Tuesday, April 11, 2017 10:40 am
Treating heroin addiction with marijuana
Keith Humphreys | Special to The Washington Post
A new drug treatment program says it has a cure for heroin addiction: marijuana.
The claim has attracted national attention, but the history of analogous miracle cures is as long as it is discouraging.
In the late 19th and early 20th centuries, some American physicians were persuaded that the best treatment for what was then called "alcoholism" or "inebriety" was morphine, an opiate. Even as late as the 1960s, researchers documented that a number of then-living morphine-addicted patients had been introduced to the drug by physicians as a treatment for their problem drinking.
At the turn of the 20th century, Bayer Corp., best known today for aspirin, rolled out what it marketed as a "safe, nonaddictive" alternative to morphine: heroin. Initially proposed as a pain killer and cough suppressant, it briefly gained a following among doctors who thought it a cure for morphine addiction and alcoholism.
William White, a historian of the addiction field, notes that a well-meaning philanthropic organization known as the Saint James Society actually "started a campaign to provide free samples of heroin to any morphine addict who wanted to take the cure."
Meanwhile, other physicians - most famously Sigmund Freud - touted yet another new wonder drug that would supposedly cure addiction to morphine, alcohol, heroin and tobacco too. It was cocaine, which claimed new victims of addiction, including William Halsted, a medical doctor, the founder of modern surgical practice.
In each case, initial enthusiasm for the "miracle treatment" waned when the new drug more often compounded than relieved the problems of addicted patients. Like an invasive species introduced intentionally into an environment to combat other invasive species, each new cure eventually became a problem in itself.
What accounts for these cycles of enthusiasm and disappointment? Historian David Courtwright of the University of North Florida emphasizes that medicine is surprisingly prone to fads.
"Physicians like new drugs. When one becomes available it often gets overused. In the 1970s, for example, physicians prescribed Valium for a wide range of conditions, from anxiety to insomnia to muscle spasms. Quite a few patients became dependent." Not incidentally, Valium was a benzodiazepine, a class of drugs that had been marketed as safer alternatives to barbiturates, a previous wonder drug that also proved to be addictive and dangerous.
The experience of patients also plays a role in persuading people that a drug is a miracle cure. Because using addictive drugs feels good in the short term (that's why they are addictive), it can seem to patients with an enormous range of illnesses that addictive drugs are making their illness better. In some cases this is true: A certain extract of marijuana appears to reduce epileptic seizures, for example. But in other cases the underlying condition is as bad as ever and the positive feelings that the patient is interpreting as successful treatment are really just the psychoactive reinforcement of the addictive drug.
Fortunately for people facing the potentially deadly disorder of heroin addiction, there is no need to rely on marijuana or any other unproven treatment. Multiple, well-researched FDA-approved medications are available, as are psychological therapies and mutual support groups that can produce additional benefits for heroin-addicted patients. The federal government operates a 24-hour-a-day helpline that can help addicted individuals access these lifesaving services ( https://findtreatment.samhsa.gov/ ).
Humphreys is a Professor of Psychiatry at Stanford University.