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ADHD and Medical Marijuana

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In recent interviews, several doctors in the Bay Area who prescribe medical marijuana for their patients discussed the growth of their practice to include adolescents suffering from psychiatric disorders like attention deficit hyperactivity disorder.

Two dozen adolescents are registered clients of the Wo/Men’s Alliance for Medical Marijuana, a patients’ collective in Santa Cruz. “It’s not everybody’s medicine, but for some, it can make a profound difference,” said Valerie Corral, one of the collective’s founders.

No accurate data is available regarding the number of minors permitted to receive medical marijuana in California because doctors are not required to record cases involving medical marijuana. However, the founder of MediCann in Oakland, California, Dr. Jean Talleyrand, claims that his team has successfully treated as many as 50 adolescents and young adults with attention deficit hyperactivity disorder (A.D.H.D.) using the medicine.

Medical professionals in the Bay Area have been at the forefront of the heated discussion over medical marijuana, helping to gain acceptance for patients suffering from terminal diseases like cancer and AIDS. However, support for using medical marijuana to treat teenagers with attention deficit hyperactivity disorder (A.D.H.D.) may become more difficult to summon, even in this context, as doctors become more permissive with their discretion.

Stephen Hinshaw, chairman of the psychology department at the University of California, Berkeley, asked, “How many ways can one say ‘one of the worst ideas of all time?’ ” He referenced research suggesting that T.H.C., the psychoactive component of marijuana, impairs cognition even further in those with attention deficit hyperactivity disorder (A.D.H.D.).

Supporters are equally steadfast, despite being in the minority. “It’s safer than aspirin,” Dr. Talleyrand remarked. Moreover, he and other marijuana supporters argue that the drug is much less dangerous than methylphenidate (Ritalin), the most common prescription stimulant for treating attention deficit hyperactivity disorder (A.D.H.D.). Possible adverse reactions to that medication include sleeplessness, melancholy, facial tics, and short stature.

California became the first state to allow medical marijuana when voters adopted Proposition 2 in 1996. However, only California allows marijuana “for any other illness for which marijuana provides relief.” Twelve other states have followed suit, authorizing cannabis for many defined, severe conditions like cancer and AIDS.

Because of this, doctors ready to “recommend” cannabis have a lot of discretion, which some utilize recklessly (in the Alice in Wonderland world of medicinal marijuana, they cannot legally prescribe it). “You can get it for a backache,” said Keith Stroup, who started the National Organization to Reform Marijuana Laws.

However, even among physicians who approve of medical marijuana, growing its use among young people is problematic.

The doctor in Sausalito, Gene Schoenfeld, stated, “I wouldn’t do it for anyone under 21 unless they have a life-threatening problem such as cancer or AIDS.”

“It’s detrimental to adolescents who chronically use it,” Dr. Schoenfeld continued, “and if it’s being used medically, that implies chronic use.”

National Institute on Drug Abuse director Dr. Nora D. Volkow expressed concern about the potential for addiction, noting that this was already an issue for the youth and those with ADHD.

Though it goes against common sense, some patients and doctors have found relief from the stress and irritability associated with A.D.H.D. by using marijuana. According to the Centres for Disease Control and Prevention, more than 4.5 million children in the United States have been diagnosed with the condition.

For those with a family history of mental illness, adolescent marijuana usage has been related to an elevated risk of psychosis and schizophrenia. According to a study published in Schizophrenia Research 2008, however, teenage marijuana users with schizophrenia had a decreased risk of developing mental health issues than nonusers.

Dr. Edward M. Hallowell, a psychiatrist, and author of multiple books on A.D.H.D., has called marijuana “a godsend” for some patients. But Dr. Hallowell says he warns his patients against using it, not only because it’s illegal in most places, but also because “it can lead to a syndrome in which all the person wants to do all day is get stoned, and they do nothing else.”

Patients under the age of 18 who are seeking a medical marijuana recommendation must have a parent or legal guardian accompany them to both the doctor’s office and the dispensaries. However, some doctors who were interviewed assumed that parents brought their kids along in the first place so they could get their kid’s medical authorization to avoid having to acquire medications illegally.

More than 40% of high school pupils in recent research by the University of Michigan used marijuana.

“I don’t have a problem with that, as long as we can have our medical conversation,” Dr. Talleyrand said, adding that patients must bring medical records to be seen by his doctors.

According to Candis Cohen, a board spokesman, an investigation into Dr. Talleyrand began in the spring after a KGO-TV story exposed questionable activities at MediCann clinics, which the report claimed had grossed at least $10 million in five years.

Not just Dr. Talleyrand and his team are open to recommending marijuana to youngsters. For example, when Dr. Frank Lucido in Berkeley approved marijuana for a 16-year-old adolescent with attention deficit hyperactivity disorder (A.D.H.D.) who had tried Ritalin unsuccessfully and was accumulating a record of minor arrests, he was questioned by the medical board but ultimately not reprimanded.

He added that the boy’s grades improved, and he was voted class president in special education within a year of starting the new treatment. To his mother, he proudly proclaimed, “My brain works.” “I can think,” Dr. Lucido declared.

“You weigh the benefits against the risks with any medication,” he noted.

Patients who qualify for MediCann and are granted permission must sign a form warning them of the drug’s risks. These risks include “mental slowness,” memory issues, nervousness, confusion, “increased talkativeness,” a fast heartbeat, difficulty performing complex activities, and hunger. “Some patients can become dependent on marijuana,” the firm warns.

The issue over medicinal marijuana has been revived by recent hints from the White House of increasing federal tolerance for state medical marijuana laws, which specifically exclude sales to minors.

Some proponents, like Dr. Lester Grinspoon, associate professor emeritus of psychiatry at Harvard University, argue that the negative connotation attached to medical marijuana stems more from its cultural link with illicit pleasure and addiction than from any doubts about its clinical value.

Some, like California Assembly Majority Leader Alberto Torrico of Fremont, advocate for stricter regulations. “The marijuana is a lot more powerful these days than when we were growing up, and too much is being dispensed for nonmedical reasons,” he said in an interview last week, adding, “Any children being given medical marijuana is unacceptable.”

The dispensaries’ lighthearted vibe may make it difficult for advocates of more tolerance to make their case.

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