uses of Medical Cannabis in the treatment of ADD/ADHD
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
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"
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
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(s) 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(s) necessary to treat the
condition without in the process consuming sufficient THC to become
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
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
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
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
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
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
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
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
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,
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 manyfoodswe 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 pulmonarysystem." 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.
Expedia coupon code. "The ratio of lethal to effective
dose for medical marijuana is estimated to be as 40,000 to 1. By
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
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
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.
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completed show this strain of cannabis helps in the treatment of