Dr Samuel Murray (BMed, MBA)
Chronic pain affects more than 40% of Brits, meaning that over 28 million people in the UK live with pain that has lasted three months or longer. A recent study by The British Pain Society suggests that a third of these people struggle with pain that is moderately or severely disabling. This includes patients with neuropathic pain, back pain, fibromyalgia, cancer-related pain and other causes of chronic pain. Chronic pain is often misunderstood, and can have a devastating impact on both those that suffer through it, and their families and friends.
The UK is not alone in this ‘silent epidemic’. In the US, healthcare costs associated with chronic pain are more than cancer and cardiovascular disease combined. The use of the morphine-based opioid painkillers to treat chronic pain has skyrocketed throughout the developed world over the past decades. In 2015 in the US, 240 million prescriptions were written for opioids, and deaths related to the use of these drugs have been increasing throughout the OECD. Reaching crisis point, the US has recently managed to slightly decrease the availability of opioids. Worryingly though, the availability of opioids in the UK increased 68% between 2013-2016. Clearly, how best to treat chronic pain is one of the biggest challenges that the healthcare system faces. Unfortunately there’s a common misconception that patients want to be treated with painkillers, or worse still, that a patient’s chronic pain is somehow their fault. In my experience, most patients are very reluctant to take opioid painkillers, perhaps even more so than the doctors that are reluctant to prescribe them. Chronic pain needs to be tackled holistically, and prescription medication should only form a part of an overall treatment plan. Talk to your GP about exercise, meditation, and counselling, these things can be a huge help. Your GP or Pain Consultant may also suggest involving other health practitioners like physios, occupational therapists and psychologists – we doctors don’t always know best!
In many cases though, despite doing everything possible, medication is needed to treat pain, and the best course of treatment needs to be carefully considered by the patient and their doctor/s. There is, and probably always will be a need for opioids to treat chronic pain in certain situations, when all safer options have been exhausted.
There is also role of cannabis-based products in the treatment of chronic pain. Just like opioids, cannabis-based products should never be first-line, and should really only be used as a last resort. For many patients where other conventional treatments have already been tried, cannabis-based products can be a valuable addition to their overall treatment. Cannabis-based products are very new in the UK, and UK health professionals are understandably cautious. Cannabis is not without risks, and definitely isn’t for everyone, and really should only be used as a last resort.
Working as a doctor at Cannabis Access Clinics Australia over the past year, I have been pleasantly surprised by results I have seen using small doses of THC and/or CBD based treatment. In Australia, Cannabis-based products are also tightly regulated to ensure patient safety. Cannabis should be used as a part of an overall pain treatment plan, and is by no means a silver bullet – you should be suspicious of anyone who tells you otherwise. With all this being said, it has been truly heartening to see the impact that cannabis-based treatment has had on the quality of life of many of my Australian patients.
Encouragingly, many of my Australian patients have been able to reduce their reliance on opioid-based painkillers, many being able to eventually stop them completely. While this is my experience, more research is needed to understand the role in safely reducing the reliance on opioid treatment for treatment of severe chronic pain. In conjunction with Applied Cannabis Research, Cannabis Access Clinics will be running a number of studies to investigate the role that cannabis based products can have in treating UK patients with Chronic Pain, as well as how this treatment may impact the health systems increasing reliance on opioid painkillers.
While I will not personally be prescribing in the UK, I am very excited to take on the role of General Manager of Cannabis Access Clinics UK, and to be working alongside our team of specialists lead by GMC registered Anaesthetist and Pain Consultant Dr Gerard Sinovich.
Cannabis Access Clinics UK is soon to launch. If you’re interested in participating in one of these studies, and would like more information, contact firstname.lastname@example.org or book an eligibility consult with one of our health professionals.