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."