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02/01/17
Opiates Vs. Cannabis for Post Surgery Recovery

Preceding her hip surgery, Nikki Lastreto made the decision to use cannabis as much as possible to help with the post op discomfort instead of traditional opioids.

Opioids are pain relievers that connect to the parts of the brain that control pain and emotions. They increase the levels of the “feel good hormone”, dopamine, generating a heightened sense of relaxation and happiness. However, long term use of opioids can lead to addiction because the brain will require more and more of the drug to produce the same levels of relief which could eventually lead to dependence and addiction.

“Prescription opioids are absorbed into our blood vessels. Once in the vessels of the brain, transporters help these compounds to travel to their target cells where they bind to specific receptors. That binding leads to pain relief and other positive feelings.

But the brain picks up the increased binding of these receptors. After a few weeks, it starts to remove opioid receptors to lower the signal and decrease receptor binding to where it was before. The opioids are in the blood, but they’re not affecting the brain as much as they did before. That means the same dose of medication has less of an effect and more is needed to treat the same pain. This phenomenon is called tolerance”. – Devi E. Nampiaparampil, MD

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While at the hospital, Ms. Lastreto made it very clear that she did not want any opioids post surgery. She would only receive full anesthesia, which included a light dose of oxycodone. She had brought with her all of her own cannabis (edibles, oils, and tinctures) as she was advised by the hospital they could nor provide or administer it to her.

Lastreto had a variety of cannabis products at varying intensity to help with the severity of pain she could possibly experience. The cannabis plant has several cannabinoids (chemical compounds), the most well known being THC (tetrahydrocannabinol) that gives you that euphoric feeling. The other is CBD (cannabidiol), and is non-psychoactive. Cannabidiol is “an appealing option for patients looking for relief from inflammation, pain, anxiety, psychosis, seizures, spasms, and other conditions without disconcerting feelings of lethargy or dysphoria”. – Project CBD.org

“MJ4X medical oil concentrate, which is basically what we have known as Rick Simpson Oil(cannabis extracted oil), but this is truly made with organic methods…it is very high in THC and is also used by cancer patients for their pain and healing. In addition, she gave me some of her high CBD (Ratio 1:20 THC-CBD) Bhutan brand tincture for pain. My friend Rosebud tells me that strong CBD has been proven to help stimulate bone growth and healing”.

“After months of research, I have settled on the Altai chocolate covered cherry Pips…Each little cherry is 10 mg of cannabis, a light dose for me, so I can start slow and build up as necessary. Not only do they make me feel good in my head, but in my body as well. – Nikki Lastreto

Cannabis is also split into 3 different categories: indica, sativa, and hybrid. Indica has a very relaxing effect and can be used for insomnia and pain relief. Sativa has an uplifting effect and is good for daytime use. Lastly, hybrids are a mix of the two. Hybrids can be tailored to meet an individual’s specific need. With the varying options, Lastreto was able to take what she needed according to the pain she was having. If the pain was intense, she opted for something with a higher THC.

“For a heavier hit, and a solid night’s sleep every time, I go to my old high school friend who makes the most delicious caramels in the world. And do they pack a punch! I think it has something to do with the way they melt in your mouth and hence absorb exceptionally well. I have a feeling that a bit of caramel and a dropper of Blue Dream sleeping tincture, and I’ll sleep like a baby. And when it’s time for exercise, it will be a sativa chocolate cherry and a hit of the Sierra Berries tincture, and I should be dancing with my walker in no time”.

Post surgery Lastreto experienced some nausea. She was checked on by the nurses and was given a variety of medications to help with inflammation and nerve pain every four hours. She was assured that no opioids were in the mixture. The nausea continued for three days and although cannabis was a temporary fix, each day she was progressively getting worse. She later found out that the mixture the nurses were administering her, did contain a light dose of the narcotic tramadol and something called gabapentin, which can make you feel very sick. She immediately stopped taking the medication and was released from the hospital that day and experienced withdrawal symptoms for the next 24hours.

Opioids have two different categories, prescription and illegal. Prescription opioids are drugs such as morphine, oxycodone, codeine, and hydrocodone. The illegal opioid is heroin. Besides the addictive factor, opioids also have unpleasant withdrawal symptoms.

“About a day after the recovery from that, I awoke one morning before dawn with strong heart palpitations, a pulse rate of 160…I was having hot and cold sweats, my brain was very clouded and my blood pressure went down to only 70…

…Ever since I left the hospital, I have been only using cannabis for pain and it is absolutely no problem. Yet in the manual all patients are given, it instructs people to wean themselves off the narcotics by 3-4 weeks. The pain is so minimal that narcotics are unnecessary. Especially after living with real pain for years before the replacement”. –Nikki Lastreto

With very few side effects, cannabis has been proven to take away some of the pain that opioids can’t. It has a therapeutic effect that can ease the psychological factors of pain. Lastreto is recovering beautifully from her hip replacement surgery. Only one month after her surgery was she able to walk using only a cane to assist her.