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November 22, 2007

Focusing and Getting High: A key relationship. (Clinical, Legal, Historical)

Whether considered from the standpoint of optics, geometry, or cognition, “focus” involves bringing attention to bear on a central point. As a practical matter, most humans can only focus comfortably on  one image or thought at a time; so much so, that one can easily understand how a child’s powerful impulse to investigate several stimuli at once could be both distracting to him and a distraction for those around him.

 It’s precisely that pattern of behavior that many of the young male pot users treated for ADD in school over the past twenty five years are now able to recognize in themselves. Rather than boredom or inattention, ADD may be better understood as representing a fear of missing something: in essence, a pediatric anxiety syndrome characterized by the child’s chronically heightened awareness and the frustration produced by his rapidly shifting attention and list of unfinished assignments.

That anxiety seems expressed somewhat differently when the same children become young adults. At that point, it seems to be more a concern over having too much to do; one that can turn them into frazzled multitaskers. They are also the same  patients who have discovered that a few morning tokes can provide just enough relief for them to make a list and thus become more efficient.  

There are several directions I could go from here in attempting to clarify what may already sound like heresy to the DEA: inhaled pot became popular with troubled adolescents in the mid-Sixties precisely because it was a reliable anxiolytic that can also be easily controlled by experienced users.  In that context, it may be most helpful to consider what  getting high” actually means.

Following pot's discovery by juveniles in the late Sixties, a ritual quickly developed for trying it, usually with friends or older siblings, that was akin to those already observed by first-time users of alcohol and, to a lesser extent, tobacco.  Also; comparison of the ages at which pot applicants were trying all three agents reveals that within a few years of its introduction to the teen market, pot was being tried at the same age as the other two agents.  Consumption of alcohol to the point of intoxication, often accompanied by vomiting, is almost routine. For cigarettes, the “head rush” felt when nicotine is first inhaled is a simpler end point. For pot it's a more complex and subtle dual process; the first part is registering the very rapid anxiolytic effect of inhaled cannabinoids and the second is becoming able to recognize and control it by toking. Because it's so subtle, at least 40 percent of  initiates didn’t "get high" until their second or even third attempts. Most experienced users will then usually describe the feeling simply as “relaxing,” but a more helpful description is that
almost immediately following the first toke, "the world suddenly becomes a nicer place.”

Once a user has been high, the ability to recognize that feeling becomes the key to its precise control. It's really the point at which one stops toking that ends a session. In essence, knowledge that one is “high” is what allows pot’s anxiolytic effect to become a guide to dosage. When a session is over; usually within an hour and a half,  the user can either  light up again or wait until later. What’s clear from interviewing thousands is that nearly all chronic users have developed consistent schedules and techniques for dealing with a range of individual symptoms. Employing those techniques involves several factors, including their own experiences, personal beliefs about drug use, and fear of having that use exposed.

Given its plethora of complex effects, the varying uninformed opinions about its use and the amount of "scientific" misinformation that's been promulgated over the past four decades, the highly variable, yet strikingly similar patterns of use employed by its illegal users is seen as  powerful evidence that cannabis is being used safely and effectively for self-medication; undoubtedly by a larger fraction of the American public than has been realized.

Also, our vain attempts  to repress that use over the same interval may well have kept us ignorant of its many benefits far longer than was necessary and done far more damage than we  realized.

Doctor Tom

Posted by tjeffo at November 22, 2007 04:35 AM