Around this same time last year, 27-year-old Minnesota millennial Hunter Christensen posted a Facebook status:
“I’m out of rehab now and celebrating 100 days of being needle free. Let’s have a cake.”
An announcement such as this one would likely have been a source of shame only a decade ago, but not today thanks in large part to the “everything is for public consumption” attitude of social media. Addiction, and things like it, no longer carry the stigma of failure, disgrace and discomposure.
The open discussion about how to treat drug and alcohol addiction is leading researchers, counselors and even law enforcement to embrace what’s rapidly becoming an effective weapon for the war on drugs — cannabis.
The concept is one component to a growing global approach to addiction treatment called harm reduction, which accepts the idea that complete abstinence — touted for so many decades before — may not be possible. In its place, a policy of reducing the long term harm and crippling consequences of drugs and alcohol can be employed in the treatment of addiction.
Maia Szalavitz, a neuroscience journalist and the author of "Unbroken Brain: A Revolutionary New Way of Understanding Addiction” says, "Addiction is compulsive behavior despite negative consequences. If you're using a substance responsibly and not having negative consequences, why should anyone care?"
While this flies in the face of the traditional hardline AA approach trumpeting complete abstinence as the only solution, recent studies and theraputic practice support this newer idea of harm reduction.
"Our retention rates are so much better with being able to give [recovering alcoholics] something," says Joe Schrank, a trained social worker who has spent the last 15 years working with addicts and now treats alcoholics at his southern California rehab, High Sobriety, with cannabis.
High Sobriety is one of a growing number of treatment centers that has adopted a strategy of treating alcoholism as a physical defect rather than a character defect. The proponents claim the solution is a medical one, which requires a stronger scientifically supported response rather than an exclusive spiritual approach.
"I never think of drug use as any kind of moral thing," Schrank said. "Actually, I like drug use, although it didn't really work out for me."
Research seems to suggest that "moderation management” may help some people who've struggled with alcohol. Keith Humphreys, the section director for mental-health policy at Stanford's department of psychiatry, concluded that making the method an option for people with drinking problems "seems on balance a benefit to public health."
“I used to drink a traveller of vodka a day,” says 29-year-old Rafael Cogswell, a cannabis convert who lives in Denver. “I tried the AA thing and it never worked longer than a couple months at most. I started smoking weed after I fell one night I was hammered and was in too much pain to make it to the liquor store. That was two years ago and I haven’t drank a drop since.”
Alcoholism isn’t the only addiction affected by harm reduction benefits of cannabis. Two studies published recently are detailing how marijuana is putting a tourniquet on opioid abuse.
"We do know that cannabis is much less risky than opiates, as far as likelihood of dependency," says W. David Bradford, a professor of public policy at the University of Georgia. "And certainly there's no mortality risk for obtaining it when it’s legal.”
Bradford and three colleagues studied whether people who have easy access to marijuana are less likely to seek opioids for pain management. The researchers used data collected from Medicare records and found that in states with legal marijuana, opioid abuse was reduced by nearly 14 percent.
During the time the study was being conducted, opioid abuse was on the rise nationally, so the data measured the slowing of use rather than a net reduction of opioid usage. That’s no small discovery, however. Researchers found that in states with legal marijuana, 1.8 million fewer opiate pills were dispensed and marijuana dispensaries cut daily doses by nearly 3.7 million.
While Bradford was quick to caution that the research indicates a correlation rather than a proven causation, it certainly suggests that easier access to marijuana may help ease the opioid crisis.
A second study released the same day by Heifi Wen, from the University of Kentucky College of Public Health, reports similar findings. Wen and his colleagues studied the effects of state and local law on the opioid epidemic. They found that more permissive marijuana laws "have the potential to reduce opioid prescribing for Medicaid enrollees, a segment of population with disproportionately high risk for chronic pain, opioid use disorder and opioid overdose. Nevertheless, marijuana liberalization alone cannot solve the opioid epidemic."
Bradford agrees that marijuana legalization is playing an important role. "But it is not without risks," he says. "Like any drug in our FDA-approved pharmacopeia, it can be misused. There's no question about it. So I hope nobody reading our study will say 'Oh, great, the answer to the opiate problem is just put cannabis in everybody's medicine chest and we are good to go.' We are certainly not saying that."
Many remain unconvinced, however, and data supports the argument that early exposure to marijuana may actually increase the propensity for opioid abuse. Dr. Mark Olfson, a professor of psychiatry and epidemiology at Columbia University, found early-use marijuana users were six times more likely than nonusers to abuse opioids.
What Olfson found was that young people who were experimenting with pot for recreation may be more likely to experiment with other drugs, but he conceded that there may be a link between people who are using marijuana for chronic pain, rather than prescription opioids or heroin, in reducing addictive harm.
What this means, essentially, is more studies need to be done to determine that sweet spot between use and misuse; but the data suggests that a cannabis component to treatment may be life saving or at the very least, life improving, for chronic addicts.
Scientific debate aside, sometimes the proof is simply in the practice.
Today, Hunter Christiansen posted on Facebook:
“It’s been one year since I left rehab, 465 days sober, and I want to celebrate with a cake again. Anyone have some edibles?”
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