I am interested in finding out about synthetic THC and chemotherapy. I believe I read something once about a prescription drug available at considerable cost which is a slightly modified cannabinoid. Do you know anything about this?

In 1985 the U.S. government approved Marinol (dronabinol) on prescription for the nausea and vomiting of cancer chemotherapy. In 1992 the weight reduction syndrome of AIDS was added. Dronabinol is identical to tetrahydrocannabinol, the main active constituent of marihuana. However, it is produced synthetically and is packaged in sesame oil in capsules. It was originally placed in Schedule II but recently has been moved to Schedule III, allowing for multiple refills of prescriptions. Some doctors are afraid of prescribing it "off-label" but their fears are unfounded. Marinol is costly, and patients who have used both it and whole plant marihuana generally report that the latter is more effective.

Sincerely yours,
Lester Grinspoon, M.D.

I am a 22-year-old mother, leading a productive life with the help of marihuana. I have recently discovered your website and would like to commend you on your studies. I have a few questions I hope you can help me with. I have written to you prior to this in more depth of my own personal experiences with marihuana. You are free to use this letter as well as the last at your own liberty. I understand that you are extremely busy but would greatly appreciate any advice or suggestions you could provide.

I suffer from depression with anxiety, insomnia, suicidal tendencies, and severe mood swings. Loss of appetite (my weight fluctuates rapidly between 100-110 pounds, I am 5'5) and intolerance to foods results in nausea, vomiting, lightheaded, dizziness, excessive headaches, and shaking. It is also extremely helpful with my allergies, which make me ill with headaches (occasionally migraines), sore throats, severe sinus pressure, and inability to go outside on bad days. Not to mention the relief I get when suffering from extreme menstrual cramping. Could I possibly obtain a doctor's recommendation for any of this? I have already found marihuana to be extremely helpful to me, more than the alternate available medications such as Prozac. I would have to supplement my marihuana use with such a diverse array of medications, it is absurd and very expensive. Will you please clarify what is exactly stated as necessary medical conditions that can result in a legal recommendation under California state law? Also, would you please recommend a doctor who is open to medical marihuana use in southern California? Anywhere in the Los Angeles, Orange County, San Bernardino and surrounding areas would be easily accessible to me. I would also be open to a San Francisco trip if needed. Thank you so much for everything you are doing in this tedious (?) marihuana movement, you are much respected and appreciated. I will be eagerly awaiting your response.

It's clear that marihuana is very helpful to you, and what you are really requesting is help in obtaining it legally. Even in California that is not easy, mainly because of the federal government's fierce opposition to Proposition 215. I suggest you get in touch with Valerie Corral at the Wo/Men's Alliance for Medical Marijuana, 1803 Mission St. #553, Santa Cruz, CA 95060. Her organization is dedicated to helping people who need medicinal cannabis. She knows the California scene quite well and may be able to identify a physician who can help you. I hope so.

Sincerely yours,
Lester Grinspoon, M.D.

I have suffered from obsessive compulsive disorder for virtually as long as I can remember. I have been a daily marihuana user since I was about 17 (now 28) and since that time have very rarely suffered from the OCD in any way. Have you heard of similar experiences and is there a medical explanation for my relief?

I have not heard of other patients with severe obsessive-compulsive disorder who get relief from cannabis. However, people who suffer from Tourette syndrome often find that cannabis is useful, and this syndrome is thought to be related to OCD. I will be very interested to learn of other OCD patients who share your experience. In the meantime, thanks for sharing it with us.

Sincerely yours,
Lester Grinspoon, M.D.

Since 1988, the quality of my life has been declining. The most recent of several herniated disc operations was in June of 1999. For 12 long years I have suffered from constant pain. During this period, I have taken every kind of medication prescribed by licensed physicians, ranging from pain pills to muscle relaxants in a futile attempt to live a normal life. None of the traditional medical therapies have helped me. My physical activity is restricted to walking less than five minutes at a time before the pain becomes unbearable. I cannot lift even moderately heavy objects.

All the doctors and surgeons with whom I have consulted have said there is nothing more they can do to help me. I will never be able to live a normal life again, even under the influence of legal medical prescriptions, which include Tylox, Percodan, Darvocet, and basically every muscle relaxant that has ever been made. Finally I tried smoking marihuana. I had heard that it works effectively without side effects. I discovered it was the only thing that would consistently calm down my muscle spasms, and it would provide this result without the consequences of the hard drugs that had been prescribed for me.

In an effort to provide a small, private and independent source, I studied growing techniques and began to grow some marihuana plants in my home. Eventually I learned to produce enough for myself without any substantial cost and without having to interact with any facet of the drug subculture in the area, which would have forced me to purchase the herb from someone who distributed it. I did not know people who distributed it, but had managed to acquire small amounts through mutual acquaintances. Now I was free from those kinds of contacts and could depend on myself to feel more positive and happy in my life.

Using the herb overcame continual depression and allowed me to have a desire to do things. Growing the herb was in itself a positive and therapeutic activity. Finally my world began looking up for the first time since I lost my job of 21 years as a result of the injuries I had sustained. I had worked first as a pressman then in a supervisory capacity for a major newspaper publisher. So I understand the satisfaction associated with responsibility and productivity, and when the source of this satisfaction suddenly disappeared after consuming half my life, adjusting was very difficult.

I acknowledge that I broke the currently existing law by growing this small amount of marihuana, but constant and significant pain can change your perspective. While I technically broke the law, I was harming no one and in no way contributing to the delinquency of any other person. Plus the use of the herb allowed me to be a more productive and useful person to society by living a life that is not a drain on society.

On October 12, 1999, agents of the federal marshal entered my home under the authority of a breach warrant. They confiscated all my plants and irrigation and lighting equipment used to grow the marihuana as well as equipment that was not used for this purpose. One piece of equipment in particular that was unjustly seized was a generator my mother had purchased as a gift for me in case of loss of electricity. I use an electrical machine that helps me breath when I am sleeping, so this generator is an important asset.

However, I was not arrested then or since. But I have been kept in suspense, making my life a complete hell since then. I cannot understand why people who are obviously physically challenged are persecuted and mistreated. This country did not become the greatest country in the world with this kind of manipulative treatment of the population. And I do not believe this warrant was legal, and there was no probable cause to search my home and seize my property. Other than this one situation, I have never been in trouble with the law in my life.

I believe medical marihuana is the clear solution for my life and feel it is important for me to claim my right as a citizen by pursuing the unhindered, legal use of it. I could either grow it myself or receive it through a federal program.

The only other drug that has come even remotely close to the positive affect of marihuana is Marinol. But for the limited effect it provides, the cost is very great. Thirty pills usually cost from $200 to $280, and at a normal dosage of four pills per day, the monthly cost exceeds $800. Since I am depending on a monthly check of $1,200 for Social Security disability, I am unable to afford this drug. I am forced to choose between hunger and pain, which is no quality of life at all. I have approached the county health department, but they refuse assistance based on my disability benefit.

It appears those who are disabled suffer extreme exploitation as well. I finally was able to get a doctor to make a phone call and arrange for me to get 30 pills of Marinol for $150 through a small private pharmacy. Marinol is still listed as a Schedule II drug in my state, though the FDA now lists it as a Schedule III drug.

Unfortunately my access to Marinol has been cut off as of last week. The doctor who prescribed this for me has admitted that my muscle spasms have reduced while using it, but he has never before prescribed this and he has offered no indication that I will be allowed to receive more of it.

Even sadder is that probably there are many justifiable cases such as mine where victims suffer needlessly because of an unjust law. And probably there are many instances where otherwise lawful people are treated like criminals. For example, a week after my generator was confiscated, a storm caused the loss of power to my community for a four-day period. The only way I was able to rest was to rent a hotel room. I did manage to persuade my doctor to fax a letter stating my condition and my need for the device called a c-pep. Within a few days, my attorney said that the law enforcement agency had agreed to return the generator, but I never received it.

I feel that I qualify for the federal program for medical marihuana or I should be authorized to grow my own.

Sincerely,

Thank you for your letter. Yours is a well-articulated if unfortunately common story; there is no question that cannabis is the drug of choice for you and that it is cruel that you should be deprived of same, Having said that, I am afraid there is little more that I can do for you. The present laws have put you in an impossible situation, and physicians are pretty much helpless to do much about it. In your last paragraph you mention that you "qualify for the federal program for medical marihuana"; there is no such program now. You go on to say, "I should be authorized to grow my own"; it is not possible to get such authorization in the state of Florida.

Sincerely yours,
Lester Grinspoon, M.D.

I have multiple sclerosis. I am told that this drug can help me. I am a 35-year-old female and have smoked cannabis only once, when I was 14. The drug prescribed by my neurologist, Copaxone, is too expensive. It costs $1,000. I have no insurance and am a single mother working two jobs. I am in a slow decline with the disease. I am told that cannabis will help with the depression and pain. I would like more information.

The easiest way for me to provide more information is to suggest that you read pages 80 through 93 of our book, Marihuana, the Forbidden Medicine, revised and expanded edition (Yale University Press, 1997). If you still have questions after reading it, I will be glad to answer them.

Sincerely yours,
Lester Grinspoon, M.D.

I have a cousin in Florida who is undergoing chemotherapy. His oncologist is offering a prescription for marihuana but no suggestion on where to "cash" this. Would you provide direction? Thank you in advance for you response.

Your cousin's oncologist is giving him a worthless piece of paper. Nowhere in the country can a valid, redeemable prescription for marihuana be written.

Sincerely yours,
Lester Grinspoon, M.D.

Thank you for your work and compassion. I am a 39-year-old paraplegic, mother of two. I have been a paraplegic for 20 years. I find that smoking marihuana is very helpful for my spasms, back pain and bladder incontinence (due to bladder spasms). I buy my marihuana at the Toronto medical marihuana use centre. It is not truly legal but I feel more dignified getting it there than from "drug dealers." My questions are:

1) How much is considered moderate use and how much heavy use? I smoke about half an ounce of excellent grade pot per month. Is that moderate?

2) I also take an antidepressant, Zoloft (from the Prozac family). Is there any information on how such a drug might interact with marihuana?

The distinction between moderate use and heavy use is not a precise one. In any event, it does not make much difference whether your use is defined as moderate or heavy. Smoking half an ounce a month is the equivalent of about half a gram a day. In my view, this imposes very little risk, surely less than the risk of the conventional medicines you would otherwise use. As for your second question, there is no published information on Zoloft-cannabis interactions. Of the few patients I have seen who have used both cannabis and drugs in the Prozac family, none have had any difficulties.

Sincerely yours,
Lester Grinspoon, M.D

I am a 22 year old female. I am a customer support representative, and lead a productive life. I have a 2-year-old son, and am engaged to his father. I began to experiment with marihuana recreationally when I was 14. At the same time I started seeing a psychologist and was diagnosed with depression. Although I was aware of how much better I felt when I smoked, I wasn't clear exactly why and felt guilty for doing it. I quit smoking several times because of the negativity I received from my parents and some peers. I still suffer from bouts of deep depression that come on suddenly and without warning, lasting 1-3 weeks at a time. I have seen a psychologist in the past and have even been on prescribed Prozac (with little result). Unfortunately I could not afford to continue treatment and had to end it some time ago. When these episodes come on, I usually cry a lot for no apparent reason. I have no motivation and even have difficulty getting out of bed to tend to my 2-year-old son. I'm extremely irritable and lose my patience frequently. I lose my appetite, and end up forcing myself to eat the little I can stomach. I suffer from insomnia and it takes hours for me to fall asleep. When I finally do, it is a restless sleep. I wake up almost every hour on the hour, throughout the night, and by morning I'm exhausted. I feel so guilty because I realize that I am neglecting my son, and it is unfair to my fiancé as well. I am treating him unfairly by reacting in such an irritated way to his feeble childish attempts to get my attention. He gets so upset when he sees me crying. No matter how hard he attempts to comfort and soothe me, I can't stop myself.

I have found that when I smoke, I am in a happy mood, I am able to play with my son, I have a healthy appetite, I have no trouble falling asleep, my sleep is restful, and I wake up feeling energized. I rarely cry, if at all. My home life and family relationships are eased of stress, and interaction with my family is much more enjoyable. I began smoking again soon after my son's birth in 4/98. I am in quite a dilemma here. Although there are obviously profound positive results, with apparently no ill side effects the consequences are extremely dangerous to myself as well as my family. I am in constant fear of anyone finding out about my choice of "medication", as I do not wish to lose my home, car, and possessions, not to mention the most important thing in my life, my son. I had a scary experience in the past where the cops were called on me and my son was threatened to be taken away. I am a good mother and my son is a healthy and happy child.

I have heard of marihuana permits being issued but am finding it virtually impossible to obtain any further information on how to obtain one. Any suggestions or information would be extremely helpful and much appreciated. I hope to hear from you soon and will be anxiously awaiting your reply.

I am sorry to have to inform you that even if you live in one of the seven states which have approved medical marihuana initiatives, it would still not be possible for you to get marihuana legally. None of those states recognize depression as a condition for which marihuana should be available. However, you should know many other people who suffer from depression find marihuana more useful than conventional antidepressants. Hopefully we will soon see the day when you can use the medicine which you believe is most effective and least toxic.

Sincerely yours,
Lester Grinspoon, M.D.

I am diagnosed with intracranial hypertension also known as pseudotumor cerebri. I was wondering if marihuana would help with the high pressure headaches or the swelling behind my eyes. Any info would be greatly appreciated.

You are the third patient with pseudotumor cerebri we have heard of. Two of those patients have found that cannabis is successful in reducing cerebrospinal fluid pressure. One of these cases is presented on page 191 of Marihuana, the Forbidden Medicine, the revised and expanded edition (Yale University Press, 1997). This is a very small number of patients, and it remains to be seen whether marihuana will prove useful as a treatment for this rare disorder. Nevertheless, because it is so remarkably non-toxic, you have very little to lose by trying it.

Sincerely yours,
Lester Grinspoon, M.D.

I am a psychiatrist in Washington with patients who have asked me an array of questions which I have no answer. I thought perhaps you or a colleague could help.

1. How can medicinal marihuana be obtained from a physician?
2. How would a patient find a physician who can prescribe marihuana?
3. From what diseases, maladies, disorders would a patient have to suffer, over what period of time, in order to be prescribed marihuana?
4. Once prescribed marihuana, how do they go about filling their prescription?
5. How does one go about obtaining a license or permit to grow medicinal marihuana in Washington (state)?
6. How could a physician obtain additional license to prescribe marihuana? (And not the other Schedule I drugs).

Thank you in advance for your time and consideration.

Marihuana cannot be obtained from a physician. However, in the seven states which have approved medical marihuana initiatives, physicians can write notes that allow patients with some conditions to use marihuana as a medicine. Each of the state laws has different terms and restrictions. The voters of Washington passed such an initiative last year, and you can learn about what is allowed through your state medical society.

Sincerely yours,
Lester Grinspoon, M.D.

If a person is diagnosed with Hepatitis C, does marihuana help and how? How is one approved to be given marihuana as medicine?

Many people with Hepatitis C find marihuana useful for the relief of some of such symptoms as the nausea and appetite loss. Unless you live in one of the states that has passed a medical marihuana initiative, there is no way you can get approval to use it legally.

Sincerely yours,
Lester Grinspoon, M.D.

I must share my story: When I was young my dad had to work a lot so my brothers and I were left alone. My mother was very ill with schizophrenia and we kids never had any peace. Now Mom is better thanks to medication. I inherited not schizophrenia but manic-depression or bipolar disorder. For about 4 years I took Luvox and Avidin with many side effects: weight gain, inability to concentrate, short-term memory loss, and exhaustion. I was smoking ganja, but not very often. At the time I did hear stories of medicinal ganja for migraines and chemotherapy, but not a thing about bipolar disorder. I'm here to say that today I have lived a normal life because of Mary Jane for 8 months without the use of pills!! The only thing that puzzles me is why are there no studies being conducted on the use of marihuana and mental illness? If the American government is so concerned about its citizens, these tests should have happened 10 years ago.

You are quite right in asserting that there is nothing in the medical literature about the use of cannabis in the treatment of bipolar disorder. One exception is a paper we published in June of 1998 in the Journal of Psychoactive Drugs entitled "The Use of Cannabis as a Mood Stabilizer in Bipolar Disorder: Anecdotal Evidence and the Need for Clinical Research." This paper presents accounts by people whose stories resemble yours. You may also want to look at the section on depression and other mood disorders in our book, Marihuana, the Forbidden Medicine, the revised and expanded version (Yale University Press, 1997), page 138.

Sincerely yours,
Lester Grinspoon, M.D.

Is there nicotine in marihuana?

There is no nicotine in marihuana.

Sincerely yours,
Lester Grinspoon, M.D.

We have a friend who has extreme nausea from chemotherapy and antibiotics, but she cannot smoke. Is there a preferred way to ingest marihuana? Does cooking it in brownies weaken the effect?

Cooking marihuana in brownies does not weaken the effect, but people with severe nausea and vomiting often have difficulty eating the brownies. If she can eat the brownies, she should anticipate that the effect will take an hour or two to come on. Another possibility is to prepare cannabis in butter, freeze it, and use it as a suppository.

Sincerely yours,
Lester Grinspoon, M.D.

I have been severely depressed for over 3 years and on every antidepressant, with no freedom from wanting to commit suicide. One month ago I started smoking marihuana, which I have not smoked in over 10-15 years, and I am like a new person. I even laugh again, am getting energy and do not think of killing myself. Is marihuana helpful in depression?

Could you please send me info if it is or isn't?

It appears that for some people marihuana acts as an antidepressant. You may be one of those people. I suggest that you read the section on depression and other mood disorders in our book, Marihuana, the Forbidden Medicine, revised and expanded edition, pages 138 through 162.

Sincerely yours,
Lester Grinspoon, M.D.

I have smoked on and off since I was 14 years old. The off time was when I didn't have the money for it. I got married, had kids, and wasn't smoking for about 16 years. I had a seizure in 1996 that hospitalized me for a while, and now I am on Dilantin for life. Since then I have picked up my marihuana use regularly, more than I expected. I was wondering if the original smoking might have contributed to my seizures? Is my current use of marihuana helping prevent seizures or just hurting me?

There is no reason to believe that your use of marihuana has contributed to seizures. As for your current use, marihuana has been used as an anticonvulsant medication since the middle of the 19^th century. About 15% of people who suffer from seizure disorders get no or little relief from conventional medicines, and many of them do get relief from cannabis. Furthermore, even people who do get good relief from conventional medicines often prefer cannabis because it has fewer toxic effects. I suggest you take a look at the section on epilepsy in our book, Marihuana, the Forbidden Medicine, the revised and expanded edition, Yale University Press, 1997. You will find it on page 66.

Sincerely yours,
Lester Grinspoon, M.D.

I have read in numerous documents that women have smoked cannabis during childbirth. One document even goes so far to say that the African women smoke cannabis until they are stupefied. Does this have any negative effects on the child? Assuming that it is only at childbirth that the cannabis is smoked.

In the 19^th century cannabis was widely used as an analgesic during childbirth. There are no reports of negative effects on the newborn. In fact, obstetricians noted that the babies were "pinker" than babies of mothers whose respiratory systems may have been affected by physiologically depressing anesthetics. Today some women supplement their "natural childbirth" with smoked cannabis.

Sincerely,
Lester Grinspoon, M.D.

My grandfather is currently battling lung cancer as well as brain tumors. He is currently on morphine but he gets barely any sleep (3-4 hours a night). He has severe headaches which the morphine is not doing too good of a job on right now. Unfortunately, medicinal marihuana is not legal in my state. But I was still wondering if marihuana would help him get to sleep, and more importantly whether it would affect him in any negative ways. Thank you. Your response will be most appreciated.

Marihuana has a long history of use as a soporific -- a drug that helps people sleep. There is no certainty that it would help your grandfather, but it is most unlikely to "affect him in any negative ways."

Sincerely yours,
Lester Grinspoon, M.D.

Please tell me if there are some studies regarding marihuana as a treatment for psoriasis. I have psoriasis pretty bad, and it wasn't that bad at all until a few weeks after I quit smoking pot. This was a few years ago, and nothing seems to have helped relieve it.

I am considering starting back up. Also, if you could tell me what approach to take to my doctor regarding this. I doubt that he would be an open-minded listener. If you know of any sympathetic doctors in Lexington, Kentucky who would share similar views, I would greatly appreciate the help.

I do not know of any studies on cannabis in the treatment of psoriasis, but I have heard from some patients who find it useful. You may be interested in a case of pruritus (severe itching) presented in our book, Marihuana, the Forbidden Medicine. You will find it on pages 131 to 134 of the revised and expanded edition (Yale University Press, 1997). I'm afraid we cannot provide more specific information or identify a sympathetic physician in Lexington, Kentucky.

Sincerely yours,
Lester Grinspoon, M.D.

I have a 16-year-old son that has been diagnosed as being bipolar and also having ADD. He is currently taking prescription medications for both of these conditions. However, he says that when he smokes marihuana it makes him feel better and more balanced. Quite frankly, he does exhibit much more control and focus when he is "high". My question is whether there are there any medical research projects anywhere in the world addressing these possibilities. If so, please help me to locate them. Thank you in advance for any assistance that you can provide.

As far as I know, there are presently no studies on the use of cannabis in bipolar disorder. We have published a paper on the subject entitled "The Use of Cannabis as a Mood Stabilizer in Bipolar Disorder: Anecdotal Evidence and the Need for Clinical Research." It is in the Journal of Psychoactive Drugs, Volume 30, pages 171-177, April-June 1998.We point out that case histories and clinical experience suggests the usefulness of cannabis for some people with bipolar disorder, and we call upon the psychiatric community to initiate further studies.

Sincerely yours,
Lester Grinspoon, M.D.

Does marihuana help chronic migraine headaches?

Yes, for many people marihuana is very helpful in relieving the pain and nausea of migraine headaches.

Sincerely yours,
Lester Grinspoon, M.D.

After living with chronic nerve pain for several years, I tried marihuana. A friend gave me some during a bout, I smoked only 4 or 5 inhales, and I woke up with most of the pain gone. My pain medications Ultram and Elavil didn't work this well; sometimes hardly at all. Relief lasted into the evening of the next day. I slept well and comfortably after smoking a little, whereas usually I'm up most nights, or wake up a lot. I'm afraid to mention it to my doctor, because he was even against my changing pain medications when I told him the Elavil and Ultram didn't seem to work as well anymore. It's incredible to me that marihuana is still illegal.

I know that I can get it somehow, but I'm wondering if it can be done legally in the U.S.

No matter what state you live in, your doctor cannot prescribe marihuana. However, some states have enacted laws which allow for limited medical use of cannabis. If you live in one of those states, you will have to determine whether the treatment of pain is covered under the state law, then find a doctor to write a note for you and a way to obtain marihuana. Even in the seven states which have now passed such initiatives, it is not easy.

Sincerely yours,
Lester Grinspoon, M.D.

Cannabis helps me tremendously with the nausea that accompanies my migraines. I would like to try Marinol because of the illegality of natural cannabis. I would feel more comfortable approaching my doctor if I could show him some "professional" information pertaining to the use of Marinol to treat migraine and its accompanying nausea. Could you point me in a proper direction in my search?

Marinol is generally not as useful as whole cannabis for most medicinal purposes. I am especially skeptical about its use for the nausea that accompanies migraine headaches because it takes so long to act (usually at least an hour). I am not aware of any scientific literature which supports the use of Marinol for the treatment of the nausea of migraines.

Sincerely yours,
Lester Grinspoon, M.D.

I am a forty-one-year-old father of two with Hepatitis C and idiopathic epilepsy. Due to the stress antiepileptic medications would put on my liver and the apparent difficulty in finding the medication and or combination of medications that would be effective, I have decided that marihuana might offer a safer avenue of relief. The IOM report admitted to anecdotal evidence of its effect on epilepsy, but the Epilepsy Foundation of America is unwilling to help investigate this further. Do you know of any studies conducted on the use of marihuana by epileptics?

Cannabis has been used as an anticonvulsant in Western medicine since the middle of the 19^th century. While perhaps 85% of epileptics get relief from conventional drugs, many of those who do not have successfully used cannabis. And many who do get relief from conventional drugs prefer cannabis because it side effects are less serious. You may want to look at the section on epilepsy (pages 66-79) in the expanded and revised edition of our book, Marihuana, the Forbidden Medicine, Yale University Press, 1997. It also provides the citations you requested.

Sincerely yours,
Lester Grinspoon, M.D.

I was involved in an accident two years ago and had major compression fractures of thoracic 8-9-10. I have undergone physical therapy for two years and my condition has steadily become better, unfortunately with great physical pain at times. Muscle spasms and residual tightness and knotting of the muscles is so great at times that I can not get out of bed in the morning. I have used almost all analgesics that are out there, but most leave me with a stomach ache or so zonked out that I cannot function. I have recently tried marihuana to help the spasms and was especially pleased with the results. I am currently a resident of Washington and marihuana is supposedly medicinally legal. I have talked to a few doctors, and they all agreed that marihuana was definitely beneficial but because of federal implications they could not legally prescribe it and I would have a hard time getting the supply legally. My questions are: Is this all accurate information? Can I get this medicine legally in Washington State or is it really better to wait until federal mandates allow it? A few of the doctors I talked to let me sample Marinol, which I guess is synthetic THC. It made me tired and seemed to be much different from a smoked dose. Please help me get these facts straight. It would be greatly appreciated.

I suggest that you get in touch with John F. Wilson, who has just opened a branch of the Green Cross for Eastern Washington. John is a medical marihuana user and a very fine man, and I'm sure he will be helpful to you.

Sincerely yours,
Lester Grinspoon, M.D.

I would like to know about having Marinol prescribed for a seizure disorder in Illinois. I suffered a head injury in the Marine Corps which resulted in a seizure disorder. I have found marihuana helpful but must take random urine test in my workplace. With the reclassification of Marinol, could I have it prescribed for a seizure disorder in my state?

Many people find marihuana useful for the treatment of seizures. It is not clear whether Marinol is equally useful, but it is unlikely to do any harm. As you correctly state, Marinol has now been moved from Schedule II to Schedule III by the federal government. States generally follow suit, and Illinois will surely do so. In any event, even as a Schedule II drug, Marinol can be legally prescribed for any purpose your physician considers appropriate. To sum up, it may not work as well as whole cannabis, but taking it won't hurt you and prescribing it won't hurt him.

Sincerely yours,
Lester Grinspoon, M.D.

I am 39 years old. I suffered a severe back injury in 1991. Because of the injury to my back, and the complications that will arise if I have surgery I have decided not to have it done. I am currently taking Ultram one to four times a day. I have severe muscle spasms in my back. The Ultram doesn't work all that well. I have found that cannabis works great for relieving my spasms. Also my doctor is OK with the fact that I smoke pot. I am due to go to court this spring. I was busted for growing 3 small plants. They were for my personal use. Is there anyway my doctor can write something up to say that marihuana is OK to use for my back, without my doctor getting into trouble?

Your doctor cannot get into any legal difficulty by writing a note to the effect that cannabis appears to be more helpful than other drugs in the treatment of your muscle spasms. He may fear objections from his Medical Society or damage to his reputation, but there is nothing illegal about sharing this clinical observation.

Sincerely yours,
Lester Grinspoon, M.D

First of all, I've got to tell you it's really exciting to see people so well-prepared introducing marihuana concepts that were taboo not so long ago. Now, here's my case. I've been a ganja smoker for a few years now and the benefits could fill a few pages, starting with my grades, going through my creativity and ending with my self-growth. Now I'm starting a new stage of life; I'm 3 weeks pregnant. I've looked through my Developmental Psychology books and my husband's medical books, and I couldn't find a thing that either supported or trashed the use of marihuana during pregnancy. My husband says the act of smoking (combustion) may have an effect on the fetus. If this is so and I can't smoke during my pregnancy, can I at least have it in the form of tea or mixed with food? It's not just for the relaxing effect. I know it will do a lot of good when I start with the nausea. I'd appreciate ANY information you can give me. Thank you.

A number of people have asked about marihuana during pregnancy; you will find my answers elsewhere on this website. I generally refer to the work of Melanie Dreher, a nurse-anthropologist who has studied women and children in Jamaica. She compared the children of women who used cannabis throughout pregnancy with the children of women who did not use it, and found no significant differences. You may wish to look up her work.

Sincerely,
Lester Grinspoon, M.D.

I have some questions relating to marijuana that perhaps you can help me with. I am a senior at Tufts University, who has, for numerous reasons, chosen to smoke marijuana regularly throughout college. Naturally sharp, organized, and motivated, I felt as though it could do me no harm so long as I curtailed my use following college (or shortly thereafter). Until recently, I have never been able to recognize any problems, academic, personal, or medical (with one exception that I will mention later) or otherwise that could be directly linked to my marijuana use. No one, except certain friends who have for their own reasons chosen to curtail their marijuana use, has ever suggested that marijuana may be impairing me in any way. Indeed, through much of college, I was very happy to make marijuana a part of my lifestyle. I sincerely believed, and would like to continue to believe, that not only does it not hinder, but in fact enhances my creative, social, intellectual, and aesthetic senses. However, as the end of college approaches, I have become aware of what may be a marihuana-related psychological impairment, as well as a medical condition, which I will attempt to describe at length so that perhaps you could advise me as to whether or not it is in fact marijuana that is contributing to or is responsible for these problems.

I have always attempted to maintain a degree of mental lucidity whereby I gauge my behavior accompanying drug use against behavior accompanying periods of sobriety, so that I can accurately assess the effect drugs may be having on my life. Often, I yielded results that ran counter to popular convention, in that I found myself being MORE socially inclined and intellectually curious amidst periods of heavier marihuana use vs. periods of abstinence. Moreover I was HAPPIER, marijuana has universally eased my stress in a manner that is far more pleasing than other methods I have employed. That short, mild, blissful high eases me to sleep and serves as a kind of reward at the end of the day for what I otherwise find to be the pursuit of education in a "pressure-cooker" environment. Generally smoking 4-5 nights a week, and usually a couple of times during the day on weekends and vacations -- never more than two or three grams of high quality sinsemilla per week-- I love the high and feel that it is the perfect natural accompaniment to my generally cerebral, creative, and socially inclined temperament.

Recently, however, I have noticed a troubling inability to generate witty responses and fast paced "banter' when speaking with other people while totally sober. I am an English major, and have always considered myself quite articulate, and while I can still write "A" essays with no problems, I am having difficulty expressing complex thoughts at what I consider to be a satisfactory pace. If anything I have cut down on smoking as of late, yet these phenomena don't seem to be dissipating.

I understand that THC binds to receptors that are particularly dense and numerous in the hypothalamus (I believe that is the name of the brain structure I am thinking of -- or the part of the brain that processes sensory information and generates certain elements of speech. Is it possible, Dr. Grinspoon, that after a few year period of moderate to heavy use, that these receptors become "clogged" or dysfunctional, so to speak, with THC such that the portions of the brain that are responsible for not only short-term memory but the aforementioned "banter" and quick wit do not work at full speed? I have read that marijuana may impair one's ability to adapt quickly to novel situations, again due to its effects on one particular brain region. It seems that my problems may all be related to marijuana's effects on this brain region.

The reason I am seeking your counsel is that I would really prefer not to quit just yet; it would be an enormous affront to my current lifestyle. Quitting would be acceptable only if I were certain that marijuana is the culprit. It is still very feasible to me that I have entered a more reticent stage as a result of numerous life circumstances that happen to coincide. Being naturally given to brooding or ruminating when times of stress or change are approaching, it could just be a phase that is entirely unrelated to marijuana, in which case I would prefer to continue using.

The aforementioned medical condition is mild, unilateral gynecomastia. I had slightly more severe bilateral gynecomastia when I was a teenager, then it disappeared entirely, then returned during the fall of my junior year in college. Marihuana is often instigated as being capable of causing gynecomastia, but I have never seen the condition on any one of the dozens upon dozens of heavier pot smokers I have known. I am inclined to believe that gynecomastia is one of those mysterious conditions about which relatively little is known, and that marijuana is the convenient "scapegoat", similar to coffee. Again, definitive answers on these types of issues are very difficult to find, and I would much appreciate your medical opinion.

Please advise me on these issues, Dr. Grinspoon, I hold your opinion in very high regard, having read your work and thoroughly perused your websites. I have included as much detail as possible, so that perhaps the exchange is useful for your purposes as well as mine.

I am mystified by your story. In more than 30 years of studying cannabis, I have never come across a similar problem. There is no evidence that "receptors become clogged or dysfunctional" from the use of cannabis, nor is there any reason to believe that it damages the hypothalamus. I am at a loss to explain your symptoms. They are of the kind frequently seen in people who are depressed.

As for gynecomastia, in the mid-70s, two Harvard surgeons published an article about some young marihuana smokers who had developed gynecomastia. The article was widely publicized in the lay press and left an impression that marihuana can cause male gynecomastia. Later studies have completely refuted this. Some young men develop gynecomastia as they mature physically. It is almost invariably temporary but occasionally requires treatment. It is in no way related to the use of marihuana.

Sincerely yours,
Lester Grinspoon, M.D.

I suffer from chronic pain and general anxiety disorder and would like to know in your professional opinion if you think I would benefit from a doctor's recommendation for medical marihuana? Do you have the names or addresses of any doctors/cannabis clubs in my area (northern California) that you might be able to refer me to? Thank you for any help you may be able give me on this matter.

Cannabis may be helpful for both the general anxiety disorder and the chronic pain. In the shared stories section in this website, you will see the account of a patient who found cannabis quite useful for chronic anxiety.

Sincerely yours,
Lester Grinspoon, M.D.

I have a 3-year-old child who eats next to nothing and is the size of a 1 1/2-year-old (he has had a lot of different investigations done, and nothing was found to be a problem)

I have smoked marihuana in the past and my appetite increased dramatically. Have there been any investigations into marihuana appetite stimulation, with small children in mind been done?

None that I know of.

Sincerely yours,
Lester Grinspoon, M.D.

I am a 21-year-old male in Pennsylvania. I have been a marihuana smoker for about 7 years. I live with my girlfriend and we smoke it together. We both enjoy the enhancements, not only for the mind, but sexually as well. I dont smoke it for medical reasons except to relieve stress and to have a good night sleep. I mostly do it at home. I've tried smoking it a number of different ways including rolled, pipes, water pipes, and so on. I am 6'4" and about 305 lbs. I'm not too much overweight but for about 20-30 pounds. Most of my weight is in my strength, but I've still got a good gut on me. I eat fairly well and take vitamins daily. But when I smoke I get the "munchies" pretty bad and then eat things that I shouldn't. I work 10-12 hours a day on my feet, so it's not like I dont get some exercise. I've been trying to lose weight, but can't because when I smoke I eat.

My question is, is there something I can do to not get hungry afterwards, or maybe smoke it another way? Or is that just a disadvantage to the enjoyment of smoking it?

The munchies are a common effect of marihuana as a medicine. For some people -- for example, patients who are losing weight to a dangerous degree because of AIDS -- this is not a side effect but the major reason for using cannabis. As for those who are concerned about weight, the answer is discipline.

Sincerely yours,
Lester Grinspoon, M.D.

My cardiologist says that marihuana messes up the fat cells in your blood. Any truth to it? I have had 7 stent placements and replacements, and angioplasty in the last 32 months and my doctor says that the marihuana is what is causing part of my problems. My cholesterol is below normal levels, but I still have too much fat in my blood cells. I am a regular user of marihuana and feel so much better when I use it. I take vasotec, niaspan, imdur, lopressor, pepcid, prilosec, nitrostat, Ticlid, aspirin, Wellbutrin and Ambien. I am a white male, age 46, 5' 9" tall, 137 pounds. I am a nonsmoker and non- drinker. The marihuana helps me in a lot of different ways. I can write more if you need me too.

I know of no basis for the statement that "Marihuana messes up the fat cells in your blood." Perhaps this is a misunderstanding of the fact that cannabinoids are stored in fat cells before being gradually excreted. There is no evidence that they increase the amount of fat or damage the cells.

Sincerely yours,
Lester Grinspoon, M.D.

I too like many of the examples I read have irritable bowel syndrome. I have never been one to take too much, if any, over the counter drug for this condition, but have tried most products. I find some of these drugs effective but am concerned with side effects with prolonged use.

My question is concerning toxic side effects of cannabis. I have been using cannabis for over 15 years as a recreational user (1-3 times per month) but with the increase of IBS symptoms over the last 3 years find myself using cannabis almost every day. Cannabis has been a savior for me. No more cramps, better appetite, diarrhea. I am concerned with the side effects of using cannabis so frequently. How does it affect long-term brain function. (Short-term memory seems to be affected after smoking.) What about cancer of the lungs, mouth, throat etc?

Any information would be greatly appreciated.

Although not harmless, cannabis is much less toxic than any of the other drugs you have used to treat your irritable bowel syndrome. Studies of people in Puerto Rico, Costa Rica, and Greece who used cannabis daily have found no serious resulting pathology.

Sincerely yours,
Lester Grinspoon, M.D.

My father has a heavy headache similar to migraine called "Horton's headache." (hope you know about it). My question is: is it possible that marihuana can relieve his pain? (Please answer to the email supplied, and you are free to ask more about his headache and publish my questions and answers anywhere.)

Horton's headaches are among the most severe known to humans. Fortunately, they are rare. I do not know whether cannabis would be useful in the treatment of this pain. But since Horton's headaches are thought to be related to migraine, and the pain of migraine is often relieved by cannabis, it might be worth trying. Cannabis may help, and it won't hurt.

Sincerely yours,
Lester Grinspoon, M.D.

I've had multiple sclerosis for over seven years now and am on more medications than you can imagine! Every morning the first thing I do is go to the fridge, get something to drink, and get a handful of pills (13) and down them. Pot really helps calm my stomach and I can't really eat without it. It also really helps with all of the muscle spasms and pain.

I live in Oregon, and they've made it legal for medical use, but I can't find a doctor that's brave enough to give me a prescription! (You have no idea how frustrating this is).

Do you have a list of doctors or something in Oregon that will prescribe marihuana for medical reasons? I have no idea where to get this information as I've never needed to know before. It's amazing that I can go through a ton of Percodan and other really strong drugs that are wasting my system, but I can't get the one thing that really seems to help the most.

Thanks for any help you can give me.

There is a physician in Oregon who I believe will help you or refer you to someone who will. His name is Ric Bayer and his e-mail address is ricbayer@home.com.

Sincerely yours,
Lester Grinspoon, M.D.

I was recently diagnosed with epidural fibrosis surrounding L5/S1 after a spinal injury and subsequent surgery. After a laminectomy, I was also diagnosed with foot drop, and wear a posterior lift orthotic. The radiating pain is constant, and I am at wit's end. I've had scripts for Percocet, Vicodin, and Valium. They work for the pain, but I am not able to think clearly, nor function at work (I am a nurse).

I live in Arizona, where medicinal marihuana is frowned upon. I am willing to relocate to California if circumstances appear to be more favorable. Do you have any information or can you direct me to any clinics in Calif that prescribe? How "legal" is it there, and would it be worth relocating? As I said, I am at wit's end. I can't sleep for more than two or three hours at a time, due to the pain waking me up. This is slowly destroying my life, and I feel my overall health has deteriorated dramatically over the past 2 years. Any advice or direction you could give would be most appreciated.

You may be able to get the treatment you want in California. I suggest that you contact Valerie Corral of the Wo/Men's Alliance for Medical Marijuana in Santa Cruz. Valerie has helped many people with a medical need for cannabis, and she will know where you might relocate. Her address is 1803 Mission St., PMB 553, Santa Cruz, CA 95060.

Sincerely yours,
Lester Grinspoon, M.D.

I currently suffer from constant, moderate to severe sciatic pain, due to a ruptured disc (L5-S1), as well as 2 bulging discs directly above it. Doctors have said that I am not a surgical candidate, since I have great spinal flexibility (due to martial arts training) and the disc spacing is good. As I said, I have some sort of back and sciatic pain from the time I get up until the time I go to bed. I take muscle relaxants (Soma) daily to cope with the pain. The problem is that the Soma makes me drowsy and basically worthless for anything after taking it. I also get depressed, as I know that this is what life is going to be like from here on out. As a marihuana smoker in my teens (I'm 40 now), I know what a good pain reliever it is. I work for the state prison system here in California, and am concerned about using marihuana, due to the employment implications. I was wondering if Marinol might be something of a more effective treatment than the Soma? I have read that Soma can cause some liver problems, and am concerned about that. Any advice? Thank you very much for your answer.

Soma does have serious toxic side effects, and in my opinion it is not a very effective drug. Whole smoked or ingested marihuana is better for the treatment of chronic pain than Marinol. However, Marinol is legally available and for many people quite useful. I advise you to try it. Even if it does not work, you have nothing to lose, because it will not harm you.

Sincerely yours,
Lester Grinspoon, M.D.

I was wondering if there is any way to use marihuana during pregnancy (for nausea) or if it would harm the fetus.

I have answered this question elsewhere on this website.

Sincerely yours,
Lester Grinspoon, M.D.

I currently suffer from Depression and ADD along with hypertension.

My current medication is Tenormin, Zoloft, and Adoral. The current problem I am encountering is the sleeplessness at night. I have not smoked pot since I was a lot younger (I am now 37). But it used to make me very relaxed and could easily fall asleep.

My Question: Are there any known drug interactions with the use of marihuana?

I would really like to know since my psychiatrist does not want me to take any lower doses.

Any information would be greatly appreciated.

Thank you.
Anonymous

As far as I know, there are no published accounts of interactions marihuana and the drugs you mention. In my experience with many patients who use cannabis and other psychiatric drugs, I have not found any evidence of significant interactions.

Sincerely yours,
Lester Grinspoon, M.D.

I am a 29-year-old mother of 3 small children who was diagnosed with chronic pancreatitis last year. After having both of my knees totally rebuilt I found the pain constant and controlling. My doctors told me to use Aleve at a very high dose to escape possible dependency of prescription medications. That dosage is most likely what caused the pancreatitis. I have since my diagnosis experimented with marihuana as a pain medication and have found very few side effects. However I am in constant fear of exposure from law enforcement or my children who only know it is illegal. I have recently moved from Texas to Indiana and am planning a move to Oklahoma in the summer due to my husband's employment and just finding it is difficult and frightening. Am I doing more harm than good to myself with this "self treatment"? How can something that has worked so well for me and let me return to as normal a life also land me in prison? Is there any hope of ever legalization in the future? If not what is the problem? Please help me. I have never used it in front of my children and only relieve myself after they have gone to bed, but I worry that their seeing me in what is sometimes a great amount of pain will also have adverse effects on them.

There is every prospect that marihuana will be legally available as a medicine in the not too distant future. So many people have come to recognize its value that pressure is now being exerted on governments. Since 1996 seven states have passed initiatives allowing qualified patients to use marihuana medicinally. When this will come and how restrictive the rules will be, no one can say. But take heart; it is going to happen.

Sincerely yours,
Lester Grinspoon, M.D.

Every time I visit your site, I leave with a heavy burden. So many people would benefit from medicinal marihuana and yet they are not legally allowed. I have your site linked from mine as it has been for almost a year now. I applaud you for all you do and the strength it takes.

Thanks very much.

Sincerely yours,
Lester Grinspoon, M.D.

I would like to know if smoking marihuana has any effect on blood pressure.

The effects of cannabis on blood pressure are generally mild and variable. Some patients with hypertension report that cannabis lowers their blood pressure. I suspect that this is a secondary effect of its relaxing, anti-anxiety action.

Sincerely yours,
Lester Grinspoon, M.D.

I have been a fan of your work for several years now and have referenced your work in several of my undergraduate papers. I am presently in the last year of my undergraduate degree and in route to law school next fall. Currently, I am working on a paper researching whether or not there is any correlation between the educational attainment and support of legalizing marihuana for medical use among American adults. I would greatly appreciate it if you could let me know of any information you have come across that would be relevant to this question. I have no objection to my question or name being used on your website or in any publication you may find it useful for, however please do not include my e-mail address. Thank you kindly.

Sincerely,

Five or six years ago the ACLU conducted an extensive survey of opinions on cannabis as a medicine. If I recollect, they did find a correlation between educational level and support for legalizing medicinal marihuana. The poll was conducted by a company called Beldon and Rosseloni. Loren Siegel at the ACLU office at 125 Broad St., New York, NY 10004-2400 should be able to provide you with the data. She may even be able to send you a copy of that carefully designed and executed poll.

Sincerely yours,
Lester Grinspoon, M.D.

I have been reviewing many articles on the Internet with reference to the medical use of marihuana and you appear to be the person with the most knowledge of the subject.

I am an attorney in (City), (State). We have a case involving a client who was involved in an automobile accident nine years ago with organic damage to the brain, leaving him with seizures. Our client is disabled and receives SSI benefits due to this condition. In addition, he has found that the use of marihuana helps control these seizures. Our client was arrested for possession of marihuana and we are at a point in this case where the judge has agreed to consider a lesser sentence if we can provide information showing that the marihuana could, in fact, provide relief to our client's seizures. Could you please provide me with information by way of your own opinion or any other authority you may be aware of supporting our clients use of medical marihuana.

I appreciate any assistance you may be able to give us in this matter.

About 80% of people with seizures get moderately good to good relief from existing anticonvulsants, but those who do not often find cannabis helpful. Furthermore, even patients who do get relief from conventional anticonvulsants often prefer cannabis because it has few side effects and no serious toxic side effects. For a concise summary of this topic, consult the revised and expanded edition of Marihuana, the Forbidden Medicine (Yale University Press, 1997), pages 66 through 80.

Sincerely yours,
Lester Grinspoon, M.D.

My name is Kelly Paige and I am the Manager of the Oregon Medical Marihuana Program. I work for the State of Oregon Health Division. Under the Oregon Medical Marihuana Act, the Health Division is charged with considering adding new conditions to those listed in the Act. I have received petitions from individuals to include the following conditions: Depression; Anxiety; Bi-Polar Disorder; Post-Traumatic Stress Disorder; Schizophrenia; and Attention Deficit Disorder. Can you direct me to any relevant literature or studies which address the use of medical cannabis in treating these disorders? Thank you.

Unfortunately, there is no literature of the kind I believe you (and all of us) would like to see, namely large double-blind controlled clinical studies. Almost everything that is known about marihuana's therapeutic uses comes from case studies and clinical experience, just as it did in the 19^th century. This would put all of us who care for patients who find cannabis useful in a difficult position, except that it is so safe that we do not have to worry about harm to the patient -- only about whether it works. Having said that, I suggest that you look at our book, Marihuana, the Forbidden Medicine (Yale University Press, revised and expanded edition, 1997). For each condition citations are given where there is other than anecdotal evidence.

Sincerely yours,
Lester Grinspoon, M.D.

I have heard that the reason medical marihuana is beneficial to people with glaucoma is because it relieves the pressure and stress on the eye. I would like to ask you this: my mother has had diabetes ever since she was a small child. It has caused numerous terrible health problems for her. Over the past couple of years, her diabetes has caused increased pressure in the blood vessels in her eyes and they often explode, causing temporary blindness lasting the span of several weeks to several months, permanently decreasing the quality of her eyesight with each explosion. She is using laser surgery almost monthly to try to stop this. My question is, would marihuana decrease this pressure in her eyes and possibly stop this? Please answer, I have searched the web trying to find helpful information and to no luck. I am afraid that with the current trend my mother will go completely blind within a couple of years.

Marihuana is not useful for the kinds of symptoms your mother describes. Cannabis is useful in the treatment of glaucoma, a different disease of the eye which results from increased intraocular pressure; the marihuana lowers this pressure and thereby relieves the symptoms.

Sincerely yours,
Lester Grinspoon, M.D.

My name is Jay and I have complex partial seizures. I have used marihauna in the past to treat my seizures, but because of my job I am no longer able to smoke marihuana because of random drug tests. So I have been trying anti-seizure medication (something I have not had to use for about five years) and the side effects are getting to be a problem. I wonder if you could share with me some arguments to help me convince my doctor to put me on Marinol. I live in Tennessee, which still has a ban on marihuana. Any help or answers would be greatly appreciated.

Marinol may not be as useful as whole smoked or ingested marihuana for the treatment of your seizures, but many people report good relief. Your doctor should have no hesitation in prescribing Marinol (dronabinol) because it is now a Schedule III drug. Even if it does not provide you the same relief as whole smoked marihuana, he will have lost nothing by prescribing it, because it is so safe -- surely less toxic than the medications he is now prescribing. It might be helpful to show him the section on seizures in our book, Marihuana, the Forbidden Medicine (Yale University Press, the revised and expanded edition, 1997).

Sincerely yours,
Lester Grinspoon, M.D.

I was wondering if there is any proof that marihuana (used in a medical aspect) can help relieve the symptoms of neurological diseases (Tourette syndrome, OCD, etc.)?

Cannabis is useful in the treatment of various neurological diseases, notably multiple sclerosis, paraplegia, and quadriplegia. It has a longstanding history of usefulness in the treatment and prevention of migraine headaches; in fact, in the last edition of his textbook, Sr. William Osler referred to it as the best treatment for migraine. It is also increasingly recognized as a symptomatic treatment for Tourette syndrome.

Sincerely yours,
Lester Grinspoon, M.D.

I'm a student of biology and I'm 24 years old. I have suffered from chronic depression since my early childhood. Three years ago my doctor prescribed fluvoxamine, 100 mg a day. At first it worked and I felt alive for the first time in my life. Half a year later I started smoking cannabis; it helped me to relax.

Last spring and summer I suffered from a terrible depression and I tried to kill myself. My doctor immediately sent me to a psychiatrist. I started smoking pure cannabis daily to make my life bearable. Since a few months my daily medication consists of 200 mg fluvoxamine (Faverin) and 100mg sulpiride (Dogmatil). I'm taking l-phenylalanine supplements (500 mg) daily.

I have read your book, Marihuana the Forbidden Medicine, and have tried to find information of the combination of fluvoxamine, sulpiride and cannabis, but I found very little information. Could you help me? I'm very interested in the combination of these drugs. I have asked my psychiatrist, but he knows very little of this. He is very interested in the matter, though.

I also browsed through the question and answer section on your site and found some questions related to SSRIs and cannabis. I have good experiences with the combination, because it makes me experience emotions better and gives me a feeling of being more at home inside my own mind. This seems to be the case with more users of SSRIs and cannabis, who largely experience the same, which makes me wonder why we never hear of any research being done in this field.

Could you help me or recommend me some articles or books about this subject? I would appreciate it.

Little is known about interactions between cannabis and other drugs used in psychiatry. I know of no literature which addresses the combination of cannabis with fluvoxamine or supride. I have had considerable experience with people who use cannabis with other pharmaceuticals, and for whatever it's worth, I have yet to learn of a drug interaction of any sort. Given the frequency with which cannabis is used in combination with the various antidepressants, I suppose that if there were serious adverse reactions, we would know about them by now. However, it will be years before we have a definitive answer on this point.

Sincerely yours,
Lester Grinspoon, M.D.

I’ve been a recreational marijuana user for 15 years. Most often I’m fortunate enough to have it. I’m self-employed and the idea for my business came to me in a cannabis-induced state. A lot of ideas, or revelations, come to me after smoking. But that’s not why I’m writing. I am an active person and seem to be more effective and productive when I’ve had a good night’s rest. At times when I don’t have any marijuana, it is more than obvious that I have difficulty sleeping. Not only am I restless before bedtime (making it difficult to go to bed as well as falling asleep) the quality of sleep suffers as well. It is especially evident the next day as I am tired, unmotivated, and unable to concentrate. I am a resident of the state of Washington which recently legalized marijuana use for medical reasons. However, insomnia does not seem to be mentioned as an illness that could be treated by marijuana. Are there any studies that show that it could or should be?

There are no modern studies that demonstrate the effectiveness of cannabis as a hypnotic (sleep-promoting drug). However, in the 19^th century insomnia was one of the conditions for which cannabis indica was most widely prescribed. The problem is that it does not work for everyone. It puts some people to sleep but keeps others awake by stimulating intellectual activity, and for many, it can have both of these effects at different times and in different circumstances.

Sincerely yours,
Lester Grinspoon, M.D.

My mother has secondary bone cancer for which she has undergone successive treatments of radiotherapy. Because of where it is in her bones (pelvis and bottom of her spine), they were unable to avoid irradiating her bowel. She has been suffering from nausea and loss of appetite and I was wondering if you have any information about the use of marihuana to counter side effects of radiotherapy (as with chemo). 

Cannabis is useful for relieving nausea and appetite loss from any cause, including radiation treatment.

Sincerely yours,

Lester Grinspoon, M.D.

Contact Info:

Bob Cox
cox@rmi.net

----------------------------

The following review of the book you referred to will be published in the December 1999 issue of The Quarterly Review of Biology (Vol. 74, No. 4).

(Link soon available)

Sincerely yours,
Lester Grinspoon, M.D.

I am a 45-year-old male, married with two grown children (23 & 25). I had two failed back surgeries nearly ten years ago and have taken thousands of pills for pain, nerves, sleeping, emotions and God only knows what else. But now I have been told that I have hepatitis C.

My doctor tells me the pills aren't good for my liver, which has its problems already. I tried cannabis for my condition after not smoking anything for nearly ten years. It helped my stomach a great deal, helped me sleep and even helped the pain because it relaxed me and eased the spasms and all. It took the place of all my pills except a pain pill or two a day (Tylenol 4). Anyway I am in a class action lawsuit in Pennsylvania next month for medical marihuana and really need a recommendation or something from a doctor saying that it would be better for me than the pills because of my liver. I am afraid to mention it to my doctor here in fear that she will stop treating me or mess up my insurance. Can you please help me? Thank you Sir.

I cannot comment on the efficacy of the analgesic medicines you have been taking, because you do not identify them. But I can say that cannabis has never been found to have toxic effects on the liver. Therefore, given that it relieves your symptoms, it would be the drug of choice for you but for its illegality.

Sincerely yours,
Lester Grinspoon, M.D.

I live in Colorado, where medical marihuana goes back to vote in November, and I’m so happy. I’m 17 years old and have had Crohn's disease for about 4 years now. When I first got it I was constantly sick or in the hospital and missing a lot of school. To begin with, I’m a little guy, for the prednisone has stunted my growth. I was so sick I was down to 70 pounds but I was only 4'10". I was totally against marihuana because of my age and the "Your brain on drugs" commercial. But when my Mom and Dad, who are very successful, brought me marihuana to try, I knew I could trust them. And I’m glad I did. I’m getting a shot once a week called methotrexate. It would make me so sick I would throw up every time I ate. So I smoke right after I get my shot and the next day. I have not gotten sick since I’ve started smoking medical marihuana, and I have been able to drop the prednisone to where I can finally grow. I’ve already grown about 2 inches in 8 months, and best of all I’ve been able to eat so now I weigh 100 pounds.

I also have a question to ask. Marihuana has been wonderful for my health, and my Mom wants to tell my doctor, but I’m scared he will be against it. So what I’m asking is, should I be truthful and come out? Also, if marihuana does become legal in Colorado, which I'm sure of, what should I do if my doctor is against it? Should I change to a doctor that is for it to get a prescription, or stay with my doctor now but do what I've been doing, get it illegally? Thank you and good luck. I'm a believer.

Yours is a common story. Others have told us that cannabis helps relieve the symptoms of Crohn's disease. Your mother is correct in wanting to share this information with your physician. Patients do better when they and their physicians are open with one another. If your physician is open-minded, he will see for himself how useful cannabis is, learning about its medicinal uses in the most important way a physician can learn -- from his patients.

Sincerely yours,
Lester Grinspoon, M.D.

I am a 25-year-old male living in Washington. I have suffered from insomnia for my whole life. It takes me close to 2 hours to fall asleep. I tried marihuana with great success. I don't have a doctor, so how can I be reviewed to receive medicinal marihuana from Green Cross in Seattle?

Promoting sleep is one of the oldest medicinal uses of cannabis. In fact, it is probably the safest of soporific or sedative medicines. Unfortunately, it will probably be very difficult to obtain for this purpose, because even in the states that have passed medicinal cannabis initiatives, insomnia is not listed as one of the symptoms for which a physician can recommend marihuana.

Sincerely yours,
Lester Grinspoon, M.D.

Would you please tell me the advantages of using marihuana for people with glaucoma and the means of administering it if smoking would be a problem?

Not all people find cannabis useful for the treatment of glaucoma. Those who do are generally patients for whom conventional medicines have failed or who find the side effects and toxicity of these medicines distressing. Small amounts of marihuana will lower intraocular pressure, but it must be taken every two or three hours to keep the pressure down. Fewer people find Marinol useful for this purpose, but it does have the advantages of a longer-lasting effect and (for some) the absence of a need to smoke. Attempts have been made to develop an eyedrop, so far without success.

Sincerely yours,
Lester Grinspoon, M.D.

Thanks for answering my previous question, but I have another related question that comes from the Mayo Clinic also. It is in relation to the psychological effects of marihuana, namely paranoia.

Dr. Kramlinger, a Mayo Clinic psychiatrist states the following in an article about schizophrenia at http://www.mayohealth.org/mayo/9801/htm/schizophrenia.htm

"Not everyone who acts paranoid or distrustful is schizophrenic. "Some people have what's called paranoid personality disorder. This is a tendency to be suspicious or distrustful of others, without the other features of schizophrenia — the chronic deteriorating course or periods of active psychosis," Dr. Kramlinger says, adding that in some people it's difficult to distinguish between schizophrenia and paranoid personality disorder. He also notes that some people with depressive disorders may have paranoid features. Other causes of paranoia include substance abuse, particularly with stimulants such as amphetamines and methamphetamines, but also heavy use of alcohol and marihuana."

Marihuana actually does not cause a great degree of paranoia. It is actually the draconian laws imposed upon us that cause paranoia. Can an herb such as marihuana cause such a psychological reaction or is it really a fear of what can happen if we are caught? Also, couldn't this paranoia be elicited by light use instead of "heavy abuse"? It seems that anyone who knows the results of being caught will be paranoid.

Maybe there is a residual effect.

Dr. Kramlinger is correct in everything he says about paranoia except his comment about the heavy use of marihuana. In rare cases, marihuana temporarily causes paranoid thinking, almost always along with considerable anxiety. The reaction is uncommon and usually occurs in a person who is using cannabis for the first time. One reason for it is that naïve users do not always know how to adjust the dose and may get more than they are prepared for. Experienced users rarely suffer paranoid reactions to marihuana. It is also true that paranoid reactions are more common when the legal risks of using cannabis are great.

Sincerely yours,
Lester Grinspoon, M.D.

Is it true that the federal government has a marihuana farm in Alabama?

The federal government has only one marihuana farm. It is located in Oxford, Mississippi.

Sincerely yours,
Lester Grinspoon, M.D.

Will cannabis benefit against or subdue the dementia or Alzheimer's disease of a 70-year-old male?

Few palliative medicines are available for one of the most devastating disorders of old age, Alzheimer's disease. Nineteenth century physicians found an oral extract of cannabis to be useful. In 1890 Dr. J. Russell Reynolds wrote: "In senile insomnia with wandering where an elderly person…is fidgety at night, goes to bed, gets up again, and fusses over his clothes and his drawers; then thinks that he has some appointments to keep and must dress himself and go out to keep it…in this class of cases I have found nothing comparable in utility to a moderate dose of Indian hemp -- viz one quarter to one third of a grain of the extract given at bedtime. It has been absolutely successful for months and indeed years without any increase in dose." In a recent study by B. J. Volicer, an investigator at Boston University, Marinol was found to improve appetite and reduce disturbed behavior in patients with Alzheimer's disease.

Sincerely yours,
Lester Grinspoon, M.D.

This story starts 7 years ago (now I am 26). I started to experience headaches (bad ones and all the time), and I had never had one before. Since then I have lost jobs, friends, girlfriends and have had to drop out of school because of the headaches as well as the fear they generate. I suffer from chronic cluster headaches, which are like migraine but don't last so long. This makes traditional headache medicine treatments obsolete, because by the time they start working the headache is over (I use oxygen to abort the headache). Last January I decided to quit smoking cigarettes and started smoking pot instead. Since I made this change I went from getting at least one headache a day to one a week (or from 2 oxygen tanks every 2 weeks to 2 tanks in 4 months.) The strength of the headache also dramatically decreased. Now when I get a headache I can abort it within 10, sometimes 5 minutes. They used to go 40 minutes to an hour. I have recently brought this to my doctor's attention and he thinks it is great. I approached him with the idea that Marinol could be used instead, because I know and the doctor knows that I'm still smoking a carcinogen. He proceeded to look in his medical book and tell me that he cannot prescribe because federal agents would respond. I have tried not smoking pot recently and the results were horrible, so I know for a fact that cannabis helps my headache, and my doctor concurs. However, his book said that Marinol is restricted to cancer patients and AIDS patients, with one exclusion for people who won't eat (bulimia or whatever it is called). My question is, how can I empower myself and my doctor to treat this legally, so I can finally get on with my life after seven years being stolen from me. I do live in California. However, I know that the feds are going after doctors and patients who are using Prop 215.Any suggestions would be greatly appreciated.

Your doctor can prescribe Marinol. The two uses he mentions are the so-called labelled uses, but doctors can also prescribe the drug off-label, that is, for other purposes. Now that Marinol has been moved from Schedule II to Schedule III, there is no legal bar or difficulty in his prescribing it. It may not be as helpful as whole smoked marihuana, but it will certainly do you no harm. Cluster headaches are one of the most severe forms of pain. I hope your physician will give you a trial of Marinol.

Sincerely yours,
Lester Grinspoon, M.D.

I am a 25-year-old collage graduate who suffers from manic-depression. I have been unable to keep a job for the past three years and have had no success with prescribed meds. I think marihuana is my saving grace. It mellows my highs and levels my lows. Is there any way the open clubs can mail me marihuana? That would be great. Thanks,

We have seen a number of people suffering from bipolar disorder who find cannabis useful. However, a cannabis club cannot mail marihuana to you. Even if you presented yourself in person at such a club, it is not clear that you could be supplied with marihuana, because manic-depressive disorder is not generally recognized under present state initiatives as one of the indications for the use of cannabis.

Sincerely yours,
Lester Grinspoon, M.D.

I've read mixed things about marihuana and insomnia. One that concerned me particularly was a doctor's statement that, like alcohol, marihuana may help induce sleep but reduces quality of sleep. Do you have any research one way or the other?

And a comment on marihuana's immunosuppressive effect: I found it very helpful for allergy symptoms this ragweed season.

I know of no evidence for your doctor's statement that cannabis lowers the quality of sleep. Nineteenth-century physicians who prescribed it as a sleeping medicine noted that their patients awoke refreshed, without a hangover of any kind.

In answer to your second question, cannabis has immunomodulatory effects which are apparently helpful in the treatment of such illnesses as multiple sclerosis, Crohn's disease, and urticaria. Many people also find it useful in the symptomatic treatment of their allergies.

Sincerely yours,
Lester Grinspoon, M.D.

My mother has secondary bone cancer for which she has undergone successive treatments of radiotherapy. Because of where it is in her bones (pelvis and bottom of her spine), they were unable to avoid irradiating her bowel. She has been suffering from nausea and loss of appetite and I was wondering if you have any information about the use of marihuana to counter side effects of radiotherapy (as with chemo). Many thanks

Cannabis is useful for relieving nausea and appetite loss from any cause, including radiation treatment.

Sincerely yours,
Lester Grinspoon, M.D.

I am 14 years old, and I suffer from frequent migraines and severe insomnia. Recently I discovered that marihuana helps both health problems. I have been prescribed dozens of drugs for both problems, but none have worked. I was wondering if it is valid to use marihuana for otherwise untreatable migraines and insomnia. Thanks.

Migraine and insomnia were two medical conditions for which cannabis was often prescribed in the 19^th century. Although there are modern drugs for both these conditions, some people still find cannabis more effective.

Sincerely yours,
Lester Grinspoon, M.D.

I was just diagnosed with ankylosing spondylitis, which is a form of arthritis that affects the spine, hips, neck, and shoulders. I am in constant pain from my joints fusing together as well as my muscles being inflamed and sore. I have used marihuana to help my appetite and to take the edge off the pain (I refuse to take Rx painkillers.) My question is, what would be the best approach to ask my doctor about a prescription for marihuana? And what is your opinion on marihuana use for this type of arthritis?

Your doctor cannot give you a prescription for marihuana. In some states he is allowed to give you a note that makes it possible for you to use cannabis for this kind of pain relief. There is no question that people with this disorder find marihuana useful (see case reports beginning on page 126 of the revised and expanded edition of Marihuana, the Forbidden Medicine). In my opinion, cannabis is safer for this purpose than the NSAIDs and acetaminophen.

Sincerely yours,
Lester Grinspoon, M.D.

I am a 53-year-old male. I have congestive heart failure (CHF) and also suffer from muscular pain. My primary physician tells me I have a virus which has affected my heart muscle and muscular system. My CHF is under control using common heart meds and I do not have shortness of breath, even with moderate physical activity. My BP is about 140/65. However, this virus has made me one vertical, barely ambulatory ache. I stay in various levels of pain, day and night. I take Vicodin, Darvocet and Percocet for the pain. I recently obtained a small amount of marihuana and upon ingestion noticed a sharp decline in my muscular pain. So I asked my primary physician about medical marihuana, as it is legal here in California. He graciously declined because of legal issues only. He was supportive of my using medical marihuana for pain, but could not come to deal with the legal aspects of a recommendation.

Having a desire to give medical marihuana a try (legally), I have made a consult appointment with a pro medical marihuana physician at a cost of $150.00. My questions are (in your opinion), do the benefits of marihuana outweigh the risks having CHF? Should I continue attacking my liver with large doses of Tylenol? Should I save the $150.00 and cancel this appointment coming up in October?

I'm afraid I cannot answer any of your questions definitively. I have no experience with the effect of cannabis on congestive heart failure, and I do not know anyone who does. I can say that cannabis would be better for your liver than acetaminophen (Tylenol). By now you have undoubtedly made a decision. I would be most interested in any follow-up information you can provide.

Sincerely yours,
Lester Grinspoon, M.D.

I have a question. My husband is an AK amputee. He was involved in a motorcycle accident some 10 years ago. In addition to the amputation, he has had reconstructive surgery on his other knee and has a plate in his arm. Although phantom pains have always plagued him (he kept the leg for 17 days while they tried to make sufficient repairs to save it), they have significantly increased in the last couple of years. He has been prescribed codeine, which he gets refilled every month, but it doesn't always work. Do you have any suggestions, or have you heard of this method being effective for phantom pains? I am desperate to help him as he often wakes in the middle of the night with the remaining part of the leg "cramping" badly. Thank you for your insight.

-------------------------------------------------------

Dear Dr. Grinspoon:

I've previously submitted a question regarding phantom pains, but thought I might try this avenue to possibly get a quicker response (I realize you guys are really busy). My husband was in a severe motorcycle accident about 13 years ago and has an AK amputation. The other knee is completely rebuilt as well as a rod in his left arm.

My main question is that I'm growing increasingly concerned about his phantom pains. Prior to amputation, he had the leg on for 17 days, in a type of "cage" with bolts going in several different places, but especially in the foot. He has always had phantom pains - says he especially feels a burning like the bolt is still just below his big toe. We hoped that they would ease over the years, but the opposite seems to be happening. They seem to be increasing in intensity and in how often they occur.

He is currently on monthly codeine meds, but, of course, over time that loses its efficacy. He has tried many of the suggested common remedies -- taking the prosthetic on and off, wrapping the stump in a warm towel, etc. -- and they haven't really helped.

He doesn't smoke or drink alcohol and is a little concerned about trying this method, but we are both desperately looking for something to help him.

Possibly, when you have time, you could give me your opinion, or refer me to someone who might know more about it, and/or help me to know where he could find a physician that he could talk to about a prescription. He probably wouldn't do it without a prescription because he is "Mr. upstanding citizen" - but I worry that the pain is upsetting to him and leaves him depressed.

Any help or ideas you could give would be GREATLY appreciated. Thank you so much!

We do not have a great deal of experience with phantom pain, but in Marihuana, the Forbidden Medicine (revised and expanded edition, 1997), we present one case in which a patient got excellent relief from Marinol. After reading this case history, you may want to consider asking your husband's doctor to prescribe Marinol.

Sincerely yours,
Lester Grinspoon, M.D.

I have suffered from irritable bowel syndrome since I was an adolescent. Through diet, I can control most of the symptoms except for the painful cramps I experience nearly every morning. A few years ago, I discovered that just an inhalation or two of cannabis upon waking immediately ended the painful stomach cramps with no strong or distressing side effects. In fact, since I've started using cannabis sporadically to treat the cramps, I no longer seem to need Prozac, and I even made the Dean's List at my college. My allergies also seem to not bother me as often as they used to.

I have discussed my cannabis use with my doctor, but he is very conservative and strongly disapproves. He has prescribed me LEVBID (hyoscyamine sulfate, 0.375 mg) for the cramps, but the side effects are harsh and the drug should not be taken over an extended period of time.

Cannabis works great for me, but its illegality is a problem where I live. I am currently pursuing a Masters in social science education and hope to teach, but could not in many places if convicted of a "drug crime." My hope is that legal Marinol might work for me.

Dr. Grinspoon, would you know of a doctor in my area (western Oklahoma) who has experience with Marinol? Your assistance would be greatly appreciated.

I do not know of a physician in Oklahoma who has experience with Marinol. However, it is now a Schedule III drug, and your own physician can prescribe it. While Marinol is not as useful for most people as whole smoked marihuana, it does work and work well for some. Neither you nor your physician has anything to lose by trying it.

Sincerely yours,
Lester Grinspoon, M.D.

I have a question. My mother has been diagnosed since 1988 with multiple sclerosis. She is the kind of person that, unless a doctor prescribes her something, she won't take or use it. I am her son. I also take care of her every day because there aren't too many things she can do on her own. I am always trying to get her to use marihuana for medical reasons. I smoke for my own personal use but I am always reading on the Internet and in magazines about the positive effects it can have on people with certain illnesses, like MS. My question is, is there somewhere where she can get a doctor to prescribe it for her or if she could be part of a study or something? She has told me she would try it if a doctor gave it to her or she was part of a study. Please, if you can help me, I would be forever in your debt. I just can't sit here and watch her in so much pain all the time. Please reply ASAP; hope to hear from you soon. Thanks for taking the time to read this.

Thank you sincerely,
John Andras & Lynn Andras (my mother)

Sadly, no doctor can prescribe marihuana, and there are no clinical studies on the use of marihuana in multiple sclerosis. I hope the situation will change in the not-too-distant future.

Sincerely yours,
Lester Grinspoon, M.D.

I have looked high and low for information regarding the effects of marihuana during pregnancy. All I can find is instances where the mother smokes constantly, day in and day out. All I want to know is this... is there any danger in having a puff here and there during pregnancy, say maybe twice a month? I don't drink or smoke and avoid caffeine as much as possible, and I don't want to put my unborn child in harm's way. However, I've never heard of a baby born addicted to pot, or anything of the sort. What are your opinions on this? I'm waiting for some accurate information. Thank you.

In my view, the best policy for pregnant women is to avoid all drugs unless they are absolutely necessary. Having said that, I would refer you to the work of Melanie Dreher, an anthropologist and nurse. Her work is discussed elsewhere on this site. She studied Jamaican women who smoked marihuana while pregnant and compared their babies to those of Jamaican women who did not smoke marihuana. Using a large battery of tests and following the children for several years, she found no differences between the two groups.

Sincerely yours,

Lester Grinspoon, M.D.

I have open-angle glaucoma. The prescription eye drops I use have not helped. I have been on them for a couple of years. Recently I tried marihuana to see if it would help. It lowered my pressure down tremendously, but the problem is I cannot find a doctor in my city who will take a risk. They are afraid of losing their licenses and they do not believe that the marihuana helped. Please send me in the right direction as to where I can get help. I live in Selma, Alabama. Keep up the good work and thank you.

Sadly, there is no physician in the United States who can prescribe marihuana. Physicians can prescribe Marinol (dronabinol), a synthetic form of tetrahydrocannabinol, the main active ingredient in marihuana. It is not nearly as likely to be useful to you as whole smoked marihuana, but it might be worth a try.

Sincerely yours,
Lester Grinspoon, M.D.

Hello, I live in North Carolina. I had to have brain surgery to remove tumors in February of last year. Since my surgery I have had seizures and my right hand constantly shakes. My speech is also stuttered at times. However, I find that when

I smoke pot I become very relaxed and my hand and speech completely clear up. "My hand will almost immediately stop shaking", I have told my doctors. They say that it has been known to help in seizures. I would like to know what doctor I should talk to see if I could get marihuana for medicinal use. I see a neurosurgeon, a neurologist, a psychiatrist, and a physical therapist.

I am sorry to say that no doctor in North Carolina can help you get marihuana for medicinal use. Several states have passed initiatives which allow limited use of cannabis as a medicine, but North Carolina is not among them.

Sincerely yours,
Lester Grinspoon, M.D.

I have been diagnosed with adult ADD. I have been prescribed many meds such as Paxil, BuSpar, Prozac, for anxiety. I have been given drugs like Adderol or Cylert for the ADD. None work better to calm me and keep me focused than smoking marihuana. I live in Wisconsin. Is there any way that I could get a medical permit to cultivate and use for my own use??

Many people have discovered, like you, that cannabis is useful in the treatment of ADD. Unfortunately, this use, like any other use, is illegal. Even the states that have passed medical marihuana initiatives do not allow its use for the symptomatic treatment of ADD. There is no way presently that you can get a "medical permit" to cultivate marihuana for your own medical use.

Sincerely yours,
Lester Grinspoon, M.D.

I just read an article about the benefits of marihuana. In that article somebody says that smoking a joint helps for asthma. Because I’ve had asthma since I was eight years old and everybody said that the worst thing you can do with asthma is to smoke, I was wondering if it's really true that marihuana helps?

Whole smoked marihuana has mixed effects on asthma. On the one hand, the smoke is an irritant and for that reason a bronchoconstrictor. On the other hand, the cannabinoids are bronchodilators. Whether whole smoked marihuana will be useful to a particular patient will depend on which of these two effects predominates. Ultimately cannabis may become an important addition to the armamentarium for treating asthma, but perhaps as a laboratory-developed analog which can be delivered through an aerosol which does not irritate. Meanwhile, there are some people who find whole smoked marihuana helpful.

Sincerely yours,
Lester Grinspoon, M.D.

I have visited your website regarding medicinal use marihuana, and I am writing to you because I am concerned about my husband. Let me fill you in on his past medical history. He has undergone eight major back surgeries -- three laminectomies, two to remove scar tissue buildup, one spinal cord stimulator, one to replace spinal cord stimulator wires, and one unsuccessful surgery to replace the SCS wires due to excessive scar tissue. My husband was never a drug user but has taken numerous prescribed medications with terrible side effects which include mood swings, stomach pain, headaches, insomnia, and major withdrawal symptoms. 

About one year ago he went fishing with a friend and left his prescription medication at home. His friend gave him a joint out of pity. This is when he started smoking marihuana on a regular basis to control his pain. Since then he has gone from taking 8-10 Vicodin ES and 4 Soma a day to a non-narcotic pain medication called Darvon-65. He only takes 6 of these a day. He is no longer taking BuSpar and Prozac for depression and is no longer taking any Soma.

 This has changed his attitude towards life. His mood swings are gone. He still has pain but is able to deal with it so much better. After three years of not being able to work, he is back to work and able to function normally. But he is a union electrician, and they often drug test employees. My husband is not comfortable trying to get his medication (as he calls it) on the street. We have recently moved to the Portland area and we have heard about the medical use of marihuana in Oregon. Is this true, and how would he go about getting a prescription for it? I believe this is a miracle drug given to us from God. Our relationship has greatly improved since he has been on this medication and I am afraid of legal problems which may jeopardize our family and his livelihood.

Sincerely yours,
Lester Grinspoon, M.D.

I am looking for any information on the medical use of marihuana for Crohn's Disease. I have recently been diagnosed with Crohn's and have been using MJ as medicine for nausea, pain, and anxiety. I have not been able to locate any studies on this matter specifically. Can you help me?

When we wrote the second edition of Marihuana, the Forbidden Medicine we listed Crohn's disease as one of the less common medical uses of marihuana. At this time we would have to say that it is used fairly often for the symptomatic treatment of Crohn's. You will have difficulty locating studies, because the evidence is entirely anecdotal (see some examples). Nonetheless, this evidence is most persuasive. We have yet to hear of a patient with Crohn's disease who suffered in any way as a consequence of using cannabis.  

Sincerely yours,
Lester Grinspoon, M.D.

I am frequent marihuana smoker. I am also a sufferer from frequent migraine headaches. I will admit that I do not always smoke marihuana to treat my migraines, but when a migraine does arrive, I use marihuana to treat it. I rarely go to doctors and simply refuse to take any synthetically manufactured drug (this includes illicit drugs such as LSD). The problem I have is that often when a migraine arrives, I do not have the marihuana to treat it. This forces me to live with the problems associated with my migraine (vision problems, sensitivity to light, nausea vomiting etc). I am considering growing marihuana to alleviate this problem, but am somewhat scared of the consequences. I would like to find a doctor to recommend it. What sort of doctor should I visit, and are there many doctors who recommend marihuana for migraines? I live in southern California, and under prop 215, I should be able to cultivate enough for my own personal use.

You should see a neurologist about your migraine headaches. You will find one in southern California who is familiar with the long history of the use of cannabis in the treatment of migraine and courageous enough to write you a commendation that would allow you to get marihuana under the provisions of Proposition 215.

Sincerely yours,
Lester Grinspoon, M.D.

I am 31 years old and I have had diabetes since I was 17. As a teen I tried marihuana maybe three times, experimenting like most teens do, but I never was able to get into it like some did; I would rather drink beer or some other kind of alcoholic beverage. It is only in the last 2 to 3 years that I have realized the benefit of smoking marihuana. I was living in Tennessee and my health had progressively gone down hill. I was constantly nauseous, with severe pain in my toes due to poor circulation and the worst headaches I had ever had. Someone had offered me a joint to smoke recreationally, which I graciously turned down. But that started me thinking about the medical aspect of marihuana. I began researching marihuana on the Internet and realized that it might help me with some of my symptoms. I began using it regularly and immediately noticed several changes. The nausea was gone when I smoked marihuana. My appetite was suddenly back. The pain in my toes was not even noticeable and my headaches were few and far between. I would like to ask whether you have heard of any medical studies on marihuana and diabetes and whether it is beneficial to people like me. Any info on this matter would be greatly appreciated. Thanks for your time and the info on your site.

I am sorry to have to report to you that there are no clinical studies on the usefulness of marihuana in the treatment of some of the symptoms of diabetes. There are anecdotal accounts; one is given in our book, Marihuana, the Forbidden Medicine, and there are several on this website. Sadly, you like so many other patients will have to wait until this therapeutic option is legally available to you.

Sincerely yours,
Lester Grinspoon, M.D.

I am 59 years old and have been suffering from peripheral neuropathy for about ten years. I have been everywhere for treatment and it is the consensus that my neuropathy is the hereditary type. I have just retired from being an electrician, mainly because of this condition. After trying all the conventional treatments, I find that marihuana is most helpful in the relief of pain and discomfort. I only wish that it could be regulated and standardized. My big problem is finding a good quality product. What a messed up country we live in, where booze is promoted while an herb which is so beneficial is relegated to the criminal element.

I live in the Boston area and would be more than willing to take part in any studies or programs providing treatment and relief to people with peripheral neuropathy. It seems to me that documented proof of the benefits of marihuana as a medical tool would be helpful.

Dr. Grinspoon, if you know of any studies being considered in the Boston area, I would be grateful to you if I could be included. I have an extensive medical history which might be of some help in setting up or being included in a study program.

I want to thank you, doctor, for taking the time to read this note, and I wish you much success in your project.

Unfortunately the only clinical study I know of at this time is one which involves the use of marihuana in the treatment of the AIDS weight reduction syndrome in San Francisco. Hopefully in the not-too-distant future there will be many more clinical studies which will eventually lead to the availability of cannabis and cannabis-derived products for the treatment of symptoms like yours.

Sincerely yours,
Lester Grinspoon, M.D.

My husband is 32 years old and has had three lower back surgeries, all of which have failed to make the pain in his back go away. We have been to several different doctors and pain specialists. I have watched my husband literally be tortured by the different therapies and techniques that these doctors use. He has probably been on every pain pill known to man. Some will work for a while, but then he will build up a tolerance and just feels drowsy and sick. We have two young children that require a lot of energy. He was unable to function as a father or husband until a friend suggested that he try smoking marihuana instead of taking the pain pills. Since my husband has taken his friend's advice we have had a better relationship, and he has been able to function as a father and deal with the pain. The only problem is that the amount of marihuana it takes for him to be pain-free exceeds our budget. We are currently seeking a way to legally obtain marihuana from a physician. Please help!

Your husband's experience is quite common. It is most unfortunate that this medicine, which can be so much more effective in this situation than conventional drugs, should be both illegal and because of its illegality, so expensive. If it were available as a medicine it would and cost very little. Unfortunately at the present time there is no way he can legally obtain marihuana from a physician. I do wish I could help.

I attach a letter we sent NORML about our friend's problem with her hyperactive (ADHD) son in his teens. Having looked at your excellent website (love the caduceus/leaf logo!), we are interested to see someone recommending cannabis for this syndrome.
All the very best

Nick and wendy
Tetsab@aol.com

(here is the attachment)

Hope we might be able to get some advice from you on the above. We live in the UK and have a friend who has a hyperactive (ADHD) son in his teens. A medical consultant recently advised him very strongly against taking marihuana while on his prescribed Ritalin, suggesting possible brain damage as a consequence.

This is obviously of concern and we wondered if you are aware of any such danger. Clearly, it may be the consultant merely wishes to 'warn him off' any experimentation with recreational drugs due to the high risk of this young man having an addictive personality (this apparently IS documented).

We have come across your organization while attempting to research this on the Net and thought it possible you might be able to point us in the right direction if not actually answer this query. We would be quite happy for you to forward this e-mail to anyone you believe might know the answer.

Your e-mail has been forwarded to me. I am not aware of any dire consequences of using marihuana and methylphenidate simultaneously, nor am I persuaded that there exists "an addictive personality." Furthermore, if you consult our book, Marihuana, the Forbidden Medicine, or look elsewhere on this website, you will find anecdotal accounts which suggest that for some people who suffer from ADD or ADHD, marihuana appears to be useful.

Sincerely yours,
Lester Grinspoon, M.D.

I have been a quadriplegic c5-c6,for 16 yrs. My spasms, which can be quite violent, are almost nonexistent when I am under the influence of marihuana. I was a cannabis child from 1969 and used marihuana for a variety of depth perspective qualities...meditation, inner cleansing, artistic, music creativity, abstract tangenting on various subjective areas. I have even served time for my beliefs in marihuana, 10 months in federal prison in 1996-1997. My federal probation officer requested that I get a prescription for medical marihuana. Can you prescribe it for me? I live in Montana and don't believe I can get one from these war-on-drug lovin' doctors here. I would be glad to help you and your endeavors. You can use me and my name as martyrical or substantial evidence in your endeavors.

I have to stand up for my beliefs...even in my wheelchair. I can write for you or do some work for you, please let me know.

I am sorry to tell you that no physician in the country can write a prescription for marihuana. In a few states which have passed medical marihuana initiatives, physicians are allowed to write letters certifying that patients need marihuana for the symptomatic treatment of a few specified illnesses. However, Montana is not among these states. I am most appreciative of your offer to help.

Sincerely yours,
Lester Grinspoon, M.D.

I am a medical user of marihuana, but I am only 17 years old and no doctors will prescribe medicine for me. I have tried more then 50 different kinds of medications and marihuana is the only one that seems to work. I get migraines and then real bad nausea and I get sick, but if I take a few puffs then I feel a lot better. The nausea and the migraine go away and I am able to stay awake and enjoy the day. If it weren’t for marihuana I would be throwing up and sleeping the whole day and be in a lot of pain. I get migraines every day and I am not able to go to school because of this. I am being home tutored so I can someday get a college education. Is there anyway that I could obtain a doctors note to get medical marihuana in the state of NY? What are the laws on growing marihuana in NY?

Marihuana has a long history of use in the symptomatic treatment of migraine headaches. I have no doubt that in the not-too-distant future this usefulness will be generally recognized and either whole smoked marihuana and/or cannabinoid analogs will be legally available to migraine sufferers who do not get good relief from available medicines. Unfortunately, there is no way that you can now legally use or grow marihuana as a medicine in the state of New York. While most sufferers do not find Marinol as useful as whole smoked marihuana in the treatment of migraine, a few do. This is something your physician could prescribe and it might be worth a try. It won't be as easy as using whole smoked marihuana because of the nausea and vomiting and the fact that it takes at least an hour or an hour and a half to experience any therapeutic effects. Nonetheless, as this is your only legal alternative, it may be worth experimenting with.

Sincerely yours,

Lester Grinspoon, M.D.

I was nearly 46 years old and things were going well. Through some ups and downs, my career had progressed from earning a Ph.D. in geochemisty to working as a planetologist for NASA, then a professor of geology at the University of California, and finally an environmental hydrologist for a small consulting firm. In two weeks my own tiny consulting firm, with the first contracts already in hand, would be formally launched. And I had recently started to share the San Francisco house of my sweetheart of four years - the last, cautious step before marriage. Life was good.

A bicycle ride for a little exercise ended the good life. Head met pavement and, despite the helmet, pavement won and head lost. Thankfully, I have no memory of the month in three different hospitals, diagnosed with a "moderately severe" brain injury. Unfortunately, though, I can still remember what I once was and what I can no longer be or do.

My sweetheart took care of me for two years, but I was no longer the person she had loved and we separated when it seemed I was able to look out for myself again. Nothing is left of my career. The California Dept. of Rehabilitation sent me recently to a class to review a subset of my former career. I could understand everything easily, but could remember nothing and was unable to complete the class. I can still write but, it seems, only about personal matters that still find room in the remnants of my brain. I am way too slow at it to earn a living.

The brain is where we "are". Change the brain and change *what* and *who* we are. With such a complex organ, it’s no surprise that each brain injury is as unique as a fingerprint. The undesired, new "me" has a constellation of cognitive deficits, which makes living alone on disability in post-trauma life difficult but not impossible. Constant fatigue plagues me, which my neuropsychologist relates to the loss of many brain cells, requiring remaining cells to work overtime. And, most devastating, treatment-resistant severe depression dominates my life.

Almost all victims of brain injury suffer depression because of the great losses that leave us disabled and strangers to loved ones and to ourselves. The many psychiatrists I have seen in the six years since that bicycle ride seem to agree that my persistent depression is something else, though, probably caused by the physical damage to my brain. They use the term "organic depression." Another term: "rapid cycler." I’m not bipolar or manic-depressive, but my moods can change dramatically for no apparent reason, in either direction, in minutes, and a cycle can last from hours to weeks. At its best, my mood is "mildly" depressed, at its worst, suicidal. I can hide mild or moderate depression, so most casual acquaintances don’t know about the mood disorder.

When I am obsessed by thoughts of suicide, without a drive to actually carry through with it ("suicidal ideation"), I classify the depression as "strong". When I have to fight impulses to end my life *now*, by whatever means is available in the instant, my depression is "severe". I am strongly depressed maybe 10 - 25% of the time. Severe depression usually hits only several times a year, but I was on the edge of dialing 911 for help three times in two weeks last autumn. I estimate my chances of death by suicide, eventually, at about 50:50. Oddly, my suicide will probably be involuntary - I will be fighting it until too exhausted to resist.

Several years ago, with traditional medical treatments failing me, I started smoking marihuana when the suicidal urges would hit. It was wonderfully effective, short-circuiting the urges and giving me some needed rest from the battle. Usually the urges did not come back when the other effects of marihuana wore off, so I was safe until the next cycle. Marihuana also relieved all the milder forms of depression, but for only as long as the "high" lasted.

As an antidepressant, marihuana has a short "half life", becoming effective quickly but wearing off in an hour or two. In contrast, traditional antidepressants have long half-lives, taking days or weeks to start working but persisting for days so that, with doses two or more times daily, the benefit is continuous. So, unlike traditional antidepressants, marihuana can be used effectively by a rapid cycler like me to head off crises. I am aware of no other medication that has this immediate benefit. And because the traditional antidepressants don’t work for me anyway, marihuana can make life less miserable at times when it won’t interfere with safety or life’s chores.

To try to save money when so much of my disability income was going to prescription medications, and to reduce the risk of procuring a supply, I started to grow a few marihuana plants, hidden among the corn in my garden. But, as has happened every year since whacking my head, the depression caused me to stop attending the garden. Because of memory deficits, I didn’t even remember the pot was out there when a dispute with a neighbor arose. Eventually a court order was issued to control the neighbor’s antisocial behavior, but not before he took revenge by reporting me for marihuana cultivation. I was arrested and handcuffed and spent 24 hours in county jail before my brother could drive 400 miles to bail me out. After a year of legal wrangling, thousands of dollars in legal expenses, and devastation to my already ruined self-image, charges were dropped.

So now I’m stuck. The only medication proven effective for my particular disorder is illegal at the federal level and in legal limbo at the state level. If arrested for using marihuana again, I will certainly go to prison. In prison, I will certainly commit suicide. The federal government continues to oppose the California law that legalizes medical use of marihuana, and my shrinks seem to be a conservative bunch, so I have not been able to get a recommendation from a doctor to use marihuana under state law. My financial and cognitive resources are so limited that I have not gotten very far with finding another doctor willing to recommend or prescribe medical marihuana. Where do I take my risks now? With suicidal urges in the absence of marihuana, or with arrest in this perversely moralistic country for medical use of marihuana, then suicide in prison?

Any suggestions for a California doctor (I now live in northern California, between San Francisco and Sacramento) who would be willing to consider my request for medical marihuana would be greatly appreciated. I just discovered this web site and, through it, your book, which I will obtain and read for material I can use to try to convince an MD to write a recommendation for me. I will explore your and other web sites, but would appreciate pointers to additional materials that would help convince an MD in my favor.

You may use any or all of this letter in any publications or on a web site, but I must remain anonymous because of possible related criminal legal exposure.

Sincerely yours,
Lester Grinspoon, M.D.

I am searching for information on the use of marihuana in Crohn's disease. This information is needed for a friend who will be pleading a medical defense in an upcoming trial in the backwoods town of Talladega, Alabama. I have contacted several NORML committee members and am waiting to hear from them concerning medical issues. I am seeking information from you because I feel that the added burden of this court case along with my friend’s already intolerable pain from Crohn's may perhaps be more than he can stand. In the week since his arrest for first degree possession my friend is becoming more and more ill, and depression is setting in fast. Please tell me how I can help my friend.

Many people are now discovering how useful marihuana is for the treatment of some of the symptoms of Crohn's disease. I suggest that you call the attention of the court to the section on Crohn's disease in our book Marihuana, the Forbidden Medicine. You will also find other cases on this website that illustrate its usefulness. I hope this helps.

Sincerely yours,
Lester Grinspoon, M.D.

I am a thirty-four year old male software engineer. I have a wife and two beautiful daughters. Approximately five years ago I was clinically diagnosed with bipolar disorder.

Looking back, I remember symptoms: Deep depression, feelings of despair, suicidal thoughts, hateful thoughts and deeds, angry confrontations in high school.

What is even more revealing is that, since that time, I have discovered that both sides of my family have the same disorder; some worse, some not.

I nearly lost my marriage. Then I discovered Zoloft. This seemed to help at first but two or three years later it began to seem as if it was not working any longer.

The result was (what I'll call) a nervous breakdown. I was so deeply depressed that I took a handful of Wellbutrin (Buspar) and the rest of the Zoloft tablets. I voluntarily admitted myself to a hospital. I discussed with my doctor going to the mental ward so that I could be brought down from the Zoloft slowly and try a different drug.

I got admitted and a new doctor took over my case. Apparently there was a lack of communication between the two doctors. To put it simply, I was not taken off Zoloft but put on lithium. This did nothing for about two weeks, but then my hands began to shake so badly that I could not work. I felt that I had to stop taking it, so I did and the shaking left.

It was during this period and several months after that I began using marihuana. Then the source became unreliable. I tried to find another but it was just as unreliable with low quality weed.

I am now under the care of a new psychiatrist who has prescribed Klonopin and

Zyprexa (olanzapine tablets). The Klonopin makes me forget all but my name so I stopped taking it. However, I know the marihuana works. Is there any direction in which you can point me to obtain a prescription or at least a recommendation? You see, my wife fears the legal penalties for cultivation, but some sort of recommendation will alleviate her fears.

Please help if you can!

You might show your psychiatrist a paper entitled, "The Use of Cannabis as a Mood Stabilizer in Bipolar Disorder: Anecdotal Evidence and the Need for Clinical Research", published in the Journal of Psychoactive Drugs, Vol. 30, the April-June 1998 issue, and the section on marihuana and bipolar disorder in our book, Marihuana, the Forbidden Medicine. Although your psychiatrist cannot prescribe marihuana, he could give you a trial of Marinol, the commercially available synthetic THC. I am not at all sure that it would work, but it certainly won't hurt you.

Sincerely yours,
Lester Grinspoon, M.D.

I have been diagnosed with chronic depression. I tried different SSRIs, but the side effects were very unpleasant. When I lived overseas for six years, I used cannabis on a regular basis and my moods and life were great and I felt wonderful. When I returned to the U.S. I stopped overnight with no problems. One year later I felt terrible with all the symptoms of depression. The reason I quit was the legal problems here. I have too much to lose if I were to get caught. My question is, what does it take for my doctor to prescribe Marinol here in the state of Florida (besides a lot guts on the doctor's part)?

Thanks

The federal government has recently rescheduled Marinol to a less restrictive classification, so "a lot of guts on the doctor's part" are no longer required to prescribe it. It might not be as useful whole smoked marihuana, but it is certainly worth exploring.

Sincerely yours,
Lester Grinspoon, M.D.

I am a bipolar who is unable to tolerate mood stabilizers; therefore I'm on Risperdal only. I'm also unable to take an antidepressant due to my manic tendencies. Marihuana is the only thing I have found to work for my depression. Is there more information available on this subject, and is bipolar one of the illnesses being considered for medical need?

There is very little information about the use of cannabis in the treatment of bipolar disorder. We have discussed this use in our book, Marihuana, the Forbidden Medicine, and in a paper, "The Use of Cannabis as a Mood Stabilizer in Bipolar Disorder: Anecdotal Evidence and the Need for Clinical Research", published in the Journal of Psychoactive Drugs, Vol. 30, the April-June 1998 issue. Bipolar disorder is not one of the illnesses covered by present state initiatives for medical marihuana.

Sincerely yours,
Lester Grinspoon, M.D.

I have open-angle glaucoma. When I don't use marihuana the pressure goes up extremely high and I see fuzzy. The doctor who told me to continue using it died about 8-9 months ago and now I cannot get the treatment I need. Before he died he tried an experiment, and when I was using it the pressure stabilized. Even though I am 50% blind in my left eye and partially blind in my right eye, the marihuana helped to slow down the process of losing my sight completely. Now I am trying to find a doctor who believes that marihuana will help slow the process of going blind. Unfortunately I live in a town that believes it is a sin and will persecute you to the fullest extent of the law. Will you please help me?

Dianne Atchison

I wish I could help, but there is nothing I can do. Furthermore, because the use of cannabis for any purpose at all is illegal in the state of Alabama, there is no physician who can help you find a way to use it legally. I hope this situation changes soon. In the meantime,

Sincerely yours,
Lester Grinspoon, M.D.

Please tell me if long-term marihuana use damages the liver as does long-term alcohol use.

Thank you.
Tammie

There is no evidence that long-term use of marihuana damages the liver.

Sincerely yours,
Lester Grinspoon, M.D.

I am wondering how the Mayo Clinic can say that marihuana causes breast enlargement and impotence in men. If you search their website (Oasis health magazine) for marihuana you will see. I have quoted studies that refute their statements, and they will not provide me with the studies that back their claims.

Can you shed some light on the Mayo Clinic's less than truthfulness? Or are all the other sources being untruthful? This is quite a problem for those who think the Mayo is never wrong.

In the early 1970s two Harvard surgeons reported that adolescent males who used cannabis were more likely to get breast enlargement, a phenomenon which naturally and temporarily occurs infrequently during this period of hormonal change. A very large study conducted by the U.S. Army refuted the claim, as has every other study of it since. The myth that marihuana causes impotence is no longer spread even by the government or the Partnership for a Drug-free America. I have no idea why the Mayo Clinic clings to these outdated ideas, but it surely is a shame that it lends its name to misinformation.

Sincerely yours,
Lester Grinspoon, M.D.

It is important that both you and your neighbor inform your physicians about the ways in which you find marijuana useful as a medicine. Physicians, who usually learn about new medicines from journals and drug house promotional activities, are gradually learning about the medicinal value of cannabis through their patients. Your physicians cannot do much for you where this problem is concerned, but you are in a position to help them learn something about this important medicine. Only with an informed medical establishment, can we hope to get the kind of legislation that will make it legally available to you and so many other patients who find cannabis more useful than conventional drugs.

Sincerely yours,
Lester Grinspoon, M.D.

I have read your Forbidden Medicine work and the historical use of cannabis for migraines as well as the current anecdotal data on your web site. However, I have not seen any reference to Marinol and migraines. As Marinol has been rescheduled at the federal level and is being rescheduled at the state level, do you have any knowledge of its benefits for the nausea, headaches, and frequency of migraines? Would physicians be able to prescribe Marinol for migraines even though it is not indicated for such use by the manufacturers?

Thanks so very much for your care and research on cannabis. I only hope that your medical colleagues will really listen and that we are finally in the darkest hour before the dawn.

Many people who suffer from migraine find cannabis useful. Of these, some find that Marinol is also effective. The only way for you to learn whether it would be useful to you it is to have a trial of Marinol. It may or may not do as well as whole smoked marihuana, but it will not harm you. Physicians have always had the authority to prescribe medicines off-label and your doctor could prescribe Marinol for the treatment of your migraine. One way or the other, I would be interested in a follow-up note.

Sincerely,

Lester Grinspoon, M.D.

Lester Grinspoon, M.D.

I’ve been a spinal cord injured c-5 quad. for 24 years. I’ve smoked pot all along. I’m convinced of the pain/spasticity/attitude-improving qualities of marihuana. Because I am paralyzed my problem is actually physically smoking. I have limited use of my hands/fingers. How can I safely smoke? I’ve heard of vaporizers. How do they work, where does one get one? Open flame is dangerous for a wheelchair user. On top of it all, my circumstances require discretion. How can I camouflage my equipment? These questions are of a practical nature, but without a way to administer marihuana, it can’t help.

1) Have you heard of medical uses for marihuana and fibromyalgia?

2) I have been prescribed Elavil to assist in getting better sleep. Are there any known interactions between Elavil and marihuana?

3) I was originally prescribed Klonopin for the fibro also, but found it too strong. If I eventually go back on it, are there any known interactions between Klonopin and marihuana? (From the reading I have done, this drug seems to have potential for having serious adverse reactions w/marihuana) Thank you for any information you can provide.

In answer to your first question, a number of patients have reported that marihuana is useful in the treatment of some of the symptoms of fibromyalgia. As for your other questions, I know of no interactions between cannabis and the tricyclic antidepressant Elavil or the benzodiazepine anti-anxiety drug Klonopin.

Lester Grinspoon, M.D.

I have been using hemp for several years as a relaxation and digestive aid. I suffer from Parkinson’s disease and related chronic pain. My stomach is about gone from so much Motrin. I recently got busted for 3 grams. Asked my regular doctor for a prescription. He told me he does not do that, but to look on the Internet for one. Any idea where I can obtain such a prescription? I have insurance and a complete medical history to fax to a M.D. who would be willing to review my case and consider writing such a prescription. I live in a very conservative state.

At this time it is not possible for physicians to write prescriptions for marihuana. About a half dozen states have passed initiatives which in one way or another allow patients to obtain cannabis legally if a doctor certifies the need for it. I hope that in the not-too-distant future, it will be easier for patients to use marihuana as a medicine.

Lester Grinspoon, M.D.

I have only just now learned about your book and website. I think your site and what you are doing is so very helpful. Thank you. I am also writing to you on several other accounts. I am a psychiatrist who is interested in the possible use of Marinol (now) and marihuana (ultimately) for individuals with bipolar disorder. I have personally used marihuana medicinally off and on for 20 years. It is the only thing that helps my nausea (anxiety related) and stops severe suicidal mood and obsessive, morose suicidal brooding that can last for days (for months once when I did not self-medicate at all). I have two lovely daughters and I am dating a nice man. I have a fulfilling private practice in psychiatry with an excellent clinical reputation. I have never been sued, and there are no complaints against me.

Recently someone unknown to me mailed me a package that a certain postal inspector discovered to contain marihuana. There are no legal charges against me, and the inspector’s behavior broke every law I know. He went to the Missouri State Board of Healing Arts, which is now considering whether to put me in a program for impaired physicians and undergo routine random drug screens. All of this is to be public knowledge. They haven’t bothered to check on my clinical performance, my reputation in the community, the opinion of any of my patients, or whether I am even impaired. After being ambushed at my office for a urine test, I went directly to my psychiatrist’s office. He sent me for a screen the same day, and it was negative, but that may not be good enough for the board. Would you be willing to perform a consultation/second opinion, possibly re the legality of my use of Marinol for my obsessive-compulsive disorder and bipolar disorder? I am, of course prepared to pay you for your services. My psychiatrist is very conservative, but I think he will consider any suggestion I make as long as my arguments are logical and documented by the literature and the proposed intervention is likely to help. You could help me by: (1) explaining to the State Board that I am an excellent physician, not impaired, and receiving Marinol for my bipolar disorder; (2) providing a brief psychiatric consultation, and discussing it with my psychiatrist. Could I get into a clinical research protocol? Could I run a clinical research trial in my private practice?

Thank you for taking the time to read this. The excerpts from your book were so helpful to me. The worst part of all this is feeling like a criminal.

I have consulted with this physician who suffers from bipolar disorder. I started her on Marinol, which follow-up reveals to be quite helpful to her. Unfortunately her psychiatrist is unwilling to continue to prescribe Marinol.

Lester Grinspoon, M.D.

Is it possible that marihuana could promote resistance to or some sort of immunity to the common cold? I have smoked steadily since age 15 (I’m 39 now) and have not had a cold since age 22, although I am constantly exposed to the virus. Also, I do not get the flu very often (maybe every 5 to 6 years), even when directly exposed.

Contact Info:

I have no reason to believe that marihuana promotes resistance to the common cold. If there were any evidence of that, it would certainly be easier to persuade the authorities that it should be legally available as a medicine.

Sincerely yours,
Lester Grinspoon, M.D.

Thank you for this web site and your compassion. In the midst of these powerful tales of human tragedy and courage, I send you my question with some trepidation. I hope you will not find it frivolous - please believe me when I tell you it is deeply, deeply important to me.

My beloved 16-year-old cat is undergoing chemotherapy for hepatic lymphoma. I am told it is likely that the cancer can be controlled if he can just endure the treatments. But he is severely depressed and refuses all food. He is literally wasting away in front of my eyes. If I can't get him some help it will be the starvation that kills him, and probably soon - he has lost over 30% of his body weight already. And it kills me to think that he is suffering with nausea, which I must believe he is. He is a strong cat, still fighting, and he lets me know daily that he is not ready to die yet, so I cannot bear to give up on him. There is a chance he can recover if only he could eat. Conventional veterinary medicines have not helped. From everything I’ve read it seems that my cat’s experience with chemotherapy is no different from that of many humans with this terrible disease. I believe that he could be helped by marihuana, just as people are. I would do anything for him. Please, please... do you know of any reports of veterinary use of marihuana? Can you tell me even where to start?

I will be indebted for any suggestions. I don’t think we have very long. Thank you for anything you can offer.

Very sincerely,
Jennifer Allen

Ps I live in Alaska so there are fewer hurdles to circumvent here if I can find someone willing to help me. Thank you.

Contact Info:

I don't know whether cannabis would have appetite-enhancing effects in a cat; one can never be sure of extrapolations from animals to humans and vice versa. Nonetheless, it is worth a try. Your major problem will be getting the cannabis into your cat. You might consult some of the many recipe books for cannabis and see if there is a recipe that might appeal to your cat. Cannabis can also be prepared as a suppository or in capsules. Veterinarians have ways of getting animals to take medicines in capsule and other forms; it might be wise for you to consult a veterinarian on that issue.

Sincerely yours,
Lester Grinspoon, M.D.

I want to know what would be the best way to introduce someone who is terminally ill to the benefits of medical marihuana. My close friend was diagnosed with breast cancer and underwent chemotherapy. She was in remission for some time, but recently she wasn’t feeling too good, went to the doctor, and was told that the cancer was back and has spread to her liver, spine, and brain. My dear friend has such a love for life, and is living her final days in enjoyment with friends and family. Even though she is expected to pass away shortly, she is starting to experience pain and an upset stomach. I personally know the benefits of medical marihuana, and I know what a help it is to my medical condition.

Our government has been so successful at brainwashing everyone into thinking marihuana will ruin your life, and has no use except to intoxicate a person, that is so difficult to introduce an individual to marihuana. I am afraid that I will run into this problem when asking if she would be willing to try marihuana for a short-term experiment to override her symptoms. Thank you for your advice!

Contact Info:

Your friend resembles a patient discussed in the Revised and Expanded edition of Marihuana, the Forbidden Medicine, page 222; I suggest that you look at this case and use it as a model when you discuss the matter with your friend.

Sincerely yours,
Lester Grinspoon, M.D.

I started smoking pot when I went to college. I loved it and instantly became a connoisseur. In January of 1998 I suffered a traumatic brain injury. I have been doing well, but one thing always nagged me at the back of my head: what about bud? Was it OK now with my TBI? I took a chance and started smoking again. My grades have not suffered like Uncle Sam says. It actually makes me more focused, for some reason I cannot explain.

I have no direct experience of the use of cannabis by patients with traumatic brain injuries. However, an analog of tetrahydrocannabinol called dexanabinol has recently been developed specifically for the treatment of stroke and brain syndrome. Researchers have also shown that tetrahydrocannabinol and cannabinol, two constituents of marihuana, have antioxidative properties that are helpful to people with brain trauma. Therefore I do not think that you are taking much of a chance, especially if marihuana helps you to be more focussed.

Sincerely yours,
Lester Grinspoon, M.D.

My mother has advanced cancer colon cancer that has metastasized to her lungs. Eating makes her sick to her stomach, and she is wasting away. I understand marihuana can help her get an appetite. We live in Ohio where I don’t think it has been approved for medical use. Further, I don’t think she could smoke it, because she hasn’t smoked a day in her life. Please give me a suggestion on what we can do.

Contact Info:

Your situation is remarkably similar to that of a California man, Fred Hermon, whose account appears on page 222 of the Revised and Expanded edition of Marihuana, the Forbidden Medicine (Yale University Press, 1997). His mother was dying of cancer and unable to eat. He managed to help her smoke, and it made an enormous difference. She shortly gained 10 pounds and was able to work in her garden again.

Sincerely yours,
Lester Grinspoon, M.D.

I have been diagnosed with Menière's disease, which causes multiple physical problems. This disease is tremendously misdiagnosed by doctors and slowly takes your life away. The severe vertigo attacks and nausea make even walking to your mailbox a frightening ordeal. I use marihuana to control my nausea and severe abdominal pain. I live in Oregon, where we have finally allowed medical use, but I have no idea how to find a physician who is willing to prescribe it for me. Can you offer any ideas on where to start looking or who to ask here in Oregon?

Thank you, Sharon

Contact Info:

You are not the first person who has reported that cannabis is useful in the symptomatic treatment of Menière's disease. I suggest you contact Dr. Rick Mayer at 877-600-6767; he is a physician who played an important role in getting the Oregon initiative passed. If he can't help you himself, he will certainly know of physicians who can.

Sincerely yours,
Lester Grinspoon, M.D.

I am a resident of Oregon and wish to obtain a prescription for medical marihuana due to chronic pain. How can I find out which doctors are sympathic and are actually writing valid prescriptions?

Contact Info:

Please see my answer to Ms. McCarthy above.

Sincerely yours,
Lester Grinspoon, M.D.