Tag Archives: Sven-Olov Carlsson

Marijuana Can’t Treat the Opiate, Heroin Epidemic

Any marijuana use leads to less intelligence potential, less empathy for life, less motivation and poorer decision making.  A war on drugs is a protection and defense of our brains.   Governor Susana Martinez probably recognizes how Colorado’s marijuana problem leads to the drug epidemic and filters into New Mexico’s substance abuse issues.   Read about her veto in Part 1.

One young man who gave us a testimony explained how his marijuana use led directly to heroin addiction.

In Colorado, Dr. Libby Stuyt, addictions psychiatrist, traces a direct line from marijuana legalization to the heroin epidemic.    Colorado’s recent report on heroin has shown that the number of deaths from heroin overdose have doubled between 2011 and 2015.

In fact, Pueblo County, has suffered from heroin use and addiction more than any other Colorado county.  Pueblo, Denver and Boulder have the highest rates of youth marijuana use.   Southern Colorado is suffering the most from the heroin epidemic. Counties that have banned marijuana dispensaries have been affected the least by the heroin.

Misunderstanding of the Opioid and Heroin Epidemic

Since the government has clamped down on opiate prescriptions, more users have replaced the pain drugs with heroin.  Since the legalization of marijuana, Mexican cartels have replaced much of their marijuana with heroin.  Heroin is now cheaper and addicts find it easier to get heroin than prescription pills.

Politically there is a great deal of misunderstanding about the opioid epidemic. If it was initially caused by over prescribing of medications, that’s no longer primarily the case.   Seth Leibsohn wrote an insightful article on the subject last week. The abuse of opioid prescriptions acquired legitimately constitutes a small portion of the overdose problem, he said. *

A simple crackdown on prescriptions will not solve the problem, according to Maia Szalavitz.  Although Szalavitz misunderstands the  inherent danger in using marijuana,* she explains the underlying causes of substance abuse quite well.  Impulsive children are at high risk of becoming drug users, but so are some highly cautious and anxious young people.   Two thirds of people with opioid addictions have had severely traumatic childhoods, and the more exposure to trauma, the higher the risk.  We need to help abused, neglected, fragile and otherwise traumatized children before they turn to self-medication as teens.  On the other hand, we should also provide tools and teach coping skills to children who are impulsive, ADHD or anxious.   (Overmedicating children doesn’t allow them to develop the skills needed to transition into adulthood.)

Let’s Help People Get off ALL Drugs

Effective treatment for addictions is getting off all drugs, not going to other harmful, brain-altering substances.   “The goal in helping a loved one with a substance use problem is not to reduce their use. It is to stop drug use,” according to Sven-Olov Carlsson of Drug Policy Futures.  He gave the opening address at the World Federation of Drugs Conference in Vienna last year.  As Carlsson said, the current heroin epidemic proves that “harm reduction” is not saving lives.

No one sets out to become an addict.   Fortunately, more people and states are realizing the foolishness of allowing “medical” marijuana for intractable pain.  It opens up a Pandora’s Box of problems, as in California and elsewhere.

Addiction specialists estimate that one in five American adults is addicted to drugs or alcohol.  With such large numbers, there should be no “stigma” attached to addiction or treatment.  A new or revised health care act should maintain the provision to treat addiction.

Those who are addicted have a strong need to protect a secret.  Their brains have been hijacked and there isn’t a straight path back to previous functioning.

Optimum treatment requires a period of time when the person is not using any substance of addiction in order for the brain to heal.  During that time, the person needs to be able to learn new things. The lack of treatment resources which allows this to happen is a big barrier to recovery.   Marijuana cannot be used to treat this current drug epidemic.

___________________________________________________________________________*  Another recent article explains how doctors began to take pain seriously, treating it as a fifth vital sign.  Szalavitz based her 10% addiction rate for marijuana on the weaker pot of the ’70s and ’80s, not the pot of today.  She also disregarded teen users of pot.


The Addiction Paradigm Shift Away from Heroin to Marijuana

Drug Epidemic isn’t Because of Opiate Pills

“If you only know opiate addiction through the media or the political debates right now, or the political rhetoric, you’re going to be under the impression it’s because doctors are over-prescribing opiate medication.”    It’s not true at all, said Jon Daily LCSW, CADC II, on March 17, 2016, at Sierra Vista Hospital in Sacramento.  The topic of his talk was Heroin to Marijuana: A Paradigm Shift We Need Now.

Daily says that “drug bias” is enabling the epidemic of heroin addiction among youth today. Like others who work in treatment and recovery, Daily knows that addiction to substances of abuse are interconnected.  Frequent marijuana users are more likely to become alcohol or heroin addicts.   A study by researchers from Columbia and Yeshiva University — released in April — showed the likelihood of alcohol use disorder to be 5x more likely for people who were marijuana users at an earlier time period.

Daily challenged the counselors, therapists and physicians in the room to think differently about the connection between the choice of drug and addiction. “I want you to close your eyes and imagine your child. And then imagine that you got a call that that your child was caught using alcohol. Now imagine that you got a call that your child was using marijuana,” he said. Daily paused a few seconds to let those thoughts settle in. “And now imagine that you got a call that your child was using heroin. It feels different, doesn’t it?” he said.

“Drug bias” gets in the way of intervening sooner and more effectively when parents and professionals discover that a young person is using.  Daily explained: “Addiction doesn’t really matter which drug is involved.”

The chart was published by NIDA in November 2015

Now that the big concern of today is heroin, the bigger concern should be that the addiction was there long before the heroin was there.   His remarks were consistent with Sven-Olov Carlsson’s statement about the ineffectual drug policies that have led to the heroin problem.

It Starts with Weed, not Opiates or Heroin

“So if you’ve been using drugs for a long time, say weed, or alcohol, then you might try a lot of pills, then try another drug,”  Daily explained.  He emphasized that addiction is not so much about the specific drug but about the development of reward systems.   (The most recent surveys of drug use by American teens shows that  6% of high school seniors are daily marijuana users, 3x the rate of the next biggest drug of abuse, alcohol.  With this rate of abuse, it’s logical to predict that heroin problems will continue, or get worse.)

Before his talk, Daily surveyed the doctors with whom he associates. He asked them, “Of the opiate addicts you treated, how did it start?”  He found that 98% percent of the clients his associates work with were already addicted to another drug when they started to get pain pills.  (He acknowledges there are those who get addicted to pain pills after a car accident and multiple surgeries, but he emphasizes that this group is in a tiny minority.)  Daily doesn’t explain addiction as simply being about genetics, or about addictive personality.  One’s first reaction to opiates is affected by trauma experiences earlier in life, shame experiences in childhood. It’s affect disregulation, but not clearly understood.

AddictionThere needs to be greater understanding of the nature of addiction with medical practitioners.  Prescriptions for opiate painkillers can lead to a dependency that evolves into heroin use which is cheaper and easy to access via the internet.

However, the low perception of harm with youth using marijuana contributes to the heroin epidemic because most people do not understand a) that addiction to heroin and marijuana are essentially the same disease, and b) the THC levels of marijuana (the chemical component that gives the intoxication) are much higher today than in previous time periods.

The ways in which kids are using pot in high concentrations, known as wax/dabs and oils consumed as edibles (cookies, candies, etc.), makes it very addictive and can also cause psychotic breaks.

Daily urges medical and healing professionals to advocate for education and intervention when the first known instance of use of alcohol and drugs by a minor child. “It is much easier and more cost-effective to do prevention and early intervention than to reverse the harm from long-term addiction,” he said. Daily supports the CARA Act which will provide Naloxone or Suboxone to addicts. “And yet our system is set up to reverse the harm too long after onset of addiction.”

Daily’s comments are consistent with a position we have advocated to advance drug prevention.  Jon Daily is the founder and clinical director for Recovery Happens Counseling Services in Fair Oaks, Davis and Rosedale.  He specializes in the outpatient treatment of adolescents, young adults and their families with addictive disorders and dual diagnosis issues. He is the co-author of (2006) “How to Help Your Child Become Drug Free,” and (2012) “Adolescent and Young Adult Addiction: The Pathological Relationship to Intoxication and the Interpersonal Neurobiology Underpinnings.” Jon has been an instructor to nurses, medical residents and has taught post-doctoral students for UC Davis. Currently he instructs graduate students for University of San Francisco.

Please watch the complete Video.

Drug Policies Should Prevent the Start of Drug Use

Sven-Olov Carlsson gave an opening address at the 5th Annual World Federation of Drugs Conference in Vienna on March 12-13. His speech challenged  ideas about drug policy that are popular at this time.   “The goal in helping a loved one with a substance use problem is not to reduce their use. It is to stop drug use,” he said.

Anyone who believes that a “Harm Reduction” emphasis (instead of drug prevention) needs to take a close look at the current heroin epidemic and ask if we are really saving lives. Today some countries  favor harm reduction policies over drug prevention.  These policies fail to acknowledge the difficulty of treatment and that harm reduction only prevents immediate death.   More lives will be saved when we stop the drug use, and prevent the initiation into drug usage.

While it is important that the Senate passed the  CARA Act and that the House will now take up their version of the Comprehensive Addiction and Recovery Act, we are sorry that Congress is not addressing youth marijuana use as a gateway to opiate abuse which in turn leads to heroin abuse.

In his opening address Carlsson said that a successful drug policy makes it clear that drug use is unacceptable. The future of an improved drug policy is not to legalize intoxicating drugs of abuse, including marijuana.  (The United States is demonstrating that legalization does not work.)

In the US, funding for D.A.R.E. has been drastically reduced, with most schools no longer using the D.A.R.E. program. Since some of the states have legalized medical marijuana it has become controversial to be anti-pot, and D.A.R.E. responded by cutting marijuana out of its standard curriculum.  It’s time to replace that program with a more effective anti-drug prevention education in schools–geared at the state of affairs today.

The US should listen to Carlsson, President of the World Federation of Drugs.   In his speech, he proclaimed:  “It is in the development of a balanced, restrictive drug policy that prevents drug use, and that intervenes with drug users to provide them with a path to life-long recovery.

“Instead of legalizing drugs, an enlightened drug policy can harness the criminal justice system to thwart drug markets, facilitate entry into treatment and restrict incarceration to egregious offenders.”   In other words, a public heath approach and a criminal justice approach should not be considered as opposites.

Read Carlsson’s entire address:  Drug Policy Should Prevent Initiation of Drug Use

Carlsson is from Sweden which has a drug policy based on prevention and treatment.  It has only 5% of youth drug users in contrast to 22% in the USA.   Socialist policy depends on low drug use and keeping marijuana illegal, something that Bernie Sanders’ followers don’t understand.   (Sanders may understand, but he wants young voters on his side. )