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March 15, 2007

Pharmaceutical versus ‘natural’ sleep

I can’t recall a time since 1995, when I bought my first computer, joined the drug policy reform movement and became a news junkie that there have been so many news items reflecting the absurdity of our war on drugs. All that’s required to appreciate the irony is relating some of them to the kind of  insider information pot users have provided me over the last five years.

For example, it was announced on TV last evening that a man had been arrested for driving while asleep and there are  a number of news and blog items about the FDA seeking warnings  for some of the new sleep aids, like zolpidem (Ambien) and eszopiclone (Lunesta), which may not be all that safe.  In order to fully appreciate the implicit irony, one also has also to remember that insomnia, was derided as a serious symptom by Barry McCaffrey  right after it was listed as a condition treated by cannabis in 1996. Despite McCaffrey’s skepticism, sleep deprivation is increasingly considered a major cause of morbidity in our go-go modern world, and  also thought to be fairly frequent cause cause of late afternoon auto crashes.  So much for the general’s medical judgement.

 Insomnia is also the second most cited medical benefit pot affords my applicants, right after relief of ‘stress and anxiety.’ Although they don’t often volunteer that information, almost 90%, readily admit to insomnia if questioned about whether they use pot for sleep.

How does it facilitate sleep? The mechanism seems disarmingly simple: its rapid and predictable anxiolytic (literally ‘anxiety dissolving’) effect diminishes anxiety just long enough for fatigue to take over. Much insomnia seems generated by worry over  things that happened earlier in the day, or uncertainty over might happen tomorrow. It’s quite clear that for many cannabis users, at least, the non-specific ‘relaxing’ effect of cannabis is all that’s required for a night of restful sleep. I’ve heard that scenario enthusiastically confirmed by far too many chronic users over the past few years to question its validity.

There is also a substantial minority of chronic users (perhaps 10%) who find that when used close to bedtime, it has an opposite effect; it acutely stimulates their thought on a variety of subjects to the point where they have trouble falling asleep. However, cannabis is also extremely versatile; if they hadn’t learned to avoid using it shortly before bedtime and continued using it for its other perceived benefits, they probably wouldn’t have been seeing me for a recommendation.

Doctor Tom

Posted by tjeffo at March 15, 2007 05:55 PM