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01/07/2007 00:00:00

US: Medical Marijuana: Treatment for Marijuana Dependence

(MOLALLA, Ore.) - I found this article discussing this subject with a
computer search. The title was “Marijuana: Medical Implications” from
the journal American Family Physician (Vol. 60/No.9, pgs. 2583-93) by
Dr. John R. Hubbard, et al at Vanderbilt University School of Medicine.

The first few sentences in the abstract are: “Over 50 percent of people
will use marijuana sometime in their life. While intoxication [sic]
lasts two to three hours, the active ingredient...[THC], can accumulate
in fatty tissues, including the brain and testes [ouch].”

I'm a bit surprised at the cavalier use of “intoxication.” Nobody says
that patients who are using Morphine or Oxycontin are intoxicated, but
they certainly are by the same token.

After 1937, when Cannabis in any form was illegal, researchers were able
to get research grants to study adverse effects of Cannabis but not
beneficial effects. My wife, a nurse, witnessed the first injections of
Penicillin in her hospital in Newcastle, England. The patient was
surgically draped and the Chief of Surgery at Grand Rounds, in surgical
garb and rubber gloves, gave the injection into the buttocks of the
patient. Over the next two days, the patient was repeatedly questioned
about adverse side effects. One of his complaints was a pain in the
testicle. (This was NOT a long needle). For the next several years, pain
in the testicle was considered an adverse effect of Penicillin. So much
for the adverse effects of Marijuana.

There are at least two reasons for adverse effects from Marijuana. The
old stuff (prior to about 1990) was very low in THC, the chief medical
agent. There are at least two more important ones—CBD and CBN. Old
stuff, when burned in a cigarette, was very irritating to the mouth,
throat, breathing tubes and lungs. It caused coughing and a headache. If
it contained more than a little THC, it would cause bloodshot eyes,
vasodilation, followed by increased heart rate and the “munchies”, all
considered adverse effects.

If a person got some strong stuff but didn't know it until he took a big
inhalation, he would really get “high” in a hurry. This is very
unpleasant, scares the person and may cause a whole bunch of anxiety,
panic attacks, etc. This is frequently followed by deep sedation or
sleep. Some people enjoy the “high”, sedation and sleep.

Auditory and visual hallucinations are common with very high doses but
may be euphoric and some people seem to enjoy them. The term psychedelic
has been used but usually applies to LSD or “magic mushrooms”, etc.
Medical Marijuana users discover that adverse effects are brought on by
heavy doses and they avoid them.

The article states that about 100,000 people seek treatment for
Marijuana dependence each year. This is really strange, as 750,000
people are arrested each year for Marijuana use. One would presume that
those represent the most affected patients but probably the legal system
requires many to have treatment or drug counseling, which they regard as
both punitive and hilarious.

The article is very serious about treatment for Marijuana dependence.
Patients should

(1) be evaluated for other drug-related disorders (e.g., alcoholism),

(2) be evaluated for psychiatric disorders (e.g., depression),

(3) be evaluated for medically related problems (e.g., chronic pain),

(4) be educated about adverse effects,

(5) have supportive care for panic reactions,

(6) have supportive care for withdrawal symptoms,

(7) be aided in providing education of spouse and family, and

(8) receive a referral to a relapse prevention program. Most medical
marijuana patients would consider all of these treatment strategies as
being much funnier than the U.S. government produced movie Reefer
Madness, which is so absurd that it really isn't humorous.

It is noted that Dr. Hubbard is Director of the Substance Abuse
Treatment Program at the Nashville Veterans Affairs Medical Center. I
would guess that this explains the over-cautionary sense of his article.
I know at least a dozen Cannabis doctors who would consider his article
not humorous but very tragic.

Phillip Leveque has spent his life as a Combat Infantryman in WWII,
Physician and Toxicologist.

Author: Salem News via UKCIA

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