Pubdate: Wed, 03 May 2006
Source: Anderson Valley Advertiser (CA)
Column: Cannabinotes
Copyright: 2006 Anderson Valley Advertiser
Author: Fred Gardner
Bookmark: (Cannabis - California)
Bookmark: (Cannabis - Medicinal)
Bookmark: (Tod Mikuriya, MD)


It's no coincidence that the new O'Shaughnessy's includes five 
articles on post-traumatic stress disorder and three on forgotten 
aspects of the history of cannabis as medicine. When Tod Mikuriya 
first became interested in cannabis as a medical student c. 1960, he 
realized that understanding might be found in two directions: 
clinical experience (input from patients, then unavailable) and the 
pre-Prohibition medical literature. So it makes sense that some 40 
years later the journal Mikuriya founded would focus on a psychiatric 
condition that cannabis is being used to treat, and would publish 
documents filling in the gaps in our historic miseducation.

The PTSD pieces include three patients' stories and two articles by 
clinicians, including one by Mikuriya himself, rife with original 
observations: " Although it is now widely accepted that cannabinoids 
help extinguish painful memories, my clinical experience suggests 
that 'extinguish' is a misnomer. Cannabis modulates emotional 
reactivity, enabling people to integrate painful memories -to look at 
them and begin to deal with them, instead of suppressing them until a 
stimulus calls them forth with overwhelming force.

"The modulation of emotional response relieves the flooding of 
negative affect. The skeletal and smooth muscle relaxation decreases 
the release of corticosteroids and escalating "fight-or-flight" 
agitation. The modulation of mood prevents or significantly decreases 
the symptoms of anxiety attacks, mood swings, and insomnia.  While 
decreasing the intensity of affectual response, cannabis increases 
introspection as evidenced by the slowing of the EEG after initial 
stimulation. Unique anti-depressive effects are experienced 
immediately with an alteration in cognition. Obsessive and pressured 
thinking give way to introspective free associations (given relaxed 
circumstances). Emotional reactivity is calmed, worries become less 
pressing.  Used on a continuing basis, cannabis can hold depressive 
symptoms at bay. Agitated depression appears to respond to the 
anxiolytic component of the drug. Social withdrawal and emotional 
shutting down are reversed. The short-term memory loss induced by 
cannabis that may be undesirable in other contexts is therapeutic in 
controlling obsessive ideation, amplified anxiety, and fear of loss 
of control ignited by the triggering stimuli."

The patients' stories are from survivors of combat (Al Byrne) and 
sexual abuse (Erin Hlidebrandt, Christopher Largen), and all took 
courage to tell. Byrne said after talking at the recent Patients Out 
of Time conference in Santa Barbara that he'd left out some points 
he'd meant to make. (Don't we all, all the time?).  Byrne calls the 
condition post-traumatic stress - " not a disorder but a logical 
response to people trying to kill you." His afterthoughts:

"PTS can be 'inflicted' in 3 ways. You are a victim, you are the 
cause of trauma, you are a witness. When I spoke to my early years 
experience in the Navy I meant to point out that these events caused 
no trauma. There was no negative consequence for me personally. 
However the Vietnam experience was different. The story I related was 
as a  witness to a major bombing of jungle/people, that was a 
traumatic  event...

"Hopefully, treatment quickly is the norm. For instance: I was still 
working at combat counseling when the first vet from the first gulf 
war came in.  He was going nuts when his friends hit a pothole in the 
street or went over a bump. Why? Turned out he was with the first 
troops to drive, at speed, into Kuwait City. The drivers were ordered 
to stop for nothing, the bumps were bodies, alive and dead, that the 
trucks he was in had crushed. We hope we  got him doing ok and his 
coming to us quickly was a big help. Please  stress the importance of 
getting trauma folks help right away."

In the star chamber night

Forgotten are the scents of old Tonkin

Four-hundred twenty to one

For war what's another forty billion?

They've got what's called a gang mentality

'Cept you, Barbara Lee,

'Cept you, Barbara Lee,

'Cept you.

On the next-to-last day of 1996 Drug Czar Barry McCaffrey reiterated 
the Clinton Administration's opposition to the medical use of 
marijuana at a well-attended White House press conference. He was 
flanked by Attorney General Janet Reno, Health & Human Services 
Secretary Donna Shalala, and Alan Leshner, head of the National 
Institute on Drug Abuse. The key visual element was a large chart on 
an easel to which McCaffrey kept referring with scorn. The heading 
read "Dr. Tod Mikuriya's (215 Medical Advisor) Medical Uses of 
Marijuana." Twenty-six conditions were listed in two columns of 13. 
One of the conditions was misspelled as "Migranes."

As Shalala gazed at the chart and nodded agreement, McCaffrey told 
the media, "This isn't medicine, this is a Cheech and Chong show." He 
warned that use of marijuana violated federal law and would lead to 
reprisals, including the loss of prescription-writing privileges for 
any doctor who recommended it to patients.  Reno said that 
prosecutors would focus on doctors who were "egregious" in 
recommending marijuana.

In a New Year's Day interview at his home in the Berkeley hills, 
Mikuriya analyzed the set-up: "As doctors become more fearful, I'll 
obviously get more and more patients who are using cannabis or are 
considering it. Will that make it seem that there's something 
'egregious' about my practice?"

Mikuriya called the chart "a crude dirty trick -the kind of 
disinformation the U.S. military put out during the Vietnam War. Only 
in this case the 'enemy' is the people of California."

The AVA subsequently interviewed the McCaffrey aide who compiled the 
chart, Dave Des Roches, "special assistant for strategy planning," a 
West Pointer who had retired from the Army after nine years and moved 
over from the Pentagon to the Drug Czar's office.

Des Roches said he'd based the chart on Mikuriya's "Medical Marijuana 
Handbook" as posted on the Internet. He explained: "What he does 
there is put in every use in recorded history of marijuana for 
medical purpose. I'm sure he'll say 'I'm not endorsing this,' but 
it's on the internet, it's published, his name is on the front of it."

Des Roches thought that some of the conditions Mikuriya listed were 
especially ludicrous: "'Writer's cramp' -I had to show that one to 
General McCaffrey, he didn't believe it. 'Removal of corns' -because 
it was sold in patent medicines! And can you believe 'Recall of 
forgotten memories?' He bases that on something from John Stuart 
Mill!" (At the time there had been a spate of highly publicized cases 
involving false accusations based on "recovered memories" of abuse 
during childhood.) Des Roches was highly amused by Mikuriya's "whole 
laundry list" of conditions for which marijuana provides relief, and 
so was his boss, McCaffrey, in front of a worldwide TV audience on 12/30.

It would turn out that the very thing the brass were ridiculing 
Mikuriya for -his documentation that cannabis can be used to treat an 
astonishingly wide range of conditions-is, arguably, his most 
significant accomplishment. The implications of cannabis's 
versatility have been developed by Mikuriya and other clinicians in 
the 10 years since Prop 215 passed, and by lab scientists, too. 
Cannabinoids are now known to affect the cardiovascular, digestive, 
endocrine, excretory, immune, musculo-skeletal, nervous, 
reproductive, and respiratory systems!

As a clinician observing the effects of cannabis on human beings who 
provide verbal feedback (unlike mice and dogs), Mikuriya inferred its 
mechanism of action and defined it as "an easement" (rather than a 
sedative, hypnotic, hallucinogen, etc.) because in both the physical 
and mental realms, cannabis has a relaxing effect.

O'Shaughnessy's is the journal I produce for Dr. Mikuriya's Society 
of Cannabis Clinicians. To get the Spring '06 issue and future 
issues, send a contribution of any amount to CCRMG, p.o. Box 9143, 
Berkeley, CA 94709. It's a 501c3 organization, so your contribution 
is tax-deductible. (CCRMG stands for California Cannabis Research 
Medical Group, the original name of the SCC. They changed it because 
it sounded too Jewish. That's a joke.) Keeping the good ship 
O'Shaughnessy's afloat is a most worthy cause. The medical marijuana 
movement rests on the courage of a small group of doctors, and it's 
important that they have an outlet in which to publish their findings 
and observations.
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MAP posted-by: Jay Bergstrom