Jun 09 2009

Cannabis for psychiatric conditions

Posted by J. Craig Canada in autism, law, psychiatric, ptsd

Marijuana continues to be in the news.  Charles Lynch is scheduled to be sentenced on the 11th.  Last week the Croatia Supreme court ruled to allow the use of marijuana to treat post-traumatic stress disorder.

Among several states considering exemptions for medical marijuana is New Jersey.  What’s happening there is as good an example as any of what’s wrong with the movement.  Following is an article describing the latest permutation of New Jersey’s legislation and two responses I posted in their comments.

New Jersey wrestles with medical marijuana legislation

by Chris Megarian and Susan K. Livio/The Star-Ledger
Sunday June 07, 2009, 8:01 AM

The State Police and the New Jersey Army National Guard took to the South Jersey skies in a Black Hawk helicopter last week to train officers how to locate and bust marijuana growers.

A day later, lawmakers in Trenton approved a bill they hope, if enacted, would allow seriously ill residents to legally use marijuana for medical purposes.

The two events highlight a thorny question for New Jersey: How do you make it legal for some residents to smoke pot, while it’s against the law for everyone else? Lawmakers are looking at 13 states that allow medical marijuana to make sure the legislation they pass has enough restrictions so only those who really need it can get it.

One mantra they seem to have adopted: Don’t be like California.

California has been widely criticized for adopting legislation that is too lax. There, retail outlets have been selling to an estimated 200,000 registered users and have been the repeated target of federal drug enforcement raids.

New Jersey lawmakers "were very concerned about opening the floodgates, being irresponsible and allowing people who should not use this abuse this," Assemblyman Reed Gusciora (D-Mercer), one of the sponsors of the bill, (A804), said during Thursday’s Assembly Health Committee hearing. They "certainly did not want to send out the message we are encouraging illegal drug use," he said.

These concerns drove dramatic revisions:

Only people suffering from specific diseases — AIDS, cancer, multiple sclerosis, amyotrophic lateral sclerosis and seizure disorders — would be allowed to use the illegal drug. The original bill defined eligible users by their symptoms.

Only the registered patient may retrieve the drug from the grower, or, if the patient is unable to do so, a courier service could be arranged to deliver the pot to the patient’s home. The original bill allowed a designated caregiver to retrieve the illegal drug on the patient’s behalf.

No one would be allowed to grow their own pot. The original bill would have permitted patients to grow as many as six plants — and possess up to one additional ounce of usable marijuana. Under the new version, patients could only get the drug — no more than one ounce a month — through a licensed nonprofit growing facility.

"New Jersey appears to have learned some lessons from California," said Dan Abrahamson, director of legal affairs for the Drug Policy Alliance in California.

When the California law passed 13 years ago, "it gave very little guidance to anyone — law enforcement, counties — how to make this law work best for public safety and health," Abrahamson said. "There was some chaos that ensued."

Overnight, dispensaries operating whenever and however they wanted opened in communities that didn’t want them, he said. Critics contend only a small percentage of medicinal users there have serious illnesses.

With cities and counties allowed to enact different laws, pot is sold legally from hundreds of shops in Los Angeles, and dispensaries have doctors on-site to assess patients’ ills. Oakland allows people with a medical card to acquire as many as 72 plants, "for any illness for which marijuana provides relief," according to recent published reports.


New Jersey, on the other hand, would have the most restrictive medical marijuana law in the country, lawmakers say.

Activists worry about that.

Jim Miller, president of the New Jersey chapter of the Coalition for Medical Marijuana, said restricting which conditions can be treated with marijuana and limiting how much patients can get is like saying "We want to limit how many people we can help, and we want to limit how much we can help them."

Miller, however, added: "It’s better to ensure that a bill will be passed and then work to make it better."

The changes could make the issue less politically radioactive.

On Friday, Assembly Speaker Joe Roberts (D-Camden), who decides which bills get posted for a vote, offered qualified support.

"The speaker has said he is open to supporting a bill that contains safeguards to ensure marijuana would be available only to those with truly legitimate medical needs and only under strict doctor supervision," said Derek Roseman, a spokesman for Assembly Democrats. "The amended bill moves closer to meeting those requirements. But other major issues, such as requiring doctor and patient education and finalizing law enforcement matters around distribution and possession, still need to be addressed."

Roberts would not post the bill for a full Assembly vote until his concerns are met, Roseman said.

Attorney General Anne Milgram also said the bill is better. "It tightens up the provisions … that could have become loopholes by people seeking to divert marijuana for illicit purposes," said spokesman Peter Aseltine.

New Jersey is among more than a dozen states wrestling with medical marijuana legislation, said Karmen Hanson, a policy analyst for the National Conference of State Legislatures. In recent weeks, bills passed the state senates in Delaware and Illinois.

Hanson said the issue is in constant flux, with some states "starting from scratch, some tinkering" and others scaling back laws. Abrahamson, of the Drug Policy Alliance in California, said this ongoing review is helpful: "It needs to be flexible and change to fit the communities’ needs."

But as the training by helicopter at Fort Dix last week indicates, law enforcement is not taking a softer stance on marijuana.

Using GPS and compasses for navigation, the spotters in the sky relayed coordinates to the teams on the ground, who trekked through the woods to find the marijuana plot.

The annual haul in homegrown marijuana varies, but in good years more than 3,000 plants can be discovered and destroyed, including marijuana cultivated indoors, said Detective Sgt. William Peacock, commander of the State Police Marijuana Eradication Squad.

"That’s nothing compared to California," he said, "but for our built-up state, that’s a bunch of marijuana."

Staff writer Rudy Larini contributed to this report.

New Jersey wrestles with medical marijuana legislation – NJ.com

Here’s my response, which you can also find in the comments attached to the article.

Posted by CApatient on 06/08/09 at 3:27AM

I’ve been a patient in California since 1995. My first thought is that I would be against this bill because it is a sell-out. From what I’ve read it’s not going to help patients.

California is the only state that allows the use of cannabis for psychiatric conditions and that’s something I want to address. But before I do I want to give you some context. I was a member of The San Francisco Cannabis Buyers club in 1995, before passage of The Compassionate Use Act of 1996. This was a 5 story building in the middle of town where several hundred people congregated on any given day. I was there myself pretty much daily. I knew and observed many patients using it for many conditions over several years. I was one of the people responsible for “any other condition for which marijuana may provide relief”.

It frustrates me to distraction to see our so called leaders and spokesmen such as Nadleman and Abrahamson of the Drug Policy Alliance make comments that cause one to wonder how much the pharmalords paid them.

Some facts. (For supporting documentation please see my webpage: www.palmspringsbum.org/medical.html)

Pharmaceuticals as prescribed are the fourth leading cause of death in this country. This was declared by the Journal of The American Medical Association in 1998.

“Going Postal” entered the vernacular at the same time Prozac entered the pharmacopea.

10% of Americans are on some sort of SSRI. 5% of them will experience mania and/or suicidal/homicidal ideation and/or sleepwalking as a side-effect. That is 1.5 million maniacs waiting to explode.

Recent studies have concluded these pharmaceuticals work no better than a placebo.

Cannabis is the best medicine for a wide range of psychiatric conditions including depression, bi-polar condition, post traumatic stress disorder (it stops the nightmares, among other things), attention deficit disorder…I could go on and on and on.

I am a victim of the SSRIs. I took Prozac (receiving it free) as a participant in a study about 1985, and dropped out. I had a whole list of horrible side-effects, including electric shocks through my nerves, throughout my entire body. I was hypersensitive to light – I could not be out in the sun more than a couple of minutes because I experienced pain similar to peripheral neuropathy in my exposed skin. The pressure in my eyes was so great they would not change focus, so I could not read. But the most frightening thing of all is what they call sleep-walking – which in my experience was believing you were having a momentary fantasy, a passing thought, when you were actually doing it. When you combine this ‘side-effect’ with homocidal/suicidal ideation, which these drugs produce, you get Columbine.

“7 of the last 12 students responsible for school shootings were either on anti-depressants or withdrawing from them.”

In 2001, the ten American drug companies in the Fortune 500 list ranked far above all other American industries in average net return, whether as a percentage of sales (18.5 percent), of assets (16.3 percent), or of shareholders’ equity (33.2 percent). These are astonishing margins. For comparison, the median net return for all other industries in the Fortune 500 was only 3.3 percent of sales. The most startling fact about 2002 is that the combined profits for the ten drug companies in the Fortune 500 ($35.9 billion) were more than the profits for all the other 490 businesses put together (33.7 billion).

Let me emphasize this again. The combined profits of the ten largest US drug companies reaches 35.9 billion – a sum higher than the combined profits for all other 490 corporations on the Fortune 500 List!

These drugs are addictive, and what these pushers have done is shorten the half-life from 30 days for Prozac, to 1 day for Paxil. The drug companies call it “discontiunation” syndrome.

So, folks, can we can the crap about the dangers of cannabis and get real

Posted by CApatient on 06/08/09 at 3:15PM

A few more points:

Seriously ill patients require more than an ounce per month. I use an ounce about every 20 days. I have known MS patients that required 4 ounces, or more, per month. So by crafting legislation that limits exemptions to a short list of “serious” conditions and then limiting the amount these people can receive per month to an ounce, and prohibiting them from growing their own, you are insuring that nobody benefits.

Well, the growers will benefit, and profit.

And the lawyers.

And the black market.

And the medical marijuana and anti-prohibition organizations.

But the patients, and particularly those who are the most ill and in the greatest need, will be screwed.

6 plants and an ounce is not enough either. To start with, you’re doing good to get 2 ounces from an indoor plant. It takes about 2 months minimum to get a plant to ‘bloom stage’, and 8 weeks for the bloom cycle. And the buds needs to dry and cure for at least another month.

What is the patient supposed to do if their plant produces more than an ounce?

6 plants and an ounce means the patient cannot bloom more than one plant at a time, which means they cannot grow outdoors. It does get cold and snow in New Jersey during the winter, doesn’t it? So medical marijuana will be only for the rich and instead of bringing relief to patients, it will be used to steal whatever they have left.

Even experienced growers have crop failures. Even if you pull all the males, the females can still go hermaphrodite and pollinate an entire grow – which ruins all the plants for medicinal purposes. And then there’s insect infestations and plant diseases.

And what if all six of your plants turn out male?

And we all know the government can never do anything right. A prime example is Canada’s attempt to grow. They called it the Flim-Flam mine. And they gave the contract to a company that had never grown marijuana before.

Marijuana is NOT easy to grow. It requires a lot of time, knowledge, experience, and a green thumb.

In Canada they actually tried to grow marijuana in an abandoned MINE, with stale air full of heavy metals. It was a complete disaster. Nobody would buy the stuff. Patients in Canada are still dependent on the black market because of the demands of law enforcement, along with every state in this country that has passed a medical marijuana exemption, except California.

Law enforcement hates California’s Compassionate Use Act of 1996 because it has stood the test of time, and because it has survived every legal challenge. Marijuana busts are easy pickins, not like a meth lab that can be set up and taken down in a matter of hours.

Dispensaries are sprouting in California like weeds because the pills don’t work, and because the public demands relief. It is a wholesale repudiation of the pharmaceutical industry, the medical establishment, the FDA and the DEA.

This is, at root, about whether we own the government or whether the government owns us. It is about who determines what we put in our bodies.

I believe I am the one that should determine what goes in my body, and I believe our nation was founded on that principle. And I believe it is treason to the Declaration of Independence, The Bill of Rights, and the Constitution to use the full force of government and the police to force me at gunpoint to take dangerous addictive pharmaceuticals that the human body has never encountered in all of evolution rather than a plant that has been used medically by the human race for thousands of years.

On the topic of medical marijuana for psychiatric conditions, I came across a powerful Letter to The Editor published in the Los Angeles Times 7 Jun 2009.

Decriminalize marijuana

The war on drugs has caused too much collateral damage: Even the ill face stigmatization by using an alternative to harsh pharmaceuticals.

By Marie Myung-Ok Lee | June 7, 2009

I’m on the phone getting a recipe for hashish butter. Not from my dealer but from Lester Grinspoon, a physician and emeritus professor of psychiatry at Harvard Medical School.

I came to marijuana while searching for a safer alternative to the powerful antipsychotic drugs, such as Risperdal, that are typically prescribed for children with autism and other behavioral disorders.

There have been few studies on the long-term effects of these drugs on a growing child’s brain, and in particular autism, a disorder whose biochemical mechanisms are poorly understood. But there is much documentation of the risks, which has caused the Food and Drug Administration to require the highest-level “black box” warnings of possible side effects that include permanent Parkinson’s disease-like tremors, metabolic disorders and death. A panel of federal drug experts in 2008 urged physicians to use caution when prescribing these medicines to children, as they are the most susceptible to side effects.

We live in Rhode Island, one of more than a dozen states — including California — with medical marijuana laws. That makes giving our son cannabis for a medical condition legal. But we are limited in its use. We cannot take it on a plane on a visit to his grandmother in Minnesota.

Even though we are not breaking the law, I still wonder what my neighbors would think if they knew we were giving our son what most people only think of as an illegal “recreational” drug. Marijuana has always carried that illicit tang of danger — “reefer madness” and foreign drug cartels. But in 1988, Drug Enforcement Administration Judge Francis L. Young, after two years of hearings, deemed marijuana “one of the safest therapeutically active substances known to man. … In strict medical terms, marijuana is far safer than many foods we commonly consume.”

Beyond helping people like my son, the reasons to legalize cannabis on a federal level are manifold. Anecdotal evidence from patients already attests to its pain-relieving properties, and the benefits in quelling chemotherapy-induced nausea and wasting syndrome are well documented. Future studies may find even more important medical uses.

Including marijuana in the war on drugs has only proved foolhardy — and costly. By keeping marijuana illegal and prices high, illicit drug money from the U.S. sustains the murderous narco-traffickers in Mexico and elsewhere. In fact, after seeing how proximity to marijuana growers affected the small Mexican village of Alamos, where my husband spent much of his childhood, I was adamant about never entering into that economy of violence.

Because Rhode Island has no California-like medical marijuana dispensaries, the patient must apply for a medical marijuana license and then find a way to procure the cannabis. We floundered on our own until we finally connected with a local horticultural school graduate who agreed to provide our son’s organic marijuana. But given the seedy underbelly of the illegal drug trade, combined with the current economic collapse, even our grower has to be mindful of not exposing himself to robbery.

Legalizing marijuana not only removes the incentives for this underground economy, it would allow for regulation and taxation of the product, just like cigarettes and alcohol. The potential for abuse is there, as it is with any substance, but toxicology studies have not even been able to establish a lethal dose at typical-use levels. In fact, in 1988, Young of the DEA further stated that “it is estimated that … a smoker would theoretically have to consume … nearly 1,500 pounds of marijuana within about 15 minutes to induce a lethal response.” Nor is it physically addicting, unlike your daily Starbucks, as anyone who has suffered from a caffeine withdrawal headache can attest.

Although it has been demonized for years, marijuana hasn’t been illegal in the U.S. for that long. The cannabis plant became criminalized on a federal level in 1937, largely because of the efforts of one man, Harry Anslinger, commissioner of the then newly formed Bureau of Narcotics, largely through sensationalistic stories of murder and mayhem conducted supposedly under the influence of cannabis. Cannabis was still listed in the U.S. Pharmacopeia, or USP, until 1941 as a household drug useful for treating headaches, depression, menstrual cramps and toothaches, and drug companies worked to develop a stronger strain.

In 1938, a skeptical Fiorello LaGuardia, mayor of New York, appointed a committee to conduct the first in-depth study of marijuana’s actual effects. It found that, despite the government’s fervent claims, marijuana did not cause insanity or act as a gateway drug. It also found no scientific reason for its criminalization. In 1972, President Nixon’s Shafer Commission similarly concluded that cannabis should be re-legalized.

Both recommendations were ignored, and since then billions of dollars have been spent enforcing the ban. Public policy analyst Jon Gettman, author of the 2007 report, “Lost Revenues and Other Costs of Marijuana Laws,” estimated marijuana-related annual costs of law enforcement at $10.7 billion.

I was heartened to hear California Gov. Arnold Schwarzenegger’s recent call for the U.S. to at least look at other nations’ experiences with legalizing marijuana — and to open a debate. And given the real security threats the nation faces, U.S. Atty. Gen. Eric H. Holder Jr.’s announcement that the federal government would no longer conduct raids on legal medicinal marijuana dispensaries was a prudent move. Decriminalizing marijuana is the logical next step.

Marie Myung-Ok Lee teaches at Brown University and is working on a novel about medical malpractice.

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