By Andrea Lyn Van Benschoten, Web Content Editor
No matter how you consume news, you can’t avoid stories about the “opioid crisis.” The FDA is evaluating the use of opioid medications in children’s medicine. Multiple municipalities are suing drug manufacturers in an effort to recoup the cost of managing overdose calls. In March 2016, the FDA asked the National Academies of Sciences, Engineering, and Medicine (NASEM) to outline the state of the science regarding prescription opioid abuse and misuse, as well as the evolving role that opioids play in pain management.
Patients will do almost anything to avoid living a life in pain. By the time the patient considers medicinal pain management, they have already tried options such as massage, acupuncture, vitamin supplements, yoga, even walking, and just about anything else that may work.
The oxymoron of opioid “pain management”
No one wants to just “manage” their pain. They want to eliminate it so they can live normal, productive, and happy lives. For many, however, long-term pain management is an unfortunate reality. What makes pain management even more frustrating is the more restrictions put on opioid medications, the harder it is for those who have a legitimate need to get their medications.
No one wants to be forced into the pain management cycle. No one.
Visiting pain management doctors can be a humiliating process. It can include urine tests to prove you are actually taking the medications prescribed and not selling them, visiting multiple doctors to ensure they concur with the course of treatment, and monthly visits to the doctor to review your entire case before you receive your next prescription. Despite all this, patients endure this regular humiliation in order to continue on their pain management regimen. Patients live in regular fear that they could have their medication cut off, leaving them with few options.
The challenge of medical marijuana
In recent years there’s a new pain management option – medical marijuana. Many look at cannabis as a viable alternative to opioids for pain management. Medical marijuana may help ease pain, nausea, and loss of appetite in people who have cancer and HIV. Some research suggests medical marijuana may cut down seizures in people with epilepsy. Some studies show it also may ease multiple sclerosis symptoms like muscle stiffness and spasms, pain, and frequent urination. However, because it is an illegal drug nationally, it is a challenge to gain access and the regulations vary widely from state to state. California voters were the first to legalize medical marijuana, in 1996. It's now legal in 29 states and the District of Columbia.
Just like using opioids for pain management, medical marijuana has its own set of challenges.
For example, in my home state of New Jersey, you need to register with the state to acquire an ID card to purchase medical marijuana. The patient needs to have an ongoing relationship with a physician who is registered with the state and approved to prescribe medical marijuana. Medical marijuana in New Jersey is approved for a very narrow list of medical conditions. If your ailment isn’t on the list, chances are you won’t be approved.
The patient needs to upload proof of residency, personal photograph, official physician statement, and pay a $200 fee for the ID card. You also need to pre-register with an alternative treatment center (ATC); one of six licensed in the state. The approval process takes an average of four to six weeks.
Once the patient has been approved and receives their card, it is time to make an appointment. It is worth mentioning that all purchases need to be made in cash. Dispensaries are not allowed to discuss prices without a patient registration number. An average cost at one location is approximately $400 per ounce. Additionally, medical marijuana is not covered by insurance or Medicare. The patient is allowed to purchase a maximum of two ounces in a 30 day period. So that’s $800 plus tax just for the cannabis; not any supporting items, such as grinders, rolling papers, and the like.
Who can afford that?
Another important point is that just because a patient is approved for medical marijuana use in New Jersey, doesn’t mean that the patient can travel outside the state with their legally purchased medical cannabis. So if this pain management option works, you can’t leave the state for a vacation and continue your pain management treatment. You are literally a prisoner to your pain management option.
So which do you choose?
So a pain management patient has two options. Use traditional opioid medications that are risky, however your medication will be covered by insurance and you will be able to travel outside your state. Or if medical marijuana is approved in your state, you can begin the approval and purchase process, which is not covered by insurance and limits your use to inside your state lines.
Neither of these choices are very good.