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ADD/ ADHD & Cannabis studies completed

Overview

Attention deficit hyperactivity disorder (ADHD) and attention deficit disorder (ADD) symptoms may begin in childhood and continue into adulthood. ADHD and ADD symptoms, such as hyperactivity, implulsiveness and inattentiveness, can cause problems at home, school, work, or in relationships.

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Science & Research

Updated - Anecdotal - ADHD by Ryan P.
Updated - Study ~  Marijuana and ADD Therapeutic uses of Medical Marijuana in the treatment of ADD.
2013 - News ~ Can Marijuana Calm Symptoms of ADHD?
2011 - News ~ Why Omega-3s Affect Your Mood
2009 - Anecdotal/News ~ Why I Give My 9-year-old Pot.
2009 - Anecdotal/News ~ Why I Give My 9-Year-Old Pot, Part 2.
2009 - Anecdotal/News ~ Why I Give My 9-Year-Old Pot, Part 3.
ADHD by Ryan P

Other ANECDOTAL (PERSONAL STORIES)

Marijuana helps me allot.

Many memories of my life (and current circumstances) bring a great deal of stress especially when I get mad (I think of something bad which leads to more and more bad thoughts that wont stop and it just pisses me off more). I was taken from my parents at age 3 for an uncertain reasons and placed into foster home after foster home because I was a 'bad child', then after about 6 or so homes and 5 years of very bad stuff, I was put into a residential center. Neither place was fun and was making my childhood a worse memory.

I was adopted at age 8 and put directly into the special education program at the local grade school, which I think was a bad idea because I could not get the grasp of how the real world/people worked, and being in a special-ed class with kids having the same problems as me was not teaching me good things.

I kicked a teacher while being restrained one day (in one of MANY violent tantrums) (about 4 months after starting school), and was expelled into a private alternative school where I seemed to survive and was started on Ritalin. When Ritalin turned me into a zombie, I think adderall, imipromine (might have been to help me sleep), and some others were tried as well.

I was diagnosed with ADHD around age 8 and was placed on many different drugs such as methylphenidate (Ritalin), and probably others that I do not remember. I stopped taking the medications because they were not helping my anger, I barely ate, and things were going to hell. After that, I barely made it out of the private alternative school I was kicked into, finally making back into the public school system.

I had about 4 months of 8th grade at a real school to get ready for public high school. I was still having problems but was being heavily monitored and was in after-school therapy 3 times a school-week for about 4 years. Once high school started, things were very different from what I was used to, and I was expected to keep up with everyone (not that I didn't understand the class work or couldn't do it, but things were very out of order and confusing because I was not in-sync with the public school system or anyone in it).

First smoked 3/4 into freshman year. I first tried marijuana not knowing it would help alleviate my stress, depression, and ADHD/RBS while making me finally feel good about myself as a person, but to 'be cool and get high'. When I went to class 'high', I did nothing but pay attention to the teacher (not being able to clearly see the board/TV would usually cause me to not write anything because I couldn't see what to write, or the examples/notes.

Being hassled about this was not easy because I did not like to blame it on my lazy eye, or the fact I was too nervous wondering what everyone else was thinking about me (which is why I wouldn't sit up front or closer, usually in the back corner), and this is still a problem. Unfortunately, this was the last class of the day so I could not test "wow I can actually concentrate on what's going on and follow through with what needs to be done without getting confused and lost" for the whole school day.

I tried getting high after 2nd period to see how I could do in my English class, I could concentrate on what was being read without thinking "oh crap she is looking at me" (or something similar) over and over, I was too into the book/movie.

I could actually write stories and things I would normally not be able to do (I'd start something else and then forget about my ideas, and would get very mad because this was getting me into trouble). I could calculate math better because I could concentrate on the problems without being distracted and forgetting what I was thinking.

I could think more logically, and things came to me way easier. I was also a more social person and could carry on a decent conversation while 'high', it made me more 'loosened up' I guess.

After a short period of 'experimenting' I got caught up in 'fixing myself' and being able to enjoy life, that I started using more and more to level things out and keep being depressed/angry all the time on a down-low. This only caused problems (mostly because its illegal thus most peoples opinions are evil and uneducated), and I got into trouble with my dad for using drugs, got kicked out of public school (back into the previous alternative school) because I was using on school premises and was caught 3 times with a pipe in my possession.

I found it nearly unbearable to live without being 'high' (I think being high is a side-effect of using cannabis as a medication) because things were so much easier to comprehend and my brain and body went much smoother, and I rarely got angry. I lost all my dealers by getting kicked out of public school and resorted to some kids around the block. They just dragged me down into much heavier (social, getting wasted) use along with drinking occasionally. When medicating, I never smoked to get high, just little bit every 3 or 4 hours to get mellow and level things out. At parties/friends' house was different. I could not even have friends until I started using because I was too worried about things and would always 'do my own thing'.

I have resorted to some pretty stupid things to attain marijuana. I pretty much feel that life is a pile of sh** when I'm not 'high' because I know things can be SO much better, but the little stupid things (like the law) are keeping me from sustaining a mentality that life is going to be okay. But as soon as the marijuana wears off, I am angry, cant sleep, depressed (I guess because I'm tired of living with all this crap when I know it can all be helped (for a while at least)), and things are again back to the way they have been my whole life, also knowing that it will be very hard to keep medicating with what I know works because people will not recognize it DOES help some people, and can be used in GOOD ways instead of all the hyped-up evil.

The stress factors of the very irritating things I have been through stir up memories and emotions that I must get rid of somehow or another or I feel like I'm going to kill somebody (these feelings can be suppressed while cannabis helps me focus my brain for more productive things like computers (my gift), and my life). I found that it is not the marijuana wearing off that aids in area of stress and depression, but the fact that going back to being screwed up knowing I could make things all better and function properly with just a little help, but that help is out of my reach (legally, and financially) which causes more stress and depression. This is not necessary.

I do not like smoking, or like smoke period. I think digesting (cooking/eating) cannabis would be substantially better for my health than smoking it (unless things get too hairy and need immediate relief); I have not been able to experience the difference between eating and smoking because I never have had enough, and barely ever have enough to keep my sanity. Like, when I get mad (and I have been known to get mad at the dumbest things), I get extremely angry because after thinking a bit, I know all this stuff, and thoughts go from one to another, yet I can't make things just work out the way they should, and it's not right. I usually try and understand both sides of the problem, but can only really follow through with my thoughts if I am medicated (with cannabis, which seems to be my all-in-one potion).

I am aware there are other man-made medications for ADHD, RBS, depression, anxiety, and whatever else I may have, but I highly doubt they provide the same sense of well-being (relief of depression and clearing the head) while simultaneously treating a persons abnormal brain chemistry that drives them up the wall so to speak. Works on all my aches and pains as well. I have not tried dronabinol (Marinol) because from what I have read, I feel herbal cannabis (and its 60+ cannabinoids) has a much more positive effect on my problems than pure synthesized-THC (which still does not do all the same things as naturally occurring THC).

Besides, I do not like the idea of taking any form of coke or speed (that can cause me not to eat (which is already a problem, I get so stressed that I get sick and throw up, and then have to smoke to relieve the stress and be able to put something in my stomach) and may cause a stimulant dependency) when a plant from the ground when eaten, can fix most if not all of my problems allowing me to continue life knowing things will be alright for a while. Why prohibit those who can benefit from natural herbs legally do so? People are dependant on a LOT of things to keep themselves well.

That is just my say in what marijuana does in part of ADD and other psychological areas. I know plenty of other people who can say pretty much say the same.

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Attention-deficit hyperactivity disorder (ADHD) is a neuropsychiatric syndrome, affecting human infants and adolescents. The syndrome is characterised by impaired attention and by impulsive-hyperactive behaviour. Italian researchers studied ADHD in an animal model, using the spontaneously hypertensive-rat (SHR) strain, which is regarded as an animal model for ADHD.

The SHR rats were compared to normal rats. In tests it appeared that there is a subgroup within the SHR rats which reacted very impulsive. Researchers found that animals of this impulsive SHR subgroup presented a reduced density of CB1 cannabinoid receptors in the prefrontal cortex of the brain. The administration of a synthetic cannabinoid that – like THC – binds to the CB1 receptor normalized the impulsive behavioural profile in this subgroup of SHR rats, but had no effect on normal rats.

Until now there is no clinical research with cannabis or single cannabinoids in ADHD but several patients report positive effects. Additionally, a clinical study on THC in Tourette’s syndrome demonstrated an improvement of obsessive compulsive behaviour.

(Source: Adriani W, et al. The spontaneously hypertensive-rat as an animal model of ADHD: evidence for impulsive and non-impulsive subpopulations. Neurosci Biobehav Rev 2003;27(7):639-51)

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Association between cannabinoid receptor gene (CNR1) and childhood attention deficit/hyperactivity disorder in Spanish male alcoholic patients

Molecular Psychiatry (2003)

 

G Ponce, J Hoenicka, G Rubio, I Ampuero, M A Jiménez-Arriero, R Rodríguez-Jiménez, T Palomo and J A Ramos

  1. Unidad de conductas adictivas, Servicio de Psiquiatría, Hospital 12 de octubre. Madrid, Spain
  2. Banco de Tejidos para investigaciones Neurologicas, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain

Correspondence: J Hoenicka, E-mail:[email protected]

*These authors contributed equally to this work.

The mesolimbic dopaminergic system seems to be the main system responsible for the rewarding properties of the brain in response to abuse substances.

The endocannabinoid system is in turn known to regulate the dopaminergic system through the CB1 presynaptic receptors. This property might well account for the role of these systems in learning, memory, behavior, as well as the reinforcing properties of abuse substances.

The CB1 receptor is encoded by the CNR1 gene (6q14–q15), which is known to carry a nine-allele microsatellite polymorphism containing repeats of a single trinucleotide, ATT, which localizes to the 3'UTR of the gene and has been related to drug dependency states in Caucasian populations.

Moreover, a link has been found between this polymorphism and the properties of the event-related wave p300.

Some studies having suggested that p300 variations might function as a marker for an underlying, hereditary, predisposition to alcoholism.


Moreover, a direct relationship has been found between p300 wave fluctuations and attention deficit/hyperactivity disorder (ADHD).

In recent years, the relationship between ADHD and addictions has been stressed.

ADHD has been linked to the malfunctioning of catecholaminergic systems, which also play a fundamental role in the brain's rewarding system.

These data suggest that the link between the cannabinoid system and the p300 wave could be related to some aspects of ADHD. In this study, we found a quantitative relationship between the largest-sized alleles of the CNR1 gene and the presence of ADHD during childhood in Spanish male alcoholic patients.

This study was conducted with 107 male alcoholic patients below the age of 50 years both with and without ADHD antecedents during childhood. Other 92 male individuals were taken as controls, and were also subject to a genetic study.

Such study was preceded by a clinical interview to ensure the absence of disorders because of substance abuse. Alcohol dependency was assessed with a structured clinical interview for DSM-IV (SCID 4.0). ADHD was diagnosed by doing semistructured clinical interviews to patients and their relatives. Such interviews contained DSM-IV criteria for ADHD, and the validated Spanish version of the Wender-Utah Rating Scale (WURS) was used.

The Cloninger three-dimensional questionnaire was used to assess personalities. PCR amplification was performed with the primers 5'-GCTGCTTCTGTTAACCCTGC-3' and 5'-TCCCACCTATGAGTGAGAACAT-3'.

The PCR was performed in a 10 l reaction volume containing 2.5 mm MgCl2, DMSO (4%) and -dCTP,32 with 58°C being the annealing temperature.

Nine allelic types were identified in autoradiographs of polyacrylamide gels and distributed according to Comings et al,3 so that the shorter alleles (<5) were separated from the longer ones.

This led to three different genotypes (<5/<5, <5/5, and 5/5), which were analyzed as a qualitative variable. Statistical calculations were performed with the SPSS statistical package.

In comparison with non-ADHD patients and control individuals, those alcoholic patients who suffered from ADHD during childhood were found to carry the longer forms of alleles (5) (2=9.665, df=2, P=0.008 and 2=8.525, df=2, P=0.014, respectively).

Moreover, the average in WURS score is greater in individuals homozygous for the 5 forms than in the <5 homozygous individuals, with the heterozygous lying in between.

Such difference is statistically significant for the overall score (ANOVA, F=3.210; P=0.044) and for factor 4, which contains items specifically related to inattention (ANOVA, F=4.209; P=0.017). A grading of the results was observed, which probably indicates a quantitative influence of the different alleles.

It has been suggested that the microsatellites might form Z-DNA structures and thereby may play a role in gene regulation, and that the magnitude of the effect could be dependent upon the length of the repeats.10

The number of ATT repeats of the allele with the greatest score for each genotype was taken as a quantitative variable. A statistically significant correlation was also observed between allele sizes and WURS scores, and also with the novelty seeking score (see Table 1), in agreement with previous studies that relate novelty seeking with ADHD.

The case–control design used in this study may give rise to spurious associations influenced by population stratification. This study is preliminary, and a family-based study will be useful to verify these associations.

To the best of our knowledge, this is the first study relating the CNR1-gene polymorphisms with ADHD in alcoholic patients. These data are consistent with the fact that the cannabinoid system is known to affect dopaminergic transmission, with the malfunctioning of the dopaminergic system being regarded as a potential physiopathological cause of ADHD.

Further studies are needed to determine the functional basis of the observed association.

 References

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Barba Jacob and the history of marihuana

[Article in Spanish]

Abstract

The outstanding Latin-American poet Porfirio Barba-Jacob (1883-1942) was a heavy user of marihuana. In this paper the author provides some data concerning historical antecedents of marihuana--mainly in Latin America--and he discusses its influence upon Barba-Jacob's life and poetry.

The hypothesis that consumption of marihuana is used by some hyperkinetic adults as self-induced pharmacotherapy is outlined.

PMID:
 
3296662
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 Marijuana - MedlinePlus Health Information

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Marijuana and ADD Therapeutic uses of Medical Marijuana in the treatment of ADD

It was mentioned in the Portland newspaper that the Oregon Health Division is considering allowing medical marijuana to be used to treat Attention Deficit Disorder (ADD) under the Oregon Medical Marijuana Act.

At first glance it might seem counter-intuitive to use a medication that has a public perception of decreasing attention to treat a condition whose primary symptom is a deficit of attThe mesolimbic dopaminergic system seems to be the main system responsible for the rewarding properties of the brain in response to abuse substances.1 The endocannabinoid system is in turn known to regulate the dopaminergic system through the CB1 presynaptic receptors. This property might well account for the role of these systems in learning, memory, behavior, as well as the reinforcing properties of abuse substances.2

The CB1 receptor is encoded by the CNR1 gene (6q14–q15), which is known to carry a nine-allele microsatellite polymorphism containing repeats of a single trinucleotide, ATT, which localizes to the 3'UTR of the gene and has been related to drug dependency states in Caucasian populations.3 Moreover, a link has been found between this polymorphism and the properties of the event-related wave p300,4 some studies having suggested that p300 variations might function as a marker for an underlying, hereditary, predisposition to alcoholism.5

Moreover, a direct relationship has been found between p300 wave fluctuations and attention deficit/hyperactivity disorder (ADHD).6 In recent years, the relationship between ADHD and addictions has been stressed.7 ADHD has been linked to the malfunctioning of catecholaminergic systems, which also play a fundamental role in the brain's rewarding system.8 These data suggest that the link between the cannabinoid system and the p300 wave could be related to some aspects of ADHD. In this study, we found a quantitative relationship between the largest-sized alleles of the CNR1 gene and the presence of ADHD during childhood in Spanish male alcoholic patients.

This study was conducted with 107 male alcoholic patients below the age of 50 years both with and without ADHD antecedents during childhood. Other 92 male individuals were taken as controls, and were also subject to a genetic study. Such study was preceded by a clinical interview to ensure the absence of disorders because of substance abuse. Alcohol dependency was assessed with a structured clinical interview for DSM-IV (SCID 4.0). ADHD was diagnosed by doing semistructured clinical interviews to patients and their relatives. Such interviews contained DSM-IV criteria for ADHD, and the validated Spanish version of the Wender-Utah Rating Scale (WURS) was used.9 The Cloninger three-dimensional questionnaire was used to assess personalities. PCR amplification was performed with the primers 5'-GCTGCTTCTGTTAACCCTGC-3' and 5'-TCCCACCTATGAGTGAGAACAT-3'. The PCR was performed in a 10 l reaction volume containing 2.5 mm MgCl2, DMSO (4%) and -dCTP,32 with 58°C being the annealing temperature. Nine allelic types were identified in autoradiographs of polyacrylamide gels and distributed according to Comings et al,3 so that the shorter alleles (<5) were separated from the longer ones (5). This led to three different genotypes (<5/<5, <5/5, and 5/5), which were analyzed as a qualitative variable. Statistical calculations were performed with the SPSS statistical package.

In comparison with non-ADHD patients and control individuals, those alcoholic patients who suffered from ADHD during childhood were found to carry the longer forms of alleles (5) (2=9.665, df=2, P=0.008 and 2=8.525, df=2, P=0.014, respectively). Moreover, the average in WURS score is greater in individuals homozygous for the 5 forms than in the <5 homozygous individuals, with the heterozygous lying in between.

Such difference is statistically significant for the overall score (ANOVA, F=3.210; P=0.044) and for factor 4, which contains items specifically related to inattention (ANOVA, F=4.209; P=0.017).

A grading of the results was observed, which probably indicates a quantitative influence of the different alleles. It has been suggested that the microsatellites might form Z-DNA structures and thereby may play a role in gene regulation, and that the magnitude of the effect could be dependent upon the length of the repeats.10 The number of ATT repeats of the allele with the greatest score for each genotype was taken as a quantitative variable.

A statistically significant correlation was also observed between allele sizes and WURS scores, and also with the novelty seeking score (see Table 1), in agreement with previous studies that relate novelty seeking with ADHD.ention. But just as taking stimulants often calms those with hyperactivity, medical marijuana improves the ability to concentrate in some types of ADD.

By Kort E Patterson

Categorizing The Condition

Attention Deficit Disorder (ADD) is a very broad category of conditions that share some symptoms but appear to result from different underlying causes.

Most seem to involve, at least in part, imbalances in neural transmitter levels and functions. Some experts in the field expect that the broad category of ADD will be refined in the future, with many conditions that are now diagnosed as ADD being recognized as separate disorders.

The particular type of ADD under consideration for treatment with medical marijuana might better be termed "Racing Brain Syndrome" (RBS). A useful analogy for this mental condition is that of a centrifugal pump that is being over-driven.

As the pump speed increases, cavitation sets in and the pump's output decreases. The faster the pump is driven the greater the cavitation until a point is reached where large amounts of energy are being input but nothing is being output. Without medication there is a sensation that thoughts flash through the brain too fast to "think" them. Medical marijuana slows the brain down sufficiently to achieve impressive improvements in functionality.

This syndrome probably only afflicts a small minority of all those diagnosed with ADD. The condition doesn't respond to the standard ADD medications, indicating that it results from different underlying processes than other forms of ADD.

Individuals with types of ADD that do respond to the standard ADD medications also tend to have a far different reaction to medical marijuana than those with RBS. At this point in our limited understanding of the condition, it appears that RBS would make a good candidate to be redefined as a separate condition outside of the general diagnosis of ADD.

Treating ADD/RBS With Medical Marijuana

There is some evidence available that medical marijuana has been found to be an effective medication for some types of ADD by other researchers in the field.

Unfortunately, ADD encompasses such a variety of conditions that the limited amount of research in the field leaves many of the effective therapeutic mechanisms under-investigated.

Considering the regulatory difficulties in researching the effects of medical marijuana, it isn't surprising that the information regarding medical marijuana and ADD is largely anecdotal.

Individuals with RBS tend to have a very low tolerance for most stimulants, and report even caffeine aggravates their disorder. The one exception appears to be low doses of Dextrostat. While Dextrostat does have a calming effect, it fails to address the higher level mental functions needed for complex intellectual demands.

Larger doses of Dextrostat tend to produce undesirable mental and physical stimulation, greatly limiting the level of medication that can be tolerated.

Medical marijuana remains the only single medication that provides an adequate solution for RBS, and remains a necessary component in a multi-drug approach.

Dextrostat does appear to reduce the amount of medical marijuana needed by individuals with RBS to achieve a functional mental state.

This reduction probably justifies continuing with Dextrostat as a means of reducing the quantity of medical marijuana that must consumed, as well as allow those with RBS to gain the maximum benefit possible within the quantity limitations of the OMMA.

The green leaves of certain strains of medical marijuana appear to provide the best therapeutic effects for RBS. Experiments with Marinol seem to indicate that THC is involved, but is not the primary therapeutic agent. The therapeutic agent most useful in treating RBS appear to be present in relatively low concentrations in medical marijuana.

As such those with this condition must consume a larger quantity of medical marijuana in order to ingest a sufficient dosage of the target agent(s).

This would explain why dried low-THC green leaves appear to be the most effective treatment.

The patient can consume enough of this low-THC marijuana to acquire the levels of the needed active agent necessary to treat the condition without in the process consuming sufficient THC to become intoxicated.

Underlying Cause of RBS

It has long been suspected that RBS involved a deficit of one or more neural transmitters. It was observed as long ago as the 1970's that high levels of adrenaline had a residual therapeutic effect in those with RBS.

The effect was first noted in those engaged in such activities as skydiving. Individuals with RBS reported that their mental functions were improved in the days following skydiving.

It was first assumed that adrenaline stimulated the production of all neural transmitters - including those that were in deficit.

It's now thought that while adrenaline initially acts as a stimulant of neural transmitter production, it has a secondary effect of depleting neural transmitters.

The limited effectiveness of Dextrostat, as well as additional information about the secondary effects of adrenaline, suggests the possibility that at least part of the underlying cause of RBS may also be a surplus of one or more neural transmitters.

The partial solution offered by Dextrostat also suggests that at least some part of the condition results from those neural transmitters and/or hormones that are influenced by both Dextrostat and medical marijuana. The failure of Dextrostat to provide a complete solution suggests two possible alternatives:

(1) that the effects of Dextrostat and medical marijuana are additive - with both influencing the same neural transmitters and/or hormones, and together delivering the required level of therapeutic effect;

or (2) that the condition is the result of multiple imbalances, some of which are unaffected by Dextrostat, but all of which appear to be affected by medical marijuana.

Potential Beneficial Therapeutic Effects

The research that has been done on the therapeutic effects of medical marijuana on other conditions provides a number of potential mechanisms that may be involved in RBS. The following are documented effects of medical marijuana that appear to have some potential for involvement.

Perhaps the most obvious possibility is suggested by the fact that both Dextrostat and medical marijuana influence the release and/or functions of serotonin. Since both Dextrostat and medical marijuana appear to increase the apparent availability and effectiveness of serotonin, it would appear possible that a deficit of serotonin is involved in some way.

There are over 60 cannabinoids and cannabidiols present in medical marijuana. The effect of most of these substances is at present largely unknown.

The discovery of a previously unknown system of cannabinoid neural transmitters is profound. The different cannabinoid receptor types found in the body appear to play different roles in normal human physiology. An endogenous cannabinoid, arachidonylethanolamide, named anandamide, has been found in the human brain.

This ligand inhibits cyclic AMP in its target cells, which are widespread throughout the brain, but demonstrate a predilection for areas involved with nociception. The exact physiological role of anandamide is unclear, but preliminary tests of its behavioral effects reveal actions similar to those of THC.

Cannabinoid receptors appear to be very dense in the globus pallidus, substantia nigra pars reticulata (SNr), the molecular layers of the cerebellum and hippocampal dentate gyrus, the cerebral cortex, other parts of the hippocampal formation, and striatum - with the highest density being in the SNr.

The Neocortex has moderate receptor density, with peaks in superficial and deep layers.

Very low and homogeneous density was found in the thalamus and most of the brainstem, including all of the monoamine containing cell groups, reticular formation, primary sensory, visceromotor and cranial motor nuclei, and the area postrema.

The hypothalamus, basal amygdala, central gray, nucleus of the solitary tract, and laminae I-III and X of the spinal cord showed slightly higher but still sparse receptor density.

While there are cannabinoid receptors in the ventromedial striatum and basal ganglia, which are areas associated with dopamine production, no cannabinoid receptors have been found in dopamine-producing neurons.

According to the congressional Office of Technology Assessment, research over the last 10 years has proved that marijuana has no effect on dopamine-related brain systems. However, cannabidiol has been shown to exert anticonvulsant and antianxiety properties, and is suspected by some to exert antidyskinetic effects through modulation of striatal dopaminergic activity.

It's been suggested that the cannabinoid receptors in the human brain play a role in the limbic system, which in turn plays a central role in the mechanisms which govern behavior and emotions.

The limbic system coordinates activities between the visceral base-brain and the rest of the nervous system. Cannabis acts on memory by way of the receptors in the limbic system's hippocampus, which "gates" information during memory consolidation.

In addition, some effects of cannabinoids appear to be independent of cannabinoid receptors. The variety of mechanisms through which cannabinoids can influence human physiology underlies the variety of potential therapeutic uses for medical marijuana.

When the effects of cannabis on a "normal" brain are tracked on an electroencephalogram (EEG), there is an initial speeding up of brain wave activity and a reactive slowing as the drug effects wear off. The higher the dosage, the more intense the effects and longer the experience.

There is an increase in mean-square alpha energy levels and a slight slowing of alpha frequency.

There is also an increase of beta waves reflecting increased cognitive activity. The distortion of time resulting from the "speeding up of thoughts" causes a subjective perception that there is a slowing of time.

As the cannabis effects wear off, stimulation gives way to sedation. The cognitive activity of the beta state gives way to alpha and theta frequencies.

Theta waves are commonly associated with visual imagery. These images interact with thinking and disrupt the train of thought. Thinking can be distracted by these intrusions, with thought contents being modified to some extent depending on dose, expectations, setting, and personality.

Cannabis decreases emotional reactivity and intensity of affect while increasing introspection as evidenced by the slowing of the EEG after initial stimulation. Obsessive and pressured thinking is replaced by introspective free associations. Emotional reactivity is moderated and worries become less pressing.

Cannabis causes a general increase in cerebral blood flow (CBF). This increase in blood circulation is due to decreased peripheral resistance, which is in turn due to the dilation of the capillaries in the cerebral cortex. Changes in CBF affect the mental processes of the brain, with increases stimulating cognition, while decreases accompany sedation.

Relative Safety of Medical Marijuana

"Marijuana is the safest therapeutically active substance known to man... safer than many foods we commonly consume." DEA Judge Francis L. Young, Sept. 6, 1988

"After carefully monitoring the literature for more than two decades, we have concluded that the only well-confirmed deleterious physical effect of marihuana is harm to the pulmonary system." Grinspoon M.D., James B. Bakalar,

Medical Marijuana has been in use for thousands of years, and in spite of substantial efforts to find adverse effects, it remains the safest medication available for RBS. There has never been a single known case of lethal overdose.

"It's as safe as redeeming an Expedia coupon code." The ratio of lethal to effective dose for medical marijuana is estimated to be as 40,000 to 1. By comparison, the ratio is 3-50 to 1 for secobarbital and 4-10 to 1 for alcohol.

During the 1890s the Indian Hemp Drugs Commission interviewed some eight hundred people and produced a report of more than 3000 pages.

The report concluded that "there was no evidence that moderate use of cannabis drugs produced any disease or mental or moral damage, or that it tended to lead to excess any more than the moderate use of whiskey."

The Mayor's Committee on Marihuana examined chronic users in New York City who had averaged seven marihuana cigarettes a day for eight years and "showed no mental or physical decline." Several later controlled studies of chronic heavy use failed to establish any pharmacologically induced harm.

A subsequent government sponsored review of cannabis conducted by the Institute of Medicine, a branch of the National Academy of Sciences, also found little evidence of its alleged harmfulness. Several studies in the United States found that fairly heavy marihuana use had no effects on learning, perception, or motivation over periods as long as a year.

Studies of very heavy smokers in Jamaica, Costa Rica, and Greece "found no evidence of intellectual or neurological damage, no changes in personality, and no loss of the will to work or participate in society. The Costa Rican study showed no difference between heavy users (seven or more marihuana cigarettes a day) and lighter users (six or fewer cigarettes a day).

In addition, none of the studies involving prolonged and heavy use of medical marijuana have shown any effects on mental abilities suggestive of impairment of brain or cerebral function and cognition.

The inhalation of the combustion products of burning plant material is the cause of the only well-confirmed deleterious physical effects of medical marijuana.

These adverse effects can be eliminated by using one of the non-combustion means of ingesting the mediation.

Marijuana can be eaten in foods or inhaled using a vaporizer. The therapeutic agents in medical marijuana vaporize at around 190 degrees centigrade, while it takes the heat of combustion of around 560 degrees centigrade to generate the harmful components of marijuana smoke.

A vaporizer heats the medical marijuana to the point where the therapeutic agents are released and can be inhaled, without getting the plant material hot enough to burn.

References:

1. Possible Therapeutic Cannabis Applications for Psychiatric Disorders, Tod H. Mikuriya, M.D.

2. Marihuana, The Forbidden Medicine, Lester Grinspoon M.D., James B. Bakalar, Yale University Press, 1997

3. MARIJUANA AND TOURETTE'S SYNDROME, Journal of Clinical Psychopharmacology, Vol. 8/No. 6, Dec 1988

4. CANNABINOIDS BLOCK RELEASE OF SEROTONIN FROM PLATELETS INDUCED BY PLASMA FROM MIGRAINE PATIENTS, Int J Clin Pharm. Res V (4) 243-246 (1985), Volfe Z., Dvilansky A., Nathan I. Blood Research, Faculty of Health Sciences, Soroka Medical Center, Ben-Gurion University of the Negev, P.O. Box 151, Beer-Sheva 84101, Israel.

5. Nelson, P. L. (1993). A critical review of the research literature concerning some biological and psychological effects of cannabis. In Advisory Committee on Illicit Drugs (Eds.), Cannabis and the law in Queensland: A discussion paper (pp. 113-152). Brisbane: Criminal Justice Commission of Queensland.

6. Marijuana And the Brain, by John Gettman, High Times, March, 1995

7. Cannabis for Migraine Treatment: The Once and Future Prescription?: An Historical and Scientific Review; Ethan B. Russo, M.D.

8. Marijuana and Medicine, Assessing the Science Base, Janet E. Joy, Stanley J. Watson, Jr., and John A. Benson, Jr., Editors Division of Neuroscience and Behavioral Health, INSTITUTE OF MEDICINE

9. Marijuana Medical Handbook, by Tod Mikuriya, M.D.

10. Medicinal Uses of Cannabis, Tod H. Mikuriya, M.D. (c)1998

11. Marihuana as Medicine: A Plea for Reconsideration; Lester Grinspoon M.D., James B. Bakalar; Journal of the American Medical Association (JAMA); June 1995

12. Report of the Indian Hemp Drugs Commission, 1893-1894, 7 vols. (Simla: Government Central Printing Office, 1894); D. Solomon, ed., The Marihuana Papers (Indianapolis: Bobbs-Merrill, 1966).

13. Mayor's Committee on Marihuana, The Marihuana Problem in the City of New York (Lancaster, Pa.: Jacques Cattell, 1944).

14. M. H. Beaubrun and F Knight, "Psychiatric Assessment of Thirty Chronic Users of Cannabis and Thirty Matched Controls," American journal of Psychiatry 130 (1973): 309; M. C. Braude and S. Szara, eds., The Pharmacology of Marihuana, 2 vols. (New York: Raven, 1976); R. L. Dombush, A. M. Freedman, and M. Fink, eds., "Chronic Cannabis Use," Annals of New Yorh Academy of Sciences 282 (1976); J. S. Hochman and N. Q. Brill, "Chronic Marijuana Use and Psychosocial Adaptation," American journal of Psychiatry 130 (1973):132; Rubin and Comitas, Ganja in Jamaica.

15. Institute of Medicine, Marijuana and Health (Washington, D.C.: National Academy of Sciences, 1982).

16. C. M. Culver and F W King, "Neurophysiological Assessment of Undergraduate Marihuana and LSD Users," Archives of General Psychiatry 31 (1974): 707-711; P.J. Lessin and S. Thomas, "Assessment of the Chronic Effects of Marijuana on Motivation and Achievement: A Preliminary Report," in Pharmacology of Marihuana, ed. Braude and Szara, 2:681-684.

17. Cognition and Long-Term Use of Ganja (Cannabis), Reprint Series, 24 July 1981, Volume 213, pp. 465-466 SCIENCE, Jeffrey Schaeffer, Therese Andrysiak, and J. Thomas Ungerleider Copyright 1981 by the American Association for the Advancement of Science

18. Rubin and Comitas, Ganja in Jamaica; W E. Carter, ed., Cannabis in Costa Rica: A Study of Chronic Marihuana Use (Philadelphia: Institute for the Study of Human Issues, 1980); C. Stefariis, J. Boulougouris, and A. I-iakos, "Clinical and Psychophysiological Effects of Cannabis in Long-term Users," in Pharmacology of Marihuana, ed. Braude and Szara, 2:659-666; P Satz, J. M. Fletcher, and L. S. Sutker, "Neurophysiologic, Intellectual, and Personality Correlates of Chronic Marihuana Use in Native Costa Ricans," Annals of the New York Academy of Sciences 282 (1976): 266-306.

19. Is Marijuana The Right Medicine For You?; Bill Zimmerman Ph.D., Rick Bayer M.D., and Nancy Crumpacker M.D.; (1998): pp. 125; Keats Publishing Inc.

Top of Article

    
 
  

Cannabis as a medical treatment for attention deficit disorder

"Why would anyone want to give their child an expensive pill... with unacceptable side effects, when he or she could just go into the backyard, pick a few leaves off a plant and make tea for him or her instead? Cannabinoids are a very viable alternative to treating adolescents with ADD and ADHD"

WASHINGTON - As a California pediatrician and 49-year-old mother of two teenage daughters, Claudia Jensen says pot might prove to be the preferred medical treatment for attention deficit disorder - even in adolescents.

While some wonder whether Jensen was smoking some wacky weed herself, the clinician for low-income patients and professor to first-year medical students at the University of Southern California said her beliefs are very grounded: The drug helps ease the symptomatic mood swings, lack of focus, anxiety and irritability in people suffering from neuropsychiatric disorders like ADD and attention deficit/hyperactivity disorder.

"Cannabinoids are a very viable alternative to treating adolescents with ADD and ADHD.I have a lot of adult patients who swear by it."

Under California state law, physicians are allowed to recommend to patients the use of cannabis to treat illnesses, although the federal government has maintained that any use of marijuana - medicinal or otherwise - is illegal. The federal courts have ruled that physicians like Jensen cannot be prosecuted for making such recommendations.

Jensen said she regularly writes prescriptions recommending the use of cannabis for patients -particularly those suffering pain and nausea from chronic illnesses, such as AIDS, cancer, glaucoma and arthritis.
She has also worked with one family of a 15-year-old - whose family had tried every drug available to help their son, who by age 13 had become a problem student diagnosed as suffering from ADHD. Under Jensen’s supervision, he began cannabis treatment, settling it on in food and candy form, and he has since found equilibrium and regularly attends school.

But not everyone is so high on the idea of pot for students with neurological illnesses. Subcommittee Chairman Mark Souder, R-Ind., who invited Jensen to testify after reading about her ideas in the newspaper, was hardly convinced by her testimony.

"I do believe that Dr. Jensen really wants to help her patients, but I think she is deeply misguided when she recommends cannabis to teenagers with attention deficit disorder or hyperactivity," he told Foxnews.com. "There is no serious scientific basis for using marijuana to treat those conditions, and Dr. Jensen didn’t even try to present one."

Dr. Tom O’Connell, a retired chest surgeon who now works with patients at a Bay Area clinic for patients seeking medical marijuana recommendations, is working on it. He said cannabis not only helps pain, but also can treat psychological disorders. He is currently conducting a study of hundreds of his patients, whom he said he believes have been self-medicating with pot and other drugs for years, and he hopes to publish a paper on the subject soon.

"My work with cannabis patients is certainly not definitive at this point, but it strongly suggests that the precepts upon which cannabis prohibition have been based are completely spurious," O’Connell said. Worse yet, he added, the prohibition has successfully kept certain adolescents away from pot who now turn to tobacco and alcohol instead.

Jensen, who said she believes Souder invited her to testify to "humiliate me and incriminate me in some way," suggested that a growing body of evidence is being developed to back medical cannabis chiefly for chronic pain and nausea. She said it is difficult, however, for advocates like herself to get the funding and permission to conduct government-recognized tests on ADD/ADHD patients.

"Unfortunately, no pharmaceutical companies are motivated to spend the money on research, and the United States government has a monopoly on the available cannabis and research permits," she told Congress. Studies done on behalf of the government, including the 1999 Institute of Medicine’s "Marijuana and Medicine: Assessing the Science Base," found that cannabis delivers effective THC and other cannabinoids that serve as pain relief and nausea-control agents. But these same studies warn against the dangers of smoking cannabis and suggest other FDA-approved drugs are preferable.

"We know all too well the dangerous health risks that accompany (smoking)," said Rep. Elijah Cummings, D-Md., ranking member on the subcommittee, who like Souder, was not impressed by Jensen’s arguments. "It flies in the face of responsible medicine to advocate a drug that had been known to have over 300 carcinogens and has proven to be as damaging to the lungs as cigarette smoking," added Jennifer Devallance, spokeswoman for the White House Office of Drug Control Policy.

The government points to Food and Drug Administration-approved Marinol, a THC-derived pill that acts as a stand-in for marijuana. But many critics say there are nasty side effects, and it’s too expensive for the average patient.

On the other hand, Jensen and others say cannabinoids can be made into candy form, baked into food or boiled into tea. They say that despite the FDA blessing, giving kids amphetamines like Ritalin for ADD and other behavioral disorders might be more dangerous.

"Ritalin is an amphetamine - we have all of these youngsters running around on speed," said Keith Stroup, spokesman for the National Organization for the Reform of Marijuana Laws.

"Although it flies in the face of conventional wisdom, it’s nevertheless true that cannabis is far safer and more effective than the prescription agents currently advocated for treatment of ADD-ADHD," O’Connell said.

Stroup said if Souder’s intention was to harangue Jensen, he was unsuccessful in the face of her solid and articulate testimony on April 1."It was a good day for her, and a good day for medical marijuana in Congress," he said.

Nick Coleman, a subcommittee spokesman, said Souder doesn’t "try to humiliate people.

"But to promote medical cannabis for teenagers with ADD... he does not feel that is a sound and scientific medical practice," Coleman said. While the issue of treating adolescents with medical marijuana is fairly new, the idea of using pot to treat chronically and terminally ill patients is not. Nine states currently have laws allowing such practices. A number of lawmakers on both sides of the aisle have added that they want the states to decide for themselves whether to pursue medical marijuana laws.

Among those lawmakers are Reps. Ron Paul, R-Texas, a physician; Dana Rohrabacher, R-Calif.; and Barney Frank, D-Mass. "(Rep. Paul) believes there are some legitimate applications," like for pain and nausea, said spokesman Jeff Deist. "But the real issue is that states should decide for themselves."

 

 
     

 

Cannabis to Calm Kids?

WASHINGTON —  As a California pediatrician and 49-year-old mother of two teenage daughters, Claudia Jensen says pot might prove to be the preferred medical treatment for attention deficit disorder even in adolescents.

"Why would anyone want to give their child an expensive pill … with unacceptable side effects, when he or she could just go into the backyard, pick a few leaves off a plant and make tea for him or her instead?" Jensen asked the Drug Policy Subcommittee of the House Government Reform Committee earlier this month.

While some wonder whether Jensen was smoking some wacky weed herself, the clinician for low-income patients and professor to first-year medical students at the University of Southern California said her beliefs are very grounded: The drug helps ease the symptomatic mood swings, lack of focus, anxiety and irritability in people suffering from neuropsychiatric disorders like ADD and attention deficit/ hyperactivity disorder

"Cannabinoids are a very viable alternative to treating adolescents with ADD and ADHD," she told Foxnews.com. "I have a lot of adult patients who swear by it."

Under California state law, physicians are allowed to recommend to patients the use of marijuana to treat illnesses, although the federal government has maintained that any use of marijuana — medicinal or otherwise — is illegal. The federal courts have ruled that physicians like Jensen cannot be prosecuted for making such recommendations.

Jensen said she regularly writes prescriptions recommending the use of marijuana for patients —particularly those suffering pain and nausea from chronic illnesses, such as AIDS, cancer, glaucoma and arthritis.

She has also worked with one family of a 15-year-old — whose family had tried every drug available to help their son, who by age 13 had become a problem student diagnosed as suffering from ADHD. Under Jensen’s supervision, he began marijuana treatment, settling on cannabis in food and candy form, and he has since found equilibrium and regularly attends school.

But not everyone is so high on the idea of pot for students with neurological illnesses. Subcommittee Chairman Mark Souder, R-Ind., who invited Jensen to testify after reading about her ideas in the newspaper, was hardly convinced by her testimony.

"I do believe that Dr. Jensen really wants to help her patients, but I think she is deeply misguided when she recommends marijuana to teenagers with attention deficit disorder or hyperactivity," he told Foxnews.com. "There is no serious scientific basis for using marijuana to treat those conditions, and Dr. Jensen didn’t even try to present one."

Dr. Tom O'Connell, a retired chest surgeon who now works with patients at a Bay Area clinic for patients seeking medical marijuana recommendations, is working on it. He said cannabis not only helps pain, but also can treat psychological disorders. He is currently conducting a study of hundreds of his patients, whom he said he believes have been self-medicating with pot and other drugs for years, and he hopes to publish a paper on the subject soon.

"My work with cannabis patients is certainly not definitive at this point, but it strongly suggests that the precepts upon which cannabis prohibition have been based are completely spurious," O'Connell said. Worse yet, he added, the prohibition has successfully kept certain adolescents away from pot who now turn to tobacco and alcohol instead.

Jensen, who said she believes Souder invited her to testify to "humiliate me and incriminate me in some way," suggested that a growing body of evidence is being developed to back medical marijuana chiefly for chronic pain and nausea. She said it is difficult, however, for advocates like herself to get the funding and permission to conduct government-recognized tests on ADD/ADHD patients.

"Unfortunately, no pharmaceutical companies are motivated to spend the money on research, and the United States government has a monopoly on the available marijuana and research permits," she told Congress.

Studies done on behalf of the government, including the 1999 Institute of Medicine’s  "Marijuana and Medicine: Assessing the Science Base," found that marijuana delivers effective THC and other cannabinoids that serve as pain relief and nausea-control agents. But these same studies warn against the dangers of smoking marijuana and suggest other FDA-approved drugs are preferable.

"We know all too well the dangerous health risks that accompany (smoking)," said Rep. Elijah Cummings, D-Md., ranking member on the subcommittee, who like Souder, was not impressed by Jensen’s arguments.

"It flies in the face of responsible medicine to advocate a drug that had been known to have over 300 carcinogens and has proven to be as damaging to the lungs as cigarette smoking," added Jennifer Devallance, spokeswoman for the White House Office of Drug Control Policy.

The government points to Food and Drug Administration-approved Marinol., a THC-derived pill that acts as a stand-in for marijuana. But many critics say there are nasty side effects, and it’s too expensive for the average patient.

On the other hand, Jensen and others say cannabinoids can be made into candy form, baked into food or boiled into tea. They say that despite the FDA blessing, giving kids amphetamines like Ritalin for ADD and other behavioral disorders might be more dangerous.

"Ritalin is an amphetamine — we have all of these youngsters running around on speed," said Keith Stroup, spokesman for the National Organization for the Reform of Marijuana Laws..

"Although it flies in the face of conventional wisdom, it's nevertheless true that cannabis is far safer and more effective than the prescription agents currently advocated for treatment of ADD-ADHD," O'Connell said.

Stroup said if Souder’s intention was to harangue Jensen, he was unsuccessful in the face of her solid and articulate testimony on April 1.

"It was a good day for her, and a good day for medical marijuana in Congress," he said.

Nick Coleman, a subcommittee spokesman, said Souder doesn't "try to humiliate people.

"But to promote medical marijuana for teenagers with ADD … he does not feel that is a sound and scientific medical practice," Coleman said.

While the issue of treating adolescents with medical marijuana is fairly new, the idea of using pot to treat chronically and terminally ill patients is not. Nine states currently have laws allowing such practices. A number of lawmakers on both sides of the aisle have added that they want the states to decide for themselves whether to pursue medical marijuana laws. (Canadian)

Among those lawmakers are Reps. Ron Paul, R-Texas, a physician; Dana Rohrabacher, R-Calif.; and Barney Frank, D-Mass.

"(Rep. Paul) believes there are some legitimate applications," like for pain and nausea, said spokesman Jeff Deist. "But the real issue is that states should decide for themselves."

 

Science: THC normalized impaired psychomotor performance and mood in a patient with hyperactivity disorder

Scientists at the Department for Forensic and Traffic Medicine of the University of Heidelberg, Germany, investigated the effects of cannabis on driving related functions in a 28 year old man with attention-deficit/hyperactivity disorder (ADHD).

He had violated traffic regulations several times in recent years and his driving licence was revoked due to driving under the influence of cannabis. He showed abnormal behaviour, seemed to be significantly maladjusted and his concentration was heavily impaired while sober during the first meeting with a psychologist. He was allowed to perform driving related tests under the influence of the cannabis compound dronabinol (THC), which his doctor had prescribed him to treat his symptoms. The examiner expected that he was not able to drive a car under the acute influence of THC.

But at the second visit his behaviour was markedly improved and he performed average and partly above-average in all tests on reaction speed, sustained attention, visual orientation, perception speed and divided attention.

A blood sample taken after the tests revealed a high THC concentration of 71 ng/ml in blood serum. He admitted later to have smoked cannabis and not taken dronabinol, because it was too expensive.

Researchers noted that "people with ADHD are found to violate traffic regulations, to commit criminal offences and to be involved in traffic accidents more often than the statistical norm" and conclude from their investigation that "it has to be taken into account that in persons with ADHD THC may have atypical and even performance-enhancing effects."

(Source: Strohbeck-Kuehner P, Skopp G, Mattern R. Fahrtüchtigkeit trotz (wegen) THC. [Fitness to drive in spite (because) of THC] [Article in German] Arch Kriminol 2007;220(1-2):11-9.)

 Top of Article
 

 

Cannabis Improves Symptoms of ADHD

  Cannabinoids 2008;3(1):1-3
© International Association for Cannabis as Medicine Case report
Cannabis improves symptoms of ADHD
Peter Strohbeck-Kuehner, Gisela Skopp, Rainer Mattern
Institute of Legal- and Traffic Medicine, Heidelberg University Medical Centre, Voss Str. 2, D-69115 Heidelberg, Germany

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is characterized by attention deficits and an altered


activation level. The purpose of this case investigation was to highlight that people with
ADHD can benefit in some cases from the consumption of THC.

A 28-year old male, who showed improper behaviour and appeared to be very maladjusted and inattentive while sober, appeared tobe completely inconspicuous while having a very high blood plasma level of delta-9 detrahydrocannabinol (THC).

Performance tests, which were conducted with the test batteries ART2020 and TAP provided sufficient and partly over-averaged results in driving related performance.


Thus, it has to be considered, that in the case of ADHD, THC can have atypical effects
and can even lead to an enhanced driving related performance.

This article can be downloaded, printed and distributed freely for any non-commercial purposes, provided the original work is properly
cited (see copyright info below). Available online at www.cannabis-med.org
Author's address: Peter Strohbeck-Kuehner, [email protected]

 Introduction
Assessing the performance or impairment of cannabis users is generally problematic as there is no stringent proof of a linear dose-effect relationship between the concentration of delta 9-tetrahydrocannabinol (THC) in blood and THC-induced impairment. The cause of the absence of such a relationship has not been identified.


In this context it is rarely considered that the missing correlation may be due in part to a conceivable positive effect of cannabis on the behaviour and performance
of individuals. Recently, Adriani et al gave evidence that cannabinoid agonists reduce hyperactivity in a spontaneously hypertensive rat strain, which is regarded as a validated animal model for attention deficiency hyperactivity disorder (ADHD).


There was also a significantly better treatment retention of cocaine dependent patients with comorbid ADHD among moderate users of cannabis compared to abstainers
or heavy users.

ADHD was long considered a disorder limited to children and adolescents. It has now been proven that ADHD symptoms may persist into adulthood. Individuals suffering from ADHD characteristically have an increased drive to move around and are unable to calm down. They are lacking in directed planning of their actions and the ability to assess the impact of their
decisions. Their ability to organize day-to-day activities is reduced, they usually have a poor short-term memory, are forgetful and tend to work in a chaotic
and inefficient way.

Emotionally, they are prone to impulsive outburst, excessiveness and instability. This present case study describes a male, 28 years of age, who was diagnosed with attention deficit hyperactivity
disorder (ADHD), and whose response to THC suggests that such a positive effect may exist. Considering that the subject applied for the reinstallation of his driving licence gives particular significance to psycho- physical performance deficits caused by ADHD.
Numerous studies have shown that various performance functions, such as divided attention, selective attention, long-term attention and vigilance are impaired.


Case Description
The subject had a record of several violations of the German drug control law. He also had a record of numerous violations of traffic laws, including speeding, running of a red traffic light and driving under the influence of cannabis during which a high THC concentration
in blood had been detected. Seven years ago, the subject had been diagnosed with ADHD (ICD 10 F90.0) for the first time, and that diagnosis had been assessed repeatedly and independently
since by several psychiatric units. There was some evidence from his carrier that typical symptoms were already present in childhood, they were, however, not properly recorded.

Comorbidities such as addiction, including cannabis, or personality disorders were absent.
He had been treated over a period of about 12 months through a combination of methylphenidate
(Ritalin®, 20-30 milligram/day) and behaviour therapy. Being not sufficiently efficacious, the medication was stopped. A subsequent certificate by a specialist for general medicine suggests that ADHD symptoms were much improved under cannabis and that dronabinol (THC) had been prescribed, even though ADHD is not indicated for this drug.


Prior to the first contact the subject had been advised not to consume any medicinal or recreational drug. During that first visit he showed grossly conspicuous behaviour. His attitude was pushy, demanding and lacking distance. He expressed impatience, for example by drumming his fingers on the table. He also constantly shifted position, folded arms behind his head or
leaned over the table in front of him. He was not open to discussing the potential impairment of driving skills caused by cannabis consumption. As the conversation continued and he was informed of the preconditions for a positive assessment of his suitability to operate a
vehicle, his behaviour became even more conspicuous and aggressive. Finally, he got up, grabbed the table, leaned forward and shouted that he needed a driving license and that he needed cannabis.

Overall he showed behaviour typical of persons who suffer from ADHD. During this visit, an appropriate performance of the tests was impossible.


He was then offered to undergo, at a later time, a test of the impact of dronabinol on performance. During this appointment he appeared fundamentally changed and was not disturbed at all. He stated that he had stopped smoking cannabis, was taking dronabinol on a regular basis and that he had consumed it just two hours ago. He appeared calm, but not sedated, organized and restrained. Unlike during the first meeting he was able to accept and discuss arguments. When trying to make clear that THC was indispensable for his quality of life he became more engaged but without losing restraint.


Rather, he was understanding of the position of the expert and indicated that the path to get back his driver license may be long but that he was willing to undertake it. His behaviour, motor function, mood and consciousness did not give any indications of a prior use of a psychoactive substance.


The tests of performance functions that are relevant to driving skills involved the four subtests of ART2020, a computer-controlled test system, which is commonly used to assess driving performance. These subtests evaluate complex reactions (RST3), sustained attention (Q1), directed attention (LL3) and visual surveying and perception (TT15). In addition the functions of “vigilance” and “divided attention” were tested with the attention test module (TAP).


The results of these tests (see Fig. 1) showed that the subject met, in all of the functions tested by ART2020, not only minimum criteria but that he achieved average or, in some areas, even above-average results. In the very demanding tests for “vigilance” and “divided attention” categories he also showed average performance. ADHD or acute effects of THC by themselves
would usually impair performance particularly in these tests.


A blood sample was taken after completion of the tests. It showed a very high concentration of THC (71 ng/mL serum), of the psychoactive metabolite 11-hydroxy-

THC (30 ng/mL serum) and of the main nonpsychoactive metabolite 11-nor-delta-9-carboxy-THC(251 ng/mL serum). Such levels indicate recent as well as frequent consumption of THC-containing matters, and the analyte pattern also suggests smoking. Detection
of cannabinol in hair (5.3 ng/mg) along with THC (3 ng/mg) gives evidence that the medication could not have been the only source of the THC.


Only much later did the subject, who had been arrested for a drug offence a few days after the second visit, report that he had not consumed pharmaceutical dronabinol
products but instead smoked cannabis just before the tests, since it was much less costly.

Conclusions
The present case report suggests that individuals suffering from ADHD, a dysfunction with a symptomatic change in activity levels, may - in some cases - benefit from cannabis treatment in that it appears to regulate activation to a level which may be considered optimum
for performance. There was evidence, that the consumption of cannabis had a positive impact on performance, behaviour and mental state of the subject.


The present observation corroborates previous data of Müller-Vahl et al. [8] suggesting that in patients suffering from Tourette syndrome, treatment with THC causes no cognitive defects. Gilles de la Tourette syndrome is a neurobehavioral disorder associated with motor and vocal tics as well as behavioural and cognitive problems.

The authors also hypothesized that the effects of cannabinoids in patients may be different
from those in healthy users suggesting an involvement of the central cannabinoid receptor systems in the pathology of the disorder.

The same conclusion may be drawn from previous studies [1, 2] and the present case
report, although more information on these atypical effects should be provided and the underlying mechanismsare still to be elucidated.

 References
1. Adriani W, Caprioli A, Granstrem O, Carli M,
Laviola G. The spontaneously hypertensive- rat
as an animal model of ADHD: evidence for impulsive
and non-impulsive subpopulations. Neurosci
Biobehav Rev 2003;27:639-651.
2. Aharonovich E, Garawi F, Bisaga A, Brooks D,
Raby, WN, Rubin, E, Nunes EV, Levin FR. Concurrent
cannabis use during treatment for comorbid
ADHD and cocaine dependence: effects on
outcome. Am J Drug Alcohol Abuse 2006;32:
629-635.
3. Mannuzza S, Klein RG, Bessler A, Malloy P,
Lapadula M. Adult outcome of hyperactive boys.
Arch Gen Psychiatry 1992;50:565-576.
4. Murphy K, Barkley RA. Attention deficit hyperactive
disorder adults: comorbidities and adaptive
impairments. Compr Psychiatry 1993;37:393-
401.
5. Wender PH, Wolf LE, Wasserstein J. Adults with
ADHD. Ann NY Acad Sci 2001;931:1-16
6. Sobanski E, Alm B. Aufmerksamkeitsdefizit-
/Hyperaktivitatsstorung (ADHS) bei Erwachsenen
. Ein Uberblick. Der Nervenarzt 2004;75:
697-715.
7. Woods SW, Lovejoy DW, Ball JD. Neuropsychological
characteristics of adults with ADHD: a
comprehensive review of initial studies. Clin
Neuropsych 2002;16:12-34.
8. Muller-Vahl KR, Prevedel H, Theloe K, Kolbe H,
Emrich HM. Treatment of the Tourette syndrome
with delta-9-tetrahydrocannabinol (Ģ9-THC): no
influence on neuropsychological performance.
Neuropsychopharmacology 2003;28.384-388.
The complete case-report was published in 2007 in
Archiv fuer Kriminologie 220: 11-19.

 Top of Article

 


 
 

 

Fitness to Drive in Spite (because) of THC

 

Strohbeck-Kühner P, Skopp G, Mattern R 
[Fitness to drive in spite (because) of THC] [Case Reports, English Abstract, Journal Article]
Arch Kriminol 2007 Jul-Aug; 220(1-2):11-9.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by a lack of concentration and/or an altered activation level.

People with ADHD are found to violate traffic regulations, to commit criminal offences and to be involved in traffic accidents more often than the statistical norm. Furthermore, they show more deviant behaviour and have an increased co-morbidity regarding substance abuse and dependence.

Hence, this disorder is of some forensic importance. The purpose of this case study is to demonstrate that in some cases people with ADHD may show unusual effects after the consumption of THC. A 28-year-old male, who showed abnormal behaviour and seemed to be significantly maladjusted and inattentive while sober, appeared to be completely normal with a very high plasma level of THC.

Performance tests conducted with the test batteries ART2020 and TAP provided average and partly above-average results in functions related to driving. Thus, it has to be taken into account that in persons with ADHD. THC may have atypical and even performance-enhancing effects.

Top of Article 



 
 
 
 

Recipe For Trouble (anecdotal story)

 

Recipe For Trouble

Is It A Crime To Give A Child Marijuana To Control Violent Outbursts?


  • Debbie Jeffries shows Correspondent Harold Dow the bag of marijuana she keeps in her freezer.

    Debbie Jeffries shows Correspondent Harold Dow the bag of marijuana she keeps in her freezer.  (CBS)

(CBS)  Debbie Jeffries of Rocklin, Calif., and her mother, Lorraine, love to cook. Lorraine has even published a cookbook, "50 Years Of Our Favorite Family Recipes."

But what they are whipping up these days isn’t in your average cookbook, reports 48 Hours correspondent Harold Dow. They’re making marijuana - medical marijuana - for Debbie’s son, Jeff.

Using marijuana as a medicine is not unusual in California. Five years ago, voters passed a law allowing patients with serious illnesses, such as AIDS and cancer, to use marijuana for pain, if a doctor approves. But this case is unusual because the patient is 8 years old.

"Jeff has been diagnosed with attention deficit hyperactivity disorder, which is ADHD; oppositional defiant disorder; conduct disorder; intermittent explosive disorder; bipolar disorder - any disorder you can think of," says Debbie, a single mother.

The disorders often lead Jeff to violent, uncontrollable outbursts.

"We’ve had to call the police," Debbie says. "I have woken up to a knife in my back. He used to stab the dogs next door. The teachers were afraid of Jeffrey. He picked up a chair and threw it at a teacher."

Doctors first started Jeffrey on Ritalin at age 3 and began adding other medications over the years, as nothing seemed to stop the outbursts.

"He was a walking pharmaceutical lab," Debbie says. "It was incredible. And nothing was working."

Debbie grew desperate last May when officials issued a deadline: Get Jeff under control in 30 days, or he would be placed under the care of the county.

That led her to an Internet article on how marijuana calms the brain and to Dr. Mike Alkalay, a pediatrician who believes in the medical powers of the drug marijuana.

"This medication has been around for 5,000 years," Alkalay says. "It's basically a Chinese herbal plant that's been used in the Middle East. It's been used in India. It's a very safe medication."

Alkalay admits 8-year-old Jeff isn’t the typical patient to receive marijuana but agreed, without seeing him, to recommend Jeff take the drug.

The decision to try marijuana shocked Debbie’s parents, Ken and Lorraine.

"There was absolutely no way I was for it," says Ken, who describes himself as a conservative. Lorraine adds, "It caused quite a bit of strife in our household."

The results were immediate.

"Within a half hour," Debbie says, "I looked over at Jeffrey, and he just had this smile about him, this glow, and he said, 'Mommy, I feel happy.' And that’s the first time that he’s ever said that."

Just how the marijuana is helping Jeff is not completely clear. "His brainwaves don't connect the way ours do," Debbie says of her son. "The marijuana is allowing him, somehow. It's filling in the gap in there for him, so he is learning how to manage his anger."

But Child Protective Services had a different opinion, and they opened an investigation. Debbie says they are accusing her of being an unfit mother and putting her son at risk.

Part of the problem is that Dr. Alkalay never saw Jeff before prescribing him the marijuana. The doctor says he was comfortable with that because "I know it's a very safe medication."

Child Protective Services is taking Debbie to court where a judge could stop Debbie from giving marijuana to her son. If that happens, Debbie says she won’t be able to control him, and will lose her son to the custody of the state.

"I’m not a criminal," says Debbie. "I’m a mother who cares for her child and will do anything to help her child."

The Result

In just under an hour at a closed-session juvenile court hearing, the judge dismissed the case against Debbie.

"I can’t even express how excited I am," she says. "It's been proven that what I'm doing to Jeffrey isn't a crime."

The decision to allow a child like Jeff access to medical marijuana may have far-reaching consequences.

"It opens up a whole door for parents who have been through what I've been through," says Debbie.Recipe For Trouble (anecdotal story)
 
 
 
 

Why I Give My 9-year-old Pot

Question: why are we giving our nine-year-old a marijuana cookie?

Answer: because he can't figure out how to use a bong.

My son J has autism. He’s also had two serious surgeries for a spinal cord tumor and has an inflammatory bowel condition, all of which may be causing him pain, if he could tell us. He can say words, but many of them—"duck in the water, duck in the water"—don't convey what he means. For a time, anti-inflammatory medication seemed to control his pain. But in the last year, it stopped working. He began to bite and to smack the glasses off my face. If you were in that much pain, you’d probably want to hit someone, too.

J's school called my husband and me in for a meeting about J's tantrums, which were affecting his ability to learn. The teachers were wearing tae kwon do arm pads to protect themselves against his biting. Their solution was to hand us a list of child psychiatrists. Since autistic children like J can’t exactly do talk therapy, this meant sedating, antipsychotic drugs like Risperdal—Thorazine for kids.

Last year, Risperdal was prescribed for more than 389,000 children—240,000 of them under the age of 12—for bipolar disorder, ADHD, autism, and other disorders. Yet the drug has never been tested for long-term safety in children and carries a severe warning of side effects. From 2000 to 2004, 45 pediatric deaths were attributed to Risperdal and five other popular drugs also classified as “atypical antipsychotics,” according to a review of FDA data by USA Today. When I canvassed parents of autistic children who take Risperdal, I didn't hear a single story of an improvement that seemed worth the risks. A 2002 study specifically looking at the use of Risperdal for autism, in the New England Journal of Medicine, showed moderate improvements in “autistic irritation”—but if you read more closely, the study followed only 49 children over eight weeks, which, researchers admitted, “limits inferences about adverse effects.”

We met with J's doctor, who’d read the studies and agreed: No Risperdal or its kin.

The school called us in again. What were we going to do, they asked. As a sometimes health writer and blogger, I was intrigued when a homeopath suggested medical marijuana. Cannabis has long-documented effects as an analgesic and an anxiety modulator. Best of all, it is safe. The homeopath referred me to a publication by the Autism Research Institute describing cases of reduced aggression, with no permanent side effects. Rats given 40 times the psychoactive level merely fall sleep. Dr. Lester Grinspoon, an emeritus professor of psychiatry at Harvard Medical School who has been researching cannabis for 40 years, says he has yet to encounter a case of marijuana causing a death, even from lung cancer.

A prescription drug called Marinol, which contains a synthetic cannabinoid, seemed mainstream enough to bring up with J’s doctor. I cannot say that with a few little pills, everything turned around. But after about a week of playing around with the dosage, J began garnering a few glowing school reports: “J was a pleasure have in speech class,” instead of “J had 300 aggressions today.”

But J tends to build tolerance to synthetics, and in a few months, we could see the aggressive behavior coming back. One night, I went to the meeting of a medical marijuana patient advocacy group on the campus of the college where I teach. The patients told me that Marinol couldn’t compare to marijuana, the plant, which has at least 60 cannabinoids to Marinol’s one. Why I Give My 9-year-old Pot

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