A lot of people in recovery from addiction feel a little nervous around this subject. After all, for us, drugs are the enemy. For many of us, marijuana was the entry drug. It was our first step into the dark side of illegal drug use that took us to stronger, harder more addictive substances. I had a very bad reaction to smoking pot it induced anxiety and paranoia. So I’m very clear it’s not something I can ever mess with.
So I was pretty shocked and intrigued to hear about how marijuana can as an ‘exit drug’, or to be clear, medical marijuana as a treatment for substance abuse?
Well that is just what harm minimization clinic ‘High Sobriety’ is proposing.
It’s a lot for people to get their heads around. I’ve had my struggles with the harm minimization model but I do believe it is a very necessary way we can save lives. I am skeptical when we fund things like needle exchanges (which is a good harm reduction measure, if part of wider treatment options) but we also need to fund other treatment options, so that people can move down the spectrum, to not just surviving, but thriving also.
I wanted to ask my friend and colleague Joe Schrank some questions about the new clinic. Not only does he provide some really interesting insight into medical marijuana he also raises some interesting questions about the treatment industry as a whole. Please read what he has to say and let me know your thoughts.
Joe, so I see you are involved in a treatment program that is based in the harm minimization model rather than the abstinence one? Can you tell me more?
At the moment my sole focus is in developing, High Sobriety, the harm reduction program. I’m not looking to disparage abstinence based programs of give the impression that harm reduction is better or the solution. The truth is, we use harm reduction all the time, motorcycle helmets, condoms, there is nothing new about it. My aim is to expand the points of entry for some people. For many, the idea of “nothing ever again” is just too daunting and while I personally am intoxication free, like Pope Francis, who am I to judge?
That sounds very interesting. I used to work in harm minimization in the UK, but I’m curious why there seems to be very little of it in the USA. Why do you think that is and how do you think this new paradigm will be received?
There are certain things Americans don’t like. Harm reduction is one of them. In spite of overwhelming evidence of the benefits of safe injection rooms, there aren’t any in America.
Our relationship with drugs has a long and torrid history and we have been stuck in the morass of criminalization. As much as we hear “addiction is a disease” Americans don’t believe that. We aren’t what we say, we are what we do and what we do is shame addiction, marginalize people inflicted with it, we set them up for failure and worst of all, we out them in cages. There will be a day when we look at our drug policy with as much shame and regret as we now view Manzanar. For Americans relationship with drugs to improve we need truth and then reconciliation.
The first truth is that criminalizing addiction makes no more sense then criminalizing diabetes. We need to understand that drug policy needs massive reform. Part of that reform would have to be the expansion of how people enter a system of improvement and how they stay engaged.
I think this will be received with a really strong reaction. People who have achieved total abstinence in a 12 step program hold that in the highest possible esteem. The premise is based on an act of providence. Harm reduction challenges that and that will always have a strong reaction. I think there are people who are very frustrated with rehab and how ineffective it is, they will be more open to the idea. For families who have lost someone to addiction, would they take them back if it meant they weren’t totally abstinent? Of course they would. There is a tremendous amount of pain and suffering out there because of the overdose catastrophe. I have lost someone very close to me to an overdose. I don’t carry guilt that we tried to force 12 step abstinence with him, but I carry regret that we didn’t give harm reduction a try.
You make some very good points and there are some hard truths in there. I definitely came from that hard-line view that abstinence is the only way, but I came to realize that I believed everyone should have the same recovery I did. I know realize that saving lives is far more important. I’m open to the idea of medical marijuana but still have some reservations. How does it work and what is the research saying?
Works like other rehab, research is solidly in favor of it as a possibility. Amanda Reiman, the Berkeley professor will address all research questions and we will post studies.
How is the abstinence based treatment community responding to High Sobriety?
They are hostile and vitriolic. Many of them who run 65k a month Malibu rehabs are lobbing “this is a money-making scheme” grenade. We are a for profit venture, like the $40 billion treatment business. We have a pro bono mission to take combat vets who want off pills and booze. I’m a socialist. If I get rich, it’ll be funding an orphanage in Kenya to bring boys to the west. I totally understand that people hold abstinence as near and dear. I have no agenda to change that. I keep saying “that’s why the TV comes with an off switch”. There is anecdotal and scholarly evidence that people can maintain cessation of lethal drugs with using cannabis as part of that effort.
The “give me abstinence or give me death” mantra is just wrong. If the current culture of abstinence that permeates so extensively is so effective, why are there so many families with a dead loved one? There are some people, mostly skilled, seasoned and trained clinicians who can say “that makes a lot of sense”. I think 12 step culture needs Vatican 2. Religions understand this. That’s why Jews have orthodox and reformed. That’s why Catholics are moving in that direction. There are certainly mass in Latin Opus Dei people and there are people in my parish that has a large gay congregation. 12 step culture has become the tea party of recovery: opposed to science, denying change, and longing for a culture that has passed. It’s very similar to people who are “opposed to gay marriage” ok, don’t marry anyone of your gender or “opposed to abortion” ok, don’t have one. The notion of imposing your way onto others doesn’t ever sit well with me. Read Langston Hughes “the more I live, the more I learn, dig and be dug in return”.
This is a really interesting conversation and really about so much more than medical marijuana, you are disrupting the market place so in many ways this is a normal reaction. You and I are both abstinent and I know 100% there is no other way for me. But I also accept that my way, is not the only way, and we are in the middle of this crisis where so many unnecessary lives are being lost.
Could you define what successful treatment looks like for your clients? And what happens when they leave?
What happens when they leave? They are beloved, they have said “you know, drugs are bad! Why didn’t I think of that?” And they become counselors. Just like on TV.
One of our goals here is to figure out what happens with solid outcome studies. My sense is Outcome studies are skewed to people doing well because people who have been to an AA indoctrination camp are afraid and ashamed to engage if they haven’t done this perfectly. My sense of what happens is life. Ebb flow, hurdles and victories, grief and loss the whole enchilada.
Please check out the High Sobriety website for more information on their research and goals.