December 18, 2009 – At the Peace in Medicine Healing Center in Sebastopol, the wares on display include dried marijuana — featuring brands like Kryptonite, Voodoo Daddy and Train Wreck — and medicinal cookies arrayed below a sign saying, “Keep Out of Reach of Your Mother.”

The warning tells a story of its own: some of the center’s clients are too young to buy themselves a beer.

Several Bay Area doctors who recommend medical marijuana for their patients said in recent interviews that their client base had expanded to include teenagers with psychiatric conditions including attention-deficit hyperactivity disorder.

“It’s not everybody’s medicine, but for some, it can make a profound difference,” said Valerie Corral, a founder of the Wo/Men’s Alliance for Medical Marijuana, a patients’ collective in Santa Cruz that has two dozen minors as registered clients.

Because California does not require doctors to report cases involving medical marijuana, no reliable data exist for how many minors have been authorized to receive it. But Dr. Jean Talleyrand, who founded MediCann, a network in Oakland of 20 clinics who authorize patients to use the drug, said his staff members had treated as many as 50 patients ages 14 to 18 who had A.D.H.D. Bay Area doctors have been at the forefront of the fierce debate about medical marijuana, winning tolerance for people with grave illnesses like terminal cancer and AIDS. Yet as these doctors use their discretion more liberally, such support — even here — may be harder to muster, especially when it comes to using marijuana to treat adolescents with A.D.H.D.

“How many ways can one say ‘one of the worst ideas of all time?’ ” asked Stephen Hinshaw, the chairman of the psychology department at the University of California, Berkeley. He cited studies showing that tetrahydrocannabinol, or THC, the active ingredient in cannabis, disrupts attention, memory and concentration — functions already compromised in people with the attention-deficit disorder.

Advocates are just as adamant, though they are in a distinct minority. “It’s safer than aspirin,” Dr. Talleyrand said. He and other marijuana advocates maintain that it is also safer than methylphenidate (Ritalin), the stimulant prescription drug most often used to treat A.D.H.D. That drug has documented potential side effects including insomnia, depression, facial tics and stunted growth.

In 1996, voters approved a ballot proposition making California the first state to legalize medical marijuana. Twelve other states have followed suit — allowing cannabis for several specified, serious conditions including cancer and AIDS — but only California adds the grab-bag phrase “for any other illness for which marijuana provides relief.”

This has left those doctors willing to “recommend” cannabis — in the Alice-in-Wonderland world of medical marijuana, they cannot legally prescribe it — with leeway that some use to a daring degree. “You can get it for a backache,” said Keith Stroup, the founder of the National Organization for the Reform of Marijuana Laws.

Nonetheless, expanding its use among young people is controversial even among doctors who authorize medical marijuana.

Gene Schoenfeld, a doctor in Sausalito, said, “I wouldn’t do it for anyone under 21, unless they have a life-threatening problem such as cancer or AIDS.”

Dr. Schoenfeld added, “It’s detrimental to adolescents who chronically use it, and if it’s being used medically, that implies chronic use.”

Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, said she was particularly worried about the risk of dependency — a risk she said was already high among adolescents and people with attention-deficit disorder.

Counterintuitive as it may seem, however, patients and doctors have been reporting that marijuana helps alleviate some of the symptoms, particularly the anxiety and anger that so often accompany A.D.H.D. The disorder has been diagnosed in more than 4.5 million children in the United States, according to the Centers for Disease Control and Prevention.

Researchers have linked the use of marijuana by adolescents to increased risk of psychosis and schizophrenia for people genetically predisposed to those illnesses. However, one 2008 report in the journal Schizophrenia Research suggested that the incidence of mental health problems among adolescents with the disorder who used marijuana was lower than that of nonusers.

Marijuana is “a godsend” for some people with A.D.H.D., said Dr. Edward M. Hallowell, a psychiatrist who has written several books on the disorder. However, Dr. Hallowell said he discourages his patients from using it, both because it is — mostly — illegal, and because his observations show that “it can lead to a syndrome in which all the person wants to do all day is get stoned, and they do nothing else.”

Until the age of 18, patients requesting medical marijuana must be accompanied to the doctor’s appointment and to the dispensaries by a parent or authorized caregiver. Some doctors interviewed said they suspected that in at least some cases, parents were accompanying their children primarily with the hope that medical authorization would allow the adolescents to avoid buying drugs on the street.

A recent University of Michigan study found that more than 40 percent of high school students had tried marijuana.

“I don’t have a problem with that, as long as we can have our medical conversation,” Dr. Talleyrand said, adding that patients must have medical records to be seen by his doctors.

The Medical Board of California began investigating Dr. Talleyrand in the spring, said a board spokeswoman, Candis Cohen, after a KGO-TV report detailed questionable practices at MediCann clinics, which, the report said, had grossed at least $10 million in five years.

Dr. Talleyrand and his staff members are not alone in being willing to recommend marijuana for minors. In Berkeley, Dr. Frank Lucido said he was questioned by the medical board but ultimately not disciplined after he authorized marijuana for a 16-year-old boy with A.D.H.D. who had tried Ritalin unsuccessfully and was racking up a record of minor arrests.

Within a year of the new treatment, he said, the boy was getting better grades and was even elected president of his special-education class. “He was telling his mother: ‘My brain works. I can think,’ ” Dr. Lucido said.

“With any medication, you weigh the benefits against the risks,” he added.

Even so, MediCann patients who receive the authorization must sign a form listing possible downsides of marijuana use, including “mental slowness,” memory problems, nervousness, confusion, “increased talkativeness,” rapid heartbeat, difficulty in completing complex tasks and hunger. “Some patients can become dependent on marijuana,” the form also warns.

The White House’s recent signals of more federal tolerance for state medical marijuana laws — which pointedly excluded sales to minors — reignited the debate over medical marijuana.

Some advocates, like Dr. Lester Grinspoon, an associate professor emeritus of psychiatry at Harvard University, suggest that medical marijuana’s stigma has less to do with questions of clinical efficacy and more to do with its association, in popular culture, with illicit pleasure and addiction.

Others, like Alberto Torrico of Fremont, the majority leader of the California Assembly, argue for more oversight in general. “The marijuana is a lot more powerful these days than when we were growing up, and too much is being dispensed for nonmedical reasons,” he said in an interview last week, bluntly adding, “Any children being given medical marijuana is unacceptable.”

As advocates of increased acceptance try to win support, they may find their serious arguments compromised by the dispensaries’ playful atmosphere.

OrganiCann, a dispensary in Santa Rosa, has a Web site advertisement listing the “medible of the week” — butterscotch rock candy — invitingly photographed in a gift box with a ribbon. OrganiCann also offers a 10 percent discount, every Friday, for customers with a valid student ID. By Katherine Ellison. Source.

December 14, 2009 — In California, the state with the nation’s most permissive medical marijuana law, several doctors say that some children with attention deficit hyperacitivty disorder, or ADHD, are being treated with marijuana — a fact that has sparked a heated debate.

Reliable figures on the use of marijuana to treat ADHD are hard to come by, as reported by The New York Times. Though California says it has issued more than 36,000 medical marijuana cards since 2004, the state does not compile statistics on prescriptions for specific conditions, such as ADHD. And many doctors and patients are reluctant to talk about it. Still, experts say such prescriptions are becoming more common as the number of pot dispensaries and doctors prescribing marijuana continues to grow.

And not everyone is happy about it.

“Let me count the ways in which prescribing marijuana for teens with ADHD is a bad idea,” said Stephen Hinshaw, professor of psychology at the University of California at Berkeley. Marijuana, Hinshaw said, is a “cognitive disorganizer” that produces roughly the same effect in users as those associated with ADHD.

“The active ingredient in pot, THC, causes short-term memory problems and inattention,” Hinshaw said, “the very same things you want a medicine for ADHD to help alleviate.”

Since marijuana has not been put through the FDA approval process, very few reliable studies have been conducted to show how it may affect ADHD, Hinshaw said.

But if the idea of prescribing pot to minors seems counterintuitive, it might be worth considering that Ritalin and Aderall, two of the most commonly prescribed medications for ADHD, are essentially amphetamines. And Hinshaw said hundreds of studies show that in low dosages, amphetamines are an effective treatment for ADHD.

“I’d have no hesitation of giving a youngster with ADHD a trial of oral marijuana,” said Lester Grinspoon, emeritus professor of psychiatry at Harvard Medical School and the author of “Marihuana: The Forbidden Medicine.”

“For some kids, it appears to be more effective than traditional treatments. And marijuana certainly has fewer potential dangers than Ritalin.”

According to the National Institute of Mental Health, children with ADHD show a variety of hyperactive symptoms, including difficulty concentrating or following directions, being easily distracted and increased hyperactivity or fidgeting.

Roughly 4.5 million American children have been diagnosed with ADHD, the Centers for Disease Control and Prevention said, but scientists are unsure what causes the condition.

“My son was diagnosed with ADHD when he was 6,” a Grass Valley, Calif., woman who wished to remain anonymous told Sphere. “He was hyperactive and had trouble in school, but we didn’t want to put him on Ritalin. Too many side effects. When he got to high school, I suddenly noticed that he’d calmed and could concentrate. I couldn’t figure it out. Then he told me that he’d started smoking pot.”

Now 28, her son still smokes pot, the woman says, and has very little problem with his ADHD.

While Grinspoon concedes that the evidence of marijuana’s effectiveness in treating conditions such as ADHD is mostly anecdotal, he believes that practitioners would be wise to start listening to the everyday experiences of their patients. “It has been hard to collect hard data because the federal government has, for so long, said, no, marijuana is not a (legal) drug.”

Hinshaw is intrigued by success stories of patients treating ADHD with marijuana, but he cautions against euphoria in the absence of data. “People with ADHD are terrible at self-reporting; that’s one of the things that characterizes the condition. Still, this is worth looking into. Any hypothesis that adheres to the proper ethical limits is worth investigating.”

At Harborside Health Center in Oakland, for instance, a doctor’s recommendation for marijuana is verified with the physician, then the medical board is consulted to make sure the doctor is in good standing. In the case of minors, only a parent or guardian is allowed to enter the dispensary.

As for the future of treating ADHD in kids with marijuana, Grinspoon said he’s optimistic. “In the long run, I think it will prove to be a wonder drug, and a less toxic one at that.” Source.