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The Opioid Epidemic… One Pharmacist’s Plan to Make a Difference

One Pharmacist’s Plan to Make a Difference in the Opioid Epidemic

Dear Friends,

The Opioid Epidemic is everywhere and it is dominating the news on TV, the Internet, Facebook, and even Twitter. It is affecting our friends, families, and our neighbors.

Let’s visit this important topic and enhance our commitment to take part in the solution to this national health emergency.

In over 37 years of pharmacy practice I have witnessed many people afflicted with chronic pain and neuropathic pain who have turned to and have been prescribed dangerous and addictive opioids.

While not everyone who takes a prescription opioid will wind up an addict, the risk is all too real. The health risks associated with these drugs are great, and addiction and overdoses are a daily occurrence. It is particularly important for you to avoid opioids when trying to address long-term and chronic pain, as your body will create a tolerance to the drug. Over time you’ll require greater and greater doses at more frequent intervals to achieve the same pain relief; this is how the addiction process begins. This is the recipe for the disaster that is the Opioid Epidemic and could have lethal consequences for you or a loved one. Please don’t risk it!

“In 2012, paramedics responded to about 900 calls for overdoses in the city [of Pittsburgh]; in 2016, it was 2,300… During 2016, 613 people died from overdoses in Allegheny County, compared with 424 in 2015...” and only 290 in 2012. (1)

Nationwide the numbers are even more startling. According to the Department of Health and Human Services, on an average day in the U.S. more than 650,000 opioid prescriptions are dispensed (2) and 78 people die from an opioid-related overdose. This includes overdoses involving prescription opioids and illicit opioids such as heroin. (3)

The economic impact is estimated in the billions with 55 billion dollars spent on health and social costs related to prescription opioid abuse each year (5) and 20 billion dollars in emergency department and inpatient care for opioid poisonings. (6)

To prevent you or someone you love from becoming addicted to prescription painkillers, or worse, becoming another potential victim of an opioid overdose, get educated today!

Let’s take a closer look at the nationwide Opioid Epidemic, opioid abuse, and offer a groundbreaking healthy alternative to help manage pain.

What is an Opioid?

Opioids are a class of drugs that include the illicit drug heroin as well as the legally prescribed pain relievers oxycodone, hydrocodone, codeine, morphine, fentanyl, and others. Opioids are chemically related and interact with opioid receptors on nerve cells in the brain and nervous system to produce pleasurable effects and relieve pain. (4)

The American Society of Addiction Medicine defines addiction as “a primary, chronic and relapsing brain disease characterized by an individual pathologically pursuing reward and/or relief by substance use and other behaviors.” It is important to remember that opioid addictions are physical. With every use the brain craves more stimulation of the opioid (Mu) receptors and the body becomes physically dependent on that simulation to continue functioning properly. If a heavy user stops suddenly the withdrawal symptoms can be life threatening.

This physical addiction means that the opioid user needs these drugs and when their prescriptions run out or become too expensive, they may turn to cheaper, more accessible, street drugs like heroin.

“There’s very little difference between oxycodone, morphine and heroin,” says Dr. Deeni Bassam, board-certified anesthesiologist, pain specialist and medical director of the Virginia-based Spine Care Center. “It’s just that one comes in a prescription bottle and another one comes in a plastic bag.” (7)

Heroin is often cheaper and easier to obtain than opioids and so has become a popular alternative. Chemically, Heroin and OxyContin are very similar and provide a similar kind of high. OxyContin is as dangerous and equally as addictive as pure heroin. More often than not though, drug dealers cut heroin with other drugs and the results can be deadly.

One of the most popular drugs to spike heroin with is Fentanyl, a drug originally developed as an elephant tranquilizer. Cut into heroin, it was meant to deliver a stronger and more extended high, but as Dr. Karen Hacker, the director of the Allegheny Health Department said, “Fentanyl is like a whole new ballgame. People are dying the first time they try it.” (8)

Most heroin sold on the streets now contains some Fentanyl and some stamp bags now contain mostly Fentanyl, which can be 100 times stronger than heroin and 10,000 to 100,000 times stronger than morphine. (8,9)

Drug overdose is the leading cause of accidental death in the U.S., with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic of overdoses, with 20,101 deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015. (10) It is estimated that in 2015, 2 million Americans had a substance use disorder involving prescription pain relievers and 591,000 had a substance use disorder involving heroin. (11)

Dr. Robert Califf, who at the time was commissioner of the U.S. Food and Drug Administration (FDA), said, “The public-health crisis of opioid misuse, addiction and overdose is one of the most challenging issues [the FDA] has faced during my time as commissioner. Solving this issue is critical to our future. It’s time to put more resources into the development of non-opioid, non-addictive medications to help people who are in serious, debilitating pain.” (12)

At Murray Avenue Apothecary, we are always looking for holistic and natural approaches to pain management. In light of the Opioid Epidemic we redoubled our efforts to find safe and effective solutions for our clients. Almost a year ago during a phone call with my friend who told me she could not take opioids for post-op neck surgery pain- she had found a non-opioid solution-I was intrigued.

Her solution? CBD Hemp Oil!

This led me, and my staff, into exhaustive research about medical marijuana, state drug laws, and CBD manufacturers.

What is CBD (Cannabidiol)? How does it work? And most importantly, how can we provide it to the people who need it most!?

There are many different varieties of the cannabis plant. Hemp, sometimes called industrial hemp, refers to the non-psychoactive (less than 1% THC) varieties of Cannabis Sativa L. Both hemp and marijuana come from the same cannabis species, but are genetically distinct and are further distinguished by use, chemical makeup, and cultivation methods. Marijuana generally is known for its high THC levels, Hemp is known for its high CBD levels.

What is CBD and how does it work?

CBD or Cannabidiol is a chemical compound extracted from the medicinal hemp plant and is one of a class of molecules called cannabinoids. CBD is non-psychoactive and does not cause intoxication and does not stimulate the CB1 receptor in the brain. Tetrahydrocannabinol (THC) is the cannabinoid that produces the euphoric and psychotropic effects of Marijuana by stimulating the CB1 receptors in the brain. Our bodies have an endocannabinoid system with hundreds of CB gene receptors. These CB gene receptors are located all over your body including in the brain, skin, connective tissue, glands, immune cells, digestive tract, and reproductive organs. They also play an important role in human health and homeostasis. CBD is a neuromodulator synthesized or made on demand and broken down quickly and not stored.

Dr. Margaret Gedde, a Stanford-trained pathologist and award-winning researcher, said, "When I started hearing the results patients were getting, I realized that the reason why [marijuana] could do so many different things in the body without being toxic is because it is acting through this natural endocannabinoid system in our bodies. That's when I said 'Wow. This is huge. There's nothing like this in medicine. There's nothing that I can prescribe that comes close to what this can do for people.’” (13)

The human endocannabinoid system strongly suggests the human organism is actually designed to make good use of the cannabis plant. In other words, the phytocannabinioids in the cannabis triggers something that's been inside us since the dawn of mankind. The endocannabinoid system exists in other animals as well, suggesting it is truly an ancient biological system.

“Although the endocannabinoid system has been known to interact with other systems…its interaction with the opioid system is now well established. These two systems share neuroanatomical, neurochemical, and pharmacological characteristics.” (14,15) This means the same receptors all over your body that interact with opioid chemicals also interact with the CBD. This important connection means that not only might CBD offer potential pain relief, it may also be used to potentially wean patients off of their Opioids.

Please have your Pain Physician contact our Pharmacists to work together as a team to help you with general health and wellness. We are here for you!

Gedde added, “So many pain medications are damaging to the stomach, to the gut. The cannabis doesn't hurt the gut. It helps heal the gut. People are so relieved … There's nothing else that does that. It won't hurt the organs. It won't hurt the liver. It won't hurt the kidneys. Ibuprofen… people can't stay on that for months and years. They can stay on cannabis. As we know as well, there is no known lethal dose for cannabis, whether it's THC or CBD. A person couldn't die from it even if they were trying really, really hard. There's nothing you can say that about. It offers so much to people on a medical level." (13)

Our CBD (Cannabidiol) Hemp Oil products are Pharmaceutical Grade Dietary Supplements containing full spectrum hemp oil derived from the whole hemp plant grown, processed, and produced in accordance with the 2014 FARM BILL, Section 7606. There is ZERO THC in our CBD (Cannabidiol) Hemp Oil (LabNaturals PCR Full Spectrum Plant Oil) products. We provide a Certificate of Analysis with proof of nondetectable THC, solvents, pesticides, and heavy metals in each batch.

Our CBD (Cannabidiol) Hemp Oil Oral Tinctures (LabNaturals PCR Full Spectrum Plant Oil) are light, oily liquids that are to be delivered orally by dropper and come in a variety of strengths. The Hemp Pain Balm ((LabNaturals PCR Full Spectrum Pain Balm) is applied directly to painful areas. We also carry CBD(Cannabidiol) soft gel capsules in 10mg or 25mg strengths (LabNaturals PCR Full Spectrum Capsules) and CBD (Cannabidiol) Chewing Gum (LabNaturals PCR Full Spectrum Gum) with 10mg of CBD (Cannabidiol) per piece. We have CBD Pet Tinctures (LabNaturals PCR Full Spectrum Plant Oil for Pets)!

Please Call 412-421-4996 for Products.

Our philosophy at the Apothecary is to START LOW & GO SLOW. Micro-dosing allows the body to rebalance itself slowly and allows our clients to find their optimal dose to improve wellness.

It makes sense to buy supplements from a pharmacy and a pharmacist with 37 years of experience.

I know biochemistry and how to balance it!

Before choosing the CBD Hemp Oil (LabNaturals PCR Full Spectrum Plant Oil) products at I looked for the following:

• Non-detectable THC

• Non-detectable Solvents
• Non-detectable Pesticides
• Non-detectable Heavy Metals
• 100% Organically Farmed in accordance with Industrial Hemp Regulations (Hemp Registration Available)
• 100% Non-GMO
• Full Spectrum PCR– Phytocannabinoid Rich Plant Oil
• A 3rd party coded Certificate of Analysis with each batch
• Hydrogenated Water and Supercritical CO2 Extraction Process

The Opioid Epidemic has reached unfathomable proportions and is killing our family members, friends, and neighbors every day!

Please share this article with those who need it most and please stop by Murray Avenue Apothecary to speak with our pharmacists.

“Be aware of your symptoms, get educated, and take a pro-active role in your health!” SM

To Your Health and Healing,

Susan

Susan Merenstein, Pharmacist and Owner
Murray Avenue Apothecary
4227 Murray Avenue
Pittsburgh, Pa. 15217
412-421-4996
MAApgh.com
LabNaturals.com
LabNaturalsPCR.com
PittsburghsPetPharmacy.com

References:

1) http://www.post-gazette.com/local/city/2017/05/10/opioid-crisis-narcan-overdose-pittsburgh-ems-first-responders-parametics/stories/201705100029
2) IMS Health National Prescription Audit
3) CDC National Vital Statistics System
4) National Institute on Drug Abuse. (2015). Drugs of Abuse: Opioids. Bethesda, MD: National Institute on Drug Abuse. Available at http://www.drugabuse.gov/drugs-abuse/opioids.
5) Pain Med. 2011;12(4):657-67
6) Pain Med. 2013;14(10):1534-47.
7) Epoch Times, September 27, 2016 Available at http://www.theepochtimes.com/n3/2162188-a-glimpse-into-the-human-toll-of-opioid-addiction/?utm_expid=.5zxdwnfjSHaLe_IPrO6c5w.0&utm_referrer=http%3A%2F%2Farticles.mercola.com%2Fsites%2Farticles%2Farchive%2F2017%2F04%2F15%2Fdocumentary-chasing-the-dragon-opioid-addiction.aspx
8) http://www.post-gazette.com/news/overdosed/2017/04/06/Allegheny-County-drug-overdoses-610-deaths-break-record/stories/201704060199
9) http://articles.mercola.com/sites/articles/archive/2017/04/15/documentary-chasing-the-dragon-opioid-addiction.aspx
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11) Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/.
12) U.S. Food and Drug Administration January 19, 2017 Available at https://blogs.fda.gov/fdavoice/index.php/2017/01/working-together-to-reduce-the-devastating-effects-of-opioid-misuse/
13) Mercola, Dr. Joseph. "Medical Cannabis – A Vastly Underutilized Therapeutic Option?" Mercola.com. 19 February 2017. Web. 18 April 2017.
14) Fernandez-Ruiz et al., 2010; Ferre et al.,2010; Tebano et al., 2012 - (www.ncbi.nlm.nih.gov/pmc/articles/PMC4318341)
15) Fattore et al., 2005; Vigano et al., 2005; Robledo et al., 2008; Trigo et al., 2010 - (www.ncbi.nlm.nih.gov/pmc/articles/PMC4318341)
16) Welty TE, et al. Epilepsy Curr. 2014;14(5):250-2.
17) McCoy KL. Mediators Inflamm. 2016;2016:5831315.
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19) Pacher P., Batkai S., Kunos G., 2006; “The Endocannabinoid System as an Emerging Target of Pharmacotherapy” Pharm Reviews.