Public attitudes toward marijuana are changing rapidly in the United States. A majority of Americans now favor the legalization of cannabis and medical marijuana is legal in 23 states and the District of Columbia. Surveys also show that many patients find marijuana more effective at relieving pain than their prescribed medications.
But for anyone with a prescribed painkiller or enrolled in a pain management program — regardless of where they live — marijuana may as well be illegal.
They face a conundrum: if marijuana is ever detected in their urine or in a blood test, they stand a good chance of being dropped by their physician.
That’s what happened to Valerie, a 53-year old Texas woman who has suffered from chronic back pain since she was a young woman. After 17 years with the same pain doctor, he dropped her as a patient when marijuana was found in a urine screen.
“He didn’t want to kick me out. He looked me square in the face and said, ‘Valerie, the DEA has put the fear of God in us.’” she recalls.
Valerie, who asked that we not use her last name, has chronic pain from scoliosis that was aggravated by a work injury and two failed back surgeries. Before she was dropped by her doctor, Valerie found she could “stretch” her 30-day prescriptions for morphine and hydrocodone by supplementing the opioids with marijuana.
“I’ve smoked marijuana for a long time and I don’t have an arrest record. I haven’t been in a wreck in probably 30 years. The last time I got a ticket was probably 20 years ago. I’m not a bad person. And it’s like they singled me out and outed me. And my life is hell now. It really is,” she says.
Valerie avoided detection for years by stopping her use of marijuana just prior to an anticipated drug test. That strategy worked until last year.
“When he kicked me out I said ‘What am I going to do if you’re cutting my off cold turkey?’ He said go to another chronic pain doctor and don’t tell them you saw me. If they know you’ve taken this test and failed it, no doctor in the state of Texas can prescribe to you.”
Marijuana has been used as medicine for thousands of years, but the scientific evidence that it can safely relieve pain without side effects is scant. Anecdotal evidence is growing, however.
A National Pain Report survey of over 1,300 fibromyalgia patients found that medical marijuana is far more effective at treating symptoms of fibromyalgia than any of the three prescription drugs approved by the Food and Drug Administration to treat the disorder.
Another recent survey of medical marijuana patients published in the Hawaii Journal of Medicine & Public Health found that nearly all (97%) used cannabis primarily for relief of chronic pain. Respondents said marijuana cut their pain scores in half and helped reduce their reliance on pain medications.
“Cannabis is an extremely safe and effective medication for many patients with chronic pain. In stark contrast to opioids and other available pain medications, cannabis is relatively non-addicting and has the best safety record of any known pain medication,” wrote lead author Charles Webb, MD.
Valerie has refused to give up marijuana or lie to other doctors about her use of cannabis. For the last 15 months she has self-medicated, using marijuana and over-the-counter Naproxen to relieve her day-to-day pain. For breakthrough pain, she takes Vicodin pills obtained through the black market.
“People have friends. There are all kind of ways (to get drugs), if you have got to have something. I do what I have to do to maybe have 10 Vicodin last me a month,” she told National Pain Report.
“I don’t like doing it and I don’t consider myself a drug addict. I’d rather not have to take anything at all. But I’m trying to survive here.”
Valerie knows the irony of the situation. Efforts by government and law enforcement agencies to stop the abuse and overprescribing of pain medication have scared many doctors into dropping patients who have a blemish on their record. Many of those patients now get their painkillers off the street or turn to illegal drugs – the very thing the government was trying to stop.
“I don’t understand where my rights as a citizen went. I don’t understand what gave the DEA the right to go in and look at my medical records and tell my doctor how to practice medicine. I don’t get that at all,” Valerie says. “All they’ve done is driven up the price of pain drugs on the street.”