Codeine vs Cannabis

February 5, 2018

Points for Pain

Last night one of the most watched events around the globe garnished our cheers and boos as we watched in anticipation of the next field goal, touchdown or big hit! The Super Bowl for many is a tradition to look forward to all year long, much like our beloved Grey Cup here in Canada. Today on the morning after one of sports biggest night’s, let us not forget the brute force used, the 100% left on that field and amount of pain some of these top athletes may be in.

Opiate use among professional football players has always been in the media, and that is no surprise ; we cheer for every tackle, we celebrate the big hits, the bigger the better in fact. It is not shocking to me that after having a 250+ pound football player repeatedly drag you to the frozen ground, you might be prescribed something for pain, a little bit of morphine, or maybe some dilaudid. The problem is, however, that these athletes are working, this is their job, and it does not “get better” or “get easier” with time.

The American Orthopedic Society for Sports Medicine began an investigation in 2007, after the amount of injuries incurred during football games began to rise drastically.

If we invest in our Grey-Cup winning Ottawa Redblacks, and want them to have the best facilities to work out in, and the nicest fields to play on, why not invest in, and be worried about their health as well? If you think about about the toll and long term implications these medications can have on an athlete’s body, you have to wonder if there are better, safer, more appropriate alternatives, that still provide the therapeutic effects that allow them to play to Gold Medal or Grey Cup standards.

The American Orthopedic Society for Sports Medicine began an investigation in 2007, after the amount of injuries incurred during football games began to rise drastically. There tend to be three common types of football related injuries, upon investigation. First, there are traumatic injuries, usually occurring in the knees (PCL/ACL ligaments) or shoulder areas. Second, there are concussions. Concussions are indicated when there has been a change in consciousness after significant impact. Third, and common among all professional athletes, is overuse syndrome, where repetitive use of the same muscles/muscle groups results in chronic pain, or inflammation.

Guess what?

These injuries can all be treated, with an organic, non-invasive and far less physically and psychologically addictive medication than morphine or dilaudid. It’s called cannabis.

Traumatic injuries to the knees and shoulders can result from the combination of speed and significant physical impact. Many of these injuries end up requiring surgery, which comes with a wait list. While the patient waits for their surgery, the inflammation and pain that results from their injury can be quite significant. Throughout the day, patients use doses of opiates to rid themselves of pain. Often, these medications are so strong, that patients feel cognitively impaired-too much so to play football. If it is unsafe to drive while consuming these pills, how can you coordinate the fine motor movements required to play such a high contact sport?

Concussions can have lasting symptoms, as seen in professional hockey players such as Sidney Crosby or Clarke MacArthur, who have never played the same since their bouts of concussions that started years ago.

One of the prominent components in cannabis, THC, is the psychoactive component. Although there is a ‘high’ effect when using this product by itself, THC is a fantastic pain medication, with one of it’s top medical uses being chronic or neuropathic pain. For football players struggling to sleep because of their pain levels, the THC is also very beneficial-and far less hazardous long term than taking varying sleeping pills/sedatives. If patients are hesitant to use THC because of a negative prior experience, or because of the potential high/cognitive effect, they can pair it with a high CBD product, which actually reduces the high effect of THC, while still allowing patients to experience its medicinal pain relief benefits.

Concussions in any sport-hockey, wrestling, or football- are very worrisome injuries. Concussions occur at many points throughout the game, because of the combination of high impact hits, and players being brought to the ground with great force. Concussions occur when there is a change in level of consciousness after a head injury, which can also result in inflammation within the brain. Concussions can have lasting symptoms, as seen in professional hockey players such as Sidney Crosby or Clarke MacArthur, who have never played the same since their bouts of concussions that started years ago.

Cannabis can prove to be an effective treatment for patients dealing with the pain, nausea, and insomnia that can arise with concussion syndromes. CBD, or cannabidiol, can be used for patients dealing with concussions because of its astounding ability to treat inflammation. By treating the inflammation in the brain, we are able to decrease pain, and actually help the injury heal, as opposed to simply masking symptoms with drugs like morphine. Although morphine is a powerful pain medication, it does not provide any healing properties the way CBD can.

The other major issue associated with concussions is the issue of nausea- a debilitating symptom that can result in weight loss and GI issues. Morphine, dilaudid and fentanyl all come with the nasty side effect of further nausea and vomiting- so maybe it treats your pain, but if it makes you even more nauseous, is it worth it? CBD is the component in cannabis that is responsible as an antiemetic; many of our oncology patients swear by CBD as their only means to reduce nausea. Although THC is responsible for the sedating or ‘sleepy’ effects of cannabis, and can therefore be helpful with patients dealing with insomnia, it is the neuroprotective properties within CBD that make me hopeful for patients with varying forms of neurological issues, from Alzheimer’s to ALS.

Overuse syndrome is a condition that affects patients who perform repeated, strenuous tasks. Overuse syndrome is very common in professional athletes, as so much of their time is dedicated to perfecting their kick, tackle, throw or running technique. Overuse syndrome comes with chronic pain in the affected area, and can acutely cause inflammation every time the exercise is performed. Many patients who are affected by conditions such as arthritis, muscle pain, or bone pain deal with the inflammatory processes that are associated with it. If these football players were given the option of experimenting with CBD, a non-psychoactive component in cannabis that is largely responsible for reducing inflammation within the body, they could potentially have pain coverage throughout the day, with no ‘high’ or cognitive effects that are usually attached to traditional pain medications.

Medications like morphine or fentanyl are too often prescribed to a patient population that does not necessarily have all the information they need to take them safely. In order to better serve the opioid dependent population, that will unfortunately always exist, we need to be able to communicate the new scientific findings that we are discovering related to medical cannabis. Often, cannabis can provide better symptom management, as well as disease control, than traditional medications. Professional athletes have jobs that require them to perform at their best, while still being functional and healthy. When we have so few options for pain control available, it is no surprise that a large portion of these athletes turn to medical cannabis.