For nearly her entire adult life, thirty-year-old Megan Kimberling identified as straightedge. The Californian didn’t smoke, take drugs, or drink alcohol, and she was hesitant to even use prescription medicines. Kimberling felt that being straightedge gave her more control of her life. But then, in 2014, an experience with a stalker left her mentally and emotionally drained. She was soon diagnosed with posttraumatic stress disorder (PTSD) and a doctor prescribed her an antianxiety medication. Desperate to feel better, she started taking it, although she felt this could affect her straightedge lifestyle. While her mental health and wellness were important to her, so was her sobriety. The antianxiety medication worked to alleviate her PTSD symptoms—paranoia, anxiety, mood swings, and heightened emotional responses—but she never grew comfortable with the idea of taking daily medication. Eventually, she began to explore alternative treatments, soon discovering the much-praised cannabidiol (CBD), the major non-intoxicating component in cannabis, which has been used to treat anxiety. “I could either go back on anti-anxiety medication, or I could try CBD,” she explains, saying that she made her choice while steadfastly maintaining that, at least with CBD, she could still identify as sober.
Stories evaluating the health and wellness benefits of cannabis have dominated the news cycle in the lead up to legalization (and will likely do so after October 17 as well). Recreational cannabis as we once knew it—often disparagingly associated with stoners or hippies—is undergoing a significant makeover. Licensed producers and affiliate companies have become heavily invested in tailoring their experiences and products to women or affluent, hip millennials with disposable income. A similar rebrand of cannabis happened in Kimberling’s current home, California, and it’s entirely conceivable that there will soon be a time when cannabis is just another part of the booming wellness market. Already, Canada is poised to be the world’s largest exporter of medical cannabis and, according to The Economist, early estimates on what Canadians will spend in the cannabis marketspace this year is anywhere from $4.2 to $6.2 billion. The global wellness industry is said to be worth over $3.72 trillion (US) as of 2015, representing more than 5 percent of global economic output, according to the Global Wellness Institute. “The alternative and complementary medicine market is expected to generate a revenue of (US) 196.87 billion by 2025,” according to a 2017 report by Grand View Research. It’s no wonder that companies are clamouring to redefine marijuana.
That rebranding, however, can sometimes backfire—particularly if it plays into old stigmas about sobriety and drug use. In early September in Toronto, for instance, California-based weed company Dosist, which has trademarked the phrase “delivering health and happiness,” threw a ten-day wellness pop-up recently with the tagline “plants over pills.” But such ableist marketing tactics run the risk of demonizing prescription-medicine use. That hasn’t stopped cannabis companies from deliberating spreading a sense that the drug is somehow better than. Google the word cannabis coupled with just about any disease, and you’ll find a cannabis company that has mixed beautiful design aesthetics with some marketing copy on how the plant can cure what ails you. CBD is at the centre of this wellness push, gaining huge mainstream popularity. The extract comes from the cannabis plant, which contains more than 60 active cannabinoid compounds, but CBD seemingly doesn’t have any intoxicating properties. Research has shown that CBD is an anti-inflammatory, and when used with other medications, it can help reduce seizures in cases of epilepsy, it can help with anxiety, and it can also help treat chronic pain. Reports have also suggested CBD could help some drug users prevent relapse.
Analytics firm New Frontier Data has predicted that CBD sales will nearly quadruple over the next four years, from $535 million (US) in 2018 to over $1.9 billion (US) by 2022. Right now, the marketplace is flush with a variety of CBD products, including capsules, sprays, topicals, concentrates, oils, edibles, and tinctures, and the products can range widely in price from under $10 to over $100, largely depending on dosage (these items are technically illegal to purchase until October 17, unless you are a registered medical patient who has an authorization from a licensed health care practitioner). As CBD’s popularity rises, however, there are deeper questions at play than its estimated market value. Beyond the question of whether it works for them, some CBD users, like Kimberling, are facing bigger questions, including, but not limited to: Am I still sober? Or, put another way: Does using CBD count as a strike against recovery or a substance-free lifestyle? This can lead into particularly tricky terrain as many people turn to cannabis products as a solution for all manner of ailments—from mental health to addiction. As we reckon with cannabis legalization as a country, perhaps what we really should be asking ourselves is how we’re going to redefine the traditional meaning of sobriety.
Zach Walsh is an associate professor of psychology at the University of British Columbia. He believes that sobriety is a complex concept. As we discuss what it means, he stops me to ask: “Are you sober when you’re asleep? Are you sober when you’re tired? There’s all kinds of shifts in consciousness, and some of the shifts in consciousness that happen without drugs can be similar to the ones that do happen with drugs.” With so much focus on terms like clean and sober, the nuances of these questions are often overlooked. But they’re also a critical part of reexamining the stigma against drug users—and, depending on the person, what it means to live as the healthiest, happiest version of yourself.
“That philosophy of having to be sober from all substances is a very old and often outdated and puritanical way of looking at substance use,” says Zoë Dodd, a Toronto-based activist and harm-reduction worker. While some argue that anything resembling a drug should never be part of a recovery journey, others believe that something like CBD doesn’t impact sobriety. Dodd belongs to the latter camp, and she emphasized to me that somebody who is dependent on one drug is not necessarily dependent on all drugs. From Dodd’s experience working on the front lines, people who are working on their recovery have always been the best to determine and define what their recovery should look like. If that recovery includes CBD, then she thinks it can work and doesn’t make them any less sober.
This way of thinking, however, is often at odds with traditional recovery models, such as twelve-step programs like Narcotics Anonymous and Alcoholics Anonymous. Even though studies have shown that people cannot become physically dependent on CBD, some people in recovery spaces have reported being ostracized from their communities for choosing to use a cannabis product like CBD. The twelve-step model, originally created in 1938 by Bill Wilson, started with the Alcoholics Anonymous program. The program had developed through Wilson’s own lived experiences, which meant that much of the content of the original twelve-step program was rooted in Christianity. While the twelve-step model is one of the longest-standing methods of addiction treatment, parts of it have been updated and reinterpreted since its original release nearly eighty years ago. One thing that has stayed constant, though, is that it asks its participants to follow an abstinence-based model that involves includes admitting the need for help, relinquishing control to a higher power, accepting help, examining your flaws and past transgressions, and seeking to make amends for the mistakes of your past.
In recent years, though, harm-reduction strategies have become more present in the public consciousness. Such strategies introduce a set of practical tactics, ideas, and programs to reduce the negative consequences associated with drug use. Harm-reduction workers use a spectrum of strategies, including safer use, managed use, abstinence, and also helping meet users “where they’re at,” rather than shaming and helping them get to where they need to be. Toronto-based Zee, requested his full name be withheld to protect his privacy, has tried a twelve-step program and harm-reduction strategies to address his lifelong battle with crystal meth and MDMA use. He says that he tried Narcotics Anonymous but immediately felt uncomfortable. As an alternative to cannabis, he asked his psychiatrist if he could try CBD,, which, he says, he soon learned helped to “keep him sane.” After his psychiatrist gave the green light, he used CBD and attended the twelve-step program, but only for a few sessions. The recovery group never felt like a safe space; he felt like he couldn’t open up about using CBD, for fear of judgement.
“There’s a huge stigma,” for people who are interested in using things like CBD in their recovery, says Caroline MacCallum, a doctor and the medical director of Greenleaf Medical Clinic in Langley, British Columbia, which helps assesses patients across Canada for their eligibility under Health Canada’s Access to Cannabis for Medical Purposes Regulations. She explains that some research has shown CBD is not addictive and notes that many addictions play on the brain’s reward system. CBD doesn’t do that. Since that’s the case, MacCallum asks, could it be as benign as an antidepressant? “Some people would say sobriety is zip, zero, nothing. But that’s a tough act to follow,” says MacCallum, adding that a person’s recovery journey is between them and their physician to decide. “I think it’s really important to treat the whole person, and if somebody’s struggling.…I would want to set [my patients] up to win.”
As someone who has struggled with their own recovery issues, drug and alcohol related, I know first hand that recovery is a personal journey. After being diagnosed with Complex Post-Traumatic Stress Disorder (C-PTSD ), stemming from a life long cycle of mental and emotional abuse, I would go through periods of dissociation, bouts of anxiety, and times where I would have difficulty sleeping. A pal suggested I try a CBD-based edible to find calm—as it had worked for them. Like Kimberling, I just wanted to feel better. When I discovered CBD did indeed work for me, I researched capsules for everyday use. I’ve been taking them ever since, and they’ve played a significant role in my trauma recovery. But I, too, have often found myself wondering if I am still able to identify as sober when I use CBD in my day-to-day life, even though I don’t use hard drugs anymore. Walsh believes this is where the trouble lies—we’re giving the moral power to define sobriety to the wrong people. “So are you breaching your abstinence by using CBD?” he asks. “That’s entirely up to the people who define abstinence.” We need to start moving to a place where people can own their recovery and define sobriety for themselves.
One former CBD user, Sam, who also lives in California and asked that we use his first name only to protect his privacy, tells me that he wishes recovery spaces would move to a model where everything is tailored to the individual and becomes more context informed. “I don’t think sobriety means the same thing to every single person,” he says, “It’s a very personal decision, and I think when we get into these very puritanical ideas that only certain people are sober, that starts to suggest that only certain people can access recovery and access these spaces, which I think is actually really dangerous.” His comments bring up a good point: people of all ages, races, genders, and cultures are affected by substance-use disorder, and some people need to access specific medications for the rest of their lives to stay alive. The same goes for people who may use cannabis products like CBD to treat anxiety or trauma-related issues like PTSD. Does this mean we shouldn’t support them in their sustained, long-term recovery? Or, more pointedly: Why is CBD, and even cannabis, often framed as a hip wellness product for certain members of society—namely those who can afford to help elevate it as an economic commodity?
The rise of CBD as wellness alternative in Canada it set to force a discussion around sobriety. In the coming months, we will, as a country, have to reexamine and redefine just how exactly we view sobriety. I’m hopeful these conversations will help widen the spectrum of sobriety and break down barriers of who gets to define it—and why. If we approach these conversations with openness, and without stigma, it’s possible we can make true change for good. As CBD gains popularity, we must give people the capacity to examine, evaluate, and possibly amended their own health, wellness, or recovery journey in a way that feels right for them. Yes, we need better medical understanding of cannabis and its related products, and yes, we also need training in the harm-reduction model. But we also need compassion, and the courage to rethink old definitions.