cannabisnews.com: Ask Dr. Ethan: Canadian Medical Marijuana Journal





Ask Dr. Ethan: Canadian Medical Marijuana Journal
Posted by CN Staff on October 01, 2002 at 20:11:51 PT
New Cannabis Magazine 
Source: CannabisHealth.com
Question 1 - Bipolarity Dear Dr. Russo, I am diagnosed as bi-polar with both the mania and the depression crash following. I am 50 years old and had my first full blown attack at age 30. Over the following 20 years I crashed several times and was subjected to all the standard pharmaceutical solutions. For the past 2.5 months I have been using cannabis to keep me focused and stable. 
I am finding that cannabis improves my concentration and attention span and is a cognitive stimulant.My question is, I am on no other drugs and, for the first time in a long time I feel good. Am I fooling myself, cured or just stoned?A.  The use of cannabis to treat bipolar problems (previously known as manic-depression) is a fascinating development. A surprising number of people so afflicted have independently made the discovery that cannabis has improved their condition, whether the mania or depression. It may also reduce side effects of other drugs used in its treatment, such as lithium, carbamazepine (Tegretol) or valproate (Depakote). Some people have found cannabis more effective than "conventional drugs" so you are by no means fooling yourself, or "just stoned."No doubt, cannabis is affecting the balance of neurotransmitters that are at the basis for this disorder. Endocannabinoids seem to be intimately involved in emotional regulation mechanisms in the limbic system. Because THC and other chemicals in cannabis mimic our own internal biochemistry, they may help replace what is missing. Cannabis strains that contain cannabidiol (CBD) also have anti-anxiety and anti-psychotic benefits.The best documentation available for this is an article by the eminent clinical cannabis prophet, Lester Grinspoon, that was published in Journal of Psychoactive Drugs in 1998.If you go to the Search engine on Lester's WWW site, Marihuana, the forbidden medicine: http://www.rxmarihuana.com/search.htm and plug in the search term bipolar, you will see many accounts of people such as you, that have benefitted from cannabis for their condition.Unfortunately, despite Dr. Grinspoon's plea for more research, no one has more formally studied this issue, most likely due to the politically-conspired near impossibility of doing clinical research on cannabis. Hopefully that situation will change soon.Question 2 - Tobacco and Cannabis Dear Dr. Russo, My partner Bill smokes 15 to 20 large 1 gram or more joints per day. He also smokes tobacco, sometimes mixed into his joints. So what is going on here, he says he could quit, but never does. The other peculiar thing is that he never seems to be stoned. How much damage is he doing to himself and how is the addictiveness of pot when mixed with tobacco?A.  It is difficult to fully analyze this situation, but certain things are evident. Firstly, your partner should know that smoking tobacco is distinctly unhealthful! The amounts you mention him as using are very great, and one should ask why? What is missing in his life, or what might he be treating by his use of tobacco and cannabis? I cannot answer that, but counselling could help discover the underlying issues. While I never recommend smoking tobacco, it is true that concomitant cannabis mitigates some of the harm to a degree. I would refer you to my Chronic Use Study, available online: http://www.montananorml.org/docs/ChronicCannabisUseStudy.pdf and to an article that indicated that cannabis-only smoking does not seem to provoke emphysema: http://www.freedomtoexhale.com/hm.htm and to an interesting study by Roth et al. that demonstrates how THC actually helps prevent carcinogenic deterioration: http://www.freedomtoexhale.com/ab.htm Remember, there has never been a documented case of a lung tumor in a cannabis-only smoker.Question 3 - Pain Control Dear Dr. Russo, I am considering the use of cannabis for pain control. I am on two other drugs that I do not wish to give up, because they seem to be helping me. The drugs are paxil and T3’s for my headaches. I have seen what mixing cannabis and alcohol can do, what interactions does cannabis have with other drugs? Am I safe to try it?A.  It is always difficult to advise people specifically about their particular situations without having the whole story. By T3’s, I assume that you mean Tylenol #3. If so, there is no way that I would recommend its chronic use. Tylenol, or acetaminophen, is a potential cumulative hepatotoxin. That means, if you take too much too long, or mix it with alcohol, it may produce irreparable harm to the liver. The other ingredient is codeine, which is addictive and counter-productive to good headache control in the longterm. Both components produce analgesic rebound when overutilized. That is, they actually perpetuate headache, probably through a mechanism of overstimulating glutamate receptors. Interestingly, cannabis is one of the few drugs that is not toxic that inhibits glutamate toxicity. See: http://www.freedomtoexhale.com/cb.htm A very long article I wrote on cannabis and headaches in the Journal of Cannabis Therapeutics also addresses these issues: http://www.freedomtoexhale.com/hh.pdfI would expect cannabis to render use of Tylenol #3 superfluous. Paxil is an SSRI antidepressant, and has more side effects such as sedation and dry mouth than other drugs in the class (Zoloft, Paxil, Celexa). Certainly cannabis could have additive side effects with it. Many clinical cannabis patients find that they no longer need additional antidepressant treatment. This is addressed in the Chronic Use Study: http://www.montananorml.org/docs/ChronicCannabisUseStudy.pdf The long history of cannabis as an antidepressant is addressed in a section of my Handbook of psychotropic herbs: http://www.haworthpressinc.com/store/product.asp?sku=2035 also available at Amazon.com, Barnes & Noble, etc.Cannabis has few noteworthy drug interactions, but you may want to look at a chapter on that written by Franjo Grotenhermen in our book, Cannabis and Cannabinoids: http://www.haworthpressinc.com/store/product.asp?sku=4513Finally, I have written a book chapter on cannabis in pain management that may be useful: http://www.montananorml.org/docs/Russo-AAPM_chapter.pdf Unfortunately, cannabis remains illegal in most areas, so I must recommend that you seek an exemption or other medical recommendation before using cannabis to treat your pain, for your own protection. As to whether it could help, the answer is that it likely would, especially if your problem is neuropathic pain. Disclaimer: Medicine is an ever changing science. While suggestions for therapeutic use of cannabis or other drugs may be made herein, this forum is designed solely for educational purposes, and neither the author, publisher, nor other parties, will assume any liability whatever for application or misapplication of any information imparted. We cannot claim scientific proof or accuracy of the material discussed, and no warranty, expressed or implied is advancedwith regard to the information.Cannabis is illegal in most jurisdictions, and the reader must apply awareness of this fact when considering its usage. Medical use of cannabis may or may not be a viable legal defense where you reside. Canadian clinical cannabis patients are encouraged to seek exemptions under existing law from Health Canada. The proper forms and procedures are available on their web site. Full disclosure and discussion of medical issues with your health care providers is encouraged, as is proper education with respect to effects and side effects of existing medication.Source: Cannabis Health Magazine (BC)Copyright: 2002 Cannabis Health MagazineWebsite: http://www.cannabishealth.com/Contact: http://www.cannabishealth.com/contact.htmDL: http://www.cannabishealth.com/ask_ethan.htm Related Articles:Fresh Evidence That Cannabis Reduces Painhttp://cannabisnews.com/news/thread14322.shtmlNevada Conference Examines Medical Marijuana http://cannabisnews.com/news/thread14282.shtmlSymposium on Cannabinoids in Pain Management http://cannabisnews.com/news/thread14269.shtml 
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Comment #23 posted by ghostman on May 22, 2003 at 17:23:01 PT:
Thank You  :)
Thank-you Dr. Russo and FoM for your kindness and quick response. I do have many of the head, neck and eye ticks that tourette patients do. Imagine the looks and comments I receive from people who don't know what Tourettes is. Marijuana has made it so that I can walk around in society with control over my symptoms. I'll visit the links that you both provided me and start doing some reading. Again Thank-you.
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Comment #22 posted by FoM on May 22, 2003 at 16:52:21 PT
Thanks Dr. Russo
You saved the day! I found what I thought would help ghostman but you're the Doc!
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Comment #21 posted by FoM on May 22, 2003 at 16:50:48 PT
ghostman, I Hope This Information Helps You
Marijuana Compound Effective In Treating Tourette's Syndrome, Study SaysMay 15, 2003 - Hannover, GermanyHanover, Germany: A primary compound in marijuana, delta-9-tetrahydrocannabinol (THC), is effective in reducing "tics" in patients suffering from Tourette's Syndrome (TS), according to clinical trail data published in a recent edition of the Journal of Clinical Psychiatry. Tourette's Syndrome is a complex neuropsychiatric disorder characterized by motor tics (sudden spasms especially in the facial muscles, neck and shoulders) and one or more vocal tics.Twenty-four patients participated in the double-blind placebo-controlled trial over a period of six weeks. Treatment with up to 10 mg of THC resulted in significant improvement of tic severity, authors wrote. No serious adverse effects to the treatment were reported.In a separate article published in Neuropsychopharmacology, authors elaborated, "No detrimental effect was seen on learning curve, interference, recall and recognition of word lists, immediate visual memory span, and divided attention" from THC during or after the treatment.The 24-patient study confirmed previous smaller patient trials that also found THC to be effective in the treatment of tics and behavioral problems in patients with Tourette's Syndrome.For more information, please contact Paul Armentano, NORML Senior Policy Analyst, at (202) 483-5500. Full text of the study, "Delta-9-tetrahydrocannabinol (THC) is effective in the treatment of tics in Tourette syndrome: a 6-week randomized trial," appears in Vol. 64 (No. 4) of the Journal of Clinical Psychiatry. Abstracts of the Neuropsychopharmacology article, "Treatment of Tourette syndrome with delta-9-tetrahydrocannabinol: no influence on neuropsychological performance," are available online via the PubMed search engine at: http://www.ncbi.nlm.nih.gov/PubMed/DL: http://www.norml.org/index.cfm?Group_ID=5647NORML's Weekly News Bulletin -- May 15, 2003: http://cannabisnews.com/news/thread16306.shtmlChronic Cannabis Use in PDF: http://www.freedomtoexhale.com/ccu.pdf Marijuana Doesn't Cause Lung Cancer: 
http://cannabisnews.com/news/thread10025.shtml
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Comment #20 posted by Ethan Russo MD on May 22, 2003 at 16:43:47 PT:
Ghostman
The latest on Tourette's and THC:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12716250&dopt=AbstractThere is no evidence that cannabis only causes lung cancer. There have been lab tests suggesting risk, but also evidence that THC prevents malignant degeneration:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11245634&dopt=AbstractA vaporizer will lower risk of any lung irritation, and a lower dosage is less likely to produce side effects.
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Comment #19 posted by ghostman on May 22, 2003 at 16:23:50 PT:
Question about Marijuana and Cancer?
I have smoked marijuana for about 8 years total from my first toke at age 18 to about 5 days ago. I have tourette's syndrome and have found that smoking marijuana has been the only thing that has aided me in controlling my ticks. Despite alomst every known medication a doctor has put me on to control these ticks, marijauna is the first drug to give me little to no side effects. For awhile I've been reading alot about these new studies and there findings that smoking marijuana causes a greater risk of getting lung cancer. I've also been reading articles about finding no documented case between smoking marijuana and cancer. I have to say there's alot to read and I'm a little confused. Certain medical sites and doctors say that short/long-term and heavy smokers are at risk, but what do they consider a long-term and heavy smoker? I know there is alot of hype and myths about marijauna, but technology and medicine is also further along then it was from the 60's and 70's. This I only relate to the subject of cancer. Honestly I'm scared to think that I can get cancer from my 8 years of smoking a medicine that has helped me function in daily life. Mainly my question is, what is your opinions on marijuana and cancer and some possible resources that I can find to research my own judgement as well. I appreciate the role marijuana plays in controlling my tourettes, it has been the only medicine that hasn't made me fall asleep in the middle of school and the only medicine that hasn't made me feel like crawling out of my skin. I appreciate any help that you can give. Thank-you. PS. I have also used a vaporizer before, but the high was a little more intense and found the twitching to be more out of control for the first hour then by smoking it.
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Comment #18 posted by VitaminT on October 03, 2002 at 17:53:41 PT
Good News Dr. Russo!
The Houston Public Library just called me back. They told me they'd be happy to have a subscription to "Cannabis Health" on the shelf and have accepted my offer.I hope the "Ask Dr. Russo" column is a regular thing!?That's good stuff!I'm going to check to make sure they have a copy of Cannabis Therapeutics in HIV/AIDS on the shelf too! Maybe I'll try to get them to order it.
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Comment #17 posted by Ethan Russo MD on October 02, 2002 at 13:23:31 PT:
More Banned Books
Perhaps your library would like to fail to order Cannabis Therapeutics in HIV/AIDS as well. Too bad that your friends with AIDS will probably have to purchase it themselves to investigate the contents.
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Comment #16 posted by VitaminT on October 02, 2002 at 13:20:15 PT
Cannabis Health too controversial for the library
I work next door to a Public Library. Today at lunch I walked next door to find out what procedure I should follow to donate a subscription for a magazine to the library. They told me, that should be simple enough! Everything was going great until they asked me what magazine it was. "Cannabis Health" I told him. Why was I was surprised at the hemming and hawing!? I told the guy "Frankly I expect more from librarians than that . . . you're acting more like a politician, no offense!" He said he agreed with me but would feel more comfortable if the Manager of the branch handled the question, so he took my number.This all makes me wonder, what other donations has my tax- supported library recieved that were too controversial for the frail and meek-minded Houston public? (You know 4 million drug-free zombies daily going to and fro in their cars) What else are they "protecting" us from? Our neighborhood by the way has been more deeply effected by AIDS than perhaps any other in the state of Texas. I've seen 3 or 4 P.W.A.'s in there at once reading or surfing the net! Heck, the Texas Medical Center w/ more Cancer patients than some states have people is only 2 miles from here!Maybe it is controversial but so is "Mein Kampf" I'll bet that's on the shelf!Lets rattle their cages people!
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Comment #15 posted by michael segesta on October 02, 2002 at 12:50:08 PT:
Fantastic!
What a fantastic magazine! More later when I have time to download the issue and sign up.
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Comment #14 posted by DdC on October 02, 2002 at 12:33:54 PT
I Just Wish I Could Learn Your Peaceful Ways FoM!
He has driven me to drink (almost I don't drink LOL!) a few times but he is a good person and has the right motives and I appreciate him.Glad you haven't taken that drink FoM. ¶8) If you think I'm a tad enthused here you should have seen my teachers in 1970. And the doctors, nurses and politico hopefuls I confront now. They do head for the bars. LOLConfrontation isn't always the best policy and having the patients to hold my temper would have helped me on many occassions I've found myself in. Especially confronting cops about cannabis.I have also found advocating can be a pleasure, if you can back it up. The ego getting its fix turning intelligent engineers into monkey's with forgotten cannabis info. Or the medical and political professions also with lowered heads and red faces after being scolded for propagandizing. Don't lie too or mess with my patients!!!I also know I can get away with advocating because I do a good job and make the agencies lots of money. Or save the patients lots of money when doing private care. Not that they're sympathetic to long haired pot toking legalizers.Thanks FoM and Doc Russo,Peace, Love and Liberty or Brain D.E.A.th!DdC
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Comment #13 posted by FoM on October 02, 2002 at 10:18:55 PT
About DdC
Now I'll make him blush. I met DdC back in August of 97 on the Political Board of Cannabis.com and he has been a person who has taught me more about Cannabis then any one individual. I had no idea what I was doing or wanted to do but he helped me learn. He has driven me to drink (almost I don't drink LOL!) a few times but he is a good person and has the right motives and I appreciate him.PS: There DdC put that in your JH pipe and smoke it! LOL!
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Comment #12 posted by Ethan Russo MD on October 02, 2002 at 10:13:34 PT:
Nice Job, DdC
Keep writing LTE's. The sooner our neighbors realize that they may have been misinformed, and that prohibitionists are a vanishing minority, the sooner there may be a public outcry to stop the war.
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Comment #11 posted by DdC on October 02, 2002 at 09:50:15 PT
Dear Dr. Russo,
After many years of looking for answers concerning the illness of cannabis prohibition I have witnessed a large postulant growth suffocating the breath of ordinary citizens. Mostly low income families. I believe it is a parasite since the past 30 years it has grown considerably. Such that I often wonder if someone is feeding it. Yet when I go for a health examination, not many from the American Medical Establishment can find it on standard x-rays or cat scans. I've also heard Judges and the Police seem to benefit from treating this illness. Saying it is so contagious they're interning many victims in camps until the proper max security facilities are built. When checking the Yellow pages for help I find many avenues to treat the illness and its side effects, but few to prevent or cure the illness. Ranging from barbaric slaughter and incarceration to medical incarceration treatment. Those who attempt acting against standard operating procedure are stigmatized and also interned, so I assume a symptom of this cannabis must be compassion. A deadly practice if profits and taxes are the goal. The growth and its symptoms of pain and angst reading bold face lies from those entrusted with our well being, personal avoidable tragedy on everyday people and a perpetuation of dysfunction the world is witnessing while the propaganda ministers churn out red white and blue commercials. Ironically it is the very plant's cancer, prohibition. That causes more to be used to relieve the buzz dissipation. We are ready. We are heard. We will cure this infestation of D.E.A.th by removing the parasites Bush, Ashcroft Walters and the robotic minions of badges and robes giving their solemn oaths of allegiance. The founding fathers designed the public servants to serve we the people, and not blind obedience to the same lineage of imperialist that left ordinary people in a Great Depression and several Holocausts. Finally more are speaking up and out about a CURE called Re-Legalizing It! Thanks for keeping reality in your life and practice...Ahhhhhhhh Re-Leaf!Cannabis also wards off D.E.A.th warthogs, weasels and flying monkey's...Peace, Love and Liberty or parasitic D.E.A.thDdC
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Comment #10 posted by TroutMask on October 02, 2002 at 08:27:48 PT
Cool
Totally fine by me, Dr. Russo! Just wanted to make sure my interpretation was correct. And certainly a compelling bit of information! Thanks for all you do!-TM
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Comment #9 posted by Ethan Russo MD on October 02, 2002 at 07:38:33 PT:
Trout Mask
I stand by my statement. 
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Comment #8 posted by malleus on October 02, 2002 at 07:30:49 PT
Remember the 'precancerous lesions"?
Twenty years ago I saw a police training film in which all the 'myths' about pot being 'harmless' (I've NEVER heard an activist claim it was, just less harmful than booze or cigs) included the line about 'precancerous lesions' forming in the lungs of US soldiers in Germany that had been users of hashish.Well, it's been twenty years, like I said, and you have to wonder if any follow-up studies were ever made about those soldiers that had these 'precancerous lesions'. Any died of lung cancer? Given how much bull has been said about these lesions, you'd think the prohibs would latch on that and not let go. You'd think they'd have followed those probably ex-soldiers around the rest of their lives to find out. But they haven't. I later learned that these lesions appear in ANY person who inhales smoke. That they are not necessarily cancerous. A fact which the prohibs cannot be ignorant of. But they keep bringing up this stuff about cannabis smoke having such huge amounts of carcinogens. Given how many people in America smoke cannabis on a daily basis, and how many have done so for the last 20 or 30 years, you have to ask:Where all the dead hippies, felled by lung cancer?
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Comment #7 posted by TroutMask on October 02, 2002 at 07:05:23 PT
Question
"Remember, there has never been a documented case of a lung tumor in a cannabis-only smoker."Is that truly an accurate statement? Does this literally mean that of all humans who have smoked cannabis only, none has ever been found to have a lung tumor?-TM
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Comment #6 posted by Ethan Russo MD on October 02, 2002 at 06:08:36 PT:
Cannabis Health
I hope that many CannabisNews.com readers will investigate the above link to this new magazine published by Brian Taylor, Cannabis Health. There is a free PDF of the entire charter issue.It is designed to be instructive to the medical user, caregiver, even health care provider. Brian is a visionary who imagines the magazine appearing in doctors' waiting rooms along with Highlights and Ladies Home Journal. Isn't that a picture? I would hope that this publication will contribute to the normalization of attitudes about cannabis.
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Comment #5 posted by Windminstrel on October 02, 2002 at 05:43:09 PT
very nice
Excellent stuff as usual, Dr. Russo. That link to the headache article was excellent as well.
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Comment #4 posted by DANA on October 02, 2002 at 01:08:36 PT
...Incarceratiophobia...
..also know as "Bustingtons Syndrome"......I'm a bag of nerves!...Unfortunately,,my doctor does not have a connection to obtain some of them new legal Marijuana suppositories.....I tried to make my own pot suppositories at home,,but I only became more upset,when I realized that I had ruined some perfectly good weed!.It was unsmokable after my failed attempt at homeopathic sphinctal insertion therapy......I guess you gotta know what your doing when it comes to makin' them suppositories.....this "grow your own", thing just doesn't apply to anally administered homegrown medications!
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Comment #3 posted by knox42897 on October 01, 2002 at 22:53:48 PT:
schizophrenia
BGreen your paranoia might be a mild form of schizophrenia, which I'm happy to report will qualify you for a medical recomendation in california. 
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Comment #2 posted by BGreen on October 01, 2002 at 22:17:48 PT
I hear you, knox42897
It's a paranoia shared by many of us.
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Comment #1 posted by knox42897 on October 01, 2002 at 21:52:00 PT:
bi polar
Hello Dr. Russo you and Dr. Stephen Banister are definetly my doctors. I personally have bi-polar and schizophrenia. I self medicate myself and don't have a problem. On my defense I would just like to state I wouldn't be so paranoid if the cops wouldn't take my medicine and through me in jail.
Pierre
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