Posted by kitty-layne on November 13, 2001, at 21:43:01
In reply to Re: ANY ad's and weed, posted by sar on November 13, 2001, at 0:33:25
I'm always bemused by people's claims that cannabis/THC has a place in psychiatry. I admit that I have self-medicated with it to the extent of daily use, and to a certain degree it works. It improves my mood, makes me more sociable and improves certain kinds of anxiety (though it worsens others). On the other hand, it makes me slow, confused, sedated, suspicious, stupid, wrecks my short-term memory and once provoked a mild episode of paranoia which didn't subside until I'd given up for a few weeks. Others I have spoken to report a dry mouth. Some of the other effects could be seen as negative. The hallucinogenic effects, for example (although these are usually just perceptual changes, ie. derealization rather than full-blown hallucinations and probably wouldn't be noticeable after a week at a low-moderate dose); the munchies; the abuse potential. Tolerance to some of the effects seems to occur, but personally I find that it is very hard to achieve the positive effects without more sedation and confusion than I can cope with while performing relatively complex tasks. Even at very low doses (eg. smokin' up before visiting the pdoc) I notice these two side effects, without strongly feeling the positive effects. Also, the effects are quite short lived, so doses would have to be taken several times a day.
Its use to treat anxiety seems dubious. Some, including me, find it useful for social anxiety. Many do not. Some even claim to feel more anxious. Many people experience mild paranoid thinking/strong suspiciousness or anxiety reactions (surely the fact that these common phenomenon are known as "the fear" should put people off?). I find that "the fear" can sometimes overwhelm the relaxing effects. I also find myself more anxious in other ways, worried about deadlines, that my family/friends are going to die/leave me, and about events in the future. Panic reactions are often reported in medical literature, though I have never known anyone to experience them. I suspect this is something that only happens to beginners who get _REALLY_ stoned and are unnerved by the hallucinogenic effects, and is a psychological rather than neurochemical problem, but I don't know.
I would argue against the use of cannabis/THC to treat depression. It tends to improve the mood for a couple of hours after a reasonable dose has been taken, and is helpful if one suffers from insomnia or loss of appetite, but it also tends to decrease motivation, concentration and energy. I sometimes feel euthymic but I know I'm still depressed. Tolerance definately occurs to the improvement in mood.
One of the things that interests me most about cannabis is that it increases the intensity of emotion. I feel flat and uninterested normally, but when I'm stoned, my feelings are more like they were when I was a child. I find I can enjoy things like films or music, and I can feel enthusiastic about things which I like. If only I could achieve this effect on its own somehow, my life would be far more meaningful and enjoyable. I have taken no other drugs that have this anti-anhedonic (no, I don't suppose that's a real word either) effect/sharpening of affect. Perhaps some sort of cannabinoid-related drug could be synthesised that had this effect without the undesirable side-effects. This would probably combine quite well with the SSRIs ;-)
IMO the limited efficacy of weed/THC, the side-effects (which are usually stronger than the therapeutic effects) and the abuse potential mean that it probably isn't effective enough to be used in psychiatry. I'm interested to see what other people think. Maybe in rare cases where no other treatment is tolerable/effective, or at low doses in combination with other drugs, it might be useful. Or, other cannabinoids could possibly be more effective. Otherwise, IMO, we should stick to using it as a mild and relatively safe recreational drug (unless of course it's illegal in your country- I'm have to say that, don't I? Don't we have freedom of speech?).
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--kitp.s. I am perfectly willing to accept that my understanding of the effects and potential usage of cannabis/THC may have been strongly affected by the fact that I have regularly taken doses much larger than would ever be used in psychiatry, in the same way that someone who has extensively used/"abused" amphetamines in high doses would probably not believe that they could be used therapeutically.
poster:kitty-layne
thread:84006
URL: http://www.dr-bob.org/babble/20011113/msgs/84163.html