Bryan Alleyne lost a lot of time to drugs before he found an unlikely cure that he says freed him from dependence.
“I was an addict for at least 20 years. Heroin, cocaine, and every kind of pill I could,” he told the Georgia Straight at a coffee shop on East Hastings Street. “But it’s been eight years and I haven’t gone back to hard stuff.”
Asked how he got clean, Alleyne proudly revealed a small tin case with three large joints inside.
“Ever since the very day that I started marijuana, it took away my cravings,” he explained. “It became my replacement. Marijuana is like my methadone.
“It’s a reverse gateway drug!” Alleyne added with a laugh.
Alleyne, a social worker in the Downtown Eastside, said he sees a lot of people using cannabis to help them deal with addictions to harder drugs.
A number of cannabis dispensary operators the Georgia Straight met with for this story reported the same. Healing Tree on East Hastings and Karuna Health Foundation on Victoria Drive, for example, both estimated that 15 to 20 percent of the patients they see are coming in specifically for assistance with addictions to harmful substances. Those include heroin and other opiates, cocaine, alcohol, and prescription medications such as the benzodiazepine family of antidepressants.
At Karuna Health Foundation, the society’s president, Sacha Canow, told the Georgia Straight that people are using cannabis as a treatment for addiction because it helps them manage cravings, minimize withdrawal symptoms, and alleviate some health problems associated with hard-drug use.
“In most cases, they’re killing an opiate addiction or a synthetic-opioid addiction, so OxyContin, heroin, Dilaudid, methadone—they are probably the most common,” he said. “It’s not like we don’t see other addictions, but those are the most common for Vancouver.”
Canow ran through addictive substances and the corresponding marijuana strains he recommends for each one.
For alcohol, a depressant, Canow suggested an indica or heavy kush, and usually in the form of an edible. For cocaine, a stimulant where the craving is mental, he advised a strong sativa, which isn’t always easy to find, he cautioned. And for heroin and other opiates, Canow recommended a heavy indica, heavy kush, or phoenix tears, an oil extract high in cannabidiol (CBD), a compound understood to have beneficial health effects.
“Basically, what they’re trying to do is medicate themselves so heavily that by the time the opiate comes out of their body, they don’t feel it as much,” he said. “You can do that with marijuana, but you’d definitely have to do it with something potent, like phoenix tears.”
In the Downtown Eastside, the Healing Tree reported that at least a fifth of its medicinal-marijuana patients are consciously using cannabis as a substitute for illicit drugs, with many more likely substituting marijuana unconsciously, and that crack and other stimulants are the most common drugs their patients are struggling with.
Studies examine cannabis benefits
Marijuana as medicine is still a relatively new concept to mainstream North America. But much of the academic literature supports anecdotal reports.
Philippe Lucas, a research affiliate at the Centre for Addictions Research of B.C., has a natural interest in marijuana as a tool for harm reduction. In 1995, he was infected with hepatitis C through tainted blood he received as a child. Lucas’s doctor advised him to clean up his lifestyle, and marijuana helped him do that, Lucas said.
“I used cannabis to help deal with the withdrawal effects, mostly of tobacco but also of alcohol,” he told the Georgia Straight in a telephone interview. “So my work really dates back to a personal experience based on the substitution effect.”
According to a forthcoming study Lucas is working on, 86.6 percent of medicinal-marijuana patients surveyed reported using cannabis as a substitute for at least one other substance. Of that group, the majority—80 percent—said they were using marijuana to get off a prescription drug; 51 percent cited an alcohol addiction; and 32 percent said they were using marijuana in lieu of an illicit substance such as heroin.
Lucas noted that those results are consistent with earlier findings he published in October 2013. That study found similar numbers for marijuana substitution and that respondents were replacing other drugs with cannabis for three reasons: less withdrawal (67.7 percent), fewer side effects (60.4 percent), and better symptom management (53.9 percent).
“Cannabis interacts with our endogenous opioid system and, in terms of dopamine release, the rewards system,” Lucas said. “So there are some good biological reasons why cannabis may be an effective substitute, particularly with pharmaceutical opiates.”
Studies aimed at more specific areas of inquiry are bearing similar results.
Dr. Jillian Scavone and colleagues at Thomas Jefferson University sought to better understand perceived negative impacts of marijuana use on patients enrolled in methadone maintenance treatment (MMT). What they found, according to a May 2013 paper published by the American Academy of Addiction Psychiatry, is that marijuana could actually be beneficial to methadone users, decreasing opiate-withdrawal symptoms in MMT patients.
“The present findings may point to novel interventions to be employed during treatment for opiate dependence that specifically target cannabinoid-opioid system interactions,” the report concludes.
Researchers have also begun exploring how cannabis can assist with addictions to stimulants such as cocaine and amphetamines. According to a September 2013 paper coauthored by Université de Montréal clinical researcher Stéphanie Olière, “Cannabinoids modulate brain reward systems closely involved in stimulants addiction, and provide further evidence that the cannabinoid system could be explored as a potential drug discovery target for treating addiction across different classes of stimulants.”
Health Canada shirks research
Canada’s Conservative government has made clear it does not share the private sector’s enthusiasm for marijuana’s potential health applications.
“Dried marijuana is not an approved drug or medicine in Canada,” reads a prominent statement on Health Canada’s website. “The Government of Canada does not endorse the use of marijuana, but the courts have required reasonable access to a legal source of marijuana when authorized by a physician.”
Neither Health Canada nor the Canadian Institute for Health Research made representatives available for interviews on the topic of medicinal marijuana.
Terry Roycroft, the president of Vancouver’s Medicinal Cannabis Resource Centre, told the Georgia Straight that the government is showing more interest in research than it once did but that private organizations are definitely leading the way.
“We’re hoping that what we’re doing with our own funding is going to open up doors for additional [government] funding,” he said.
Roycroft revealed that MCRCI recently hired an addiction specialist and noted that 90 percent of the patients she sees are using marijuana to help alleviate addictions and related health conditions.
“When you use cannabis, it reacts with your opioid receptors in conjunction with your endocannabinoid receptors, and what that does is it allows them to function about 40 percent more effectively,” Roycroft said. “People are doing this, slowly increasing the use of cannabis and decreasing the use of the narcotic, to a point where they no longer need the narcotic.”
If the government’s attitudes toward research into the health benefits of medicinal marijuana are changing, that shift isn’t happening fast enough for everybody.
In 2013, Adolfo Gonzalez, research coordinator and manager at Eden Medicinal Society, conducted a small-scale feasibility study with Dr. Paul Hornby that explored cannabis as a treatment for addiction to methadone, a synthetic opioid that some doctors argue is more addictive than heroin.
The results were promising, and Gonzalez has been trying to take the project to a clinical-trial phase ever since. But he said he hasn’t been able to receive approval from academic partners’ ethics boards, a problem he maintains is symptomatic of the government’s lack of support and organizations’ reluctance to look at marijuana as medicine.
“Health Canada is allowing private entrepreneurs to conduct the studies, but Health Canada itself does not fund or support studies at all,” Gonzalez said.
In the meantime, he continued, Eden has an ongoing “opiate substitution assistance program”, which provides patients with laboratory-manufactured cannabis pills, like those used in the 2013 experiment.
“Those proved to be quite effective for people,” he said, adding that the program has become so popular it’s now a primary service provided by Eden’s East Hastings and East Pender Street locations.
“In the Downtown Eastside, pain and addiction are interrelated, and people are self-medicating with street medications or buying other people’s over-the-counter drugs,” Gonzalez said. “Marijuana reduces the cravings and it gets rid of the pain at the same time.”