Anyone who has battled addiction understands that the road to recovery is a long and challenging one. Yet, the path to sobriety is not the same for everyone. Finding the most effective treatment strategy is, for many, a process of discovering individualized solutions to suit your particular needs and circumstances. For some patients in the early stages of recovery, this has meant the medically supervised and carefully controlled incorporation of prescription cannabis into the treatment plan. Proponents of the use of medical marijuana in recovery argue that cannabis offers significant relief from some of the more debilitating symptoms of withdrawal and detox, while decreasing the likelihood of relapse. Opponents, though, fear precisely the opposite—that the use of cannabis during recovery will not only not safeguard against relapse but may, in fact, precipitate it. The reality is that medical marijuana may yield significant benefits for some patients on their path to recovery, while, for others, the substance may pose a severe risk to their sobriety. To help determine whether prescription cannabis might be right for you, it’s important to have a discussion about it with your clinicians and understand the potential benefits, as well as the possible risks.
The Potential Benefits of Medical Marijuana in Early Recovery:
No matter what your addiction, detox can be an excruciating process. Withdrawal from alcohol, for example, can bring with it severe physical symptoms, from nausea and headache all the way to cardiac arrhythmias and seizures (1). Similarly, the process of detoxing from opioids can include significant pain, muscle aches, vomiting, and diarrhea (2).
As difficult as the physical symptoms of detox may be, it’s the mental and emotional impacts of withdrawal that are often the most debilitating. These can include everything from severe anxiety and depression, to insomnia, loss of appetite, confusion, and hallucinations (1, 2).
Arguments in favor of the use of medical marijuana as an element of a more comprehensive, medically supervised treatment plan cite the substantial body of research that suggests the drug can be used to tame some of the most savage symptoms associated with withdrawal and detox (3). The therapeutic effects of the drug are derived from its ability to activate the body’s endocannabinoid system, the body’s natural resource for mitigating pain, boosting appetite, improving cognition, promoting relaxation, facilitating sleep, and reducing anxiety (3, 4). In addition, there is some evidence to suggest that the activation of the body’s endocannabinoid system will help to reduce cravings, not only due to the effects of the drug itself, but also due to the decrease in the physiological cravings to opioids, alcohol, and other illicit substances when cannabis is also on board (3).
These myriad physiological benefits, proponents assert, will increase the likelihood that those in recovery remain in recovery. According to this perspective, patients are more likely to comply with the treatment plan if they have the tools they need to make withdrawal and detox more tolerable.
For patients who have developed an opioid addiction as a result of a chronic pain diagnosis, the withdrawal of the drug can lead not only to a return of the pain associated with the underlying condition, but also to the exacerbation of these pain symptoms. The use of medically prescribed marijuana, under the supervision of the patient’s healthcare team, can help to manage this pain in its most acute phases, giving patients and their healthcare team an opportunity to discover other, more sustainable solutions for long-term pain control (4, 5).
At Bayshore, for example, patients are provided with an array of services to help them manage the discomfort of detox and the potential reemergence of pain once masked by opioids and other substances. This includes acupuncture, chiropractic, therapeutic massage, yoga, meditation, and related practices designed to provide holistic care, treating not just the addiction, but the entire patient, mind, body, and spirit. Not only this, but Bayshore’s premier service also includes supervision, particularly through the detoxification process, to ensure the patient’s safety and support their comfort through this early stage of recovery.
The harm reduction model is predicated on the idea that a treatment plan that includes the supervised use of medical marijuana is preferable to an abstinence-only approach, which is notorious for its high relapse rates (11). Relapse after a period of abstinence from drugs or alcohol is one of the greatest risks that people in recovery face (11). Detoxing decreases the body’s tolerance to the addictive substance. That means if a patient experiencing a relapse tries to consume the same amounts of the drug as they had become used to prior to treatment, the outcome may very well be fatal (6). If medical marijuana is generally safer than other substances, and if it may also decrease the risk of a potentially life-threatening relapse, proponents assert, then, from a harm reduction standpoint, it should be a treatment option during early recovery.
Even if you and your healthcare team determine that medical cannabis for the early stages of recovery is right for you, it is important to remember that this is not intended to be a permanent, or even long-term, solution. Rather, medical marijuana use in early recovery is intended to be just one component of a far more comprehensive and long-ranging treatment plan. The goal is to incorporate the treatment under close medical supervision and for the shortest possible duration, based on the patient’s individual needs and goals and in close collaboration with their healthcare team.
The Potential Risks of Medical Marijuana During Early Recovery:
Despite the substantial interest in the incorporation of medical cannabis into the early stages of recovery, there is also significant resistance to this approach. A number of specialists in addiction and recovery have argued that incorporating cannabis into early recovery is simply substituting one addiction for another (7). This, opponents assert, may well preclude the patient and their healthcare team from addressing the roots of the addiction. Such failures to sufficiently address the causes of the addiction disorder may increase the risk that the patient will not only develop cannabis dependency but also that they will also relapse on the original drug of choice (7).
In addition to concerns over the perceived failure to sufficiently address the origins of the disorder when medical cannabis is integrated into early recovery, opponents also point to the substantial body of research suggesting that marijuana may, indeed, be a gateway to “harder” drugs and other addictions (8). In a 2020 report from the National Institute on Drug Abuse, for example, researchers found that habitual marijuana use correlated to the progression to use of and ultimate dependency on more illicit substances, including both drugs and alcohol (8). While the report notes that the mechanisms of this link are not as yet understood and may be attributed as much to social and environmental factors as to the physiology of the addiction(s) per se, opponents argue that there are still far too many unknowns to the use of medical cannabis in recovery to take the risk (9).
While proponents of medical cannabis in addiction treatment invoke the harm reduction model to support their claims, detractors assert that while, indeed, the health risks of marijuana may be less than those associated with other substances, the drug is by no means harm-free. According to current data, as many as 1 in 10 adults who use marijuana become addicted (10). In addition, long-term marijuana use has been associated with decreased IQ, asthma and other respiratory problems, bone density loss, and psychosocial harms, including relationship challenges and reduced educational and career achievement, as well as depression and anxiety (6, 10).
The debate over the use of medical cannabis in early recovery continues, and there are compelling arguments currently being made on both sides of the issue. Ultimately, however, every patient is unique, and so, too, should be every treatment plan. What works for another may not work for you, and vice versa. The key is to stay informed and discuss your needs and goals with your healthcare team. Through close collaboration and constant communication with your care providers, you and your team can forge the path to sobriety that best suits your unique recovery journey.