|
Individual psychotherapy, Cognitive Behavioral Therapy, Eye Movement Desensitization and Reprocessing, and Group Therapy are among the non-medical treatments that have been tried with limited success. Anti-depressants, sedatives, and anti-psychotic medications have also been employed with limited benefit and serious side effects. Currently the U.S. FDA has approved two anti-depressants for the treatment of PTSD.
Main among these are Zoloft and Paxil, both of which have limited efficacy and produce remission in only about one-quarter of patients. Such medications have also been found to double the risk of suicidal thinking and suicidal attempts in patients 24 years or less, which pertains to a large percentage of our returning young veterans.
Also, Medicines that act on the nervous system may be used to reduce anxiety and other associated symptoms. Anti-depressants, including selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) have been found to be effective in treating PTSD, although a doctor must monitor their use as they can have side effects. Sedatives can help with sleep disturbance. Anti-anxiety medicines may be useful, but some types, such as benzodiazepines, can be addictive.
Clearly, safer and more effective treatments are needed. PTSD not only results in an array of debilitating symptoms, but it also causes specific changes to certain areas of the brain that are responsible for the processing malfunctions that underlie this disease.
Activation of the primitive mammalian brain, or limbic system, during times of severe stress may play a role in optimizing survival. However, when this center of the brain becomes hyper-active and over-stimulated as a result of misguided neuro-plasticity, direct intervention at the cellular level is required.
The key to using Cannabis to treat PTSD lies in the distribution of naturally occurring Cannabinoid receptors in those areas of the brain that cause the symptoms associated with PTSD.
The presence of CB1 receptors in the hippocampus, amygdala, prefrontal cortex and anterior cingulate cortex supports the conclusion that Cannabinoids are involved in regulating anxiety, response to stressful situations, and the extinction of conditioned fear.
This conclusion is also supported by pre-clinical research showing that mice without CB1 receptors, or mice whose CB1 receptors have been rendered non-functional by chemical blockade, exhibit increased levels of anxious behavior and loss of the ability to extinguish previously learned fearful behaviors.
Conversely, the stimulation of CB1 receptors in the amygdala of rats has been shown to protect against the effects of stress on fear conditioning and avoidance behavior.
Early human studies using synthetic Cannabinoids have also shown that stimulation of the endogenous Cannabinoid system is significantly effective in reducing the occurrence of treatment-resistant nightmares in PTSD patients, along with subjective improvements in sleep time and sleep quality, and a reduction in daytime flashbacks.
These results stand in stark contrast to a recent study sponsored by the Veterans Administration National Center for PTSD, which showed that treatment with a second-generation anti-psychotic medication was ineffective at controlling symptoms in combat related PTSD patients.
SOURCE(s):
[1] - Post-traumatic stress disorder (PTSD) >>
www.canna-centers.com/ailments#PTSD
[2] - 420magazine.com > Forum > MEDICAL MARIJUANA > Medical Marijuana News > PTSD And Medical Cannabis >>
www.420magazine.com/forums/medical-marijuana-news/160120-ptsd-medical-cannabis.html
[3] - PTSD and Cannabis: A Clinician Ponders Mechanism of Action >>
davidbearmanmd.com/docs/ptsdccrmg.htm
Updated NORML Report Highlights Marijuana's Role In Moderating Disease Progression; 'Emerging Clinical Applications' Booklet Reviews Nearly 200 Studies On The Therapeutic Use Of Cannabis
Clinical and preclinical research on the therapeutic use of cannabis indicates that cannabinoids may curb the progression of various life-threatening diseases including multiple sclerosis, Alzheimer's disease, and brain cancer, according to an updated report published by the NORML Foundation.
NORML Deputy Director Paul Armentano, who authored the report, said: "The conditions profiled in this report were chosen because patients frequently ask me about the use of cannabis to treat these disorders. Ideally, with this report in their hands, patients can now begin talking openly with their physicians about whether cannabis therapy is appropriate for them."
Visit - norml.org/component/zoo/category/recent-research-on-medical-marijuana - for more.
Medical Use of Cannabis (marijuana) | Here to Help
> On this page:
How does cannabis work as medicine?
What conditions or symptoms is cannabis used to treat?
How do people use cannabis for medical purposes?
What is pharmaceutical cannabis, and how does it compare to herbal cannabis?
What are the side effects and risks of using cannabis to treat symptoms or medical conditions?
Drug interactions
Quality
Is using cannabis for medicinal purposes legal?
What are compassion clubs?
What are some barriers to using cannabis for medicinal purposes?
What to do if you or someone you know needs more information about medical cannabis
Visit - heretohelp.bc.ca/factsheet/medical-use-of-cannabis - for more.
HowStuffWorks "How Medical Marijuana Works"
| So how, exactly, does medical marijuana work to treat these conditions? Why, if this medicine is so effective for some people, does it remain controversial and, in many places, illegal? In this article, we'll take a look at the medical, legal, and practical issues surrounding medical marijuana in the United States. We'll examine why some people, like Burton Aldrich,
depend on it to live normally. We'll also examine some of the intriguing intersections between pharmaceutical companies, the government and the medical marijuana industry. Visit - science.howstuffworks.com/medical-marijuana.htm - for more.
Medical Marijuana Benefits, Helps These Conditions
| You might be surprised to find that it wasnt just ancient peoples who used the drug; marijuana remained in the United States pharmacopoeia until 1941. Up until that time, cannabis was freely available in shops and, in the UK, Queen Victoria, that most conservative of royals, used cannabis to alleviate her menstrual cramps. ... are predominantly using cannabis to treat symptoms of ...
We believe Medical Marijuana will help these conditions:
Please let us know your experiences in using medical marijuana to treat various conditions.
Visit - www.medicalmarijuanablog.com/benefits/conditions-helped.html - for more.
Medical marijuana (cannabis) - common uses
| Common Medical Uses for Cannabis (Marijuana) ... Medical Marijuana Dispensaries - Directory of Medical Marijuana ... Cannabidiol improves symptoms of generalized social anxiety disorder in
... Medical Marijuana Dispensaries - Directory of Medical Marijuana Dispensaries
Project CBD
Cannabinoid Profiles of Cannabis Strains
Cannabis Laboratories: The Testing Landscape in America
See also:
An Overview of the Endogenous Cannabinoid System
Visit - www.letfreedomgrow.com/cmu/index.htm - for more.
Complete List of Conditions Treatable With Marijuana
| Check out the articles below to learn about how medical marijuana can be useful in treating specific medical conditions. We'll help you find the best ways to ingest medical marijuana to
treat your condition, what strains will be most beneficial and we'll even help you connect with other folks with the same condition.
Visit - medicalmarijuana.com/treatments-with-medical-marijuana-cannabis - for more.
What symptoms do patients treat with ... , Salt Lake City Medical Marijuana ... representative for the American Alliance for Medical Cannabis ...
One question the 2011 Medical Marijuana Survey (sponsored by Legalize Utah) queried which
received some of the most detailed responses was Do you use Medical Marijuana to treat any physical or psychological conditions and if so, which conditions.
Visit - www.examiner.com/article/what-symptoms-do-patients-treat-with-medicinal-cannabis - for more.
Marijuana: 1276 user reviews - DailyStrength | (INF)
Medically, cannabis is most often used as an appetite stimulant and pain reliever for certain ... Myasthenia Gravis, Narcolepsy, Obsessive Compulsive Diso. ... I use medical marijuana o...
Marijuana
(also known as Cannabis)
Medically, cannabis is most often used as an appetite stimulant and pain reliever for certain illnesses such as cancer, AIDS and other diseases. It is used to relieve glaucoma and certain neurological illnesses such as epilepsy, migraine and bipolar disorder. It has also been found to relieve nausea for chemotherapy pa... more at Wikipedia
Treatment Success Rates ...
Top 5 Communities;
Condition, Members, Success -
Chronic Pain, 684, 86%;
Depression, 55 96%;
Bipolar Disorder, 44, 95%;
Anxiety, 32 94%;
Fibromyalgia, 26, 100%;
Overall, 90% (1106 Members) - find Marijuana helpful
Visit - http://www.dailystrength.org/treatments/Marijuana - for more.
RxMarihuana.com: Index of Medical Conditions | (INF)
Marijuana: The Forbidden Medicine. Index of Medical Conditions Addressed We will soon ... MUSCLE SPASM
PTSD
MYOFASCIAL PAIN SYNDROME
N
NARCOLEPSY
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Visit - http://rxmarijuana.com/medical_conditions.htm - for more.
Tetrahydrocannabinol - Wikipedia, the free encyclopedia | (INF)
Tetrahydrocannabinol (tet-ra-hy-dro-ka-nab-i-nol; THC), also known as delta-9-tetrahydrocannabinol (Delta9-THC), Delta1-THC (using an older chemical nomenclature), or dronabinol, is the main psychoactive substance found in the cannabis plant.
... Two studies indicate that THC also has an anticholinesterase action which may implicate it as a potential treatment for Alzheimer's and PTSD.
Visit - http://en.wikipedia.org/wiki/Tetrahydrocannabinol - for more.
Expectations (prognosis).
The best prognosis, or outcome, depends on how soon the symptoms develop after the trauma, and on early diagnosis and treatment.
Complications.
-
Depression, anxiety, and phobia, or fear of things that are not usually frightening to other people, may accompany this disorder
-
Alcohol abuse and/or drug abuse
Calling your health care provider.
While traumatic events like the September 11 tragedy can cause distress, not all feelings of distress are symptoms of PTSD.
You should talk about your feelings with friends and relatives. If your symptoms persist longer, or are worse, than those of your friends, you should contact your doctor.
You should seek help immediately by going to the emergency room or calling the local emergency number (such as 911) if you are feeling overwhelmed by guilt, if you are impulsive, thinking of hurting yourself, unable to contain your behavior, or if you are experiencing other very distressing symptoms of PTSD.
You can also contact your doctor for help with ongoing problems such as recurrent thoughts, irritability, and problems with sleep.
Prevention.
Counseling and crisis intervention soon after the event are important for people who have experienced extremely stressful situations.
They could help prevent longer-term forms of PTSD and should be part of public health responses to groups at risk, such as disaster victims.
Source: www.healthline.com/adamcontent/post-traumatic-stress-disorder
Researchers concluded that "results show good tolerability and other benefits, particularly in the patients with either pain and/or depression comorbidity". (Comorbity is the term used when a patient suffers from more than one condition). These results were presented at the 2011 Cannabinoid Conference in Bonn, Germany.
Many of our patients who suffer from PTSD report that medical marijuana has helped them by lessening anxiety, improving mood, improving sleep, eliminating nightmares and producing an overall improved sense of well-being. Many of these patients had tried and failed other medication treatments.
One often intractable problem for which cannabis provides relief is post-traumatic stress disorder (PTSD). I have more than 100 patients with PTSD.
Among those reporting that cannabis alleviates their PTSD symptoms are veterans of the war in Vietnam, the first Gulf War, and the current occupation of Iraq. Similar benefit is reported by victims of family violence, rape and other traumatic events, and children raised in dysfunctional families.
Post-Traumatic Stress Disorder
| Post-Traumatic Stress Disorder once referred to as shell shock or battle fatigue is a debilitating condition that follows exposure to ongoing emotional trauma or in some instances a single terrifying event. Many of those exposed to such experiences suffer from PTSD. The symptoms of PTSD include persistent frightening thoughts with memories of the ordeal. PTSD patients have frightening nightmares and often feel anger and an emotional isolation.
Sadly, PTSD is a common problem. Each year millions of people around the world are affected by serious emotional trauma. In more than 100 countries there is recurring violence based on ethnicity, culture, religion or political orientation.
Men, women and children suffer from hidden sexual and physical abuse. The trauma of molestation can cause PTSD. So can rape, kidnapping, serious accidents such as car or train wrecks, natural disasters such as floods or earthquakes, violent attacks such as mugging, torture, or being held captive.
The event that triggers PTSD may be something that threatened the persons life or jeopardized someone close to him or her. Or it could simply be witnessing acts of violence, such as a mass destruction or massacre. PTSD can affect survivors, witnesses and relief workers.
Symptoms
| Whatever the source of the problem, PTSD patients continually relive the traumatic experience in the form of nightmares and disturbing recollections. They are hyper-alert. They may experience sleep problems, depression, feelings of emotional detachment or numbness, and may be be easily aroused or startled.
They may lose interest in things they used to enjoy and have trouble feeling affectionate. They may feel irritable, be violent, or be more aggressive than before the traumatic exposure.
Triggers
| Seeing things that remind them of the incident(s) may be very distressing, which could lead them to avoid certain places or situations that bring back those memories. Anniversaries of a traumatic event are often difficult.
Ordinary events can serve as reminders of the trauma and trigger flashbacks or intrusive images. Movies about war or TV footage of the Iraqi war can be triggers. People with PTSD may respond disproportionately to more or less normal stimuli a car backfiring, a person walking behind them. A flashback may make the person lose touch with reality and re-enact the event for a period of seconds, hours or, very rarely, days. A person having a flashback in the form of images, sounds, smells, or feelings experiences the emotions of the traumatic event. They relive it, in a sense.
Symptoms may be mild or severe people may become easily irritated or have violent outbursts. In severe cases victims may have trouble working or socializing. Symptoms can include:
Problems in affect regulation for instance persistent depressive symptoms, explosion of suppressed anger and aggression alternating with blockade and loss of sexual potency;
Disturbance of conscious experience, such as amnesia, dissociation of experience, emotions, and feelings;
Depersonalization (feeling strange about oneself), rumination;
Distorted self-perception for instance, feeling of helplessness, shame, guilt, blaming oneself, self-punishment, stigmatization, and loneliness;
Alterations in perception of the perpetrator for instance, adopting distorted beliefs, paradoxical thankfulness, idealization of perpetrator and adoption of his system of values and beliefs;
Distorted relationship to others, for instance, isolation, retreat, inability to trust, destruction of relations with family members, inability to protect oneself against becoming a victim again;
Alterations in systems of meaning, for instance, loss of hope, trust and previously sustaining beliefs, feelings of hopelessness;
Despair, suicidal thoughts and preoccupation;
Somatization for instance persistent problems in the digestive system, chronic pain, cardiopulmonary symptoms (shortness of breath, chest pain, dizziness, palpitations).
Cannabis
| Ample anecdotal evidence suggests that cannabis enhances ability to cope with PTSD. Many combat veterans suffering from PTSD rely on cannabis to control their anger, nightmares and even violent rage. Recent research sheds light on how cannabis may work in this regard.
Neuronal and molecular mechanisms underlying fearful memories are often studied in animals by using fear conditioning. A neutral or conditioned stimulus, which is typically a tone or a light, is paired with an aversive (unconditioned) stimulus, typically a small electric shock to the foot. After the two stimuli are paired a few times, the conditioned stimulus alone evokes the stereotypical features of the fearful response to the unconditioned stimulus, including changes in heart rate and blood pressure and freezing of ongoing movements. Repeated presentation of the conditioned stimulus alone leads to extinction of the fearful response as the animal learns that it need no longer fear a shock from the tone or light.
Fear Extinction |
Emotions and memory formation are regulated by the limbic system, which includes the hypothalamus, the hippocampus, the amygdala, and several other
structures in the brain that are particularly rich in CB1 receptors.
The amygdala, a small, almond-shaped region lying below the cerebrum, is crucial in acquiring and, possibly, storing the memory of conditioned fear. It is thought that at the cellular and molecular level, learned behavior including fear involves neurons in the baso-lateral part of the amygdala, and changes in the strength of their connection with other neurons (synaptic plasticity).
CB1 receptors are among the most abundant neuroreceptors in the central nervous system. They are found in high levels in the cerebellum and basal ganglia, as well as the limbic system. The classical behavioral effects of exogenous cannabinoids such as sedation and memory changes have been correlated with the presence of CB1 receptors in the limbic system and striatum.
In 2003 Giovanni Marsicano of the Max Planck Institute of Psychiatry in Munich and his co-workers showed that mice lacking normal CB1 readily learn to fear the shock-related sound, but in contrast to animals with intact CB1, they fail to lose their fear of the sound when it stops being coupled with the shock.
The results indicate that endocan-nabinoids are important in extinguishing the bad feelings and pain triggered by reminders of past experiences. The discoveries raise the possibility that abnormally low levels of cannabinoid receptors or the faulty release of endogenous cannabinoids are involved in post-traumatic stress syndrome, phobias, and certain forms of chronic pain.
This suggestion is supported by our observation that many people smoke marijuana to decrease their anxiety and many veterans use marijuana to decrease their PTSD symptoms. It is also conceivable, though far from proved, that chemical mimics of these natural substances could allow us to put the past behind us when signals that we have learned to associate with certain dangers no longer have meaning in the real world.
What is the Mechanism of Action?
| Many medical marijuana users are aware of a signaling system within the body that their doctors learned nothing about in medical school: the endocan-nabinoid system. As Nicoll and Alger wrote in The Brains Own Marijuana (Scientific American, December 2004):
Researchers have exposed an entirely new signaling system in the brain: a way that nerve cells communicate that no one anticipated even 15 years ago. Fully understanding this signaling system could have far-reaching implications. The details appear to hold a key to devising treatments for anxiety, pain, nausea, obesity, brain injury and many other medical problems.
As a clinician, I find the concept of retrograde signaling extremely useful. It helps me explain to myself and my patients why so many people with PTSD get relief from cannabis.
We are taught in medical school that 70% of the brain is there to turn off the other 30%. Basically our brain is designed to modulate and limit both internal and external sensory input.
The neurotransmitter dopamine is one of the brains off switches.The endocannabinoid system is known to play a role in increasing the availability of dopamine. I hypothesize that it does this by freeing up dopamine that has been bound to a transporter, thus leaving dopamine free to act by retrograde inhibition.
By release of dopamine from dopamine transporter, cannabis can decrease the sensory input stimulation to the limbic system and it can decrease the impact of over-stimulation of the amygdala.
I postulate that exposure to the PTSD-inducing trauma causes an increase in production of dopamine transporter. The dopamine transporter ties up much of the free dopamine. With the brain having lower-than-normal free dopamine levels, there are too many neural channels open, the mid-brain is overwhelmed with stimuli and so too is the cerebral cortex. Hard-pressed to react to this stimuli overload in a rational manner, a person responds with anger, rage, sadness and/or fear.
With the use of cannabis or an increase in the natural cannabinoids (anandamide and 2-AG), there is competition with dopamine for binding with the dopamine transporter and the cannabinoids win, making a more normal level of free dopamine available to act as a retrograde inhibitor.
This leads to increased inhibition of neural input and decreased negative stimuli to the midbrain and the cerebral cortex. Since the cerebral cortex is no longer overrun with stimuli from the midbrain, the cerebral cortex can assign a more rational meaning and context to the fearful memories.
I have numerous patients with PTSD who say marijuana saved my life, or marijuana allows me to interact with people, or it controls my anger, or when I smoke cannabis I almost never have nightmares. Some say that without marijuana they would kill or maim themselves or others. I have no doubt that cannabis is a uniquely useful treatment. What remains is for the chemists to determine the precise mechanism of action.
SOURCE: >> PTSD and Cannabis: A Clinician Ponders Mechanism of Action >
davidbearmanmd.com/docs/ptsdccrmg.htm
Fortunately, there is something that the People of the State of Oregon can do to improve the treatment options that are available to our stricken veterans and others who suffer this condition. A new bill, SB 281, was recently introduced into the Senate, which would add PTSD as a qualifying medical condition under Oregons Medical Marijuana Program, the OMMP. Such an addition would make it possible for physicians to Qualify PTSD patients for the Program and allow them to use Cannabis free of fear from State and Local institutions.
For now, PTSD patients that live in states where medical use of cannabis is approved are using it to help decrease the debilitating symptoms of their illness and improve their quality of life. If you or a loved one is suffering from PTSD, you may find relief from the use of medical marijuana.
New Mexico, California and Delaware already allow PTSD patients to utilize Medical Cannabis, and it is likely that others will also follow suit as more states recognize the benefit that this herbal botanical substance can bring. But nothing is going to happen unless we make it. Those of us who recognize the benefit of using Cannabis to treat PTSD need to make our voices heard in the Oregon Legislature.
It is time to put the We back in We the People, by contacting your legislators and letting them know that we want this medical treatment made available to our deserving veterans.
For more information, Visit our action page to Add PTS(d) to the OMMP, and tell everybody you know about it. And get them to write and spread the word, etc. >>
mercycenters.org/action/camp_PTS.html
Welcome to Lest We Forget - PTSD Support!
| Our hope is that our website and information helps another family or military member. Much of the information comes from what we have learned, read and validated. Everyone needs to be informed but they also need to be educated.
Our goal has always been for safer, effective and evidence based treatments to be given to our active duty troops, veterans and their families by the DoD and VA for those suffering from
PTSD or TBI wounds. Over medication and poly pharmacy is never a safe or acceptable treatment, instead we hope to see more peer to peer counseling, 12 step programs, evidence based therapies and quicker and easier access to care and treatment.
visit: http://www.lestweforgetptsdsupport.org/
Veterans for Medical Marijuana Access (VMMA) |
* (ORG, inf) Incorporated in 2007, VMMA advocates for veterans' rights to access medical marijuana for therapeutic purposes. VMMA also
works to minimize the harm associated with marijuana use, which many veterans believe to be conviction and incarceration.
Contact: 1414 Low Road,
Kalamazoo, MI 49008 * or visit: http://www.veteransformedicalmarijuana.org/
The Blackdog Foundation is a 501(c)3 non-profit group designed to help assist in the recovery of Post Traumatic Stress Disorder (PTSD) for returning veterans, their families, friends, and community.
Blackdogs philosophy serves many in a community:
* Veterans (from all eras) needing assistance with re-integration into their communities;
* Veterans suffering from PTSD (Post Traumatic Stress Disorder) and their families;
* Children or young adults in conflict with peers or family members;
* Those experiencing violence in need of protection, mediation or counseling;
* Those struggling with meth addiction.
Contact info: Blackdog Foundation,
2722 Aztec Dr. NW,
Olympia WA 98502 * (360) 866-1041
*
URL: BlackDogFoundation.org
Patients Out of Time.
(ORG, action {event}) * more on The Fourth National Clinical Conference on Cannabis Therapeutics - While various aspects of clinical use will be covered, the core of the forum will involve both physical cannabis treatment and the use of cannabis for PTSD, ADD, depression and other emotional or psychological problems. Visit: www.medicalcannabis.com
Support Groups.
Additional information about post-traumatic stress disorder and coping with a national tragedy is available from the American Psychiatric Association.
The American Psychiatric Association is a medical specialty society recognized world-wide. Its over 38,000 U.S. and international member physicians work together to ensure humane care and effective treatment for all persons with mental disorder, including mental retardation and substance-related disorders. It is the voice and conscience of modern psychiatry. Its vision is a society that has available, accessible quality psychiatric diagnosis and treatment.
Contact info: 1000 Wilson Boulevard,
Suite 1825,
Arlington, VA, 22209 *
URL: www.psych.org
*
Questions?
Contact APA Answer Center *
Call Toll-Free: 1-888-35-PSYCH or 1-888-35-77924 *
From outside the U.S. and Canada call: 1-703-907-7300
California Cannabis Research Medical Group (CCRMG).
* (ORG, inf) Winter/Spring 2005 - O'Shaughnessy's; Journal of the California Cannabis Research Medical Group. Letter from a Soldier - Is Cannabis Recommended for PTSD? - Hello Dr. Mikuriya, I have recently returned home from Iraq. This was my second tour. I only had about 4 months between the two tours. I
am at a high state of alertness and I startle at certain noises. My tolerance is also very low, I get angry very easily. Not violent, I still have control but very agitated. I also have trouble sleeping and sometimes I have to take a sleeping pill or Nyquil to go to sleep. I went to my doctors and they sent me to a place on base that helps with PTSD.
Cannabis would indeed be useful in managing symptoms of PTSD. This has been known for over a century in the medical profession but forgotten because of its ... visit: www.ccrmg.org/journal/05spr/opinion.html
Medical Marijuana ProCon.org | Individual Bio - Al Byrne, Patients Out of Time
... Should marijuana be a medical option? ... International Academy of Cannabis Medicine (IACM), Veteran Outreach -- Cannabis for PTSD affected veterans. Visit: www.medicalmarijuanaprocon.org/BiosInd/Byrne.htm
Viable Forums, chat rooms and other such online resources
will be listed here as we learn about them.
Regarding the editorial "Rx for Oregon pot laws" (Aug. 29): I am glad that The Oregonian editorial board thinks enough of this subject matter to dedicate an entire editorial just to respond to the excellent article by The Oregonian's Noelle Crombie ("Medical marijuana for PTSD?" Aug. 27). However, some of the claims are misleading, and the tone is offensive to the men and women who I serve as a veterans advocate.
First, many or most of the veterans who are seen at VA hospitals for treatment of post-traumatic stress disorder are given a host of medications, including strong painkillers. So yes, many of those veterans are currently served by the provision in Oregon law that allows for chronic pain. But the inflated numbers of chronic pain patients on the Oregon Medical Marijuana Program have become a red flag to law enforcement officials who are actively seeking to dismantle the program and strip Oregonians of their protection to use cannabis under a doctor's supervision. ?
Cannabis is a well-proven pain medication that has stood the scrutiny of double-blind placebo-based studies, so it sounds reasonable when the editorial board calls for similar studies for PTSD. The lack of such studies was cited as a factor in Arizona's decision, but that isn't a reasonable demand, given that the federal government has blocked our every effort to conduct these studies. The editorial board, being well-read, must know how hard we have tried to study this indication.
Instead of asking why Arizona shot down our efforts to add PTSD as a qualifying condition, I think the better question would have been, "Why did New Mexico approve cannabis for PTSD?" It did so after considering the available medical evidence. We have a preponderance of research on how cannabis works in the brain and body, the so called endocannabinoid receptor system, and studies that show how the various chemicals in cannabis work for the various symptoms that we call PTSD. However, this information is complicated, and it takes a medically trained individual to understand this evidence, which New Mexico had in place, but unfortunately, neither Arizona nor Oregon did.
Finally, I want to address the tone of this editorial and why it is so offensive to the men and women who have served our country honorably in the U.S. Armed Forces. The editorial board portrays the veterans as pawns who are nothing more than a flag draped around the shoulders of potheads trying to change the law. Veterans come down and testify in support of a change in the law because they know cannabis works first-hand.
That's simple enough, but then why does my organization, made up of and for veterans, support the changing the law? Veterans For Medical Cannabis Access supports changing the law because we are losing 18 veterans per day to suicide, because the drugs the VA is throwing at these vets are ineffective and because we have taken the time to consider the evidence.
We believe that allowing for PTSD under the Oregon state medical marijuana law will help us better understand how many people in the program are really suffering from post-traumatic stress and are not primarily pain patients. We believe that, when this happens, it will go a long way to removing the stigma associated with seeking treatment for PTSD and will save lives.
SOURCE = Story, By Michael Krawitz.
Michael Krawitz is the executive director of Veterans For Medical Cannabis Access, based in Elliston, Va.
Are Veterans Being Given Deadly Cocktails to Treat PTSD?
A potentially deadly drug manufactured by pharmaceutical giant AstraZeneca has been linked to the deaths of soldiers returning from war. Yet the FDA continues to approve it.
March 6, 2010
| (BIZ, Articles)
Sgt. Eric Layne's death was not pretty.
A few months after starting a drug regimen combining the antidepressant Paxil, the mood stabilizer Klonopin and a controversial anti-psychotic drug manufactured by pharmaceutical giant AstraZeneca, Seroquel, the Iraq war veteran was "suffering from incontinence, severe depression [and] continuous headaches," according to his widow, Janette Layne.
Soon he had tremors. "
[H]is breathing was labored [and] he had developed sleep apnea," Layne said.
Janette Layne, who served in the National Guard during Operation Iraqi Freedom along with her husband, told the story of his decline last year, at official FDA hearings on new approvals for Seroquel. On the last day of his life, she testified, Eric stayed in the bathroom nearly all night battling acute urinary retention (an inability to urinate). He died while his family slept.
Sgt. Layne had just returned from a seven-week inpatient program at the VA Medical Center in Cincinnati where he was being treated for post-traumatic stress disorder (PTSD). A video shot during that time, played by his wife at the FDA hearings, shows a dangerously sedated figure barely able to talk.
Sgt. Layne was not the first veteran to die after being prescribed medical cocktails including Seroquel for PTSD.
In the last two years, Pfc. Derek Johnson, 22, of Hurricane, West Virginia; Cpl. Andrew White, 23, of Cross Lanes, West Virginia; Cpl. Chad Oligschlaeger, 21, of Roundrock, Texas; Cpl. Nicholas Endicott, 24, of Pecks Mill, West Virginia; and Spc. Ken Jacobs, 21, of Walworth, New York have all died suddenly while taking Seroquel cocktails.
Death certificates and other records collected by veteran family members show that more than 100 similar deaths have occurred among Iraq and Afghanistan combat vets and other military personnel, many of whom took PTSD cocktails that included Seroquel and other antipsychotics, antidepressants, mood stabilizers, sleep inducers and pain and seizure medications.
Since the 2008 publication of "The Battle Within," the Denver Post's expose of a "pharmaco-battlefield" in Iraq, in which troops were found to be routinely propped up on antidepressants, the Department of Defense has sought to curb the deployment of troops with mental health problems to combat zones. The DOD has also stepped up monitoring of soldiers who have been medicated, according to the Hartford Courant, and with good reason: 34 percent of the 935 active-duty soldiers who made suicide attempts in 2007 were on psychoactive drugs.
But the U.S. Army's Warrior Care and Transition Office reports that soldiers are dying after coming home, many in Warrior Transition Units that were established in 2007 to prepare wounded soldiers for a return to duty or civilian life. According to the Army Times, between June 2007 and October 2008, 68 such veteran deaths were recorded -- nine were ruled suicides, six are pending investigation and six were from "combined lethal drug toxicity." Thirty-five were termed "natural causes."
The mysterious deaths -- and an alarming track record -- have cast renewed scrutiny on Seroquel. Although it has not been approved for treatment of PTSD, Pentagon purchases of Seroquel nearly doubled between 2003 and 2007. Elspeth Ritchie, medical director of the Army's Strategic Communications Office told the Denver Post the drug is "increasingly utilized as an adjunct for PTSD."
The Seroquel Scandals
It would be hard to find a drug with a wider fraud footprint than Seroquel -- at least one that's still on the market.
One of its first backers, Richard Borison, former chief of psychiatry at the Charlie Norwood VA Medical Center, lost his medical license, was fined $4.26 million and went to prison for a swindle involving Seroquel's original clinical studies.
AstraZeneca's U.S medical director for Seroquel, Dr. Wayne MacFadden, had sexual affairs with two different women doing research on Seroquel, a study investigator at London's Institute of Psychiatry and a Seroquel ghostwriter at the marketing firm, Parexel. According to court documents, MacFadden even joked about the conflicts of interest with one paramour.
Last year, the Chicago Tribune and ProPublica reported that Chicago psychiatrist Michael Reinstein, who wrote 41,000 prescriptions for Seroquel, received $500,000 from AstraZenenca. Meanwhile, a report in the Minneapolis Star Tribune discredited influential studies by AstraZeneca-funded Charles Schulz, MD, chief of psychiatry at the University of Minnesota.
Seroquel was even promoted by the disgraced former chief of psychiatry at Emory University School of Medicine, Charles Nemeroff, who was accused by congressional investigators of failing to report $1 million in pharmacological income -- in AstraZeneca-funded continuing medical education courses.
And until a Philadelphia Inquirer expose last year, Florida child psychiatrist Jorge Armenteros, a paid AstraZeneca speaker, was chairman of the FDA Psychopharmacologic Drugs Advisory Committee responsible for recommending Seroquel approvals.
In a trial that began in New Jersey last month, AstraZeneca is defending itself in one of 26,000 lawsuits, denying that Seroquel caused diabetes in Vietnam veteran Ted Baker, who was prescribed Seroquel for PTSD. Last year, London-based AstraZeneca agreed to pay $520 million last year to settle suits pertaining to clinical trials and illegal Seroquel marketing.
Yet, instead of reconsidering a drug linked to an alarming number of deaths and marred by at least eight corruption scandals in 13 years -- Seroquel was even prescribed to a 4-year-old Massachusetts girl, Rebecca Riley, before her death -- the FDA continues to issue approvals for new uses for Seroquel.
Seroquel was first approved to treat schizophrenia in 1997. The FDA subsequently expanded its use, approving it for "acute manic episodes associated with Bipolar I Disorder" in 2004, "major depressive episodes associated with Bipolar Disorder" in 2006 and "maintenance treatment for Bipolar I Disorder" in 2009.
Last April, the FDA opened the door to prescribing Seroquel to people who have not even been diagnosed with schizophrenia or bipolar disorder, approving Seroquel as "an additional therapy in patients suffering from depression who do not respond adequately to their current medications."
Not that Seroquel needed a boost; its $4.9 billion in sales in 2009 signals usage far beyond the 1 percent of the population with schizophrenia and the 2.5 percent with bipolar disorder. North Carolina's Medicaid spends $29.4 million per year on Seroquel -- more than any other drug, according to the Charlotte News and Observer.
Most recently, in December, Seroquel was quietly approved for children between the ages of 10 and 17 who are diagnosed with bipolar mania and children between 13 and 17 with schizophrenia. It was a stealth end-of-the-year decision, announced not by the FDA itself but by AstraZeneca. (The change was reflected in an entry on Seroquel's FDA approval page that notes "Patient Population Altered.")
'When six people die from peanut butter we shut the factories down'
With veteran deaths in the news, family members hope the unsolved mysteries surrounding Seroquel-linked deaths of soldiers could finally force AstraZeneca to take responsibility for its product.
Stan and Shirley White lost two sons to war. Robert White, a staff sergeant, was killed in Afghanistan in 2005, when his Humvee was hit by a rocket-propelled grenade. But the death of Robert's younger brother Andrew, who survived Iraq only to succumb to a different battle, is in some ways "harder to accept" says his father.
Like Eric Layne, Andrew was taking Seroquel, Klonopin, Paxil and prescription painkillers for PTSD after returning home from his Iraq tour. Like Layne, he deteriorated physically and mentally on the prescribed cocktail until experiencing a sudden, inexplicable death.
"When six people die from peanut butter we shut the factories down, but at least 87 military men have died in the past six years on Seroquel and similar drugs and no alarm sounds," Stan White told AlterNet.
When White informed his representatives, Sen. Jay Rockefeller and Rep. Shelley Moore Capito of West Virginia, of Andrew's unexplained death, they were helpful, as was Tammy Duckworth, the VA's Assistant Secretary of Public and Intergovernmental Affairs. But packets White distributed to news organizations, Congress and the White House were acknowledged only by First Lady Michelle Obama, who forwarded hers to the VA, and Sen. Daniel Akaka of Hawaii, who chairs the Senate Committee on Veterans Affairs. In letters to White, both remarked that therapy, not just drugs, should be part of PSTD treatment.
A 2008 investigation by the VA's Office of Inspector General into the deaths of Andrew White and Eric Layne was inconclusive, finding "no apparent signal to indicate increased mortality for patients taking the combination of Quetiapine, Paroxetine, and Clonazepam when compared with patients taking other similar combinations of psychotropic medications."
"The direct impact of non-prescribed medications in these patient deaths cannot be determined," investigators concluded.
SSGT (Ret) Tom Vande Burgt's Army National Guard company was stationed outside Baghdad at the same time that Eric and Janette Layne were serving, in 2004 and 2005, but his story has a happier ending.
Like White and Layne, he was prescribed a PTSD cocktail that included Seroquel, along with Klonopin and the antidepressant Celexa, but as tremors, sleep apnea and enuresis (bedwetting) developed, his wife, Diane, questioned the high dosage, off-label use of a bipolar drug like Seroquel. After her husband was taken off his meds abruptly and it was discovered there were no records of the drugs being sent to him (or the doses) by a VA primary care doctor -- mistakes that "could have cost him his life," according to Diane -- the Vande Burgts filed a complaint with the VA Office of the Inspector General. It, however, found no wrongdoing, concluding the treatment was within the VA's "standard of care."
Under the care of a private psychiatrist, Vande Burgt's cocktail only grew, but eventually he went off the drugs with the help of his doctor, and his sleep apnea, urinary problems, tremors, weight gain, depression, mood swings, lethargy and paranoia subsided.
The way Vande Burgt describes it, Seroquel "drugs vets up" to such a degree that they "don't dream at all."
"It wipes out the hypervigilance factor," he told AlterNet via e-mail. "But as soon as the meds are decreased, the hypervigilance and anger and trust issues come raging back, worse than before."
Now the Vande Burgts, who live in Charleston, West Virginia, coordinate a PTSD support group and a Web site that emphasize nondrug solutions and the need for soldiers and veterans to have an advocate present during care for PTSD and traumatic brain injury to ensure clear communication between doctors and patient. Tom also uses the services of Give an Hour, a program in which local therapists donate one hour of therapy a week to veterans, soldiers and families dealing with PTSD.
"There is no cure for PTSD, especially in a magic pill," the Vande Burgts told AlterNet. "Good old-fashioned talk therapy and support groups are tried and true
all the others are just quick fixes that add to the problem, not addressing the root of the problem."
AstraZeneca: Too Big to Regulate?
Seroquel's ability to cause cardiac arrest and sudden death is well-known.
A search of the U.S. National Library of Medicine database yields 20 articles linking "Seroquel" and "sudden death," 24 linking "Seroquel" and "QT prolongation" (a heart disturbance that can led to death), 55 linking "Seroquel" and "toxicity," as well as such terms as "cardiac arrest" and "death."
A 2005 article in the Journal of Forensic Sciences says Seroquel was detected in 13 postmortem cases and the cause of death in three, observing that "little information exists regarding therapeutic, toxic, and lethal concentrations."
A 2003 article in CNS Drugs reports, "some patients have died while taking therapeutic doses," of atypical antipsychotics like Seroquel and that "toxicity may be increased by coingestion of other agents."
"The second-generation antipsychotics were termed 'atypical' based on misconceptions of enhanced safety and efficacy," Dr. Grace Jackson, a former Navy and Veterans Administration psychiatrist and author of Drug-Induced Dementia and Rethinking Psychiatric Drugs, told AlterNet in an interview. ("Atypical" antipsychotics supposedly function differently from "typical" antipsychotics and are thought to cause fewer side effects.)
"In 2002 and 2003, according to a VA study published in 2007, 20 to 30 percent of demented veterans [veterans with brain conditions including organic and psychiatric psychosis] died within the first 12 months of beginning treatment with an antipsychotic," said Jackson. "When you combine antipsychotics with antidepressants, benzodiazepines and antiepileptics -- especially in Iraq/Afghanistan veterans who have likely sustained traumatic brain injuries -- you have potential lethality from sleep apnea, endocrine anomalies and opioid intoxication."
Seroquel's record of causing sudden cardiac death was on the docket at last year's FDA hearings, which Stan and Shirley White and Janette Layne attended.
According to Dr. Wayne Ray, who testified before the FDA's Psychopharmacologic Drugs Advisory Committee, one study involving 93,300 users of antipsychotic drugs -- half of whom were on atypical antipsychotics -- showed that such users were at no less than double the risk of a "sudden, fatal, pulseless condition, or collapse
consistent with a ventricular tachyarrhythmia occurring in the absence of a known, non-cardiac cause."
Ray, professor of preventive medicine at Vanderbilt University School of Medicine, published the findings in an article titled "Atypical antipsychotic drugs and the risk of sudden cardiac death," in the New England Journal of Medicine last year.
Unwilling to let Seroquel's approval prospects sink just because it's dangerous, the FDA's Marc Stone, a medical reviewer, donned his AstraZeneca hat at the hearing. In a presentation rebutting Ray's testimony, he asked how the death certificates in these cases were accurate when "paramedics are more likely to identify some deaths as sudden cardiac deaths?"
"Smoking as an important risk factor for sudden cardiac death is unlikely to appear in the Medicaid claims data used in this study," Stone continued, and, "How do we know smoking wasn't a factor in the deaths -- or that antipsychotic users aren't less likely to 'communicate symptoms of cardiac disease to medical personnel?'"
He also pointed out that "Mental illness severe enough to require antipsychotic drugs
may also increase the chances of someone being homeless or living alone with little social contact," apparently forgetting that the purpose of the FDA hearings was to approve Seroquel for non-mentally ill people with anxiety and depression.
Elsewhere, Seroquel for PTSD gets good reviews.
"These data are encouraging for adjunctive treatment with a second-generation [atypical] antipsychotic in patients who have partially responded to an SSRI or an SNRI [antidepressants]," says the American Psychiatric Association's March 2009 Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder.
Matthew J. Friedman, one of its four authors, is executive director of the U.S. Department of Veterans Affairs National Center for PTSD -- and an AstraZeneca consultant.
"Quetiapine improves sleep disturbances in combat veterans with PTSD," wrote Mark Hamner in a 2005 Journal of Clinical Psychopharmacology article.
Hamner is medical director of the PTSD clinical team at the Ralph H. Johnson Department of Veterans Affairs Medical Center in Charleston, SC -- and an AstraZeneca consultant.
"Atypical antipsychotics also have an emerging place in PTSD pharmacology, particularly for symptoms of paranoia, intense hypervigilance, arousal, extreme agitation, dissociation, psychotic-type flashbacks, and brief psychotic reactions," writes Cynthia M. A. Geppert in a 2009 Psychiatric Times article.
She is chief of consultation psychiatry and ethics at the New Mexico Veterans Affairs Health Care System -- and recipient of three AstraZeneca grants.
Meanwhile, critics and activists ask: What protections are afforded to veterans enrolled in Seroquel studies -- some combining Seroquel with other drugs -- that AstraZeneca-funded doctors conduct at VA medical centers?
Many say that Big Pharma, embedded in academic institutions, medical schools, military medicine, government entitlement programs and the FDA itself is too big to regulate, like Wall Street firms. But others say the incarceration of VA Chief of Psychiatry Richard Borison in 1998 is proof the system works. (Of course, he will be out soon.)
Click > here < for the full story, links and comments.
Documentary on PTSD Needs Help to Reach Completion (VIDEO) by
Tim King, Salem-News.com
| (BIZ, Articles)
The hour-long program could help hundreds of thousands; we are looking for Americans who care to lend a hand.
(SALEM, Ore.) - Hundreds of thousands of American combat veterans are suffering from the effects of combat and war. The symptoms of PTSD: Post Traumatic Stress Disorder, are wide ranging.
The current conflicts continue to generate PTSD in our troops, and they join the ranks of veterans of the Persian Gulf War, Lebanon, Vietnam, Korea and WWII as survivors of things that no man or woman should ever witness in a civilized world.
My goal in Iraq last summer was to gather interviews for a television documentary on PTSD. What veterans are doing while at war is part of what we will explore, and even more importantly, we will show all types of different therapies that are being used successfully by vets and people who help veterans, in their adjustment back to a peaceful society.
We are seeking a partner to help with the cost of producing this extremely important program. Significant interest has already been shown by one television organization and the number of stations and venues where it can be used to help educate people about PTSD, is nearly endless.
The National Institute of Mental Health states that millions of Americans get Post Traumatic Stress Disorder every year. A large number of those Americans are our combat forces serving in Iraq and Afghanistan. The Veterans Administration's almost immediate medical answer is to provide morphine-based drugs that create vegetables and addicts. There are better, more creative ways for those who suffer from PTSD to find relief and therapy.
Visit: http://www.salem-news.com/articles/april022009/ptsd_doc_3-26-09.php
California Cannabis Research Medical Group (CCRMG) | (ORG, Articles) O'Shaughnessy's - Spring 2006 - Journal of the California Cannabis Research Medical Group ... PTSD and Cannabis: A Clinician Ponders Mechanism of Action,
By David Bearman, MD. One often intractable problem for which cannabis provides relief is post-traumatic stress disorder (PTSD). I have more than 100 patients with PTSD. Among those reporting that cannabis alleviates their PTSD symptoms are veterans of the war in Vietnam, the first Gulf War, and the current occupation of Iraq. Similar benefit is reported by victims of family violence, rape and other traumatic events, and children raised in dysfunctional families. Visit: www.ccrmg.org/journal/06spr/perspective2.html
Web Log of Dr. Tom O'Connell
(Articles, inf) * That evidence, in the form of the aggregated medical histories of applicants ... PTSD follow-up ? Is PTSD an anxiety syndrome best treated by cannabis? ... In that connection, an NPR report on PTSD among recent Iraq returnees that I happened to hear while driving home on Monday evening might also be described as shocking, but not especially surprising. I have personally encountered the same blame the victim attitude among die-hard retired military who still think we should have won the Viet Nam war and look upon ex-comrades who have been tormented by PTSD for decades as shirkers and sad sacks of s__t.
visit: www.doctortom.org/archives/2006/12/more_on_ptsd_1.html
PTSD Nightmares: PTSD Symtoms,
Dr. Phil Leveque Salem-News.com |
Dr. Leveque is a retired physician who served in WWII; he writes about PTSD as he lives with it.
(SALEM, Ore.) - One of the best depictions of PTSD nightmare terrors and violence was shown in a recent episode of Greys Anatomy.
A new doctor on the show, Owen, was a recent returnee from the military surgical operating rooms in Iraq. He was tough as nails which is a requirement for being a surgeon under those conditions but he had PTSD just as bad as any frontline Combat Infantryman.
Visit: http://www.salem-news.com/articles/april282009/doc_ptsd_4-27-09.php
MedicalMJ.org - Medical Marijuana News and Facts
* "PTSD Rates for Current Wars May Top Vietnam," Cox News Service / Journal Sentinel (Milwaukee, WI), Nov. 27, 2006, and more. Visit: www.medicalmj.org
The Razor Wire, Vol. 8, No. 3: In The News
* Cannabis for PTSD - To help treat returning Iraqi combat soldiers, California's Dr. Tod Mikuriya gave this online advice to a returning Iraq War vet for coping with Post Traumatic Stress Syndrome or PTSD: "Medically, cannabis is the treatment of choice for PTSD but definitely would spell the end of your military career. If you elect not to medicate with cannabis, the regular exercise regimen - avoidance of drugs and alcohol and a specialized debriefing - is the least worst response to this chronic psychiatric disorder." Visit: www.november.org/razorwire/2005-02/InTheNews.html
Power and Control: Montana Marijuana
(BLOG) * It [Montana] voted for medical marijuana by 62 to 38. Which is what I keep telling my Republican ... Pain and the War on Drugs ? PTSD Pot Alcohol & Substance Abuse ... Cultural Issues; PTSD Combat : Winning the War Within
visit: powerandcontrol.blogspot.com/2004/11/montana-marijuana.html
MAPS in the Media: Recent and Archival
* Doblin speculates on the possibility of conducting MDMA / PTSD research with tsunami victims
The press release mentioned MAPS-sponsored research evaluating MDMA-assisted therapy as a treatment for posttraumatic stress disorder (PTSD)
visit: www.maps.org/media/
RxMarijuana.com | Marijuana: The Forbidden Medicine.
(ORG, inf, Book) Featured Medical Marijuana Patient Accounts * to share website visitors' medical marijuana histories to provide insight into uses for this medicine which are not widely known.
If you wish to send us a personal account of your medical marijuana experiences, ... Cannabis and PTSD by Michael McKenna ... visit: www.rxmarihuana.com/shared.htm
Medical-101.com
(web-ring / link-list) * Your starting point for the best medical info. Free Medical Cannabis info Find what you're looking for! Visit: www.medical-101.com/s/medical_cannabis
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