Alcohol, heroin and other drugs can have HARD consequences – jails, institutions and death. Marijuana addiction is different. Marijuana addiction has SOFT consequences – lost potential, missed opportunities, limited relationships, stunted development. Different, sometimes obscure consequences, but no less real. But getting effective help to cease using marijuana is hard to find in Oregon.
These different consequences require separate treatment resources to be successful. The language and strategies of marijuana recovery is different from drugs with HARD consequences. Therefore, to be successful, treatment for marijuana addiction should be provided SEPARATE from alcohol, cocaine, opiates, or other drugs. The experience, culture, and physical dependence caused by marijuana is not-comparable. Mixing clients effectively reduces access to recovery and increases resistance to reduction of use or sustaining abstinence. So when you’re looking for a provider, ask about marijuana-only treatment groups. Providers which provide “substance use disorder groups” and mixing clients should be avoided. If your provider doesn’t have marijuana-only treatment groups, complain to the top.
Marijuana addicts may be different from other drug addicts because of motivation to get clean. Many alcoholics, cocaine and opiate addicts get motivated to stop using because of threat of incarceration, or significant medical issues. Marijuana addicts want to quit because they want to improve their relationship with their loved ones, improve job performance, get through school, be more social or thoughtful.
Further marijuana poses real danger for people with mental illness and other addictions. So many of us have gone untreated or been mistreated by the community mental health system that we’ve turned to marijuana to sooth our pains. Like alcohol it’s immediately effective, but marijuana too often triggers relapse into depression, delusions, fears, or psychosis. Marijuana is dangerous for many people with mental illness.
But for many – most – people smoking marijuana doesn’t result in chronic problems. In that way it’s like alcohol. Most people use it safely to relax and don’t develop an addiction. A percentage of people have trouble – not everyone. And the percentage for marijuana is a minority – somewhere between 20% and 30% will have problems caused by marijuana use. (Research on marijuana addiction has been poor until the last couple of years, biased by both opponents and proponents, so this number is somewhat vague). Marijuana is not nicotine or dilaudid, common legal drugs with high rates of addiction – 90% or more. With marijuana, a minority is harmed by the drug, and by their addiction to it.
We have no interest in marijuana per se. We’re very interested in helping people who want to stop using marijuana.
So we don’t say marijuana should be illegal. The law is the wrong tool to help people with a medical problem. Instead, we advocate for access to effective treatment for those who want to stop smoking pot. The state, in legalizing marijuana, has an obligation and the resources to provide effective treatment for those who are harmed by marijuana.
But if you want to stop using marijuana, getting treatment may be a hassle.
In 2015 marijuana proponents told Oregon voters legalizing recreational marijuana would provide dollars for drug treatment. Unsurprisingly, state and local legislators failed to protect the minority who are harmed by marijuana.
We asked Oregon’s top addiction treatment professionals at the Oregon Health Authority and at Multnomah County Mental Health and Addictions Services Division about access to marijuana-specific treatment, and outcomes from those treatments. How can people get help for marijuana? What’s the result of that drug treatment – and the public funds spent on it?
Their answer? Oregon doesn’t provide specific treatment for marijuana addiction. Marijuana addicts are included in the same treatment provided for alcoholics, cocaine addicts and heroin addicts. Further, Oregon doesn’t collect data on the outcome of that treatment for marijuana addicts. That evidence could be used to know whether treatment provided to marijuana addicts is effective – but Oregon chooses to not know.
We’ve been unable to find evidence treatment in Oregon for marijuana addiction – public or private – works at all. Know something that works? Tell us, show us evidence – send to firstname.lastname@example.org or post as a comment to this article. We’d like to know.
Addiction treatment professionals often discount marijuana addiction. Some deny marijuana is addictive, some think it’s a natural medicine, some discount the importance in comparison to other problems in the client’s life. These opinions make addiction treatment professionals a big part of the problem. Many addiction treatment professionals themselves use marijuana or used marijuana in the past without experiencing negative consequences. Example: the Addiction Counselor Certification Board of Oregon recently had to remind their licensees that they should not use marijuana. See – ACCBO Marijuana Policy Statement, 2016. Addiction treatment professionals are too often uneducated – and inexperienced. Be wary. Evidence-based information about marijuana can be got from educated and experienced clinicians and from people in long term recovery from marijuana addiction – so inquire about both training for marijuana addiction and lived experience.
So you may be on your own to get well.
Ask prospective treatment agencies during your intake call, “can you connect me with a clinician in long-term recovery from marijuana addiction?” If they’re unwilling to make the connection or demur, or say all our clinicians can help you, hang up and call another agency.
Look and listen for agencies which use language like “addiction” and not “substance abuse.” Look for agencies which talk about recovery, hire people in recovery, and refer to outside long-term community groups to provide continuing support for recovery.
But you may not need treatment. First try Marijuana Anonymous. This is a twelve-step program based on Alcoholics Anonymous. It’s free, helpful to lots of people, and all over the world.
Marijuana Anonymous – Portland, Tigard, Salem, and Bend Meetings
Below is a good overview of marijuana science and treatment from Dr. Kai MacDonald, medical director at Lasting Recovery, an outpatient clinic in Southern California.
Here are some useful peer-reviewed texts on treatment for marijuana addiction.
Marijuana Dependence and Its Treatment
Alan J. Budney, Ph.D., Roger Roffman, D.S.W., Robert S. Stephens, Ph.D., and Denise Walker, Ph.D. – 2017
Attributes of long-term heavy cannabis users: a case-control study (PDF)
Gruber, Pope, Hudson, Yurgelun-Todd – 2003
Psychosocial interventions for cannabis use disorder (PDF)
Cochrane Drugs and Alcohol Group – 2016
Available Treatments for Marijuana Use Disorders – from NIDA
The Health Effects of Cannabis and Cannabinoids – The Current State of Evidence and Recommendations for Research (PDF) This is a massive review of clinical literature on marijuana treatment as of January 2017 – perhaps the largest ever mustered. Essential reading.
Is Marijuana Medicine?
Maybe but maybe not. In 2015 94% of state-approved medical marijuana patients in California weren’t sick in a way marijuana might help. We’ve had recent candid conversations with oncologists, pharmacologists, general practitioners, pain specialists, psychiatrists, addictionologists, neurologists, and ER docs. Likely if you can have a frank conversation with a qualified physician who isn’t employed somehow by the marijuana industry and doesn’t use marijuana themselves, they’ll chuckle and say no, pot is not a medicine. BTW, the frantic testimony by users is biased. They’re users.
An Analysis of Applicants Presenting to a Medical Marijuana Specialty Practice in California
Helen Nunberg, MD, MPH, Beau Kilmer, PhD, Rosalie Liccardo Pacula, PhD, and James Burgdorf – 2015
Is Marijuana Dangerous for Teens?
There has been a substantial increase in teen use of marijuana in states which have legalized medical or recreational marijuana. Which is different than saying legal medical marijuana has CAUSED an increase in teen use. Different things. Watch this documentary, made in Portland about Cleveland High School students who smoke marijuana, and decide for yourself.
Can marijuana be used as a replacement for narcotics – opioids?
A panel of international researchers say the evidence to support the claim that expanding access to medical cannabis will reduce opioid overdose deaths in the United States is very weak and influence by confirmation bias (February 2018).