Trying to find meaningful statistics within the substance-abuse treatment business is a fool’s errand. The private high-end facilities that pocket the bulk of the industry’s $35 billion in annual profits have no incentive to share statistics, while their resource-starved public counterparts have neither time nor money for such studies.
For social worker Joe Schrank, the bottom line is that rehabs in their current form simply don’t work.
“The success rate of trying to coerce people into recovery is about 5 percent,” he says. “There is no other area of health care that will rest on a 5-percent success rate. We don’t do that with cancer. We don’t do that with diabetes. We don’t do that with anything else.”
With 20 years of experience and a focus on chemical dependency, Schrank believes his duty is first and foremost to implement harm reduction — a policy that leaves some highly controversial options on the table. This means patients at Remedy Recovery, Schrank’s newly opened facility in China Basin, are welcome to use cannabis as part of their detox and subsequent treatment.
At Remedy Recovery, cannabis is first used during the detox process, because it doesn’t interact negatively with common medications like buprenorphine and naltrexone.
“People who are addicted or physically dependent on any substance fear detox,” Schrank explains. “It’s one of the things that trips them up in starting a process of change.”
By incorporating cannabis, Remedy Recovery provides a safe way for patients enduring a detox to potentially sleep better, alleviate pain, and reduce nausea. Once the detox stage is complete, doctors work with patients to refine how cannabis will be used as part of a recovery plan. Throughout the process, cannabis is simply presented as one available medical option — nothing more, nothing less.
Naturally, members of the mainstream rehabilitation community have taken issue with Schrank’s approach. After opening a similar clinic last year in Los Angeles called High Sobriety, he moved north to the Bay Area and away from what he calls “the Bible Belt of recovery.” With more than two decades of sobriety, Schrank is emphatic that his new operation is not the enemy of traditional sobriety programs like Alcoholics Anonymous.
“We don’t want to disparage A.A.” he says. “I like A.A. A.A. was good for me. Lots of people find success in A.A. or with 12-step participation — but not enough that it should be the exclusive recommendation for people. We don’t get to mandate how people recover. We have to help them figure out how they want to recover.”
While Shrank did not personally use cannabis in his own recovery, he believes any argument against its merits as a viable medical option for those seeking sobriety are invalidated by the company cannabis is regularly cast alongside.
“The opiate public health crisis is taking 120 people a day,” he says. “That’s 64,000 people a year. It’s also important to remember that as dangerous as opiates are, twice that number of people drink themselves to death annually. That’s just become normalized. We know from research that medication-assisted treatment for substance use disorders has the best outcome. When people are given options for medication and they implement that and they stick to the plan, they have better success than people who are given coercive behavioral management only.”
By treating cannabis not as an illicit substance, but instead as medicine, Schrank believes he can help more people than other, more rigidly regimented facilities. Noting that there are 25 percent fewer overdose deaths in states where cannabis is legally available and accessible, he again points to the vastly different standards we employ where it concerns other areas of health.
“If you have hypertension, and you eat better and you work out more, you can improve that condition,” he suggests, “but you’re probably still going to be on medication to control that particular health condition. We believe it’s the same with addiction. We love when people work out and engage with the community and go to therapy and have a peer-support group. We also don’t think that they should be publicly flogged because they’re using medication to help their situation.”
Since opening their doors in mid-June, Schrank has yet to hear any outrage from San Francisco. So far, the calls have been decidedly positive: Many are prospective patients looking to confirm that at Remedy Recovery they can, in fact, smoke weed.
“I tell them that it’s not bullshit,” Schrank says. “You can smoke weed here. Pope John XXIII once issued a papal encyclical that said evangelicalism is a sin. Other people have their own relationship with God, and I think it’s the same thing with recovery. Mandating how somebody recovers is wrong.”
Zack Ruskin covers news, culture, and music for SF Weekly.