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Integrating Medical Cannabis into Addiction Treatment

Loren DeVito, PhD
Written by Loren DeVito, PhD

How one California company is using a new approach to help those recovering from addiction

Even before the opioid crisis was declared an “epidemic” in the US in 2017, thousands of people were already facing pain medication addiction. Over the last two decades, there has been a surge in the number of overdoses and deaths related to opioid use. And after decades of research, there is no quick cure for addiction or sure-fire way to discontinue drug use.

People addicted to drugs may go through rehabilitation or enroll in groups like Narcotics Anonymous. Some may try to discontinue fully, or go “cold turkey,” while others use medication-assisted treatments like Suboxone®. In one rehabilitation facilityin California, however, people are using medical cannabis to help them discontinue opioid use, and seeing welcomed changes in their quality-of-life.

High Sobriety is a cannabis-inclusive recovery environment based in Los Angeles that permits the use of medical cannabis to aid in addiction recovery. We spoke to High Sobriety’s Director of Research and Development, Sherry Yafai, MD, to learn more about her work and how she started practicing cannabis medicine.

Dr. Yafai is an emergency medicine physician whose journey to cannabis had a personal origin. Two of her family members received medical cannabis recommendations, which opened up a lot more questions than could be answered. After six months of digging into the research, Dr. Yafai realized that she needed to get involved in medical cannabis to provide better information to patients that sufficiently addressed their needs.


Image text: In addition to her work at High Sobriety, Dr. Yafai is also a member of the Board of the Society of Cannabis Clinicians and works with the UCLA Cannabis Initiative.

She opened The Releaf Institute, her medical cannabis practice, and shortly there after began working with High Sobriety. Whereas all types of cannabis were originally permitted for use on High Sobriety’s campus, upon Yafai’s arrival, the program implemented tighter regulations on cannabis products.

Dr. Yafai meets with each resident upon entry into the program and once per week thereafter to check their progress. In addition to traditional methods of recovery utilized in sober living environments, residents also choose to participate in intensive outpatient therapy at an outside facility, and visit with Yafai at her clinic. This integrated method seems to be working well for many of her patients.“I dose cannabis use for each patient on an individual basis,” said Yafai. “It’s very personalized medicine.”

Yafai also often sees High Sobriety residents through her separate medical practice. “One of the first High Sobriety residents I worked with has maintained his sobriety for the past eight months. Initially he came in and would say ‘I need more, I need more’ [medical cannabis]. About two months in, he actually came back and told me he didn’t want as much [medical cannabis anymore],” said Yafai.

A substantial amount of data supports the use of cannabis as an “exit drug” for opioids. Medical cannabis contains numerous pain-killing compounds that can induce analgesic effects and therefore be used instead of opioids, which have a much higher risk for abuse and misuse.1As such, in some states with legalized medical cannabis, patients can use cannabis for chronic pain. Recent statistical data has also shown a significant reduction in overdose deaths related to opioids where medical cannabis use is legalized.2

A more recent urgency to quell the opioid epidemic has led several states to issue emergency policies that encourage the use of medical cannabis for people who are addicted to opioids. Despite this progress in acknowledging the potential benefits of medical cannabis as an exit drug, people with addiction often face backlash from those accustomed to traditional methods of recovery. Many subscribe to the belief that people with addiction cannot claim to be “sober” or “clean” if using any substance, including cannabis. This stigma can be very challenging for those looking for support from a community in recovery.

Dr. Yafai believes that it comes down to a better understanding that we all may need something different when it comes to our health: “When we learn to stop shaming each other for our differences and for our handicaps and our needs, that’s really when we are going to come up a long way…Empathy is at the core of this.”

So how do we amplify this message on the potential benefits of medical cannabis for addiction and recovery? Dr. Yafai recommends bringing together the physician community to increase education and awareness.

“We [physicians] are not well-versed [in medical cannabis] and the reason is [that] it’s not in our medical school requirements,” she explained. “We need to go to the California medical board and demand that physicians take courses, that they get educated. “

She recommends that physicians also look to academic meetings like CannMed. In fact, Dr. Yafai will be presenting her work,at the meeting at UCLA, on patient outcomes from those that she treated at High Sobriety at their annual conference.

As for the future of medical cannabis in addiction?

“We can do better,” said Yafai.“And this is the start of doing better.”

References

  1. Hill, K.P., “Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems. A Clinical Review”, JAMA, 2015, Volume 313.

(impact factor: 47.661; cited by 237)

  1. Bachhuber, M.A., et al., “Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010”, JAMA Intern Med, 2014, Volume 174.

(impact factor: 47.661; cited by 319)

About the author

Loren DeVito, PhD

Loren DeVito, PhD

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