Addicts benefit from Vancouver's medicinal marijuana dispensaries

Cannabis dispensaries offer different strains of marijuana as treatment for a variety of substance-abuse problems, including alcoholism, and harder drugs like heroin.

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      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.”

      Philippe Lucas, a research affiliate at the Centre for Addictions Research of BC, says cannabis can offer better symptom management and less-adverse side effects than pharmaceuticals or illicit drugs.

      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.”



      One Addiction for Another

      May 7, 2014 at 2:41pm

      The cannabinoids in marihuana are not essential or conditionally essential nutrients. One of the biggest parts of any inpatient drug treatment program is going to be healthy, nutritionally sound meals delivered at appropriate intervals.

      My own research into the topic, based on reading the literature as well as personal experience, indicates that much marihuana use stems from nutritional deficiency. I suspect this generalizes to drug addiction in general. To see these illegal drug-dealers in Vancouver adopt the pharmaceutical model of treating the symptoms instead of curing the disease is abominable. The fact is that these criminals (and they are criminals, there is no retail exemption from the CDSA) are making money hand over fist on the backs of a vulnerable population. The idea that there is good access to nutritionally sound food for the poor, disabled, etc. in Vancouver is nonsense---the free food is almost totally carbohydrates, very few green/orange vegetables. Eating Canada Food Guide on Welfare/Disability is a huge challenge, if not an impossibility depending on other costs of living.

      Back in the day, these guys would have been called "snake oil" salesmen. Marihuana certainly has some medical properties, but if one has a chronic health condition, a likely culprit is malnutrition, which is simply not how our sick-care system views things. They treat symptoms, not causes. Allowing drug-dealers to adopt this model in full view of the police and public is reprehensible.

      Sound Advice for "One addiction to another"

      May 8, 2014 at 12:20am

      I strongly recommend that you re-trace your steps and try doing another recap on the literature that is available on the topic. You will find that malnutrition is typically a result of drug addiction and not a cause of it and you will also find that there is a significant amount of data that suggests that cannabis does in fact help individuals reduce the consumption of the types of drugs that lead people to deprive their bodies. Beyond that the literature actually indicates quite the opposite of what you are funny as it sounds cannabis users to actually get "the munchies", which is why many of those going through chemo turn to cannabis in trying to maintain a healthy body weight. I would like to respectfully let you know that u seem attached to antiquated notions of drug addiction that attempt to reduce this incredibly complex behavior to one factor when few human behaviors can be explained as simply as that.

      @Sound Advice for "One addiction to another"

      May 8, 2014 at 7:25am

      What literature is this? There are no real controlled studies using cannabis to "treat" addiction. Really, substituting one addictive drug for another is not curing the disease; it is substituting one non-essential nutrient for another. You have this research about methadone and dealing with "craving", but this does not address the total body picture---this is pharmaceutical bullshit.

      There is a lot of research into nutrition from the 1930s onward that is really not put to as much use as it should be, because it is not patentable, isn't possible to sell at hugely inflated prices.

      Any "addict" should look at his or her diet, see if he is getting 100% RDA of the vitamins, minerals, essential fatty acids, amino acids, in addition to enough caloric intake. I am skeptical that many addicts take this approach---most of the addicts I have known, including, I am sad to say, myself for a time, engage in "magical thinking" and refuse to accept the possibility that their situation is one that they have power over, rather than one that a drug has power over.

      One interesting study, albeit an animal model study, on marihuana found the following result, iirc: rats that were deficient in omega3 fatty acids were able to take marihuana without much effect. Once their omega3 deficiency was corrected, marihuana produced anxiety, at least insofar as we have an animal model for that. In recent years, our diets, especially the diets have become incredibly burdened by omega6 with very little omega3.

      Recent human research into chronic pain syndromes with otherwise unspecified cause implicates an excess of omega6 insofar as a diet containing less omega6, plently of omega3 improved pain in many subjects.

      Everyone quoted in this study, except, perhaps, the University researcher, has a fiscal interest in keeping addicts where they are. Social workers, dope dealers, they need clients, right? Won't someone _please_ think of the dope dealers?

      outraged by stupidity

      May 9, 2014 at 10:42pm

      I'm disgusted by the ignorance of the two posters below me. Myself and others have gotten away from opiates using cannabis and to say that dipensaries are using this as a cash grab is unrealistic. If people are using methadone to get off heroin .. than why not use cannabis and also cannabis doesn't make you withdrawal the way that methadone will. By the way methadone is in no way better than heroin it's just easier to help you deal with cravings but marijuana actually helps you eat and sleep it revamps your whole system and anyone who says different clearly hasn't been an addict. So for all those conservative people who are still trying to use propaganda against marijuana please try again as you and the rest of society have failed.

      @outraged by stupidity

      May 10, 2014 at 7:23pm

      Cold Turkey from all drugs, eating a healthy, balanced diet. If you don't have chronic pain or something like it, opiates and other sedative-analgesics like marihuana are _not indicated_.

      The idea that dispensaries are not motivated by profit is nonsensical. Back in the day the issue was that the few places sold at the market price-point of $7-$10 a gram because if they didn't, nice people who grew the bulk of the available dope came knocking and threatened to break kneecaps. With the proliferation of dispensaries, that is not the situation.

      Cannabis is no better than methadone is no better than heroin. Drug addiction is not a good thing. If one has a syndrome that is being treated by a drug, that is an acceptable use, but the vicious cycle of addiction is not best treated by more chronic drug abuse.

      As for calling me conservative, actually, I am an old head. Maybe that does make me conservative, better dead than red, after all. I never got onto the downers, but I sure did smoke a lot of pot. One day, I took a large dose of some fine _______ and during the ensuing 6-12 hours, I thought to myself "man, what am I doing here? I'm being a very stupid monkey. Why don't I try eating right and exercising?" And sure enough it worked. Is that going to work for everyone? No. Are there any outpatient programs in Vancouver that provide addicts, especially marginalized and impoverished addicts access to a gym and three square meals a day? No.

      Now, with the lack of availability of good quality _______, I do understand that not everyone can even try what I did, but that is my view of how pharmacotherapy of addiction should be treated: a high-dose ________ trip followed by a few months of quality diet and exercise with the addict gradually being weaned off of active support into independent living, either inpatient or outpatient. Are you telling me that people doped up on methadone/marijuana all day are getting the amount of physical activity recommended to maintain good health? The recommendations are 1-2 hours of 5-6 mph cardio with strength training 3x a week, depending on who you ask. If my life as a marihuana addict was any indication, even feeding myself was a challenge, let alone going to the gym and pumping iron.