Could Medicinal Cannabis Provide the Solution to South America’s ‘Pasta Base’ Problem?

On April 3 2014, Uruguay’s undersecretary for public health used a UN-hosted conference on women, drug policy, and incarceration on the Americas to propose a novel method of tackling drug addiction. ‘Jail is not a very suitable place for someone to safely overcome drug addiction’, said Leonel Briozzo, before suggesting that marijuana (legalised in Uruguay in 2013) ought to form the basis of future drug rehabilitation schemes there.

Mr Briozzo’s suggestion is a sign of the growing urgency with which the Uruguayan government regards its domestic drug addiction problem. Most of Uruguay’s problematic drug users are dependent on ‘pasta base’; a cheap, highly addictive by-product of the cocaine manufacturing process popularised in South America around the turn of the century. Known by a variety of local names (‘paco’ in Uruguay and Argentina, ‘kete’ in Peru, ‘basuco’ in Colombia and ‘merla’ in Brazil), the drug delivers an intense 10-15 minute high and is typically purchased for less than $1 per hit. Users report the need to consume the drug again immediately after its effects fade, making ‘pasta base’ not just harmful but particularly addictive.

Cannabis is being framed as offering a number of benefits to the recovering cocaine addict. Firstly, those who support its use observe that prolonged cocaine use compromises the brain’s capacity to uptake serotonin (the brain’s ‘reward chemical’ associated with feelings of wellbeing), whereas cannabis is known to increase the cerebral availability of serotonin. Secondly, cannabidiol (one of the active chemicals of the cannabis plant) has anxiety-reducing qualities, which could help combat the intense stress associated with hard drug cravings. Thirdly, it is proposed that the hunger-inducing effect of cannabis would counteract the drastic weight loss concomitant with long-term cocaine addiction.

The few studies which have been undertaken on cannabis as a drug rehabilitation tool support the argument that its use may be beneficial. One survey carried out in Jamaica concluded that for its participants, ‘cannabis cigarettes constitute[d] the cheapest, most effective and readily available therapy for discontinuing crack consumption.’ A separate study conducted in Brazil during the 1990s found that for 68% of its participants, ‘the use of cannabis had reduced their craving symptoms, and produced subjective and concrete changes in their behaviour, helping them to overcome crack addiction.’ A more recent study of heroin addicts in the US found that ‘moderate/intermittent cannabis users had greater retention rates [on drug rehabilitation programmes] compared to abstainers [from cannabis].’ However, the small scale of these studies compromises their reliability.

Despite this, Uruguay is not the first South American country to consider using cannabis as a potential cure to ‘pasta base’ addiction. In February 2014, the mayor of Bogota announced plans to introduce ‘controlled consumption centres’, where addicts could be administered carefully measured amounts of cannabis by healthcare professionals. Advocates of the scheme emphasised that the intention was not to replace one addiction with another, but to use cannabis as a ‘withdrawal attenuator’ until the point is reached when no cannabis is required by the patient at all.

Overcoming drug addiction through a substance that remains banned elsewhere will remain a controversial proposition. More comprehensive, detailed studies must be undertaken before cannabis can safely become a stock feature of drug rehabilitation programmes. However, with ‘pasta base’ use in South America showing no signs of relenting, governments there will seek increasingly novel ways of dealing with the problem.