Joe Schrank on Cannabis to Treat Drug Addiction

Joe Schrank recently opened High Sobriety – a rehab clinic that uses cannabis as a way to treat addiction to alcohol and/or other drugs. High Sobriety only opened in January and, although they are employing a somewhat controversial method, it is clear that a reasonable and novel solution is needed to the United States’ approach to how substance addiction is treated.

Could you help us explain the concept of cannabis as an “exit drug”?

There’s a bunch of different reasons that we believe cannabis is an exit drug. One being that the cultural belief that cannabis is a “gateway drug” is not correct. That’s been debunked by science and common sense long ago. We believe that for some people – probably more people than we realize – achieving total abstinence is not always the goal. They may not want to be totally abstinent.

Other people need some kind of period of replacement. Especially if they’ve had 20 years drinking alcohol or using heroin or whatever their situation is. To tell them that “you have to be totally abstinent in 30 days.” This is fine for some people, but it’s a limited number of people. Other people are much better off using a “stepping stone”.

With cannabis, you’re taking death off the table. Nobody dies using cannabis alone. There have been isolated incidents of people who have had accidents whilst impaired – driving, using heavy machinery, those kind of things – but there’s no lethal dose, just a theoretical lethal dose that nobody would be able to achieve.

So when you take death off the table, all the long-term hospitalizations and the other stuff that happens with other forms of intoxication, you have “room”. So that’s the way cannabis can be used as a “stepping stone” to a way out of addiction. That’s what we’re going for at High Sobriety.

So how many people have you successfully treated using medical marijuana?

You know, that’s an interesting question. I would say that “I don’t even know”. We’ve done this now for a long period of time, and we’ve done it in this kind of secretive, shame-based way because the culture was just not ready to hear about this form of treatment. Lots of people were like, “Oh, that’s crazy!”

So when we have had clients through the years who weren’t doing well or weren’t willing to go through abstinence, specifically with opiate addicts, and saying, “Look, there is another option” – we’ve been really successful with those folks over the last five years. I would say there’s probably about 50 of them out there.

This year was the year we decided to stop being apologetic and say, “This is what we do, and it can be helpful for some people.” We’re not trying to say, “We’ve solved the addiction problem.” Neither are we saying, “This is the best option for everybody.” We just don’t want to hide anymore.

So it’s hard to say precisely how many we’ve helped because High Sobriety only started in January. We have had some successful experiences. The people who are currently residents will tell you that they’ve flopped out of other rehabilitation centers, that they couldn’t handle the detox, those kinds of stories. But we cannot say anything for certain, as we’re working with a very small sample. We can’t give any definitive, accurate statistics.

interior high sobriety

A patient’s bed in High Sobriety. Photograph: Pete Pin for the Guardian

Has there been much recidivism in your programme?

No, not much. I think that when you respect people as individuals, you don’t try and punish them because they’ve done something that’s been bad for their health. This sets up a different dynamic, from a therapeutic standpoint.

Now, in six or eight months, my story might be different. When people get out on their own, we don’t really know. Some people have goals of cessation of cannabis use as well as stopping other addictions, using cannabis as a “process.” Other people are very clear that they don’t want to stop cannabis. Whether they go back to using a substance with higher risk is kind of unknown at this point.

Look, any treatment center can say, “Oh, we have an 80% success rate.” They’re full of shit. Firstly, they don’t really know as they tend to lack follow-ups; secondly their sample sizes lie and they don’t do large enough programme evaluations in an academic way, and finally they don’t usually have a proper researcher. We have a proper researcher in Dr. Amanda Reiman from Berkeley who is a skilled, seasoned and respected researcher. She will hopefully figure out the answers to some of these questions over the coming years.For the moment though, we cannot give a definitive answer.

How many addiction cycles start on the operating table?

There’s a lot of those people out there. You know, they go down a “rabbit hole” trying to manage pain with opiates. The body does build up a tolerance to them, so when they don’t take them, they get sick. There are a lot of those people, whether it’s chronic back pain, surgery or so on and so forth. We hear that story a lot. That’s one way people develop a dependence on opiates, for sure.


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