Pain and Opiates: Is the Opioid Crisis a Self-Inflicted Wound? (First in a Series)

Approximately 33,000 Americans in 2015 died from opiates. 22,000 of those were involving prescription opioids the same equivalent to about 62 deaths a day. These numbers are skyrocketing compared to previous years.  It is an epidemic. Can it be stopped?

(Picture from CDC, https://www.cdc.gov/drugoverdose/data/analysis.html)

The number of Americans who died from opioids is nearing the same number of fatalities on the US roads due to car accidents (38,300 in 2015). But unlike car accidents, death by overdose in theory, should be far more controllable.

Opiates eliminate pain. But they take a big toll on the human body. And if you go too far with them you may never come back. Heroin for many has been the next stop. An estimated 50% of heroin addicts start with prescriptions. Without the fix your body implodes. This short statnews.com video  describes what happens.  Enlightening and scary.  Share this with anyone you know that is taking opioids so that they understand the risk. If every child in America were to watch this video a great deal of suffering would be avoided.

Can the carnage caused by prescription drug abuse be avoided? Perhaps, but only two ways:

  1. Don’t take opiates in the first place.
  2. Don’t let opiate use take you to the point of addiction.

The Problem of Pain

We began research to identify the innovative scientists and medical entrepreneurs working to come up with new ways to address pain and its causes and to solutions to the pain problem which creates the need for opioids. We have divided our research into the following general areas, starting with medical marijuana. The first in a series of articles is on the potential for medical marijuana.   

  • CDB, Hemp Oil (related to medical marijuana)- A natural non-addictive means to deal with pain.
  • Stem Cells (injectables) -Techniques to intercede early and eliminate the source of osteoarthritic pain.
  • Neuromodulation (electricity masking the pain).
  • New Anti inflammatories (drugs)- Inflammation is a primary point of pain. New drugs can stop at the source.

Medical Marijuana as an Opioid Replacement

Can you get someone off an opiate like Oxycontin with a cannabinoid? There is a growing body of evidence that suggests that  a primary cannabinioid in the hemp plant, cannabidiol (CBD) has promise as an alternative to opioids.

And there is a growing body of evidence that medical cannabinoids have driven down the use of opioids. Most recognize that, at least for lower level applications for pain, it is a natural substance that holds great potential to reduce opioid replacement therapy as patients can avoid additional opiates by substituting cannabis.  

According to physician Dr. Dustin Sulak, adding cannabis to opioids makes the opioids safer. Cannabis can prevent opioid tolerance building and the need for dose escalation. Cannabis can treat the symptoms of opioid withdrawal, and cannabis is safer than other harm reduction options for people that are addicted or dependent on opioids.

In summary, CBD can eliminate the use of opioids for a low dose or it can be used in conjunction with opioids to reduce opiate use for higher levels of pain.

THC vs. CDB the Active Ingredients in Hemp

The cannabis hemp plant is bred for different applications. It is the source or rope. It is also the source of recreational marijuana and the reason that it is a schedule 1 drug. It depends on the strain of plant. Hemp is cannabis with lower THC content, hemp usually contains around from .03 THC, whereas a plant bred for recreational use will contain around .10 THC/

THC and CDB are two of the best known of the 80 cannabinoids that are found in the hemp (marijuana) plan.

Hemp oil, which is primarily used as a topical lotion or as a patch, has become an increasing popular means to delivering pain relief.  The plant has been used for thousands of years since the beginning of recorded history. It was once regarded as important by the medical community (in the 1920’s) but politics got in the way, likely the recreational aspect of it put it in dangerous drug territory, taking with its positive medicinal capacities into a schedule 1 drug (with the most dangerous of drugs), even more so than cocaine (schedule 2).

But the active ingredient THC used primary for recreation has overshadowed CBD which has no psychotic impact holding back its potential. General mistrust of the plant remains connected to hippies, stoners and slackers as a detriment to society’s well being.

Research

Most of the research on the potential of this is being done outside the US in countries with less burdensome regulatory constraints. Israel is leading the way. Israel is also the home of the scientist who is credited with the major advances in this area, Dr. Raphael Mechoulam, who discovered the endocannabinoid system and is in the forefront of the research.

Tel Aviv was host to the 2017 CannaTech Summit which concluded last week is a high level, three-day event of thought leaders and market disruptors in medical cannabis across the globe similar to a TED talk format. 

Companies

Cannibis stocks are emerging as solid investment plays. Some of the biggest biotechnology winners of 2017 so far are cannabis stocks. GW Pharmaceuticals (NASDAQ:GWPH), a $3 billion pharmaceutical cannabis company is up around 7% thus far in 2017. Zynerba Pharmaceuticals Inc (NASDAQ:ZYNE), a $250 million company, is up 22% year to date and close to 80% across the last twelve months. Cannabics Pharmaceuticals Inc (OTCMKTS:CNBX) with a $341 Million Market Cap.

There are an increasingly number of companies entering the space with more to follow. GW Pharma with its $3 billion market is a darling of the investment. Therapix Biosciences [NASDAQ: TRPX] went public last week with their lead indication that Tourette Syndrome (TS) is a neuropsychiatric disorder with increased prevalence among children. Therapix is also developing an ultra-low dose formulation of dronabinol, combined with sublingual and nasal delivery methods, to provide a treatment for Mild Cognitive Impairment (MCI).  The company opened at $6.30, and was trading at trading at $8.60 end of the week. Based on the 3.1 million expected outstanding share, this gives the company a current market capitalization of about $26.6 million.

Not only is this a low valuation compared to some of the mid cap players with comparable programs, like the above mentioned Zynerba, but it also falls far short of other cannabis stocks with far less promising or far less developed programs.

The above mentioned Cannabics Pharmaceuticals, which we noted above as developing topical administration assets, is pre-clinical and has a market capitalization of $330 million. OWC Pharmaceutical Research Corp (OTCMKTS:OWCP), a company working to develop cannabis based oncology therapies is, again, pre-clinical and had a market capitalization of more than $178 million at last close.

The Viridian Cannabis Stock Index, an indices of cannabis stocks, has outperformed the NASDAQ, the S&P 500 and the Dow Jones this year to date, up just short of 20% for 2017 so far.

Pain Oriented Companies

As for cannabis companies treating of pain with CDBs, the major player in the space is Mary’s Medicinals, which is regarded as the 800 lb. gorilla by competitors.  This privately owned Denver company’s core products are lotions and transdermal patches now operating in 7 states.  We expect a growing number of companies to enter this space.

In terms of investment opportunities, one relatively new player on the scene is a small public company called Premier Biomedical, Inc.  (OTCQB: BIEI) Market Cap. $6.2 Million. That is squarely going after the pain market and recently launched commercial sales of hemp oils and patches. They have impressive testimonials verified by our staff who have seen as effective in the treatment of muscle pain from sports injuries.

The company has had a couple of promising oncology and PTSD assets in development, but because of the enormous costs of their research  they decided to pivot their attention towards manufacturing and selling pain relief products to generate a revenue stream.  They began in February to begin selling what they consider to be the world’s-best 96-hour pain patch and hemp oil roll-on applicator.  They intend to introduce four more pain relief products this calendar year.  They sell their pain relief products through their website, www.painreliefmeds.com, as well as through direct distributors.

Politics and Schedule 1 Drugs: Setting Up a Battle in the 9th Circuit Court vs. DEA.

Despite the promise of CBDs as a means to fight the opioid epidemic, it looks like we’ve taken a step backward. In December the DEA (Drug Enforcement Agency) decided to place hemp on a schedule 1 product. This will deter investors from considering companies in this space, but it is unlikely to hold and it won’t stop those in pain from growing demand for these natural products which are much safer than opiates. That being said, it is hard to understand the policy or lack thereof. No one has died from a cannabis overdose.

As the casualties from the opioid epidemic pile up it will be interesting to see if policy makers, regulators, scientists and entrepreneurs can collaborate to find solutions in cannabinoids for the opioid epidemic.  

Next in the Series:  Fighting the Opiate Battle and Stem Cells