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Tramadol vs. CBD for Pain: CBD Wins

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It wasn’t the phone call anyone ever wants to receive—my 86-year-old mother had taken a fall and was on the way to the hospital. Oh, geez! The good news is that it was “only” a compression fracture of one of her vertebrae—it could have been worse in about a billion ways. Two nights of observation in the hospital and then home with a Chinese menu of medications, all designed to manage the pain while her bone has time to heal. The menu included…

  • Lidocaine patch to be changed every 12 hours
  • Ibuprofen (Motrin or Advil) every four hours
  • Tramadol every four to six hours if pain is too great for Motrin. Tramadol is an opioid that can be addictive but less so than some other options.
  • Oxy-something just in case the pain gets really bad. This is the heavy-duty one.

Pain management actually is very important for a fracture like this because doctors don’t want the patient to stay in bed—that increases the risk for blood clots and pneumonia. Instead the goal is to manage the pain so that the patient can actually move, albeit no jumping right back into the gym or, in my mother’s case, dog walking and sitting at work.

To her doctor’s credit, he spoke about the risks of opioids and stressed that Mom should use the safer options before moving on to the more powerful ones. And he also stressed that she wouldn’t be “pain-free” but that instead she should aim for tolerable pain. This is an important issue that has occurred with pain management—setting patient expectations that pain is to be tolerable rather than invisible. Invisible simply doesn’t happen in most cases, and this expectation encourages the continued use of the drugs.

With that public service announcement out of the way, her doctor still prescribed not one but two opioids for her…and was even more adamant that she should fill both prescriptions to keep her pain at bay so that she could get out of bed and avoid other complications.

Knowing full well the risks associated with opioids, my mom went as conservative as possible—lidocaine, yes…Motrin, yes. And for the first few days, she took one or two Tramadol a day to ease the pain and allow her to sleep. Doesn’t sound like much Tramadol.

But—last week, I interviewed Bob Stuttman, former head of the DEA’s New York office, for one of our Advocator podcasts, and he told me that taking any opioid even for as little as four days can increase the odds of dependence and addiction significantly. (Bob had some incredible stats about the opioid epidemic. We actually recorded several discussions. You can hear the first one on our website here or at the Apple Podcast channel here.

On Monday—four days after her fall—I sent a sample of CBD salve home to her. This is a product we have written about extensively and one that we have added to our Bottom Line Store after a lengthy search for a product that met our requirements of high quality at a good price point.

That evening, I got the following text from Mom: “The salve is good. I think better than the patch.” Progress.

The next morning, I got another text: “I have not had any meds since 9 pm. The salve is amazing.” Success!

That was a week ago. My mother hasn’t touched Tramadol or Motrin since. And thankfully, she never had to pull the Oxy-something out of the package.

Do you realize how huge that is? Imagine the potential to reduce opioid dependence if even a fraction of the more than 200 million opioid prescriptions per year could be replaced with safe, natural topical treatments that cost far less and do not bear the risks that come with prescription medication. It’s “ginormous!”

If you’re not familiar with CBD, you should be. It is related to marijuana in that they both have cannabinoids in them, but CBD products derived from hemp plants (as this product is) has no tetrahydrocannabinol (THC), the psychoactive part of the cannabis plant. Marijuana-based CBD can be sold only through dispensaries and is not currently available in all states. Hemp-derived CBD is available in all 50 states and is totally legal to sell.

More important is the power of the cannabinoid system and the array of ailments that CBD may be able to help. Pain is the most obvious. Most people are introduced to opioids as a result of some injury. According to Bob, young people receive their first opioid prescriptions for one of two reasons—wisdom-tooth extraction or a sports injury.

Seizures and anxiety are two other areas where CBD has been proved effective. Again, benzodiazepines are some of the most overused and addictive medications on the market. Women talk about needing a Xanax in a stressful situation like they talk about needing a Kleenex to blow their noses. Worse yet, the combination of opioids and “benzos” is deadly—as we witnessed with Heath Ledger, who died in 2008, and the other 10,000 or so people who died of the combination last year. It’s tragic.

Here’s the insanely frustrating part—as we listen to Washington talk about the war on drugs and debate ways to reduce health-care costs by transferring them to someone else or by renegotiating prices with the Pharma companies—there are treatments available that are far, far safer than the drugs currently being used, but doctors aren’t being trained to prescribe them and the pharmaceutical companies’ lobbying power gives them a “lock” on the industry.

Not a single doctor, nurse or anyone else among the many that my mother saw suggested CBD to her. They wrote excessive prescriptions for drugs that she should have in her cupboard “just in case.” This happens every day, millions of times a day, for injuries of all types. Most doctors say that they are aware of the dangers of opioids and that they are more conservative when prescribing them—yet the number of prescriptions written continues to rise. Thankfully, my mother is educated and careful about what goes into her body because she is extremely drug-sensitive, but others are not. They innocently follow the instructions of the experts who are practicing speed medicine with their prescription pads in a system that doesn’t provide the proper education for the experts or the time for them to actually work with patients on other options. Of course, I strongly recommend that everyone check with their doctors before starting CBD or any other pain-management treatment. That said, given the politics of the situation, your doctor may or may not be knowledgeable or supportive. Do your research. Ask your questions and be sure you have a doctor who takes the time to understand your views and works with you and not at you.

On a side note: For those of you wondering about the “cement injections,” or vertebroplasty, often given for compression fractures—latest news from Mom’s doc is that the long-term outcome is comparable between cement injections and time-to-heal, but the injections come with risks for infection or nerve damage.

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