Despite all the money, time, and resources poured into combating substance abuse, the humble marijuana plant remains a chemical and clinical mystery. Efforts to deconstruct its physiological effects have met with only mixed success; attempts to prove the addictive nature of pot (mostly government-sponsored) have been mostly futile. And because of its illegality, there is a paucity of good data about marijuana use by humans.
The Village, a sprawling drug-treatment center in Miami, is one of only three sites in the United States that is collecting this kind of data for the federal Marijuana Treatment Project. In mid-July, the Village began asking for volunteers who believe they have a problem with pot smoking and want to quit. And even though sparking up is categorically criminal, the Village emphasizes that this program is "nonjudgmental." In fact, the more often you commit the crime of smoking pot, the more qualified you become for this study, which will test the effectiveness of "brief treatment" for long-time, heavy smokers who want to quit.
"We're not the cops here," says Dr. Michael Miller, vice president for clinical services at the Village. "What we're doing is helping people who approach us who feel that they might want to make some change in their use pattern."
The Village, along with the University of Washington in Seattle and the University of Connecticut, won a grant for federal bucks to do this study. In its initial request for grant applications, the federal Center for Substance Abuse Treatment (CSAT) cited studies about the prevalence of marijuana (some five million people report weekly use) and a recent rise in use, after years of decline, among high school students. Once the CSAT, a subsidiary of the Department of Health and Human Services, settled on the three sites, it doled out $1.4 million in grant money for the first year of this three-year study. The Village's cut is $350,000 per year.
The clinical-trial phase of the project has just begun. Miller and David Duresky, coordinator of the program, say that initial responses to their small ads in New Times and the Miami Herald's "Weekend" section have been encouraging: some 80 calls and 50 over-the-phone assessments; 13 people have already begun the one-on-one, outpatient counseling sessions. By the end of the study, 150 Miamians of a cross-section of ethnicities and economic levels will have participated.
But how important is a study of the best ways to help people quit smoking marijuana? Pot's reputation as the most benign of illegal drugs still permeates American culture. Everyone knows that habitual smoking will lead to a deepening dent in the upholstery of your couch, but the idea of someone being hooked on hemp is enough to elicit a chortle from your average urbane citizen.
"I tell people now that I'm working with marijuana dependents, and professionals in our field sometimes raise an eyebrow like, 'Oh, really?'" Duresky says. "But that's not the response we're getting from the people coming in. The people coming in are desperate for help. I have several in the project who quit crack cocaine but cannot stop smoking pot. People who beat alcohol -- we have two people who were referred by their sponsors in AA because they were sober but still smoking pot."
The Village, a nonprofit agency founded in 1973, is a serious place. Some 500 addicts every year pass through the doors of its several facilities, including the big pink compound at NE 31st Street on Biscayne Boulevard. The vast majority, perhaps 75 percent, are primarily crack and cocaine users; another 10 percent or so are alcoholics, and the rest are a mixed bag that includes those dependent on pills and heroin. Many in the Village's inpatient facility are there courtesy of the Florida Department of Corrections, serving court-mandated stints of up to six months. In this kind of setting, anyone who says his biggest problem is pot doesn't rank too high in the pecking order.
"To many people, it would be embarrassing to admit that they have a marijuana problem," says Miller. "They sit in a group [of recovering drug users] feeling like they're outsiders. I think that's one of the reasons it's been difficult for them to come in for traditional group treatment."
Because of a societal perception of pot's relative harmlessness, and because of their fear of being met with disdain by both addicts and treatment professionals, chronic pot smokers who want to quit may not think that they belong in treatment. The Marijuana Treatment Project provides a place where kicking pot is taken seriously.
The Village is still taking volunteers for the free, outpatient program. Qualified 'heads are randomly assigned to one of three treatment tracks: two one-on-one counseling sessions separated by a month, nine sessions over three months, or no sessions (the control group). Later this year the control group will also be allowed to try one of the two "brief treatment" counseling programs, and they will also be subjected to a battery of tests to determine the long-term cognitive consequences -- if any -- of being continually stoned.
Two people currently staying at the Village because of marijuana use are there only because they tested positive for pot while on probation for other crimes. Both John (a pseudonym) and Rafael unequivocally categorize their previous pot use as an addiction, but neither thought he needed help, and both say they would have scoffed at the Marijuana Treatment Project.
"I wouldn't have wanted anything to do with that," says John. "I never felt like [I was addicted]. I didn't have a worry in the world. All I wanted was to get high and space out. I probably would have looked at it and just laughed."
"I would have gone, and I would have gone all fucked up," adds Rafael with a chuckle. "I would have gone high, just to sit there and listen to the bullshit they say. Because we didn't think we were addicts, we just wanted to smoke weed.
