Marijuana For Mental Health
It was with skepticism that I first heard of marijuana having psychiatric applications, other than the purely recreational. My boyfriend at the time had an unpredictable, explosive temper, and was convinced a severe head injury in his youth had rendered his brain forever altered, which he remedied by smoking copious amounts of weed. Before long, it was evident to me that he was simply a different person when he smoked; witty and hospitable, rather than anxious and manipulative. Gone was the violent anger and in its place was, for a lack of a better word - normalcy.
Little did I know that I was witnessing but the tip of the psychiatric iceberg of marijuana's potential for the mind. The questions it raised for me then still stand today, and are characteristic of what we know (or more accurately, don't know) about both psychiatry and marijuana: how exactly does it work on the brain? Can it treat physical or neurological brain damage, or was it, in the case of my ex, easing the symptoms of an underlying emotional problem? Or was it something else entirely?
Throughout history, the study of cannabis has proved to be an elusive and experimental practice, and its illegality has only hindered the process more. With the isolation of cannabinoids, the active compounds in marijuana and the discovery of the body's own corresponding endocannabinoid system in the early 90's, many strides have been made – most notably in the medical arena. Even marijuana virgins have heard reference to its application for cancer, glaucoma, multiple sclerosis and an endless list of physical ailments.
Unfortunately, when it comes to the brain and the use of cannabis in treating psychiatric, behavioral and emotional disorders, much of the research by and large simply isn’t there – not for a lack of evidence, but because it hasn’t been conducted on any large scale other than in clinical studies.
Dr. Lester Grinspoon, Associate Professor Emeritus of Psychiatry at Harvard University Medical School, is an icon in the field of marijuana research. As the result of a long and distinguished career, Grinspoon has a wealth of clinical anecdotes, although this gives his colleagues reason to admonish him.
“Everybody [says] ‘Well, that’s just anecdotal evidence, Grinspoon! You don’t have a double-blind controlled study,’” mimics Grinspoon with a laugh. “Well, we can’t! It’s illegal material. But what we do have is a lot of clinical descriptions that didn’t just appear after the advent of the double-blind study in the mid-60's. Look at all that we knew before then, about Crohn's disease, or about migraines – about all the many things we knew about marijuana, that came before double-blind studies. And people are still discovering the ways in which marijuana is useful clinically.”
“Any symptom or syndrome I would recommend marijuana for - ” continues Grinspoon, “let’s say you come in with Crohn’s disease. I can’t say it would absolutely help you, but I can say to you that there is a quite reasonable probability that it will be helpful to you based on my clinical experience, which is all anecdotal.”
I ask him about Tourette's Syndrome, a particularly intriguing neuropsychiatric disorder characterized by physical and vocal tics.
“Well, I think it's quite miraculous for these folks. I had a patient who came up here from some southern state because I hadn't listed [Tourette's Syndrome] in the first edition of my book because I hadn't heard of it,” remembers Grinspoon, “and to overcome my skepticism, this delightful young man came up to Harvard to come into my office. We took a bit of a chance, at Harvard,” he chuckles, in reference to the man's lighting up a joint in his office. “He had a few puffs of a joint, and I saw him kicking, there, he had a bad tic. And within a matter of seconds he stopped kicking completely, he talked smoothly... it was a dramatic demonstration.”
One of the smaller studies, conducted in Germany by the Arbeitsgemeinschaft Cannabis als Medizin (Association for Cannabis as Medicine), alludes to the success Grinspoon witnessed, citing an 85% efficacy rate in the Tourette's patients they surveyed.
Grinspoon oversees two websites that boast hundreds of patient accounts, many of which reference the psychiatric use of marijuana, not just for neurological but also behavioral and emotional disorders. Grinspoon is the first to admit the shortcomings of the anecdotal method, saying, “tell me about the people who have tried it and don't get relief – they don't write and say, 'hey I tried it and it's not good for me'.” However, the medical hurdles some people are forced to face are no small feat, and when they are adamant that marijuana that has helped them when all other medications have failed, their stories take on even more significance.
In the treatment of behavioral disorders, there is no story more compelling than that of Debbie Jeffries, whose son Jeffrey began to display disturbing symptoms of Obsessive-Compulsive Disorder (OCD) and unusual temper tantrums at only nine months old.
“If his bottle didn't look right to him, if he didn't get the exact amount of food that he wanted, or if the food on his plate wasn't placed where he wanted it, or the colour combinations weren't right, if his shoes weren't tied correctly, the loops weren't the right size, he had horrific anger fits,” recalls Debbie.
By the time Jeffrey was three years old he had been in and out of multiple daycare a centers for fighting and misbehaving, and it was gently suggested to Debbie that she look into medicating Jeffrey. “I was like, wow... okay, I know he's a handful but...” she recalls. “I didn't know anything about medicine for any type of mental illness or whatever it was going on with him. But my goal was, 'if I can make this child happy, I will do whatever it takes'. And that is how it's been even since before he was born. I will do anything to make sure he has life.”
Jeffrey was diagnosed with a range of disorders from ADHD to anxiety, which his doctor suggested medicating with Ritalin. When that proved ineffective, he was launched on an ever-shifting merry-go-round of pharmaceutical drugs, many prescribed to simply counteract the side effects of the original medications. “It was like, is this ever going to end?” sighs Debbie. “Is this ever going to help him?” Jeffrey's problems, rather than ceasing, simply worsened.
“At one point he was in a daycare and he threw a desk at a teacher – when he was four years old – because he was mad at her. He hit her in the face with a shovel... he would fight with kids all the time,”
Debbie remembers calmly, adding that she woke up one morning to find her son strangling her.
Finally, with every possible drug option exhausted, the doctors decided to admit five-year-old Jeffrey into the first of what became several psychiatric hospitals, but his deterioration continued. A new state-of-the-art facility for the study of autism called the M.I.N.D. Institute at UC Davis asked Debbie to bring Jeffrey in for neurological testing. On their second visit, Jeffrey became so agitated that he threw a chair at the researcher when he entered the room. “And they dismissed us from the study!” exclaims Debbie incredulously. “I felt like we were being given up on.”
By seven years old, Jeffrey was in a residential home that offered one-on-one support, and was on suicide watch because of his harsh medications. The situation was getting desperate, and Debbie and Jeffrey were at the end of their ropes, figuratively and literally: Jeffrey had been found in his room with a sheet tied around his neck. Child Protective Services gave Debbie an ultimatum: find a cure for him in thirty days or we will institutionalize him forever.
Debbie was working at a local high school with high-risk teenagers who had ADHD and other behavioral disorders when one day, a group of her students were engaged in a debate about marijuana. In assisting them, Debbie noticed the Physician's Desk Reference they were using mentioned that marijuana had psychiatric uses. A conservative Christian, Debbie was unfamiliar with the substance. “I didn't know what it smelled like, what it looked like,” she says with a laugh. “I never knew anyone who smoked it growing up. I guess I was sheltered.”
With time running out, and despite the intense skepticism of her parents, who had incidentally voted against the legalization of medical marijuana, Debbie began intensive research. She ended up finding a local organization called the Wo/Men's Alliance for Medical Marijuana (WAMM), where director Valerie Corral agreed to look into her case. Corral asked for all the relevant information available on Jeffrey, and the resident doctor working with WAMM promptly returned Debbie's call.
“Dr. Mike called me, and the first words out of his mouth were, 'are you for real?' I said, 'excuse me?' and he said, 'You've got to be kidding me. You've got all of these records for this child, and at this age, to have all these behavioral problems?' And I said, 'I'm so real, and it hurts so bad. I need help. Can you help me?” The clock was ticking: they had eleven days left. Debbie says Dr. Mike told her, 'I don't know if it will help. However, I know it won't hurt him if we try.'
Under the careful watch of Dr. Mike and WAMM, Debbie began Jeffrey on an initial dosage of one-quarter of a marijuana brownie. Debbie departed for school that day in the usual manner – with one hand on the wheel and the other hand holding Jeffrey's in the front seat so he couldn't hit her while she was driving. “Suddenly his grip loosened,” says Debbie. “I looked over at him and he had a smile on his face. I said, 'are you okay?' and he said, 'Mom, my head's not so noisy. I feel happy'. From that moment on, he was a different child. He wasn't angry anymore.”
The change in Jeffrey's behavior stunned his community. “They said he had a fantastic day, the first day he had not been in the quiet room for fighting. They said, 'whatever you did, do it again.'” As word spread, Debbie hid nothing as to the source of Jeffrey's miraculous transformation. “All the social workers who were involved with him, even before I started it on him, I told them what I was going to do, because I wanted to be up-front. There's something wrong if you have to hide something.”
Although the support around Debbie and Jeffrey grew to include their local pastor and church members, not everyone was on-side, miraculous cure or not. Debbie decided to take Jeffrey off his pharmaceutical medications to avoid any interactions, and when letters and visits produced no advice from Jeffrey's psychiatrist as to how to do it safely, Debbie found the information she needed from the local pharmacy. Six weeks later Debbie was informed that the County Child Protective Services were taking her to court for giving her son marijuana: Jeffrey's psychiatrist had turned them in.
Medical marijuana had been legal in the state of California since 1996, however the law concerning its use in children was unclear. After a six-month court battle, in December of 2001 Debbie won the right to continue giving Jeffrey his medicine in a landmark ruling. With the first of many battles behind them, Jeffrey began to rediscover the world around him and celebrated his eighth birthday with a party in the company of friends for the first time. However the peace was shattered on an early September morning in 2002 when the Drug Enforcement Agency (DEA) raided the WAMM premises and garden with chainsaws and hauled away the medicine used not only for Jeffrey, but hundreds of other patients suffering from chronic pain and terminal illnesses.
Jeffrey's medicine had been derived from four strains of marijuana in which both the flowers and leaf had been painstakingly blended together over a trial of weeks. Left with limited supplies, Corral was unable to reproduce Jeffrey's exact blend of medicine, until the following year. By that time it was too late, and he spiraled back into the world of violence and anger that for so long had been but a memory. Jeffrey was eventually sent to a ranch for troubled youth in Utah, where he remains today.
One of the mysteries of Jeffrey's story is why, when he could access marijuana once again, it failed to work in the same way, which alludes to the bigger question of what its therapeutic effect on the brain is in general.
Valerie Corral, the co-founder of WAMM who came to Debbie and Jeffrey's aid, has used marijuana for 34 years to alleviate the epilepsy she has as a result of a severe car accident. Suffering from up to five grand mal seizures a day, Corral managed to control them by carefully shifting from a pharmaceutical regimen onto medical marijuana. “Having had neurological problems, it allowed me an insight into the complexity of such disorders. In Jeffrey’s case I puzzled over the exact ratio of leaf to flower. I eventually came upon the particular blend that worked for Jeffrey that we call Neuro-Leaf,” explains Corral, “which is a balanced mix of one part bud, or the bud shake which would be high in crystal content, to two parts leaf. A significant element rests in the cooking process, which is prolonged and extremely sensitive – one must avoid high temperatures. Jeffrey’s Grandmother LaRayne devised a method that fit the family’s trying schedule and demands. I use it so much with children now – children with cancer, and seizure activity. It repeatedly produces an efficient neurological effectiveness.”
This particular blend is Corral's first choice when it comes to treating psychological disorders, and the fact that the different marijuana strains had been selected and combined for their neurological effects is perhaps what made it so effective for Jeffrey, and why when WAMM was raided the recipe simply couldn't be duplicated fast enough.
“There are two different basic types [of Neuro-Leaf],” explains Corral, “one is an indica base, made from both the flowers and the leaf of cannabis indica and the other is the same derived from cannabis sativa. But, I found that interspersing a blend of both varieties from time to time assists in maintaining a dependency that can lead to the need to increase dosage. I find that when this is systematically repeated, the effect is to interrupt the neurological imbalance that leads to, as in Jeffrey’s case, fits of anger and violent outbursts.”
As an epileptic, Corral says that on a neurological level, marijuana is “kind of like a circuit breaker. When you have a seizure, it feels like an electrical overload, as though there is a short circuit and you go into electrical overload. That may sound simplistic, but when I use marijuana, in that instance, it appears to steady the electrical imbalance, which creates a pathway that leads away from the aura and eventual seizure to create a state of calm.”
In the field of Attention Deficit Disorder (ADD or ADHD), marijuana is also creating both waves and unexpected states of calm. It is beginning to emerge that, much like epilepsy, marijuana may have a calming effect on the brain – without any of the unwanted side effects commonly seen in pharmaceutical options such as Ritalin. Dr. Claudia Jensen, a pediatrician for 23 years, advocates the use of marijuana for ADD, and has found clinical success in its use particularly in patients for whom – like Jeffrey – all else failed.
Dr. Jay R Cavanaugh is another medical professional associated with the American Alliance for Medical Marijuana who in 2002 wrote a passionate defense of parents who were successfully using medical marijuana for ODD, OCD, Autism, ADHD, Tourette's and Bi-polar disorder in their kids. He states that although the cause of childhood brain disorders is still unknown, it “seems to involve the way in which brain cells (neurons) communicate with one another.” Cavanaugh wrote that endocannabinoids within the human body “are active in the brain and play a vital role in regulating brain function,” and that they may be “the most important chemicals of all in establishing and maintaining homeostasis or balance in key brain systems and other systems elsewhere in the body.”
Debbie agrees that the problem with Jeffrey may have resided within his endocannabinoid system. “It was a cannabinoid deficiency,” offers Debbie, “and the cannabinoids in the marijuana, that's what helped him. It's not the THC but the cannabinoids that helped him – at least that's the theory.”
With so much potential for relief within the field of psychiatric disorders alone, it begs the question: why exactly are there so few studies that have been conducted on the use of marijuana in this field. Illegality, as stated by Grinspoon earlier, is certainly an issue in many countries, but there are other hurdles that stand in the way of discovering marijuana's full psychiatric potential. Pharmaceutical companies fund the lion’s share of research, and in order to make a return on all the dollars they invest, they need to patent what they discover.
“They can’t put a patent on it because it’s a natural herb,” says Dr. Bruce Levine, a clinical psychologist and author of Surviving America's Depression Epidemic: How to Find Morale, Energy and Community in a World Gone Crazy. “What they did with cocaine was that they made a synthetic version of it – that’s what amphetamines are, they’re just synthetic versions of cocaine – and then once they made a synthetic version of it, you tweak a little chemical here and there and come up with Dexatrin, Ritalin, or Dextro-methamphetamines. Then you can patent these things.”
Levine believes that if there were a double-blind study that compared marijuana to psychiatric drugs, the marijuana would far outperform it – not least because psychiatric drugs perform at a level that is often virtually indistinguishable from placebos. He cites the case of football player Ricky Williams, who was removed as British pharmaceutical giant GlaxoSmithKline's spokesperson after stating that marijuana was 'ten times better' than their drug Paxil for his social anxiety.
“The question is, why any of these psychotropic drugs – these drugs that effect neurotransmitters, mood-altering drugs – why they become psychiatric drugs,” asks Levine. “It’s more economic and political than scientific. It has a lot to do with whether something can be patented. […] Whether any of these things, that affect cognitive function or your emotionality, whether they become psychiatric drugs is all politics and economics, it’s nothing to do with science.”
Marijuana's subtle complexity as a plant and psychoactive substance has still only been but touched upon, and there the mystery remains - not only as to how exactly marijuana works psychologically, but the politics surrounding its legislation as well. When compared with the side effect-riddled pharmaceutical options, with the accompanying risks of organ damage and addiction, marijuana is at the very least a viable alternative – especially for children. I'll admit that initially, I was slightly scandalized at the thought of a child munching down a marijuana muffin on his way to school. But it is hypocritical to claim that popping a couple Ritalin with the morning OJ is any better, even if it does have the added comfort of legal and social acceptance.
At the end of the day, if safer medication in the form of marijuana is what people want, then it will have to come from the people. “Everything great has never come from the top down – we can't look to the government to be brilliant,” muses Corral. “They maintain the status quo, that's how they keep their jobs. We are the ones that are brilliant, we are the dreamers. It's the people. It's always the people. And it's the force of the people – the will and the force of the people that changes governments minds. That's our job.”
Lester Grinspoon's website: www.rxmarijuana.com, and www.marijuana-uses.com
Debbie Jeffries' book: Jeffrey's Journey, available through Amazon.com or local booksellers
Wo/Men's Alliance for Medical Marijuana: www.wamm.org
Dr. Jay Cavanaugh's piece in full: www.letfreedomgrow.com/cmu/for_the_children.htm
Dr. Bruce Levine's books: Surviving America's Depression Epedemic: How to Find Morale, Energy and Community in a World Gone Crazy and Commonsense Rebellion: How to Take Back Your Life From Drugs, Shrinks, Corporations and a World Gone Crazy