by Paul Fassa
Health Impact News
Dr. Dustin Sulak, DO, is considered an international expert in clinical medical cannabis. DO stands for Doctor of Osteopathic Medicine, which can be considered an MD with an automatic bent toward a more holistic medical approach. Dr. Mercola is a DO or osteopathic physician, for example.
Dr. Sulak heads his own Integr8 Health Clinics in Maine and a satellite clinic in Massachusetts where not only does he practice medical applications of cannabis, his clinic analyzes different cannabis strains and researches their specific applications. He also provides a free online educational service for health practitioners and patients that provides the latest data and advice for using cannabis medically.
Dr. Sulak delivered a two hour presentation in Portland, Maine to a live audience that was carried simultaneously online. His lecture focused on how he uses cannabis to replace prescribed narcotic opioid pain killers, such as Oxycontin and morphine, to avoid or cure opioid addictions.
Opioid Pain Killers are Widespread and Dangerous
All you have to do is Google “opioid drugs” and you’ll see a slew of institutional interventions designed to help people withdraw from opioid based pain killers successfully. But they are not nearly as effective as Dr. Sulak’s clinically proven approach. The admitted failure rate of abstinence interventions is 92 percent.
Former FDA head from 1990 to 1997 Dr. David Kessler conceded during a CBS News interview that there is an opioid epidemic, adding:
“This has been one of the great mistakes of modern medicine.” Dr. Kessler called it “… an American condition. This is an American disease.” (Source .)
With only five percent of the world’s population, the USA uses 80 percent of the world’s opium based opioid supply. Dr. Sulak showed a slide that said forty-four (44) people die daily from opioid pain killer overdoses. Eighty percent (80%) of heroin addicts were once prescribed opioid drugs for legitimate pain concerns.
One problem is opioids are not as helpful for chronic pain as most may think. As one’s opioid tolerance to an opioid drug increases, the demand for higher doses with more prescriptions involving other pain killers becomes an obsession that invites addiction.
Using CDC statistics, Dr. Sulak revealed that opioid drug sales quadrupled in the decade between 1999 and 2010. Not surprisingly, the death rate from prescription pain killers also quadrupled during that time. As those drugs filter out into the populace, more take them non-medically, especially teenagers. In the USA, one in 20 over 12 years of age used opioid pain killers non-medically during 2010.
Almost 7,000 people are treated by emergency facilities in the U.S. daily for overdosing opioid pain killers or using them in a manner other than directed. Nearly half of opioid users who go for 30 days or more wind up taking opioid drugs for another three years and beyond.
Dr. Sulak explained that two major studies have shown no positive long term pain relief from opioid use for chronic pain compared to placebo. Conversely, many studies confirm opioid side effects ranging from addiction to death by overdose, usually by heart attack or breathing cessation.
The open window of opioid pain relief is small. As the diminishing pain relief demands more opioid use, the borderline of overdosing is rapidly approached. And the success rate from conventional withdrawal strategies is virtually nil.
Dr. Sulak mentioned an Israeli clinic that had a 70 percent successful opioid withdrawal within seven months without adverse symptoms. That’s much better than the eight percent from other “standard” methods of opioid abstinence bolstered by pharmaceuticals with their own side effects.
Where states have authorized medical marijuana use, opioid overdosing declined on average 25 percent.
This is why Dr. Sulak wants more physicians who reside in states that have legalized medical marijuana to understand his methods of gradually safely substituting cannabis for opioid pain killers.
How Cannabis Can Be Used for Safe and Effective Opioid Drug Withdrawal
Not one person has ever died from overdosing cannabis. The gap between levels needed for pain relief and overdosing is immeasurably wide. And the worst that happens from overdosing cannabis, which varies among individuals, is one becomes less efficient at tasking or becomes frightened by the sudden time perception warp and heightened awareness, maybe even becoming paranoid.
But there are no permanent physiological damages with cannabis, while several things can go wrong physically by dosing opioid based pain killers over time, including a physiological addiction that most can’t escape. Some healthy experts say the morphine used in hospice guarantees one’s painless but more rapid exit from this plane of existence. One’s vital organs rapidly degenerate from the morphine.
Dr. Sulak warns against oversimplifying the two main cannabis strains of indica as sedative and sativa as energizing. Most hemp plants with THC are hybrids of those two strains, and the ratios of THC and CBD vary as do the several other less prominent cannabinoids and terpenes to create what’s known as an “entourage effect.”
Terpenes or terpenoids are distinguishable by scent. Sulak recommends the sniff test with this example: if it smells like lavender, that cannabis contains terpenes identical to lavender, which is a relaxing herb. To become more energized, the scent should be like pine, which energizes and uplifts.
The combination possibilities are many, influencing a variety of different applications for different situations. That’s why Dr. Sulaks Integr8 Health Clinics also lab analyze different cannabis buds and leaves for their patients to determine what works best for different conditions and constitutional types.
Dr. Sulak recognizes all the different types of cannabis consumption methods, including smoking, vaping (inhaling from a vaporizer), which can stifle a short period of any acutely surging pain or urgings to take another opioid. But he prefers systemically using measurable oral methods of ingesting cannabis. He considers edibles, cannabis prepared in food, too difficult for determining dosage.
In his clinical practice, Dr. Sulak’s dosing ranges from .015 mg per kilogram of weight a day to 30 mg/kg/day. An example he used is a 70 kg (just under 155 lbs) person could receive anywhere from one mg of cannabis to 30 mg per day, depending on that person’s needs. Day dosing incorporates energizing cannabis strains while the evening dose turns to sedating strains.
Dr. Sulak prefers a gradual withdrawal from opioids by combining daily cannabis and opioid use, taking each simultaneously. It’s been discovered that a very small amount of THC cannabis, even one milligram, which is way below the level of psychoactive activity, can reduce opioid use 50 to 80 percent within weeks among opioid addicted patients who have no history of cannabis use.
For opioid addicted patients with a history of cannabis use, Dr. Sulak recommends a six day “resensitizing” period. It starts with a two day abstinence from cannabis, then the next four days optimum dosing is sorted out by starting lower than what was previously considered normal.
The rationale for this is explained by how endocannabinoid receptors, which are internal duplicates of cannabinoids in the body, retreat into cells and “hide” if the externally induced THC/CBD exocannabinoid dosing is higher than needed. The two day cannabis fast lures the endocannabinoid receptors back onto the outer walls, increasing THC/CBD endocannabinoid receptor efficiency.
Those who are new to cannabis simply start at a sub-therapeutic dose then work up to the optimum dose. Those who have aversions to the THC high can ameliorate the undesirable effect by adding more CBD to the THC cannabis.
It’s been Dr. Sulak’s clinical observation that proper cannabis dosing for all medical situations has a bell curve, where a certain dose’s efficacy peaks at the top, indicating optimal dosing. Then the curve of efficacy drops with increased dosing as the optimum dose is passed.
This confirms the phenomena of endocannabianoids retreating from outer cell walls and “hiding” within cells. Dr. Sulak sums it up by saying “less can be more.”
Regarding the psychotropic effects of THC, Dr. Sulak considers that one could benefit from the feelings of connectedness and higher awareness many of his patients report. He adds that insights and lessons learned through cannabis consciousness last beyond cannabis use.
Dr. Sulak’s presentation demonstrated what an erudite, centered, and compassionate medically trained holistic cannabis practitioner he is. He hopes many will take advantage of what he’s offering.
Dr. Sulak was one of the featured key-note presenters at the first-ever Holistic Cannabis Summit  just held recently. The entire summit can now be purchased, giving both patients and doctors the most comprehensive library of Medical Cannabis research  available today.