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Does Cannabis Use Really Cause Opioid Use Disorder?

 Does Cannabis Use Really Cause Opioid Use Disorder?

This may seem like a big leap, but some people still manage to make it. So we thought maybe we should take a look at both sides of this argument to understand the issue.

The Attorney General for the Trump Administration, Jeff Sessions, consistently comes into conflict with advocates for cannabis in America. His stance has been about the same for as far back as his career in politics, and recent actions by Jeff Sessions have caused a stir with those in support of legalization, whether medical or recreational.

Now, it seems Sessions believes that cannabis use is actually why we have an opioid crisis.

Looking at Opioid Stats

Recently, Jeff Sessions was speaking at the Heritage Foundation to the Reagan Alumni Association this week. As part of the conversation, Sessions did put a lot of focus on cutting prescriptions for opioid painkillers as a critical element to fighting the crisis. So many people who use illicit opioids like heroin or fentanyl start with prescription drug abuse. This much has been shown in several studies, such as one from 2017 published in Addictive Behaviors which found:

  • 9% of people getting opioid use disorder treatment in 2015 started with prescription drugs
  • This is an improvement from 84.7% in 2005

Some would argue that better regulations put into practice over the last several years have helped to curb that trend.

However, Sessions went on to say,

“The DEA said that a huge percentage of the heroin addiction starts with prescriptions. That may be an exaggerated number; they had it as high as 80 percent. We think a lot of this is starting with marijuana and other drugs too.”

It was that last comment that caught a lot of attention. It wasn’t all that shocking, considering Sessions never been a supporter of cannabis use. Still, some people found this commitment to the gateway drug mentality to be a little out of touch.

So, we should look into the argument from both sides.

Can You Connect Cannabis and Opioids?

A recent paper in the American Journal of Psychiatry shows Mark Olfson and a research team delves into data concerning the gateway drug concept.

The team uses data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to examine the association between:

  • Cannabis use reported in the 2001-2002 survey
  • Non-medical use of prescription opioids 3 years later

In relation to the survey the term ‘non-medical use of a prescription opioid’ is defined as using the drug “without a prescription, in greater amounts, more often, or longer than prescribed, or for a reason other than a doctor said you should use them” during the previous 12 months.

Olfson and his group claim that according to the data:

  1. Cannabis users more often ended up using opioids

People who used cannabis in the 12-month period prior to the initial interview were at increased risk of non-medical use of prescription opiates 3 years later.

They even checked the variables, and found this was true even when the data were adjusted to control for:

  • Age
  • Sex
  • Race/ethnicity
  • Family history variables
  • Antisocial personality disorder
  • Other substance use disorders
  • Mood or anxiety disorders

Those studied who used marijuana were still at higher risk of opioid use.

  1. Increased cannabis use correlated with increased opioid use disorder

According to the researchers, the percentage of people with Incident Prescription Opioid Use Disorder at the second interview increased as the level of cannabis use reported at the first interview increased.

To clarify, Incident Prescription Opioid Use Disorder was defined as use that occurred after the first interview that qualified to be considered opioid use disorder, restricted to people who had no prior lifetime history of opioid use disorder.

So essentially, the people who reported to using more cannabis at the beginning of the study were more likely to show signs of opioid use disorder 3 years later.

But Does Connection Equal Causality?

One thing the authors do acknowledge outright is that the majority of adults who use cannabis do NOT start using or increase use of prescription opioids.

Another thing the researchers acknowledge is that their study isn’t proof that cannabis use causes opioid use. The association of marijuana use with non-medical prescription opioids after 3 years in no way means that marijuana use is proven to actually cause opioid use.

The researchers do have a few ideas though.

  1. Brain Changes

Some animal studies seem to have shown that it is possible for cannabis to lead to changes in the brain that make individuals more susceptible to opioid misuse.

  1. Environment

Another argument is that there are several non-biological factors that can elevate the risk of opioid use. Those who regularly use marijuana may be more likely to interact with people who have access to opioids.

Correlating Drug Use

Many researchers have actually cautioned that there’s no solid evidence that marijuana use causes harder drug use.

In fact, a lot of experts and advocates argue that while marijuana use can easily correlate with harder drug use, so can alcohol and tobacco.

The first drugs many people ever use are alcohol or tobacco, which are both legal for adults and fairly easy to get. Yet, no one automatically assumes drinking or smoking cigarettes will lead to heroin use. However, if the same data and logic used by Olfson and his group were applied to alcohol and tobacco, we would probably see a huge correlation. So many advocates argue why should cannabis use be treated any different?

A 2002 report by RAND’s Drug Policy Research Center (DPRC) suggests that it is not marijuana use, but individuals’ opportunities and unique propensities to use drugs that determine their risk of initiating hard drugs. The Institute of Medicine came to a similar conclusion to the ‘gateway drug’ concept back in 1999.

So, no evidence thus far has been conclusive, only correlational.

The Anti-Gateway Affect?

There are also those out there that believe marijuana legalization would actually have the anti-gateway affect, meaning studies have suggested there is evidence that access to marijuana actually reduces some opioid use.

This growing body of investigation indicates that medical marijuana legalization, in particular, can lower the number of people misusing opioids. Some insist it is because cannabis can help to treat chronic pain instead of opioids. Others even think access to marijuana would cause people to substitute their alcohol use. However, research in this area is still finite. Now it’s far too early to tell if this would actually be an effective strategy.

There is even a new study from David Powell and Rosalie Pacula of the RAND Corporation and Mireille Jacobson of the University of California Irvine that examines how medical marijuana legalization- particularly in states with the most access- impacts opioid-related deaths. These researchers concluded,

“These findings suggest that broader access to medical marijuana facilitates substitution of marijuana for powerful and addictive opioids.”

So while there are those who would put the data behind marijuana being a big part of the problem, there are those who avidly believe it is actually a huge part of a different strategy to overcome the opioid crisis.

What Can We Do?

Whichever side of this argument you’re on, there needs to be more time and energy put into exploring both perspectives. If the correlation between cannabis and opioids were ever proven to be more than meets the eye, then more needs to be done to make sure that legalization or decriminalization efforts co-exist with addiction treatment and support options.

If medical cannabis is found to be useful to help treat some who otherwise would be at elevated risk of chronic pain issues, opioid use disorder or even opioid-related death, then more should be done to make sure this method of treatment is safely studied and developed.

Either way, we must continue to work toward helping every individual suffering from substance use disorder of any kind. Whether it is marijuana use disorder or opioid use disorder, there should be safe and effective treatment options available.

There should always be resources available to help people who suffer from abuse. Supporting addiction recovery means breaking the stigma and offering holistic and effective solutions. Palm Healthcare Company is here to help. If you or someone you love is struggling, please call toll-free now.

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Is Ice Cream a Gateway Drug?

Is Ice Cream a Gateway Drug?

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Or, at least, is beer-flavored ice cream one?

Last month, well-known ice cream maker Ben & Jerry’s, along with Colorado beer-brewer New Belgium, announced that the two companies would be collaborating in order to create a new flavor to add to the ranks of all the flavors that have come before: Salted Caramel Brownie Brown Ale. They are billing it as “an ice cream infused craft beer.”

It might sound disgusting – or at the very least weird – but, this isn’t the first time ice cream and alcohol came together in holy matrimony. And it isn’t the first time for Ben &Jerry’s, specifically. Last spring, the beloved confectioner launched a new product on the West Coast with a series of “frothy beer floats.”

Now, this isn’t just a case of beer and frozen treats coming together for the sheer sake of it. The popular-for-its-politics ice cream company is in it for more than just trend-setting. In the press release announcing the partnership, the involved parties made clear that the focus of the collaboration is meant to be on the companies’ shared efforts of “supporting sustainable agriculture” and “focus[ing] on environment awareness.”

Controversy: Is Ice Cream a Gateway Drug?

Some might argue that mixing a frozen treat that generally appeals to the younger crowd (e.g. children) with an adult treat (e.g. alcohol) is a recipe for disaster. Or, in the very least, it’s tasteless.

But, if you were to apply that logic, then you’d be remiss to overlook some of the flavors they’ve introduced over the years; flavors like Coffee Caramel Buzz and Coffee and Coffee BuzzBuzzBuzz! With these examples, one could argue that the company promotes childhood caffeine addiction. That’s just starting out light.

Then there’s Chocolate Therapy, which sounds like it’s promoting self-medication with food, making it OK to self-soothe with a substance (i.e. food), leading to disordered eating and perhaps an eating disorder, such as binge eating.

Then you’ve got Karamel Sutra, which pays homage to The Kama Sutra, the ancient Hindu “sex text.” This Ben & Jerry’s flavor clearly promotes underage sex.

And, before we move on to this beer/ice cream pairing, let’s not forget that the ice cream giant already has a flavor – since 2013 – called White Russian, inspired by the vodka-based cocktail of the same name.

It’s clear that Ben & Jerry’s has been promoting alcohol use – not to mention other vices – by children for quite a while now.

Right?

Well, that’s the concern of Alcohol Justice, a California-based non-profit advocacy, research and policy organization, that sees itself as the watchdog of the alcohol industry, attempts to “hold Big Alcohol accountable for the harm its products cause.”

So, for example, Alcohol Justice advocates banning flavored alcoholic beverages, such as Mike’s Hard Lemonade, because they target “youth (especially girls).” Furthermore, it seeks to raise federal excise taxes on alcohol, and the organization wants to ban Palcohol, a powdered-alcohol product we’ve written about in the past.

Although some of their concerns and arguments may be valid – or at least understandable – groups like Alcohol Justice might be taking things a bit too far. For example, according to the non-profit organization,  “daytime [wine] tastings, with little to no monitoring, in family-friendly settings, are inappropriate and threaten public health and safety” and that “children watching parents drinking alcohol when they shop for fruit or vegetables is a practice very damaging to impressionable young minds.”

After all, in far more progressive countries that embrace wine-drinking and other imbibing of spirits, alcohol use among underage youth is not as much of a problem as it is here. Perhaps not making something taboo as to tempt the younger ones into trying things is the way to go, after all.

If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135 to speak with an Addiction Specialist today. We are here 24/7 to take your call.

E-Cigs and Vapes: the Undercover Gateway Drugs?

E-Cigs and Vapes: the Undercover Gateway Drugs?

Author: Justin Mckibben

This article is probably going to draw a bit of attention, and I’m sure that there will be a great deal of opinions seeing as how I have personally witnessed how popular ‘vapes’ and ‘e-cigs’ have become, especially in the recovery community. I have friends who dedicate more time and money to customizing their ‘vape mods’ and mixing their ‘vape juices’ than anything else, and it is kind of funny to see this hobby sprout up out of nowhere and become a notable trend. With all the innovations, artsy styles, and various flavors electronic cigarettes are making a lot of waves, but is it possible this new fad is actually a gate-way drug that is just disguised as a helpful alternative to nicotine?

Studies on the E-Cigs

One study conducted some time ago by the University of California, San Francisco found that using these devices is actually associated with the heavier use of conventional cigarettes. One of the lead authors of that study, Stan Glantz who is the director of the Center for Tobacco Control Research and Education at the University of California, expressed growing concern with the increase of e-cigarette use among adolescents.

“We are witnessing the beginning of a new phase of the nicotine epidemic and a new route to nicotine addiction for kids.”

In a more recent study that has been published in the New England Journal of Medicine, neuroscientist Eric Kandel and his wife, Dr. Denise Kandel are raising a few eye-brows, red-flags, and arguments after they issued claims following their data that warned readers and consumers alike that electronic cigarettes, vapor cigarettes and their variations, are very likely to be considered undetected gateway drugs for adolescents.

Based off the findings of the two researchers on recent studies performed on mice, the results reveal that e-cigarettes prime the brain for the use of illegal drugs like cocaine and marijuana. As e-cigarettes deliver highly addictive “pure nicotine” to the brain, the chemistry of the brain was altered in all the mice that the researchers used for the study. These noted alterations did what these scientists say geared up the animals brains for a cocaine addiction. Professor Kandel went on to explain,

“One drug alters the brain’s circuitry in a way that enhances the effects of a subsequent drug.”

Basically saying that by adolescence using e-cigs or vapes, they are conditioning their brains so that when the individual comes into contact with other illicit drugs, it is already more vulnerable and likely to develop a serious substance abuse habit or life threatening addiction.

Cause for Concern

Kandel and his wife, both from Columbia University, wrote extensively on the subject of the heightened risk to young people and how using electronic cigarettes can affect the developing mind and precondition it for using more dangerous drugs. At the end of their report in the New England Journal of Medicine, the two blatantly caused a bit of a surprised uproar when they wrote:

“Our society needs to be concerned about the effect of e-cigarettes on the brain, especially in young people, and the potential for creating a new generation of persons addicted to nicotine. The effects we found in adult mice are likely to be even stronger in adolescent animals. Priming with nicotine has been shown to lead to enhanced cocaine-induced locomotor activity and increased initial self-administration of cocaine among adolescent, but not adult, rats… Nicotine clearly acts as a gateway drug on the brain.”

So one might say that the real target of this last accusation is aimed more toward nicotine itself and not e-cigs, so technically big tobacco should be more concerned and vapor cigarettes should actually be safer, right? Now even though the typical e-cigarette user is a long-term smoker who has been unable to quit, more and more young people, who may not even have been smokers initially, are taking up the habit as it has evolved into a popular trend with all the variations in styles, and asking about someone’s ‘vape mod’ is apparently a good ice-breaker.

One huge problem is that nicotine has a much more powerful and influential effect on the adolescent brain, which according to this study will lead to later problems with being susceptible to drugs. Professor Kandel, who in 2000 shared the Nobel Prize in Physiology or Medicine for his research on the physiological basis of memory, stands firm on his assessment of the situation. Even more disturbing is that many people actually exploit vapes and e-cigs to consume other drugs because they make it easier to fly under the radar while smoking narcotics in public places.

So the question is, how much can actually be said about the contribution of e-cigs and vapes to the development of addiction or addictive qualities in adolescence who use them? The study published is geared toward identifying the vape and e-cig as a possible epidemic that will end up creating more addicts than ever. Either way this just goes to show that as new drug threats are exposed, along with other health risks being realized in some substances people currently exploit, there is a greater need than ever for awareness as to the devastation of the disease of addiction, and more attention needs to be given to the possibility or recovery. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135. We want to help. You are not alone.

 

 

No Folks, Marijuana is NOT a Gateway Drug

No Folks, Marijuana is NOT a Gateway Drug

 By Cheryl Steinberg

Being less of an alcohol fan and more a certified pothead (in my using days, that is), I was always annoyed by the people who would go around saying that marijuana is a gateway drug; that it leads to “harder” drugs. First of all, like me, most kids and teens who do experiment with substances try alcohol before they do anything else. So, why don’t people go around calling alcohol a gateway drug? Oh right, it’s legal…and socially acceptable.

Did you know that alcohol is one of the three deadliest – and legal – drugs? Marijuana’s death toll, on the other hand is zero. A bit fat zero. Now, I don’t advocate smoking weed for those of us in recovery but, I think there can be a lot of medicinal value to marijuana and, besides, I think it’s about time the rest of the world stops vilifying pot and starts accepting that their beloved booze is actually quite dangerous. In fact, it’s poison in the blood stream.

Do you know how alcohol works – the reason why people under the influence of it slur their words and have difficulty with coordination? In a nutshell, when you drink (a lot of) alcohol, your brain thinks that you’re dying. Therefore, it starts shutting down all non-essential  processes, such as speak and coordination, allowing for only the important stuff – like breathing – to keep you alive. Sounds like a good time, right?

On the other hand, you have marijuana, known as cannabis to the rest of the world. This plant has lots of potential when it comes to improving quality of life. Only until recently, however, have we even been able to begin to research marijuana’s medicinal qualities. In the U.S., marijuana has long been a Schedule I drug, categorizing it as having a high potential for abuse and having no known medical qualities.

No Folks, Marijuana is NOT a Gateway Drug

And there’s more evidence that marijuana does not lead to the use of harder drugs. Therefore, contrary to popular belief, marijuana use might not be as dangerous as some critics have been claiming.

Emory University researchers, in a new study, looked at federal surveys and states that legalized medical marijuana in order to evaluate the impact of this new legal status on the use of other drugs. Researchers found that the legalization of medical marijuana legalization did lead to more drug use – that of more marijuana (trolled ya!) They specifically looked at adults 21 and older and saw that this population’s use of marijuana increased after the new legislation BUT, this increase did NOT lead people to try harder drugs.

The study had two major findings:

  • Before the legalization of medical marijuana, 11.1% of adults 21 and older reported using marijuana in the past month; after legalization, that rose to 14.2%. But, it seems, medical marijuana legalization had no effect on children and adults aged 12 to 20.
  • There was also no significant increase in alcohol abuse and dependency, cocaine use, or heroin use after medical marijuana legalization, even though marijuana use increased for adults.

This most recent study revealed findings that mostly support previous research about marijuana use. A 2012 study from research institute IZA found that the legalization of marijuana for medicinal use did not lead to higher rates of marijuana use among high school students. Another report from Glenn Greenwald found drug use among Portuguese adults 20-24 increased following the decriminalization of all drugs in Portugal, while overall drug use actually fell among teenagers.

The study offers some food for thought where it comes to states that are considering whether to legalize marijuana for recreational or medical purposes. For one, it suggests relaxed marijuana laws can lead to more regular marijuana use, although not among teenagers. But the study also indicates that marijuana use might not be as dangerous as some critics of the drug fear.

If you’re like me, a drug is a drug is a drug – no matter its legal status. In the past, I used to think that marijuana was harmless but, more and more people are seeking treatment in the form of drug rehab for their marijuana use, alone. If you struggle with marijuana or any other drug, help is available. Please call toll-free 1-800-951-6135 to speak directly with an Addiction Specialist.

10 Things Everyone Gets Wrong About Addiction

10 Things Everyone Gets Wrong About Addiction

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Recovering from drug abuse and addiction isn’t a matter of willpower. People do not choose to become addicted just like they don’t choose to have diabetes or cancer. Turns out, both genetics and environmental factors (family life, upbringing and peer pressure) play a part in the risk of developing addiction.

Here are 10 things everyone gets wrong about addiction.

Myth #1: Addiction is a choice and a matter of willpower

10 Things Everyone Gets Wrong About Addiction

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Brain imaging studies have shown that there are differences in the brain that are both a cause of and effect from drug addiction. Long before drugs enter the picture, there are actual physiological differences in people who become addicted compared to those who do not. And, after someone graduates to long-term drug abuse, there occur changes in the structure and function of the brain. This makes it difficult to control impulses, to feel pleasure from natural rewards like food or sex, and to focus on anything other than getting and using drugs (mental obsession).

Myth #2: You can’t get sober with just one attempt

10 Things Everyone Gets Wrong About Addiction

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Yes you can. It is possible to recover from drug addiction without relapsing. There are many people in recovery who only had one attempt at getting clean and sober and have been ever since that first attempt. While relapse can be a part of recovery, it is not necessarily the case for everyone.

Myth #3: People who are chronic relapsers are hopeless

10 Things Everyone Gets Wrong About Addiction

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On the flipside, drug addiction is a chronic disorder and sometimes, people do relapse. That isn’t to say that their situation is a hopeless one. Recovery is still possible, even after multiple relapses. It’s important to realize that recovery is a long-term process that oftentimes requires multiple attempts at treatment before complete and consistent sobriety is achieved.

Myth#4: There’s only one way to recover

10 Things Everyone Gets Wrong About Addiction

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There’s no “magic bullet” when it comes to drug treatment that will “cure” addiction. People use and abuse drugs for different reasons and therefore have different abuse-related problems. In actuality, patients can respond very differently to similar types of treatment, even when they’ve been abusing the same drug. As a result, drug addicts need an array of treatments and services that are tailored to address their specific needs.

Myth #5: People forced into treatment don’t have a chance at success

10 Things Everyone Gets Wrong About Addiction

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In fact, two of the main reasons people enter drug treatment are because they are court-ordered or because a loved one urged or demanded that they go. Studies have shown that people who enter drug treatment programs because they were forced, that is to say, faced a “high pressure” situation to address their addiction actually do somewhat better in treatment, regardless of the reason they sought treatment in the first place.

Myth #6: People usually get addicted to only one kind of drug

10 Things Everyone Gets Wrong About Addiction

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Polysubstance abuse is the term used for people who abuse more than one substance. Another term you might hear is ‘cross addiction,’ which, when complicated by drug interactions and side effects, makes polysubstance abuse riskier and more difficult to treat than other types of drug abuse.

Myth #7: Marijuana is a “gateway drug”

10 Things Everyone Gets Wrong About Addiction

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Research shows that the addiction rate among those who smoke marijuana is lower than that of those who drink alcohol. Furthermore, there is little scientific evidence that pot is a trigger for using “harder drugs.” Not to mention, most teens begin experimenting with substances like alcohol and inhalants.

Besides alcohol and inhalants, another more likely culprit is the class of prescription drugs – to include painkillers (oxycodone/Oxycontin, hydrocodone/Vicodin), amphetamines (study drugs such as Adderall and Ritalin) and anti-anxiety meds (Xanax, Valium). These are more easily accessible by teens and have strong addictive properties.

Myth #8: Drugs abuse “fries” your brain

10 Things Everyone Gets Wrong About Addiction

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Remember those anti-drug ads that showed an egg frying in a pan with a narrator saying: This is your brain on drugs?” This is a more a perfect example of melodrama than truthfulness. Yes, drug abuse certainly affects the brain but, recovery allows for the brain, mind, and body to heal. There are many people who are in recovery and who have become highly respected and successful people. This myth gives the wrong impression that recovering addicts and alcoholics are somehow “damaged” and that they can never lead normal lives.

Myth #9: You have to “hit rock bottom” in order to recover

10 Things Everyone Gets Wrong About Addiction

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Every person has a different “rock bottom.” For some people, it’s getting arrested or being homeless. A lot of times, though, it’s not that extreme. Losing an important personal relationship (such as through divorce), being confronted by a loved one or doing poorly at work or school might be the motivation someone needs.

This is an important myth to challenge because, if you wait until your loved one hits what you think is their rock bottom, it just might be too late. Many, many people die from the disease of addiction.

In fact, there is virtually no evidence that supports this idea of a “rock bottom” when it relates to their chances of success at recovery. It’s better to get help early rather than to hold out for the perfect moment of desperation.

Myth #10: If you’re motivated, you can successfully complete treatment in a couple of weeks

 

10 Things Everyone Gets Wrong About Addiction

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Research shows that a minimum of 90 days of treatment to have a beneficial effect. To be followed up with further supervision and support, such as an IOP and then sober living, which offers more freedom than inpatient treatment but with some structure for accountability. When it comes to recovery programs, the best chance of success is the length of treatment.

If you or a loved one is struggling with substance or addiction, please call toll-free 1-800-951-6135.

 

Sources:

http://www.psychologytoday.com/blog/where-science-meets-the-steps/201305/5-myths-about-addiction-undermine-recovery

http://www.cnn.com/2012/09/13/health/jaffe-addiction-myths/

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