Tom Rael’s first epiphany came two years ago when he looked up from his drink and caught his reflection in the bar mirror.
His eyes were red and dull because he was perpetually stoned, toking every hour or so to maintain a constant high. His face was slack and prematurely lined. He looked too old for someone barely 30.
“What have you become?” he asked himself.
He stopped drinking, but he kept smoking. Cannabis was natural, he figured, so it was harmless, right? But two years later, he went to an Alcoholics Anonymous meeting and listened to someone describe a dry drunk, resentful and constantly simmering with anger and frustration. Rael felt a jolt of recognition.
“It hit me that I had the exact same symptoms, but from weed,” he said.
“I realized that I had a real problem and that I couldn’t say it was ‘just pot’ anymore. Smoking wasn’t about being with friends no more. It meant sneaking around, worried that people at church would notice, that people at work would notice. Yet I couldn’t stop, and I couldn’t function. I would call that addiction.”
Now 33 years old and a client at Step 13, a residential program that trains recovering addicts through education and work, Rael knows that many people reading this story might be rolling their eyes.
Addicted to cannabis? Is that even physically possible for anyone who’s not in the cast of the 1936 propaganda movie “Reefer Madness”?
Year in review:
Special report from The Cannabist
“I thought marijuana addiction was a joke,” said Rocco Mastriona, 18, who is in his second residential program for substance abuse at Arapahoe House. It’s where he spent his 17th and 18th birthdays.
“My primary drug was heroin, but marijuana played a big role in my relapse after the first time I left Arapahoe House. I thought if I stayed away from pills and heroin and just smoked weed, I’d be OK.”
But Rael and Mastriona and roughly 9 percent of those who use cannabis risk becoming addicted, just as about 15 percent of the people who use alcohol are at risk for becoming alcoholic.
“We know that most of the people who use marijuana recreationally are not addicted, ” said Patrick Fehling, an addiction therapist at the Center for Dependency Addiction and Rehabilitation at the University of Colorado Hospital.
“But of all the people who use marijuana, about 9 percent, or one out of 11, is at risk for addiction.”
Fehling said people become addicted when their tolerance level rises; there are withdrawal symptoms when use is discontinued; they feel a loss of control when they can’t get high; and they continue to use despite negative consequences, valuing getting high over obligations to work, family, friends, relationships and finances.
“Marijuana advocates will say it’s not as addictive as tobacco, and they’re correct,” Fehling said.
“The numbers change with other substances. Alcohol, I believe, is just above the 10 percent range, so of all the people you see who drink, one in 10 have a problem where they lose control or it hurts their lives. The vast majority of people who use recreational marijuana are not addicted.”
But for those at risk for addiction, especially people diagnosed with chronic mental health disorders including mania, depression, anxiety and schizophrenia, marijuana dependence can be ruinous.
Marijuana continues to be among the top drugs abused in Colorado, based on treatment admissions and other data from the National Survey for Drug Use and Health and law enforcement drug testing.
In 2012, the most recent year for which statistics are available, clients with marijuana addiction accounted for slightly more than 19 percent of Colorado’s residential rehabilitation programs.
The Rocky Mountain Poison and Drug Center reported that calls concerning marijuana ranked second to alcohol for 2011 and 2012.
Rehabilitation counselors say marijuana closely follows alcohol, opiates and sedatives as the four most-abused substances.”We’re seeing more and more patients who heavily smoke marijuana and who also have mental health problems,” Fehling said.
“Which came first? The addiction or the mental health disorder? We don’t know. I don’t think anyone believes that marijuana can cause schizophrenia or bipolar disorder.
“People who do have significant mental illness have a harder time sticking with rehab. They go off their meds. Even for people without mental illness, addiction is a chronic disease.”
Rael, who grew up in a conservative Christian home and avoided alcohol, drugs and sex when he was an adolescent, was 21 when he took his first hit.
It was at a New Year’s Eve party with his cousins. Rael was reeling after being rejected by the Marine Corps. After he enlisted, a physical revealed that he had a torn ligament in this knee.
“For me, being a Marine was something I wanted all my life,” Rael said. “That was my future. Suddenly, there was nothing.”
So when someone passed a bong at the New Year’s party, he sucked up some smoke and liked how it felt. His cousins cheered: Straitlaced Tom was finally getting high!
“I felt like one of the guys,” Rael said, looking back. “Part of the group, not the square who won’t smoke or drink. I smoked the next day. And from then on, weed was a regular thing.”
Rael spent most of his waking hours high.
“I’d wake up at 4:20, and say, ‘Well, it’s 4:20,’ and smoke a joint and go back to sleep,” he said, referring to the long-standing stoner code for getting high.
“I smoked when I got up. I smoked before work. I’d cut lunch to get high. I’d get high after work and before I went to bed. My car needed brakes, but I needed to spend my money on weed. I’d shift from gear to gear to stop. People at work liked me, but I’d tell myself that they wouldn’t if they knew what I was really like.”
Mastriona knew exactly how his family felt about his drug use. They could tell when he was high. When he left for his second try at rehab nine months ago, his little sister, age 7, told him that she didn’t want him to come home because “you’ll just leave again, like you always do.”
“Not a day goes by that I don’t think about where I came from,” Mastriona said.
Cannabis and addiction
One in 11 people is at risk for addiction to cannabis, especially if that person has a mental health disorder or has a genetic predisposition for a mental health disorder. Substance-abuse treatment programs focus on helping addicts recover control of their lives through accountability and re-education. Here’s a look at a couple of local treatment programs, both of which have room for additional participants.
For men only. Its principle tenets are sobriety, work and accountability.
Up to 151 residents pay fees of $10 a day (or $260 a month) and stay an average of nine months. Punctuality is expected from the beginning. “When I filled out the application to come to Step 13, they told me to come back at 3 p.m. — right at 3 p.m., not one minute before and not one minute after,” said Tom Rael, a Step 13 resident.
Residents are required to take Antabuse, an anti-alcohol drug, and blow a Breathalyzer every time they return from an off-site appointment. They are subject to random urine analysis tests, along with mandatory attendance at sobriety support meetings.
Participants work, either in-house at Step 13 or through the organization’s partnership with Goodwill Industries and Ready Temporary Services.
To remain in the program, residents must get up and make their beds at 6 a.m. and work from 7:30 a.m. to 4 p.m. They’re responsible for buying their own food and cooking their own meals and taking classes on budgeting and finance.
Over time, residents earn privileges, such as moving from the dormitory bedroom to a private room or apartment. About 32 percent of the men accepted at Step 13 successfully transition to sobriety and independence.
Thirteen facilities statewide treat adolescents and adults, with gender-segregated dormitories. The cost is determined by a sliding-scale fee based on income.
The 20 adolescent residents, ages 12 to 18, remain on campus throughout their stay, with a regimented schedule that includes school classes, behavior modification workshops, activities, recovery support meetings and job training.
Residents are drug-tested whenever they return from going off-campus with a pass for a meeting with a physician, court or family member. They’re also subject to random drug tests.
Claire Martin: 303-954-1477, firstname.lastname@example.org or twitter.com/byclairemartin