Pubdate: Wed, 26 Dec 2012
Source: AlterNet (US Web)
Copyright: 2012 Independent Media Institute
Author: Paul Armentano


Study Suggests Some Are Taking It as a Substitute for Prescription
Drugs and Alcohol

Three quarters of medical cannabis consumers report using it as a
substitute for prescription drugs, alcohol, or some other illicit
substance, according to survey data [2] published in the journal
Addiction Research and Theory.

An international team of investigators from Canada and the United
States assessed the subjective impact of marijuana on the use of licit
and illicit substances via self-report in a cohort of 404 medical
cannabis patients recruited from four dispensaries in British
Columbia, Canada.

Researchers reported that subjects frequently substituted cannabis for
other substances, including conventional pharmaceuticals. Authors reported:

"Over 41 percent state that they use cannabis as a substitute for
alcohol (n=158), 36.1 percent use cannabis as a substitute for illicit
substances (n=137), and 67.8 percent use cannabis as a substitute for
prescription drugs (n=259). The three main reasons cited for
cannabis-related substitution are 'less withdrawal' (67.7 percent),
'fewer side-effects' (60.4 percent), and 'better symptom management'
suggesting that many patients may have already identified cannabis as
an effective and potentially safer adjunct or alternative to their
prescription drug regimen."

Overall, 75.5 percent (n=305) of respondents said that they substitute
cannabis for at least one other substance. Men were more likely than
women to report substituting cannabis for alcohol or illicit drugs.

Authors concluded: "While some studies have found that a small
percentage of the general population that uses cannabis may develop a
dependence on this substance, a growing body of research on
cannabis-related substitution suggests that for many patients cannabis
is not only an effective medicine, but also a potential exit drug to
problematic substance use. Given the credible biological, social and
psychological mechanisms behind these results, and the associated
potential to decrease personal suffering and the personal and social
costs associated with addiction, further research appears to be
justified on both economic and ethical grounds. Clinical trials with
those who have had poor outcomes with conventional psychological or
pharmacological addiction therapies could be a good starting point to
further our under-standing of cannabis-based substitution effect."

Previous studies [3] have similarly demonstrated cannabis' potential
efficacy as an exit drug. A 2010 study [4]published in the Harm
Reduction Journal reported that cannabis-using adults enrolled in
substance abuse treatment programs fared equally or better than
nonusers in various outcome categories, including treatment
completion. A 2009 study [5] reported that 40 percent of subjects
attending a California medical cannabis dispensary reported using
marijuana as a substitute for alcohol, and 26 percent used it to
replace their former use of more potent illegal drugs. A separate 2009
study [6]published in the American Journal on Addictions reported that
moderate cannabis use and improved retention in naltrexone treatment
among opiate-dependent subjects in a New York state inpatient
detoxification program.

Full text of the study, "Cannabis as a substitute for alcohol and
other drugs: A dispensary-based survey of substitution effect in
Canadian medical cannabis patients," appears online [2] in Addiction
Research and Theory. NORML Advisory Board Member Mitch Earleywine [7]
is a co-author of this study.
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