by Chris Conrad
The euphoriant effect of cannabis is particularly beneficial for depression patients, but its resin also moderates the extreme mood swings experienced by manic depressives. This antidepressant effect was first demonstrated under modern clinical conditions by researchers who contributed to the LaGuardia report in 1942.16 Their study also verified the value of cannabis in treating appetite loss and opiate addiction. A few years later, a British study again showed the medical utility of cannabis in treating depression.17 Out of fifty depression patients who received large doses of cannabis extract, thirty-six showed improvement. Follow-up studies were less successful, whether due to drug, dosage, setting, or design. In most cases, much lower doses were given than those used in the British study. In the most recent trial, in 1973, the researchers themselves noted that “the relatively brief duration of the trial (one week) must be kept in mind, since standard antidepressants require two to three weeks to produce clinical improvement.”18 With no subsequent research having been done in this regard, we must look to a patient’s case history as a way to gauge the efficacy of cannabis.
The other side of depression is the wildly energized experience of mania, and for people who have both conditions, life is a see-saw of emotional and physical ups and downs. A Virginia woman described her experience using cannabis to control her manic depression like this. “Suppose I am in a fit of manic rage—the most destructive behavior of all. A few puffs of this herb, and I can be calm. My husband and I have both noticed this; it is quite dramatic. One minute out of control in a mad rage over a meaningless detail, seemingly in need of a strait jacket, and somewhere, deep in my mind, asking myself why this is happening and why I can’t get a handle on my own emotions. Then, within a few minutes, the time it takes to smoke a few pinches—why, I could even, after a round of apologies, laugh at myself! But this herb is illegal, and I have a strong desire to abide by the law. . . . I took lithium for six months and experienced several adverse side effects—shaking, skin rashes, and loss of control over my speech. . . . The combination of lithium side effects and increased manic-depressive symptoms drove me back to the use of cannabis. . . . Cannabis does not cure my condition, and over the years it has probably continued to worsen. But with judicious use of this medicine, my life is fine. I can control things with this drug. . . . Often I do not experience a ‘high’ at all, just a return to normal.”19 This moderating function of cannabis is critical for her to maintain her stability. Her situation has also responded to the use of THC pills, although she prefers the natural herb.
When a patient is prescribed a series of interactive medications to treat a condition, cannabis may actually serve the same function as some pharmaceutical drugs, such as Valium, or it may help mitigate some of the other drugs’ side effects. The herb can also provide a pleasant distraction from traumatic or distressing life situations, as was noted among U.S. troops in Vietnam.
The federal government has done a number of clandestine research projects in New Mexico and elsewhere using Vietnam veterans suffering from Posttraumatic Stress Disorder (PTSD), with significant findings that have not yet been made readily available. Many veterans who first experienced cannabis in Southeast Asia have found it to be quite useful in dealing with the flashbacks and sudden fits of anger, anxiety, and depression that are associated with the disorder. Curiously enough, veterans of the 1991 Persian Gulf War also report that the effects of Gulf War Syndrome appear to be mitigated by the use of cannabis. Recent evidence indicates that these troops were exposed to doses of nerve gas a number of times during the conflict. The exact nature of the neurological benefits of cannabis in both these situations may not be properly understood until the government ends its ongoing cover-up of what really happened to these veterans.
The U.S. Department of Veterans Affairs conducted a secret study of marijuana use among veterans suffering from PTSD, to determine the reasons for marijuana use and how side effects from marijuana differs between different diagnostic categories of psychiatric patients. Preliminary data suggest both similarities and differences in why mental health patients use it and what side effects they experience. Many patients from all diagnostic groups reported use of marijuana to help relax and to socialize. The PTSD group more often used marijuana to help with sleep, decrease nightmares, prevent bad memories of the past, and improve self-esteem. Bipolar patients tended to use marijuana to stabilize their mood. Depressed patients often reported use for “fun.” Schizophrenics reported more unpleasant side effects than did patients with other diagnoses.20
Ingesting a minute, homeopathic dose of cannabis tincture can reduce or eliminate the pathological ringing sound in the ears known as tinnitus. Some anecdotal reports indicate that a puff or two of cannabis can bring relief, as well. It is suggested that the micro-dose neurologically inoculates the nervous system against having hallucinations, thereby immunizing it against responding to internally generated sounds. Cannabis was popularly used in the 1960s and 1970s to help people who were experiencing discomfort, anxiety, and overwhelming hallucinogenic effects from taking LSD. Particularly for those who had used cannabis before, the herb seemed to reduce the visual brilliance of the experience, lower overall stress and restore a level of familiarity that allowed the subject to cope with their mental situation a little better. Conversely, it has also been smoked near the end of an LSD experience to allow the subject to extend their experience or trigger a new level of psychedelic thought and visual stimulation.
Although cannabis and its extracts can be useful for patients suffering from psychosis,21 its use should be approached with a great deal of caution and in a closely monitored setting. High doses of THC can cause anxiety, which could potentially trigger or aggravate a psychotic episode in an at-risk personality. This is particularly true if high doses of pure THC are used without any buffers to reduce anxiety. Fortunately, natural cannabis resin produces lower concentrations of THC, and mixes in the anxiolitic compound CBD. Federal Bureau of Narcotics psychiatrist Dr. Walter Bromberg noted in 1938 that “The patient who is developing a functional psychosis strives in the incipient stage to overcome the unconsciously perceived difficulties. In this sense [cannabis] usage represents a healthy reactive tendency, even though the mechanism may be unknown to the patient.”22 In the 1990s, Harvard Psychiatrist Dr. Lester Grinspoon has had success prescribing THC pills for depressive and manic-depressive patients.23 Unfortunately, the pills do not contain CBD. Hence, for a more balanced effect, a patient is better off using cannabis flowers.
A major advantage of cannabis over many other mood-altering drugs is that the patient remains fully functional and in control. Cannabis smokers retain their mental faculties, personal responsibility, and a relatively high degree of mental clarity. They remain aware of their physical pains and problems, but also feel a sense of detachment that helps them keep things in proportion. This perspective, along with the herb’s pain-relieving effects, has played a profound role in helping terminal patients face their impending deaths with courage and dignity. The nineteenth-century physician William O’Shaughnessy poetically described this sublime and soothing effect as enabling the physician “to strew the path to the tomb with flowers.”
Lest I begin to sound too enthusiastic, however, it should be noted that anecdotal evidence indicates that overuse of cannabis has, in some cases, led people to feel distracted, uncomfortable, lacking in motivation, unclear in their thinking, or even somewhat dependent on using cannabis as a way to cope with everyday life. Adolescents and addictive personalities are particularly at risk in this regard. Whenever anything gets in the way of normal functioning, its use should be reevaluated and modified or discarded.
In any case, marijuana is not physically addictive. Its use does not automatically lead to escalated dosages, physical dependence, and delirium or painful withdrawal. To the contrary, familiarity usually leads to increased sensitivity and the use of lower dosages, while most regular users find a comfortable level of usage—perhaps saving it for weekends or af
ter work—and maintain that pattern for years on end. For the vast majority of consumers, ending their use of cannabis is simply a matter of willpower.
Various studies have also shown cannabis to be useful in drug abuse diversion, including drug substitution and alcohol withdrawal.24 Cannabis has been used to mitigate withdrawal symptoms from alcohol and heroin in human populations.25 A similar benefit has been demonstrated in animal models. A number of people have described wild, alcoholic indulgences in their teen years and early adulthood, and credited their discovery of the benefits of smoking cannabis for having diverted them from a life of recklessness and physical deterioration. All of these individuals have family histories of alcohol abuse. Several people have also reported that they use cannabis to help them deal with the physical toll that resulted from years of heavy drinking, and also use the herb to satisfy their social cravings and keep them from relapsing into alcoholism.
In each of their circumstances, although they use more cannabis than they might wish, the patients indicate that any problems caused pale in comparison to the addictions, physical deterioration, and social harm from which this healing herb has saved them.
Chapter 7
Sight for Sore Eyes
The eyes are a sensory extension of the brain, organic light detectors through which we gather visual data and convert it into neurological impulses. More poetically, the eyes have been described as windows to the soul. Cannabis can help those windows remain clear.1
Inner ocular pressure (IOP) has nothing to do with blood pressure. It has to do with the eye’s regulation of a watery fluid called aqueous humor. This fluid normally circulates through the eye in a flow that drains away through tiny funnels along the rim of the iris, where it meets the cornea. The blockage of these funnels has potentially disastrous consequences. Glaucoma is a condition which interferes with the eyes’ normal release mechanisms and raises the IOP up to dangerous levels. It is one of the nation’s leading causes of blindness. In glaucoma, the angle at the opening of those tiny funnels causes them to close up, resulting in a backup of aqueous fluids. This is somewhat analogous to closing the floodgates on a dam in a river to produce a lake. The problem is, you don’t want those valves closed, because the eye is too fragile to withstand the resulting pressure. The buildup of pressure squeezes the sensitive ocular nerves and blocks the flow of visual data, causing cumulative deterioration. The optical nerves do not normally repair themselves once tissue has been damaged, so each episode results in a progressive loss of vision. The result is a gradual loss of peripheral vision and the development of tunnel vision, in which the patient is steadily limited to an ever-shrinking field of sight. Unless the eye pressure is brought down to a safe level, the patient will go blind. Many sufferers of glaucoma who face sensory deprivation find fast relief in the cannabis flower’s ability to lower the fluid pressure inside the eyeball itself.
Glaucoma accounts for 15 percent of blindness. In the United States alone, three to four million people have this disease and are at risk of serious loss of sight, particularly senior citizens. About 6 percent of Americans over the age of sixty-five encounter the condition. One out of fifty persons under the age of thirty-five has suspiciously high pressure that could warrant further investigation. Few daily marijuana smokers are among them, because regular use of the herb helps hold down the pressure and prevent this painful process. Cannabis drugs have been shown to reduce IOP in lab animals as well as, or better than, conventional pharmaceutical drugs, with fewer or no medical side effects.2 In recent years, THC and other derivatives have also successfully been extracted for eye drops, but cannabis works without directly acting on the glaucomatous process.3 Orthodox medical strategies seek to open up those drainage ducts either by chemistry or by surgery. Cannabis uses a different mechanism than do pharmaceutical drugs, thus it can help in situations where conventional drugs have not worked.4
The question remains, however, as to how cannabis does reduce this pressure. The dam analogy may again aid our understanding. The floodgates are shut, the river is blocked, and it overflows its banks. Similarly, blocked eye ducts lead to a backup of ocular fluids. As an engineer would open up the floodgates to release water and lower the water level, so orthodox medicine seeks to reopen these ducts and drain the excess fluid. Nature’s gentler alternative is to let the water spread out and be absorbed into marshes that suck the water down into an underground water table. Similarly, instead of opening the valves, cannabis dehydrates the eyes, thereby reducing the volume of fluid that is trying to pass through them. This reduces the pressure, saving the eye and maintaining healthy vision for years on end.
Cannabis is at least as effective in reducing eye pressure as are currently legal medicines, but without toxic side effects, change in eye color, or damage to the liver and kidneys, all of which have been associated with presently approved glaucoma drugs. Cannabis can be smoked or eaten to reduce the pressure. Both clinical studies and practical experience bear this out. When faced with a patient whose vision and ocular structure have been destroyed by glaucoma, few would withhold whatever relief an herb can provide.
VIEWING THE WORLD THROUGH ROSE-COLORED EYES
Robert S. Hepler, M.D., first prescribed marijuana in 1975 for Robert Randall, a glaucoma patient facing imminent blindness. Randall had long been aware that just before his eye pressure went out of control, he saw rainbow outlines around lights. He inadvertently discovered that if he smoked cannabis, those auras disappeared—and his eye pressure dropped. Randall subjectively recognized that there was a connection between those two occurrences. Unfortunately, the police discovered his house plants, took his medicine away, and arrested him. Randall had to prove in court that his use of marijuana was a matter of medical necessity.
The option of surgery carried with it unacceptable risks. Available drugs were inadequate to control his eye pressure. Dr. Hepler measured the patient’s IOP levels, and found that large doses of smoked marijuana effectively reduced Randall’s pressure into a safe range over the course of an entire test day. He concluded that the only known alternative to preserve the patient’s remaining eyesight would be to include cannabis as part of this regular medical regimen. The judge agreed, and Randall became the first person to receive medical marijuana from the government as part of the federal Compassionate Investigational New Drug (IND) program. John Merritt, M.D., and Richard North, M.D., treated Randall and monitored his condition over the years. More than a decade later, they testified to DEA administrative law judge Francis Young that they were convinced that the patient’s ongoing use of cannabis had saved his fragile eyesight. Robert Randall’s case history helped the judge determine in 1988 that cannabis is a safe and effective medicine for the treatment of glaucoma.5 In 1996, more than twenty years after being told that he was about to go blind, Randall still smokes cannabis every day, and he still can see.
Elvy Musikka had congenital cataracts and other eye problems from early childhood. As her already bad eyesight continued to deteriorate, she endured prescription pharmaceutical drugs that had uncomfortable side effects but little benefit, and eye surgeries that resulted in glaucoma by early adulthood. She tried drug after drug, experiencing a “nightmare” of side effects. Turning to ever more desperate measures, she underwent a risky surgery on her better, right eye. The operation left her blinded in that eye.
Desperate to save the little sight she had in her other failing eye, she finally stopped resisting suggestions that she use marijuana to reduce her IOP. To her grudging surprise, she found that it seemed to work. Musikka discussed the situation with her doctor, conducting her own experiments by eating marijuana brownies before certain visits to the doctor. His measurements verified that the herb did, indeed, bring down her eye pressure.
Elvy decided to grow her own plants so as to remove herself from the underground market, and found that she had a green thumb. That was enough to attract the attention of the police, who arrested her. Elvy argued medical necessity and the judge agreed
to hear the testimony. That’s when she learned that her doctors had never made notes on her observations about cannabis. She had to rely on the testimony of expert witnesses and her new physician, who testified that smoking marijuana did make a measurable difference in her eye pressure, and that nothing else had been effective. The judge ruled in her favor, stating that Elvy “would have to be insane” to forego the use of medical marijuana. She was placed on the federal IND program.
Musikka continues to receive three hundred government-prepared marijuana cigarettes to smoke each month, more than one for every two waking hours. Even though they are not as good as the medicine she once grew herself, Elvy Musikka maintains that her vision has actually improved, thanks to her steady use of cannabis for twenty years. She is an avid crusader for medical rights who expresses her outrage that other patients are denied access to a medicine that has helped her so much. “I didn’t lose my eyesight to glaucoma,” says Elvy. “I lost it to ignorance.”
OTHER EFFECTS OF CANNABIS ON THE EYES
Bloodshot eyes are a highly consistent physical indication of resination.6 This phenomenon appears with smoked doses as low as 2.5 mg THC.7 Using an 18-mg dose, Dr. Andrew Weil found such reddening in all frequent cannabis users and in eight out of nine inexperienced subjects.8 People with conjunctivitis, or inflamed eyes, might take this into consideration before smoking cannabis, but as yet there is no data to suggest any real risk. The reddening of the eyes is not caused by ruptures in blood vessels, but by dilation of the vessels, which makes them more visible. There are eye drops available that constrict these capillaries again, to hide the redness, but their use is not recommended.