The Medical Marijuana for Bipolar Lie

UPDATED

Everyone seems to have a friend who has been helped by medical marijuana. When my wife had chemotherapy, we had it as a backup in case the anti-nausea drugs did not work for her. Glaucoma is a disease with medical research backing the effectiveness of medical marijuana. But the medical marijuana industry goes beyond what is proven by science. It welcomes those who use it for many other diagnoses despite the absence of peer review studies. In other words, if you can get a doctor or a nurse practitioner to write you a script, you can get high legally for any disease you can name. And the worst of the lies medical marijuana prescribers and retailers let fly is the lie that marijuana helps the symptoms of bipolar disorder.

Here is my full disclosure: First, I do not oppose legalization of marijuana provided it is regulated at least as well as alcohol. There need to be laws governing its sale to minors, bans against driving under the influence, etc. But other than that, I have no problem with seeing it available as a leisure drug. There’s considerable evidence that the liquor industry does not want this, but alcohol is worse than cannabis in some regards. Second, I have smoked marijuana. Here is where my strong feelings about the subject come from. When I was in college, I was talked into toking by my peers. They did not force it down my throat, they did not blow smoke into my lungs, they did not deceive me in the sense that they told me things that they knew were not true. I started using the drug by my own choice.

But now we come to the third and most telling part of my self disclosure. Shortly after I started toking the “evil weed” as we jokingly referred to it, I became paranoid, hypersexual perhaps, and manic. I stopped smoking, but the symptoms continued. When I went to the school counseling center (this was back in the 1970s when all was good) I was told that marijuana was not harmful and that I was faking my symptoms to control my girlfriend. A year later, I had a serious episode which should have landed me in the hospital except my family objected to the idea of psychiatric intervention and, besides, I did not tell them. During this episode I believed that I was God and that I had done a terrible job creating the world which was now out of my control. (Descarte’s Demon anyone?) I saw a different therapist who told me that my problem could be solved if I ate more. I lapsed into a depression tinged with some of the fears of my manic episode and only survived the semester by dropping one of the five classes that I had chosen to take.

The rejection of the theory that my marijuana use had triggered the symptoms remained with me for many years. I didn’t smoke, but I struggled through long depressions only occasionally interrupted by brief hypomanic episodes. Because I did not believe I was bipolar, I attributed these to character flaws — an idea supported by my family. I suffered — sometimes aloud but often in silence because people don’t want to hear about your problems when you are down for the most part. My room was my only teacher in the evenings. The lesson I learned was that I was a horrible person who might not deserve to live. My marriage (which has lasted 27 years) helped, but I remained unaware of my condition for 16 years into that relationship.

I still did not trust marijuana. You wouldn’t see me turning in people who I knew grew it. All around me I could see people who smoked it with no effects that I could see. The few who had symptoms did not talk about them, I learned later.

Then the research started piling up. Speakers at conferences began taking on the medical marijuana industry’s claim that it was good for bipolar disorder. Doctors in the Netherlands — where pot and its derivatives are legal — observed their bipolar and schizophrenic patients who smoked pot getting worse. There was a rumor of a clinical trial of cannibis in the United States which had to stopped because the bipolar patients became increasingly psychotic. And the peer-reviewed studies from several countries began affirming my original suspicions, that there was a clear connection between pot smoking and the onset of bipolar disorder.

The latest such report emerged a week ago. Researchers at the University of Warwick examined the literature exploring the connection:

Lead author Dr Steven Marwaha said: “Previously it has been unclear whether cannabis use predates manic episodes. We wanted to answer two questions — does cannabis use lead to increased occurrence of mania symptoms or manic episodes in individuals with pre-existing bipolar disorder? But also, does cannabis use increase the risk of onset of mania symptoms in those without pre-existing bipolar disorder?”

The researchers looked at a number of previous studies and concluded that cannabis use preceded the onset of mania symptoms.

Dr Marwaha said: “The observed tendency for cannabis use to precede or coincide with rather than follow mania symptoms, and the more specific association between cannabis use and new onset manic symptoms, suggests potential causal influences from cannabis use to the development of mania. It is a significant link.”

Here’s something very important to remember about this article. It is a review which means that the authors read several studies. The argument that some made when I announced it on Facebook — that this is just one study — is invalid. This is several studies which the researchers have used to derive their findings. Marijuana, scientists are finding, pushes people into bipolar disorder and makes their symptoms worse.

Since posting the article on my Facebook page, I have met with several arguments disputing the findings. First was the item that I just mentioned: that this is just one study. You have seen me deal with that.

A second argument said that this could not possibly be true because not everyone who has smoked marijuana develops bipolar disorder. I actually concede this as true, but it does not mean that there is not a causal link. Current understanding of bipolar disorder holds that it is genetic. People who have the gene are at risk for having it triggered. And here comes marijuana to do the job for them.

Someone thought she had got me by noting that not everyone with bipolar disorder has smoked marijuana. That is probably also true. But many conditions have multiple causes. Take cancer for example: there are people who have never smoked who develop lung cancer nonetheless. Does this mean that smoking does not cause cancer? No. Smokers have a higher incidence of lung cancer than those who do not smoke. The difference is staggering. While the question of the difference remains undiscovered country, the point remains that an awful lot of people with bipolar disorder developed their symptoms after starting cannabis.

A new study shows that cannabis use among people with bipolar disorder increases both manic and depressive symptoms! So it isn’t the panacea that NORML is trying to sell you! Because many people using medicinal marijuana for bipolar do not check in with psychiatrists, their symptoms may go unnoticed! Cannabis use is just another kind of self medication and like other types, it doesn’t do the job.

Big pharm often plays a big part in arguments for medical marijuana. We hear — without evidence — that they are behind these studies. They must want to prevent people with bipolar from using medical marijuana because it will cut into their profits. This is an assertion that is often made by the complementary and alternative medicine movement (CAM) in support of many “treatments”. A few things must be said here:

  1. Big pharm is regulated by the Food and Drug Administration. Every product that it produces is tested for efficacy and safety. This is not true of CAM including the medical marijuana industry. When something goes wrong with Big Pharm, the FDA and the medical journals come down hard on them. Where is the agency that patrols the claims of medical marijuana? Don’t look. It is not there.
  2. We hear a lot about the profits that Big Pharm stands to lose if CAM treatments become popular. But no one follows the money in the other direction. CAM is a $4 billion dollar a year industry. Until recently, they have been free to make all kinds of claims about what their products can and can’t do. The medical marijuana industry wants the same thing that Big Pharm wants: more customers. They aren’t hippie saints who just want to give good to the world. Soul-less capitalists walk within their ranks. Given their insistence or at least their refusal to rebut claims that marijuana is good for bipolar disorder, it is clear that they care more about the money than about the patients.
  3. Someone will probably claim that I am a paid tool of Big Pharm. Nope. I don’t even let them advertise on my page. (Or anyone, for that matter.)
  4. My mind is closed. True. But I am open to any new treatment no matter how strange the source. Recently, a study out of Washington University in St. Louis found that laughing gas can help with severe depression. That is the product of Science, not folklore.
  5. Is medical marijuana better because it is herbal? So is deadly nightshade and strychnine. St. John’s Wort can be poisonous. But there are herbal medications that have been proved to work beginning with digitalis which is derived from foxglove. What does mainstream medicine do with these? It finds the active ingredient that does the actual work and purifies it to reduce the side effects. The result is a safer product.
  6. Does medical marijuana have side effects? Of course it does! Paranoia is one common side effect that some users find comical in their peers. Most users of marijuana smoke it for the side effect of getting high. If you were to derive the nonpsychoactive ingredient from pot and sell it, my bet is that many of the people who claim to be smoking it for their health would not use it. It’s not what they are after it for.

But then some people claim it really does help their bipolar by “taking the edge off”. There are a few problems with this contention. You can let your desire to get high get in the way of objectively analyzing who you are. It might be that you are on enough mood stabilizers and anti-psychotics that you don’t experience the psychotic symptoms. Let’s also not forget that people in bipolar mania often suffer from “lack of insight”. Remember when you were sure that everyone was sick except for you? I suspect that people with bipolar disorder who think marijuana helps them are deep in this delusion. The scientific data says otherwise. But when you are that enthralled with your “cure”, you don’t want to consider the studies. You just want to feel good.

I know some people who say that “if people says it works for them, we should believe it.” This is a very unethical stand to take given the mounting evidence connecting marijuana with bipolar disorder. You are doing the moral equivalent of saying nothing when your friend drinks alcohol mixed with Xanax to calm his nerves. The people who do this claim that their doctors say it is OK. Really? If you don’t doubt it, then CODA is for you.

But suppose you have an ancestor — like I do — who smoked and drank and lived to the age of 95? I hand it to my grandfather, but I note that in his later years he tapered off. And given the mass of scientific evidence, I am not going to enter the great casino of the tobacco industry to try my luck at not developing lung cancer. Nor am I going to start smoking because some relative of mine does and says it helps his bipolar.

I leave you with this: if you have bipolar, smoking pot is a bad gamble. You may think it is helping you, but it is very likely that the symptoms of your illness are getting worse and you are unaware of it. Get your mind back. Make a better decision about treating your illness. Don’t tell your friends with bipolar disorder or those who have it in their families that it is okay to use. Don’t let the medical marijuana industry turn you and your fellow sufferers into mindless consumers.

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Joel is the founder of DBSA South Orange County. He received a degree in Anthropology from Pomona College, one of Forbes Magazine’s ten top undergraduate schools. His manic adventures include traveling to former Yugoslavia during the 1992 war, believing he was the Creator of a messed up Universe, road rages, and running up $40,000 in credit card bills. He lives with his wife, dog, and cat in Trabuco Canyon, California.