Pubdate: Mon, 23 Oct 2006
Source: CounterPunch (US Web)
Copyright: 2006 CounterPunch
Contact:  http://www.counterpunch.org/
Details: http://www.mapinc.org/media/3785
Author: Fred Gardner
Cited: Society of Cannabis Clinicians http://societyofcannabisclinicians.org
Bookmark: http://www.mapinc.org/mmj.htm (Marijuana - Medicinal)
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)

AN INTERVIEW WITH JEFFREY HERGENRATHER, MD

What Have California Doctors Learned About Cannabis?

It has been 10 years since California voters enacted Proposition 215, 
making it legal to grow and use cannabis, with a doctor's approval, 
for medical purposes. Prop 215 didn't create a record-keeping system 
because the authors didn't trust the government and didn't want to 
generate a master list of cannabis users. So, over the course of the 
past decade, a vast public health experiment has been conducted in 
California but no state agency has been tracking doctors who approve 
cannabis use or patients who medicate with it.

To assess the results in the absence of government-garnered data, I 
surveyed doctors associated with the Society of Cannabis Clinicians. 
The SCC was founded by Tod Mikuriya, MD, in 2000 so that doctors 
monitoring their patients' use of cannabis could share data for 
research purposes (and, alas, respond to threats from federal and 
state authorities). More than 20 doctors have attended SCC meetings, 
which are held quarterly. Philip A. Denney, MD, is the current president.

Some responses to the survey have not yet been received, but it 
appears that the specialists have approved cannabis use by more than 
140,000 patients. "Approve," not "recommend," is the apt term, since 
more than 95 percent of the patients consulting specialists had been 
self-medicating previously.

The specialists account for approximately 40% of the letters of 
authorization on file with an agency that issues ID cards on behalf 
of cannabis dispensaries (to spare them having to confirm the 
validity of each customer's letter of approval). Extrapolating from 
this ratio, I estimate the number of Californians who have used 
and/or provided medicinal cannabis legally under Prop 215 to be about 350,000.

The complete survey will appear in the Fall issue of O'Shaughnessy's, 
a journal I produce for the SCC. What follows are excerpts from the 
response of Jeffrey Hergenrather, MD, a former family practitioner 
who has been conducting cannabis consultations in Sebastopol since 1999.

Q. How many patients will have received your approval to use cannabis 
through October 2006?

A. 1,430

Q. What percentage had been self-medicating with cannabis prior to 
consulting you?

A. 99%

Q. With what medical conditions have they presented? List top five 
and approximate percentage (total can exceed 100%).

Chronic pain (62%), Depression and other mental disorders (30%), 
Intestinal disorders (12%), Harmful dependence (10%), Migraine (9%) 
are the most common conditions being treated.

Q. What results do patients report? How does cannabis appear to work 
in treating their symptoms?

A cannabis specialist soon becomes aware of two remarkable facts. The 
range of conditions that patients are treating successfully with 
cannabis is extremely wide; and patients get relief with the use of 
cannabis that they cannot achieve with any other pharmaceuticals.

The testimonies that I hear on a daily basis from people with serious 
medical conditions are moving and illuminating. From many people with 
cancer and AIDS come reports that cannabis has saved their lives by 
giving them an appetite, the ability to keep down their medications, 
and mental ease. No other drug works like cannabis to reduce or 
eliminate pain without significant adverse effects. It evidently 
works on parts of the brain involving short-term memory and pain 
centers, enabling the patient to stop dwelling on pain. Cannabis 
helps with muscle relaxation, and it has an anti-inflammatory action. 
Patients with rheumatoid arthritis stabilize with fewer and less 
destructive flare-ups with the regular use of cannabis.

Other rheumatic diseases similarly show remissions. Spasticity cannot 
be treated any more quickly or efficiently than with cannabis, and, 
again, without significant adverse effects.

Patients who suffer from migraines can reduce or omit conventional 
medications as their headaches become less frequent and less severe.

About half of the patients with mood disorders find that they are 
adequately treated with cannabis alone while others reduce their need 
for other pharmaceuticals. In my opinion, there is no better drug for 
the treatment of anxiety disorders, brain trauma and post concussion 
syndrome, ADD and ADHD, obsessive compulsive disorder, and 
post-traumatic stress disorder. Patients with Crohn's disease and 
ulcerative colitis are stabilized, usually with comfort and weight 
gain, while most are able to avoid use of steroids and other potent 
immunomodulator drugs.

People who were formerly dependent on alcohol, opiates, amphetamines 
and other addictive drugs have had their lives changed when 
substituting with cannabis. Patients with end-stage renal disease on 
dialysis and those with transplanted kidneys show mental ease, 
comfort, and lack of significant graft-versus-host incompatibility 
reactions in my small series.

Diabetics report slightly lower and easier-to-control blood sugar 
levels, yet to be studied and explained.

Sleep patterns are typically improved, with longer and deeper sleep 
without any hangover or significant adverse effects.

Many patients with multiple sclerosis report that their condition has 
not worsened for many years while they have been using cannabis 
regularly. MS and other neurodegenerative diseases share the common 
benefits of reduced pain and muscle spasms, improved appetite, 
improved mood and fewer incontinence problems. Many patients with 
epilepsy are adequately treated with or without the use of other 
anticonvulsants.

Patients with skin conditions associated with systemic disease such 
as psoriasis, lupus, dermatitis herpetiformis, and eczema all report 
easement and less itching when using cannabis regularly.

Airway diseases such as asthma, sleep apnea, COPD, and chronic 
sinusitis deserve special mention because I encourage the use of 
cannabis vapor or ingested forms rather than smoking to reduce airway 
irritation. Finally, most obese and morbidly obese patients respond 
with weight loss and improved self esteem. I believe that cannabis 
and psychotherapy work well together in fostering behavioral changes.

Q. Have you compiled demographic data or can you estimate the 
breakdown with respect to your patients' age, gender, race, economic status?

Gender: 62% male, 38% female. Ages range from 14 to 86 years old. The 
male mean age is 45.9 years with a median age of 46. The female mean 
age is 47.4 with a median age of 48 years. The graphs of the age and 
gender distribution are similar with the exception that there is a 
bump in the leading edge of my male patient population as compared to 
the females, which I account for by young men's work injuries, sports 
injuries, motor vehicle accidents, and problems stemming from 
military service, including injuries and post-traumatic stress 
disorder. The vast majority of patients in my practice are of 
Caucasian / Indo-European descent, with only about 1% 
African-American, 2% Native American, 1% Pacific Islanders, and 2% Asian.

Q. Have you observed or had reports of adverse effects from cannabis? 
If so, please describe.

Is there a downside to the use of cannabis? The sense of intoxication 
rarely lasts longer than an hour and tends to be more troubling to 
the novice than to the experienced user. For some people cannabis can 
induce dry mouth, red eyes, unsteady gait, mild in-coordination, and 
short-term memory loss, all of which are transient. These effects are 
reportedly trivial compared to those brought on by pharmaceutical alternatives.

Cannabis use is steadily finding acceptance in society. Still, for 
many it remains awkward if not totally impractical in the workplace. 
People whose jobs require multi-tasking such as pilots, drivers, 
dispatchers, switchboard operators, and many professionals find the 
intoxicating effects of cannabis inappropriate in the workplace, and 
therefore reserve their use for after work. Strains

Q. What have you learned re strains and dosage?

Cannabis is a complex, un-patentable plant with vast pharmacologic 
potential. Different strains contain different mixes of cannabinoids 
and terpenes that give them distinct qualities. Some strains energize 
you; others put you to sleep. Many patients, when they find a strain 
that suits their needs, try to obtain it on a regular basis. Unless 
they are growing their own from cuttings, however, they have to rely 
on growers and distributors to reproduce and make available the 
preferred strain from year to year.

Due to Prohibition, California growers have been denied the tools of 
analytical chemistry to test the cannabinoid contents of their 
plants. This has impeded the development of strains aimed at treating 
various conditions. Nevertheless, patients continue to educate 
themselves about cannabis as medicine and how best to use it. Over 
the years that I have specialized in cannabis therapeutics, health 
benefits reported by patients have been substantiated and explained 
by findings from research centers around the world.

Vaya Con Dios

The great Freddy Fender died last week -lung cancer at age 69. From 
his Associated Press obit: "his career was put on hold [in 1960] when 
he and his bass player ended up spending almost three years in prison 
in Angola, LA., for marijuana possession." He was born Baldemar 
Huerta and took the name Fender in honor of his electric guitar when 
he signed with Imperial Records in 1959. He took "Freddy" because he 
thought it sounded good with Fender. I never stopped giving my vinyl 
"Best of Freddy Fender" a spin.

Look at how America treats its artists, its national treasures! 
Clifford Antone, founder of Austin's famous blues club, died in May 
of this year. He served two prison terms, according to his obit in 
the New York Times, "one in the 1980's for possessing marijuana and 
another from 2000 to 2002 for dealing more than 9,000 pounds of the 
drug and laundering money Mr. Antone was known for his generosity to 
musicians. He organized a series of benefits for victims of Hurricane 
Katrina and recently he helped arrange an apartment and nursing care 
for the 92-year-old pianist Pinetop Perkins."

Paul Armentano of NORML has analyzed a new U.S. Department of Justice 
report for 2004 and concludes that U.S. taxpayers are now spending 
more than a billion dollars annually to incarcerate citizens for pot. 
Armentano estimates that 33,655 state inmates and 10,785 federal 
inmates are locked up on marijuana charges. The DOJ report didn't 
provide stats for county jails.

Thousands behind bars cannot see the stars

Shining o'er the land of the free

They could be at home if they could grow their own

Or get it from the local pharmacy. 
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MAP posted-by: Richard Lake