The experience of detoxing from a drug like heroin mirrors chemotherapy in a lot of ways, Schrank explained. Among other symptoms, both cause bone pain, insomnia, and nausea. Cannabis has been effective in dramatically alleviating those symptoms, Schrank said. With the pain and discomfort of withdrawal being one of the largest deterrents to recovery, cannabis could help entice more patients to start down—and stay on—the road to recovery.
Cannabis remains a Schedule I controlled substance, which makes it extremely difficult for researchers to get approval to use it in a clinical study. But the emerging patterns are promising: According to a report released in January by the National Academies of Sciences, Engineering, and Medicine, cannabis has been demonstrated to help treat chronic pain, and certain oral cannabinoids have been effective in preventing and treating adults with “chemotherapy-induced nausea and vomiting.” And the National Institutes of Health recently awarded a five-year, $3.8 million grant to researchers for the first long-term investigation to see if medical marijuana reduces opioid use among adults with chronic pain.
There’s less hard science around marijuana’s effects on addiction. The National Academy report “found no evidence to support or refute the conclusion that cannabinoids are an effective treatment for achieving abstinence in the use of addictive substances,” Dr. Marie McCormick, chairwoman of the report committee, told the New York Times.
Nevertheless, a large body of observational research has emerged around cannabis, said Leo Beletsky, a drug policy expert and professor of law and health sciences at Northeastern University. That means scientists have observed real-world data and then formed hypotheses as a result, he explained. “Most of the research that we have on the impact of cannabis in the pain and chronic pain world is from these kinds of observational research.”
This is what High Sobriety’s formula is based on.
Vince Sercia, middle, and Leland Kulok, right, help their surf instructor Dano bring surfboards out to the beach before a surf lesson in Santa Monica on Friday, July 28, 2017. High Sobriety includes an exercise component, and Dano gives surf lessons specifically to people in treatment. His sessions also include a meditation component. (Justin L. Stewart for Leafly)
What the findings have shown, Beletsky said, is that cannabis, like opioids, behaves as a “broad spectrum drug” and that both not only have a “euphoric effect” but have been successful in relieving pain, emotional distress, and depression. To the extent cannabis can address the same needs as other, more dangerous drugs a patient may be using, he said, it could function as a less-risky replacement, he said. “You’re going to be drastically reducing people’s risk of addiction and overdose.”
Amanda Reiman, a former manager of marijuana law and policy at the Drug Policy Alliance who acts as an unpaid advisor to High Sobriety, said the program has the chance to reinforce existing evidence of cannabis for treatment.
People have been using cannabis as an “under the radar” harm reduction tool for years, and as a replacement drug for opioids for even longer, she said. “This is not something new. I think that High Sobriety is an opportunity to formalize it.”
As far back as the late 1800s, hemp was denoted as a cure for opium sickness, she said. And in recent years, the role of cannabis has become so prevalent some that marijuana dispensaries have begun hosting AA meetings, she said, so people using cannabis in their recovery can convene outside the abstinence-only confines of a 12-step program.
Research on the function of cannabis as a painkiller also continues to evolve. A 2011 study out of the University of California, San Francisco, concluded that patients with chronic pain may see more relief when doctors add cannabinoids to an opiates-only treatment. This combined therapy may also allow for lower opiate dosages, according to the same study. In 2014, a report from JAMA Internal Medicine found that states with legal medical marijuana saw a 25% reduction in opioid-overdose deaths.
“Cannabis really fits into this arsenal of what can we give someone when they don’t want to go back to opioids, but they aren’t able to function the way they want in complete sobriety,” Reiman said.
Amid the nation’s overdose epidemic, US spending on addiction treatment will surpass $42 billion by 2020, according estimates from the National Institutes for Health. And like most recovery facilities, High Sobriety isn’t cheap. One of the biggest hurdles for the organization, Schrank said, is that unable to accept insurance, so treatment is open only to patients wealthy enough to afford it.
An alcoholic man with a propensity for scotch has replaced his booze with pre-rolled joints. A woman with a dependence on Valium and wine now uses edibles for anxiety.
The first month at the center costs $42,500, which includes housing, food, doctor and therapist visits, clinical services, and recreational activities. When clients first enter the facility and enter the detox period, they are monitored 24/7 and are under constant supervision of a doctor, Schrank said. Afterward, patients transition to a schedule that typically includes three to five individual therapy sessions per week, community meetings, doctors appointments, and an exercise component. Clients receive medical and dental treatment if needed, said Schrank, and often receive trauma therapy, legal or marital counseling, or other services. Most guests end up staying longer than a month, and costs decrease as they need less individual care, Schrank said.
How does that price tag compare? Inpatient rehab facilities vary significantly in cost depending on location and luxury level. Some estimates range from $10,000 to $20,000 per month on the low end to up to more than $100,000 at luxury facilities. At Promises—the rehab clinic to the stars, in Malibu—a 31-day program costs around $60,000 to $90,000, depending on requests.
High Sobriety currently hosts five residential clients and has about 10 former residents who still frequent the center for meetings and regular check-ins, Schrank said. In an attempt to avoid making patients feel imprisoned at the facility, there are gates but no imposing fences, patients are allowed to keep their phones, and they’re even permitted to leave the facility and venture into neighboring Culver City (although they are randomly breathalyzed and subjected to urine testing).
“It keeps me responsible and accountable but I still have the freedom of being a human,” says Mac Kirk, the musician who counts High Sobriety as his most treatment facility of dozens. “I want to be able to make this an investment and make it my last fucking treatment center.”
Vince Sercia, Leland Kulok, and their surf instructor on their way to meditate and surf in Santa Monica. Patients at High Sobriety attend surfing lessons and also do cycling workouts to focus on physical health. (Justin L. Stewart for Leafly)
For many of High Sobriety’s success stories, cannabis remains an integral part of their life well past treatment. Schrank cites one in particular—an alcoholic with a propensity for scotch—who has replaced his booze with pre-rolled joints. Another woman, who entered the program with a dependence on Valium and wine, now uses edibles for anxiety and a cannabis spray under the tongue for sleep.
There have been some relapses, he acknowledges, which isn’t unusual in the addiction community. Other patients are conflicted about whether to continue cannabis use in the long run.
Leland Kulok, 26, has been at High Sobriety for just over two weeks, part of his effort to end nearly eight years of heavy opioid use. He had already cycled through a handful of rehab programs when his parents discovered Schrank online. At the time Kulok was living in New York, he recalls, smoking heroin nearly every day and never leaving his apartment.
Now in treatment at High Sobriety, Kulok said that while cannabis helped his initial transition in recovery, it actually makes him paranoid. He’d eventually like to stop using it completely.
“A lot of 12-steppers and a lot of the recovery community sees marijuana as a gateway drug or as something that should be avoided,” he says, “but I think it can also be helpful to people who’ve been using for a long time and are sort of on the path to full abstinence.”