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A few decades ago, we knew very little about the chemistry of cannabis. Most of what I encountered in college was low quality, compressed, greenish-grey material with lots of stems and seeds – commonly known as “Mexican brick weed.” It was likely to make you feel passive, immobile, and hungry – a much more benign combination than the various effects you might experience from too much beer or Mad Dog 20/20.
Of the many compounds in the plant, we only heard much about two back then – THC and CBD. At the time, our elementary knowledge could be summed up in a few words: THC is the mood-altering component (what gets you “high”) and CBD is the part that makes you relaxed. We didn’t want to be relaxed, though, so we interpreted this to mean that “good marijuana is high in THC and low in CBD” and bad marijuana is the other way around.
In the years that followed, Mexican brick weed became increasingly scarce as the American cannabis industry bred more potent plants that contained an ever-higher percentage of THC. But for many of us who had dabbled in it in our early 20’s, an intensely altered state was no longer something we desired.
As legal restrictions loosened up, specialists in botanical medicine were eventually able to gain a better understanding of cannabis chemistry (we still have a ways to go) and breeders began to develop strains that produced a more specific effect – calming, stimulating, and so on.
Furthermore, although the market for Mexican brick weed seemed to be long gone, it turned out that there was a high demand, especially among older consumers, for a product with its effects – essentially a breed with a high level of CBD and a very low quantity of THC. Something a connoisseur would have once called low quality cannabis is now sought after. And an increasing number of my patients tell me they use this - or simply CBD alone - not to “get high” but to de-stress, decrease pain, sleep better, manage neurological disorders, and more.
A patient with very stubborn idiopathic nerve pain (meaning, the cause was unknown) came in one day reporting that the pain had been remarkably better since our last visit. “I hate to break it to you, Doc,” he said with a smirk on his face, “but it wasn’t the acupuncture.” He went on to tell me that he had been using a topical CBD lotion, and that it was more effective than anything else he had tried.
Another patient, who had for years experienced an anxious tightness in her chest in social situations, told me that a small amount of oral CBD resolved it without causing any other perceptible effect. She said, “I don’t feel different in any other way. I do my work, I can think clearly. I just don’t have that anxious feeling.”
And several patients who were tired of using pharmaceuticals to treat their insomnia have told me of their success with a variety of CBD products. They generally find them just as effective as sleeping pills, but with the advantage of being natural. Also, unlike the prescription drugs, they don’t worry that the CBD could put them into such a deep slumber that they might not hear a smoke detector or other emergency.
Now, if there’s one thing that rubs me the wrong way, it’s a “cure-all” – and that’s because there aren’t any! There’s no substance out there that’s good for everything or everyone, and I’d be remiss as a healthcare practitioner if I implied otherwise. CBD isn’t going to fix your life, and some people don’t experience any noticeable benefit from it. But I can say that, for many, it’s a useful natural helper with an excellent safety profile. And I’m eager to see what more we learn about this and other remarkable plants.
Be well,
Dr. Peter Borten
P.S. Just as we were publishing this article, I discovered a new study in the journal Nature on the use of CBD in the treatment of pancreatic cancer. Pancreatic cancer has a dismal 5-year survival rate of just 5%. But in this study, mice with pancreatic cancer who were given CBD plus chemotherapy survived THREE TIMES longer than those who were treated with only chemotherapy. While we don't yet know how this will translate to treatments for humans, it's one more way in which this astounding plant is a promising tool for healing.
Click Here to Learn More About Dragontree CBD Infused Body Care Products And Get Free Shipping On Your Next Order
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In this month’s series on pain, I’ve detailed the interventions that I feel make the biggest difference in sustainable pain management without medication. I haven’t mentioned drugs because I feel their side effects make most of them inferior for chronic pain management. For short term use, I have no problem with aspirin or ibuprofen. Many of my our clients are as naturally-oriented as I am, and want to avoid pharmaceuticals at any cost, but if you get a headache once a year, don’t feel guilty about taking an aspirin for it! For longer term use, I encourage you to try the measures I’ve discussed and also to consider some natural analgesic and anti-inflammatory supplements, many of which are profiled in an article on joint pain I wrote a few years ago.
Now I will introduce a few final practices to help you avoid pain:
1. Pay attention to your posture. I’ve written a lot about posture, so here’s the deep and brief. The majority of our pain results from muscular strain, and a great deal of our muscular strain is postural strain. We may think about posture when we sit at a dinner table and perhaps when we lift a heavy box, but all day long we have opportunities to improve our posture and lessen the total strain our activities exert on our bodies.
Some of the key situations to pay attention to posture are: (A) Sitting on a chair or couch. (B) Holding a phone up to the ear. (C) Typing on a phone, tablet, or computer. (D) Driving. (E) Exercising (F) Sleeping.
In exercise, we call good posture “good form,” and without it, our workout isn’t as comprehensive, plus there’s a much higher risk of injury. When talking on the phone, we should be careful not to tilt the head to one side. When typing, keep the shoulders back, the chest open, and the spine straight. When driving, be aware that keeping your elbows up in order to grip the steering wheel means a prolonged strain of the back – take breaks, stretch, drink water, relax.
2. Get your sleep situation optimized. By bedtime, most people – even those with chronic pain – crawl into bed without having given a thought to the fact that they always wake up sore. This could simply be the result of 8 hours of immobility, but since we spend a third of our life in this place, it’s worthwhile to make it thoroughly rejuvenating to the body. Or at least, to ensure that it isn’t a detriment.
Unfortunately, many of the positions we put ourselves in create postural stress or put excessive pressure on sore spots. I’ve had patients make tremendous recoveries from severe pain just by changing their sleep configuration. Investigate mattresses and pillows of varying firmness. Get a body pillow, and/or multiple smaller pillows and experiment with positioning them so that all parts of you feel supported. Avoid positions that crimp muscles or joints (such as sleeping with an arm above your head or under your pillow). Almost everyone does best sleeping on their back, possibly with a small support under the arch of the neck and another under the arch of the lower back.
3. Treat your life like an all day workout. This is another subject I’ve covered extensively in the past, so I’ll bottom line it. All day long, we work certain muscles for longer than we ever dream of working them at the gym. And we habitually (though unintentionally) work the same muscles day after day and neglect the same muscles day after day. If we were approaching our day’s activities as a workout, we’d stretch before and after, we’d drink lots of water, we’d take breaks, we’d be well-rounded, etc. Try to bring the same level of consciousness to your everyday activities. Switch it up, take breaks, stretch, move around, engage your core, have good form, drink water and electrolytes, etc.
Holistic practices of conditioning, such as taijuquan (tai chi) and yoga are excellent in part because they help us to use the body and breath in a balanced way throughout our day. Of course, it’s up to you to not think of these as compartmentalized practices, but to endeavor to do yoga/tai chi all day long. Your life will change in ways that far exceed the alleviation of pain.
I hope you earnestly apply these recommendations and overcome your pain.
Be well,
Dr. Peter Borten
[post_title] => Unlocking Pain, Part Four – Body Mechanics
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Last year a disabled veteran came to see me for help with back pain. As we talked about his history, a familiar story arose. He got injured, experienced a lot of discomfort, was prescribed opioid painkillers, and became addicted to them. He described how his journey through his addiction treatment center and how, for several years, “I lost my personality and my life. I was barely a human.”
He lived in a numb haze, with no sense of humor or interest in anything, until a new doctor specializing in recovery treatment for all levels of addiction, finally recognized what was happening and began to wean him off these drugs. Much of the pain remained, but we were able to work on that. More importantly, he got his life back, and his friends and family got him back.
The familiar part of the story is the widespread long-term use of opioids and the unfortunate consequences. The uncommon part is that he got off of them. A 2017 study by the Centers for Disease Control called “Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use” looked at 1.3 million opioid users over 9 years.1 It found that the longer the initial prescription period, the higher the likelihood of long-term use. If someone used an opioid for 10 days, there was a 20% chance they’d still be using it a year later. At 35 days, the risk of yearlong use was about 45%. A 2014 study in the Clinical Journal of Pain came to a similar conclusion – the higher the initial dose and the longer the initial use of an opioid, the greater the chance of the patient developing a condition of abuse and dependence.2
It’s worth mentioning that both of these studies excluded patients with cancer pain (which is often expected to require ongoing medication, perhaps until death). That is, the great majority of those who were on opiates for several years were using it to manage back pain or joint pain (or to manage their dependency on opiates). Thus, we can assume that the prescribing doctors either didn’t know of an alternative method for pain relief or didn’t care. Do effective non-opioid alternatives exist? In the words of some ancient healer: Hell Yeah!
The first modality that comes to my mind, as you might guess from the story above, is acupuncture. Acupuncture is no longer a fringe therapy. Its effectiveness is well supported by clinical research (comparable to opioids in effectiveness3), it’s routinely offered by many hospitals in the U.S., recommended as a standard option for pain management by health systems around the world, and even adopted by the U.S. military (in a form called “battlefield acupuncture”) for severe pain.
If acupuncture has been unsuccessful at managing your pain, I advise that it isn’t always an instant miracle. Sometimes it takes several treatments to produce significant, lasting results. Also, practitioners vary in their specialties and level of skill. If you don’t experience any relief after a couple sessions, try someone else – and ask if they specialize in pain. Further, a licensed acupuncturist is almost always going to be more skilled and certainly has more training than a medical doctor or physical therapist who also does acupuncture.
While it’s great to receive acupuncture from a professional, it’s also useful to know how to utilize this system to manage pain on your own. Many acupuncture points can provide effective pain relief simply by pressing on them. Especially when traveling, or when needles weren’t available or practical, I’ve often utilized acupressure to successfully eliminate my own pain or that of friends and family. There are specific points for pain in different locations, though one of the most utilized for pain anywhere in the body is called Large Intestine 4, and it’s located in the muscular web between the thumb and index finger. If you press around in this area on the back of the hand, especially directing your pressure toward the hand bone that leads to the index finger (second metacarpal), you will find a tender spot. Pushing firmly on this spot while moving the painful area may alleviate your pain.
Mindfulness-based pain management techniques can also be very effective, and they have the added benefits of helping you live more in the present and experience more gratitude. These strategies were pioneered mainly by Jon Kabat-Zinn, and are based loosely on Buddhist meditation. There are numerous books and courses available in his Mindfulness Based Stress Reduction (MBSR) practice. The basis of these techniques is non-avoidance of discomfort – learning not to resist or mentally depart from the experience at hand, but to instead “turn toward” it and explore it willingly, whereupon it ceases to feel like suffering, and may even open us to a whole new dimension of experience.
Breathing is another vital practice for self-management of pain. How we breathe can profoundly affect both our mental state and the feelings in our body. I have witnessed people doing breathing exercises which, within a half hour, turned off pain that had persisted for decades. In a way, breathing through pain is similar to mindfulness techniques, in that we’re willingly bringing our attention to the experience. I feel that the power of the breath to reduce pain makes so much sense – it seems like an intelligent plan that we should all be equipped with the means to facilitate our own healing. In the most basic way, you can imagine that, with each inhale and exhale, you’re moving the breath – and energy along with it – through the painful area.
After years of teaching these and many other pain relief techniques to my patients, I decided to gather all my knowledge into an online course. In it, I teach a philosophy for understanding pain that will make sense and will illuminate your perspective of what’s happening. And I explain and demonstrate a huge array of methods for eliminating your own pain. As I was creating the course, in fact, the others who were involved in the project kept asking me, “How much more are you planning to include in this?!” But there are so many useful approaches, so many opportunities not just to overcome the pain, but to grow and evolve as a person, and that’s my real goal for participants in the course.
My greatest hope is to see fewer and fewer cases like that of my veteran friend – fewer cases of opioid dependence, fewer cases of pain relief at the expense of the joy of life. And more cases of people overcoming pain in ways that are empowering and even help them heal and awaken. If you’re in pain or know someone who is, check out the course. It’s called Live Pain Free. It’s affordable, and you’ll learn things you’ll use for the rest of your life.
Be well,
Peter
Let Me Teach You How to Erase Your Own Pain Without Drugs
Sources:
1: Shah A., Hayes C. J., Martin B.C. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use — United States, 2006–2015. MMWR Morb Mortal Wkly Rep 2017;66:265–269. DOI: http://dx.doi.org/10.15585/mmwr.mm6610a1
2: Edlund, M. J., Martin, B. C., Russo, J. E., DeVries, A., Braden, J. B., & Sullivan, M. D. (2014). The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic noncancer pain: the role of opioid prescription. The Clinical journal of pain, 30(7), 557-64.
3: Grissa, M. H., et al. Acupuncture vs intravenous morphine in the management of acute pain in the ED. The American Journal of Emergency Medicine, Volume 34 , Issue 11 , 2112 – 2116.
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A few decades ago, we knew very little about the chemistry of cannabis. Most of what I encountered in college was low quality, compressed, greenish-grey material with lots of stems and seeds – commonly known as “Mexican brick weed.” It was likely to make you feel passive, immobile, and hungry – a much more benign combination than the various effects you might experience from too much beer or Mad Dog 20/20.
Of the many compounds in the plant, we only heard much about two back then – THC and CBD. At the time, our elementary knowledge could be summed up in a few words: THC is the mood-altering component (what gets you “high”) and CBD is the part that makes you relaxed. We didn’t want to be relaxed, though, so we interpreted this to mean that “good marijuana is high in THC and low in CBD” and bad marijuana is the other way around.
In the years that followed, Mexican brick weed became increasingly scarce as the American cannabis industry bred more potent plants that contained an ever-higher percentage of THC. But for many of us who had dabbled in it in our early 20’s, an intensely altered state was no longer something we desired.
As legal restrictions loosened up, specialists in botanical medicine were eventually able to gain a better understanding of cannabis chemistry (we still have a ways to go) and breeders began to develop strains that produced a more specific effect – calming, stimulating, and so on.
Furthermore, although the market for Mexican brick weed seemed to be long gone, it turned out that there was a high demand, especially among older consumers, for a product with its effects – essentially a breed with a high level of CBD and a very low quantity of THC. Something a connoisseur would have once called low quality cannabis is now sought after. And an increasing number of my patients tell me they use this - or simply CBD alone - not to “get high” but to de-stress, decrease pain, sleep better, manage neurological disorders, and more.
A patient with very stubborn idiopathic nerve pain (meaning, the cause was unknown) came in one day reporting that the pain had been remarkably better since our last visit. “I hate to break it to you, Doc,” he said with a smirk on his face, “but it wasn’t the acupuncture.” He went on to tell me that he had been using a topical CBD lotion, and that it was more effective than anything else he had tried.
Another patient, who had for years experienced an anxious tightness in her chest in social situations, told me that a small amount of oral CBD resolved it without causing any other perceptible effect. She said, “I don’t feel different in any other way. I do my work, I can think clearly. I just don’t have that anxious feeling.”
And several patients who were tired of using pharmaceuticals to treat their insomnia have told me of their success with a variety of CBD products. They generally find them just as effective as sleeping pills, but with the advantage of being natural. Also, unlike the prescription drugs, they don’t worry that the CBD could put them into such a deep slumber that they might not hear a smoke detector or other emergency.
Now, if there’s one thing that rubs me the wrong way, it’s a “cure-all” – and that’s because there aren’t any! There’s no substance out there that’s good for everything or everyone, and I’d be remiss as a healthcare practitioner if I implied otherwise. CBD isn’t going to fix your life, and some people don’t experience any noticeable benefit from it. But I can say that, for many, it’s a useful natural helper with an excellent safety profile. And I’m eager to see what more we learn about this and other remarkable plants.
Be well,
Dr. Peter Borten
P.S. Just as we were publishing this article, I discovered a new study in the journal Nature on the use of CBD in the treatment of pancreatic cancer. Pancreatic cancer has a dismal 5-year survival rate of just 5%. But in this study, mice with pancreatic cancer who were given CBD plus chemotherapy survived THREE TIMES longer than those who were treated with only chemotherapy. While we don't yet know how this will translate to treatments for humans, it's one more way in which this astounding plant is a promising tool for healing.
Click Here to Learn More About Dragontree CBD Infused Body Care Products And Get Free Shipping On Your Next Order
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