Pubdate: Mon, 26 May 2008
Source: CounterPunch (US Web)
Copyright: 2008 CounterPunch
Website: http://www.counterpunch.org/
Details: http://www.mapinc.org/media/3785
Author: Fred Gardner
Note: Fred Gardner edits O'Shaughnessy's the Journal of Cannabis in 
Clinical Practice.
Bookmark: http://www.mapinc.org/mmj.htm (Marijuana - Medicinal)
Bookmark: http://www.mapinc.org/testing.htm (Drug Testing)

MARIJUANA AS A TREATMENT FOR PTSD

Does the VA Care?

U.S. District Judge Samuel Conti will rule any day now on a suit 
brought by Veterans for Common Sense and Veterans United for Truth. 
The vets want the judge to order the Department of Veterans Affairs 
to upgrade its mental-health services. Some 500 vets are committing 
suicide every month. There is a backlog of 600,000 disability claims, 
half of them involving post-traumatic stress and depression. The wait 
to have your claim adjudicated can be five years or more. Lawyers for 
the VA state that 1,300 therapists have been hired to solve the 
problem; and anyway, they contend, a judge can't tell the VA how to 
conduct itself, only Congress can.

Outside Conti's courtroom in the San Francisco federal building one 
morning a Vietnam vet I'd met long ago asked what I was doing there. 
I said maybe I'd write about the runaround that vets have been 
getting from the VA in connection with PTSD. He said, "Welcome back," 
as if I had gone somewhere. Single Issue Politics separates us from 
our potential allies.

California cannabis specialists report that 3-5% of their patients 
have PTSD diagnoses. The late Tod Mikuriya, MD, being a psychiatrist 
who made his own diagnoses, saw a slightly higher percentage. This is 
from Mikuriya's classic 2005 paper on the subject:

"Approximately eight percent of the 9,000 Californians whose cannabis 
use I have monitored presented with PTSD (309.81) as a primary 
diagnosis. Many of them are Vietnam veterans whose chronic 
depression, insomnia, and accompanying irritability cannot be 
relieved by conventional psychotherapeutics and is worsened by 
alcohol. For many of these veterans, chronic pain from old physical 
injury compounds problems with narcotic dependence and side effects of opioids.

"Cannabis relieves pain, enables sleep, normalizes gastrointestinal 
function and restores peristalsis. Fortified by improved digestion 
and adequate rest, the patient can resist being overwhelmed by 
triggering simuli. There is no other psychotherapeutic drug with 
these synergistic and complementary effects.

"In treating PTSD, psychotherapy should focus on improving how the 
patient deals with resurgent symptoms rather than revisitation of the 
events. Decreasing vulnerability to symptoms and restoring control to 
the individual take priority over insight as treatment goals. 
Revisiting the traumatic events without closure and support is not 
useful but prolongs and exacerbates pain and fear of loss of control."

Veterans in California and other states with medical marijuana laws 
are faced with an especially cruel choice, says disabled Air Force 
vet Michael Krawitz (who lives in Virginia): "use medical marijuana 
and leave the VA or take the VA's medicine and stop using medical marijuana."

It has been well established that pain patients can cut their opioid 
use in half by adding cannabis to their regimen. Krawitz, 44, is 
challenging the legality of the "pain contract" that the VA insists 
some patients sign in order to get their prescribed opioids --thereby 
subjecting them to having their urine tested for illegal drugs. 
Krawitz says forced drug testing by the VA violates the 4th Amendment 
protection against unreasonable search; the 5th Amendment protection 
against forced self-incrimination; and the 14th Amendment right to 
equal protection under the law (because only pain patients are made 
to sign the contract).

*

DO TED KENNEDY'S DOCTORS KNOW?

Jeffrey Hergenrather, MD, a Sebastopol, California doctor, reports in 
the current O'Shaughnessy's on a case in which cannabis apparently 
countered the advance of glioma multiforme (the aggressive brain 
tumor that has afflicted Senator Edward M. Kennedy).

P.J., a 50-year-old man, was still enjoying motorcycle riding and 
surfing when he began having right parietal headaches with increasing 
frequency and severity in the spring of 2003. Within three weeks from 
the onset of pain, P.J. saw his primary-care doctor, who advised 
over-the-counter pain medications. A few weeks later the pain 
worsened and P.J. began to drop things from his hands and slur his 
speech. On hearing this, the doctor ordered a brain scan.

P.J. was found to have a large stage-4 brain tumor, subsequently 
diagnosed as a glioblastoma multiforme. P.J. got his brain surgery in 
July '03, followed by radiation therapy. He was also referred to a 
study group at a major teaching hospital. Now, more than four years 
since his surgery, P.J. continues to improve despite the ominous 
prognosis with the diagnosis of glioblastoma multiforme. Untreated 
patients are found to live about three months from diagnosis. Treated 
patients have a median survival of 10-12 months. In the best case 
scenario people with this tumor are alive at 18 months. Very few are 
still alive after five years.

What's different in P.J.'s case is that every day he eats at least 
five cannabis capsules that he prepares for himself. The cannabis 
helps P.J. with his appetite and sense of well-being.

Of great interest is the fact that he has been seizure-free and there 
has been no recurrence of the tumor on his follow-up brain scans, 
MRIs, and PET scans (conducted three or four times per year since 
2003). Just back from a road trip to visit family, P.J. is out riding 
his bicycle on the rural roads with increasing confidence and he has 
re-applied for his driver's license.

Several labs have reported in recent years that cannabinoids can 
inhibit the growth of gliomas in various in vivo and in vitro models. 
Researcher Herbert Schuel (who has elucidated the role of 
cannabinoids in fertilization) predicted in 2005 that if and when the 
FDA approves a cannabis-based medicine, it will be as a treatment for 
glioma. "They have nothing else for glioma," said Schuel. "Nothing 
else that works."

The drug companies would have us believe otherwise. "Hints of 
Progress, and Longer Life, as Drug Makers Take on Brain Cancer" read 
the headline on a New York Times piece May 23. It ballyhooed Temodar, 
a drug from Schering-Plough shown in clinical trials to extend 
patients' survival from 12.1 months to 14.6 months (in conjunction 
with surgery and/or radiation). Temodar "is on track to surpass $1 
billion in sales this year, which would make it the first blockbuster 
drug for brain cancer."

Medical news on the business pages is never ironic; it's simply a 
given that profit is the primary goal of research. Thus the Times' 
brain-cancer story by Alex Pollack noted matter-of-factly that the 
brevity of life after a glioblastoma multiforme diagnosis -- the 
speed with which it kills -- has inhibited drug development. "The 
typical life span isn't that long, so it doesn't have the recurring 
revenue stream," Pollack quotes the chair of a nonprofit that 
promotes brain-cancer research.

"But the situation is changing," Pollack goes on. "As pharmaceutical 
companies have been able to sharply raise prices for cancer drugs in 
recent years, it has become possible for treatments for even rare 
cancers to have hefty sales -- as demonstrated by Temodar." 
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MAP posted-by: Richard Lake