Fighting drug addiction to substances such as heroin and cocaine has always been an incessant and unyielding battle. Even if a drug user is fully aware of their acute and chronic addiction problem and wants to voluntarily seek help, they are up against some very, very difficult odds. Treatment for serious addiction to substances like heroin and cocaine only result in a long-term rehab success rate of just 5%. In other words, only 5 out of 100 drug abusers are ever able to live a life where they are able to successfully practice total abstinence from drug abuse.
5% is an abysmal number, considering the amount of time, money effort, and dedication it takes to go through a treatment program.
With decades of experiments, studies and constantly tweaked approaches to better and fine-tune addiction treatment programs, drug rehab service providers are now beginning to wonder if total abstinence is even the end result that they should be aiming for.
Sometimes, aiming too high and against mathematical improbability proven over decades and decades, is just plain senseless.
As the name suggests, it is a treatment approach where everyone involved in the drug addiction treatment program accepts that achieving total abstinence is quite impractical, and therefore not worth even working towards.
The focus instead is to reduce dependence on potentially lethal drugs like cocaine and heroin. This is done by introducing a non-lethal or significantly less intrusive drug or substance that the patient can continue to use and seek a “high”. In other words, the success of this treatment approach relies on substituting at least part of patients’ conventional drug abuse habits with habits where they use or even abuse a significantly less lethal drug.
Marijuana is the primary choice of substance that is used as an alternative drug in harm reduction treatment programs. Marijuana has no lethal dose and has side effects that are far less intrusive than those provided by heroin, crack, cocaine or methamphetamine use. There is also a clear trend where marijuana is blurring the lines on legality, on the verge of becoming a substance that will be increasingly accepted as a substance that can be legally used. Also, both modern, as well as traditional sciences, have very clearly suggested that marijuana can offer some very established medicinal benefits as well.
All these factors have made marijuana the prime candidate when it comes to the substance of choice to be used in a harm reduction treatment program.
Here’s an analogy that might help you better understand what harm reduction treatments are trying to do.
Imagine a shipwrecked lone survivor who has somehow managed to find a small canoe to save himself on, in the middle of an ocean. The problem is that the canoe has a hole in it. The survivor has tools to do one of two things.
Scenario 1. Plug the hole perfectly, but only with a 5% chance of success
Scenario 2. Plug the hole imperfectly, but with a much, much higher chance of success that will buy him more time to hopefully be rescued
Now, in the above analogy, the ocean’s vast waters that can sink the canoe in a heartbeat is the danger(s) represented by side effects of serious drug abuse. The survivor is a drug abuser who wants to get better. The boat and its ability to stay afloat is the response mechanism to treatments, with treatments in the analogy being the two possible scenarios laid out above.
Scenario 1 is where the drug user wants to completely quit, or seek 100% abstinence from drug abuse, with a 95% chance of failure. Scenario 2 is where the survivor accepts and understands that scenario 1 is an extremely improbable solution and when he decides that plugging the hole imperfectly gives him a much better chance to feasibly fight off drug addiction, even if it will mean that he will continue to use fewer drugs or even substitute the drug in question, with a less lethal drug.
Instead of setting abstinence as the end-goal, new age rehab practitioners are considering treatment programs where the aim is to reduce the intensity of addiction rather than seek total abstinence.
This new consensus to adopting a treatment program where the end result is simply a reduced rather than eliminated dependence on dangerous drugs like cocaine, crack or heroin is what is being called the “Harm Reduction” theory.
Marijuana is emerging as the leading choice of drug that will be used as the “substitute” drug in a harm reduction treatments.
Like mentioned before, there have been virtually no cases where someone has overdosed and died from marijuana. This is actually a very persuasive factor that has led to marijuana being used in harm reduction. Ultimately, the most revered goal in any drug addiction treatment program is to eliminate or at least drastically reduce the risk of death resulting out of drug abuse.
There are other reasons as well. Though only suggested and proven by unestablished independent studies, there have been very positive findings that seem to suggest that marijuana has the ability to specifically target and reverse ill effects of heroin, cocaine and crack abuse, some of the most common forms of drug abuse all over the world.
The specific ways in which marijuana can positively affect patients suffering from addiction to these substances is described in more detail below.
Independent studies have proven that the Cannabidiol in marijuana is specifically capable of reversing impairment caused by glutamatergic receptors, a class telltale symptom of heroin drug abuse.
Marijuana use also prevents heightened anxiety and depression that otherwise can lead patients to chronically use heroin, to avoid just those two very strong withdrawal symptoms.
Again, independent and small-scale studies have shown that marijuana use can reduce dependence on abuse of crack cocaine, by as much as 50%. Though this isn’t an effect that immediately transcends after one begins to use marijuana in a harm reduction treatment, the studies very clearly indicate that it is a medium to a long-term trend that repeats itself consistently.
The most notable of these studies is what is called the M-J Milloy studies, where 124 chronic crack addicts in Canada were introduced to harm reduction treatments where they used marijuana to reduce dependence on crack cocaine.
In fact, the findings of this particular study have been so encouraging that the path has been paved for a full-scale and more established clinical trial, in the hope of producing conclusive and marketable results that will allow rehab centers across the world to offer harm reduction treatments.
Other theories have propagated that the THC and Cannabidiol present in marijuana are capable of helping patients avoid certain behaviors that invariably cause them to abuse heroin and cocaine. In other words, marijuana use may be able to negate certain biological triggers that generally cause a very strong urge to abuse heroin and cocaine.
Another rather unconventional study, performed on rodents no less, has suggested that marijuana use has the ability to disrupt what is called the reconsolidation of memories resulting from cocaine and heroin abuse. By causing the mind to “forget” the highs associated from heroin and cocaine abuse, the body has a much better chance to disassociate the pleasure factor derived from these two very powerful drugs, thereby absenting cravings that otherwise lead to drug abuse.
Though the prospect of using marijuana in a harm reduction treatments seems exciting, there is considerable opposition to both the harm reduction theory as well as the use of marijuana in harm reduction treatments.
First, there is the fundamental opposition that questions fighting one drug abuse by introducing another drug abuse.
There are also several other specific opposition cases being made. For example, two of three studies that investigated the use of marijuana and harm reduction theories suggested that they indeed reduced the severity of addiction to heroin and cocaine. However, one of the studies not only didn’t find a positive correlation but actually found that use of marijuana made withdrawal symptoms and detoxification responses deteriorate in quality, leaving patients in a much worse state than when they were trying to fight off addiction with conventional rehab programs.
As mentioned several times in this post, Harm Reduction treatment programs that use marijuana are a very introductory concept. More and more clinical and large-scale studies are being commissioned every day, to further study the practicality of such treatment programs.
With the search for treatment programs that provide a path to help at least majority of drug-addicted patients reach a state of abstinence proving to be frustratingly futile, there might come a time when harm reduction treatments are not just more popular but actually advised, even if only with a resigned sigh.
Dr. Vikram Tarugu, M.D, is the CEO of Detox of South Florida, Inc and medical professional focused on addiction. A veteran in the medical field with over 25 years of professional experience. He is a consultant for many South Florida Rehab centers. Patients travel from allover the US to seek his help with addiction and Hepatitis C treatment.
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