Editorial: On pain, drugs and addiction

Sara Golling
By Sara Golling
August 24th, 2017

The opioid crisis is deeply troubling, for many reasons.  One reason is the tragic deaths of so many, so unnecessarily; another reason is the likelihood that those deaths were precipitated by pain, either physical or psychological, that caused a search for relief in the illicit drugs that were fatally used. Another reason is the threat felt by many parents of young people who, they fear, may be tempted to hazard their lives because they think there is something glamorous about taking risks in the form of drugs.  Another troubling result of  the crisis is the denial of effective relief to those suffering from severe physical pain.

Has everyone heard of “Rat Park” ― a set of experiments designed to test the supposition that various drugs are immediately addictive?  The outcome of the experiments drew the conclusion that the various drugs tested on the rats were much more attractive to those who were being held in the rat equivalent of solitary confinement; whereas the rats who were free to socialize, play, mate and have offspring, and to exercise whenever they felt like it in varied and interesting surroundings, did  not tend to consume the drugs which were freely available to them.

If the same is true of humans, then those who are more likely to become addicted to drugs are those who think they need to use them for extended periods to relieve the pain of their existence.  That pain may be caused by illness or injury, or by mental anguish from a multitude of possible causes.  Then there is the loaded term “addictive personality disorder” — but is there really such a thing? Experts hold differing views.

In his well-known book “The Natural Mind,” Dr. Andrew Weil examines humanity’s history of using and abusing psychoactive drugs, and proposes that there are alternative ways of achieving the altered states of consciousness that he thinks drug users are seeking; his analysis of the hazards and uses of various drugs is refreshingly objective, but one reviewer  who is a neuroscientist objects strongly to some of Weil’s conclusions. (Being no neuroscientist, I think the book is a very worthwhile read, but would caution against swallowing any and all conclusions as undisputable fact.)

Many of the deceased victims of drug use are young. This fact leads back to the reasons for taking drugs:  peer pressure, immature judgment, and / or the anguish of an individual’s circumstances. And what about the drugs themselves?  There seems to be less certainty than ever about exactly what one may be ingesting, and whether or not it may be contaminated with harmful levels of pesticides or other additives.

Even cannabis has been found to be contaminated.

Many young people mistakenly believe that cannabis is harmless; and we all know how strongly people of any age cling to their mistaken beliefs. The reasons for hanging onto beliefs in the face of overwhelming evidence to the contrary are explained clearly and engagingly in the book “Mistakes Were Made (but not by me),” by clinical psychologists Carol Tavris and Elliot Aronson; and in a graphic form (replete with bad language) in the “Oatmeal” comic titled “believe.” Once a person believes something, that belief is extremely difficult to dislodge IF the person feels that he or she has something to lose by changing the belief. So getting a young person who uses, or wants to use, cannabis, to understand that it is not harmless to people under the age of about 25 years, that it does result in impairment, that it can result in undesirable changes to the brain,  and that heavy use can actually trigger psychosis in vulnerable individuals and bring on mental illness such as schizophrenia or severe bipolar disorder, can be a real challenge. The myth of harmlessness is out there, and many people want to believe.

Yes, cannabidiol or CBD (one of the cannabinoids in cannabis) has been found to help with a number of medical conditions, and many physicians are calling for more and better-quality research on its potential medical benefits.  And as a result of years of selective breeding for higher levels of THC, the psychoactive component of cannabis, many strains of cannabis are now higher in THC and lower in CBD, which is not good news for the brains of young recreational users.  Cannabis is no different from any other drug in that it has hazards, especially with regular or heavy use.

For parents or others who may want to talk with young people about drug use and its dangers, starting with cannabis, Health Canada has teamed up with “Drug Free Kids Canada” and is distributing a free brochure to help open the topic, and to help adults avoid common errors in communication that can shut it down instead of opening it up. It’s available online ― just click this link to check it out.

Meanwhile, parents can ensure that young people have other, more interesting and constructive things to do than stupefying themselves with cannabis, alcohol, or other chemicals.  And that they know they are loved  ― without being smothering or over-controlled. Just in case the “rat park” experiments really do have valid conclusions for humans too, and that seems very likely, doesn’t it?

For chronic pain sufferers, for those with sudden debilitating pain from injury, or severe post-surgical pain, recent policy on limiting prescriptions for effective pain-killers because of their potential addictiveness may have gone too far.  It has gone too far when people suffering intense pain, who have no history of drug abuse, are denied effective pain relief and are instead given lectures on the hazards of painkillers and addiction.    

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