PRACTICE MANAGEMENT MEDICAL MARIJUANA BY BRUCE NICHOLSON During a time when the opioid crisis in Pennsylvania has led to greater scrutiny surrounding prescribing of opiates, patients seeking pain relief often face limited options. Although the state has begun to address the opiate misuse problem and ensure they remain available as a treatment option, another type of pain-relief medication has become the de facto treatment for many patients: nonsteroidal anti-inflammatory drugs (NSAIDs). While many people think that NSAIDs are relatively low-risk medications, a study by the American Journal of Medicine found that annually, around 107,000 Americans are hospitalized for gastrointestinal (GI) complications due to NSAID use. 22 22 Lehigh County Health & Medicine | FALL 2017 And at least 16,500 NSAID-related deaths occur among arthritis patients alone. If the Center for Disease Control counted the number of fatal GI toxicity issues caused by NSAIDs in its National Vital Statistics report, it would be listed as the 15th most common cause of death in the United States. Recent data surrounding heart disease and NSAID use has lead the FDA to require labeling of all NSAIDs including those sold over the counter to warn patients of the potential cardiac risks.Several studies have produced substantial results showing that cannabinoids - the chemical compounds found in medical marijuana - reduce pain and are approximately 20 times more potent than aspirin as an anti-inflammatory.