Feds Squash Doctor Training on Cannabis for Pain

As reported by the Associated Press, The American Academy of Pain Medicine has cancelled its plans for a webinar in July aimed at training doctors on the use of cannabis instead of opiates for pain. The cancellation followed "a request from the U.S. government agency that provided the funding." The agency was the Substance Abuse and Mental Health Services Administration, or SAMHSA, a division of the U.S. Department of Health and Human Services (HHS).

“We cannot speak to the reason that SAMHSA has asked that we not proceed with this webinar, but the webinar will no longer take place,” AAPM spokeswoman Megan Drumm said in an email to AP.

Scheduled speakers for the course, titled "Opioid Prescribing Amidst Changing Cannabis Laws,” were pain doctors from the University of Texas and the University of California, San Diego. They planned to cover how to select patients for medical cannabis, appropriate products and doses, and how to “wean opioids in patients on chronic opioid therapy,” according to the course description.

A study released in March concluded that only 9% of medical schools are teaching students about cannabis as a medicine.  “I’m not surprised by the findings,” commented Mark Steven Wallace, MD, chair of the Division of Pain Medicine at UC San Diego Health and one of the speakers scheduled for the now-cancelled webinar. Dr. Wallace said there is an opportunity for experiential learning on the topic at pain clinics like his, where medical cannabis is recommended “every day.”

Dr. Wallace has observed that some chronic pain patients arrive at the clinic after having tried and responded negatively to medical marijuana. “Quite often that’s because they have not been using the right formulation or have been using too high a dose,” he said. “We find that a low dose of a strain that combines THC [tetrahydrocannabinol] with CBD [cannabidiol] is most effective, but you won’t find that mentioned in the literature or taught in the classroom.” 

"Benzos" and Opiates: The Deadly Combination That Killed Philip Seymour Hoffman

NPR's "All Things Considered" had an extensive story tonight about benzodiazepines, which are commonly prescribed for anxiety, and opioid drugs, which have been increasingly "co-prescribed" with "benzos" like Valium in the last several years. According to the story, 30% of opioid-related deaths also involve benzos, which contribute to the slowing of breathing that can kill heroin users.

The story was triggered by the news that the untimely and tragic death of Philip Seymour Hoffman was the result of just such a combination.

I recently re-viewed Hoffman in Almost Famous, in a key role as famed rock journalist Lester Bangs that he nailed with only an afternoon's preparation. The filmmaker has said he had no match, and it seems the world agreed. He's also great in The Talented Mr. Ripley, Charlie Wilson's War, and Boogie Nights (as well as, of course, Capote).

I was moved by the outpouring of grief for Hoffman after his death, and wonder if he knew while he was living how much he was appreciated. I really choked up when I read this piece in Elle about a woman who not-so-secretly wanted to marry him. I knew what she meant: Hoffman was a stoner girl's dream, projecting a kind of easy-going warmth and humility that are rarely seen in combination with the intelligence and prowess he possessed. Yeah, he was teddy-bear chubby and not-traditionally handsome, but, as one reviewer put it, "We can easily imagine Hoffman as an an amiably stoned anything."

The only film he directed, Jack Goes Boating (pictured), was described (in play form) by the New York Times as "a gentle portrait of pothead losers in love."

"You're likely to leave the theatre with a contact high from the ripe pleasure that Mr. Hoffman and his castmates derive from portraying everyday eccentrics," wrote the newspaper's Ben Brantley, adding, "Most particularly, though, 'Jack' is about its title character’s pursuit of perfection, of talismanic, Zen-like moments to hold against life’s chaos."

The play featured a "stoned dinner party from hell" and "the most eloquent sex scene on any stage in New York." Variety reported, "Assuming the movie follows the play, Hoffman will sport blonde dreadlocks and spend a lot of time smoking a bong and pretending to be a Rastafarian."

Hoffman also attended the LA Shadow Convention, which had a strong anti-drug-war component, while filming Last Party 2000, a documentary he made about the 2000 presidential election.

NFLer Ricky Williams, a former Paxil spokesperson who used marijuana for his Social Anxiety Disorder, pronounced it "10 times more helpful than Paxil" as a confidence builder. Paxil is an SSRI (Selective Serotonin Re-uptake Inhibitor, meaning it mimics a low dose of LSD). 

Meanwhile, California NORML is receiving another spate of desperate calls from patients whose doctors are heartlessly threatening to deny them their opioid pain medications because they use medical marijuana. This despite the fact that the US Veterans Administration announced in 2010 it would allow medical marijuana use by patients on opioid therapy. A recent study of 21 individuals with chronic pain concluded that “vaporized cannabis augments the analgesic effects of opioids without significantly altering plasma opioid levels. The combination may allow for opioid treatment at lower doses with fewer side effects.”

Geraldo Rivera issued a blistering commentary for Fox News Latino on the War on Drugs in the wake of Hoffman's death.

UPDATE 4/17: A new review study concludes "cannabis is both safer and potentially less addictive than benzodiazepines and other pharmaceuticals that have been evaluated as substitutes for alcohol." And another study finds a possible link between the use of SSRIs during pregnancy and autism.

One year later: Philip Seymour Hoffman Could Be Alive Today If The Drug War Was Over