Study suggests cannabis may reduce crack use

May 19, 2017 by M-J Milloy And M. Eugenia Socias, The Conversation
A medical cannabis grower. Credit: Shivanshu Pandev/flickr, CC BY-SA

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

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 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).

Vancouver’s Downtown Eastside has a history of innovative harm reduction responses to drug use. Credit: Emma Kate Jackson/flickr, CC BY

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 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.

Explore further: From pill to needle: Prescription opioid epidemic may be increasing drug injection

Related Stories

From pill to needle: Prescription opioid epidemic may be increasing drug injection

May 8, 2017
The prescription opioid epidemic is shrinking the time it used to take drug users to progress to drug injection, a new Keck School of Medicine of USC-led study suggests.

Most crack users in Victoria, Vancouver risk disease by sharing pipes

July 18, 2011
(Medical Xpress) -- Most people who smoke or inject crack in Victoria and Vancouver share their crack paraphernaliaa practice—that can spread serious infectious diseases. That’s according to new data from the University ...

Brazil has 370,000 regular crack cocaine users: study

September 19, 2013
Brazil has 370,000 regular crack cocaine users in major cities, including 50,000 minors, an official study found Thursday.

Marijuana could help treat drug addiction, mental health

November 16, 2016
Using marijuana could help some alcoholics and people addicted to opioids kick their habits, a UBC study has found.

Brazilian crack addicts to be forcibly committed

January 4, 2013
(AP)—Officials in Brazil's most populous state say they will start forcing adult crack addicts to go to rehabilitation centers in an effort to curb growing use of the drug.

Given the choice, patients will reach for cannabis over prescribed opioids

February 27, 2017
Chronic pain sufferers and those taking mental health meds would rather turn to cannabis instead of their prescribed opioid medication, according to new research by the University of British Columbia and University of Victoria. ...

Recommended for you

Americans misinformed about smoking

August 22, 2017
After voluminous research studies, numerous lawsuits and millions of deaths linked to cigarettes, it might seem likely that Americans now properly understand the risks of smoking.

Women who sexually abuse children are just as harmful to their victims as male abusers

August 21, 2017
"That she might seduce a helpless child into sexplay is unthinkable, and even if she did so, what harm can be done without a penis?"

To reduce postoperative pain, consider sleep—and caffeine

August 18, 2017
Sleep is essential for good mental and physical health, and chronic insufficient sleep increases the risk for several chronic health problems.

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

In a nutshell: Walnuts activate brain region involved in appetite control

August 17, 2017
Packed with nutrients linked to better health, walnuts are also thought to discourage overeating by promoting feelings of fullness. Now, in a new brain imaging study, researchers at Beth Israel Deaconess Medical Center (BIDMC) ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.