Opioid prescriptions reached an all-time high of 15.4 million prescriptions dispensed to 3.1 million people between 2016 and 2017, following the trend of worldwide opioid hypnosis in the wake of a failed drug war. Australia has jumped into the trap, the Australian Institute of Health and Welfare reported that 1 in 24 Australians have misused a prescribed opioid in the last 24 months. Behind the medicinal veil lies a staggering abuse rate of 1 in 3. Indeed, as the drugs are accompanied by a higher propensity to obtain chronic pain and mental illness, the patient falls into the self-fulfilling trap of addiction. With an average prescription rate of five per patient, the prolonged implementation for an alternative to opioids is long overdue. Hysteric lawmakers and the media like to point fingers at the pharmaceutical companies for their reckless claims of non-addictive opioids, yet until the finger is pointed inward and the replacement of opioids is encouraged instead of silenced, the opioid epidemic will not slow down.
When presented with the problem of addictive behaviour, a common misconception is to believe that the criminalisation and stigmatisation of the addictive behaviour will alleviate the addiction. Instead, a science-based, clinical approach is necessary to provide safe alternatives to reduce the harm drugs-of-dependence impose onto society. Stigmatised alternatives have been shunned through decades of misinformation stemming from the political silencing of counter-culture during the 1960s and ‘70s. Breeding a culture of hate and subversion, governments have continued to push a vilified narrative to disparage and criminalise the use of opioid alternatives, with an especially vitriolic campaign against cannabis. Chronic pain is a major provocateur for opioid prescriptions, leaving the patient to build a dependence off the back of an incurable ache. Cannabis, when conjugated with a small dose of morphine or oxycodone, has been shown to, on average, significantly decrease chronic pain by 27%, considerably enhancing the analgesic properties of opioids. The shared pharmacologic properties of cannabis work synergistically with the opioid, producing a more effective pain relief than higher dosed opioids, and hence decreasing the easily preventable risk of addiction. A randomised double-blind placebo-controlled study published in the Journal of Psychoactive Drugs found that 20 mg of THC was slightly more effective at relieving pain than 120 mg of codeine in 10 terminally ill cancer patients. Additionally, other breakout studies suggest a link between medicinal cannabis use and cancer withdrawal. With 1 in 5 Australians experiencing chronic pain, the potential for a regulated, all-encompassing medicinal revolution is not only possible but necessary, to free Australians from literal and psychological prison.
If the benefit of medicinal cannabis vastly outweighs the societal cost imposed by opioids, why hasn’t the government rushed to introduce sweeping legislation? Simply because of the reluctance induced by a traditionally entrenched stigma. Current Victorian law dictates that for medicinal cannabis to be dispensed, a doctor must apply on behalf of a requesting patient to the Therapeutic Goods Administration, who when receiving the application decides whether a patient’s described symptoms require a medicinal cannabis prescription. This means that patients diagnosed with chronic pain, epilepsy, multiple sclerosis and a plethora of other high-care disorders and illnesses, need to wait weeks or even months for approval from a third-party who, unlike your doctor, hasn’t personally assessed the severity of your condition. The danger of prescribing medication based on the number of boxes you tick, and whether an administrator had their coffee that morning, should be raising red flags immediately. If drugs of non-dependence replaced opioids en masse, the commercial and medicinal advancements would revolutionise the currently monopolised pharmaceutical industry. It is time to eliminate the double-standard that holds patients’ arms behind their backs and to start looking at patients as people, rather than dollar bills.