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Onward,
Alexander, Jeffrey, Becky and Deva
Weekend
Edition
November 11 / 12, 2006
Pot Shots
Marijuana,
the Anti-Drug
By FRED GARDNER
The extent to which medical cannabis
users discontinue or reduce their use of pharmaceutical and over-the-counter
drugs is a recurring theme in a recent survey of pro-cannabis
(PC) California doctors. The drug-reduction phenomenon has obvious
scientific implications. Medicating with cannabis enables people
to lay off stimulants as well as sedatives -suggesting that the
herb's active ingredients restore homeostasis to various bodily
systems. (Lab studies confirm that cannabinoids normalize the
tempo of many other neurotransmission systems.) The political
implications are equally obvious. Legalizing herbal cannabis
would devastate the pharmaceutical manufacturers and allied corporations
in the chemicals, oil, "food," and banking sectors.
Put simply, the synthetic drug makers stand to lose half their
sales if and when the American people get legal access to cannabis.
In the 10 years since Proposition
215 made it legal for California doctors to approve cannabis
use by patients, the PC docs did not adopt a common intake questionnaire,
and, with one exception, did not collect systematic data on which
pharmaceutical drugs their patients had chosen to stop taking.
However, the consistency with which the doctors describe this
phenomenon has a force as impressive as any slickly presented
"hard" data.
This summer I surveyed 19 PC
doctors who, between them, had approved and monitored cannabis
use by more than 140,000 patients. Herewith some replies to a
question about patients reporting reduced reliance on pharmaceuticals.
Frank Lucido, MD: "Chronic
pain patients report reduced use of opioids, NSAIDs, muscle relaxants,
sleeping pills. Psychiatric and insomnia patients reduce use
of tranquilizers, SSRI antidepressants, and sleeping pills. Neurologic
patients reduce use of opioids, muscle relaxants, NSAIDS, triptans
and other migraine headache remedies." Marian Fry, MD:
"Medications discontinued or reduced include Oxycontin,
Norco, Percoset, Vicodin, Flexerol, Soma, Valium, SSRI antidepressants,
and blood-pressure medications Norvasic and Hydrochlorothiazide.
Approximately 1% of my patients report reduced reliance or discontinuation
of seizure medication by substituting Cannabis for Dilantin and
remaining seizure free. Many of my Glaucoma patients no longer
require their Timoptic drops and are able to maintain normal
pressures with the use of Cannabis. Many of my patients who have
lost hope in conventional pharmaceutical treatments report enhanced
health, decreased pain, decrease depression and an overall sense
of well being despite chronic illness."
Helen Nunberg, MD is medical
director of MediCann, a statewide chain of clinics through which
53,000 patients have received approvals. Nunberg reviewed records
of 1,800 patients seen at nine clinics. "Prescription drug
substitution is very significant," she writes. "51%
of the 1,800 patients report using cannabis as a substitute for
prescription medications; 48% report using cannabis to prevent
prescription medication side effects; 67% report using cannabis
to reduce dosage of prescription medication; 49% of patients
using cannabis for chronic pain were previously prescribed an
opioid (such as hydrocodone) by their personal physician."
Philip Denney, MD: "Cannabis
allows significant decreased use or elimination of many prescription
medications, particularly narcotics. Patients usually report
decreases of 50% or better."
Tom O'Connell, MD: "Vicodin
and other opioids; lithium; Klonopin; various sleep aids; and
the whole gamut of psychotropic medications from Prozac to Xanax.
I don't tell patients to stop taking anything, but I will suggest
they discuss it with the prescribing doctor. I have the feeling
that most don't."
William Eidelman, MD: "Opioids,
sleeping pills, anxiolytics, SSRI anti-depressants."
Hanya Barth, MD: "Approximately
90% of my patients have at one time or another tried traditional
medications for their symptoms and found that they produced significant
side effects. With cannabis most patients report either being
able to manage their symptoms without any other medications,
or using less than they would ordinarily have to. It is not unusual
to have patients come for a recommendation, bringing a whole
bag of medications that they are taking. They might then return
the following year saying that they no longer needed many of
them and had cut back on many others.
"It is also true that
most patients who were using alcohol to manage their symptoms
or who were abusing alcohol or speed or opiates, etc. find that
they can stop these drugs when they have marijuana. Many also
report that they were using those drugs to manage certain symptoms
such as pain or anxiety and then became addicted. This is especially
true of certain populations, mainly the homeless and the mentally
ill. Even cigarette smokers often state that they can substitute
cannabis for nicotine.
"What amazes me overall
is the efficacy and lack of side effects. It is not that the
pain stops but that the mind doesn't fixate on the pain in the
same way. In addition, the muscles that become tense around an
area of pain can cause secondary symptoms, which then are relieved
with cannabis. If someone is in pain and/or anxious, he or she
often has a hard time sleeping. With cannabis, patients report
that they are able to sleep better, wake up more refreshed, have
less secondary depression and are able to function more efficiently
the following day. Many hypnotics can only be taken at a certain
time (not at 4 a.m., for example). However, having a puff of
cannabis at that time will help them fall back asleep without
a morning hangover."
Dr. A: "Narcotics, including
heavy narcotics such as Fentanyl."
William Courtney, MD: "While
the percentage of patients in my practice using cannabis for
management of ADHD is small, those who have discovered its benefits
are pleased that they can achieve control without having to continue
to use Ritalin, etc."
Tod Mikuriya, MD: "Opioids,
sedatives, non-steroidal anti-inflammatories, and SSRI anti-depressants
are commonly used in smaller amounts or discontinued. These are
all drugs with serious adverse effects."
Jeffrey Hergenrather, MD: "A
cannabis specialist soon becomes aware of two remarkable facts.
The range of conditions that patients are treating successfully
with cannabis is extremely wide; and patients get relief with
the use of cannabis that they cannot achieve with any other pharmaceuticals.
"The testimonies that
I hear on a daily basis from people with serious medical conditions
are moving and illuminating. From many people with cancer and
AIDS come reports that cannabis has saved their lives by giving
them an appetite, the ability to keep down their medications,
and mental ease. "No other drug works like cannabis to
reduce or eliminate pain without significant adverse effects.
It evidently works on parts of the brain involving short-term
memory and pain centers, enabling the patient to stop dwelling
on pain. Cannabis helps with muscle relaxation, and it has an
anti-inflammatory action. Patients with rheumatoid arthritis
stabilize with fewer and less destructive flare-ups with the
regular use of cannabis.
"Other rheumatic diseases
similarly show remissions. Spasticity cannot be treated any more
quickly or efficiently than with cannabis, and, again, without
significant adverse effects.
"Patients who suffer from
migraines can reduce or omit conventional medications as their
headaches become less frequent and less severe.
"About half of the patients
with mood disorders find that they are adequately treated with
cannabis alone while others reduce their need for other pharmaceuticals.
In my opinion, there is no better drug for the treatment of anxiety
disorders, brain trauma and post-concussion syndrome, ADD and
ADHD, obsessive compulsive disorder, and post-traumatic stress
disorder.
"Patients with Crohn's
disease and ulcerative colitis are stabilized, usually with comfort
and weight gain, while most are able to avoid use of steroids
and other potent immunomodulator drugs.
"People who were formerly
dependent on alcohol, opiates, amphetamines and other addictive
drugs have had their lives changed when substituting with cannabis.
"Patients with end-stage
renal disease on dialysis and those with transplanted kidneys
show mental ease, comfort, and lack of significant graft-versus-host
incompatibility reactions in my small series. "Diabetics
report slightly lower and easier-to-control blood sugar levels,
yet to be studied and explained.
"Sleep patterns are typically
improved, with longer and deeper sleep without any hangover or
significant adverse effects.
"Many patients with multiple
sclerosis report that their condition has not worsened for many
years while they have been using cannabis regularly. MS and other
neurodegenerative diseases share the common benefits of reduced
pain and muscle spasms, improved appetite, improved mood and
fewer incontinence problems. Many patients with epilepsy are
adequately treated with or without the use of other anticonvulsants.
"Patients with skin conditions
associated with systemic disease such as psoriasis, lupus, dermatitis
herpetiformis, and eczema all report easement and less itching
when using cannabis regularly.
"Airway diseases such
as asthma, sleep apnea, COPD, and chronic sinusitis deserve special
mention because I encourage the use of cannabis vapor or ingested
forms rather than smoking to reduce airway irritation."
All these clinical reports
jibe perfectly with lab studies showing that synthetic THC enables
rodents to achieve pain relief with half the amount of opioids.
(Under the rules of evidence established by corporate Science,
rodents are considered more trustworthy witnesses than we, the
people, are.)
Fred Gardner is the editor of O'Shaughnessy's
Journal of the California Cannabis Research Medical Group. He
can be reached at: fred@plebesite.com
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