Weed is having something of a moment. It seems all of my friends who used to spend their weekends drowning themselves at the bar have given up the bottle for the kush. And although the renaissance may have started out west, it's rapidly spreading to the east coast. Jersey already has a medical marijuana program, and New York just released regulations for its own slated to start next year. With pot's rising popularity, many people are wondering if we will see a corresponding decline in binge drinking and hard drug use.
A study published last fall in JAMA Internal Medicine showed that states with legal medical marijuana had a 25 percent reduction in opiate overdose deaths. As a strong proponent of alternative recovery methods, I was eager to investigate. The internet is rife with blog posts and message boards about those who benefit from marijuana as an alternative to alcohol, or credit medical cannabis in their recovery from hard drugs and alcoholism. But despite legalization becoming an increasingly mainstream idea, stigmas have stuck around, and saying you're getting clean by toking up can catch people off guard as much as announcing you've gotten sober through Satanism.
To learn more about weed's use in recovery I spoke with Amanda Reiman, PhD MSW, author of the 2009 study "Cannabis as a Substitute for Alcohol and Other Drugs" in Harm Reduction Journal and manager of Marijuana Law and Policy at the Drug Policy Alliance. After completing fellowships with the National Institute for Health, Reiman now continues her research on the effectiveness of pot as a replacement for hard drugs and alcohol.
VICE: What did you find during your research when looking at cannabis as a replacement for alcohol and other drugs?
Amanda Reiman: I started looking at the medical cannabis patient population. Anecdotally we had heard from patients that they were using cannabis primarily because they didn't want to use certain prescription drugs; they were looking for medicine that had fewer side effects. But we also found there were groups of people that were using cannabis because they had hazardous use of other substances, like alcohol or opiates. I did a large survey study in Berkeley of 350 patients. We asked them if they were, in fact, substituting: "Are you choosing to use cannabis instead of something else?" What we found was that about 75 percent of them were using cannabis as a substitute for prescription drugs, about half of them said they were using cannabis as a substitute for alcohol, and about 20 percent said they were using it as a replacement for illicit substances. That study was replicated with an additional 400 patients in Canada and we found the same thing. Then it was replicated a third time in Canada with about 1,000 patients, and we found the same thing.
And how does it work as a substitute?
We started to look at the mechanisms. I conducted a very small study a few years ago in San Francisco where we had eight individuals who were methamphetamine users looking to practice harm reduction. They were using [marijuana] to stay within a bound of methamphetamine use. And we tried to figure out what it was about the cannabis that was helping them stay within their boundaries of methamphetamine use. What was really interesting was that when we talked to the participants and asked them, "How is cannabis helping you not use methamphetamine?," they all said pretty much the same thing, which is that one of their issues in trying to keep their boundaries is that they didn't have the mindfulness. They would get the urge to use methamphetamine and just act on that urge without really thinking. Cannabis gave them mindfulness. They were able to slow down and really think about what they were doing, and what their body was saying to them. They were able to think about whether they really wanted to engage in methamphetamine use, or if they'd rather smoke some pot and go to sleep.
That makes sense.
The obvious thing is that [cannabis] acts as a psychoactive substitute. You want to get high on substance A, but instead you're getting high on substance B. That's a pretty simplistic way to look at it. When you take a little further look what you're seeing is that there are actual properties of the cannabis plant that can aid in getting off of other substances. When you look at the withdrawal symptoms of drugs like opiates and alcohol—things like nausea, tremors, trouble sleeping—these are all conditions which cannabis is really good at fixing.
So for someone who's trying to wean themselves off opiates or alcohol, having access to cannabis actually may make it less likely that they're going to relapse, because the withdrawal symptoms won't be as severe. One of the reasons people relapse is that the withdrawals get so bad. So if they can use cannabis to help with the withdrawal symptoms, it's less likely that they're going to return to that drug that was giving them problems.
If I told people I wasn't drinking but was fine with smoking weed, some would say I've simply switched one addiction for another. What's your response to that?
That is one very specific framework of recovery: abstinence-based recovery. But that's only one framework when it comes to recovery. There's a whole other framework around harm reduction where folks would say, "Look, as long as life is where you want it, and you're not getting into trouble with the law, and you're able to keep a job, and your family situation is going well and you're happy, then that's the most important thing." The goal of substance treatment isn't necessarily to demand abstinence as much as it is to help someone manage their life in a manner where substances are no longer interfering in a negative way.
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