Harvard University’s Dr Peter Grinspoon on Oxycodone and Cannabis for Harm Reduction

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Via El Planteo.

Dr Peter Grinspoon is a general practitioner at Harvard University, writer, medical cannabis specialist, and lecturer. In 2016, he published the book “Free refills: a doctor faces his addiction” which seeks to explain the vulnerability of health workers to drug addiction and quickly became a global bestseller because it confronts the stigma, taboos and prejudices associated with addiction.

Peter’s relationship with medical cannabis is a long-standing one, dating back to his relationship with his father, Dr. Lester Grinspoon, who in 1971 wrote the book Marihuana Reconsidered, which calls for the legalization of cannabis. And in fact, the cannabis genetics bank, Barney’s farm, in the city of Amsterdam, created a stump in his honor.

“Barney’s has a strain called Dr. Grinspoon. I have to admit I tried it. And it’s a really good strain. It’s very insightful. It’s very stimulating and cerebral, much like my dad,” says Peter proudly, from his home in Newton, Massachusetts.

Free filling

In his writings and lectures, Dr. Grinspoon advocates harm reduction policies for drug treatment. His book deals with taboo subjects in the medical field and in society in general.

Peter tells us that the idea of ​​“free refills” refers to healthcare professionals with unrestricted access to prescriptions, but in general the title also refers to a particular phenomenon that began in the United States in 2000, when Purdue Pharmaceutical undertook a massive advertising campaign “to convince everyone that the treatment for chronic pain was opioids, especially OxyContin. “

Oxycodone is a potent opium-derived pain reliever that decreases discomfort by increasing pain tolerance, causes sedation, drowsiness, and depresses breathing. Prolonged use generates addiction and withdrawal symptoms such as cold sweats, cramps, dizziness, tachycardia, diarrhea, vomiting and hallucinations.

“It has been sold to all of us doctors and patients. Millions of people have been put on OxyContin, an incredibly addictive way to treat pain.”

Grinspoon explains that healthcare professionals are more prone to addictions “because we are under so much stress and have access to so many drugs, which results in much higher rates of addiction than the general public.”

“I became heavily addicted to prescription opioids to the point that the DEA raided my office in 2005. So I decided to write a book about my addiction and my recovery,” recalls Peter.

Dr Grinspoon understands that anyone can become addicted, so his book seeks to humanize addicts and overcome social stigma.

“Because the stigma is what really hurts people. People are afraid to ask for help. The book made a bit of noise because no one else thought they could talk about it. If people think they can get help, they won’t be punished. and they will be treated, so we are looking to open a safer route to recovery, ”he says.

-What does OxyContin generate in the brain and what are the risks?

Well the reason people take it is that it numbs both physical and emotional pain. I have found that many people with Oxy addiction have trauma or a history of untreated anxiety and depression.

It causes a very strong euphoria of optimism, and of course once you use it for a while you stop feeling the euphoria and start feeling miserable. You quickly go from fun to a very miserable lifestyle.

The pills are very expensive on the streets, and many users end up struggling with an addiction to cheap heroin, which is often tainted with fentanyl. This is why people overdose. And that’s why it’s important to have public health policies that seek to reduce harm, that support people in their recovery.

Adult cannabis and harm reduction

In 2020, 93,000 people died in the United States from opioid overdoses and Dr Grinspoon believes cannabis has a big role to play in public health.

“In general, people can use cannabis instead of opioids for chronic pain. By combining opioids and cannabis, the doses can be kept low (since most problems you have with opioids are dose related) and cannabis can help relieve opioid withdrawal symptoms.

However, he explains that there is not enough scientific evidence to confirm the possibility of replacing methadone with cannabis, in reference to public health policies that seek to prevent the spread of STDs and HIV / AIDS.

-Why does cannabis work, why does it have so many uses?

Well, we have this system of receptors in our bodies and in our brains, neurotransmitters that we’ve had for millions of years. Cannabinoids, which are molecules in cannabis, boost the functioning of this natural neurochemical system: the endocannabinoid system.

This natural system controls all kinds of critical bodily functions such as hunger, temperature control, memory, learning, processing, emotions.

There is a structural similarity between these natural chemicals in humans and the chemicals in the cannabis plant.

This is probably why we started growing cannabis around ten thousand years ago.

An interesting thing is that cannabis does several things at once, so it’s a bit difficult to study. If someone has fibromyalgia, cannabis will treat their pain and inflammation, anxiety, and help them sleep, making the patient able to participate more in the world and feel happier.

This sometimes requires our attention, as cannabis makes things taste better and sometimes people can gain weight. It’s not that magical, everything cannabis does is good.

-And speaking of improving people’s lives, what can you tell us about Q2 medical cannabis clinics?

Q2 is a very interesting clinic, which I am very proud to be a part of. It has locations in Latin America and is designed to serve those who want or need to start health treatments with cannabinoids.
Each clinic (in Mexico, Peru and Brazil) is a little different because the rules are a little different from one country to another. We have a training program, designed by Dr Raquel Peyranube, a wonderful Uruguayan professional, specialist in endocannabinology and problematic drug use.

Q2 is a cohesive clinic which, although governed by country-specific parameters, also incorporates general principles to make it a global network of learning and best practices in medical cannabis.

What should lawmakers do?

Grinspoon believes that harm reduction policies are about maximizing freedom, access to cannabis and its benefits.

He warns that a certain percentage of people can become addicted to cannabis and that the plant should not be consumed by pregnant or breastfeeding women.

“You cannot drive after using it. And teenagers should be careful as it can affect their brain development. These are the main harms of cannabis. However, these have been greatly exaggerated over the past 80 years, especially by the US government, “says Dr. Grinspoon.

According to the Dr, any good regulatory policy will maximize access to cannabis but minimize the damage. Something complex, although the results of legalization in the United States seem encouraging.

He explains that in the United States, the rate of cannabis use among adolescents has remained stable and even dropped a bit, “because when it is illegal, for example, a dealer will sell it to anyone. But now that it’s legal, ID is needed. “

Dr Grinspoon believes drug harm reduction begins with education and honest communication, to avoid infantilizing users and public opinion.
“If you tell the truth about cannabis, teens are more likely to listen to you. With a mature education, most teens are sane enough to listen to you.”

Another key issue for Grinspoon in harm reduction regulation is the fiscal aspect of cannabis legalization.

He understands that “the tax problem” is complex because “if you don’t tax enough, you don’t have the income to educate or treat people” but if you tax it too much, “it becomes too expensive and everyone turns to the illegal market”.

“In the United States, crime has not increased, drug use among adolescents has not increased, incomes are important and hundreds of thousands of people are no longer at risk of going to prison for cannabis, which frees up public resources for education and the public. health budget. “

Finally, Grinspoon points out that a legal product is always a much safer product for human consumption.

Today, legal cannabis is carefully screened for fungi, heavy metals, pesticides, etc., “something unthinkable 15 years ago when we had to resort to the dealer. Now we know everything in cannabis.

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