Date: Wednesday, November 15 2006
Marijuana, the Anti-Drug
By FRED GARDNER
The extent to which medical cannabis users discontinue or reduce their use of pharmaceutical and over-the-counter drugs is a recurring theme in a recent survey of pro-cannabis (PC) California doctors. The drug-reduction phenomenon has obvious scientific implications. Medicating with cannabis enables people to lay off stimulants as well as sedatives -suggesting that the herb's active ingredients restore homeostasis to various bodily systems. (Lab studies confirm that cannabinoids normalize the tempo of many other neurotransmission systems.) The political implications are equally obvious. Legalizing herbal cannabis would devastate the pharmaceutical manufacturers and allied corporations in the chemicals, oil, "food," and banking sectors. Put simply, the synthetic drug makers stand to lose half their sales if and when the American people get legal access to cannabis.
In the 10 years since Proposition 215 made it legal for California doctors to approve cannabis use by patients, the PC docs did not adopt a common intake questionnaire, and, with one exception, did not collect systematic data on which pharmaceutical drugs their patients had chosen to stop taking. However, the consistency with which the doctors describe this phenomenon has a force as impressive as any slickly presented "hard" data.
This summer I surveyed 19 PC doctors who, between them, had approved and monitored cannabis use by more than 140,000 patients. Herewith some replies to a question about patients reporting reduced reliance on pharmaceuticals.
Frank Lucido, MD: "Chronic pain patients report reduced use of opioids, NSAIDs, muscle relaxants, sleeping pills. Psychiatric and insomnia patients reduce use of tranquilizers, SSRI antidepressants, and sleeping pills. Neurologic patients reduce use of opioids, muscle relaxants, NSAIDS, triptans and other migraine headache remedies." Marian Fry, MD: "Medications discontinued or reduced include Oxy something or the other, Norco, Percoset, Vicodin, Flexerol, Soma, Valium, SSRI antidepressants, and blood-pressure medications Norvasic and Hydrochlorothiazide. Approximately 1% of my patients report reduced reliance or discontinuation of seizure medication by substituting Cannabis for Dilantin and remaining seizure free. Many of my Glaucoma patients no longer require their Timoptic drops and are able to maintain normal pressures with the use of Cannabis. Many of my patients who have lost hope in conventional pharmaceutical treatments report enhanced health, decreased pain, decrease depression and an overall sense of well being despite chronic illness."
Helen Nunberg, MD is medical director of MediCann, a statewide chain of clinics through which 53,000 patients have received approvals. Nunberg reviewed records of 1,800 patients seen at nine clinics. "Prescription drug substitution is very significant," she writes. "51% of the 1,800 patients report using cannabis as a substitute for prescription medications; 48% report using cannabis to prevent prescription medication side effects; 67% report using cannabis to reduce dosage of prescription medication; 49% of patients using cannabis for chronic pain were previously prescribed an opioid (such as hydrocodone) by their personal physician."
Philip Denney, MD: "Cannabis allows significant decreased use or elimination of many prescription medications, particularly narcotics. Patients usually report decreases of 50% or better."
Tom O'Connell, MD: "Vicodin and other opioids; lithium; Klonopin; various sleep aids; and the whole gamut of psychotropic medications from Prozac to Xanax. I don't tell patients to stop taking anything, but I will suggest they discuss it with the prescribing doctor. I have the feeling that most don't."
Robert Sullivan, MD: "Opiates, muscle relaxants, antidepressants, hypnotics (for sleep), anxiolytics, neurontin, anti-inflammatories, anti-migraine drugs, GI meds, prednisone (for asthma, arthritis)."
William Eidelman, MD: "Opioids, sleeping pills, anxiolytics, SSRI anti-depressants."
Hanya Barth, MD: "Approximately 90% of my patients have at one time or another tried traditional medications for their symptoms and found that they produced significant side effects. With cannabis most patients report either being able to manage their symptoms without any other medications, or using less than they would ordinarily have to. It is not unusual to have patients come for a recommendation, bringing a whole bag of medications that they are taking. They might then return the following year saying that they no longer needed many of them and had cut back on many others.
"It is also true that most patients who were using alcohol to manage their symptoms or who were abusing alcohol or speed or opiates, etc. find that they can stop these drugs when they have marijuana. Many also report that they were using those drugs to manage certain symptoms such as pain or anxiety and then became addicted. This is especially true of certain populations, mainly the homeless and the mentally ill. Even cigarette smokers often state that they can substitute cannabis for nicotine.