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The Opioid Epidemic…One Pharmacist Making a Difference

Dear Friends,

The Opioid Epidemic is everywhere and even though it is no longer dominating the TV news cycle doesn’t mean it has gone away. It is affecting our friends, families, and our neighbors every single day.

Let’s revisit this important topic and enhance our commitment to take part in the solution to this national health emergency.

In over 40 years of pharmacy practice, I have witnessed many people afflicted with chronic pain and neuropathic pain who have turned to and have been prescribed dangerous and addictive opioids.

While not everyone who takes a prescription opioid will wind up an addict, the risk is all too real. The health risks associated with these drugs are great, and addiction and overdoses are a daily occurrence. It is particularly important for you to avoid opioids when trying to address long-term and chronic pain, as your body will create a tolerance to the drug. Over time you’ll require greater and greater doses at more frequent intervals to achieve the same pain relief; this is how the addiction process begins. This is the recipe for the disaster that is the Opioid Epidemic and could have lethal consequences for you or a loved one. Please don’t risk it!

Please continue reading to find out about CBD – the “green” light in the darkness of opioid addiction – because by replacing addictive, toxic, and dangerous opioid use with natural, non-toxic CBD oil we can attempt to make a major difference in the Opioid Epidemic, both here in western Pennsylvania and across the nation.

“In 2012, paramedics responded to about 900 calls for overdoses in the city [of Pittsburgh]; in 2016, it was 2,300… During 2016, 613 people died from overdoses in Allegheny County, compared with 424 in 2015...” and only 290 in 2012. (1)

Nationwide the numbers are even more startling. According to the Department of Health and Human Services, on an average day in the U.S. more than 650,000 opioid prescriptions are dispensed (2) and 78 people die from an opioid-related overdose. This includes overdoses involving prescription opioids and illicit opioids such as heroin. (3)

The economic impact is estimated in the billions with 55 billion dollars spent on health and social costs related to prescription opioid abuse each year (5) and 20 billion dollars in emergency department and inpatient care for opioid poisonings. (6) These numbers are growing every day.

To prevent you or someone you love from becoming addicted to prescription painkillers, or worse, becoming another potential victim of an opioid overdose, you must get educated today!

Let’s take a closer look at the nationwide Opioid Epidemic, opioid abuse, and offer a groundbreaking healthy alternative to help manage pain.

What is an Opioid?

Opioids are a class of drugs that include the illicit drug heroin as well as the legally prescribed pain relievers oxycodone, hydrocodone, codeine, morphine, fentanyl, and others. Opioids are chemically related and interact with opioid receptors on nerve cells in the brain and nervous system to produce pleasurable effects and relieve pain. (4)

The American Society of Addiction Medicine defines addiction as “a primary, chronic and relapsing brain disease characterized by an individual pathologically pursuing reward and/or relief by substance use and other behaviors.” It is important to remember that opioid addictions are physical. With every use the brain craves more stimulation of the opioid (Mu) receptors and the body becomes physically dependent on that simulation to continue functioning properly. If a heavy user stops suddenly the withdrawal symptoms can be life threatening.

This physical addiction means that the opioid user needs these drugs and when their prescriptions run out or become too expensive, they may turn to cheaper, more accessible, street drugs like heroin.

"There’s very little difference between oxycodone, morphine and heroin,” says Dr. Deeni Bassam, board-certified anesthesiologist, pain specialist and medical director of the Virginia-based Spine Care Center. “It’s just that one comes in a prescription bottle and another one comes in a plastic bag.” (7)

Heroin is often cheaper and easier to obtain than opioids and so has become a popular alternative. Chemically, Heroin and OxyContin are very similar and provide a similar kind of high. OxyContin is as dangerous and equally as addictive as pure heroin. More often than not though, drug dealers cut heroin with other drugs and the results can be deadly.

One of the most popular drugs to spike heroin with is Fentanyl, a drug originally developed as an elephant tranquilizer. Cut into heroin, it was meant to deliver a stronger and more extended high, but as Dr. Karen Hacker, the director of the Allegheny Health Department said, “Fentanyl is like a whole new ballgame. People are dying the first time they try it.” (8)

Most heroin sold on the streets now contains some Fentanyl and some stamp bags now contain mostly Fentanyl, which can be 100 times stronger than heroin and 10,000 to 100,000 times stronger than morphine. (8,9)

Drug overdose is the leading cause of accidental death in the U.S., with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic of overdoses, with 20,101 deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015. (10) It is estimated that in 2015, 2 million Americans had a substance use disorder involving prescription pain relievers and 591,000 had a substance use disorder involving heroin. (11)

Dr. Robert Califf, who at the time was commissioner of the U.S. Food and Drug Administration (FDA), said, “The public-health crisis of opioid misuse, addiction and overdose is one of the most challenging issues [the FDA] has faced during my time as commissioner. Solving this issue is critical to our future. It’s time to put more resources into the development of non-opioid, non-addictive medications to help people who are in serious, debilitating pain.” (12)

At Murray Avenue Apothecary, we are always looking for holistic and natural approaches to pain management. In light of the Opioid Epidemic we redoubled our efforts to find safe and effective solutions for our clients. Almost two years ago during a phone call with my physician-friend she told me she could not take Dilaudid for post-op neck surgery pain. She said she had found a non-opioid solution and I was intrigued.

The solution? CBD Hemp Oil!

This led me, and my staff, into exhaustive research about medical marijuana, state drug laws, and CBD manufacturers.

What is CBD? How does it work? And most importantly, how can we provide it to the people who need it most!?

There are many different varieties of the cannabis plant. Hemp, sometimes called industrial hemp, refers to the non-psychoactive (less than 0.3% THC) varieties of Cannabis sativa L. Both hemp and marijuana come from the same cannabis species but are genetically distinct and are further distinguished by use, chemical makeup, and cultivation methods.

CBD or Cannabidiol (Canna-Bi-Diol) is a naturally occurring compound in the hemp plant and is one of a class of molecules called cannabinoids. Tetrahydrocannabinol (THC) is the cannabinoid that produces the euphoric and psychotropic effects of Marijuana. Typically, hemp has very little THC naturally. CBD is non-psychoactive and does not cause intoxication. CBD contains ZERO THC.

Our bodies, and those of almost all animals, have an endocannabinoid system with hundreds of CB receptors. It is the greatest system you’ve never heard about. These CB receptors are located all over your body including in the brain, skin, connective tissue, glands, immune cells, digestive tract, and reproductive organs. They play an important role in human health and homeostasis or balance. THC has a strong affinity for CB1 receptors found in high concentrations in the brain and therefore cause the psychoactive effects of marijuana.

The endocannabinoid system strongly suggests that the human organism is actually designed to make good use of the cannabis plant. In other words, the phytocannabinioids in the cannabis plant triggers something that's been inside us since the dawn of mankind. The endocannabinoid system exists in other mammals, reptiles, fishes, and more, suggesting it is truly an ancient biological system.

Dr. Margaret Gedde, a Stanford-trained pathologist and award-winning researcher, said, "When I started hearing the results patients were getting, I realized that the reason why [marijuana] could do so many different things in the body without being toxic is because it is acting through this natural endocannabinoid system in our bodies. That's when I said 'Wow. This is huge. There's nothing like this in medicine. There's nothing that I can prescribe that comes close to what this can do for people.’” (13)

“Although the endocannabinoid system has been known to interact with other systems…its interaction with the opioid system is now well established. These two systems share neuroanatomical, neurochemical, and pharmacological characteristics.” (14,15) This means the same receptors all over your body that interact with opioid chemicals also interact with the CBD. This important connection means that not only does CBD offer potential potent pain relief, it may also be used to wean patients off of their Opioids.

We have developed an Opiate Weaning Protocol at Murray Avenue Apothecary that works closely between the patient, physician, and pharmacist to safely and effectively achieve the desired results. Please have your Physician contact our Pharmacists to work together as a team to help with your opioid prescription weaning protocol. We are here for you!


Gedde added, “So many pain medications are damaging to the stomach, to the gut. The cannabis doesn't hurt the gut. It helps heal the gut. People are so relieved … There's nothing else that does that. It won't hurt the organs. It won't hurt the liver. It won't hurt the kidneys. Ibuprofen… people can't stay on that for months and years. They can stay on cannabis. As we know as well, there is no known lethal dose for cannabis, whether it's THC or CBD. A person couldn't die from it even if they were trying really, really hard. There's nothing you can say that about. It offers so much to people on a medical level."

LabNaturals CBD – Hemp derived CBD

At Murray Avenue Apothecary we carry our own brand of CBD products called LabNaturals Broad Spectrum CBD Hemp Oil. CBD stands for “Phytocannabinoid Rich” and describes an oil containing CBD and other cannabinoids. Our hemp oil products are derived from the whole hemp plant grown, processed, and produced in accordance with the 2014 FARM BILL, Section 7606. These products deliver healthful benefits, without the psychoactive or “high” effect associated with this type of botanical. There is no detectable THC in our LabNaturals CBD products so urine drug test screens should be negative, however we cannot guarantee this because not all tests are THC specific and all cannabinoids are molecularly similar. You should be aware of your employer’s drug testing policy.

Every LabNaturals CBD product is third party tested to ensure purity, potency, and consistency. In a study published in the Journal of the American Medical Association, 84 commercially available CBD products on the internet were chemically analyzed by an independent lab. The researchers found that ONLY 31% of the products tested contained the precise amount of CBD advertised on the label!

Without third party testing there is no way to ensure quality and consistency or that a product is correctly labeled and does not contain toxic chemicals and residues. We provide Certificates of Analysis with proof of non-detectable THC, solvents, pesticides, and heavy metals for each product. These Certificates of Analysis also confirm the actual amount of CBD in the bottle to be sure our labeling is accurate. This makes LabNaturals CBD an appealing and trustworthy option for people looking for potential relief from inflammation, pain, anxiety, depression, seizures, spasms, and other conditions.

There are over 40 examples of health conditions we found that may show benefit from CBD use including ADHD, Arthritis, Diabetes, Alcoholism, MS, Chronic Pain, PTSD, Depression, Osteoporosis, Epilepsy, and more. (19) CBD has been studied for its antiemetic, analgesic, antiepileptic, and immunomodulatory effects. CBD has also been studied in settings of mood disorders(16,17,18). CBD has demonstrable neuroprotective and neurogenic effects, and its anti-cancer properties are currently being investigated at several academic research centers in the United states and around the world. (19)

Our LabNaturals CBD Broad Spectrum Hemp Oil comes in a variety of products including liquids, topicals, and capsules. Pets need pain relief too and we have created CBD Liquids just for our furry family members!

All of our LabNaturals CBD Hemp Oil products are available Over-the-Counter (OTC) and do not require a Medical Marijuana card.

We are now carrying several OTC products including:

CBD Broad Spectrum Hemp Oils - Light, oily liquids that are to be delivered orally by dropper and come in a variety of strengths. Place under the tongue, hold for 2-3 minutes for enhanced absorption, and swallow.
CBD Broad Spectrum Hemp Oil Capsules - 10mg or 25mg - Small water-soluble softgel capsules that are taken orally.
CBD Broad Spectrum Hemp Oil Pain Balm - 1000mg per Jar - A smooth and spreadable balm applied topically to painful areas like arthritic joints and painful damaged nerve areas.
CBD Broad Spectrum Hemp Oils for Pets - Light, oily liquids that are to be delivered orally on treats or food and are perfectly sized for our furry family members.
CBD Chewing Gum - 10mg per Piece - Sugar-free gum that delivers CBD through the oral mucosa by chewing each piece for ten minutes. Many of our arthritic clients love this gum!

Our General Serving Guidelines are to Start LOW & Go SLOW!

Everyone is different and everyone’s internal balance system is different. Some people are only a little “out of balance” and other people are way “out of balance.” Some people are very sensitive to substances and others are less responsive. There is no magic number, no formula, and no test to determine how “out of balance” you are. The good news is we have a great method to discover your “happy place” or “optimal dose.” We call this process “micro-servings.”

Many people need less CBD than they think they do, and more is not always better. By starting low and slowly increasing until you find your personal perfect balance you may get optimal benefits without wasting money on excess CBD.

Please Note: The amount of body fat, duration and severity of condition, GI/Liver function, individual biochemical makeup, and endocannabinoid balance may affect outcome. Some clients feel an immediate response, others take more time. Be patient, it may take months to fully rebalance your Endocannabinoid system.

Some Potential Minimal Side Effects include a temporary headache, potential feelings similar to dizziness and fatigue.

Many people feel more mentally alert and focused with CBD so we suggest starting it in the AM.

ATTENTION: Some medications may interact or impact serving size. Please call 412-421-4996 or 412-586-4678 to speak to a Pharmacist about any medications you are taking or visit us at 4227 Murray Avenue.

CBD products are not recommended for use in pregnant women because of the role the Endocannabinoid system plays in reproduction and infant development.

For all these reasons, it makes sense to buy CBD from a pharmacy and a pharmacist with 40 years of experience and expertise instead of from a random website or vape shop. I’ve done the research, I know biochemistry, and I know how to balance it!

Why did we choose our LabNaturals Broad Spectrum Plant Oil over other brands?

• No Detectable THC
• No Detectable Solvents
• No Detectable Pesticides
• No Detectable Heavy Metals
• Non-GMO
• Organically Farmed in accordance with Industrial Regulations (Reg. #69763)
• Broad Spectrum Entourage Effect
• Available over-the-counter (OTC) – no card or prescription needed
• Products are tested both internally and independently for potency, purity, and consistency.
• Hydrogenated Water Extraction Process and Supercritical CO2

The Opioid Epidemic has reached unfathomable proportions and is killing our family members, friends, and neighbors every day! Natural therapies, including CBD supplementation, may provide an alternative, non-toxic treatment to Opioid addiction.

What do you have to lose?

Please share this article with those who need it most and please stop by Murray Avenue Apothecary to speak with our CBD specialists. You can also learn more about our products and view a price list at www.LabNaturalsCBD.com

To Your Health and Healing,

Susan Merenstein, RPh/Owner

For More Information on CBD Please Consult the Following Paper from The National Institutes of Health: PACHER P, BÁTKAI S, KUNOS G. The Endocannabinoid System as an Emerging Target of Pharmacotherapy. Pharmacological reviews. 2006;58(3):389-462. doi:10.1124/pr.58.3.2.