Tokyo Starfish

Kurt Lybarger spent 35 years in the construction industry without any major accidents, so on the cold day he fell 15 feet off a ladder, flipped forward through the air, and slammed onto his feet in a pile of metal trusses, it may have taken a moment for his brain to tell his body that something was wrong.

Then the pain erupted from his heels.

As Lybarger felt his sneakers tighten, he took them off and looked down at his swollen, misshapen feet. One of his employees drove him to the hospital, where he was administered a series of potent pain medications.

“Nothing was working,” Lybarger said. “The pain was so bad.”

A CT scan revealed that compartment syndrome, a dangerous condition that results in insufficient blood supply to the body’s nerve and muscle cells, had developed in Lybarger’s left foot. He was given an epidural injection to numb the pain, then rushed into emergency surgery.

“My heels were completely shattered, like in hundreds of little pieces,” Lybarger said.

A rod was inserted through the back of his heel in an attempt to temporarily stabilize the area, but Lybarger said the procedure damaged his Achilles tendon and left him with acute pain that still lingers today.

Two weeks later, he returned for surgery to remove the rod and bone fragments. The area around the rod had become infected, but surgeons were able to remove the affected tissue and begin the process of repairing Lybarger’s broken heels.

With the initial repair work done, Lybarger began an ongoing recovery process that confined him to an in-home hospital bed for two months. He ran his construction business, High Desert Building & Design Inc., from his living room, managing the pain with prescriptions for oxycodone and slow-release oral morphine, to which Lybarger became addicted.

“Every 12 hours, I had to take a new pill,” he said. “I was addicted at that point. I just didn’t like how those were feeling.”

The use of prescription opioids for the treatment of pain has risen sharply in recent years, according to the Centers for Disease Control and Prevention. Of the more than 56 million Americans who filled at least one prescription for an opioid in 2017, an estimated 1.7 million suffered from related substance use disorders.

Lybarger wanted to taper his opioid use. His son, who was working at Bend dispensary Tokyo Starfish at the time, brought him a vaporizer pen filled with cannabis concentrate. It provided the pain relief he needed in order to scale back the painkillers, but the tingling in Lybarger’s feet persisted, a result of nerve damage sustained during his heel surgeries.

A breakthrough came when his wife bought him a topical salve that contained cannabidiol, or CBD, a nonpsychoactive cannabinoid derived from the cannabis plant. Lybarger applied it to his feet.

“Instantly my feet calmed down—no more buzzing,” he said. “It just stopped.”

Lybarger was supposed to take his prescribed opioids for seven to eight weeks, but cannabis products helped him wean off the pills within five weeks, he said.

Many pain sufferers report that cannabis and CBD products relieve pain better than prescription opioids, and evidence suggests that overdose deaths are decreasing in states where medical cannabis is legal. A 2017 study of 2,700 cannabis users found that 46 percent had ditched prescription drugs for weed. As of January, 84 percent of patients on Oregon’s medical cannabis program reported using cannabis for severe pain.

The medical community remains divided on the issue. Illinois and New York recently launched programs that allow patients with an opioid prescription to try medical cannabis instead, prompting pushback from medical groups that argue there is insufficient clinical evidence to support it.

CBD, which Lybarger said alleviated the pain in his feet, is used as a treatment for neuropathic pain. Sativex, a prescription drug containing CBD, has been available in Canada since 2005. The U.S. Food and Drug Administration last year approved an oral solution containing CBD for the treatment of seizures associated with two rare forms of childhood epilepsy. That approval did not reclassify the CBD molecule itself, however; it remains banned under federal law.

Just over a year after his accident, Lybarger is back to work full time. He credits cannabis products and CBD with his ability to manage the lingering pain on a day-to-day basis.

“It’s made me actually able to cope at work all day,” he said. “This is actual medicine.”

Lybarger will undergo another surgery next year, which will once again confine him to a hospital bed for two months. Still, he remains focused on a complete recovery.

“I’m looking forward to getting back to surfing.”

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