Does cannabis help people beat drug dependency?

Drug policy around the world is focused on preventing people from becoming drug dependent. But given that some people do become drug dependent, what can we do to help them? Over the years many ideas for effectively beating drug dependency have come forward, from the obscure drug ibogaine to firing lasers into the brain. One simple idea is slowly gaining currency: cannabis as a substitute drug for other substances considered more harmful.

In 2012 a research team surveyed the customers of four medical marijuana dispensaries in British Columbia, Canada.  Three quarters of them said they substitute cannabis for at least one other substance. 41% of them substitute it for alcohol, 36% for illicit substances, and 68% for prescription drugs. The three main reasons people gave were less withdrawal, fewer side-effects and better symptom management.

A 2006 study by the New York State Psychiatric Institute found that cannabis users were more successful than other patients in abstaining from cocaine use. And a 1999 study in Brazil found that 68% of subjects who self-medicated with cannabis in order to reduce cravings were able to give up crack altogether.

But why would cannabis help beat drug dependency? The craving and impulsiveness of drug dependency is associated with low levels of serotonin, a chemical found in the brain. Cannabinoids such as THC are seratoninenergic agonists, which means they can activate serotonin receptors on brain cells, thereby mimicking the effects of serotonin. In this way cannabis can reduce craving and impulsiveness.

In addition, people who have participated in studies have suggested that the ritual of rolling a joint helps to reduce the habituated psychological dependence associated with the preparation of crack cocaine.

Bogota, the capital of Colombia, will soon be opening “controlled consumption centres”, where drug dependent people can consume in a safe environment, with the goal of kicking the habit. They will bravely test out the theory that cannabis is a good substitute. Julián Quintero, from the charity Acción Técnica Social, explains how it will work: "The first thing you do is to start to reduce the dose. After that, you begin to change the way that it's administered: if you were injecting heroin, you move to smoking heroin; after smoking heroin, you move to combining it with cannabis; after that, you're staying with the cannabis." After that there’s a good chance of them becoming functional again.

The Canadian research team concludes their report by saying, “Given the credible biological, social and psychological mechanisms behind these results, and the associated potential to decrease personal suffering and the personal and social costs associated with addiction, further research appears to be justified on both economic and ethical grounds.” Cannabis has for many years been accused of being a gateway drug. However it seems that it would be much more accurate to call it an exit drug.