling cannabis does not affect the overall federal illegality of cannabis. This means that state-legal cannabis businesses will not automatically be federally legal, as their federal illegality will continue under Schedule III. While Schedule III drugs may be legally prescribed and sold under federal law, the various restrictions (such as requiring FDA approval of any such Schedule III drug and DEA registration of a distributor) mean that your average dispensary, even medical dispensaries, will still be federally non-compliant.  For these same reasons, the reclassification to Schedule III does not mean that marijuana grown pursuant to state programs can be sold in interstate commerce. Marijuana products, even under Schedule III, are only federally legal if they are federally approved and there are only three FDA-approved cannabis-based drugs developed to date (Marinol, Epdiolex, and Syndros).

RELATED: Cannabis Industry Employs The Same As These Companies

Intellectual Property & Cannabis Trademarks

The United States Patent and Trademark Office (USPTO), the agency tasked with examining federal trademark applications, has generally required use of a mark to be lawful under federal law in order to receive federal trademark registration under the U.S. Trademark Act (see Examination Guide 1-19). The federal illegality of cannabis has thus prevented trademark registration in connection with most cannabis products. Unfortunately, cannabis rescheduling will not remedy this issue. Even in Schedule III, cannabis products would have to be federally lawful, with lawful use of a Schedule III drug requiring FDA approval.

Entitlement to Federal Bankruptcy Protection 

Currently, plant-touching cannabis companies are not entitled to federal bankruptcy protection. That is because the U.S. Bankruptcy Code requires that bankruptcy plans are “proposed in good-faith and not by any means forbidden by law.” Since even state-regulated cannabis companies violate the federal Controlled Substances Act (CSA), they are disqualified. Unfortunately, rescheduling to Schedule III of the CSA alone will not likely solve that barrier to bankruptcy. While some have argued otherwise, the fact is that to manufacture, distribute, or dispense a Schedule III Controlled Substance, businesses must be registered with the Drug Enforcement Administration (“DEA”). Any business or person not registered with the DEA is not authorized to manufacture, distribute, or dispense it. Meaning that violations would likely constitute an unlawful act under the CSA. Consequently, an attempt by the non-complying business to commence a voluntary petition seeking federal bankruptcy protection will likely result in a motion to dismiss the case by the U.S. Trustee’s Office.

However, in light of a recent trend among bankruptcy court’s in allowing ‘one-step-removed’ distribution of cannabis-related assets, federal rescheduling may very well result in a more liberalized approach to administering bankruptcy cases so that bankruptcy judges will be more willing to look past the issue of marijuana’s federal illegality.

Status Quo

There are several aspects of the existing cannabis industry which would not be immediately changed by rescheduling cannabis to Schedule III. Ongoing banking issues including the lack of access to standard commercial bank loans and lines of credit would likely persist; difficulties in processing cannabis transactions due to the reality that major credit card companies like Visa, Mastercard and others will likely still not service marijuana businesses; general federal illegality; and the criminalization of cannabis (and continued incarceration of certain offenders) in prohibitive states would remain following rescheduling.

While many had hoped for the de-scheduling of cannabis, the change in stance of the DEA, a longstanding adversary of cannabis reform, is no small feat.

Terran Cooper is a regular contributor to The Fresh Toast.  He is part of Falcon Rappaport & Berkman LLP. This article was developed in part with the help of Andrew Cooper and Matthew Foreman.



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