FOR BETTER OR WORSE

09.05.14

Is Weed the Secret to Beating Opiate Addiction?

In the U.S., 46 people die each day from opioid overdose—and that number isn’t doing anything but growing. Could marijuana be what’s missing from addicts’ recovery?

Kevin had been addicted to heroin for six years when he used marijuana to complete his final detox 20 years ago.

Searing back pain, restless legs, nausea, and sleepless nights—the tortuous symptoms of an opiate withdrawal—had made detoxing off the drug nearly too painful for the native Midwesterner to bear. With the introduction of cannabis, things changed. “The headaches and body aches seemed lessened,” Kevin says of his experience. “Yes, I was still sick, but it made everything just a little more tolerable, and every little bit helps in that position.”

At a time when America is searching for solutions to a burgeoning opiate problem that kills 46 Americans a day, a new tool for jumpstarting the fragile recovery process is emerging: medical cannabis. Proven to alleviate symptoms of serious medical conditions including cancer, AIDS, Crohn’s disease, and glaucoma, cannabis is beginning to gain notice as an effective alternative to synthetic painkillers.

In a study published last month in the Journal of the America Medical Association, access to medical cannabis was associated with significantly lower state-level opioid overdose mortality rates. States with medical marijuana laws showed almost 25 percent less average annual opioid overdose deaths than states without laws. While some addiction specialists argue that switching from opiates to marijuana is “like changing seats on the Titanic,” success stories of users like Kevin paint a picture of how impactful it can be.

“I had detoxed several times before I finally got off heroin for good in 1994,” he says, recalling years of Narcotics Anonymous meetings which required him to abstain from all drugs. “Each time I [detoxed], I used cannabis while I used heroin. It definitely helped with the process of withdrawal,” he says. “Once I stopped using heroin for good, I never used cannabis again.”

On top of providing relief from the physical pain associated with opioid withdrawal, Kevin says it helped his emotional state of mind as well. “Getting as stoned as I possibly could—which at times seemed difficult—was a way to cope with my situation. I think psychologically, just doing something gave me some sort of solace.”

While there are many stories like Kevin’s, little research has been done to explore the potential benefit of marijuana for opiate addicts. One study, funded by the National Institute for Health and published in May 2013’s American Journal of Addiction, found that those who consume cannabis during opiate withdrawal experience less severe withdrawal symptoms. The research also showed that once the patients stabilized on methadone, there was a decrease in their cannabis use. While this study was focused on methadone maintenance treatment, the results show promise for the larger opiate-using population—a group that’s been growing exponentially for years.

With an increase in opioid prescriptions starting in the early 2000s, overdoses in the U.S. began to skyrocket. From 1999-2008, the U.S. saw a 300 percent increase in overdose death from painkillers, with close to 15,000 deaths in 2008 alone. By 2010, an estimated 2 million Americans reported using painkillers for the first time non-medically—bringing the total number of those abusing painkillers in America to 12 million. In recent years, the problem has grown to epidemic proportions. In 2012 alone, health care workers wrote out an estimated 259 million prescriptions for painkillers—enough for each adult in America to have their own bottle. The CDC estimates that 46 Americans die each day from overdose on opioids.

Use and abuse of these drugs has reached an epidemic level as policy-makers, families, and users themselves scramble to find options that combat addiction. In a recent testimony, Dr. Daniel Sosin, the acting director of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC), stated that one of the department’s three main efforts is gathering data for evidence-based decision-making that improves public health. In the face of an epidemic that poses a lethal threat to 12 million individuals who use prescription painkillers, the government and the health care industry have all but ignored cannabis.

The stigma that still lingers around marijuana means the public has yet to fully get behind the concept, either. In an interview following the release of the JAMA study, Kevin Sabet, director of Project SAM (Smart Approaches to Marijuana), spoke out condemning the concept that marijuana could save the life of someone suffering from an opioid addiction. “There may be promise in marijuana-based medications but that's a lot different than ‘Here’s a joint for you to smoke,’” he said.

In an interview with The Daily Beast, Amanda Reiman, director of the Drug Policy Alliance, shot back at Sabet’s jab. “That was a pretty callous thing to say. A lot of people have lost loved ones to opioids, and I bet they’d be willing to try just about anything to get their family member back,” says Reiman. “If we’re talking about saving people from an opiate overdose, I am pretty sure smoking a joint would be welcomed.”

Other success stories reflect a similar theme. Justin, a clean-cut 24-year-old with sweet Southern charm (“yes ma’am”) and a love for music, has come a long way since his days using heroin. Currently employed and housed, he used for five years before getting clean. “I was determined to change my life and stop letting that stuff rule me,” he says. “I hit rock bottom—losing most of my family, burning my bridges with them and everyone else. I knew it was time to change, and I was completely willing and ready for that to happen.”

The experience Justin had with cannabis was similar to what has been described by many users: “It calmed me down [and] made my anxiety and nausea symptoms go way down. It really helped my appetite as I would not eat hardly ever, especially when the withdrawals first started.” In a state with limited treatment options, Justin had no health insurance and no money for expensive opiate replacement programs. “After I was done with detox, I got a job and started living ‘right.’ I still use cannabis every day,” he says.

According to the National Institute for Drug Abuse, medication may be an essential component of an ongoing treatment plan, enabling opioid-addicted persons to “regain control of their health and their lives.” The three main types of medication for opiate withdrawal and recovery are methadone, buphrenorphine, and naltrexone. These treatments can be expensive, ranging between $500 and $800 per month, and may create both a physical and psychological dependence. Some users describe it as worse than the drugs they were abusing before they entered treatment.

The Substance Abuse and Mental Health Services Administration (SAMSHA) describes the side effects of marijuana as sleepiness, trouble concentrating, and decreased social inhibitions. These seem mild in comparison to the harsh side effects of replacement medications. Certainly, these stories of recovery demand more research on the benefits of medical cannabis.

“I have a life today that I never would have imagined could be part of my reality,” Kevin reflects. “I am almost 51 years old. Not only did I never think I would see 30, but I was convinced I would die with a needle in my arm, or wrapped around a telephone pole from nodding out on my motorcycle. There’s a good life waiting for you outside of that spoon.”