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May 07, 2013

ADD: Misunderstood, but Nonethless Real

As often pointed out in this blog, I had little knowledge of "marijuana" when I began taking histories from Californians seeking to use it legally under the protection of Proposition 215 in 2001. Without going into tedious detail, the "medical marijuana" phenomenon has also shown amazing durability in the US since 1996, a fact of curiously little interest to federal politicians or the "mainstream" media.

A major reason for that suppressed interest may be that once one could be officially labeled a felon and incarcerated for daring to self-medicate with cannabis, it became too shameful/costly for most users to discuss openly. In striking contrast, drinkers defying the Eighteenth Amendment were never arrested as felons or labeled "drug addicts," nor have smokers maintaining their nicotine addiction with cigarettes ever been stigmatized as criminals. Quite the opposite; Bond and Hammer, the fictional heroes made famous on both sides of the Atlantic by Ian Fleming and Mickey Spillane were both avid cigarette smokers who could handle their favorite liquor with aplomb and no loss of deadly efficiency.

Think also, of what might have happened to Laura Bush or Barack Obama had cigarette use been made a crime. FDR, a notorious chain smoker himself, signed Harry Anslinger's Marijuana Tax Act into law in 1937 without comment, while "Uncle Walt" Disney, who died of lung cancer on his 65th birthday, has somehow managed to have cigarettes posthumously air brushed out of almost all surviving photos.

Finally, patients tend to trust doctors with information they wouldn't consider telling anyone else. Perhaps not all doctors; but at least some of us. From the beginning, I've treated pot applicants as patients, an approach that seems to work with most.

Be that as it may, what I'm most interested in at this critical juncture is describing the connection I've uncovered between cannabis and an increasingly common- but still terribly misunderstood- condition known as ADD, or "Attention Deficit Disorder."

No, cannabis doesn't cause ADD; rather it mitigates its symptoms quite effectively when consumed in appropriate doses, a complex issue because of the ignorance imposed on all by a ridiculous policy. But that's another matter.

To be stressed at this juncture is that ADD is a syndrome, as opposed to a disease because there's no characteristic biopsy or laboratory test. It's really a cluster of characteristic behaviors that can be seen in both children and adults. In my opinion, the critical mechanism responsible for those behaviors has yet to be recognized despite the increasing attention ADD has been receiving for over forty years.

Ironically, being allowed (required) to question the steady stream of applicants I began seeing at a busy Oakland "pot club" about their use of a criminal drug is what opened my eyes to the fact that they were self-medicating. Not that they understood it themselves; an important clue was learning that significant numbers had been diagnosed as having ADD and treated with Ritalin in primary school. Following that key revelation, a series of light bulbs went on one after the other: ADD is a pediatric anxiety syndrome that frequently persists into adult life. Depending on severity, it can range from a minor nuisance to a serious state of chronic rage or anxiety encouraging hostile behaviors ranging up to homicide and/or suicide by those severely affected.

A final thought I want to leave behind (but plan to return to frequently in the future) is that ADD begins with children missing the presence- either actual or perceived- of their biological fathers over some critical interval between sentience and puberty. Why daddy is absent seems far less important to the child than the fact that he's not there when needed. The consequences of such paternal deprivation can range from mild to severe and, most importantly: can be significantly mitigated by cannabis.

Thus the search for daddy has dominated both my history taking and collateral research for several years. The increasing depth of biographical coverage through search engines has added a dimension that is very helpful and together with accumulated patient data, has given me enough material to last a (literal) lifetime.

Doctor Tom

Posted by tjeffo at May 7, 2013 07:02 PM