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Health

At This LA Rehab Center, Cannabis Is an ‘Exit’ Drug

August 16, 2017

By Mac Kirk’s own count, he’s already attended more than 30 drug rehabilitation programs. With a propensity for heroin, Xanax, and “pretty much everything under the sun,” the 20-year-old musician moved from New York to the West Coast in April to get clean. Bouncing between recovery facilities and sober living centers, Kirk overdosed twice this year.

Then he found High Sobriety.

The concept behind the Los Angeles-based recovery center is relatively simple: Instead of demanding complete drug abstinence—which has been the reigning method of treatment in Alcoholics Anonymous and offshoot programs based on the 12-step model—High Sobriety promotes a “cannabis-inclusive” model that uses marijuana as a means to smooth withdrawal’s rough edges and replace other, more life threatening drugs. Cannabis isn’t just tolerated, it’s provided as part of the program.

“This is the only reason I went to treatment, is because of the cannabis.”
Vince Sercia, High Sobriety resident

High Sobriety opened its doors in January and has so far housed about 30 patients. From the sidewalk on Venice Boulevard, it looks like a block of newly renovated condos. On a recent morning, on the large deck of one of the residential units, a group of tired-eyed young men lounged in the mild morning sunshine. One resident, Vince Sercia, took puffs of pot from a pocket-sized vape pen.

Sercia, 21, has used everything from black tar heroin to designer benzodiazepines, he tells me. High Sobriety is his third rehab facility, and after the “worst 30 days” of his life detoxing through another program, Sercia was reluctant to give recovery another shot.

“I just wouldn’t have gone to treatment if it wasn’t for this place,” he says. “This is the only reason I went to treatment, is because of the cannabis.”

Mac Kirk, left, talks with staff and a fellow resident at at High Sobriety treatment center on Monday, July 24, 2017. The center focuses on harm reduction, offering patients an alternative to abstinence from all substances by allowing the use of cannabis. (Justin L. Stewart for Leafly)

High Sobriety co-founder Joe Schrank is himself 20 years sober and successfully used Alcoholics Anonymous to quit drinking. But while it worked for him, he said he’s learned that AA’s strict parameters, emphasis on complete abstinence, and faith-based curriculum aren’t a good fit for everybody.

“One of the dark secrets about rehab that nobody wants to say is there are some people who should not be totally abstinent,” he says. “They’re not pleasant people if they are. They don’t function well—if they do.”

To that end, High Sobriety employs an unconventional approach. As Schrank puts it, “We’re trading drugs that will kill people for a drug that will not kill people.”

As a clinical social worker, Schrank has spent decades in the recovery community. He’s worked as a residential therapist at the swanky Promises facility in Malibu, CA; established a plush sober-living facility in Williamsburg, NY, called Loft 107; and launched a website, The Fix, focused on addiction and rehabilitation. After years of working within the 12-step system—and witnessing its shortcomings, he says—he decided to build a recovery facility of his own. If all goes well, he’ll open a second center, in Las Vegas, later this year.

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Substituting cannabis for drugs like heroin, alcohol, and prescription opioids is a type of “harm reduction,” Schrank explains, a recovery paradigm that prioritizes reducing the negative consequences of drug use rather than stopping patients from using completely. High Sobriety is aimed at patients who haven’t responded to traditional rehab programs—and there are a lot of them. According to recent estimates, AA is only successful for 5% to 10% of people. Some experts even say it can even be detrimental for a number of reasons.

“One of them is that everyone believes that AA is the right treatment,” Dr. Lance Dodes, a psychiatrist and addiction specialist, told NPR after writing a book debunking the science behind 12-step programs. “AA is never wrong, according to AA,” Dodes said. “If you fail in AA, it’s you that’s failed.”

On top of that, despite AA’s emphasis on full abstinence, program participants often falls short of that goal. Many who do successfully stop using alcohol or other drugs end up dependent on coffee and cigarettes.

The High Sobriety treatment center and housing complex in Culver City. (Justin L. Stewart for Leafly)

While the 12-step formula is the most commonly used approach to addiction treatment, it has a growing number of critics. Dr. Mark Willenbring is one of them. Willenbring, an addiction psychiatrist with decades of experience treating drug and alcohol disorders in combination with mental and physical disorders, says programs like AA are hardly scientific.

“There’s no reason for us to be treating substance abuse with prayer,” he said. “That’s what you do when you don’t have a treatment, you use prayer.”

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He’s referring to AA’s many mentions of a higher power. Though the organization says it’s not a religious group and is open to all comers, seven of its 12 steps refer either overtly or by thick insinuation to God. Four name God directly. Step 3, for example, says, “We made a decision to turn our will and our lives over to the care of God as we understood Him;” Step 11: “We seek through prayer and meditation to improve our conscious contact with God as we understand Him, praying only for knowledge of His will for us and the power to carry that out.”

AA is more support group than actual treatment option, Willenbring said. And while its abstinence-only model is often the right one in his eyes—in fact, for alcoholics who can relapse with just one drink, he says these types of absolutes are necessary—the program’s God-laden rhetoric is unhelpful for many, he said.

After working for the National Institutes of Health, Willenbring in 2013 founded the Alltyr Clinic in Minnesota as an alternative to traditional rehab models. Patients there receive customized care that addresses their particular mental health diagnosis alongside their substance abuse issues. Treating those simultaneously proves to be “absolutely critical,” he said.

Leland Kulok smokes a cigarette on an outside deck of the High Sobriety treatment center. (Justin L. Stewart for Leafly)

“We don’t just call addiction a disease, we treat it like one,” he said. “People ask me what my model is, I tell them it’s health care.”

Yet while Willenbring said he’s all for new alternatives to the 12-step model, he scoffed at High Sobriety’s use of cannabis as a treatment method, which he called “asinine” and a “marketing ploy.”

“It’s a really stupid idea,” he said. “I’m not going to mince words on this one.”

The effects of cannabis on the body are complex, and the concept that cannabis can be used as a “replacement drug” is illogical, Willenbring said. If you’re going to use one drug to treat another, it has to have similar effects on the body as the patient’s drug of choice, he said, which is why methadone is used to treat heroin—it tickles the same opioid receptors. If marijuana were in fact a treatment for drug abuse, Willenbring wouldn’t be in business, he quipped, because so many patients who come to see him are already smoking cannabis regularly.

Schrank is used to this type of reaction. Since launching High Sobriety, he’s been called a “drug dealer” and accused of orchestrating a “money-making” scheme to sell “snake oil.” Cannabis isn’t a silver bullet or a cure-all, he acknowledges, and he says he doesn’t use it himself. But he urged skeptics to consider the growing body of evidence that shows cannabis has huge potential.

To the extent cannabis can address the same needs as more dangerous drugs a patient may be using, it could function as a less-risky replacement.

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.

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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 may also help relieve 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.”

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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 that some 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.

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“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).

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“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 recent 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.

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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.”

Hayley Fox's Bio Image

Hayley Fox

Hayley Fox is a freelance writer based in Los Angeles. She writes about cannabis legalization, news, crime, and culture in Southern California and beyond. Her work has been published online and in print for Leafly, Rolling Stone, Playboy, VICE, LA Weekly, and others.

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  • Unni Sivasankaran

    Its actually beyond that… it improves memory, lung health, hardworking capacity, dignity… many much more
    essential qualities of real “PROFESSIONALS”…

    • Wendy Luna

      All I’m going to say is…it works! 100%. I kicked and never looked back. 6 years and counting with NO relapses. Thank you cannabis. I saved me.

      • Marc Colello

        9 months and 4 days for me today, wouldn’t be where I’m at now without it. I’d still be going to the methadone clinic every morning hating life and still using. Not to mention I was a zombie on 30 mg of Valium everyday.. No more thanks.

        • Laura Cornwell

          How did you kick methadone?

        • Unni Sivasankaran

          Om Namasivaya Marc,
          Valium at 30 mg. I think its a higher dose. How u manage? try to wean off. many side effects. I suggest Yoga. just try. good luck. sure i will pray for you.

  • Robert Burns

    As far as the 12-step approach, the head of the U.C.S.D. School of Psychiatry recommended to me the book “The Sober Truth Debunking Bad Science Behind 12-Step Programs and the Rehab Industry” by Dr. Lance Dodes, M.D. and Zachary Dodes. I am a lawyer with a client who grows medical marijuana amongst the homeless community in the urban wilderness with an high CBD component, extracts it, and gives it free of charge in capsule form to heroin AND meth addicts and claims great success. I am very turned off by the “The first month at the center costs $42,500” approach which smacks of a Tijuana cancer clinic scam.

    • Snapper

      I did not read the entire article but wondered about a guy who had been to 30 rehab centers. If this is the one and the costs is $42500- who can possibly afford that? Surely no insurance company would accept him as a customer. MJ edibles have been a great alternative to alcohol for me.

      • kristine08

        That’s so true. Insurance is not going to pay for most of us. Most of us do not have an extra half a million dollars to get clean.

  • kristine08

    So how much does it cost to get clean from opiates? I weaned myself down to (1) 20MG Oxycontin q/AM and 10 MGS Oxycodone at 7PM. This is post a 360 degree lumbar fusion @ S-I, L4-5, with 2 artificial discs implanted in 2016.
    March 27, 2017 I had to have an XLIF fusion with a plate at L3-4, due to a deformity from waiting too long for surgery. (scoliosis was setting in really bad)
    I tried and failed once to get off the last amount on my own. I used medical marijuana program in CT., but the flu-feeling was so bad, I actually was praying for death to take me. I called 4 clinics in CT.,They all told me, “DO NOT DO THIS ON YOUR OWN! You need to be in a medical facility for 90 days due to the length of time on this medication.”
    I was also prescribed incorrectly back in 2002, Xanax. Life was throwing all kinds of tragedy on me, and later, I found out, it is suppose to be a PRN med for panic attacks. He had me taking it TID! Even thin, I went to every clinic and behavioral program I could find I was turned away from every one.
    One APRN switched me from XANAX to Klonopin, so I am not really better off, its still a benzo.
    I know I am physically addicted. I also know I am not a junkie and I have never snorted, ran out early or sold medication. I am someone that used narcotics responsibly.
    I was told by all 4 clinics, that if I was on heroine, they would take me now.
    I am not snorting heroine in order to get off the last 30MGS of Oxycontin/oxycodone.
    Also, thinking anyone on narcotics for 16 years can just stop taking it, is irresponsible and dangerous.

    • Bradley Tarver

      I’d recommend trying a suboxone taper if you’re having trouble withdrawing from the oxycontin. I did that a few years ago to get off a dosage of dilauded. Now I use marijuana to manage chronic pain but it’s not a cure all when you’re withdrawing

      • kristine08

        I have to try and find out if I can even find a place that will accept me.Like I said, I was told if I was addicted to heroine, they would take me right away. I am not using heroine to get into an opiod addiction program.
        Thanks for your response. That was very kind of you.

        • Bradley Tarver

          yeah I just went to the suboxone website and called all the doctors in my area that prescribe it and called till I found a doctor that had patient spots open, that’s the only thing is doctors have a set limit on the amount of patients they can treat. My doctor didn’t make me do any type of program it was just medication to help me withdraw without all the anxiety and painful cramps

  • Whoa

    Marijuana has a bad reputation, it’s that simple. If you ever been to a traditional treatment center, you’re familiar with the prescription medications distributed to the clients at least once per day. We’re already easing our emotional and mental pain from addiction with a smorgasbord of drugs. CBD doesn’t include a “high”, and is very effective medicine for a myriad of withdrawal symptoms. How can that be a bad thing?
    I was one who put myself in a 12 step treatment program and found it to be so wrong for me in a lot of ways. Counselors told me I would

    relapse because I wasn’t 100% with their program. That was 4 years ago and no relapse. I have read The Sober Truth and found it very gratifying as my beliefs are very much in line with Dr Lance Dodes, however, he was not able to give a model of treatment that would work for more people. Maybe cannabis is part of the answer. It’s at least worth a try.

    • Danny

      For that very reason I have switched my method of speaking about cannabis. If we continue to refer to it as a slang term it will never lose its negative associations put on it for all the wrong reasons.
      So I only refer to it as cannabis now or medical cannabis we have a long way to go if we want society to have a positive Association with the best plant the earth gave use. It starts with the sellers and users to retrain the way they speak about it.
      I’m from Canada and it’s legal across the country now that there says a lot.

  • Pete Logan

    I was (or am) a full blown alcoholic and I drank to deal with my PTSD ( Vietnam Veteran) so 7 yrs ago I got my Medical Marijuana card and I haven’t had a drink sense. I was involved with AA for over 25 yrs, but could never get pass 2 yrs sober an then relapse. I’ve also been through about 7 or 8 programs at the VA, one lasted a year. Anyway now I’m Healthy and Happy.

    • Natalie D. Davis

      Thank you for serving our country

  • Will Cunningham

    I wish I had the money to go to a place like that. I need cannabis but am stuck in a bad state. Waiting years for it to be legal.

    • Unni Sivasankaran

      Come to Kerala, India. Cheap and best.

  • PabloDali

    Traffic fatalities linked to pot increase sharply in Colorado
    https://the-journal.com/articles/63504

  • Natalie D. Davis

    I think I’m going to try this with 80mgs Methadone (in regard to how I can’t seem to make it past the 30 day mark without having a heroin relapse); I am also hooked on Methamphetamine right now to the point where it causes these awful AWFUL nicotine-fit like cravings when I go much longer than 8-12 hours without. And then I’m also on 8mgs of Xanax (prescribed), but would like to get down to 2mgs. Of course I wouldn’t be doing all this at once. I think I will start with the meth and the heroin relapses, then see if my psychiatrist can get my dosage down on the benzos, and then taper down off the methadone at the clinic lastly…

  • Cid

    I understand the benefits of Cannabis, medicinally. How it helps both physically and mentally – cancer patients, ptsd, and other diseases. But I don’t think it’s all or nothing. I don’t think it’s 100% safe or appropriate for use. It has a place, each person is unique to its effects, so while it might be a miracle cure for one person, it could be a disaster for another, and there seems to be no room for an honest discussion about that. It’s just NOT black and white, as is the case with most things. There’s so little honest research on cannabis, that knowing it’s limitations is difficult at best, and folks either want to demonize it or make it the savior of the world. There’s also a spiritual aspect to this plant, whether anyone wants to admit it or not. It’s used in Peru and the Amazon as a master teaching plant and has it’s own set of unique spiritual elements which are in no way respected or even considered in Western society. I also think the greater problem is the need to medicate any kind of discomfort that comes our way, emotional or physical. We have become a society that views difficulty and emotional discomfort as something shameful and wrong, and find the solution in a plethera of emotion numbing drugs and activities, rather than the more difficult and painful task of dealing with it on a deeply personal and spiritual level. This in of itself makes it almost impossible to understand Cannabis and it’s benefits and limitations. I have grown and used cannabis medicinally, but not recreationally. I use it rarely as a medicine, and am not drawn to use it in any other capacity. I’ve made edibles for folks with insomnia and who are fighting cancer, I’ve made salves for arthritus and tinctures for pets, and yet, I have a son who smokes wax all through the day. He is depressed, withdrawn, avoiding all his friends and family, and is completely shut down. He looks awful, his skin, his eyes, he’s gained a ton of weight, and is basically using cannabis to hide and not deal with his life. Cannabis isn’t helping him, he’s totally lost and not functioning. I’m trying to find a program that will help him get off cannabis and help him to more constructively face those life issues that are overwhelming him. His addiction to Cannabis is palpable and real, and I wish I knew how to get him the help he needs. So yes, cannabis can help, but it’s a two edged sword that needs to be used mindfully and respectfully.

  • Sabrina Marina

    Oh when you make it to San Diego I so want in on this for so many reasons!!!!! Brilliant! Sorry if you don’t agree but I’m so sick of watching people’s souls disappear