Opioid Crisis and Medical Marijuana

Question 1

What are significant barriers to adequate pain care?

Answer 1

• Gaps in knowledge and competencies for providers
• Systems and organizational barriers
• Need for more education and research

Question 2

What are the steps to managing chronic pain?

Answer 2

-Determine when to initiate or continue opioid for chronic pain
-Establish treatment goals
-When starting treatment, prescribe IR not long acting
-When prescribing, start with the lowest effective dosage
-Evaluate risk and benefits, reevaluate every 1-4 weeks
Review patients controlled substance history
-Urine drug testing before starting and then annually
-Establish pain contract
-Avoid prescribing opioids with Benzodiazepines when possible.

Question 3

What system is responsible for the action of relaxation, eating, sleeping and forgetting related to marijuana use?

Answer 3

Endocannabinoid system

Question 4

CB 1 Receptors:

Where are they found? What do they effect?

Answer 4

CNS

Modulate cognition
Memory
Motor function
analgesia

Question 5

CB 2 Receptors:

Where are they found?
What is their effect?

Answer 5

Found mainly in tissues related to immune function such as WBC, bone marrow, tonsils, thymus and spleen

Affects receptor having analgesic effects focused on inflammation

Question 6

What effect does THC have?

Answer 6

Psychoactive
_enhances analgesia
-Shown to have anti-inflammatory effects
-More CNS side effects

Question 7

What effect does CBD have?

Answer 7

Non-psychoactive

-Analgesia and anti-inflammatory effects without the SNS side effects

Question 8

What schedule is marijuana?

Answer 8

Schedule 1

Question 9

Dronabinol (Marinol) Use

Answer 9

Treatment of N/V associated with cancer chemotherapy in patients who have failed to respond to conventional antiemetics.