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Could Cannabis Help Reduce Crack Use?

Cannabis has long been misrepresented as a gateway to higher risk drugs such as heroin or cocaine. However, the latest research being conducted points to the opposite being true, and that it can help people with a dependency on such substances to kick their addiction.

Scientists from the BC Centre on Substance Use (BCCSU) recently published a study that expands on their previous work with drug users in Vancouver’s Eastside and Downtown South.
They observed 122 people who had a history of crack cocaine use, and reported on the frequency of their intake. It was found that their use declined when self-medicating with cannabis. This is exciting news, especially given that there is no current proven pharmaceutical therapy to treat crack dependency.
It’s estimated that there are between 14 and 21 million users of cocaine across the world, with approximately 7 million of those with a “use disorder”; in other words, a clinically significant impairment. These people are exposed to numerous health risks, from cuts and burns from unsafe pipes to highly infectious diseases such as hepatitis and HIV.

Limiting Intravenous Drug Use

Dr. MJ Milloy, an assistant professor in the Division of AIDS in the Department of Medicine at the University of British Columbia and research scientist at BCCSU, revealed the findings of a related study, saying, “Recently, we looked at the experiences of 450 young people living on the streets and using drugs who had not yet started to inject drugs, and zeroed in specifically on their cannabis use. There were periods where people who were using cannabis at least once a day, and we found that those people were 33% less likely to initiate injection. It was a statistically significant effect when we considered our model of the patterns of drug use such as age and gender that impact the initiation of injection.”
The BCCSU’s findings align with smaller studies that have taken place in Brazil, which is experiencing an epidemic of crack cocaine use and is the world’s largest consumer of the drug. In one study, 25 crack cocaine users who were seeking treatment reported using cannabis to reduce the urge to use crack. Over a nine-month period, 68% of them stopped using the drug.
It’s a very encouraging statistic, but Dr. Milloy knows that there is much more work to be done, and sees the impending legalization of cannabis as an excellent opportunity to learn more about the phenomenon.
He says, “One of the first things we did was to ask people about the idea of substitution, as people might actually choose a strategy to use cannabis instead of other drugs. When we started, we thought they would use cannabis instead of opioids. Cannabis, as you know, has an analgesic effect, and we were very surprised when we found that the primary substance people reported substituting was crack cocaine. When we looked further into the data, we found that this sort of intentional cannabis use was associated with a decline in crack cocaine use. This was a surprising result.”

How Does Addiction Work?

The team began to piece together the clues as to why this was happening. Many addictive substances set up a feedback loop in the brain, and the first part of it is the pleasure, pain relief, or other subjective effects. For crack, it’s a very short-lived euphoria lasting about 15 minutes, and people who are withdrawing can suffer extreme cravings. These can be life threatening and are often the motivation behind increasingly dangerous drug use practices such as sharing pipes or needles.
Dr. Milloy describes how this feedback loop may be disrupted, adding “[Cannabis] interacts with the body by way of the endocannabinoid system, which is a way that cells talk to each other. Endocannabinoid molecules help to regulate sleep, mood, hunger and all sorts of things that are reported effects of cannabis. They have cousins in the natural world called phytocannabinoids that are produced by plants. When humans expose themselves to these phytocannabinoids, they hijack the body’s internal endocannabinoid system. What we’re trying to do is to learn more about the system and harness these beneficial effects.”

Taking Research to the Next Level

The next step in the BCCSU’s research is progressing at pace. The team is in talks with a partner in the private sector to start up a clinical trial, which will be a pilot study to see if by exposing people to cannabinoids, they can change some parameters of their addiction. This will include exposing them to cannabis in different ways. If any signals of effect are observed, then the next step will be a bigger study that will involve its subjects randomly assigned cannabis or a placebo.
Does the method of cannabis intake affect how it may help cure addiction? It’s part of the puzzle preoccupying Dr. Milloy. He explains, “We’re trying to tackle it head on and figure out the variance between individuals. For example, one person may want to use high-powered THC joints, while someone else may want to use high-CBD oils at night. We have suspicions of what methods may work better than others, but we don’t have the scientific data we need to plan a trial right now.”
Even though the current data is very promising, Dr. Milloy is well aware of the amount of work ahead. He recounts, “I’ll never forget a couple of years ago when Dr. Julio Montaner (Director of the British Columbia Centre for Excellence in HIV/AIDS), an eminent researcher and physician who began treating people with HIV and AIDS before we even knew what it was in the earliest days of the pandemic, said to me, ‘Cannabis science reminds me of where we were at with HIV 40 years ago. We don’t really know anything!’”