Marijuana: Its Addictive Nature and Its Use in Treating Addictions
Doctors and researchers have long sought out ways to cure disease, heal the sick, and tend to those in pain. This has led to many miraculous breakthroughs and discoveries, as well as treatments that have changed society and stirred public debate, like the use of marijuana medically. Marijuana has a long and controversial history when it comes to being used medicinally, and only as of the past 20 years has become even remotely legal to use. While it has many strong proponents for its use to help with many things, from coping with cancer treatments, to chronic pain, to symptoms of mental illness, it has many more saying that it is a danger, and a “gateway drug” to using harder and more dangerous substances. But what is the truth of the matter? What is the danger of marijuana as an addictive substance?
While these are important questions to answer, there is a further question that needs to be answered as well. There have been articles coming out over the past year, and research dating back the past several years, suggesting that marijuana can be an effective treatment for more serious substance abuse, alcoholism, and opioid addiction, which is ravaging many counties in the country. News articles are coming out suggesting that marijuana use can effectively cure addictions. Darren McCarty, former Detroit Red Wing pro hockey player, credits his use of marijuana as having “saved” him from his alcoholism, and “healed” him from that disease after four tries at rehab (WDET). So, let’s take a look at the claims that it can help a person overcome addiction to other substances as well. Can marijuana use help alleviate symptoms of addiction to other substances?
There are two things that are vital to say first before continuing to the heart of the article. First, any decisions about treatment and sobriety, especially when they involve medications, should be done with the help of a physician and a substance abuse professional. This is an absolute must. And second, this article phrases things very carefully at times, because it is reflecting current understanding and research on the subjects presented. Research and knowledge bases change over time, and it is important to keep in mind that what is known to be true today, may be disproven with certainty later.
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Marijuana as an Addiction
Long have we been taught that marijuana is a “drug,” a psychoactive substance that can affect the brain and nervous system impacting mood, thought, and cognition. And to all drugs, or at least the illegal ones, we were taught to “just say no” to them. Marijuana we were told, was insidious because it was a “gateway drug,” leading to harder and more dangerous substances. That may have been what we were all told, but how true is it?
Well, the truth is not as simple as all drugs are bad. Marijuana, or cannabis, is a depressant that can cause a relaxed feeling, mild euphoria, and increased appetite, while it may also impair memory and motor skills, and in some cases cause agitation and paranoia. Marijuana’s addictive properties are hotly debated, as its proponents say it is not addictive, and those opposing it feel it is just as addictive as any other drug.
To summarize current understanding of addiction, there are two different ways to be addicted to something, physically, and psychologically. A physical addiction is when the body becomes so used to a substance, that it is dependent on it, and will experience withdrawal symptoms, sometimes serious, if that substance is removed. A psychological addiction is when something becomes such a habit that the person believes they need it to function, and will cause distress if that substance is withdrawn, although physical symptoms will likely be minimal. Either way the result of addiction is damage done across all spheres of a person’s life, their health, family, friends, work, spirituality, morality, and mental well-being.
Cannabis is in a unique position. It is a psychoactive substance, presents with euphoric and relaxing properties, but it is not as physically addictive as any of the other illicit substances. (Psychology Today). Yes, a physical addiction can occur, but it is unlikely, not an impossibility, just unlikely. For many the physical addiction and the withdrawals are the hardest part, as they will relapse just to avoid the pain of detox and withdrawal symptoms, but with marijuana, withdrawal symptoms are often mild. It is the psychological aspect of addiction that can be hard with marijuana, because it is just as psychologically addictive as any substance, and can present as an easy coping strategy for life when there are any adversities to overcome. For some, it becomes the only way to manage life, and the only relationship that matters. The rates of those addicted to marijuana are often debated, but estimates put it at 9% of individuals who use it will develop a dependence on it (NIDA). The debate becomes how much of that is a physical addiction and how much of that is psychological.
Marijuana’s Use in Treating Addiction
Now, an interesting treatment protocol is making the rounds in the news and social media about cannabis being used to help treat opiate addiction, and we have seen that it has been used to treat alcoholism, per Darren McCarty’s story. While it is important to keep an open mind, and explore new options and potentials to help those struggling with addictions, it is equally vital to make certain that people are given proper care, and not placed in more jeopardy. Research is beginning to come in on the use of marijuana to medically help with the detox process and the treatment of addictions, so let’s begin with what is known so far.
There is a concept in the fields of addiction and mental health called harm reduction. This strategy is focused on people who are not able to completely change their behavior yet, and will continue to use or do other maladaptive or harmful behaviors. The idea behind harm reduction is that the therapist and the client work together to implement a plan to limit use, do it as safely as possible, or other steps to, obviously, reduce the chance of harm being done to self or others.
An example from my work was a client who was a heroin user of several years and told me quite clearly that he was not ready or willing to stop using. The feeling for him was too good to give up. The consequences, however, were starting to add up and he could also acknowledge that he cannot keep going on forever like this. Here I chose to use the harm reduction model rather than say he cannot come to counseling any longer until he was willing to stay 100% clean and sober. His idea, to which I agreed, was that he would use once a month, and provide random drug tests to demonstrate that he was keeping his end of the deal, while we worked towards achieving his goals for therapy. This would be an example of harm reduction in action, working on minimizing the damage done by his using.
Cannabis has been talked about as a possible harm reduction drug. It’s side effects and long term effects on the body are not as severe as other drugs, and presents with less of a physical addiction possibility (Medscape). It also has shown the potential to relieve some of the symptoms of detox and withdrawal from alcohol, which will help alleviate the discomfort and potential reason to avoid treatment and sobriety (Medscape).
There is also potential for its use in treatment of other drug addiction, including the opiate addiction. This follows both with the harm reduction model, reduces cravings and helps manages the withdrawal symptoms (Medscape). Overall there has been enough research showing that it is helpful or beneficial to the treatment process that it warrants further study (NCBI). This is all not saying it is a cure for addiction by any stretch of the imagination. It is being used as an aid in the treatment process, and it is generally recommended that the clients taper off usage after a certain point, so it is not viewed as a lifelong medication (NCBI).
So far this sounds very promising, but there are potential downsides. As stated above, this is also an addictive substance, psychologically, or to a lesser extent, physically, and that needs to be thought about when it comes to the overall well-being of the person in treatment, whether this will be helpful, or become another dependency. There is conflicting evidence about is long term health impacts overall, but there is consistent evidence for it damaging cognition in the long term, hurting memory, focus and intelligence (NIDA). And it is unclear yet, the risk of relapse, when switching one mind altering substance for another. This is a subject that requires a lot more study, and currently there are no clear treatment protocols to follow with its use as a medication.
It is hard to say what we are looking at right now. Could this be a way to help many through detox and treatment? Could this be a safer medication for heroin users than methadone? Or could this lead to even more addiction and further stays in treatment facilities? There is a call for more research because there is not enough evidence to answer any of those questions yet.
As of right now it would seem like marijuana as part of treatment would need to be specifically targeted to people that would present the lowest risk of abuse, and gain the most from its use. This could help clear the hurdle of getting people over detox, which can be torturous to even watch, let alone go through, and get them stable to enter into longer term treatment, physically able to do so. Right now, we must understand this better, but it looks like the potential is there for this to help the right people.
- Addiction Treatment Success Rates
- Addiction Treatment “Step-Down” Process
- Matrix Model Of Addiction Treatment
- Having Fun In Recovery From Addiction
- Substance Use Disorder and Attention Deficit/Hyperactivity Disorder
Healthline – Marijuana Addiction Is Rare, but Very Real
Medscape – Role for Cannabis in Treatment for Opioid Addiction?
NCBI – Medical marijuana users in substance abuse treatment. Harm Reduction Journal