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The Evidence Is Overwhelming: Cannabis Is an Exit Drug for Major Addictions, Not a Gateway to New Ones

People dependent on cocaine, opioids and other prescription drugs could ease out of their addictions with cannabis.

By Paul Armentano / AlterNet

May 12, 2017

It is time for politicians to put to rest the myth that cannabis is a gateway to the use of other controlled substances — a theory that is neither supported by modern science or empirical data.

Over 60 percent of American adults acknowledge having tried cannabis, but the overwhelming majority of these individuals never go on to try another illicit substance. Further, nothing in marijuana’s chemical composition alters the brain in a manner that makes users more susceptible to experimenting with other drugs. That’s why both the esteemed Institute of Medicine and the Rand Corporation’s Drug Policy Research Center conclude that "[M]arijuana has no causal influence over hard drug initiation."

In contrast, a growing body of evidence now exists to support the counter notion that for many people, pot serves as a path away from the use of more dangerous substances, including opioids, alcohol, prescription drugs, cocaine, and tobacco.

For example, in jurisdictions where marijuana use is legally regulated, researchers have reported year-over-year declines in opioid-related abuse and mortality. According to data published in the Journal of the American Medical Association, deaths attributable to both prescription opiates and heroin fell by 20 percent shortly after marijuana legalization and by 33 percent within six years. Overall, the study’s investigators concluded, “States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.” Data published this past April in the journal Drug and Alcohol Dependence also reports a dramatic decline in opioid pain reliever related hospitalizations following legalization.

Patients’ use of other prescription drugs has also been shown to fall in states where marijuana is legally accessible. Newly published data from both the United States and Canada finds that patients curb their use of anti-depressants, anti-anxiety drugs and sleep aids after initiating cannabis use—a reality that is quantified in their spending habits. According to researchers at the University of Georgia’s Department of Public Policy, Medicare recipients residing in medical marijuana states spent millions less on prescription drugs as compared to patients with similar ailments in non-legal states. Patients’ spending on Medicaid related services is also significantly lower in cannabis-friendly states.

Emerging data also indicates that pot use is associated with reduced cravings for cocaine. Writing last month in the journal Addictive Behaviors, investigators at the University of Montreal and the University of British Columbia reported that subjects dependent on crack cocaine subsequently reduce their drug use following the intentional use of cannabis. They concluded: “In this longitudinal study, we observed that a period of self-reported intentional use of cannabis … was associated with subsequent periods of reduced use of crack [cocaine]. … Given the substantial global burden of morbidity and mortality attributable to crack cocaine use disorders alongside a lack of effective pharmacotherapies, we echo calla for rigorous experimental research on cannabinoids as a potential treatment for crack cocaine use disorders.” The findings replicate those of a prior Brazilian study which also determined that the therapeutic use of cannabis mitigates crack cocaine cravings and consumption.

Empirical data also reinforces this contention. Specifically, Americans’ use of cocaine has fallen dramatically in recent years, during which time the percentage of adults acknowledging using cannabis has risen.

Scientific data also suggests that cannabis may reduce some people’s cravings for alcohol and tobacco. For example, clinical trial data from the United Kingdom finds that subjects administered cannabidiol, an organic cannabinoid, reduces their cigarette smoking by 40 percent compared to participants provided a placebo. Data published earlier this year in the International Journal of Drug Policy reported that over ten percent of Canadian medical cannabis patients acknowledge using pot in lieu of tobacco.

Survey data from the United States reports even larger declines in cannabis users’ consumption of alcohol. According to a May 2017 study in the Journal of Psychopharmacology, over 40 percent of medical cannabis dispensary members acknowledge reducing their alcohol intake. A 2014 literature review published in the journal Alcohol and Alcoholism adds, “While more research and improved study designs are needed to better identify the extent and impact of cannabis substitution on those affected by AUD (alcohol use disorders), cannabis does appear to be a potential substitute for alcohol.”

Finally, for those seeking treatment for drug dependency, cannabis may also play a positive role. In fact, studies report that pot use is predictive of greater adherence to abstinence among heroin dependent subjects, and those who consume it occasionally are more likely to complete their treatment regimen as compared to those who not.

In light of this scientific evidence, combined with a growing number of Americans’ first-hand experience with cannabis, it is hardly surprising that public confidence in the ‘gateway theory’ is waning. According to survey data compiled in 2016 by YouGov.com, fewer than one in three US citizens agree with the statement, “[T]he use of marijuana leads to the use of hard drugs.” Among those respondents under the age of 65, fewer than one in four agree. Public opinion data provided earlier this week by Yahoo News finds even less support, with only 14 percent of adults expressing “significant concern” that cannabis “leads to the use of other drugs.”

In short, both scientific and public opinion reject the contention that marijuana use promotes the use of other drugs. It’s past time for public officials to renounce this rhetoric as well.

Paul Armentano is the deputy director of NORML (National Organization for the Reform of Marijuana Laws) and serves as a senior policy advisor for Freedom Leaf, Inc. He is the co-author of the book, Marijuana Is Safer: So Why Are We Driving People to Drink? (Chelsea Green, 2013).

Ive been saying it for years.

give some poor soul a garbage bag o weed, a case of beans & a lighter. Take the locks off the doors 2 weeks later & mr or mrs meth-head are found lighting their own farts laughing their heads off.

Happy as Larry.

Now some might argue that you now have someone addicted to cannabis.
Give me a fella that is jonesing for a bong anytime over some shiv wielding crackhead who thinks Yogi the bear (me) is holding out on him.
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Cannabis; the cure for cocaine addiction


A drug can prove to be a cure for another drug. A new study found out that crack cocaine disorders can now be treated by the use of cannabis.

Researchers from the University of British Columbia examined the effects of intentionally used cannabis upon people who frequently used crack cocaine. The results showed that the intentional use of cannabis reduced the frequency of cocaine among the volunteers.

Crack is an extremely addictive type of cocaine and is one of the most commonly used drugs in many countries and its addiction builds up quickly. If misused, the drug can cause various health, psychological and neurological issues.

The lead researcher of the study, Dr. Milloy along with his team made use of three studies between 2012 and 2015 that inspected the cannabis use for controlling crack. Then, through thorough analysis, the researchers evaluated the crack intake frequency before, during and after the use of cannabis.

Per their research published in Addictive Behaviors, the end result showed that the frequency of use notably decreased as compared to before with daily use dropping from 35% to less than 20%, as Science Alert reports. The results seem to be quite promising keeping in view the exceptional safety profile of cannabis.

Since there are no existing cures for the treatment of crack cocaine disorders, this recent research can prove to be helpful in curing the drug addictions. It is already known that cannabinoids can revise cocaine urge by their connections with the endocannabinoid system’s CB2 receptors. Also, cannabis has shown effectiveness for being able to lower the use of tobacco, opioid and alcohol, informs Medical Marijuana Inc.

The team is further planning to conduct more researches to confirm that cannabis might prove to be an efficient tactic for those who want to decrease their crack or other drug’s use, either as reduction for harm or as a complete treatment.

In the midst of an opioid epidemic, studies are showing that states with “[m]edical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates.” This anecdotal case of a woman who successfully stopped using oxycontin by using cannabis was written by Humboldt County writer, Sharon Letts and first appeared in PROHBTD.

In 1997, 28-year-old Oregon resident and stay-at-home mom Amy Mellen was pregnant with her second child when her physician prescribed Percocet for severe migraines that began when she was in college.

“My migraines were debilitating,” Mellen shared. “It was impossible to care for my oldest daughter, while pregnant with my youngest daughter. I get vision tracers that take over my entire field of vision—my face, lips, and fingers go numb—and I have a horrible time forming words to speak. These symptoms begin before the actual headache happens.”

According to the Migraine Research Foundation, migraines are the third-most prevalent and sixth-most disabling disease in the world, with “an extremely incapacitating collection of neurological symptoms.”

The Mayo Clinic lists triptan medications as commonly prescribed to treat migraines. Triptans are serotonin receptor agonists that narrow, or constrict, blood vessels in the brain to relieve swelling or inflammation. Side effects from triptan may include “reactions at the injection site, nausea, dizziness, drowsiness and muscle weakness.”

Of the many brands of triptan, Mellen initially took sumatriptan (brand name: Imitrex). Dosing recommendations for the drug say it should be taken right away, then stopped for lengths of time, due to patients developing a tolerance. In a few months’ time, Amy said she needed a stronger dose.

Regina Nelson, PhD, is director and founder of The eCS Therapy Center in Denver, Colorado. Her doctoral studies had a concentration on medical cannabis, the Endocannabinoid System (ECS), and daily dosing; on which she’s penned four books, to date.

“Many women find that migraines increase with their menstrual cycle or during menopause,” Nelson explained. “Hundreds of women have reached out to the eCS Therapy Center for help with this issue, and most find that a daily regimen of cannabis oil helps alleviate the inflammation that is believed to cause migraine pain, while decreasing the frequency of migraines over time.”

Pregnancy & Pain Killers

After giving birth, Mellen’s obstetrician prescribed the antidepressant Effexor, which is also used to treat anxiety and panic disorders. It’s listed on Drugs.com as a “selective serotonin and norepinephrine reuptake inhibitor,” or SSNRI, and is commonly cross-marketed by pharmaceutical companies as a pain killer.

“I wasn’t depressed, and still don’t feel I am, or ever was—but I’ve been on antidepressants of some kind for 19 years because of the pain issues,” she said.


Mellen noted her migraine pain worsened during her menstrual cycle, so Lupron, often used for endometriosis, was added. Longtime use is dangerous, but Mellen said that during the three months she took the medication the migraines subsided dramatically.

“My doctor at the time thought a hysterectomy might ease my symptoms, as every time I had a period, my migraines were worse, but my insurance company didn’t agree, so I was kept on the pills,” she explained. “By 2001 I was in such pain and bleeding so badly, I was screaming to go to the hospital.”

With this latest visit to the ER, doctors found fibroids, and for reasons that aren’t clear, a partial hysterectomy was approved by her insurance company; with Mellen stating it lessened her migraines overall.

Accidental Addict

The following year in 2006, after a near-fatal auto accident worsened her pain, Amy said her dependency on the pain medication increased.

“I rolled my car three times,” she recalled. “My head and left arm hit the asphalt on the highway each time I rolled. After five hours in surgery, I woke up in a hospital bed with a morphine pump that didn’t even touch the pain—so I was then given Dilaudid—and that’s what began my nightmare into addiction.”

According to Drugs.com, Dilaudid (hydromorphone) is an opioid pain medicine for “moderate to severe pain.” A narcotic, its many side effects include a central nervous system depression in which breathing slows or stops. With misuse, the drug can result in addiction, dependence and overdose death.

“I had never used pain meds before, except for the migraines,” Mellen explained. “And I knew nothing about what they do to our bodies and brains. I went home from the hospital after two weeks with bottles of OxyContin, Percocet, muscle relaxers and more.”

By 2008, after 18 months on the OxyContin, 30-year-old Mellen said she began seeing news reports of people becoming gravely addicted.

The Centers for Disease Control and Prevention (CDC) report that opioids (painkillers) and opiates (heroin) “killed more than 33,000 people in 2015, more than any year on record.” Alkaloids from opium poppy, which are used to make heroin, also make up the active compounds in opioid pain relievers.

“I thought to myself, no, that will never happen to me!” Mellen said, emphatically. “I had never done drugs, let alone been addicted to them. My doctor suggested I switch from Oxy to methadone, and that’s when I became a legal junkie. I asked her, ‘Isn’t that for heroin addicts?’ But she really had no other help for me, her hands were tied. All she could offer was the lesser drug.”

Mellen said she was also offered Suboxone, a drug commonly used in addiction treatment centers to replace OxyContin with some success.

“I chose not to use Suboxone because I thought, what’s the point of taking another pill that would do the same thing—and I would still be addicted?” she added.


“I’ve seen tons of testimonials on the web of people just as addicted to Suboxone, and then needing higher and higher doses.”

Mellen, who had never been “a partier” as she put it, was now in the same category as a heroin addict, rapidly gaining weight in the process.

“I’ve had weight issues all my life,” Amy explained. “It’s because I use food to cope with my feelings. I also suffer from OCD [Obsessive Compulsive Disorder], and it felt like my obsession with food turned into an addiction with the painkillers added. By 2010, my weight ballooned to 410 pounds.”

Benzo Brain Madness

Aside from the weight gain, Amy said she dealt with post-acute withdrawal syndrome, or PAWS. According to Addictions and Recovery, opioid addiction symptoms can include “mood swings, anxiety, irritability, tiredness, variable energy, low enthusiasm, variable concentration, and disturbed sleep.”

“Benzo brain, or PAWS, is real,” Mellen shared. “My brain has no idea how to regulate emotion, common sense is out the window, and I have an awful time making decisions.”

A recent “live” Facebook posting showed Mellen in tears in her car, having driven to an entirely different town than a scheduled meeting was located.

“I was never like this before the meds,” she said in anger. “I had so much patience before—for my kids, my husband. Now, nothing moves fast enough in my brain. I forget things and have to retrace my steps all day long—and that’s really no joking matter.”

Replacing Pharma with Plants

Mellen said she had never tried cannabis when a friend of her husband, Todd, reported he cut his Oxy intake in half just by smoking.

“I first smoked to see if it really worked,” Mellen said. “When it gave me relief, I asked, ‘What’s next?’”

Mellen was still in pain while on the pharmaceuticals, but fearful of upping her intake. Studies done by Dr. Donald Abrams, Chief of Hematology-Oncology at San Francisco General Hospital, completed in 2011 at the University of California at San Francisco, demonstrated that taking cannabinoids with prescribed painkillers can reduce the amount of pain meds needed by 25 percent overall. His research also showed a 30 percent reduction in morphine intake and about a 20 percent reduction in oxycodone, specifically, just by smoking cannabis.

And though Dr. Abrams said he has many patients using cannabis products who are able to stop pain medications, anti-nausea therapies and sleeping pills, he’s still skeptical of its effects without proper trials.

“We have no clue as to how they [cannabis products] are absorbed, how long they last, or anything as no studies have ever been done with a product of known composition [to the cannabis oil],” he clarified.

On May 9, 2015, Amy said she took a half grain of rice-sized piece of cannabis oil with a spoonful of peanut butter.

“Every two weeks I increased the dose, but I was still on the pills,” she said. “As the oil started working, my doctor told me my blood sugars had dropped.”

Metformin, which she took for type 2 diabetes, was the first prescription med to leave Mellen’s pharmacopeia, which had ballooned to 41 prescription pills and supplements a day. She needed so many pills, not only for the original diagnosis, but to quell many symptoms thereof.

“Every couple of weeks another medication or supplement dropped off as I increased my cannabis oil intake,” she said. “On July 31, 2015, less than three months after starting the oil, I took my last five-milligram Percocet.”

Dr. Nelson has had many experiences with patients at The eCS Therapy Center in Denver, with a stated “100 percent” of all cases reducing pharmaceutical use.

Reports show that prescriptions for opiates and narcotics may be reduced up to 25 percent in legal states such as Colorado, but most don’t appropriately credit cannabis as being a contributing factor,” Nelson said. “Prescription pain medications are the greatest killers in our society. Cannabis is non-toxic, and most find it to be an incredible replacement for most pharmaceuticals over time.”

One of Nelson’s books, The eCS Therapy Companion Guide, helps patients ingest the right amount for a specific need.

“Patients find that by titrating slowly to a comfortable dose between one and five milligrams per kilo of weight, over time, they can gain control of their pain issues with a focused use of cannabis therapies,” Nelson added.

Greener Pastures

Mellen said it took three months to replace the pills, with 100 pounds shed within the first year, and 205 pounds shed, all told.

Dr. Abrams, though, disagrees with Mellen’s insistence that going off the pills helped her lose the weight. “Sounds like this woman lost a lot of weight, which can also go a great distance in decreasing her symptoms and getting her off drugs—more so than using cannabis, for sure,” he added, though Mellen’s weight loss timeline begs to differ.

According to a paper published in the U.S. National Library of Medicine’s National Institute of Health website (PMC 4204468), cannabis is said to stimulate appetites in HIV/AIDS and cancer patients, but in studying the general population of short and long-term cannabis users, a “lower body mass index” was found. In other words, cannabis is said to stimulate appetites where needed, while regulating metabolism in the average weight bearing person.

Another paper published in The American Journal of Medicine found that regular cannabis consumers have what’s called “fasting insulin,” i.e., insulin levels in the body before eating, 16 percent lower than non-cannabis users. The study also showed 17 percent lower insulin-resistance levels in cannabis users, with smaller waistlines overall.

Mellen just celebrated her two-year anniversary of replacing painkillers with cannabis. Her doctor is currently weaning her off a low dose of antidepressant, Wellbutrin, her last prescription medication.

Her daily cannabis regimen includes the use of topicals via lotions and salves; ingesting infused foods; taking low doses of oil, and smoking or vaporizing cannabis flower, which she said gives her immediate relief of pain and anxiety, in combination with the other applications.


“I’ve self-detoxed 27 times over the years, and it’s not a pretty sight to transition off opioids—ask my family,” she said. “In retrospect, I know it wasn’t a good thing to do without having something better to replace it with. Now I feel confident to share my story with others, so that they can be helped. The situation with opioids in the U.S. is serious, and you can’t just tell someone to stop taking them. I would have never been able to do this without transitioning to cannabis.”

While Mellen is frustrated with the health industry today, she doesn’t blame her doctor.

“My doctor’s hands were tied,” Mellen said. “I believe our government’s denial of cannabis as medicine keeps doctors from knowing the truth. When I told my doctor I took my last Percocet, and finally explained my cannabis use, she actually started tearing up and said she wanted to run to the top of the building and shout it out to the world, but she couldn’t.”

While Amy’s physician witnessed Mellen’s transformation and went on record to say she is “fully supportive of Amy,” she hesitates to make her name public, fearing patients will reach out to her for advice, when she isn’t trained in cannabis as medicine.

“Amy is really the one who did 100 percent of the work,” her doctor explained. “It’s super amazing that she is now speaking out and can be a role model and mentor others who are going through similar struggles.”

Sunil Kumar Aggarwal, MD, PhD, FAAPMR, is a physician based out of Seattle with a focus on cannabis as medicine, science and medical geography. Dr. Aggarwal said he’s not surprised about Mellen’s story in the least.

“Significant dose reductions in chronic opioid use, improvement in blood sugar control, improvement in mood, migraine prevention—all of these effects have been documented in the clinical trials and epidemiologic literature for cannabis,” he explained. “Not to mention, early 20th century medical literature, wherein Sir Dr. William Osler, the father of Internal Medicine, and founder of Johns Hopkins [Hospital], was known to be of the opinion that cannabis was the most superior treatment for migraines.”

Aggarwal said, if cannabis had been used in the beginning of Mellen’s treatment, many problems could have been avoided, stating, “This too, is a common refrain from patients who have discovered this treatment.”

In 2016, 47-year-old Mellen moved from Oregon to Maryland after her husband, Todd, was promoted at work. She immediately began speaking out in a very public way, becoming one of Maryland’s first registered cannabis patients in its new medical program.

“The most heartbreaking part of my story is, if I had known about the cannabis oil I’m on now years ago, I might not have had to go through so much, and put my family through so much,” she lamented. “It could have saved me a world of pain, literally and figuratively.”


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