Study: marijuana may reduce crack use – Business Insider

cocaine crack pipeFlickr/Torbakhopper

North America is in the midst of a drug overdose disaster. In
British Columbia, Canada, where nearly 1,000 people died of overdose in 2016,
officials have declared a public health emergency.

While over-prescription of painkillers and contamination of the illegal opioid supply by
fentanyl
, a potent synthetic analgesic, are at the heart of
the problem, opioid users are not the only ones at risk.

Public health officials in BC are warning that fentanyl has been detected in
many drugs circulating on the illicit market, including crack
cocaine.

The possibility of opioid overdose is an unusual new threat for
people who use crack, which is a stimulant. Its consumption,
either through smoking or injection, is not necessarily deadly.

If misused, though, crack can certainly cause health harms,
including cuts and burns from unsafe pipes. Sharing pipes can
also transmit infectious diseases such as HIV and hepatitis
C
. In the long run, frequent and heavy crack consumption may
contribute to psychological and neurological
complications
.

Despite the estimated 14 to 21 million cocaine users
worldwide, the majority of whom live in Brazil and the United
States
, scientists have yet to find an effective medical
treatment for helping people who wish to decrease problematic use
of the drug.

Cannabis-assisted treatment

marijuana pot weed
Medical
marijuana patient Roger Lingle sniffs a starter plant he bought
at the Canna Pi medical marijuana dispensary in Seattle,
Washington, November 20, 2012. Washington State’s Initiative 502,
that was approved by voters in the November 6, 2012 general
election, legalizes marijuana in Washington State effective
December 6, 2012. Marijuana remains illegal at the Federal level.
Picture taken November 20, 2012.
Anthony Bolante/Reuters

Now Canadian scientists are working on an unconventional
substitution for it.

Research done by the BC Centre on Substance Use in Vancouver
shows that using cannabis may enable people to consume less
crack. Could marijuana become to crack what methadone is to
heroin – a legal, safe and effective substitute drug that
reduces cravings and other negative impacts of problematic drug
use?

Between 2012 and 2015, our team surveyed more than 100 crack
cocaine users in the city’s Downtown Eastside and Downtown South
neighbourhoods. These are poor areas where crack is common among
people who use drugs. We found that people who intentionally used
cannabis to control their crack use showed a marked decline in
crack consumption, with the proportion of people reporting daily
use dropping from 35% to less than 20%.

Data for this study, which was recently presented at the Harm Reduction Conference in
Montreal
, were drawn from three open and ongoing prospective
cohorts of more than 2,000 people who consume drugs (not
necessarily just stimulants). They were the Vancouver Injection
Drug Users Study (VIDUS); the AIDS Care Cohort to Evaluate
exposure to Survival Services (ACCESS); and the At-Risk Youth
Study (ARYS).

We used harmonised procedures for recruitment, follow-up and data
collection. Individuals in these cohorts were recruited through
snowball sampling and extensive street outreach in the Downtown
Eastside and Downtown South areas.

First, we asked participants if they had substituted one drug for
another in order to control or slow down their consumption. A
total of 122 participants (49 from VIDUS, 51 from ACCESS, and 22
from ARYS) reported that they had done so at least once in the
last six months. These were the subjects included in our
analysis, contributing to a total of 620 interviews over three
years.

When we analysed these participants’ crack use histories over
time, a pattern emerged: significant increases in cannabis use
during periods when they reported they were using it as a crack
substitute, followed by decline in the frequency of crack use
afterwards.

Self-medication

Our findings are in line with a smaller case-series study in
Brazil that followed 25 treatment-seeking individuals with
problematic crack use who reported using marijuana to reduce
cocaine-related craving symptoms. Over a nine-month follow-up
period in that study, conducted by Eliseu Labigalini Jr, 68% of
participants had stopped using crack.

As in our study, in Brazil cannabis use peaked during the first
three months of follow-up, with only occasional use of cannabis
reported in the six months after that.

Qualitative studies in Jamaica and Brazil also indicate that crack
users frequently self-medicate with cannabis to reduce cravings
and other undesirable effects of crack.

Other research has shown that long-term cannabis dependence might
increase cocaine cravings and risk of relapse. Rather than
contradict findings from Canada, Brazil and Jamaica, these
discrepancies suggest that patterns of cannabis use and
dependence, and the timing of self-medication with cannabis, may
play a role in individual outcomes.

Building on the finding from this preliminary study, the BC
Centre on Substance Use is planning more research to confirm
whether using cannabis might be an effective strategy for people
seeking to reduce their use of crack or other stimulants, either
as harm reduction or as treatment.

Canada’s recent move to legalise and regulate marijuana should
facilitate this work. For decades, stigma and prohibition have
blocked rigorous scientific evaluation of cannabis. Now these
obstacles are beginning to disappear, enabling our team to better
understand and unlock the therapeutic potential of cannabinoids.

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