FORGOTTEN MEMORIES

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.