7News Investigation: Swapping Pills for Pot

NEWTON, MA (WHDH) - For Stephen Mandile, it started with morphine.

The Iraq veteran was injured in a humvee accident more than a decade ago. He suffered six herniated discs, along with damage to his nerves – and his mind.

“They had me on 57 different medications. I had taken ten different opioids,” Mandile said.

At one point, Mandile said he was taking more than 100 pills every week, and was suffering daily withdrawals.

“I was definitely an addict,” Mandile said. “I was sweating all the time, being really confused all the time, and not really being able to talk. Having trouble staying awake.”

He said on his darkest days, death beckoned.

“I’d be driving down the road and just have the urge to just cut the wheel and drive off a bridge,” Mandile said. “I could have easily been one of the four Massachusetts residents a day that die of opioid overdose.”

Then, a few years ago, Mandile discovered marijuana. He said it takes the edge off of his pain and his post-traumatic stress disorder, freeing him from nonstop pill-popping.

“Having PTSD and having the problems and everything is like hearing 100 different songs in your heads at once. And when I’m able to get the right strains of marijuana, it’s like putting on headphones and just listening to one song,” Mandile said.

“We’re trying to open the door for people who have no other doors open,” said Dr. Benjamin Caplan with Canna Care Docs in Waltham.

Canna Care Docs works with medical marijuana patients across several states, and has eight locations across Massachusetts.

Caplan is one of a growing number of doctors in Massachusetts looking to dull the pain of the opioid crisis with pot.

“We have a standard ladder of care that we offer patients. Sometimes they go through that ladder and they’re still feeling helpless. They’re still feeling pain,” Caplan said of more traditional medical treatments.

Caplan said every day in his office, he sees patients who have exhausted their other options and consider themselves addicts. And he insisted marijuana can help beat addiction to opioids, which are often prescribed to treat pain. Supporters say pot is a safer and less addictive alternative.

Caplan told 7NEWS about a female patient with terminal breast cancer. He said she’s seen amazing results transitioning from opioids to marijuana.

“To see her coming in saying, ‘Wow, this has really lifted my spirits.’ She gets to be with her children. She gets to be with her family. How can anyone not get emotional about that?” Caplan said.

Limited studies have shown promise. A 2014 report in the Journal of the American Medical Association for Internal Medicine found rates of opioid overdose were 25 percent lower in states with legal medical marijuana. And a 2016 report in the American Pain Society’s Journal of Pain found medical marijuana patients cut their opioid use by 64 percent.

“But there’s also less robust quality data, which is patient reports, epidemiological information. And that’s all telling a consistent story,” Caplan said of emerging anecdotal evidence pointing to positive results.

Caplan said he uses detailed logs to track progress patient by patient.

“We’re organizing this process to make it as methodical and scientific – as data-driven – as we can,” Caplan said.

But critics fear it’s smoke and mirrors.

The National Academy of Sciences recently found that there is “no evidence to support or refute” the idea that marijuana helps kick addictions.

“There just isn’t the science out there yet that says how much, what the dosage is, how often you take it,” said Fred Newton, President and CEO of Hope House Addiction Services in Boston. “I really think that it needs to be explored more.”

Newton said he is cautiously optimistic about pot’s potential to treat his clients who are addicted to opioids. But many in the addiction recovery community worry about a lack of hard evidence for such treatments – and have reservations about steering drug addicts toward another drug.

“The goal of treatment should always be abstinence,” Newton said.

7NEWS asked Mandile if he’s just replacing one drug with another drug.

“Absolutely. I’m replacing one medicine with another medicine,” Mandile replied.

Mandile, who’s still smoking pot, said he’s now completely off of opioids. His mission now is to help other veterans do the same.

“It’s the medicine that has given my life back, and I will advocate for it every way I can,” Mandile said. “The fight against opioid addiction is now my life’s work.”

One big reason that there’s so little data on medical marijuana treatments is that it’s still illegal under federal law – so funding and running rigorous studies is nearly impossible.

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