Patients in Oregon embrace medical cannabis as opioid alternative — without guidance
Dawn Faihtinger is in her 60s and lives in an RV at a park on the Oregon coast.
She’s been battling pain for nearly 50 years, ever since she was hit by a car as a teenager.
“I was in a coma for seven weeks,” she said. “I had a compound fracture of my right leg. Had my skull split open.”
Faihtinger later learned she had multiple sclerosis. She spent 15 years in a wheelchair and on heavy doses of opioids, including Oxycodone and fentanyl.
“I went to Cedar Hills hospital and threatened to commit suicide unless they put me in because I was tired of all the drugs,” she said. “It had done such damage to my body that it was overwhelming. I couldn’t think straight, I couldn’t drive. The pain was outrageous.”
Faihtinger’s story is a common one and helps explain why someone dies of opioid abuse every other day in Oregon: Opioids are highly addictive and extremely painful to kick.
Doctors help by gradually weaning patients off the drug and by offering alternative therapies for pain, such as acupuncture or physical therapy.
In Oregon and Washington, doctors also can suggest medical cannabis, but most don’t.
They say the science behind cannabis isn’t as thorough as other therapies. And because cannabis is illegal at the federal level, some health-care employers tell their providers to steer clear.
Christian Le used to be a physician at St. Charles Health in Bend. Now he operates Green Earth Medicine, a chain of cannabis-friendly Oregon clinics.
Le said his customers are often struggling with pain management by themselves, and they want to try marijuana to treat their pain but aren’t sure how.
The truth is, there is no accepted textbook on medical cannabis treatment.
Le said he understands doctors might be nervous about recommending cannabis to someone already addicted to opioids, but he fears patients are paying the price.
“If you’re using opioids, I guarantee you’re going through hell … because of the withdrawal effects,” Le said. “So if you’re able to replace that with something that is non-harmful, non-toxic, then that’s a natural decision. Nobody has to convince you to do that.”
Last year, a study by the National Academies of Sciences, Engineering and Medicine found that marijuana is an effective way of treating pain. Another study, published in the medical journal JAMA, found states with medical cannabis had 25 percent less opioid overdose deaths.
Back in Faihtinger’s RV, she remembers years of going through opioid withdrawal, only to be prescribed the drug again.
“You get the really severe jerks, muscle spasms, nausea, can’t sleep, can’t eat real well. It’s like having the flu a million times and can’t do anything about it,” she said.
Many people have suffered the same fate dealing with opioids.
But eventually, Faihtinger managed to find Dr. Cat Livingston at Oregon Health and Science University’s Richmond clinic in Portland.
They spent three years building a personalized toolkit of therapies to help Faihtinger deal with pain — including medical cannabis.
But Livingston said Faihtinger was the one who had to figure out dosages and strains because the research simply doesn’t exist.
“We don’t recommend a specific dosage or route,” Livingston said. “I would say the main recommendation that I have is not to smoke things into your lungs.”
That’s because prolonged smoke inhalation can cause serious lung damage.
Faihtinger uses a vape pen. But she also grows her own cannabis and turns it into butter for cooking.
Finding the right balance of dose, strain and delivery took years, she said.
“I have one that helps me sleep because I have a problem sleeping. I have one that helps me with pain when I need it. I know how long it takes until it works,” Faihtinger said.
But, she conceded, cannabis has its limitations. She can’t use it at work. She doesn’t want to mow the park lawns while under the influence. Her mowing days are the worst for pain.
“If I have a bad day, then I take my one Vicodin and that works for the day,” she said.
Vicodin is an opioid. Faihtinger said she’s extremely careful not to use it too often.
Faihtinger said it’s up to patients themselves to figure out what works best for their pain, whether it be marijuana, daily walks or avoiding sugary foods.
“We have to do it for ourselves. You can’t expect the doctors to do it all,” she said.
In the meantime, medical cannabis remains in a scientific backwater as the federal government refuses to pay for research, saying that cannabis has absolutely no benefits, just like heroin or LSD.
About this series
OPB is participating in a special reporting series, “Opioid Crisis: The Ripple Effect,” that takes an in-depth look at how the national opioid crisis is affecting individuals, families, communities and institutions in the Northwest.
This series is part of a public media collaborative funded by the Corporation for Public Broadcasting. This national initiative includes reporting from ideastream in the greater Cleveland area and WXXI News in Rochester, New York, who, like OPB, explore how their local communities are affected by the crisis.