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How to Wean Off Opioids

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Opioids, narcotic painkillers, killed 33,000 Americans in 2015,1,2,3 and nearly 42,250 in 2016 — over 1,000 more deaths than were caused by breast cancer that same year4 — and the addiction trend shows absolutely no signs of leveling off or declining.

On the contrary, recent statistics suggest the death toll is still trending upward, with more and more people abusing these powerful narcotics. According to the most recent data5 from the U.S. Centers for Disease Control and Prevention (CDC), overdose cases admitted into emergency rooms increased by more than 30 percent across the U.S. between July 2016 and September 2017. Overdose cases rose by:

  • 30 percent among men
  • 31 percent among 24- to 35-year-olds
  • 36 percent among 35- to 54-year-olds
  • 32 percent among those 55 and older

Considering opioid overdose is now the No. 1 cause of death of Americans under the age of 50, it’s quite clear we need safer alternatives to pain management and more effective ways to wean off these extremely addictive drugs.

Risk of Addiction Is Very High

Studies show addiction affects about 26 percent of those using opioids for chronic noncancer pain, and 1 in 550 patients on opioid therapy dies from opioid-related causes within 2.5 years of their first prescription.6

Despite the drugs’ high risk of addiction, a 2016 NPR health poll7 indicated less than one-third of people said they questioned or refused their doctor’s prescription for opioids. The most common drugs involved in prescription opioid overdose deaths include8 methadone, oxycodone (such as OxyContin®) and hydrocodone (such as Vicodin®).

However, as noted by Dr. Deeni Bassam, board-certified anesthesiologist, pain specialist and medical director of the Virginia-based The Spine Care Center, “There’s very little difference between oxycodone, morphine and heroin. It’s just that one comes in a prescription bottle and another one comes in a plastic bag.”9

Indeed, many addicts find the transition from prescription opioids to street drugs like heroin to be a relatively easy one. When a prescription runs out, the cost to renew it becomes unmanageable or a physician refuses to renew a prescription, heroin, which is often cheaper and easier to obtain than opioids, is frequently a go-to solution.

Postsurgical Intervention Lowers Patients’ Risk of Opioid Addiction

Unfortunately, many patients are still under- or misinformed about the addictive nature of these pills, and are often not told how to get off them. Addiction can occur within weeks of use, and if a patient is prescribed a narcotic for long-term or chronic pain, addiction is extremely likely. In one 2016 Canadian study, 15 percent of complex surgical patients developed severe postoperative pain leading to extended use of opioids.10

To minimize the risk of addiction, the Transitional Pain Service at Toronto General Hospital includes follow-up meetings twice a month for the first two months following surgery, and then monthly meetings for another four months. As explained by Science Daily, the goal of these meetings is to “prevent acute pain from becoming chronic post-surgical pain and taper opioid use or wean to zero if possible.”11

To help patients with their pain, the program uses a variety of methods, including nonopioid medications, exercise, acupuncture and mindfulness training, the latter of which has been shown to help patients with pain-related stress and disability, thereby allowing them to successfully wean off higher doses of opioids.12

In the U.S., Stanford University offers a similar program, called the Comprehensive Interdisciplinary Pain Program. These kinds of programs are really crucial, as expecting patients to quit cold turkey is a recipe for disaster. Many state authorities and insurance companies are now cracking down on opioid use, restricting how much a doctor can prescribe.

While this is needed, it leaves long-term opioid users in a pinch. Many who are now unable to refill their prescriptions receive no guidance on how to quit or support to help them find other ways to relieve their pain.

Little Is Known About How to Safely Wean Off Opioids When You’re in Chronic Pain

As noted in Scientific American,13 “ … [T]here’s very little research on how best to taper opioids for chronic pain patients. For example, although studies show that drugs such as buprenorphine can help addicts recover, little is known about their value in the context of chronic pain.”

One scientific review,14 which included 67 studies on tapering opioids for pain patients found only three of the studies to be of high quality; 13 were found to of “fair” quality while the rest were weak. Still, the evidence available suggested that tapering off the dosage does improve both pain and quality of life.

However, the strongest evidence was for multidisciplinary care with close patient monitoring and follow-up — methods that are not widely available and rarely covered by insurance. Scientific American reports:15

“One thing seems clear from research and clinical experience: Reckless restriction is not the right response to reckless prescribing. ‘Forced tapers can destabilize patients,’ says Stefan Kertesz, an addiction expert at the University of Alabama at Birmingham School of Medicine. Worried clinicians such as Kertesz report growing anecdotal evidence of patient distress and even suicide.

The brightest rays of light in this dark picture come from a burst of new research. In May a team led by Stanford pain psychologist Beth Darnall published the results of a pilot study16 with 68 chronic pain patients. In four months, the 51 participants who completed the study cut their opioid dosages nearly in half without increased pain.

There were no fancy clinics, just an attentive community doctor and a self-help guide written by Darnall. A key element was very slow dose reduction during the first month. ‘It allows patients to relax into the process and gain a sense of trust with their doctor and with themselves that they can do this,’ Darnall says.”

Canadian Study Shows Tapering Dosage Post Surgery Helps Many Patients Avoid Long-Term Opioid Use

A study17 evaluating the success rate of Toronto General Hospital’s Transitional Pain Service found nearly half of those who had not used opioids prior to surgery successfully weaned themselves off the drugs. Among those who had already used opioids prior to surgery, 1 in 4 was successful. As reported by Science Daily:18

“The study followed patients at high risk for developing chronic pain and problematic opioid use for six months after surgery. In patients who did not take opioids for a year before surgery, the study found that 69 percent were able to reduce their opioid consumption, with 45 percent of them being able to stop completely.

Those patients who were taking a prescription opioid before surgery reduced their opioid use by 44 percent, with 26 percent of them weaning off completely.

‘The assumption is that all patients after surgery are fine with their opioid use, but we have found that in a high-risk segment of patients, that is not the case,’ says Dr. Hance Clarke, director of the Transitional Pain Service at [Toronto General Hospital].

‘We need better ways of identifying these patients, and then helping those who are having difficulty in reducing or eliminating their opioid use. Otherwise, we run the risk of de-escalating patients too fast and having them look elsewhere for opioids or other drugs if we don’t guide them’ …

One of the strongest predictors in the study of remaining on opioids long-term after hospital discharge is the dose upon discharge: the higher the dose, the more likely the patient will remain on opioids long-term.

For patients who were on opioids before surgery, emotional distress factors such as anxiety or depression, and pain catastrophizing — excessive pain-related worry, along with an inability to deflect thoughts from pain — were important factors in how well these patients could wean off opioids.”

Guidance on Opioid Tapering

Guidance on opioid tapering published in the March/April issue of the Canadian Pharmacist Journal includes the following highlights:19

  • Adult patients with chronic noncancer pain who are on a 90-milligram (mg) morphine equivalent dose daily or greater should consider opioid tapering to the lowest effective dose and discontinue use if possible
  • Other reasons to consider tapering include lack of improvement in pain and/or function, nonadherence to the treatment plan, signs of addiction, serious opioid-related adverse effects or patient request
  • Prescribers are urged to collaborate with pharmacists to support and monitor patients during opioid tapering
  • A multidisciplinary approach is associated with success in weaning patients off opioids
  • Benefits of tapering include relief of withdrawal symptoms (e.g., pain, sweating or anxiety), reduction in opioid adverse effects and improvements in overall function and quality of life

The Guideline urges physicians to discuss tapering with their patients, and to “prepare them by optimizing nonopioid therapy as appropriate for their pain and comorbidities.” This includes the use of acetaminophen, nonsteroidal anti-inflammatory drugs, gabapentinoids20 and cannabinoids, just to name a few. The guideline also recommends:

“… [O]ptimizing nonpharmacological therapy and psychosocial support, setting realistic functional goals, creating a schedule of dose reductions and frequent follow-up and having a plan to manage withdrawal symptoms.”

To taper opioids for chronic noncancer pain, the guideline recommends:

  • Gradually reducing 5 to 10 percent of the morphine-equivalent dose every two to four weeks, with frequent follow-up
  • Switching from immediate-release opioids to extended-release on a fixed schedule
  • Collaborating with the patient’s pharmacist to assist with scheduling of the dose reductions

Two alternative methods include doing a medically supervised rapid dose reduction at a withdrawal center, as withdrawal symptoms can be severe and/or dangerous, or switching to methadone or buprenorphine (naloxone), followed by gradual tapering of these drugs.

How Kratom Can Help With Opioid Withdrawal


Two other alternatives I want to address here are kratom and medical cannabis. It’s a toss-up as to which one is more controversial, but there’s evidence to support both. In the video above, I interview Christopher McCurdy, professor of medicinal chemistry at the University of Florida College of Pharmacy about the use of kratom for pain relief and opioid withdrawal.

McCurdy, a former postdoctoral fellow in opioid chemistry at the University of Minnesota under a National Institutes of Health (NIH) postdoctoral training fellowship, has spent nearly 15 years investigating how kratom affects opiate addiction and withdrawal, and is convinced it may be of tremendous benefit.

Kratom (mitragyna speciosa) is part of the coffee family, but has a very different chemistry than coffee beans. It’s been used in traditional medicine in Thailand and Malaysia for centuries, both as an energy booster and opium substitute. The plant contains a number of alkaloids, a primary one being mitragynine, which has opioid activity.

It and many other alkaloids in the kratom plant were recently called out as opioids by the Food and Drug Administration (FDA) commissioner. “A lot of people were upset about that at first, but I think they need to understand that an opioid is any molecule that can interact with opioid receptors or those proteins in the body,” McCurdy says.

In other words, an opioid is not identical to an opiate, derived from opium poppy, such as morphine, oxycodone or oxymorphone. Opioid is a generic term that includes even endogenous endorphins that bind to opioid receptors in your body. And, while mitragynine has opioid activity, it’s very different from other opioid molecules.

McCurdy’s research shows that compared to methadone and buprenorphine (two drugs used to treat opioid addiction and opioid withdrawal), kratom had a much cleaner profile and was milder in its action. Whereas buprenorphine and methadone are full agonists or activators of opioid receptors, mitragynine appears to be only a partial agonist. McCurdy explains:

“We initially sent out purified alkaloid of mitragynine for a screen across a whole panel of central nervous system drug targets … What we found was a really remarkable profile of this molecule. Mitragynine binds with opioid receptors … but it also interacts with adrenergic receptors, serotonin receptors, dopamine receptors and adenosine receptors.

Adenosine receptors are the target for caffeine. It kind of explains why some of these alkaloids in the plant might cause this stimulant-like effect. It also interacts with alpha-2 adrenergic receptors, [which] are … used in opioid withdrawal. Agents that activate alpha-2 receptors, like clonidine, are used in opioid withdrawal treatment to stop withdrawal symptoms such as shaking, sweating and heart racing …

In all honesty, when I got the report back from the company that screened the molecule, I thought, ‘Wow. We just found nature’s answer to opiate addiction’ because here it was interacting with many of the same targets that we would target pharmacologically on an individual basis.”

How Kratom Curbs Opiate Addiction

As explained by McCurdy, there are three traditional opioid receptors: mu, delta and kappa, all three of which are associated with numbing or dulling pain. In other words, they’re analgesic receptors. They block or slow pain signal transmissions at the spinal cord level, so your brain doesn’t process the pain signals as much.

  • The Mu receptor was named for its ability to interact with morphine. The mu receptor is responsible for the euphoric effects associated with opiates. It’s also primarily responsible for respiratory depression.
  • The delta receptor is also a target for selective analgesics, and does not appear to have as strongly addictive capabilities as the mu receptor. Unfortunately, the delta receptor is linked to convulsions, and many drug trials aimed at the delta-selective opioid receptor had to be halted due to seizures that could not be resolved. Kratom does not appear to significantly interact with delta receptors.
  • The kappa receptor, while good for killing pain, causes dysphoria or aversion, meaning when you take a compound that activates kappa, it makes you feel so awful you don’t want to take it again. For this reason, kappa-activating pain drugs have repeatedly failed in clinical trials and people don’t want to continue the drug.

Kratom appears to be a partial agonist for all of these receptors, only weakly affecting delta and kappa. And, while the mu receptor is the primary target of kratom, animal trials suggest the abuse potential of kratom is quite low. To learn more, see “Kratom as an Alternative for Opium Withdrawal” or listen to McCurdy’s interview.

Medical Cannabis — Another Effective Pain Reliever That Is Much Safer Than Narcotic Pain Killers

Medicinal cannabis is another effective pain reliever which, unlike narcotic pain killers, cannot kill you.21 The reason a cannabis overdose remains nonlethal is because there are no cannabinoid receptors in your brain stem, the region of your brain that controls your heartbeat and respiration.

Statistics bear this out as well. In states where medical marijuana is legal, overdose deaths from opioids decreased by an average of 20 percent after one year, 25 percent after two years and up to 33 percent by years five and six.

In 2010, the Center for Medical Cannabis Research released a report22 on 14 clinical studies about the use of marijuana for pain, most of which were FDA-approved, double-blind and placebo-controlled. The report revealed that marijuana not only controls pain but in many cases, it does so better than pharmaceutical alternatives.

Cannabis has also been shown to ease withdrawal symptoms in those trying to wean off opioids. CNN Health reports23 Dr. Dustin Sulak, a renowned integrative medicine physician based in Maine, has helped hundreds of patients wean off opioids using cannabis, as has Dr. Mark Wallace, a pain management specialist and head of the University of California, San Diego Health’s Center for Pain Medicine who started studying cannabis in 1999 with a state grant.

“He looked at the literature and realized that pot had a long history of therapeutic use for many disorders including … pain. Within a decade, there were enough studies to convince him that marijuana was a real alternative to use in his practice. He estimates that hundreds of his patients … have been weaned off pills through pot,” CNN reporter Nadia Kounang writes, adding:

“According to the Drug Enforcement Administration, marijuana is a Schedule I drug, meaning it has no medical use and a high potential for abuse. ‘We have enough evidence now that it should be rescheduled,’ Wallace said. Sulak wonders, ‘When will the medical community catch up with what their patient populations are doing?’”

Nonopioid Pain Relievers Work Just as Well as Opioids for Acute Pain

If a person comes to the emergency room with severe acute pain, most physicians will prescribe them an opioid to relieve pain. However, research24 published in JAMA suggests opioid-free options may work just as well. This is valuable information, considering the fact that many get hooked on opioids when prescribed an opioid for acute pain caused by a sports injury or oral surgery, for example.

The study evaluated the effects of four different combinations of pain relievers — three with different opioids and one opioid-free option composed of ibuprofen (i.e., Advil) and acetaminophen (i.e., Tylenol) — on people with moderate to severe pain in an extremity due to bone fractures, shoulder dislocation and other injuries.

The patients had an average pain score of 8.7 (on a scale of zero to 10) when they arrived. Two hours later, after receiving one of the pain relief combinations, their pain levels decreased similarly, regardless of which drug-combo they received.

“For patients presenting to the ED [emergency department] with acute extremity pain, there were no statistically significant or clinically important differences in pain reduction at two hours among single-dose treatment with ibuprofen and acetaminophen or with three different opioid and acetaminophen combination analgesics,” the researchers concluded.

Speaking to Vox, the study’s lead author, Andrew Chang of the department of emergency medicine at Albany Medical College, Albany, New York, said,25 “Some (not all) physicians reflexively think fractures require opioids, but this study lends evidence that opioids are not always necessary even in the presence of fractures.”

Considering the steep risks involved — even when taken as directed, prescription opioids can lead to addiction as well as tolerance, along with other issues like increased sensitivity to pain, depression, low levels of testosterone and more26 — the less you expose yourself to opioids, the better. For a list of additional suggestions for how to relieve pain without resorting to opioids, see “Do We Really Need Opioids for Pain?

Please understand though that although nonopioid pain relievers are not likely to cause addiction, they are fraught with their own problems. Tylenol taken even for a few days can cause severe liver and kidney problems in susceptible people. Taking N-acetyl cysteine (glutathione precursor) can alleviate many of the problems though.

It is also important to recognize that opioids do have a legitimate purpose for those in acute pain, but the evidence is beyond overwhelming that they are being prescribed indiscriminately in many cases as a result of greedy drug companies and doctors that are paid to prescribe opioids, resulting in tens of thousands dying from addiction.

These numbers are so high that they have actually resulted in a loss of two years in the average life expectancy of the average American. So, if you know someone that is on these dangerous medications, do everything you can to warn and plead with them to get off opioids as soon as possible.

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Post-vaccine surge? Michigan’s spring coronavirus case spike close to previous year’s autumn high

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(Natural News) The spike in new Wuhan coronavirus infections recorded in Michigan over the spring is similar to a spike seen during the 2020 fall season. According to a Wall Street Journal analysis, the state’s daily coronavirus case count averaged more than 7,000 for almost two weeks – before taking a slight dip to 6,891 on April 20. This echoed similar figures back in November and December 2020, which saw sharp rises in infections for those two months before plunging.

Back in autumn of last year, Michigan averaged more than 7,000 cases per day for a span of 10 days. New infections dropped slightly, then briefly spiked as the December holidays approached. It then fell to the low 1,000s for the succeeding two months – until ascending again in March.

According to University of Michigan internal medicine professor Dr. Vikas Parekh, the sudden increase in new infections could be attributed to several factors. Among the factors he cited was re-openings, which increased people’s interactions and mobility. Parekh said the loosened restrictions contributed to the spread of the highly contagious U.K. B117 variant.

“As the B117 variant spreads nationally, we will likely see other stats [with] their own surges – although I hope none are as bad as Michigan,” the professor remarked. He continued: “The milestone just tells us we are not yet in the clear, especially as we still have large portions of our population who are not vaccinated yet.”

Parekh also expressed optimism over the lower daily caseloads the Great Lakes State reported. He said he believes both cases and hospitalizations have plateaued and will likely decline soon. The professor commented: “[COVID-19] positivity has been declining now for one week, which is usually a leading indicator of case decline.”

Meanwhile, the state cited younger populations and youth sports, such as basketball, wrestling and hockey, to increase new COVID-19 infections. Because of this, Gov. Gretchen Whitmer called to suspend youth sports and indoor dining in the state. She also exhorted high schools to conduct remote class sessions for two weeks to curb the spread of the pathogen.

Michigan still experienced the spike in cases despite having one of the highest vaccination rates in the country

During the opening stages of the U.S.’s immunization drive against COVID-19, Michigan boasted of having one of the highest vaccination rates nationwide. A report by Bridge Michigan even noted the initial “frenzy for vaccines” that “far exceeded the state’s limited supply.” But things have appeared to turn around for Michigan, as it now struggles to reach the 70 percent vaccination rate needed for herd immunity.

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Scottish mom’s legs turn into a pair of “giant blisters” after first dose of AstraZeneca’s coronavirus vaccine

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(Natural News) Sarah Beuckmann of Glasgow, Scotland, felt a tingling sensation in her legs and noticed a rash flaring up around her ankles a week after getting her first dose of AstraZeneca’s coronavirus (COVID-19) vaccine on March 18.

She also had flu-like symptoms right after the vaccination.

Beuckmann called her doctor to arrange an appointment the morning she noticed the rash, but by the afternoon her skin was already breaking out into blood-filled blisters. Blisters also appeared on her legs, hands, face, arms and bottom.

“I ended up asking my husband to take me to A&E,” said Beuckmann, referring to “accident and emergency,” the equivalent of an emergency room (ER). “When I got there, my heart rate was sitting at 160bpm, which they were very concerned about. I got put on an ECG machine.”

Doctors determine AstraZeneca’s COVID-19 vaccine triggers the rash

Medics carried out tests for HIV, herpes and other skin conditions to work out what triggered the rash, but all results came back negative. Doctors finally determined that the vaccine caused her rare reaction after carrying out two biopsies.

“Once they found that it was a reaction to the vaccine, they put me on steroids and that really seems to be helping my progress,” said Beuckmann. She had been advised by her doctor not to get the second dose of AstraZeneca’s COVID-19 vaccine because of her reaction.

Beuckmann spent 16 days at Queen Elizabeth University Hospital. She was discharged to recover at home. The 34-year-old mother of one is currently wheelchair-bound due to the bandages on her legs and blisters on the soles of her feet. She may need physiotherapy to help strengthen her leg muscles.

“They are starting to heal and they’re looking a lot better than they were but as the blisters started to get worse, they all sort of merged together,” she said. “I didn’t know what was going on.”

With the blisters merging, her legs have looked like a pair of “giant blisters.” Beuckmann admitted that at one point she feared her legs might have to be amputated.

Dermatologist agrees COVID-19 vaccine causes the blisters

Dr. Emma Wedgeworth, a consultant dermatologist and spokeswoman at the British Skin Foundation, agreed that Beuckmann had likely suffered a reaction to the vaccine.

“Vaccines are designed to activate the immune system. Occasionally people will have quite dramatic activation of their immune systems which, as happened in this case, can manifest in their skin” Wedgeworth told MailOnline. “This poor lady had a very severe reaction, which thankfully is extremely rare.”

It is not clear why Beuckmann, who works in retail, was invited for a vaccine. Scotland’s vaccine rollout was focused on people over the age of 50 when she got vaccinated, although vaccines are available to those who are considered at risk from the virus, or live with someone considered vulnerable.

At least 20 million Briton have had AstraZeneca’s COVID-19 vaccine, which drug regulators say causes a rash in one percent of cases. They say rashes caused by the jab tend to go away within a week.

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Trojan labs? Chinese biotech company offers to build COVID testing labs in six states

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In 2012, BGI acquired Complete Genomics, a DNA sequencing company and equipment maker. The funds for the $117.6 million purchase were raised from Chinese venture capitals. The company has expanded its footprint globally. According to its website, BGI conducts business in more than 100 countries and areas and has 11 offices and labs in the U.S.

People are concerned about China’s access to American DNA data

Some said that with Complete Genomics providing an American base, BGI would have access to more DNA samples from Americans, helping it compile a huge database of genetic information. Some also worried about the protection of the genetic information’s privacy.

According to a 2019 report from the U.S.–China Economic and Security Review Commission (USCC), BGI “has formed numerous partnerships with U.S. healthcare providers and research organizations to provide large-scale genetic sequencing to support medical research efforts,”

There are three main reasons why many people in the biotech community and government have expressed concerns about China’s access to American DNA data.

In the “60 Minutes” interview, Evanina discussed the very likely scenario in which Chinese companies would be able to micro-target American individuals and offer customized preventative solutions based on their DNA.

Evanina asked: “Do we want to have another nation systematically eliminate our healthcare services? Are we okay with that as a nation?”

The second concern is that China may use DNA to track and attack American individuals. As the USCC report states: “China could target vulnerabilities in specific individuals brought to light by genomic data or health records. Individuals targeted in such attacks would likely be strategically identified persons, such as diplomats, politicians, high-ranking federal officials or military leadership.”

The third concern is that China may devise bioweapons to target non-Asians. Steven Mosher, president of the Population Research Institute, discussed it in his article “What Will China Do With Your DNA?” published by The Epoch Times in March 2019.

He wrote: “We know that the Asian genome is genetically distinct from the Caucasian and African in many ways. … Would it be possible to bioengineer a very virulent version of, say, smallpox, that was easily transmitted, fatal to other races, but to which the Chinese enjoyed a natural immunity? … Given our present ability to manipulate genomes, if such a bio-weapon can be imagined, it can probably – given enough time and resources – be realized.”

An article from Technocracy said: “China’s aggressive collection of American DNA should be doubly alarming because it can only spell one ultimate outcome: biowarfare. That is, genetically engineering viruses or other diseases that will be selectively harmful to U.S. populations.”

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