Group 5 You might be reading the title of this post and thinking, “Wait a second … You want to treat drug addiction with cannabis? Isn’t that a little backwards?” Well, we argue that this is a moot point, as we consider cannabis/marijuana/hemp/whatever you want to call it – but more specifically, the flowers and whole plant extracts that form the unique cannabinoid and terpenoid profiles – to be medicine, as explained throughout this blog. Also, if you are suing opioid medications for chronic pain and want to find an alternative that could very well help, then getting yourself a medical marijuana card might well prove to be very helpful. First, to define addiction: it is a condition which results in a person ingesting a substance or engages in a behaviour that gives them pleasure, to the detriment of all other responsibilities, i.e. the “high” or the “thrill” becomes more important than anything else in their lives. Addictions of all types are similar, whether it’s drugs, sugar, trans-fats, gambling, sex or even violence. Dopamine (the “reward-seeking” chemical) plays a role in many types of addiction, but is by no means the only mechanism causing addiction. There are also several ways addiction manifests itself, and different substances or activities work in different ways. With opiates and opioids, the onset of tolerance and eventual addiction is rapid, whereas alcohol is not necessarily addictive right away (psychological and even a sort of short-term physical addiction can be rapid, though), but becomes extremely physically addictive after a long period of use. Accessibility to the addict’s drug of choice makes a huge impact socially as well: legal, reasonably-priced access to alcohol means it is arguably a larger problem overall in the US and the world over, especially as it’s a common part of many people’s and countries’ cultures. Addiction can therefore be defined not only by the impact it has on the individual, but also on society as a whole. Is this cannabis plant really more addictive than opioids? To explain to you how and why cannabis works as a treatment for drug addiction, we shall go through the three main aspects of addiction: physical, mental and social/environmental. We shall do this mostly in reference to addiction to painkillers (opiates and opioids), alcohol, barbiturates, benzodiazepines and amphetamines. If you’d like to read more on the scientific reasons why cannabis could be used to treat drug addiction, check out our blog post “Does Legalizing Cannabis Reduce Drug Abuse?” Pharmaceutical drugs are often far more addictive than cannabis. Physical Dependence Physical dependence is what happens when a person has taken a physically addictive substance for some time, and begins to actually need the substance for normal functioning. These substances usually cause actual bodily changes, as artificially flooding the body with such substances means that the body stops producing certain hormones and chemicals usually produced by it naturally. Physically addictive substances include: Opioids, e.g. oxycodone, fentanyl, morphine Alcohol Barbiturates Benzodiazepines, e.g. diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax) Nonbenzodiazepine hypnotics, e.g. zopiclone, zolpidem Nicotine Antiepileptic drugs, e.g. valproate, lamotrigine, vigabatrin Antipsychotic drugs, e.g. clozapine, risperidone, olanzapine Selective Serotonin Reuptake Inhibitors (SSRIs) Blood pressure medications, including beta-blockers like propanolol, clonidine Androgenic-anabolic steroids Glucocorticoids Those who stop using any of the above drugs after a significant time of using them will suffer from physiological and psychological withdrawal symptoms, including raised heart rate and/or blood pressure, sweating, vomiting/nausea, diarrhea, confusion, seizures and hallucinations. Going “cold turkey” from a physically addictive substance can potentially lead to fatal withdrawal conditions, especially when concerned with GABA agonists and positive allosteric modulators such as alcohol, benzodiazepines and barbiturates. As you can see, many of these physically-addictive substances are available on prescription. Many normal, everyday people that you know in real life may well have a condition or illness that requires them to take one or more of the above substances, and in many instances might in fact be addicted to them. The term “addiction” often brings up an image of someone who might be unemployed, on state-assisted housing programmes or potentially homeless, and generally in bad environments. This is not always the case, and often addictions are hidden in plain sight – we’ve all heard of the “functional alcoholic”. In some cases, it is not unusual to find someone who suffered from a medical condition necessitating the prescription of one of the above then, as their prescriptions lessen, pain becomes greater or tolerance develops, moving onto street drugs in order to combat pain and/or chase euphoria. “Medical” use turns “recreational” on the head of a pin. Some readers will also note that many of the above substances may be replaced by cannabis and several of its many cannabinoids – a far less addictive substance mentally, and physically non-addictive as far as current evidence suggest. In some cases, cannabis is even more effective at its jobs than any of the above drugs. So, not only can cannabis replace or reduce intake of other, highly addictive, tolerance-forming drugs (whether prescribed or not) with psychoactive effects that can make vaporizing a little cannabis seem like a walk in a park. Furthermore, cannabis can help with treating withdrawal symptoms such as nausea and blood pressure. The lack of physical addiction makes cannabis the ideal medication of choice to replace other opiate- and benzodiazepine- based drugs usually used for those going through withdrawal (e.g. morphine, diazepam). Alcohol – a physically addictive drug. Psychological Dependence Not all drugs are physically addictive, but still produce extreme cravings by those who use them. Examples include amphetamines and cocaine, both of which cause an increase in dopamine in the synaptic cleft (although the two work in different ways). Though the effects of withdrawal can look similar to those who are physically addicted to a substance (sweating, nausea, raised heart rates), the difference is that going “cold turkey” will not result in fatal convulsions. Basically, after a long period of (for example) amphetamine or cocaine abuse, the user experiences an extreme “crash”, and emotional-motivational withdrawal symptoms arise. This means depression, anxiety, a loss of interest in activities that may have once been pleasurable and a general state of unease or restlessness. Like with those who are physically dependent on a drug, cannabis can be the perfect replacement for those who are psychologically addicted to a drug. Moreover, cannabis can act as more than just a “replacement”, but as a way of removing the need to “chase the dragon” entirely – use can be tapered and measured, then gradually reduced with few if any withdrawal symptoms (cannabis is not very addictive). The other advantage of cannabis for addiction? Its range of effects, which go from energetic to euphoric to relaxed to a mixture of the lot – all bases are covered, and poly-drug users needn’t seek a dangerous cocktail of “uppers” and “downers” to get the effects they’re looking for. Social/Environmental influences on Dependence Other than those who get addicted to a substance due to medical conditions and post-injury pain, many issues surrounding addiction may come from family life and peers, or just unfortunate circumstances. Many who suffer from addictions of various types may have come from violent, abusive and/or negligent childhoods, where parents were also drug abusers or had what some might call “addictive personalities”. Moving from one environment to a similar one when they’re older is not an uncommon story for many people, and the cycle continues. Unfortunately, cannabis cannot solve emotional trauma resulting from growing up in an abusive environment or a peer group intent on staying hooked on addictive drugs, but seeking treatment is certainly one of the first steps to getting those problems solved. Breaking out of such an environment is essential for preventing relapses. Yes, for some people, cannabis can definitely help overcome addiction and even come to terms with certain problems and issues- many who suffer from post-traumatic stress disorder (PTSD) can attest to that – but it is not the only thing that will. It is also just as important to find rehabilitation methods that do not completely prosthelytize addicts – the rate of recidivism from attending institutions that do so is extremely high, and one could argue a waste of time and money, as some drug treatment centers are more interested in inculcating a lop-sided morality on their patients rather than an end to their addiction. Pharmaceuticals and dollar bills. Meanwhile, going to a compassionate doctor, finding a decent dispensary and going to a lounge where patients have a supportive social environment to go to (and where people are likely to realise that there’s a massive difference between those who use a little cannabis once every few years on their camping trips and those who use opiates everyday) can get rid of their addictions effectively. Addiction problems will not be solved by the Nurse Ratcheds of the world. Should you be looking to reduce your intake of painkillers, or are afraid of using them and looking for an alternative (very sensible, in our opinion), then book an appointment with Leafwell as soon as possible, and see how we might be able to help you.