Using Medical Marijuana as a MAT for Addiction

01/25/18: Addiction

The controversy around the use of medical marijuana seems to be easing up within healthcare communities. Why then is there growing apprehension in its use in the drug rehab industry? The concerns are rooted in the conflicting opinions about medication-assisted treatments for drug detox and recovery. But the confusion doesn’t end there. State laws regarding marijuana possession and use don’t align with federal laws. Even medical practitioners and researchers differ on how to view scientific findings. With increased drug use and related deaths due to opioid addiction, providing addicts and rehabs more options to help minimize the discomfort of detox and associated withdrawal symptoms is paramount to getting a handle of the national problem. Opening the discussion about using medical marijuana as a MAT continues to fall under serious scrutiny. Here’s why.

FDA Has Protocols, Medical Marijuana Isn’t a Good Fit

According to a recent article in Rolling Stone magazine, Debra Snyder of the Treatment Research Institute, known for their work on policy and reform for substance abuse treatment, stated "Marijuana-derivative medications to treat a substance abuse disorder… does not align with the currently available FDA-approved Medication Assisted Treatments for Opioid Use Disorders." A large part of the concern is that medical marijuana research is stuck between a rock and a hard place. Because the federal government still classifies marijuana as a Schedule 1 drug, it is defined as highly addictive and serves “no currently accepted medical use” (sharing this designation with heroin and ecstacy.) Really? Activists in the medical profession, addiction treatment industry and marijuana advocates are becoming more vocal as proponents of medical marijuana as a MAT.

MAT Guidelines Bring Question to Medical Marijuana Use for Opioid Rehab

Any drug that is allowable for use as a medication-assisted treatment in addiction rehab has gone through a lengthy process in evidence-based findings and government approvals. There are also specific criteria, four fundamental principles of medical ethics that the MAT must fall within, throughout its use. It isn’t just about the drug itself but how it applies to the patient.

Four Principals of Acceptable MAT Drugs

Medication-assisted treatment drugs and their use must adhere to a medical treatment model. The four characteristics that provide industry guidelines are as follows:

• Beneficence
• Autonomy
• Nonmalfeasance
• Justice

Beneficence exists when the MAT is given with proper diagnoses from the treatment provider and the treatment itself is supported with evidence-based findings. Since federal funding for medical marijuana is virtually nonexistent due to its Schedule 1 drug status, can beneficence be met by using medical marijuana as a MAT? Autonomy covets a patient’s right to choose the care that is in his or her best interest. When a patient discusses the use of cannabis as a form of treatment for drug addiction with their treatment provider, even if the care provider does not believe it is the right path, the patient has the right to choose. In the event this does not fall into the guidelines of a specific treatment facility, another recovery program may be better suited for the individual. Nonmalfeasance promotes the use of opioid medications for the treatment of opioid addictions as it provides a gentler way to endure the withdrawal process to minimize cravings and ease the pain often associated with removing dangerous opioids like heroin and Oxycontin from the body and the brain. Medical marijuana is thought of as a more humane way to treat opioid addiction. Nonmalfeasance is meant to remove harm or injury to the patient. Justice takes all patients and what would serve their best interests, within the community. Medication-assisted treatment and its providers must treat all patients equally and work as advocates for the best medical and ethical treatment possible. By including medical marijuana as an option for MAT, it widens the scope of acceptance as a possibility for the future.

MAT Conflict Grows Amongst Drug Rehab Industry

Aside from the debate regarding the federal Drug Enforcement Agency’s classification of marijuana and division on the seemingly potential merits to medical marijuana use, addiction treatment providers remain polarized on the subject.  More drug rehabs are taking advantage of this gaping hole in treatment theory and capitalizing on it, offering marijuana to ease the process of recovery, further creating doubt in the ethical practices of the alcohol and drug rehab industry.

Is Drug Transference the Only Way to Curb the Problem?

The immense damage that drug use can cause to a person will often compromise neurological and mental health. This, in part, is why MAT was introduced as the means to ween addicts through detox and recovery. Depending on the severity of the addiction and associated medical issues, the dependency on the new drug is long-term. Is this converse to the basics of sobriety or is this different than the realm of abstinence?

Medical Marijuana Effectiveness Cannot Accurately Be Measured

Current practices in MAT involve highly-regulated locations where the treatment is dispensed to patients through a measured dose on a regular schedule. The people and processes are monitored and managed to prevent abuse and minimize risks to the patient, the facility and the surrounding community. How can you measure something that can’t be measured? Such is the dilemma with medical marijuana. Although CBD, the natural cannabinoid found in cannabis, is heralded as therapeutic and beneficial for the treatment of pain, it is difficult to assess its strength from person to person. While other drugs are physically addictive, marijuana is psychologically addictive. Researchers at Washington State University College of Nursing studied the effects of medical marijuana on 150 participants who were in opioid addiction treatment. Dr. Marian Wilson soon realized that what she hoped to discover was far different than the conclusions assessed. “For people who are using cannabis the most, they have a very strong relationship between pain and mood symptoms… if cannabis is helpful, the more they use it the fewer symptoms they’d see.” Unfortunately, the more patients used cannabis during the study, the frequency of pain, anxiety and depression increased. Overcoming addiction successfully involves the learning and practice of positive coping mechanisms and behavior modification, medical marijuana use may threaten long term sobriety. And with a continued chemical dependency (natural or not), does the dependency increase the risk of relapse?

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Authored by Melanie Stern, Content Director for Scottsdale Recovery Center, Arizona Addiction Recovery Centers and Cohn Media, LLC. Writer and broadcaster covering the following industries: addiction rehab, health care, entertainment, technology and advocate of clear communication, positivity and humanity at its best.

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