Dear Dr. Grinspoon,

I am a 40 year old male who is slowly recovering from a viral attack which has left me with permanent nerve damage and spasticity and involuntary hand movement. I require two canes to walk largely because of the spasticity. Given the variety of marijuana available, and the options of smoking or eating, how can I find out which  combination has been successful in dealing  with spasticity, so as to give it a fair chance of working for me?.

Thanks,
Anonymous

Dear Anonymous,

There is a great deal of interest in the possibility that different strains of cannabis have qualities that are e particularly useful for the treatment of certain symptoms or syndromes. However, this work is not sufficiently advanced to be of any practical use to you.  To find a r strain that is especially helpful for you,, you will have to rely on trial and error.

Sincerely yours,
Lester Grinspoon MD

Dr. Grinspoon,

 My husband and I have been trying to get pregnant for a year and a half using a fertility awareness method.  So far, nothing.  We are both daily smokers and have been so for the past 5 years.  Do you think marijuana has adversely affected my reproductive organs?

-Anonymous

Dear Anonymous,

 There is no compelling medical evidence to suggest that your fertility problems are a consequence of your use of cannabis.

 Sincerely yours,
Lester Grinspoon MD

Dear Doctor,

I have multiple sclerosis and am looking for a strain that would be best for me.  I can grow indoor plants and would like to find a strain that is good for CNS disorders such as MS.  I am confined to a chair and cannot walk.  I am in pain constantly.  However, I do not want to feel groggy and sedated.  I would like to feel clear and uplifted. 

Any suggestions would be greatly appreciated,

Dolores

Dear Dolores

Researchers are now trying to determine which strains of cannabis are best for particular medical needs.  However, I suspect it will be some time before this work ripens to the point where patients can make use of it.  Beyond identifying strains which are especially useful for particular symptoms, there are, as you know, many legal hurdles to overcome.  In the meantime, you can experiment on your own to find the strain that seems to suit you best. 

 Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I am a marijuana user and I have heard that harmful side effects can occur from smoking the stems.  Now I keep the stems and use them for tea.  I was wondering if the rumors about smoking stems are true and if there are any problems from using the stems to make tea.  Thank you, you do a wonderful service. 

Sincerely,
Clark Hill

Dear Mr. Hill,

The stems contain very little of the cannabinoids, the therapeutically useful substances in the marijuana plant.  Therefore, to smoke stems is to expose your lungs to the smoke for little gain.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon;

I realize that you are a busy man and likely receive numerous solicitations on this site every day, and understand that you cannot answer every query.  However, I am unable to get any information regarding my particular situation and must re-submit my case to you, as things have deteriorated since first presenting my questions to you. I will try to be brief in the hope that you will be able to give me some direction, as my doctor is unwilling to discuss marijuana at all.

I am a habitual user of marihuana of many years, self-medicating for the purpose of mood stabilization and alleviation of insomnia.  Without regular use, I suffer chronic bouts of severe depression and anxiety, and rarely sleep more than 2 or 3 hours a day.

My problem, however, is that with increasing regularity, smoking marijuana has had very troubling results.  After smoking even trifling amounts of marijuana, I almost immediately begin to develop the following symptoms:

• sustained rapid heart rate(last night after three small 'hits' from a joint, I timed my heart rate at 140bpm for half an hour at a steady rate)

• tightness in  my chest and throat

• increased anxiety(though without any focus, i.e. as in an anxiety attack)

• massive gastric distress (as if I have serious indigestion, it manifests itself through near constant and sometimes painful belching)

• chills and uncontrollable shivering.

These symptoms, as I said, manifest nearly immediately after smoking, and vary in duration and severity seemingly dependent upon the quantity and quality of the marijuana I use.  I am reticent to use prescribed chemicals to control my depression (Zoloft and Prozac make me feel altogether unstable) and nothing else helps me sleep.  I have been tested for the presence of ulcers (which symptoms my doctor has described as similar to those above) and GERD [gastroesophageal reflux disorder] (likewise) but both with negative results.

As I mentioned, my physician is unwilling to discuss marijuana use in any way ('If it makes you feel bad, don't use it.'), but I feel that there must be more information than this at your disposal.  Any help or insight you might offer would be greatly appreciated.

Thank you for your time and consideration.
William Burgess

Dear Mr. Burgess,

I am afraid that I cannot be of much help to you.  An increase in the heart rate invariably accompanies the smoking of marijuana; however, this tachycardia is usually transient and not particularly bothersome. Anxiety in inexperienced users sometimes occurs, but something resembling a generalized anxiety disorder appearing after years of use is unusual.  I have never seen a patient who suffers from chills after smoking, but it is said that this does occur rarely.  I am at a loss to explain the other symptoms, but given their regular appearance, I concur with your doctor's advice.

  Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

Five years ago I went in for what I thought was going to be routine Reflux surgery. I turned out to be anything ... but while doing the Nissan Wrap the surgeon did not insert the bogie(sp?) & when he tightened up the stitches it cinched my esophagus up like the drawstring on a plastic garbage bag. It is also believe that my vagal nerve was either severed or the blood & oxygen supply was compromised during this surgical mishap ... which either way diminished its ability to function properly.

After the surgery I could not swallow anything. Not even water. A barium swallow test revealed that I had less than a 1cm opening from my esophagus to my stomach. I lost 60lbs. within the next 30 days & was only kept alive by my family doctor with daily vitamin shots.

After two more surgeries to try & fix the problems sustained during the first surgery the new surgeon was able to give me a partial relief in regards to swallowing. I still have to have my esophagus dilated every 6-8 weeks or it starts closing up on me & swallowing becomes more & more ... painful.

I was put on several strong prescription painkillers including diladid, loritabsn and Demerol. I was also put on strong muscle relaters too (SOMA).

Needless to say I live in La~La Land most of the time due to the pain I live with on a daily basis & I truly hate it! I was able to get my doctor to back off of the diladid due to it making me throw up every time I took it. They switched me to Meprozine which carries an anti-nausea drug in it & that helped ... a lot!

I have taken my treatment in this matter into my own hands & do not take the medical community’s word as the gospel any more I am always on the lookout for new drugs that will end my dependence on these manmade painkillers or at least reduce it to some degree.

A couple of years ago I read an article about medical marijuana & decided to try smoking a joint in place of my painkillers for a two-week period. I had access to some fairly strong herb thru a close friend. For the week I tried this I cut my pain medication in ... "Half"!!!

Smoking as few as 2-3 joints a day ... spaced apart ... I was able to not only diminish my esophageal pain but was also able to reduce the esophageal spasms ... greatly! I also felt soooooo much better in general! I did not take any muscle relaxers that whole two weeks either! I just did not need them. The herb took care of the esophageal spasms more than I ever imagined it could have!

Needless to say I was amazed at the results ... especially over such a short test period (1 week). I decided to confide in one of my doctors.

The doctor I confided in was not surprised one bit & said so. He then told me that I could embark on this "Self Treatment" but that he could not condone it under our State's laws and under Federal laws! He said if I got caught ... that I would feel the full weight of the law upon my shoulders & no slack would be cut due to my medical condition.

In your opinion ... can you tell me how & why smoking such a small amount of herb could give such a dramatic effect & in such a short time? Also ... was this just all in my head (wishful thinking?) or were there medical things that the herb was doing to the damaged parts of my body that can be explained to me from a realistic medical standpoint?

I also must add that I discontinued the use of the herb after the two-week trial due to the legal aspects my doctor cited & nothing else. If I were allowed to,. I would incorporate the herb use with my prescription use in order to lessen the prescription use of the painkillers and muscle relaxers.

Last of all, I want to add that my doctors have never failed to remind me that I am addicted to these prescription pain killers & that if ever a day came that my damaged internal parts could be repaired & the pain killers not needed anymore. I would have to be slowly weaned off them. I just think that ironic since I experienced no withdrawals from smoking the 2-3 joints per day.

I thank you ahead of time for any light you can shed on this for me.

Dear Anonymous,

In my view, cannabis is the least toxic of the drugs you use to treat your symptoms, and from your description, it seems to be the most effective.  Your situation highlights the absurdity and cruelty of the laws that prevent someone with your needs from freely using this substance as a medicine—even in a state that has passed a medical marijuana initiative. Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

My son has been diagnosed with bipolar disorder, manic.  He self-medicates with M. Psychiatrists keep saying its no good for bipolar, but the hospital gives him much stronger stuff that causes side effects, and the marijuana does not. Can you help me with evidence that could help him?

Thank you,
Anonymous

Dear Anonymous,

See the paper titled "The Use of Cannabis As a Mood Stabilizer in Bipolar Disorder" by myself and James B. Bakalar.  It is reprinted on this website.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I'm starting a support group for women in the UK who have or have had hyperemesis gravidarum, a severe and very debilitating form of morning sickness. I am trying to find as much practical information as possible with the aim of preventing therapeutic abortion and making these women's lives more bearable during the illness which, as you presumably know, can last the entire pregnancy (sometimes even after delivery). The extent of the nausea and vomiting and resultant loss of appetite is such that most doctors agree the risk of using anti-emetics such as Zofran is justified, but I know of a good many cases where even this has been unsuccessful as a treatment. Not only that, but it is effectively unavailable in this country due to the great expense and the fact that we have nationalized health care, so most HG patients are offered only much less effective drug treatments - if these fail, they are very likely to be persuaded to abort.

I note from the Q&A on your site that women have used cannabis historically and recently for nausea in pregnancy and specifically for HG, and have heard of one such case personally. However, cannabis is illegal in this country (although I think there may be some lenience where medical reasons such as MS or chemotherapy can be cited) and I would therefore like to know (a) whether Marinol is available over here and (b) whether it would be likely to be effective in HG anyway? I say this, because I gather the dose depends on the when the last meal was ingested (usually several weeks ago in HG patients) and the effects may take some time to appear. Any advice you can give me would be fantastic, as there are so many women suffering needlessly right now.

Dear Anonymous,

There is little that I can add to what I have already said about this use of cannabis in Marihuana, the Forbidden Medicine.  I do not know how useful Marinol would be in this situation.  For one thing, patients with severe nausea frequently have difficulty ingesting capsules of any sort.  Also, if successfully ingested it takes more than an hour before the patient can hope to experience symptom relief.  Generally speaking, Marinol is not as effective as whole marijuana, but it is certainly worth a try.

Sincerely yours,
Lester Grinspoon, M.D.

Dear Dr. Grinspoon,

Thank you for this informative site!

My question to you is regarding a possible interaction between the antidepressant Serzone and the recreational drug cannabis.

When one is taking Serzone, would there be any significant interactions if the individual were to smoke cannabis, or THC?

Any help you can give me would be greatly appreciated and I look forward to your reply as I am at loss on who to ask regarding this matter!

I live in Toronto and came across your web site on the search engine, DOGPILE Meta-Search!  I'm glad I found you and again look forward to your feedback!

Thank you in advance for your time!

Best Regards,
Nick

Dear Nick,

I am unaware of any interaction between cannabis and Serzone.  While I cannot assure you that there are no interactions between these two drugs, I think it is unlikely given the paucity of reports of toxic interactions of any drug with cannabis. 

Sincerely yours,
Lester Grinspoon MD

Dear Gloria,
I am sorry to be so tardy in responding to your question but the Web manager of this site was delayed in sending your letter on to me.  On the one hand, I would be cautious about introducing cannabis to a marijuana-naive person of your father's age.  Yet, given the severity of his prognosis and the likelihood that cannabis might afford him some relief, you may wish to cautiously explore the possibility that it may be useful to him.  If you decide to use cannabis, it might be well for you to let him have one puff and then wait two to three minutes before offering him the next puff until he either becomes uncomfortable or gets symptom relief.  I do not think it would "aggravate his heart condition" but you might be well advised to talk to his cardiologist about this.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I'm a 28-year-old male from Wisconsin. I’m getting married in June. My future wife wants to have a baby right after we are married. But she says that I must quit smoking pot, which I have been enjoying since I was 14, because she believes that the THC in my blood will affect my sperm and alter the baby's health. I said there wouldn’t be any complications but she doesn’t believe me. My question is would there be any problems with the reproduction cycle from me smoking weed?

Sincerely,
Bryan

Dear Bryan,

There is, in my opinion, no credible evidence that a man's use of cannabis will in any way negatively impact the fetus which results from impregnation with his sperm.

Sincerely yours,
Lester Grinspoon MD

I am a 34-year-old male who suffers from chronic back and neck pain as a result of injuries. I also have ankylosing spondylitis and suffer from attacks of acute iritis. I find that s cannabis is not only good for nausea and pain relief but also seems to stop the pressure from building up in my eye.  It also stops weeping. Why is this?

Barry C.

Some users report that cannabis diminishes tearing while chopping onions, and it is well established that it lowers intraocular pressure. This is the first I have heard that cannabis may be useful in the symptomatic treatment of acute iritis.

Sincerely,
Lester Grinspoon, MD

Dear Dr. Grinspoon,

I'm not only bipolar but have a very serious case of obsessive-compulsive disorder. I am a recovering cancer patient. I had a fourth stage neuroblastoma as a baby. I'm currently 17. I have been taking Zoloft and a combination of other drugs to control my symptoms. They controlled them to a point but  made me not happy or sad, just a blah. I had no interest in life, and it made me hate living and everything about this world. I began smoking marijuana occasionally. I not only enjoyed the recreational effects, but for days to follow I actually laughed at jokes and enjoyed just hanging out with friends. It took away pain and just generally made me happy. I am currently trying to get Marinol prescribed for me, but I don't think it will have the same effect as the actual marijuana. I hope you have some feedback for me on the general idea of using marijuana as a drug for mental disorders like manic depression.

Thanks, Jeff Agosta.

Dear Jeff,

  Other patients who suffer from bipolar disorder have also found cannabis useful.  You and your doctor may want to look at a paper that James B. Bakalar and I published on this subject in the Journal of Psychoactive Drugs ; it is reproduced elsewhere on this WebSite.  We have also written about this use of cannabis in our book Marihuana, the Forbidden Medicine (second edition, 1997).

  Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

  First a big thanks for your work in putting together Marihuana: The Forbidden Medicine.  Thanks for all your help in encouraging proper research of marijuana's medicinal value.

  I live in Washington.  I have a cousin in California, 16 or 17, who suffers from Crohn's disease.  She is the daughter of my aunt on my mom's side of the family.  My mom and presumably my aunt are fairly traditional and certainly afraid of marijuana.  My mom figured out I did marijuana in high school but I do not know if she believes I continue to do it now, as I'm about to get a BS at the Univ. of Washington and start a respectable career as a software developer at Microsoft.  I'm in a position where I see marijuana as safe, and the real risk is from irresponsible use and law enforcement.   In order to treat her condition, the doctors would like to do more surgery.  Because Crohn’s disease makes it hard to eat, she has lost so much weight she may not be strong enough to operate on.  I feel strongly that marijuana could help her regain her needed weight.  Reports in the shared stories seem to suggest other symptoms could be alleviated.   My question is, do you have any advice or can you point me towards advice on how to bring up marijuana use to such an unreceptive audience?  Never mind the issues of acquisition and use. How can I first begin to suggest marijuana, hopefully with the effect that my aunt and her husband look into the subject and are able to make an open decision on their own?   My impulse is to send her a copy of your book, and a plea from me to read it.  Also, as your book does not mention Crohn’s disease (as I recall) I would send a link to the shared stories involving Crohn’s disease.

  Thank you for your time and commitment to compassionate treatment

Dear Anonymous,

  You must be referring to the first edition of Marihuana, the Forbidden Medicine; in the second edition (1997) there is a discussion of Crohn's disease with an illustrative case starting on page 186.  While one cannot be sure that cannabis would be helpful to your cousin, many people suffering from this difficult disorder find that it is very useful in symptomatic treatment, including weight retention and even gain.  I  hope it will be possible for her to try marijuana. Of course, I would be delighted if you sent her the book. 

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

 I am very interested in new research regarding the use of marijuana and the treatment or control of bipolar- disorder and depression.  My husband uses marijuana regularly and has for years.  I find that when he is able to use it regularly, he is more motivated, patient and communicative.  He works full time as a machine programmer making 50,000 gross per year.

He is not what anti-marijuana supporters would stereotype as a lazy "pot head".  We have three children and he is a wonderful father and husband (when he can smoke herb).  When he cannot smoke, he tends to be very depressed, tired, negative, paranoid and impatient. At times, I was afraid that he was suicidal. These are not symptoms of an addiction.  He quit smoking herb for over a year and these symptoms persisted on a constant basis.  It is against our beliefs to use synthetic mood stabilizing drugs and we are wondering if you know if it sounds as though he could be eligible for a medical marijuana license?  And if so, what resources are available to locate doctors who prescribe marijuana as an alternative to anti-depressant medications?  I am tired of knowing that we are breaking the law in order to keep my husband psychologically healthy.  Can you help?

Mrs. Galauski

Dear Mrs. Galauski,

While the psychiatric establishment continues to ignore the therapeutic usefulness of cannabis in the symptomatic treatment of bipolar disorder, I am convinced that it is more useful than conventional approaches to some patients who suffer from this very troublesome illness.  You may be interested in seeing what we have written about this  in our book Marihuana, the Forbidden Medicine and in a paper published in the Journal of Psychoactive Drugs and reproduced on this website; its title is The Use of Cannabis As a Mood Stabilizer in Bipolar Disorder.  If you look in the section headed Personal Accounts,  you will find "Marijuana and Bipolar Disorder", by John Frederick Wilson.  Besides referring you to these sources of information, there is little I can do.  Even those states that allow some use of cannabis as a medicine make no provision for its use in the treatment of bipolar disorder.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I have hepatitis C- discovered 4 years ago through a routine exam during my second pregnancy and undoubtedly due to my “wasted youth”. I have stopped drinking but started smoking a bit of hash in a cigarette joint (as they do here in Italy) with my husband almost every night. It’s made the difference in our sex life.   I have to admit it helps a mother to know there's a prize at the end of a long day after the kids fall asleep and would therefore really hate to give it up -but would if I were convinced it was harmful to me because of my liver condition. So can you tell me if it's hard work for my liver to process it all or can I go on my merry way?

Thanks -
Lori

Dear Lori,

As far as I know there is no reason to be concerned about using cannabis under the circumstances.  Many people with hepatitis C use it just as you do and I am aware of no reports of liver  toxicity.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon, 

My name is Jay Amarillas, and I have a question concerning medical marijuana. In high school, I played football, I got a really bad head injury -- 3 separate concussions, and my skull was bruised.  

The doctor told me that I would most likely get really bad headaches for a long period of time after this injury.  He was right, the headaches began to really bother me.  They are so bad that I have to lie down and fall asleep for them to go away. Any kind of pain reliever does not even work unless taken in large doses, which is dangerous.  

I used to smoke marijuana occasionally when I was younger. Now I smoke it more often and it seems to distance the headaches and makes them not as intense. I now smoke marijuana daily and it has been my savior.  The headaches only occur maybe twice a week now and they are not as intense as before.  

My question is, how would I go about finding any way to get a prescription or anything that will help me with these headaches? I have been asking around my area for any doctors who deal with this sort of practice and have been searching on the internet and found your website.  Can you please help me out or give me some information on what I should do or steps I should take? Thank you for your time and I hope to be hearing from you soon

Jay Amarillas

Dear Mr. Amarillas,

The use of cannabis for the symptomatic treatment of headaches is a very ancient one. For some people it seems to be better  than any of the conventional medicines. Unfortunately, there is no way you can get a prescription for marijuana.  You can get a prescription for Marinol (dronabinol), which is a synthetic tetrahydrocannabinol.  It is generally not as effective as whole smoked marijuana, but some patients find  it useful.  You may wish to ask your doctor to consider providing you with a prescription.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

 Are there any success stories regarding the use of marijuana to control a flare-up of ulcerative colitis?

Mindy

Dear Mindy,

Yes, there are success stories from patients who find marijuana useful in treating the symptoms of ulcerative colitis.  However, there are also reports from people with ulcerative colitis who find that cannabis is not useful.

Lester Grinspoon MD

Dear Dr. Grinspoon,

Having been a smoker for about 10 years, I have had increasing numbers of bad experiences while smoking.  I would call them extreme bouts of anxiety. They are almost always related in some way to sort of "judgment" of myself , or by  others, in terms of spiritually,  emotionally,  or religiously based criteria.  I have since stopped, though I am curious if there exists literature on the subject of marijuana use and subsequent anxiety attacks with religious undertones.  Please let me know of any information that you may share with me.

Thank you.

Dear Anonymous,

In communities such as the Rastafarian or the Ethiopian Zion Coptic Church where the use of ganja is widespread, it is well known that, on rare occasion, a member of the community cannot use cannabis without experiencing anxiety.  They are commonly referred to as people who "don't have a head for ganja".  Little is known about why this happens to some people.  Because the anxiety is uncomfortable, people who suffer from this reaction invariably avoid cannabis.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I have 2 confirmed diagnosis of autoimmune disease called Necrobiosis and Eryathema Nodosom, and now they think I have lupus.  I am currently taking Vicodin for the constant pain I am in every day and wonder which is the worst of two evils-- smoking pot, to help alleviate pain and get some rest, or taking Vocodin every day?  Is the Vicodin physically addicting when smoking pot is not?  I would like more information on this subject.  

Thank you.

Dear Anonymous,

Vicodin is a combination of a narcotic and acetaminophen.  The narcotic is addicting and there are some serious long-term consequences of using large doses of acetaminophen regularly over a long period of time.  From a medical point of view, cannabis is by far the less toxic of the two drugs.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

My name is Philippe Lucas, and I'm the founder/director of the Vancouver Island Compassion Society, a non-profit medicinal marijuana center located in Victoria, BC.

As you know, cannabis is legal to use and cultivate in Canada with a section 56 exemption to the Canadian Drugs and Substances Act.  To obtain this exemption, one must fill out an application with a doctor's support.  My problem is that although I suffer from Hep-C (and at least 3 Canadians already have a ministerial exemption for this condition), my doctor will not fill out an application with me.  He suggests that the "scientific evidence" available doesn't point to cannabis as being directly beneficial to liver conditions.

Here's the irony: the "scientific evidence" to which he refers to is your tome on cannabis' medical uses, "The Forbidden Medicine".

In fact, this doctor will recommend the use of cannabis in writing for any one of the conditions recommended in your book.  I have tried to explain to him that research on Hep-C is in its infancy and that scientific evidence re liver disease and cannabis use simply wasn't available presently.  The society which I run helps about 20 people to deal with the symptoms of Hep-C (loss of appetite, nausea, localized pain, depression...) as well as the known side effects of Rebetron/interferon treatment (flu-like symptoms, fever, fatigue, insomnia...).

My question is that since my doctor has a misplaced (but well-intentioned) loyalty to your research, is there any scientific evidence that you know of that suggests why exactly Hep-C is so responsive to cannabis use?

  Many thanks,
Philippe Lucas

The widespread understanding that cannabis is useful in the symptomatic treatment of hepatitis C is not based on controlled studies but rather on a considerable accumulation of anecdotal evidence.  Many patients with hepatitis C find that marijuana is the best available approach to their nausea and loss of appetite.  If your doctor accepts that it is useful for the other conditions described in Marihuana, the Forbidden Medicine, he should accept this use, for it is based on the same kind of evidence.

Sincerely Yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I am a 36-year-old woman who suffered a severe burn injury in June of 1999. I sustained 21% TBSA on the upper front portion of my body and face, and severe inhalation injuries as well. . I was in an induced coma for six weeks after the accident, and during part of that time, I was in a hyperbaric oxygen chamber.  

While I was still comatose, there was a large amount of swelling of my entire head, including my face. When I awoke from the coma, I had a foggy spot in my left eye and was examined by both an ophthalmologist and a neurologist. I also had a CT scan and a lumbar puncture. The end result was not what I cared to hear, as I was diagnosed with pseudotumor cerebri. Recently, the eye doctor found permanent damage in the left eye that has left me partially blind, with the right eye showing some new damage as well. The neurologist did yet another spinal tap, which showed that the pressure was way too high in my brain, and he then drained off about a half cup of spinal/brain fluid.

My current Rx's for this are: 500mg Diamox 3X daily, and 200mg Amytriptyline at bedtime. I am currently still on pain and itch meds due to severe scar pain and itch. I take 10mg OxyContin 2X daily and 5mg OxyIR up to 3X daily for pain control. For severe itch I am taking 200mg Neurontin 3X daily, 300mg Cimetidine 2X daily, and 25-50mg Atarax as needed, but no more than 6 tabs per day. As far as the pseudotumor cerebri goes, my symptoms vary from headaches that do not respond to medication, nausea, vomiting, dizzy spells, and inability to concentrate, up to occasional blackouts from the headaches, though these are very rare. I take Prilosec and Compazine for nausea control, but even those don't work very well.

In the past I had been a mild user of marihuana -- maybe 6 or 7 times a year. Recently, my usage has increased, to the point of my purchasing it. It seems to help control the nausea better and headaches a little better than anything else does. My neurologist suggests getting a shunt in my brain, which does not thrill me at all, and if I can avoid having it done, then I will do whatever it takes, illegal or not. A friend suggested I look up the medicinal uses of marihuana, and I found your site. Do you think daily use of marihuana can help my current condition? And if so, how much is enough?

  Thanks for your time,
R. Johns

Dear Ms. Johns,

Several patients have reported to us that they find cannabis useful the treatment of pseudotumor cerebri.  You will find an illustrative case history and a discussion of this interesting use in Marihuana, the Forbidden Medicine.

  Sincerely Yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I read somewhere that smoking through a water bong is a great way to filter out a significant percentage of the carcinogens in marijuana smoke.  Is this reliable information?  Thanks

Dear Anonymous,

What little data exists suggests that water bongs do little more than cool the smoke.  A vaporizer is a much better choice.  See the brief discussion of vaporizers on this web site under Frequently Asked Questions.

  Sincerely Yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I don't use marihuana for medicinal purposes, but you are the only ones who seem to know anything about marijuana and diabetes.

Are there any side effects? This is very important to me.

Thanks
Laurel

Dear Laurel,

We are unaware of any deleterious effects on people who suffer from diabetes, with the possible exception of the "munchies".

  Sincerely Yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

First of all I’m sorry if English is not enough good:-(

I'm Francesco, I live in Rome (Italy) and I suffer of migraine since I was about 5 years old.

I think it is something genetic, because my mother suffers too.

My kind of migraine is what you call (in Marijuana: the Forbidden Medicine) "Cluster headache".

It is a very hard migraine; I used to suffer it 3-4 times a week, with a very hard headache concentrated around the right eye, with nausea and vomiting.

I went to a doctor the first time when I was about 8-9 years old; and now, that I am 20, I still go to him.

My doctor is a very important neurologist of my town; and, from the first time he checked me, he said that there was no cure for my migraine, that I’ll have to live with my headache for all my life.

So I started to take a lot of kind of medicine, increasing the doses, or even changing the medicine with a stronger one because of addiction.

Moreover this kind of medicine didn't prevent the migraine, they only stopped it ... in 40% of cases, in the other 60% I had to stay in a dark room, in my bed, without light or noise for 15-20 hours ... with a TERRIBLE HEADACHE!!!

When I was 16 I started to use marijuana (prevalently Hashish) for recreational use, and when I started to use it daily I discovered that my migraine seemed to be ELIMINATED!!

Since I started a daily use of marijuana I had no migraine even for 5-6 months!!

Occasionally I had to stop with marijuana for days or weeks, and the migraine re-appeared; and after then, when I could restart to smoke my "medicine" the migraine disappeared.

I love Marijuana; I loved her when I didn't know its therapeutic uses, now I love her much more!

I would like to know where I could have information about the medical uses of it for migraine, because I want to say it to my doctor and I would like to know if someone ever succeed to obtain "Permission of Medical use of cannabis" in Italy (I don't think so :-(( ).

I'm afraid, because in some years I’ll have to "serve" the army, where I can't use Marijuana ... have I to suffer of migraine for 1 long year???

Please help me!! Thanks a lot
Francesco

Dear Francesco,

There is an Italian translation of Marihuana, the Forbidden Medicine that you may wish to share with your doctor.  Or, your doctor may wish to review what nineteenth century Western physicians had to say about the use of cannabis in the treatment of migraine.  Sir William Osler, as late as the last edition of his textbook of medicine (1913), described it as the best medicine for the treatment of this difficult syndrome.  Given the limited usefulness and considerable toxicity of present-day treatments, some physicians believe that cannabis continues to be the best treatment for many patients.  Hopefully, it won't be long before you will be able to use it legally as a medicine in Italy.  I believe that day will arrive sooner than you think.

  Sincerely Yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I am a family physician who has been asked to speak for one of my patients arrested for using marijuana to help his asthma.  It seems to help.  Can you tell me about any research/study about the efficacy of marijuana in asthma?  

Michae Huff MD    

Dear Dr. Huff,

Because whole smoked marijuana has both bronchoconstrictive and bronchodilatory properties, some patients with asthma  get relief while others find the smoke too irritating.  Recently research in Hungary and California has demonstrated that anandamide (the endogenous cannabinoid-like ligand) is a powerful bronchodilator.  This confirms clinical experience indicating that marijuana is useful for the treatment of the symptoms of asthma.  Patients with asthma may be particularly interested in the use of a vaporizer, a device which allows the patient to inhale cannabinoids free of smoke.  These devices are briefly described on this site under  Frequently Asked Questions , with directions to other Web sites which describe three types of vaporizers.

  Sincerely Yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I am in somewhat of a dilemma, for I am compelled to direct my father towards the use of marijuana to alleviate pain and suffering associated with cancer treatment.

I have a Ph.D. in metaphysics; yet, all the verbiage in the world that I can muster is leaving me short of this seemingly simple task.  Normally, I would buy your book and mail it to my father, but after the chemotherapy, radiation, and surgery, he is in no position to read a treatise, let alone a book.

So, I am seeking some honest, succinct facts that may encourage him to help himself through the avenue of Nature's medicine, namely -marihuana-.

  Is there a "Dear Dad/Mom, try pot because" format you could recommend?  Neither of my parents has ever used marihuana, so it's a rather trying task for me.

Yet, I know from experience alone that his symptoms of sleeplessness, nausea, and joint pain would subside greatly.  How can I put these in short, research-supported words to him?

  Deep regards,
Rolf William Erickson Ph.D.

Dear Dr. Erickson,

I wish there were some "Dear Dad/Mom, try pot because" publication, especially one with modern medicine's seal of approval.  Unfortunately, today you are left pretty much to your own devices.  When I am confronted with an older patient who has never used marijuana but who clearly stands a good chance of profiting from this medicine, I do two things.  I first of all assure the patient that, while I cannot guarantee that it will help, I can assure him or her that it will do no harm.  

If the patient can accept that, then I teach an older marijuana-naive patient to use it very cautiously.  I suggest that they smoke for the first several times with someone whom they trust and who is knowledgeable about marijuana.  I ask that they take one puff, inhale deeply, hold it for the few seconds, and then exhale.  I instruct them to wait about three of four minutes between puffs, even though they will have to re-light the marijuana cigarette each time.  I ask them to do it at this pace until one of two things happen; they find that they are beginning to get symptom relief, or they are becoming anxious or uncomfortable in any other way.  In either case, this is the point at which they should stop smoking.  This usually works.  

Once they discover that it does relieve symptoms and is not as scary as they may have been led to believe, they will feel more comfortable about smoking on their own and at a faster pace.

  You might try this approach with your father.  I hope it works.

  Sincerely yours,
Lester Grinspoon MD

Dr. Grinspoon,

What are the effects of marijuana on the liver of a hepatitis C patient?

  Theresa

Dear Theresa,

As far as I know there have been no reports  that cannabis has deleterious effects   on the livers of people who suffer from hepatitis C.

  Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

I have been suffering from gout on and off for years. I am 35 years old, not typically the age for gout, but nevertheless suffer very painful attacks. Has marijuana ever been known to help relieve the symptoms of gout?

Dear Anonymous,

Marijuana, in the form of an alcoholic solution known as tincture of hemp, was used in the nineteenth century as a symptomatic treatment for gout.  Because it was one of the very few analgesics available to physicians of that time, it was used for the symptomatic treatment of a variety of pains including that of gout.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon

Does marijuana help people with anxiety and panic disorders? Jorge

Dear Jorge,

I have previously responded to the question you ask.  I suggest that you look under the section of this WebSite titled "Shared Stories" where you will find an account by a patient who suffered from anxiety and panic disorders.  Her name is Donna Stepansky.

  Sincerely Yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

Three years ago, at the age of 44, I was FINALLY diagnosed with one of the acute porphyrias.  I believe I have had the disease since I was at least 11 years old.

Just recently I resumed my marihuana smoking and believe me, there is some joy in living again.  The marihuana, for me, is the BEST analgesic.  What is really interesting is the fact that I experience diuresis after smoking--wonderful for me as I have long periods of time when I pack around 25 pounds of fluid and cannot use diuretics.  And it is wonderful for my marriage; we can have beautiful hours of lovemaking that are pain free! I am a former RN and at times I think of writing a book that documents the horrific medical experiences I had prior to the porphyria being found.  What is most tragic is that I was encouraged to stop using marihuana and put on a nightmare course of psychiatric drugs when I was younger...these caused me a great deal of harm (dyskinesia included).  I would be interested if there are any other porphyria people who find marihuana is the best treatment for them.  

Thank-you

Dear Anonymous,

I believe you are the first person with porphyria I have heard from who, if correctly diagnosed, achieves significant symptom relief with cannabis.  It would be most helpful if you could provide me with documentation of the diagnosis.

Sincerely Yours,
Lester Grinspoon MD

Dear Grinspoon,

My son Michael is now 16 years old and has had Tourettes Syndrome since age 4.  It has been a living hell for him and us (his parents).  I am William Howard his father and I found your site very interesting.  I read two accounts of marihuana use for the treatment of TS.  I am very open-minded and so is Michael my son.  We would be very interested in the finished book or any clinical trial information (participation) that you might offer.  The trial that was performed in Germany (I think) was amazing.  I hope you are able to overcome the obstacles that are before you.  Please contact me if my son or I can be of help to you.

Sincerely,
William L. Howard

Dear Mr. Howard,

Until the United States government fully accepts cannabis as a medicine and supports the kind of clinical studies which will establish a scientific basis for its modern use as a medicine, we will have to continue to rely on anecdotal evidence.  While this is not the best kind of evidence, it is, with the exception of the German study, all we have at the present time.  The decision to prescribe (or in this case, to use) a medicine is, in effect, the result of a risk/benefit analysis.  Given the very limited toxicity of cannabis, it appears to me that in the face of so much anecdotal evidence of its usefulness in the treatment of Tourettes syndrome, the benefit of a trial of marijuana outweighs any extralegal risk.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon,

Seven years ago my mother was diagnosed with trigeminal neuralgia.  In 1996, she had brain surgery to correct the problem; when it didn't take, she had the same surgery again three days later.  This time it seemed to work; she was without pain in her jaw for the first time in four years, and she was able to function normally.  I was in high school at the time, and I thought the problem had been solved.  However, in the past year and a half, she has been experiencing pain again, although nothing like the level that she had before the surgery.  She has been trying several different approaches this time around; medication after medication (and acupuncture) seems to be ineffective.  I was wondering if there have been any research or studies done on the effect of medical marijuana on a person with this disease.

Any answer at all is appreciated; if there are any other resources for medical marijuana research that you think I should consult, by all means please say so.  Thank you very much for your time.

Dear Anonymous,

There is, to the best of my knowledge, no modern research on the use of cannabis in the symptomatic treatment of trigeminal neuralgia.  However, it was widely used for this purpose by Western physicians in the nineteenth century.  The evidence is anecdotal, but, inasmuch as it would not cause any harm, your mother may wish to consider a trial of this older treatment.

Sincerely yours,
Lester Grinspoon MD

Dear Dr. Grinspoon:

I am asking the following on behalf of my sister, who suffers from chronic pain due to a neck injury, asthma, and depression.  She is 35 years old and used marijuana recreationally several years ago, but she does not now use it medically for fear of legal repercussions.  I believe that her asthma has become worse since her neck injury, which occurred in a work-related accident a few years after she ceased smoking marijuana.

I have read evidence on this site and in other literature (albeit mostly anecdotal) that marijuana has been an effective treatment for at least some people with any one of these three conditions.  My question has to do specifically with the treatment of asthma.

My sister has told me that she uses three different inhalers to control her asthma, all of which have undesirable side effects.  In addition, she sometimes uses a nebuliser to administer her asthma medication.  I am wondering if it might be beneficial/possible to use marijuana in a nebuliser, perhaps in the form of a tincture.

In addition, I have read the other comments you have made on this site concerning asthma, and I am wondering if any of the following might be beneficial in reducing the bronchoconstrictive qualities of marijuana smoke while increasing the potential effects of marijuana as a bronchodilator:

(1) Using a vaporizer that heats the drug to the point where it releases beneficial chemicals while limiting the release of tars associated generally with burning organic material, or