Thursday, April 22, 2010
Oaklanders Quitting Oxycontin with Cannabis
Health & Medicine David Downs — Thu, Apr 22, 2010 at 10:46 AM
East Bay residents are enrolling in twelve-step-like classes that use cannabis to quit heroin, pills, cigarettes, alcohol, and other addictive substances, defying decades of Narcotics Anonymous and Alcoholics Anonymous tradition.
Even though NA and AA both mandate abstinence from all illegal drugs, that one-size fits all approach doesn't work for all addicts, says Harm Reduction Clinical Consultant Jennifer Janichek. For the last six weeks, Janichek, along with two other clinicians, have been running pro-cannabis mental health and addiction services for a handful of people out of the Harborside Health Center in Oakland. The free mental health services paid for by the area's largest cannabis dispensary explain the safest way to smoke pot — which is not physically addictive — and use it to combat depression, anxiety, and addiction.
For years, there've been anecdotal reports about people using cannabis to quit harder drugs. The process is called “substitution”, and it's a tactic that's beginning to be endorsed by the “harm reduction” philosophy of mental health. Janichek says the philosophy of harm reduction is most popularly associated with needle exchanges, condom disbursement, ecstasy pill testing, and seat belt laws. Harm reduction accepts that some people will engage in risky behavior, and therefore clinicians should seek to reduce the harms associated with such risks. That might include endorsing a little pot over a lot of OxyContin.
“A lot of these folks go to NA or AA and can't talk about their medical cannabis use because it's frowned upon," Janichek says. "NA and AA wouldn't view users as being sober. I've talked to folks who've had a really good experience in NA except they couldn't share that piece of their life.”
So Harborside crafted a program that's similar to traditional twelve-step programs, but ignores the pot smoking. This concept of substitution is cutting edge, with new research just coming out. According to a poll of medical cannabis users by UC Berkeley's Dr. Amanda Reinman, published in the Harm Reduction Journal of December 2009:
“Forty percent [of those polled] have used cannabis as a substitute for alcohol, 26% as a substitute for illicit drugs and 66% as a substitute for prescription drugs. The most common reasons given for substituting were: less adverse side effects (65%), better symptom management (57%), and less withdrawal potential (34%) with cannabis.”
With that reality in mind, Janichek designed a Substance Use & Misuse Clinical Services Program at Harborside Health Center that is currently at capacity. The program includes information sharing sessions, depression forums, social skills groups, online support groups, and one-on-one counseling. She says most of the clients who sign up report depression, anxiety, and mostly a lot of questions.
“These are people that are functioning for the most part in most areas of their life, they're just trying to work on some things,” she says. “People are looking for more information about different substances. A lot of folks are DARE generation at this point and they haven't been given honest information on the basics of different drugs and what they do to your body.”
Kids want to know if it's okay to break up Adderall and snort it, or which is healthier: smoking out of a bong or hitting a joint, she says. She consults the literature and tells them.
Janichek would never order someone with a problem to simply quit smoking pot. Harm reduction inverts the AA model where users must admit their powerlessness. Addicts aren't powerless, they're smart enough to make their own choices, she says.
“I would have the person reflect on the risks and limitations of their use and help them come to an understanding of 'do I want to change?' We really believe in building off the positive rather than being powerless.”
Janichek is tracking the outcomes of Harborside's free, cannabis-positive mental health services, with the goal of extrapolating the data into guidelines and replicating the services in other dispensaries.
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Next month I get all of my remaining teeth removed. There is no way on earth I will be able to do that without something for the pain, and also I have anxiety disorder and have been prescribed benzodiazepenes in the past, but I never take it for more than 90 days without stopping because I am concerned about becoming physically addicted to it. I have gone to NA meetings, and the drug that took me down to the lowest bottoms and deepest depressions I have known in my life is crack cocaine. When not on a binge, I would drink to excess. I no longer drink, and am not taking benzos, but I do smoke cannabis as often as I have access to it..which is no more than two or three times a week tops, and usually not more than half a dozen times a month. I will be given tylenol with codeine for the pain from the extractions, but it will be the cannabis that will keep me from being in too much physical ...and emotional..pain. I am disabled due to ptsd and a host of mental health issues under that umbrella, like panic disorder, generalized anxiety disorder, major depressive disorder, and agoraphobia. If not for cannabis, I would be far less functional than I am, and if I could, I would smoke it more often, and be better off because of it. I don't go to NA or AA meetings anymore because of how I would be judged..even though I had legal prescriptions for any med I ever took besides cannabis, and never once abused them, I would have people in the meetings tell me I was relapsing if I took any "mind altering" substance..because of that, I went off my quitiapene for a few weeks, and was a total basket case at the end of it...I was up for days without sleeping and it is something I will never do again. Even after getting a sponsor that was okay with me using psychiatric meds, including the ativan, I would far rather use cannabis than ativan..cannabis is not physically addicting, and I don't build up a tolerance to it. This is such a relief to finally "come clean".
This is an example of Milton Friedman's Iron Law of Prohibition working in reverse: the availability of a weaker, more natural form of a drug leads people OFF of stronger drugs.
Medicinal Cannabis has been a god-send. I have major knee issues that cause excruciating pain throughout the day. My primary care physician has prescribed me vicodin and oxycontin on many occasions. I could not function on these, let alone the nausea I would feel. I do admit that the medicinal cannabis is not taking care of all the pain. At least it is taking some of the edge off so that I can function without the side-effects.
becauase oxies are most addictive coccaine isnt UPPERS are not addictive physically but Downers are including alcohol
Jct: You luck-boxes to have such easy medical access. If it's good for all these diseases, I'd like to use it to prevent the diseases before I get them.
buprenorphine (Suboxone/Subutex)? why use more opioids to treat an opiate addiction? For those who do not want to use an unnatural remedy for their addiction, I see how this can work for many who want to go with a more healthy choice, buprenorphine (Suboxone/Subutex) side effects include, Dysphoric mood, Piloerection, Nausea or vomiting, Diarrhea, Muscle aches/cramps, Yawning, Lacrimation, Mild fever, Rhinorrhea, Insomnia, Pupillary dilation, Craving. Sweating, Distress/irritability, extreme cases under supervision have resulted in extreme depression and suicide, it's not a safe effective treatment and a disclosure statement is signed beforehand and is why it is FREE. anything FDA approved she be under strict scrutiny.
I have been using it to help with depression and anxiety for years. I havent been hospitalized in 8 years, I went to college and graduated near the top of my class,and I have two beautiful children. Too bad I have to constantly worry about being tested on the job if I have an accident. In my profession I wouldn't smoke it b4 work or at work b/c of the heightened feeling and I work with nasty stuff. I would throw up and get freaked out. Part of the reason I have been able to change my life so drastically is b/c of pot. I just wonder if my smoking would make a difference in cali for my job issue if it becomes legal.
Why did you put Oxycontin in your title? Oxycontin isn't even mentioned once in the report. Instead the report states: "Cocaine, MDMA and Vicodin were reported most frequently (N = 5), followed by LSD (N = 4), mushrooms and Xanax (N = 3)." So why focus on Oxycontin in your article?
From my own personal experience from getting off meth, I can say that marijuana honestly becomes a centering agent. Going from messed up all the time to dead sober, withdrawals included, is a lot more bearable if you can have a joint or two to get you through your day...given this requires some supervision because weed does lower your inhibitions and scoring that next bag of real narcotics becomes a more realistic step when you're stoned. But with a will to quit and a little self-confidence....cannabis really does help when it comes to getting people off drugs
My goodness!! a common sense approach to addiction!!
I have been in the substance abuse treatment field almost as long as I have been "in recovery" about 20 years to be exact. I have seen thousands of especially young "society branded addicts" die and fall by the wayside because of the aa/na "all or nothing" approach.
I was told that when I was in treatment that one hit off a joint would quickly lead to "jails, institutions and death".
Imagine my surprise when it turned out to be b.s.
Too many people, especially the young are told this and believe it so it becomes a self fulfilling prophecy if they do have a "slip" and take a hit from a joint. They figure "well, I might as well go all the way now" and we lose them. Some of them forever.
To live for years or decades without the use of intoxicants is an unnatural state, as evidenced by thousands of years of historical evidence.
I too, was an NA "hero" suffering from tooth extractions, broken bones, a dry socket, and torn rotator cuff without the use of anything stronger than an advil, (or sometimes 4-5 advil). So guess who has an ulcer now? But I earned a lot of medallions along the way. Cannabis is the safest, in fact the only safe and effective, non addictive drug, and will not lead to degradation and homelessness, even if you puff after 20 years sober.
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