epilepticme
08-18-2008, 04:56 PM
More and more people are finding themselves able to kick sometimes long-term, damaging and expensive alcohol habits without any of the uncomfortable symptoms of withdrawal which normally comes with long-term addictions, and they are doing it thanks to cannabis.Ninety-two Northern Californians using cannabis as an alternative to alcohol obtained letters of approval from the author - Physician Tod Mikuriya MD.
Their records were reviewed to determine characteristics of the cohort and efficacy of the treatment ??defined as reduced harm to the patient.
All patients reported benefit, indicating that for at least a subset of alcoholics, cannabis use is associated with reduced drinking.
The cost of alcoholism to individual patients and society- at-large warrants testing of the cannabis-substitution approach and study of the drug-of-choice phenomenon.
INTRODUCTION
Physicians who treat alcoholics are familiar with the cycle from drunkenness and disinhibition to withdrawal, drying out, and apology for behavioral lapses, accompanied over time by illness and debility as the patient careens from one crisis to another. (Tamert and Mendelsohn 1969)
??Harm reduction? is a treatment approach that seeks to minimize the occurrence of drug/alcohol addiction and its impacts on the addict/alcoholic and society at large.
A harm-reduction approach to alcoholism adopted by 92 of my patients in Northern California involved the substitution of cannabis ??with its relatively benign side-effect profile?? as their intoxicant of choice.
No clinical trials of the efficacy of cannabis as a subtitute for alcohol are reported in the literature, and there are no papers directly on point prior to my own account (Mikuriya 1970) of a patient who used cannabis consciously and successfully to reduce her problematic drinking.
There are ample references, however, to the use of cannabis as a substitute for opiates (Birch 1889) and as a treatment for delirium tremens (Clendinning 1843, Moreau 1845), which were among the first uses to which it was put by European physicians.
Birch described a patient weaned off alcohol by use of opiates, who then became addicted and was weaned off opiates by use of cannabis. ??Ability to take food returned. He began to sleep well; his pulse exhibited some volume; and after three weeks he was able to take a turn on the verandah with the aid of a stick.
After six weeks he spoke of returning to his post, and I never saw him again.?
Birch feared that cannabis itself might be addictive, and recommended against revealing to patients the effective ingredient in their elixir.
??Upon one point I would insist ??the necessity of concealing the name of the remedial drug from the patient, lest in his endeavor to escape from one form of vice he should fall into another, which can be indulged with facility in any Indian bazaar.?
This stern warning may have undercut interest in the apparently successful two-stage treatment he was describing.
At the turn of the 19th century in the United States, cannabis was listed as a treatment for delirium tremens in standard medical texts (Edes 1887, Potter 1895) and manuals (Lilly 1898, Merck 1899, Parke Davis 1909).
Since delirium tremens signifies advanced alcoholism, we can adduce that patients who were prescribed cannabis and used it on a longterm basis were making a successful substitution.
By 1941, due to prohibition, cannabis was no longer a treatment option, but attempts to identify and synthesize its active ingredients continued (Loewe 1950).
A synthetic THC called pyrahexyl was made available to clinical researchers, and one paper from the postwar period reports its successful use in easing the withdrawal symptoms of 59 out of 70 alcoholics. (Thompson and Proctor 1953).
In 1970 the author reported (op cit) on Mrs. A., a 49-year-old female patient whose drinking had become problematic.
The patient had observed that when she smoked marijuana socially, on week-ends, she decreased her alcoholic intake.
She was instructed to substitute cannabis any time she felt the urge to drink. This regimen helped her to reduce her alcohol intake to zero.
The paper concluded, ??It would appear that for selected alcoholics the substitution of smoked cannabis for alcohol may be of marked rehabilitative value.
Certainly cannabis is not a panacea, but it warrants further clinical trial in selected cases of alcoholism.?
The warranted research could not be carried out under conditions of prohibition, but in private practice and communications with colleagues I encountered more patients like Mrs. A. and generalized that somewhere in the experience of certain alcoholics, cannabis use is discovered to overcome pain and depression ??target conditions for which alcohol is originally used?? but without the disinhibited emotions or the physiologic damage.
By substituting cannabis for alcohol, they can reduce the harm their intoxication causes themselves and others.
Although the increasing use of marijuana starting in the late ??60s had renewed interest its medical properties ??including possible use as an alternative to alcohol (Scher 1971)?? meaningful research was blocked until the 1990s, when the establishment of ??buyers clubs? in California created a potential database of patients who were using cannabis to treat a wide range of conditions.
The medical marijuana initiative passed by voters in 1996 mandated that prospective patients get a doctor??s approval in order to treat a given condition with cannabis ??resulting in an estimated 30,000 physician approvals as of May 2002. (Gieringer 2002) Just a year later, the estimate stands at abut 50,000.
In a review of my records in the spring of 2002 by Jerry Mandel, PhD, 92 patients were identified as using cannabis to treat alcohol abuse and related problems. This paper describes characteristics of that cohort and the results of their efforts to substitute cannabis for alcohol.
CLICK (http://ccrmg.org/journal/03sum/substitutealcohol.html) to read the full, fascinating paper.
Their records were reviewed to determine characteristics of the cohort and efficacy of the treatment ??defined as reduced harm to the patient.
All patients reported benefit, indicating that for at least a subset of alcoholics, cannabis use is associated with reduced drinking.
The cost of alcoholism to individual patients and society- at-large warrants testing of the cannabis-substitution approach and study of the drug-of-choice phenomenon.
INTRODUCTION
Physicians who treat alcoholics are familiar with the cycle from drunkenness and disinhibition to withdrawal, drying out, and apology for behavioral lapses, accompanied over time by illness and debility as the patient careens from one crisis to another. (Tamert and Mendelsohn 1969)
??Harm reduction? is a treatment approach that seeks to minimize the occurrence of drug/alcohol addiction and its impacts on the addict/alcoholic and society at large.
A harm-reduction approach to alcoholism adopted by 92 of my patients in Northern California involved the substitution of cannabis ??with its relatively benign side-effect profile?? as their intoxicant of choice.
No clinical trials of the efficacy of cannabis as a subtitute for alcohol are reported in the literature, and there are no papers directly on point prior to my own account (Mikuriya 1970) of a patient who used cannabis consciously and successfully to reduce her problematic drinking.
There are ample references, however, to the use of cannabis as a substitute for opiates (Birch 1889) and as a treatment for delirium tremens (Clendinning 1843, Moreau 1845), which were among the first uses to which it was put by European physicians.
Birch described a patient weaned off alcohol by use of opiates, who then became addicted and was weaned off opiates by use of cannabis. ??Ability to take food returned. He began to sleep well; his pulse exhibited some volume; and after three weeks he was able to take a turn on the verandah with the aid of a stick.
After six weeks he spoke of returning to his post, and I never saw him again.?
Birch feared that cannabis itself might be addictive, and recommended against revealing to patients the effective ingredient in their elixir.
??Upon one point I would insist ??the necessity of concealing the name of the remedial drug from the patient, lest in his endeavor to escape from one form of vice he should fall into another, which can be indulged with facility in any Indian bazaar.?
This stern warning may have undercut interest in the apparently successful two-stage treatment he was describing.
At the turn of the 19th century in the United States, cannabis was listed as a treatment for delirium tremens in standard medical texts (Edes 1887, Potter 1895) and manuals (Lilly 1898, Merck 1899, Parke Davis 1909).
Since delirium tremens signifies advanced alcoholism, we can adduce that patients who were prescribed cannabis and used it on a longterm basis were making a successful substitution.
By 1941, due to prohibition, cannabis was no longer a treatment option, but attempts to identify and synthesize its active ingredients continued (Loewe 1950).
A synthetic THC called pyrahexyl was made available to clinical researchers, and one paper from the postwar period reports its successful use in easing the withdrawal symptoms of 59 out of 70 alcoholics. (Thompson and Proctor 1953).
In 1970 the author reported (op cit) on Mrs. A., a 49-year-old female patient whose drinking had become problematic.
The patient had observed that when she smoked marijuana socially, on week-ends, she decreased her alcoholic intake.
She was instructed to substitute cannabis any time she felt the urge to drink. This regimen helped her to reduce her alcohol intake to zero.
The paper concluded, ??It would appear that for selected alcoholics the substitution of smoked cannabis for alcohol may be of marked rehabilitative value.
Certainly cannabis is not a panacea, but it warrants further clinical trial in selected cases of alcoholism.?
The warranted research could not be carried out under conditions of prohibition, but in private practice and communications with colleagues I encountered more patients like Mrs. A. and generalized that somewhere in the experience of certain alcoholics, cannabis use is discovered to overcome pain and depression ??target conditions for which alcohol is originally used?? but without the disinhibited emotions or the physiologic damage.
By substituting cannabis for alcohol, they can reduce the harm their intoxication causes themselves and others.
Although the increasing use of marijuana starting in the late ??60s had renewed interest its medical properties ??including possible use as an alternative to alcohol (Scher 1971)?? meaningful research was blocked until the 1990s, when the establishment of ??buyers clubs? in California created a potential database of patients who were using cannabis to treat a wide range of conditions.
The medical marijuana initiative passed by voters in 1996 mandated that prospective patients get a doctor??s approval in order to treat a given condition with cannabis ??resulting in an estimated 30,000 physician approvals as of May 2002. (Gieringer 2002) Just a year later, the estimate stands at abut 50,000.
In a review of my records in the spring of 2002 by Jerry Mandel, PhD, 92 patients were identified as using cannabis to treat alcohol abuse and related problems. This paper describes characteristics of that cohort and the results of their efforts to substitute cannabis for alcohol.
CLICK (http://ccrmg.org/journal/03sum/substitutealcohol.html) to read the full, fascinating paper.