E70 - Can a junkie drop heroin making cannabis his new heroine?

One of a series of episodes focusing on cannabis use in opioid harm reduction, Kirk brings a story of one man’s experience. The episode follows a discussion Kirk has with Mr. Mark Heinrich who is “a craft cannabis farmer in Manitoba, Canada and pretty much a lifelong junkie and addict.” The episode follows Heinrich’s years of problematic substance use, leads us into his experiences with Methadone and how he self-medicates with cannabis. This episode is a very personal journey presented as information on how one man uses his medicine in harm reduction. Kirk and Trevor then discuss their personal views of Mark’s story; each approaching it through their individual professional lens.  

Saturday, 05 June 2021 19:51

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Desiree Dorion
Marc Clement

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Episode Transcript

Trevor: Kirk, through the marvels of technology, we are several kilometers apart, and yet we are talking through the Intermoweb again. 

Kirk: Actually, I'm a little closer than you might think. I'm about one of the most remote one of the more remote nursing stations in the province. However, I'm rather south I'm actually just a little north of the Whiteshell. 

Trevor: Yeah, well, that's what you were saying. I've I grew up close to the Whiteshell and I haven't been to the actual community you're in, but I have fished close by. It is a beautiful part of the province. 

Kirk: Yeah. So I'm I think maybe three, 400 kilometers away from Dauphin. 

Trevor: There's just definitely no roads that go here from here to there. 

Kirk: No, sir. No, no roads. Only a helicopter. I have to get here by helicopter. So how are you doing Trevor. I haven't seen you for God, weeks. 

Trevor: Yeah. And in person I don't even remember when 

Kirk: I saw the way I saw you in the parking lot. 

Trevor: Oh, that is true. I saw you in the parking lot of the pharmacy. So that's as close to as we've gotten in a while. 

Kirk: That's right. And yeah, that's about it. So I brought you a story that I think really works well with the opiate stories we had. We did Dr. Grinspoon. And then also you had the Tilray interview with. 

Trevor: Philippe Lucas. 

Kirk: Yeah. Which I thought was a fantastic episode, but I brought you a self-declared junkie. 

Trevor: Yes. Mark is Mark has a lot of experience. 

Kirk: Yes, he does. And my conversation with him was about an hour. I don't I don't presume we're going to use all of the interview. There's some critical parts of it that I that I want to extract from it. I met this gentleman on Instagram. He is a listener to us. So hello out there, Mark. I'm listening to us. Yeah. And thank him for I guess bearing himself and talking to us about his addiction issues is a substance, substance disorder, abuse disorders. And it started very young. And he explains that in this story. And he bears his soul. Man The conversation we got, we go down several rabbit hole. 

Trevor: Yes.

Kirk: And yeah, several. And the conversation the conversation sort of took different paths as we went. So I can't really say we were flowing. We just chatted. And I love those kind of interviews. When we just chatted. And there's a couple of things I want people to sort of listen here. What we've got here is we've got a gentleman who is self-declared, who calls himself a junkie, and he describes and physically describes himself as a junkie. So I've met I've met some people with addiction issues in corrections. And this just gentleman in my conversation, he describes himself as when he spent time in corrections. He said he has spent time in living rough. He has spent time on the different side of the law. This is all part of the conversation. He now he now is growing his own and using his homegrown cannabis as a way to help him-self get off opiates. Now, he's also on the methadone program. He's also on the methadone program. So and that brings its own challenges and he gets into that. So I found the conversation. Well, as I do all of them. I love this I love this podcast that we do Trevor by the way

Trevor: We get to talk to some fascinating people. Don't we 

Kirk: Yeah. And that's what I like about this. Every one of these podcasts, for me is a Con-Ed experience, right? It definitely is a Con-Ed experience. And as a nurse, Kirk Nyquist, The Nurse, you know, and. 

Trevor: Trevor Shewfelt the pharmacist. 

Kirk: And for me, this was an opportunity to spend an hour in a clinic room with a junkie and talk about cannabis. What did you think about the interview?  

Trevor: He is a challenging guy. Like I you probably dealt with more people with substance use disorders than I have. But as I think I've mentioned before in the podcast, our pharmacy does we are part of a methadone program, Suboxone program. So, I talk to people with substance use disorder every day. Frankly, the people I talked to kind of by the definition they're in the program are doing relatively well, you know, everyone's got their problems, but, you know, most of them are, you know, housed and employed and in relationships. And, you know, life is; life is might not be perfect, but moving along, he has been in much worse straits than that. So, yeah, we'll talk about more in the wrap up. I have a lot of compassion for Mark, but I think it also just listen for how difficult it is to be a health care professional who specializes in in addiction medicine because people like Mark come with a lot of problems. Like there is just there's a lot of there's a lot going on. Like you don't just suddenly wake up one day with a heroin addiction. And that is your one problem. There is a lot going on. And just listen for that and Mark's story. There's a lot going on.  

Kirk: Yeah. And I know I know in the wrap up you're going to explain a little bit more about methadone; this isn't really a story about the methadone program, but I think it's important to talk about what harm reduction is and cannabis is role and harm reduction. And this is and this is why I brought the story to the to you. And I wanted to bring as the podcast, because this now brings a lived experience. And you were saying off camera, off mike, basically what this man is bringing to us is a lived experience and how cannabis is helping him. And he's by no means done his journey. Is he still in the works in the swing of it. So let's do you want to just go into the story? 

Trevor: Yeah, let's hear from Mark and then I think we've got a bunch to say and follow up and. Yeah,  

Mark: My name is Mark Heinrich. I go by @dialated_dank online on social media. I'm a craft cannabis farmer in Manitoba, Canada, and pretty much a lifelong junkie. and addict. 

Kirk: OK, so you actually you actually searched us out about a year ago asking if your story would be of interest. And it very much is as explained to you. Trevor has been doing some studying on opiates from a Ph.D. that's done by Tilray. And we've also got an M.D. you is talking about using it actively. I was just reading an article coming from Normal about how cannabis has helped people with addictions. So, you know what, I'm just... Mark, I'm just going to let you go. So why don't you explain to us what your story is, and I will try not to interrupt you. 

Mark: OK, so let's see here. I started doing drugs at a very, very early age. I kind of I found I found out I was adopted right as I was turning 13. And that kind of just flipped my whole world view. I was raised in a very religious household. And so when I found out I was adopted and my parents had been lying to me my whole life, everything just flipped. And I was like, well, if they've been lying about that, what else have they been lying about.  At that point, I thought if I smoked a joint, I could die. Like that's how drugs were presented to me. If you smoke a joint, you will become a heroin addict and you might even die. So, I think the first thing I actually did mushrooms before I smoked weed; might have smoked hash before. But anyways, so I started going down the list of drugs and finding out that, oh, these don't kill me. They actually make me feel good and then fell into a pretty harsh addiction, first to cocaine, for would have been 16 through 30. So, for about 15 years, I was a pretty hardcore cocaine addict. I would have stints of sobriety here and there. And I was functioning for the most part. But in and out of jail, I guess not functioning. In and out of jail, would get a good job, have it for a couple of years. Lose it. My resume looked really good, but my rap sheet looked about as good as my resume did. So, it was a 50:50 shot most. And then at thirty-one, I discovered heroin and it just it grabbed me by the balls in a big, big way and I'll try not to go off on a tangent here, but even heroin, like the way it grabbed me, had I had I known what heroin was. Had there been any documentation. If Carl Hart had written his book 20 years ago, I wouldn't have been a heroin addict. We've just put so much on drugs that have nothing to do with drugs. There are safe ways to consume all of these substances and what's made them unsafe is government prohibition and regulation. Well, regulation is making a bit better now, but prohibition definitely exacerbated the problem. So, anyways, I managed to get on to methadone after I think about six years in heroin addiction and I've been on methadone. I'm still on it now. I've been on it going on eight years, I think. And I was never told when I went on methadone that this was going to be for life. The chances are you're going to be on this for life. It wasn't until after the doctor prescribed it to me and I started talking to other people that they were like, I've been on it for 12 years. I've been on it for 20 years. I've been on for 15 years now for six years. I'm going to be on it for life. And then we started talking to the doctors and as I started looking into it, I was like, this stuff is worse for me than heroin was like, if you want to get off methadone, it's like I have been actively trying to get off methadone for the past two or three years, just tapering down because they put you up to such a high dose that it's almost impossible to come down. And they don't tell you that when you want to quit methadone, if you get your life in order, if you get your head straight and your addiction under control and you want to get off methadone, it's almost impossible. But even when you get down, I'm now on five milligrams a day and I'll often only take half a dose a day. So, I'm between two and a half to five milligrams a day. The last six times I've tried to cut my dose down like a milligram or two, I go into insane withdrawals immediately, so I have to go back up to five or six and then I come down for a week and then I get that withdrawals and then back up. And they don't tell you that methadone has a six-month withdrawal table like you can have precipitated withdrawals for up to six months after going down to half mg from half to zero. And heroin has like a four to four to seven-day window. So, putting somebody on methadone to get them off heroin is the stupidest thing in the world. It makes no sense. Besides the fact that the government gives it to you, it would make way more sense to put people on heroin maintenance program where you get pure pharmaceutical heroin and they taper you down slowly. Worst case scenario, they cut you off. You're in withdrawal for three days right now. If I can't get to the pharmacy, which the nearest one is 30 miles away from me, I have no vehicle, no license. So, if I somehow don't arrange a ride every week to pick up my methadone and I miss two days, I get cut off with zero help and forced into a six-month withdrawal that could almost kill me, whereas heroin, if I was on a program and I missed it. Worst case scenario, I'm going into withdrawal for a couple of days. I shake it off and I'm back to work. So, putting somebody on a substance that's worse than the substance they're on to get them off of it doesn't make any sense to me. And then so I started looking at natural ways to get off of it. 

Kirk: Mark, I'm going to interrupt here. So did you grow up in the "Just Say No" "Nancy Reagan days" of Just Say No and all that? 

Mark: Yeah, I was born in seventy-six. 

Kirk: OK, all right. Just Say No is in the eighties I think wasn't it. So you were just a kid. 

Mark: But that was on all my Saturday morning cartoons. 

Kirk: So when you went to the DARE program and all that sort of stuff. 

Mark: Yeah, they came through school, we saw all the videos with the egg cracking in the frying pan. 

Kirk: If you started at 13, then by the time you reached your twenties, you were your full into it. 

Mark: Oh, yeah, yeah, yeah. And I got kicked out of the house fairly. I went to juvie and got kicked out of the house. So,  I was actively in the industry of drug production and sales for the majority of my life as well. 

Kirk: You weren't living rough, though. You were in the drug scene as an active participant opposed to being somebody who was using and living on the streets. 

Mark: Yes, it wasn't until a couple of years into the heroin that that that started, because if it does take you over to that extent, like I have been crying in a jail cell covered in sweat.  Like heroin does get a hold of you like that. It can't it can be a very insidious drug. 

Kirk: So here, I will break in here Trevor, just talk a bit of how we got into discussing what a functional heroin addict would look like. And essentially, after a few minutes of talking about that, I asked him what was it that triggered his need to get off heroin; that he wanted to kick his opiate habit. I was surprised by his answer.

Kirk: What broke your, what brought you to say? I want to get off this. I recognize I'm a junkie. I want to go and get help. So, did you ever had a crisis? You hit bottom. 

Mark: Just the lack of supply. 

Kirk: OK, 

Mark: Plain and simple. Lack of supply. The only time I ever had a problem with heroin was when I didn't have it. 

Kirk: OK, all right. 

Mark: One of the best jobs I ever had, which was which was one of the shortest positions I ever held in my life as well. I got while I was a full heroin addict and lost like a week into it because I ran out of heroin. So, it was just the situation we were in, the lack of finances that I had at the time. Finances were up and down. So, and then you'd have a good connection for a while and then all of a sudden, your connection goes to jail and you're sick in the streets, basically. So that was what prompted me to say I'm not going to be able to live my life. Every time I get a job, I lose it because I did great for a few weeks. But then I have a couple of days where I don't have heroin. So, I have to take time off work because I'm sick. And then a friend, an old friend said, why don't you get on methadone, just get yourself on a low dose of methadone. You can still use you'll still get high, but at least you won't get sick if you run out. Right. I'd never even heard of it before. So, I was like, OK. And then we were on methadone for a while. And then I started looking into methadone and seeing realizing that this was even worse than the heroin. And now I'm stuck on something that's going to take me the rest of my life to get off of when at that point I had kicked heroin probably six times already, successfully by myself; in jail or just locking the door and sweating it out for a few days. And so then I started looking for ways to get off of it. And I went down the iboga path, which is another natural remedy that is insane that nobody knows about. It's the natural, it's iboga. It's a natural root and bark from Africa and the concentrated ibogaine. 

Kirk: I've got a dog too. Yeah. 

Mark: I got two go looking to get outside and play with the farmers, but that's, 

Kirk: that's what my dog wants to do too

Mark: Oh, but it's illegal in the US, but it's legal in Australia, Canada, Mexico, all over the place. And they've known about it forever. And it's a natural root bark. It's an extremely powerful hallucinogenic and it causes ataxia. So, when you take it you all sudden you're paralyzed, can't move for like twelve to twenty-four hours. You trip like crazy; like hallucinations that are unlike anything else. I've, I've done every hallucinogen out there. This was unlike anything else. They were real hallucinations, but they were present where I was. Anyways. This I would go wipes all of your opiate receptors, all of them. I went from forty milligrams of methadone a day to zero in one day with no withdrawal whatsoever. OK, when I told my methadone doctor he didn't believe me and I was, he's like, there's no way you would be dead. You can't go from 40 to zero. You can't do it. We. You can't do it in a day, this is impossible, and I was like, I'm telling you, I did. I came out of it the next day. My wife was like, “Do you want your methadone?” I said, “pour it all down the sink. I don't need it.” And I was clean for almost a year after that. But so that got me looking down that road. And then this time when I started to come down on my methadone, I started hearing that cannabis and edibles could help. I didn't believe it at all. I had always tried using weed in times of withdrawal before, and it never seemed to do anything for me. I was like, it just doesn't make sense. Heroin is so powerful. Weed is weed. Like, yeah, we get some pretty powerful cannabis these days, but it's nowhere near as potent as heroin. So, I just didn't see that it could be effective in any way. And then I started making my own edibles and realizing that with edibles I could drastically reduce my methadone and take drops down that were significantly greater than anything I'd been able to do with any other help. And so, I started tapering. I was at one hundred and one hundred and eighty milligrams, I think. One hundred and sixty milligrams. I dropped in half to 80 in a week. Two weeks later I dropped to forty-two weeks later I dropped to 20 and same thing. I hadn't told my doctor because I was as I was going down, I was aware that if this didn't work I was going to need that methadone. So, I'd been saving it all at home and just taking half my dose and taking these high dose edibles with it. And then my doctor, when I finally went to my doctor and said, OK, you can take me down to 20, he's like, I can't take you down from one sixty to twenty. I said, well, I'm already drinking that anyways. And he was again, there's no way like there's no way that you went down that fast on your own. I said, Yeah, but I've been eating twenty-five hundred five thousand milligrams of cannabis a day. And he's like, no, you'd be dead. And I'm like, no, I'm obviously here talking to you and I'm telling you, this is what I've been doing. Twenty-five hundred milligrams? I don't see that like that. Our patients, we start to get five milligrams for extreme pain and anxiety and the highest we go up is maybe twenty-five milligrams. There's just no way you're taking twenty-five hundred milligrams. And that's to my point or not to my point. But that's part of my point with this all when I'm talking to other people about it is our doctors have no idea nine times out of ten what they're talking about. And they I often find that my pharmacist knows way more about what I should be doing and what I should be taking than my doctor. 

Kirk: So what put you back on methadone? Of course, your body started craving it. 

Mark: No, I slipped and started doing heroin again. 

Kirk: OK. Yeah. 

Mark: OK, so. Yeah. So, methadone is great for only one thing. It gives you your life back. So, it pulls you out of a two to four hour cycle is what I was doing up to a quarter to a half ounce of heroin a day. So, I was I was needing to inject anywhere from a quarter gram to a half gram every two to four hours. 

Kirk: So by this time you're doing IV heroin? 

Mark: Oh, yeah, yeah, yeah. 

Kirk: As well as smoking it. 

Mark: Yeah. Well, by that point I was mostly just shooting it. Once you do IV, it's very, very hard to back pedal on that. 

Kirk: So what's preventing you from going back to the iboga. 

Mark: The iboga? Costs. The ability to acquire it and taking it. You can't take it when you're alone. My wife died last year, so I live alone now and it's. Yeah, thank you. So it's one of those things where you need to have somebody there. You need to be; you have to have a baby sitter basically. And I'm on such a low dose of methadone that cannabis has been helping me come down really, really steeply. So, I I hope to be done with the methadone in a few months anyways. 

Kirk: OK, OK. And your doctor's on line with this now. Do you have the same doctor you're dealing with? 

Mark: A different doctor now, but she's, she's in agreement with it. She, she doesn't understand it as well though. When I tell her how much cannabis I take, she, she doesn't understand it and it's the same thing to her. She's like, there's no way you can't take that much like you would be comatose. A lot of these doctors don't understand tolerance. They don't understand how quickly your tolerance can build up with something like that. And they just they don't have any data on it, I guess, either. 

Kirk: So, these are specialist doctors. These are addiction doctors you're dealing with. Yeah. And are they encouraging the use of cannabis? 

Mark: Not as much as they should, in my opinion. 

Kirk: Interesting.

Mark: Yeah. They there's still a big stigma in addiction circles with any drug like they they still see it as basically replacing it. They don't really see it as a medicine or or an alternative. They see it as just adding one more drug to your repertoire. And so it's hard to it's hard to get through them sometimes. And because they are they've been trained in such an empirical way that unless they have a peer reviewed study in front of them from signed off by a thousand doctors, all the anecdotal evidence in the world doesn't mean anything to them. They don't even consider it. It very frustrating at times. 

Kirk: OK, so let's get into your file a little bit. You're obviously an addict, you've had family doctors that have that assisted you in this, but you have to go to experts in your addiction with methadone is that a family doctor or is it an addiction doctor. 

Mark: It's an addiction doctor who works at a methadone clinic and is full time. she just prescribes my methadone

Kirk: OK. 

Mark: And I think that's like she does other stuff, but that's basically all she does, 

Kirk: OK. 

Mark: And that's another problem is a lot of these doctors, it seems that they, do we not have general practitioners anymore? Are those gone 

Kirk: well they're called family docs? They're out there. 

Mark: Yeah, 

Kirk: but they tend to they tend to refer a lot, yes.

Kirk: Ok, Trevor, I am going to break in here again. You hear I say to him, let’s break into your file. This is what I do. The next 15 minutes we break into a more personal level of his file. So, if this was a clinic room I would most definitely ensure the door was shut and Mark and I would have a personal conversation so this is what we did. What I learned is his methadone doctor is in Winnipeg and his cannabis doctor is online. As we can hear in his story, he’s got experiences with drugs and cannabis and he is self-mediating. In the closed door conversation, I offer him some suggestion on how to better navigate the health system so that he and doctors can work together on this project of helping him.  So, I am going to start the conversation again where we get into him dosing himself and how he doses himself with cannabis. So yes, let’s go into there. 

KIRK: Twenty five hundred milligrams of cannabis to start to start. So obviously you're growing your own. Yes. Yes, obviously. And you obviously have. In the years that you've been doing this ACMPR MMR, you've had all that you've got your own strains, I guess that work for you. 

Mark: Yeah. Yeah. 

Kirk: Because I mean it must be a cost to this amount of cannabis. 

Mark: Yeah. Like, there's no way if I was a normal working person, there's no way I'd be able to afford it right no-way. 

Kirk: So you, you, you then obviously have your cannabis analyzed to understand how much THC is in your plants then to make these measurements or you guessing. 

Mark: At times. I don't have a testing, I don't have a testing machine here. So, we have sent stuff out for tests. But for the most part it's a roundabout guess. What I know is I have used enough that are from lab companies that have lab tested products. There we go. 

Kirk: Licensed producers, they call it now. 

Mark: Yeah. Yeah. Well I still don't buy from them but OK. Yeah. So, I do know that, that, that's what like twenty-five hundred milligrams is a starting dose. OK, depending upon how much I'm going down. So basically, what I do with my methadone is I take it until I have a day where I can go twenty-four hours without taking it ok. Because then I in for me and I do advise this to other people, but do it with your doctor's advice. So, I wait until I can go a day without taking my methadone with no withdrawal whatsoever. So, once I can go twenty-four hours and experience no withdrawals, I consider myself stable. I've got a stable dose of methadone. Once I can do that, then I take a drop. So that's where I would go down half when I was up at larger numbers. Now I'll go down a milligram or two. And during that process of going down, if I didn't have edibles, I couldn't do it. It's impossible to do. With edibles it was so easy. And again, every doctor I've when I've gone through this process is either not believed me, or just caution strongly against it, but then I come back two weeks later and say, OK, you can take me down another 20. I don't know if we would advise that. Well, if you don't, I'm just going to do it myself, so. Well, how are you doing this? Are you using again? No, I'm using cannabis. And then you tell them how much and they're like, that's not safe. And so, yeah, I think your suggestion was a good one. We need to have doctors who are aware of these things and can start bringing them to other doctors. 

Kirk: Well, the other thing about it, the other thing about Mark is that if you go to a doctor, this cannabis savvy, they may also say to you that you're doing something I've never done before. However, I'm aware of cannabis and now you become a teacher to them and they learn from you. They can help the next person with what they learn from you. You used the term RSO. Rick Simpson's Oil? Yeah. So, are you making your own Rick Simpson's Oil? 

Mark: Yeah, I'm making my own and procuring my own from other growers, 

Kirk: OK, because like I'm saying, that's a that's an awful lot of cannabis, so you must have to be concentrating it somehow. You must be getting the resin to extract that amount of cannabis out of a flower. Yeah, it's a lot of plants. 

Mark: I grow indoor and outdoor, OK? I live on a farm out in the middle of nowhere and I have my license split up into indoor and outdoor. So, I have a couple of green houses, some outdoor area to grow in and I have a couple of rooms going inside full time. Right. All right. But yeah, it does take a lot. There's no doubt about that. 

Kirk: It's a full-time job for you, I imagine, growing these plants. Yeah. 

Mark: One hundred percent that literally all I do right now. 

Kirk: OK, yeah. This is an amazing story. So just to just to backtrack. So obviously an addict did some hard drugs. You're off in the West Coast. When did you move to when did you move to Manitoba? 

Mark: Moved back to Manitoba the first time. Twenty ten. OK, and when we moved back here it was hilarious like this. In one way it's a good thing because it shows you how far Manitoba has come, but it also shows how far Manitoba lags behind. When I came out in twenty ten, probably five years before that was going to jail and having a doctor say, oh, you're an addict here, here's something we can do for you. I get to Manitoba. Our doctor in B.C. writes us a six-month script, tells us, get out there, find another clinic. Here's a six-month script to tell you over. And when you get there, we'll just transfer you to another doctor. So, we come out here, first off, only one pharmacy in all southern Manitoba that carried methadone. So, come out here. We have to travel to this pharmacy every week to get our methadone.  First, it was every day because you go witness every day and that you're OK then and it's every week. And if you're not on assistance or you don't have health coverage, you're paying a twelve-dollar bottling fee and thirty cents for your methadone every day. Yeah, like the methadone literally costs thirty cents, but you have to pay twelve dollars. bottling fee from your pocket every fricking day. It’s insane.  Anyways, So, we come out here, we start looking for methadone clinics. There's two in all of Manitoba in twenty ten. Two methadone clinics. One you had to be a resident of Winnipeg if you lived outside of Winnipeg; no go.  The other one waiting list. So, we call, we get put on the waiting lists, time goes by. We're at five months. My doctor finally says this is I can't write you another script. You guys are going to be able to methadone thirty days and there's nothing I can do about it. Please send me a list of any doctors that even prescribe methadone, because at that time, Manitoba is using his pain management. They were giving cancer patients instead of morphine. And so, we get them this list of doctors who prescribe methadone. He contacts them all directly and ask to just transfer our file. They all say no. So, we have this deadline coming down. We're not going to be able to get our methadone at all. That's where we did the iboga. OK, so then about a year and a half later, I get a really good job offer in Vancouver. Me and my wife pack up and back to B.C. We're in B.C. for about six months. Also, I got this phone call from my mum. She's like, you got a phone call today. Guess who? Who? The methadone clinic two and a half years later. Well, they're calling me to say, hey, we can take you now. I just laugh, my mom, even this old Christian lady, was like she said, yeah, I just told them. He'd be dead, he'd be dead if he was still here and hung up on them. Like, this is insane. You're expecting a junkie who's living his day in two-hour increments to wait two and a half years to get help. Yeah. So then we were in B.C. for a while. We came back here and then we came back, the same thing we had to then the one that served out of Winnipeg clients, I think it was Mine. At the time. It was called The Mine Clinic. Yeah. They could get us in right away, but we had to travel to Winnipeg every week to pick up our methadone because they had the doctor's office and the pharmacy in the same place. So every week we had to drive to Winnipeg. It was a nightmare. And then it was about a year and a half of doing that. I think maybe a year doing that, that I ended up really sick. We had missed I missed going in two days so they cut me off. And this is the thing. They put you on it. Yeah. You missed a couple of days. They cut you off. They don't care at all that they have sentenced you to the six-month crazy withdrawal on this substance. That's way worse than what you were on. And no care. They just cut you off sometimes with no notice, no nothing that you go to the pharmacy to get your dose and they're like, oh, sorry. Or if you piss hot, like if they find something else in your blood, maybe eat a poppy seed bagel, you took some benzo is something they find it in your blood. So, you go in, you give your piss test for the week. The next week you go to pick up your dose that you think is going to be there and they say, sorry, you need to see your doctor next week or you need to see your doctor before he cut your script off. You need to go see him. Oh, when can I see him? He wrote your appointment for three weeks from now. Like what? What do you think I'm going to do? I'm going to go get heroin.  It just insane 

Kirk: So, OK, so your goal your goal is to use cannabis and how not so how long you've been using cannabis then like you started as a 

Mark: my whole life 

Kirk: but as a medicine now as a for the addictions issues and helping you to get off 

Mark: going back. I've been using it as a strong assist to getting off the methadone for just over a year now. All right. Yeah, it was it was just straight right around when my wife died just before just after that, I decided I need to be off of this for good. And I made the decision. It was. It was actually I made a decision in my head, that I would rather deal with possibly going back to heroin and having to deal with the withdrawal of heroin than ever going through this again, like I. Yeah, it's a life sentence that they don't tell you is a life sentence when they put you on it and it's not it's not it's not a good medication. It doesn't make you feel good. It, it gives you all kinds of other issues. Like I walk around looking like a junkie all the time, like even when I was in jail. You can tell when somebody comes on the range or when you walk onto range and you see everybody sitting at the tables, you can pick out the people on methadone. No problem. If they haven't done any street drugs for months or years, they look like junkies. Their skin is pale. They have bags under their eyes. They look like junkies. I can go into the pharmacy and I know when I'm sitting there waiting for my prescription to be filled, I know every person that comes in that's on methadone before they go to the methadone counter. You can see them when they're like methadone, methadone like it is an obvious, you're still an addict, right? You're just an addict to a to a legalize prescribed medication, which is why I don't understand why the programs that they're doing in Italy and Europe with proper pharmaceutical heroin maintenance. It just seems, even if they did it with morphine or hydromorph, anything that is a short acting that's like it is much easier to taper down on heroin than it is on methadone. I'll just say that. 

Kirk: Right. So your goal your goal is self-medicating yourself, using cannabis. You want to be off methadone, did I hear you say a year from now. 

Mark: Yeah, I initially, because I was coming down so fast, I thought it was going to be six months and I'd be done. I didn't realize how hard it was going to get. Once you get to those lower doses. It is a very powerful, powerful opiate, like it just stays in you forever. And once I got under ten milligrams and even now I've been it took me, I think, probably three months to go from six to five because every time I tried to come down the five, I take my dose, I feel great, and all of a sudden before bed, I wouldn't feel that good to be 12 hours in, I wouldn't feel that good. And I'd wake up in the middle of the night puking my guts out just from going down one milligram. All right. 

Kirk: You know, and how often do you dose yourself with cannabis? Then you do the methadone once a day 

Mark: I do the methadone once a day. And now I smoke fairly regularly throughout the day. And then I take my edibles at night hours, usually about four hours before bed. Then I pop my edibles. And that's the other thing is I have never had regular sleep on methadone. It was just something I got used to. I thought that's just the way I was. I thought I was some kind of insomniac that didn't sleep and I didn't realize that it was a big part of the methadone that was doing it to me. When I take a proper amount of cannabis like THC and CBD, it's the only time I get a full six to eight hours of sleep. So that's another big thing with me. And I might have a little bit of insomnia, but yeah, that's how I do it. So, I take my methadone usually somewhere in between noon and five and then four hours before bed, I will eat anywhere from twenty-five, to five thousand milligrams. And then I get a good sleep and I wake up feeling good. 

Kirk: Yeah. Yeah. Well, thank you. Thank you for your time man. 

Mark: Yeah. Good to chat to you. Hope to meet in person someday. 

Trevor: So, Kirk, first, first and foremost, thank you to Mark. You know, we've had a lot of personal stories on the podcast and hopefully we'll get some more down the road. But, you know, this is the definition of baring your soul, warts and all. And he's done that for everyone. So, Mark, you're a very brave guy. Thank you for that. 

Kirk: Well, what I didn't mention up front, Trevor, is this is his cannabis story. You know how we have the My Cannabis Story that we encourage our listeners to send us one or two minutes. Well, Mark sent me a message very early in our podcast experience is asking to give us my cannabis story. And I said, sure, send me two minutes. Send me two minutes. Well, he never sent it, but I reached out I reached out to him after the other two stories that you brought thinking this would be a good one. And I think it blends well. So what I'd like to understand a little bit more. Explain methadone. He goes on and he's not a fan of it. 

Trevor: Not a fan. So, Methadone is a really long acting opioid, so and so I tried not to use so opiate... As a pharmacist, we use a bunch of words interchangeably. So opioid, narcotic, morphine, morphine-like these, we're all talking about the same thing. I think I use opioid more than anything, but in case I slip into one of those other terms, we're all talking to the same group of medications. So, methadone really long acting. So, it has a variable half-life up to forty hours, but the average is twenty-two. So, our only piece of math. Yeah. I was going to say half-life is the only piece of math I'm going to do here. So, half-life is the amount of time for half of the dose to leave your body. So, methadone it's about twenty-two hours and then the but the math also says it takes five half-lives or something to completely leave your body. So, if you multiply that it's about five days. So, a dose of methadone takes about five days to completely leave your body. And we play around with the idea that methadone, once we get the dose right, should have a fairly level amount of in your body for somewhere between two and three days. Twenty-four to 48 hours ish. And that's what we like about it. The whole idea is to give you a low dose of an opioid so it keeps back the cravings for your  fast-acting opioids. So, your morphine, your, your oxycodone, your hydromorphone and your heroin, they're fast acting. So, they go in fast, they come out fast. And our understanding of addiction and cravings is the faster something leaves your body or fat. Something goes in and out sort of the more addictive it is. So, if we give you the idea is we give you a slow, long acting opioid at a low dose, like a dose, hopefully low enough that you don't feel euphoria, you don't feel high, but it stops the cravings. So, you know, you dose this thing once a day and then you can go. In a perfect world, now you go on with a regular job life relationship without having constantly worrying about when's my next hit? That's the short version. 

Kirk: So, the concept of harm reduction is we're basically trying to modulate somebody's cravings to a controlled substance. Yeah, yeah. 

Trevor: Yes. And again, it is harm reduction. OK, Kev, Mark is not the first one who was surprised that the whole idea behind methadone is not to necessarily get you down to zero opioids and most methadone doctors, practitioners, will go over with this with people at the beginning. But there's a lot to go over at the beginning. But it's harm reduction. So, you know, there's all sorts of problems with using we'll call them, quote unquote, street drugs, everything from, you know, where they altered to sharing needles, as, you know, a bunch of problems with using street drugs. And the idea is methadone is safer, not 100 percent safe, but safer. And it since it's once a day again, you dose once a day and then hopefully don't have to worry about it the rest of the day. That's kind of the that's kind of the idea behind it. And again, the methadone idea is, they're not in a big hurry, necessarily, to get you off of opioids altogether. That's not usually the goal. The goal is getting you your life back, you know, getting you employed, getting you housed. Getting you, have a stable relationship, maybe if maybe get your kids back, you know, all the things, all the sort of safety nets, get those all working first and then, you know, if everything is, then maybe consider going down to nothing. But the idea behind the methadone program is not necessarily to get you off of opioids altogether. 

Kirk: Right, right. What I like about the cannabis component here is how cannabis is helping him. I got to tell you, though, the doses that he's talking about taking in cannabis are incredibly high at some point in the conversation, actually ask them to qualify. And actually, did I hear him correctly? He did say 2500 grams or milligrams of cannabis. 

Trevor: And just to help people put it in context, remind us again Kirk, if I was to go down to the Tweed store and buy an edible, what how many milligrams is supposed to be in one gummy. 

Kirk: 10 milligrams? Yeah, I mean, 30 milligrams. 30 milligrams that you made in those gummies, well, laid you out. 

Trevor: we're talking we're talking hundreds of times higher than that. So, again, I'm not saying that this is not Mark's experience, but I as a pharmacist, I think I agree that we should throw out there. We are not advocating that everybody on opioids immediately go to thousands of milligrams of cannabis to get them off. That's we're just we're highlighting one guy's experience. 

Kirk: This is one guy's experience yet. But again, what it does do, it does it does go back to episode 69 where we learned that cannabis is helping, helping people to come off, come off, benzo, all sorts of medications. I mean, the study the study suggests that if the government if the government was to fund cannabis as medicine, well, you're probably saved dollars as a government with pharma-care products. I mean, let's get away from the stigma and start looking how cannabis can help. That's why I wanted to bring the story. Right. 

Trevor: Yeah. And I'm going to throw in a couple other sort of caveats. And you feel free to jump in here. I'm not really trying to defend methadone, but because most people out there haven't had anything to do with the methadone program. Methadone isn't perfect by any stretch, but the other. So the big problems we'll call problems with opioids in one way, opioids are I know it's going to sound counterintuitive. They're relatively safe. You know, we've have cancer patients and other people who are literally on opioids, large doses for years. And it's also counterintuitive. But if you had a safe supply of heroin, it's not really any more dangerous to be on heroin than it is to be on morphine. I'm going to qualify that. Don't take my license. The heroin is not inherently dangerous. Methadone isn't inherently dangerous. The problems, as I see it with opioids is they tend to be addictive. That's not the end of the world, you know, no one wants to be addicted, but being addicted to something is not necessarily life threatening, but they tend to be addictive and that can lead to some bad behaviors. You know, if I can't get my fix, I might be now tempted to steal, to get the money, to get my fix is one of the things that always comes up. And then the other problem with the opioids is their overdose potential. Like even people who have been using opioids at huge doses for many years are at risk of accidentally taking too much and then they die. And that's obviously a problem. But so those are kind of the biggest problems with opioids. And methadone is good at reducing those.  Is a perfect no, nothing's perfect. Like, for example, I was just rereading some of my methadone notes for the last course I took. And I'm not trying to say this makes methadone bad was just interesting. It is difficult when you're starting people out on methadone and why we often do it in hospital, because during those first two weeks, the chances of somebody overdosing when they're starting on methadone is like six times higher than if they were just using heroin. So, it's tricky to do properly. But if we get and Mark, it's not the only buddy, only person out there who said, you know, methadone isn't for me, but I just want to defend it, defended a little bit. There is a lot of people who are alive and living relatively normal lives on methadone. And they're not, you know, going back to their street drug of choice and their street life and living rough, as you were saying. 

Kirk: Yeah, what I find interesting in society is what we allow, what we allow to happen and what we accept. I know people that don't get their coffee in the morning or miss a couple of days of coffee will get a splitting headache. I know people who are addicted to this thing that what is it? Oh, cigarettes. Cigarettes that we used to promote. We know people are addicted to cigarettes. I know that alcohol, you know our premier is trying to sell alcohol in the corner stores, you know, so we have all these things that society allows us to be addicted to and we even get coffee cups, you know, that that says addictive things on our coffee cups. And we go, oh, well, we talk about opiates and we're allowing people to die in the streets because our governments, you know, the voters, whoever they are, won't recognize the fact that we have a crisis. We have more people dying of opioid overdoses right now than covid. Right. And so why do I mean, I like Mark's idea. You know, I know that heroin is a little weaker to the methadone. I understand that last longer, so blah, blah etc. But if we just allow people to access clean narcotics, you know, clean places and allow them to have their addictions, like we allow them to have their coffee as long as they're functioning, I think harm reduction should go that route. I think we need to just within the declassify all of these drugs and make them acceptable like cannabis. Gee wize, man. In the last three years, cannabis is much more acceptable. People are getting Christmas gifts. So why can't we just open up the narcotics and fentanyl and just open it all up and just clean it up so that we're not selling dirty shit on the street and letting people die in the street? I mean, and this is this is what I think. And now cannabis, as we are a cannabis podcast. So, but I think cannabis is in there again, right. If somebody if somebody was to go get their clean heroin, whether, you know, a few grams of cannabis, who's to say? I mean, the studies, the studies we are reading would suggest that it would be cheaper, less death, and people would be happier. Right. So, I think if we can do anything from this story is I think harm reduction programs are fantastic. But why don't we just get rid of these illegal drugs and regulate them like they are with cannabis and allow people access to clean, clean drugs such that I think that would be so. 

Trevor: And that's a good point. I don't know. I don't know if I'd go as far as, you know, legalize everything. But what one of the takeaways I took from this story is I think we tend to Other people with addictions, people of substance use disorders too much. Mark, Mark is a person. Mark has had experiences. Mark doesn't want to die of an overdose on the street. Mark wants to keep on living on his acreage and play with his dogs. And, you know, he misses his wife who's passed away like I think. Yep. Without sounding too much like a bleeding heart. I think one of the big things is to humanize people. Like you said, no one freaks out at somebody having a coffee addiction. True. But, you know, we don't even really freak out about, you know, the functional alcoholics who are around us doesn't know, you know, the functional alcoholic 

Kirk: and we are in health care man. We are surrounded by functional alcoholics. Yeah. 

Trevor: So, you know, we don't demonize them. You know, it's the it's the Othering, you know, and I don't know. I'm not smart enough to say I know the answer. But, you know, a lot of the opposition I see, too, like you said, be safe injection sites or come get your there was they were talking literally in Vancouver about having almost a vending machine where you can buy strips of hydromorphone. And again, I don't know I don't know which of these is the right way to go, but the whole we should you know, these people's lives are worth living, worth saving. We should definitely be doing something. 

Kirk: Yeah, yeah. Now, now think about think about six years ago. Would you have thought that the government would allow us to buy ten milligram cookies of cannabis? 

Trevor: Oh, hell no. And I think I've said this before. I really thought what? Because Justin Trudeau was in third place before he won his election or whatever it was. Twenty fifteen or something. This was. Something things that he put on the platform to get a little bit of traction, you know, I'm going to legalize pot, sure whatever, Justin. And he freaking won, like, honestly, I bet in his biography later he's going to admit I didn't think I'd win. I just throw that on to get a little bit of press. And suddenly he won and had to do something about it. Like it was it was way out in left field. 

Kirk: I don't think so. I think he I think he basically just carried on with his papa was going to do I mean, Papa Trudeau was trying to legalize pot with Jimmy Carter back in the day. So, I think Justin just did jus, promised his dad that when I become prime minister, I'll legalize pot for you. because we know that we know that Pierre Trudeau was smoke.  We know that know that Mama Trudeau. 

Trevor: Mr. Trudeau, obviously have to come on our podcast and tell Kirk which one of us was right? 

Kirk: Yes. And by the way, I thought my job was to be the bleeding heart. 

Trevor: Yeah, I know. Every so every so often 

Kirk: you're the card-carrying conservative wearing the ties buddy what are you doing 

Trevor: I am, But I still. I'm crossing over. Yeah. It's still the whole as soon as soon as you start seeing, you know them as people that people who with substance use disorders as people, then, you know, it makes more it makes more sense to help them. 

Kirk: Yes, I agree. Again, I think this was I think this is a good blend. It's part of the series in the last few weeks a little bit of opiates. So we're Reefer Medness - The Podcast. I'm Kirk Nyquist I'm The nurse. 

Trevor: I'm Trevor Shewfelt. I'm the pharmacist. 

Trevor: And I guess I want to let people know that our Web page is up. I'm a little behind on it. I'm sorry. My connection up here at the nurse's station isn't strong as it should be. I'll get I'll get up to it. I noticed the other day, you know, Trevor, we're on we're on Spotify. We're on SoundCloud, iTunes, Stitcher. we’re out there people. You can find us whatever you're listening to us on. Give us a review. Tell a friend this is episode seven zero seven. OK, we're getting up there. Yeah. 

Trevor: So, Mark picked some music for Rene to track down. It was a Manitoban band whose name escapes me, but he did pick on. 

Trevor: Yeah.

Rene: All right. So Mark had a request and he decided he wanted to hear something from Manitoba band called Propaganda. He wanted to hear something from how to clean everything. And the song that I've chosen is I Want You to Want Me different kind of version of it. But anyway, thank you. 

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