Normal Marijuana Users Treated Like Junkies in Arizona
The dream was vivid, like several she'd experienced after she was forced to quit cannabis cold turkey by the Maricopa County Attorney's Office:
Her sister bursts into her room holding a burning spliff and yelling urgently, "Here, hit this!" And she reaches out . . .
But this was what she'd been warned about during her orientation at the drug-treatment center.
Sami Dolson, 23, a Tempe waitress, woke up in a panic, echoes of sirens and thoughts of cell doors slamming shut fresh in her mind. This was in 2012, when she was going through six months of required abstinence for the Treatment Assessment Screening Center, better-known as TASC.
The nonprofit corporation headquartered in Phoenix states on its website that it provides "comprehensive treatment, education, and rehabilitation for those dealing with substance abuse."
But Dolson, a casual cannabis smoker, says she wasn't dealing with substance abuse and didn't need treatment, education, or rehabilitation.
She doesn't even believe it's possible for people to be addicted to marijuana, adding, "That's just ridiculous."
Dolson says she was at the wrong place at the wrong time when a cop caught her with weed and a pipe. She was booked into jail on a felony, as are nearly all adults caught with marijuana in Arizona. Except for qualified medical-marijuana patients, anyone busted with any amount of marijuana faces an initial low-level felony charge.
County Attorney Bill Montgomery, like his predecessors and other elected prosecutors in Arizona, usually makes a deal with first- and second-time pot offenders that includes setting aside the prosecution entirely — as long as defendants complete the TASC program. Those who don't take the deal most often are prosecuted for a misdemeanor instead of a felony.
To keep a criminal charge off her record, the first-time offender signed a deal that required a six-month commitment to TASC. Like many in her place, she did so with bitterness.
"I feel like I was treated like someone who was addicted to heroin for 20 years," she says.
She had to report to the company's Central Phoenix office and attend a five-hour orientation and education class. Thrown in a room with hard-drug users assigned to a more advanced TASC program, her beliefs about the nonexistence of marijuana addiction were reinforced.
"You'd see some people just completely gone — sores on their face, the whole thing," she says of those in the group busted for opiates, meth, or cocaine.
Participants were given a lengthy set of rules and basic information about drugs, including the supposed harms of marijuana. People there for cannabis, like her, were told that "it might be your fancy" to use pot but not to do so during the program because they might end up in prison.
Dolson actually couldn't end up behind bars with a first offense, thanks to a voter-approved 1996 bill to reform drug laws. But the threat helped keep her on track to complete the program.
She was told to call an automated line on a certain day of the week that would change each week. A robo-voice would read a list of colors. If she heard "red," that meant she had to hustle down to the TASC facility in central Mesa that day to submit to a urinalysis. To make things worse, soon after the program began, the transmission broke on Dolson's aging pickup. For several weeks, she had to catch a city bus to the pee test.
Sometimes, facility workers were "just rude." They'd bark at her if she didn't follow directions designed to thwart cheating. The urine had to be poured from a collection cup to a specimen cup, and she got scolded once for washing her hands before she was allowed.
The worst part was having people watch her go to the bathroom. She's not even comfortable undressing even in front of a doctor. Twice, female TASC workers demanded she pull her pants down farther. Without the invasive view, someone could slip another person's clean specimen in the cup instead of their own urine.
Though Dolson had been consuming marijuana several times a week up to her arrest, she experienced only one classic withdrawal symptom: memorable, realistic dreams that occurred most nights for the first few weeks after the forced abstinence. She desired marijuana after quitting, but there were no intolerable cravings. The toughest times were when her sister, also her roommate, was smoking near her and she couldn't partake.
But, in general, quitting wasn't a big deal for Dolson, and she sailed through the six-month treatment.
As promised, the criminal charge was dropped after she completed TASC. But the record of her arrest and the court proceedings related to her deferred prosecution remain online in a public database.
A year ago, Dolson and her sister were rejected in their attempt to rent a house. The prospective landlord told them his decision was based on Dolson's marijuana arrest.
Statistics are on Sami Dolson's side: Most marijuana consumers, whether frequent or daily users, young or old, aren't addicted to the drug.
The rare marijuana user who seeks treatment for cannabis dependence typically describes problems that pale in comparison to those dependent on alcohol or hard drugs.
Society doesn't treat alcohol users like Dolson, of course.
County Attorney Montgomery and Governor Doug Ducey, both devout Catholics who oppose legalization, apparently are against the idea of someone who consumes a few glasses of wine each week getting thrown in jail, followed by a forced six-month abstinence.
Even Prohibition wasn't this bad: During the 13 years that the 18th Amendment was in effect, selling and manufacturing alcohol was illegal, but possessing and drinking it wasn't.
Marijuana, for reasons that can be ascribed only to ignorance, is treated more like meth than wine under the laws of the federal government and most states. Yet science has proved that marijuana is less harmful in every way than alcohol or other mind-altering substances. Dependence or addiction to weed is nothing compared to these drugs.
Presumably, a decent percentage of Arizona's 90,000 qualified medical-marijuana patients consume cannabis on a regular basis because they believe, for various reasons, it makes them feel better.
Pot prohibitionists try to sell a different story. They want to link marijuana to the idea, not the reality, of drug addiction.
Last year, Montgomery slyly inserted clean-cut people enjoying marijuana into a public service announcement about the ravages of heroin. It was a trick funded with the public's money.
Yavapai County Attorney Sheila Polk, one of the leading anti-cannabis voices in Arizona, harps tirelessly about marijuana as an addictive drug. She began one widely published op-ed with the cynical line: "I believe in an America that promotes opportunity, not addiction . . . Arizona's child-welfare population is on the rise, and substance abuse is a significant factor."
She tweeted a link on November 2 to promote an anonymous anti-cannabis site — probably run by owners of a rehab clinic — that warns how legalization laws "manufacture addicts" and preaches against the evils of addiction.
"Am I a marijuana addict? Weed, Addiction and Legalization," says the headline of her tweet, sent on a Monday at 2:37 p.m., when presumably she should have been working the less-political aspects of her taxpayer-funded job.
The link went to an article that ponders how many "addicts" might be created if national legalization causes marijuana use to climb from 7 percent of Americans now to 42 percent, which the site says was the rate of "cigarette smokers in 1965."
This month, Ducey raised the specter of marijuana addiction in an interview with KTAR-FM News, explaining it was why he doesn't support a legalization measure expected to be on the Arizona ballot in November.
"From unemployment to homelessness to domestic violence to child neglect to our prison population . . . almost everything outside of our economy and education that I have to deal with in this state has a common culprit of drug abuse and addiction," he told the radio station.
The majority of the hundreds of thousands of marijuana consumers in Arizona (70 percent) don't use other drugs. Most hard-drug users, conversely, typically also use marijuana or alcohol. Often, methamphetamine, cocaine, or heroin users might tell social workers that marijuana is their primary drug of choice, and it might be true — even though marijuana has nothing to do with their drug-related problems.
Despite this, people who like marijuana and use it without problems have been demonized, lumped unfairly into the ominous category of "addict." Drug-reform laws, sometimes well-intended, dismantled brutally tough pot-prohibition laws a few decades ago but replaced them with the idea that people caught with marijuana need treatment.
Science proves that very few do.
Marijuana addiction is difficult to define because little if any physical component of addiction is seen in even in the heaviest users. What is known about marijuana users who fit the latest psychiatric definitions of dependence — besides that they make up only 10 percent of overall users — is that they don't experience withdrawal symptoms like heavy users of alcohol or other mind-altering drugs.
If you keep the heaviest tokers — who might resemble the "Stoner Sloth" from a new anti-marijuana ad by the Australian government — away from their bongs, dabbing tools, and Bhang bars for days, the worst you might get is slightly grumpier, less-focused versions of the same people.
Stopping the heaviest alcohol users from drinking, by contrast, requires medical supervision. Alcohol abusers can experience a huge range of withdrawal symptoms that can include convulsions, intense hallucinations, and death.
This isn't to say that some people don't, in fact, smoke too much weed. Longtime users suddenly might announce they've had enough and want to make a life change.
Actor Brad Pitt famously said in 2009 that he stopped toking because he was turning into a "damn doughnut." Rapper Snoop Dogg quit in 2003 for a while, telling the media, "Drugs cloud" your thinking and that he wanted a "better vision of myself . . . what I mean to my kids and what I mean to life in general."
It didn't last long: Last year, Snoop launched a line of brand-name cannabis products for sale in states with legalization laws.
Whatever the reasons for quitting marijuana, the consumer — not society — gets to make the decision in Alaska, Colorado, Oregon, Washington State, and Washington, D.C., where adult use is legal.
Receiving treatment for marijuana use also gets left up to the consumer in such states.
Critics complain that more kids are using marijuana these days and that more people in general are becoming addicted to marijuana. To some extent, they're right.
But in context, it's clear that so-called marijuana addiction isn't the bogeyman that prohibitionists try to scare us with.
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Marijuana use by Americans 18 and older has more than doubled since the early 2000s. Yet just a small percentage of cannabis consumers officially can be classified as dependent.
Never the wild-eyed criminals of Harry Anslinger's propaganda, these marijuana users nevertheless can be diagnosed as having a mild-to-severe cannabis-use disorder under the American Psychiatric Association's fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, also known as DSM-V.
The official definition in the psychiatric manuals of what might be called a marijuana addict doesn't include the word "addict." Instead, the phenomena of frequent and habitual use of cannabis, alcohol, and all substances believed to be habit-forming (except caffeine) have been classified by top psychiatrists as "use disorders" that range from mild to severe.
Cannabis-use disorder, the manual states, occurs when someone meets two or more of a long list of criteria that include: a strong desire to consume cannabis, tolerance of THC that requires greater amounts of ingestion to achieve the desired effect, withdrawal symptoms after stopping use, failed attempts to cut back or quit, and failure to stop in the face of obvious problems related to use.
Research suggests that 9 percent of people who use marijuana ultimately will meet the definition of having a cannabis disorder, whether mild or severe. It's the lowest addiction rate of any widely used substance. Alcohol produces disorders at a rate of about 15 percent, nicotine hooks 32 percent of people, and heroin about 23 percent, according to the National Academy of Science.
Starting any substance in the teen years increases the risk of dependency, while starting later in life reduces it. In a 2002 study published in the scientific journal Neuropsychopharmacology, it was found that about 1 in 10 people who try cannabis (similar to the National Academy of Science numbers) will be dependent on it at some point in their lives by age 54, compared to about 1 in 5 for alcohol.
But the risk of dependence on marijuana, unlike other drugs — especially alcohol — drops to almost nothing after age 30. Most cases of dependence occur between ages 15 and 25, the study found.
But those cases reside solidly in the minority of marijuana users.
Numbers vary, but according to the 2012 National Survey on Drug Use and Health, about 2.7 million Americans ages 12 and older meet the APA definition for a cannabis disorder, whether mild or severe. Meanwhile, that survey and a 2013 Gallup poll reveal that roughly 17 million to 22 million Americans regularly consume marijuana.
In other words, about 12 percent to 16 percent of current cannabis users fit the profile of what the APA calls a dependent user.
The more people use cannabis, the more likely they are to meet APA dependence criteria, says Rosalie Pacula, an economist and co-director of the RAND Drug Policy Research Center based in Santa Monica, California.
"According to recent research, half of current daily users will become dependent," she tells New Times. "So half of even current daily users will not meet" the DSM criteria.
These facts aren't referenced by the likes of Arizona prohibitionist Sheila Polk or one of her favorite sources of information, national anti-marijuana speaker Kevin Sabet, when they speak about marijuana addiction.
Dr. Kevin Hill, an assistant professor of psychiatry at the Harvard-affiliated McLean Hospital in Belmont, Massachusetts, has treated patients who want to quit marijuana. His 2015 book, Marijuana: The Unbiased Truth About the World's Most Popular Weed, spends many pages on the subject of dependence, which isn't surprising because for the past few years, he's studied various medications and other treatments for those who wish to give up cannabis or cigarettes.
Yet in an interview, Hill puts the subject of marijuana addiction in a much less gloomy context.
He says it's simply not true that "if you use marijuana, you're doomed.
"It's possible for people to use daily . . . and not become addicted," he says. "Keep in mind, when you're talking about regular or daily use, it's a wide range. Somebody who comes home at the end of the day and likes to use marijuana, it's just like someone who has a glass of wine or beer."
Many people who consume marijuana as directed by their doctor aren't addicted, either, he adds.
Alongside alcohol, there's no comparison.
He'd be less concerned about a patient who "wakes and bakes," for instance, than someone who wakes and boozes.
"I'm not afraid to say, on the whole, that marijuana is not as bad as alcohol, for a variety of reasons," he says.
"Dangerous" is a word he likely wouldn't use in relation to cannabis, but he's strongly opposed to the idea that marijuana is harmless. In his field, he's worked with plenty of people whose lives were altered negatively by their pot habit.
"I've worked with athletes who lost multimillion-dollar careers because they couldn't quit marijuana," Hill says. "If you're using daily, whether it's alcohol or marijuana, the next question I would have is, 'If you can't use it on a given day, is that going to be a major problem?'"
On a cold winter night, a small group occupies a circle of chairs at the Crossroads West Facility for Men for the weekly Marijuana Anonymous meeting. It takes up only a corner of the large room in one wing of the facility; the rest is filled with tables, chairs, and vending machines.
This is one of only three MA meeting groups in the state — another is at Crossroads for Women in Phoenix, and the third meets at Verde Valley Alano Club each Saturday in Cottonwood.
Les Lennier, 68, a former cannabis user, invited New Times to attend a meeting at Crossroads, requiring that the names of other group members be kept anonymous.
The five men and three women in attendance are white and Hispanic. Most appear younger than 35.
Following Alcoholics Anonymous traditions, the participants agree that they can't manage marijuana in their lives, that they are marijuana addicts.
The group session is led by a snarky 30-something in jeans and a T-shirt who says he's been clean for nine months after half a lifetime of selling and consuming cannabis.
As an elderly man reads from MA's list of 12 dependence criteria, the group leader loudly states his own answers.
"Has your use of marijuana caused problems with memory, concentration, or motivation?" the old man asks.
"It might have. I can't remember," the group leader answers.
"When your stash is nearly empty, do you feel anxious about how to get more . . . Do you plan your life around marijuana use?"
"Do your friends or relatives ever complain that your pot smoking is damaging your relationship with them?"
"If they did, I stopped hanging out with them."
The leader hands out achievement chips to some of the members who have been off pot for a week, a month, six months.
"Potheads are different," he explains to the others at the meeting. "We don't fit in a lot of areas. Unless you excessively drink, you don't fit in with AA . . . That's why MA started. We didn't fit in. You'd go to [a Narcotics Anonymous] meeting and people are like, 'What? You're here for marijuana? You can't get addicted to marijuana. That's not a real drug!'"
He says he wanted to quit marijuana to improve his employment prospects, because he was tired of "sneaking off" to get high every two hours at work and because he wants to explore "God's will" for him, which does not include staying high all day.
The group leader says he was just a light drinker, preferring marijuana to alcohol. He says he only dabbled in hard drugs, but not everyone at the meeting was there just because of marijuana.
"I do all the As," says a woman with a nose-piercing and tattoos. "I've done all the kinds of drugs."
The group leader asks everyone to follow along as he recites the "Seventh Step Prayer" before concluding the meeting.
Lennier, a former Phoenix-area resident who now lives in Arkansas, travels here each year to visit the Crossroads facility at 7523 North 35th Avenue to pick up his latest one-year sobriety chip. He's stayed sober 12 years and credits the success to MA.
He was addicted to marijuana for 37 years, he says. He smoked pot each morning, smoked occasionally during the day — depending on his work schedule — and ended every evening with a few more tokes.
If he's correct that marijuana harmed his life, its effect — from an outsider's perspective — can best be described as subtle.
After returning from Vietnam, where he served as a medic for the Marine Corps, he became a commercial diver for Shell Oil in the Gulf of Mexico. He worked as a sheriff's deputy in Louisiana for 12 years, claiming he never used marijuana on the job. Before he retired, he was a trauma tech for a hospital.
"I had excellent jobs — all exciting jobs," he says. But he insists that marijuana held back his career.
"I didn't feel as aggressive as I should have," he says. "I have no doubt that if I hadn't been smoking, there's no end to what I could have achieved."
He quit marijuana in 2003, he says, because he had increased mental problems related to the post traumatic stress disorder that he developed in 'Nam. He spent several months in a Veterans Affairs psychiatric ward, and when he was released, he decided to make major changes in his life, including giving up weed.
On the other hand, he has no doubt that using cannabis helped greatly with his PTSD symptoms. Since quitting pot, he's used pharmaceutical drugs only for his PTSD, which leave him feeling stripped of emotion. He believes firmly that more studies should be conducted into how cannabis may help with PTSD — and says he'd volunteer for such a study even if it meant going off the wagon.
Kevin Hill's book includes anecdotes of cannabis consumers like Peter, a 28-year-old lawyer who got good grades at an Ivy League school and is a success in his profession, and Stephen, a 25-year-old who successfully reduced his marijuana use after his fiancée complained about it.
Such cases show the gray area concerning cannabis use and the need for treatment, he notes. One way that marijuana users typically end up in treatment programs, Hill writes, is when the margin for error in life shrinks, they're required to perform at higher levels than in the past, and they wonder whether their marijuana use is holding them back.
However, it's rare for users to admit themselves to a treatment program for nothing but dependence on cannabis, Hill says.
At TASC, which also runs a full-service drug-treatment facility, cannabis-only users almost never come in for help on their own, says TASC chief operating officer Doug Kramer.
The same is true at the Phoenix Veterans Affairs Health Center. Self-admissions to the VA's substance-abuse department for cannabis-only disorders make up less than 1 percent of all substance-abuse cases, a spokeswoman says.
Partly because of the burgeoning marijuana culture in the United States, with legalization in some states and medical-marijuana clinics in a slew of others, the overwhelming majority of cannabis consumers don't believe they need professional help.
And experts say they're not wrong.
Science shows that pot may addict people on a physical level, in its own unique way.
Dopamine, a chemical that helps animals feel pleasure, is increased when molecules in marijuana called cannabinoids are introduced to the body. Humans and other animals, scientists discovered three decades ago, have an internal cannabinoid-receptor system that plays a role in just about every important physical and mental function.
Mood, appetite, pain, the propensity to contract certain diseases, proper function of numerous organs, including the brain, and the phenomenon of addiction itself — all are linked to the body's endocannabinoid system.
The body produces its own natural cannabinoids to regulate these functions. Flooding the system with similar molecules from the cannabis plant alters internal software in ways that scientists don't yet understand. But it's been known since the 1970s that frequent users who suddenly stop may experience withdrawal symptoms, including night sweats, a loss of appetite, irritability, insomnia, or anxiety.
Such symptoms, even though mild, can discourage an attempt to quit. But in the absence of serious side effects from stopping cannabis use, the question remains: Is addictive behavior by habitual users mostly psychological?
People get addicted not just to drugs, but to sex, food, exercise, or work. In fact, research shows that people who exercise get high because their bodies naturally create a cannabinoid that increases the amount of dopamine in the brain, just as marijuana does.
"It's a habit, not an addiction," says one longtime cannabis user who stopped using three months ago out of fear that he might be drug-tested while seeking a new job. After years of daily use, he missed smoking pot for a few weeks and experienced memorable dreams, but it wasn't hard overall to quit, he says.
He doesn't feel any better or worse for his abstinence, he maintains. But he's looking forward to passing his urine tests, getting his new job, and resuming his old habit of smoking, which he says he enjoys almost strictly in the evenings in front of the TV or on weekends while exercising.
"[Using cannabis] could be a positive for wellness," says Marty Otañez, an associate professor of anthropology at the University of Colorado in Denver. "I don't necessarily subscribe to [the idea of] addiction to cannabis, but I do see people reliant on it."
For sure, in many states now, people engage in recreational use of cannabis "and are doing just fine," Otañez says. They may use it daily, he says, even "wake and bake" and not have problems. But people have to figure out for themselves whether it's a problem.
According to a 2014 New England Journal of Medicine article, long-term cannabis users are less likely to achieve the education and "life satisfaction" of their peers, may develop symptoms of chronic bronchitis from smoking, and put themselves at increased risk of "chronic psychosis disorders, including schizophrenia," if they have a predisposition to these disorders.
Such drawbacks affect relatively few cannabis users, yet the status quo in Arizona is mandatory treatment for anyone caught with weed.
The most recent statistics from the TASC program show that of 2,591 people referred to TASC from July 1, 2014, to June 30, 2015, 77 percent were for marijuana offenses. Eighty-four percent of the marijuana offenders completed the program successfully while 65 percent of hard drug users completed theirs.
If Arizonans vote "yes" on a Colorado-style legalization measure expected to be on the ballot in November, it'll affect TASC greatly.
The Maricopa County Attorney's Office could not provide statistics that detail how many TASC referrals involved possession of fewer than six plants for cultivation or less than one ounce of marijuana, which would be legal under the proposed measure.
But it's safe to say most of the 77 percent of marijuana cases referred to TASC annually would disappear. This will greatly reduce the total number of Phoenix-area residents who receive treatment for cannabis use.
The loss of forced treatment actually could be a detriment for chronic marijuana users, argues TASC executive Marrya Briggs. She says she's witnessed firsthand how the forced break from cannabis consumption in TASC can be positive for some people.
"They didn't realize at the time they were using how it was affecting them," she says.
However, as the above statistics show, most marijuana offenders don't have a cannabis-use disorder, and therefore didn't need treatment.
"Some people feel very passionately that this is a lifestyle they ought to be able to lead," TASC executive Kramer says.
In November, Arizona voters will decide whether to give the state's estimated half-million cannabis users the freedom to choose their own lifestyle.
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