Pubdate: Thu, 08 May 2014
Source: Georgia Straight, The (CN BC)
Copyright: 2014 The Georgia Straight
Author: Travis Lupick


Cannabis dispensaries offer different strains of marijuana as 
treatment for a variety of substance-abuse problems, including 
alcoholism, and harder drugs like heroin.

BRYAN ALLEYNE LOST a lot of time to drugs before he found an unlikely 
cure that he says freed him from dependence.

"I was an addict for at least 20 years. Heroin, cocaine, and every 
kind of pill I could," he told the Georgia Straight at a coffee shop 
on East Hastings Street. "But it's been eight years and I haven't 
gone back to hard stuff."

Asked how he got clean, Alleyne proudly revealed a small tin case 
with three large joints inside.

"Ever since the very day that I started marijuana, it took away my 
cravings," he explained. "It became my replacement. Marijuana is like 
my methadone.

"It's a reverse gateway drug!" Alleyne added with a laugh.

Alleyne, a social worker in the Downtown Eastside, said he sees a lot 
of people using cannabis to help them deal with addictions to harder drugs.

A number of cannabis dispensary operators the Georgia Straight met 
with for this story reported the same. Healing Tree on East Hastings 
and Karuna Health Foundation on Victoria Drive, for example, both 
estimated that 15 to 20 percent of the patients they see are coming 
in specifically for assistance with addictions to harmful substances. 
Those include heroin and other opiates, cocaine, alcohol, and 
prescription medications such as the benzodiazepine family of antidepressants.

At Karuna Health Foundation, the society's president, Sacha Canow, 
told the Georgia Straight that people are using cannabis as a 
treatment for addiction because it helps them manage cravings, 
minimize withdrawal symptoms, and alleviate some health problems 
associated with hard-drug use.

"In most cases, they're killing an opiate addiction or a 
synthetic-opioid addiction, so OxyContin, heroin, Dilaudid, 
methadone-they are probably the most common," he said. "It's not like 
we don't see other addictions, but those are the most common for Vancouver."

Canow ran through addictive substances and the corresponding 
marijuana strains he recommends for each one.

For alcohol, a depressant, Canow suggested an indica or heavy kush, 
and usually in the form of an edible. For cocaine, a stimulant where 
the craving is mental, he advised a strong sativa, which isn't always 
easy to find, he cautioned. And for heroin and other opiates, Canow 
recommended a heavy indica, heavy kush, or phoenix tears, an oil 
extract high in cannabidiol (CBD), a compound understood to have 
beneficial health effects.

"Basically, what they're trying to do is medicate themselves so 
heavily that by the time the opiate comes out of their body, they 
don't feel it as much," he said. "You can do that with marijuana, but 
you'd definitely have to do it with something potent, like phoenix tears."

In the Downtown Eastside, the Healing Tree reported that at least a 
fifth of its medicinal-marijuana patients are consciously using 
cannabis as a substitute for illicit drugs, with many more likely 
substituting marijuana unconsciously, and that crack and other 
stimulants are the most common drugs their patients are struggling with.

Studies examine cannabis benefits

Marijuana as medicine is still a relatively new concept to mainstream 
North America. But much of the academic literature supports anecdotal reports.

Philippe Lucas, a research affiliate at the Centre for Addictions 
Research of B.C., has a natural interest in marijuana as a tool for 
harm reduction. In 1995, he was infected with hepatitis C through 
tainted blood he received as a child. Lucas's doctor advised him to 
clean up his lifestyle, and marijuana helped him do that, Lucas said.

"I used cannabis to help deal with the withdrawal effects, mostly of 
tobacco but also of alcohol," he told the Georgia Straight in a 
telephone interview. "So my work really dates back to a personal 
experience based on the substitution effect."

According to a forthcoming study Lucas is working on, 86.6 percent of 
medicinal-marijuana patients surveyed reported using cannabis as a 
substitute for at least one other substance. Of that group, the 
majority-80 percent-said they were using marijuana to get off a 
prescription drug; 51 percent cited an alcohol addiction; and 32 
percent said they were using marijuana in lieu of an illicit 
substance such as heroin.

Lucas noted that those results are consistent with earlier findings 
he published in October 2013. That study found similar numbers for 
marijuana substitution and that respondents were replacing other 
drugs with cannabis for three reasons: less withdrawal (67.7 
percent), fewer side effects (60.4 percent), and better symptom 
management (53.9 percent).

"Cannabis interacts with our endogenous opioid system and, in terms 
of dopamine release, the rewards system," Lucas said. "So there are 
some good biological reasons why cannabis may be an effective 
substitute, particularly with pharmaceutical opiates."

Studies aimed at more specific areas of inquiry are bearing similar results.

Dr. Jillian Scavone and colleagues at Thomas Jefferson University 
sought to better understand perceived negative impacts of marijuana 
use on patients enrolled in methadone maintenance treatment (MMT). 
What they found, according to a May 2013 paper published by the 
American Academy of Addiction Psychiatry, is that marijuana could 
actually be beneficial to methadone users, decreasing 
opiate-withdrawal symptoms in MMT patients.

"The present findings may point to novel interventions to be employed 
during treatment for opiate dependence that specifically target 
cannabinoid-opioid system interactions," the report concludes.

Researchers have also begun exploring how cannabis can assist with 
addictions to stimulants such as cocaine and amphetamines. According 
to a September 2013 paper coauthored by Universite de Montreal 
clinical researcher Stephanie Oliere, "Cannabinoids modulate brain 
reward systems closely involved in stimulants addiction, and provide 
further evidence that the cannabinoid system could be explored as a 
potential drug discovery target for treating addiction across 
different classes of stimulants."

Health Canada shirks research

Canada's Conservative government has made clear it does not share the 
private sector's enthusiasm for marijuana's potential health applications.

"Dried marijuana is not an approved drug or medicine in Canada," 
reads a prominent statement on Health Canada's website. "The 
Government of Canada does not endorse the use of marijuana, but the 
courts have required reasonable access to a legal source of marijuana 
when authorized by a physician."

Neither Health Canada nor the Canadian Institute for Health Research 
made representatives available for interviews on the topic of 
medicinal marijuana.

Terry Roycroft, the president of Vancouver's Medicinal Cannabis 
Resource Centre, told the Georgia Straight that the government is 
showing more interest in research than it once did but that private 
organizations are definitely leading the way.

"We're hoping that what we're doing with our own funding is going to 
open up doors for additional [government] funding," he said.

Roycroft revealed that MCRCI recently hired an addiction specialist 
and noted that 90 percent of the patients she sees are using 
marijuana to help alleviate addictions and related health conditions.

"When you use cannabis, it reacts with your opioid receptors in 
conjunction with your endocannabinoid receptors, and what that does 
is it allows them to function about 40 percent more effectively," 
Roycroft said. "People are doing this, slowly increasing the use of 
cannabis and decreasing the use of the narcotic, to a point where 
they no longer need the narcotic."

If the government's attitudes toward research into the health 
benefits of medicinal marijuana are changing, that shift isn't 
happening fast enough for everybody.

In 2013, Adolfo Gonzalez, research coordinator and manager at Eden 
Medicinal Society, conducted a small-scale feasibility study with Dr. 
Paul Hornby that explored cannabis as a treatment for addiction to 
methadone, a synthetic opioid that some doctors argue is more 
addictive than heroin.

The results were promising, and Gonzalez has been trying to take the 
project to a clinical-trial phase ever since. But he said he hasn't 
been able to receive approval from academic partners' ethics boards, 
a problem he maintains is symptomatic of the government's lack of 
support and organizations' reluctance to look at marijuana as medicine.

"Health Canada is allowing private entrepreneurs to conduct the 
studies, but Health Canada itself does not fund or support studies at 
all," Gonzalez said.

In the meantime, he continued, Eden has an ongoing "opiate 
substitution assistance program", which provides patients with 
laboratory-manufactured cannabis pills, like those used in the 2013 experiment.

"Those proved to be quite effective for people," he said, adding that 
the program has become so popular it's now a primary service provided 
by Eden's East Hastings and East Pender Street locations.

"In the Downtown Eastside, pain and addiction are interrelated, and 
people are self-medicating with street medications or buying other 
people's over-the-counter drugs," Gonzalez said. "Marijuana reduces 
the cravings and it gets rid of the pain at the same time."
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