By Chris Goldstein and Paul Armentano, September 8, 2007-- Millions of Americans are living in pain; so many, in fact, that doctors now prescribe enough painkillers in a single year to medicate every person in the nation. According to a disturbing new study by the Associated Press, Americans in 2005 consumed over 90,000 kilograms of powerful narcotic painkillers, not only codeine, hydrocodone and morphine, but also meperidine (Demerol) and oxycodone. In many cases, these drugs can be habit-forming. In some cases, their use can be deadly.

But what if there were a safer, cheaper, and potentially more effective alternative available for pain management, one that greatly reduced the user's risk of dependency, and one that was incapable of causing a lethal overdose?

For a handful of Americans there is. That medicine is cannabis. In 12 states, including New Mexico, patients now can use cannabis therapeutically under state law. Many of these patients use cannabis for pain relief.

Investigators at San Francisco General Hospital and the University of California's Pain Clinical Research Center assessed the efficacy of inhaled cannabis on HIV-associated sensory neuropathy. Neuropathic pain, colloquially known as nerve pain, affects an estimated 1 percent of the world's population and is typically unresponsive to both opioids and non-steroidal anti-inflammatory medications.

Researchers reported that patients who smoked low-grade cannabis three times daily experienced, on average, a 34 percent reduction in pain. Assessing the use of cannabinoids as analgesics has demonstrated that they also can alleviate the neuropathy associated with multiple sclerosis, diabetes, cancer and rheumatoid arthritis. Canadian health regulators just approved the use of an oral cannabis spray for the treatment of cancer pain.

Survey data from numerous studies also indicates that medicinal pot users typically require fewer pharmaceutical drugs than their non-using counterparts. In June, investigators at Columbia University reported that HIV patients who used cannabis therapeutically made fewer requests for over-the-counter medications, such as pain relievers and anti-nausea drugs, than subjects administered a placebo.

Evidence also demonstrates that cannabis has an adequate safety profile, particularly when compared to other pain medications. For instance, long-term use of non-steroidal anti-inflammatory drugs, such as ibuprofen and naproxen, is a leading cause of stomach ulcers and stomach bleeding, with some reports estimating that their use contributes to more than 100,000 hospitalizations and 16,500 deaths annually in the United States.

The use of narcotic painkillers such as oxycodone (OxyContin) to treat chronic pain also poses serious health risks, including death by overdose and addiction. Recently, a federal judge in Virginia ordered OxyContin-maker Purdue Pharma L.P. and three of its executives to pay more than $634 million in fines for misleading the public about the drug's risk of addiction.

By contrast, few users of cannabis, less than 10 percent, according to the National Academy of Sciences Institute of Medicine, ever become dependent on the drug, and no human case of fatal overdose has ever been attributed to cannabis.

Finally, cannabis is far less expensive to the consumer than most prescription painkillers. For example, Americans spent $4.7 billion on OxyContin between 2002 and 2004. By comparison, pain management with medical cannabis can cost patients as little as $40 per month, perhaps even less if they choose to grow their own medicine at home.

In states such as California, many medical-cannabis patients have the option to participate in locally sanctioned not-for-profit organizations which provide patients' access to medicine on a sliding scale based on what they can afford.

According to the American Chronic Pain Association, one in three Americans lives in persistent pain. Isn't it time to grant these patients legal access to a non-toxic alternative that can help them alleviate their pain and suffering?

Chris Goldstein is the producer of a daily podcast for the National Organization for the Reform of Marijuana laws, and the host of Active Voice Radio on KSFR/KSFQ in Santa Fe. Paul Armentano is the senior policy analyst for NORML in Washington, D.C.

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