A small but growing number of pain doctors and addiction specialists are overseeing the use of marijuana as a substitute for more potent and dangerous drugs. Dr. Mark Wallace, chairman of the division of pain medicine in the department of anesthesia at the University of California, San Diego, said over the last five years he has used marijuana to help several hundred patients transition off opiates.
“The majority of patients continue to use it,” he said of marijuana. But he added that they tell him of the opiates: “I feel like I was a slave to that drug. I feel like I have my life back.”
Dr. Wallace is quick to note that his evidence is anecdotal and more study is needed. Research in rats, he said, supports the idea that the use of cannabinoids can induce withdrawal from heavier substances. But in humans?
A report published in January from the National Academy of Sciences on the health effects of cannabis “found no evidence to support or refute the conclusion that cannabinoids are an effective treatment for achieving abstinence in the use of addictive substances,” said Dr. Marie McCormick, a Harvard professor who was the chairwoman of the report committee.
The group’s research did find strong evidence to support that cannabis or related compounds can be used to treat chronic pain in adults. But that is different from using it safely and effectively to wean people off drugs, and some experts in the addiction field are highly skeptical.
“The concept on its face is absurd,” said Dr. Mark Willenbring, a psychiatrist who treats addicts and formerly oversaw research at the National Institute for Alcohol Abuse and Alcoholism. He said that alternative approaches are needed to traditional drug treatment, but not this.
“I’m not prone to making exaggerated or unqualified statements and in this case I don’t need to make any: It…