Monday, August 13, 2012

Cannabis as a medical treatment for attention deficit disorder

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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 "There is no serious scientific basis for using marijuana to treat those conditions, and Dr. Jensen did not 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 is 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 does not "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."

What are the possible side effects of Ritalin (methylphenidate)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop taking methylphenidate and call your doctor at once if you have any of these serious side effects:
  • fast, pounding, or uneven heartbeats;
  • feeling like you might pass out;
  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
  • aggression, restlessness, hallucinations, unusual behavior, or motor tics (muscle twitches);
  • easy bruising, purple spots on your skin; or
  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).
Less serious side effects may include:
  • stomach pain, nausea, vomiting, loss of appetite;
  • vision problems, dizziness, mild headache;
  • sweating, mild skin rash;
  • numbness, tingling, or cold feeling in your hands or feet;
  • nervous feeling, sleep problems (insomnia); or
  • weight loss.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about methylphenidate?

Do not use methylphenidate if you have used an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam) within the past 14 days. Serious, life-threatening side effects can occur if you use methylphenidate before the MAO inhibitor has cleared from your body.
Do not use this medication if you are allergic to methylphenidate or if you have glaucoma, overactive thyroid, severe high blood pressure, tics or Tourette's syndrome, angina, heart failure, heart rhythm disorder, recent heart attack, a hereditary condition such as fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase deficiency, or severe anxiety, tension, or agitation.
Methylphenidate may be habit-forming and should be used only by the person it was prescribed for. Methylphenidate should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

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