The routine back operation Bob Deslauriers had in 1987 was supposed to fix damage wrought by a rugby-playing youth. Two decades after the fact, it nearly killed him.
The 58-year-old unknowingly received a tainted blood transfusion during the surgery, and 18 years later discovered the resulting hepatitis C infection had virtually destroyed his liver.
A transplant last year saved Deslauriers’ life, but by the time he left hospital, the engineer and former corporate CEO had another problem: He was on so much opioid painkiller, he could do little but blankly stare at the TV.
His salvation, surprisingly, came from marijuana. Pot helped wean him off all but a small dose of morphine — and made his intellectually demanding work possible again, according to a unique case study published this month.
A multi-hospital research project has now been launched to test the novel idea of using a historically illicit drug to curb dependence on a legal — but potentially debilitating — one. Meanwhile, a recent survey suggests many medical-cannabis users are already substituting weed for prescription pharmaceuticals.
Deslauriers is convinced of the benefits.
“We’re kind of conditioned in society to look down on marijuana, because of all the propaganda we’ve been fed all our lives,” says the Eastern Ontario resident. “(But) it’s basically given me my life back.”
The case also underlines the complexity of cannabis as an emerging medicine, with Deslauriers using a strain high in the compound cannabidiol (CBD) to treat his pain, and one with lots of tetrahydrocannabinol (THC) to control chronic nausea.
The concept could have wide application if proven effective, given Canada’s massive prescription opioid habit — per-capita consumption here is second only to the United States.
Hundreds of Canadians die yearly from overdosing on prescription narcotics — many simply taking what doctors recommended for chronic pain — while others spiral into addiction.
Dr. Hance Clarke, who co-authored Deslauriers’ case study, heads Ontario’s Transitional Pain Service, set up last year with provincial funding partly to help post-operative patients who become dependent on the medications.
The Toronto General Hospital physician stressed that one case does not prove the effectiveness of marijuana to phase out narcotics. But Clarke and colleagues have begun an observational study involving numerous patients, and a more rigorous randomized controlled trial is eyed for the future.
There is already some evidence that cannabis can treat certain types of pain, with the brain’s cannabinoid receptors known to be involved in pain modulation.
‘We’re kind of conditioned in society to look down on marijuana, because of all the propaganda we’ve been fed all our lives. (But) it’s basically given me my life back’
“Gone is the day where a patient says, ‘I smoke cannabis recreationally and I continue to do this for my pain’ — and I have to shy away from that,” said Clarke. “I can say, medically, I have a prescription pad and I can actually bring (cannabis) to the table as part of their pain regimen.”
The case study sounded familiar to Dr. Norm Buckley, director of the National Pain Centre at McMaster University in Hamilton, Ont., who has had patients tell him they were going to smoke marijuana to get off narcotics — and succeed.
Cannabis would appear to be safer than opioids — unlikely, for instance, to cause life-threatening symptoms in excessive doses, he noted. The problem is a lack of science to indicate what strains and what doses are appropriate for which patients, the kind of prescribing guidelines that come with pharmaceutical medicines, Buckley noted.
“Right now we’re not really using it as a medication,” he said. “We’re giving people permission to experiment with it.”
Still, a recent study at the University of British Columbia, based on an online survey of medical-marijuana patients, found that 80 per cent used it to replace prescription drugs for conditions ranging from pain to depression and HIV. The most common reason was fewer negative side effects.
The athletic, entrepreneurial Deslauriers lived a full life until about 10 years ago, playing on Canada’s national rugby team, competing in other sports and later heading a “conglomerate” whose businesses stretched from oil and gas to TV production.
Then he collapsed after a charity run in 2005, learning that he had advanced cirrhosis of the liver — triggering burst veins and internal bleeding — and would likely be dead within a week.
He survived the initial crisis and finally underwent a liver transplant, thanks to the organ part his sister donated.
Desluariers had already been on hydromorphone — a semi-synthetic morphine derivative — because of chronic abdominal pain beforehand. With the acute pain related to the surgery, the dose soared to almost 40 milligrams a day.
Though no longer running the company, he still does research work on robotics at home, but found the narcotic-induced fog made that impossible.
After beginning to smoke a CBD-rich cannabis strain, he was able to reduce the hydromorphone almost immediately, and is now down to two to eight mg per day, Deslauriers said.