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Jul-02-2007 00:07printcomments

Medical Marijuana: Treatment for Marijuana Dependence

I'm a bit surprised at the cavalier use of “intoxication.” Nobody says that patients who are using Morphine or Oxycontin are intoxicated, but they certainly are by the same token.

American Family Physician
American Family Physician (Vol. 60/No.9, pgs. 2583-93) by Dr. John R. Hubbard of the Vanderbilt University School of Medicine contains the article, “Marijuana: Medical Implications”.

(MOLALLA, Ore.) - I found this article discussing this subject with a computer search. The title was “Marijuana: Medical Implications” from the journal American Family Physician (Vol. 60/No.9, pgs. 2583-93) by Dr. John R. Hubbard, et al at Vanderbilt University School of Medicine.

The first few sentences in the abstract are: “Over 50 percent of people will use marijuana sometime in their life. While intoxication [sic] lasts two to three hours, the active ingredient...[THC], can accumulate in fatty tissues, including the brain and testes [ouch].”

I'm a bit surprised at the cavalier use of “intoxication.” Nobody says that patients who are using Morphine or Oxycontin are intoxicated, but they certainly are by the same token.

After 1937, when Cannabis in any form was illegal, researchers were able to get research grants to study adverse effects of Cannabis but not beneficial effects. My wife, a nurse, witnessed the first injections of Penicillin in her hospital in Newcastle, England. The patient was surgically draped and the Chief of Surgery at Grand Rounds, in surgical garb and rubber gloves, gave the injection into the buttocks of the patient. Over the next two days, the patient was repeatedly questioned about adverse side effects. One of his complaints was a pain in the testicle. (This was NOT a long needle). For the next several years, pain in the testicle was considered an adverse effect of Penicillin. So much for the adverse effects of Marijuana.

There are at least two reasons for adverse effects from Marijuana. The old stuff (prior to about 1990) was very low in THC, the chief medical agent. There are at least two more important ones—CBD and CBN. Old stuff, when burned in a cigarette, was very irritating to the mouth, throat, breathing tubes and lungs. It caused coughing and a headache. If it contained more than a little THC, it would cause bloodshot eyes, vasodilation, followed by increased heart rate and the “munchies”, all considered adverse effects.

If a person got some strong stuff but didn't know it until he took a big inhalation, he would really get “high” in a hurry. This is very unpleasant, scares the person and may cause a whole bunch of anxiety, panic attacks, etc. This is frequently followed by deep sedation or sleep. Some people enjoy the “high”, sedation and sleep.

Auditory and visual hallucinations are common with very high doses but may be euphoric and some people seem to enjoy them. The term psychedelic has been used but usually applies to LSD or “magic mushrooms”, etc. Medical Marijuana users discover that adverse effects are brought on by heavy doses and they avoid them.

The article states that about 100,000 people seek treatment for Marijuana dependence each year. This is really strange, as 750,000 people are arrested each year for Marijuana use. One would presume that those represent the most affected patients but probably the legal system requires many to have treatment or drug counseling, which they regard as both punitive and hilarious.

The article is very serious about treatment for Marijuana dependence. Patients should

  1. be evaluated for other drug-related disorders (e.g., alcoholism),
  2. be evaluated for psychiatric disorders (e.g., depression),
  3. be evaluated for medically related problems (e.g., chronic pain),
  4. be educated about adverse effects,
  5. have supportive care for panic reactions,
  6. have supportive care for withdrawal symptoms,
  7. be aided in providing education of spouse and family, and
  8. receive a referral to a relapse prevention program.

Most medical marijuana patients would consider all of these treatment strategies as being much funnier than the U.S. government produced movie Reefer Madness, which is so absurd that it really isn't humorous.

It is noted that Dr. Hubbard is Director of the Substance Abuse Treatment Program at the Nashville Veterans Affairs Medical Center. I would guess that this explains the over-cautionary sense of his article. I know at least a dozen Cannabis doctors who would consider his article not humorous but very tragic.

Phillip Leveque is a physician, toxicologist and WWII Combat Infantryman. Watch for his video question and answer segments about medical marijuana with Bonnie King.
You can email your questions to the doctor:

Other articles and video segments about medical marijuana on

Comments Leave a comment on this story.

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pot smoker July 20, 2009 11:27 am (Pacific time)

i found this story to be kind of stupid I've been smoking weed for 6 years frequently and I've done very good in highschool and Graduated with honors. I have never had any panic attacks or ever hallucinated and I've had very high doses of good marijuana so I find this article to be giving wrong info

ebinezer September 16, 2008 5:06 pm (Pacific time)

Hi its very fantastic and worthwhile for those who suffer from a serious disease i.e. addiction. ebinezer

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