The biggest albatross around the neck of cannabis in every arena – from the study of cannabinoids, with its monthly and even weekly discoveries, to political legislation and medical usage – has always been its falsified reputation as a substance that will lead to the use of harder drugs. Every drug-prevention warrior at some point rolls out the old “gateway drug” carpet and manages to wrap it around the entire marijuana debate.
Like many people, as a teen I was presented with this hypothesis, and even then the reasoning seemed to smell funny. With no experience to base it on, and thus no real bias either way, it simply seemed like an unprovable argument: even if an adult user of hard drugs used marijuana first, how can it ever be confirmed that the first action caused the other? Today’s scientific consensus seems equally confused; it’s easy to find reputable research that backs up both sides of the argument, usually clutched in the hands of the accompanying activists from either camp.
Strangely enough, there is yet another facet to the discussion: the experiences of people who say that cannabis has, in fact, been a gateway out for them, a way in which they have managed to get off harder, more addictive substances.
Greg Ballantine* was what the medical establishment termed a “functional addict” in that he managed to hold down various regular jobs in his hometown of Vancouver while also maintaining a daily habit of smoking heroin. After smoking marijuana by chance one day, he started to wonder if cannabis had a positive effect on his addiction. “It makes me so mad when people call cannabis a gateway drug because I felt it was like the exact opposite. It made me think, ‘what are you doing? This is heroin, a dangerous, addictive narcotic!’ Cannabis was like the voice of reason.” Ballantine believes this is one part of why cannabis began to function as a replacement for heroin – the fact that it encouraged introspection about his habit.
Victoria Adams* is a distinguished career woman who quit smoking cigarettes by using marijuana brownies. She started smoking cigarettes as a teenager and was up to several packs a day, but says pot made her think twice. “It transformed my mind so I didn’t think about cigarettes. That’s what I like about it – it makes you stop and think, to stand aside and look at yourself. It gives you such clarity, really.”
With a habit as strongly addictive as cigarettes or heroin, some additional insight into one’s habit is beneficial but hardly enough to kick the physical symptoms of withdrawal. However, both Adams and Ballantine say that cannabis helped them in this respect, as well as others. Ballantine describes it as working on several levels. First, “it distracts your mind from whirring on this one track of ‘I want to get loaded’.”Then, he says, it worked on the physical symptoms of withdrawal, settling his stomach and relaxing the frenzy of drug craving. “It alleviates the stress associated with cigarettes,” agrees Adams, saying that it treated both the tensions of quitting smoking and the other stresses that cigarettes had helped her deal with before.
Cannabis Substitution Treatment
Adams and Ballantine’s revelations are nothing new. Doctors have referenced the use of cannabis for the treatment of addiction as far back as the late 1800s, when cannabis treatments were in vogue for everything from pain relief to menstrual complaints, headaches, and even rabies. Two notable medicinal examples include Dr. William O’Shaughnessy, who experimented with cannabis substitution for more harmful drugs at the University of Edinburgh in the 1840s, and Dr. E. A. Birch, who published an article in the medical journal The Lancet in 1889 concerning the use of cannabis in the treatment of opiate addiction. By 1850, cannabis was listed in the United States Pharmacopoeia as being useful for alcohol and opiate addiction, among a long list of diseases and complaints.
Perhaps a more surprising account of the successful treatment of morphine and heroin addicts with tetrahydrocannabinol (THC) came in 1944 from a report commissioned by Mayor Fiorello LaGuardia of New York City. Initiated under the auspices of the New York Academy of Medicine as a response to increasing accounts of unfounded and hysterical marijuana hype in the media, the report aimed to be “a thorough sociological and scientific investigation.” One of the tasks of the subcommittee was to administer 56 morphine and heroin-addicted prison inmates with either THC, no treatment, or Magendie’s solution (morphine sulphate). The report’s findings were remarkable, stating that it was the subcommittee’s impression that “those who received tetrahydrocannabinol had less severe withdrawal symptoms and left the hospital at the end of the treatment period in better condition that those who received no treatment or were treated with Magendie’s solution. The ones in the former group maintained their appetite and in some cases actually gained weight during the withdrawal period.” They made specific note of the potential ?benefits of marijuana in assisting with some of the mental distress experienced during withdrawal.
The findings of the LaGuardia Commission became part of a greater contention between Mayor LaGuardia and the first commissioner of the United States Federal Bureau of Narcotics, Harry Anslinger. Anslinger built a career on being rabidly anti-marijuana, infamously declaring it an “assassin of youth”, though it is debatable as to whether even he truly believed the scare stories he planted in the media. Following the blow dealt to his credibility by the LaGuardia Report, it was Anslinger who first invented the “gateway drug” hypothesis in his desperation to give marijuana a new dangerous edge. He sought to link it to heroin, despite the fact that he had previously testified before Congress that a marijuana user does not graduate into harder drugs like heroin. His campaign was largely successful, with the Boggs Act being passed by the US Congress in 1951, a legislation that essentially lumped marijuana in with narcotic drugs for the first time.
Official research into the anti-addictive potential of cannabis then languished somewhat until the 1970s, when an enterprising American doctor named Tod H. Mikuriya had an alcoholic patient tell him that she didn’t feel the need to drink if she had marijuana available to smoke. ?For Mikuriya, this was part of a pattern that began to emerge in his practice regarding cannabis usage and its effect on alcoholics – and when the method was sanctioned by his encouragement and assistance, it often met with great success. By 2002, six years after Proposition 215 passed in the state of California (allowing medical marijuana), Mikuriya had prescribed 92 patients cannabis for both for their addiction to alcohol and its attendant problems.
In a fascinating 2004 report for the Journal of Cannabis Therapeutics, Mikuriya methodically details the journey of these patients, concluding that the substitution of cannabis for alcohol is much more than simply ‘swapping one drug for another.’ He asserts that when one looks at the role alcohol plays in auto accidents and damage to the body’s organs, there is virtually no comparison with cannabis’ “benign” side effects. On top of this, he touts the beneficial influence of cannabis on sleep cycles, appetite and energy levels, and the easing of pain and muscle spasms for the recovering alcoholic. Considering the potential benefits versus the risk, cannabis seems like a likely first option in treating addiction. There are few alternatives for most addicts; those dependent on opiates have little recourse but to get on a “maintenance program” of more addictive and side-effect-riddled Methadone.
Reward Pathways and the Endocannabinoid System
Dr. Robert Melamede, an associate professor of biology at the University of Colorado and an expert in the field of cannabinoids, says much of the official reluctance to treat addiction with cannabis has to do with the interpretation of how addiction works within the body’s endocannabinoid system. Melamede describes the endocannabinoid system, which he says was only discovered in the early 1990’s, as a thermostat-like regulating body composed of chemicals “that we produce in our bodies out of essential fatty acids.” These chemicals function within the endocannabinoid system to turn on “receptors that change biochemical pathways, and then [turn]off the chemicals that turn on those receptors to establish a kind of balance. Everywhere you look, we see that the endocannabinoid system has very protective properties. That’s what makes marijuana such a unique drug.”
Melamede continues, “It’s the only plant material out there that can tap into our universally functioning endocannabinoid system, and in doing so, mimics the effect of the way the body works. This is why it has so many activities, because the endocannabinoid system winds up literally regulating everything in our body. Among the ‘everythings’ that it regulates seems to be the reward behavior associated with various drugs of abuse.”
This profound connection between the endocannabinoid system and addictive drugs has intrigued scientists, says Melamede, because they have observed that “a lot of the rewarding properties associated with those drugs can be blocked by blocking the endocannabinoid system.” Some scientists believe that simply ‘turning off’ the endocannabinoid system is the way to combat addiction, something that Melamede says “is the stupidest thing imaginable to me, because your cannabinoid system has so many critically important roles in your health. If people are addicted to different drugs, the reason they got addicted was that stimulating those pathways provided something that their bodies needed. What I would say is that rather than using addictive drugs that are funneling through the cannabis pathways, why not just use the cannabis, which we know that in so many circumstances is actually beneficial for people?”
Other scientists are beginning to agree with Melamede, at least in part. Daniele Piomelli, Professor of Pharmacology and Biological Chemistry at the University of California, Irvine, is finding in his research that “blocking reward pathways exacerbates drug-related problems,” and although he agrees a different approach is needed that could include “the stimulation of endogenous cannabinoid pathways,” he believes much more research is needed.
Prescription Drugs and Cannabis
With so much political controversy and debate existing around drug addiction, it is easy to assume that illegal drugs are the problem, conveniently overlooking the harm and dependence wrought by legal psychotropic pharmaceutical drugs, with which cannabis may also have potential applications.
Sharon Heys* is a young mother who, in high school, had “fairly serious substance abuse tendencies” and developed a dependence to crystal methamphetamine. Deciding to quit all drugs and alcohol ‘cold turkey’, and only smoke copious amounts of cannabis, Heys says she managed to stay clean. She admits, however that she basically did nothing but “work, go home, and smoke pot.” For Heys, it was a period in her life that was marked by severe depression that, coupled with running away from home, was the reason she says she ended up having a drug problem. “If I was in Middle America or where pot isn’t available, I definitely would have been put on – and probably needed – antidepressants because I was not well.” Heys felt pot was a far better option than antidepressants, because the pharmaceuticals are “really habit forming [and]have a lot of side effects. People have told me it changed their personality so much that they didn’t feel like themselves anymore.”
Victoria Adams, who quit cigarettes using marijuana brownies and a toke here and there, had similar findings following a car accident when she was put on Paxil to deal with her anxiety. “[My husband] said I was like a dead person – no spark in me at all.” She quit the pharmaceuticals and successfully used marijuana again, finding it also worked “like a tranquilizer, but it put my personality back in, my spark.”
Another favorite claim of anti-cannabis crusaders is that marijuana is itself an addictive substance. Although there is not much evidence of pot being physically addictive, there is some research that suggests a small percent of the population can develop an intense psychological dependence on it. “From almost any angle, marijuana is a more benign drug than alcohol,” asserts Dirk Hanson, author of the upcoming book The Chemical Carousel: What Science Tells Us About Beating Addiction. “But lost in this argument, as usual, is the fact that marijuana is an addictive drug for a minority of users. It is not a risk-free substance in that respect – though from a societal standpoint, I would substitute pot for booze in a heartbeat.”
No methodology is without its potential drawbacks. But when the risks of cannabis substitution are weighed against the crushing physical, mental, emotional, economic, and social agony that addiction causes, the promise cannabis holds for a relatively safe way out is more than tantalizing. From the inducing of introspective reflection about the distress that is the very source of one’s addiction, to the easing of physical and mental pain caused by withdrawal itself, marijuana may be a viable option in helping hard drug addicts find a gateway out.
* Names have been changed to protect the individuals’ identities.