The Rorschach Inkblot test asks people to make up stories about ambiguous pictures. Rorschach’s hope was that the tales people told about each blot would reveal something about personal predilections and an approach to the world. Well, our friends at the National Institute on Drug Abuse have just published a nice inkblot test for the media. The experiment, “Tolerance to Effects of High-Dose Oral D9-Tetrahydrocannabinol and Plasma Cannabinoid Concentrations in Male Daily Cannabis Smokers,” is about (you guessed it!) developing tolerance to THC. We’ll see how media handle the implications of the results. It’s either a reassuring result for those concerned about safety on the roads or a chance for misguided alarms about purported dependence.
The experimenters drafted 13 guys who were experienced cannabis smokers to stay in the lab for several days. Each day, they had to swallow more and more Marinol. Marinol is pure THC in a pill, but without the cannabinoids and various compounds found in whole plant cannabis that mitigate the psychotropic effects of THC and perform other beneficial health functions. Many people have reported that Marinol left them far more impaired than plant cannabis, undoubtedly for this very reason. In fact, one guy dropped out “for personal reasons” and another “due to psychological reactions to THC.” These guys had smoked marijuana at least 1,000 times, so I’m guessing that they would have had a handle on “psychological reactions to THC” if they’d been allowed to (heaven forbid!) use their own stash. But the dosage was nothing to sneeze at — 120 mg of THC per day — or the equivalent amount of THC as three joints of decent medical cannabis in the U.S.
Why use Marinol instead of vaporized cannabis? As the authors proudly assert, “Many patients take oral cannabinoids daily for weeks or months with persisting beneficial clinical effects.” Yes. It is now okay for researchers at NIDA to say that oral cannabinoids are good. They mean Marinol, of course, but explaining why this wouldn’t apply to edibles is going to take quite the pretzel twist of logic. Stay tuned.
So what happened? As the title suggests, subjective reactions dropped dramatically in a few days. The guys were only about half as “high” by day five as they were on the first day of taking Marinol. But the amount of THC in their blood remained the same. That’s the definition of tolerance — a decreased effect with the same dosage. So the same guy with the same amount of THC in his blood felt fewer effects on one day than he did a couple days before.
What does this mean? Ah! That’s the real Rorschach Inkblot test for the media. What it really means is that tolerance to the subjective effects of THC is a lot like the tolerance we see for prescription drugs like Vicodin and other over-the-counter drugs like Benadryl. Folks who feel high at first don’t feel it after a few doses. It’s not much of a leap to assume that these effects correlate with motor skills. All the worry about medical users screwing up at work is probably misplaced; they’ll be tolerant after a few doses. And per se driving laws that suggest that a certain amount of THC in the blood means someone is definitely impaired are on thin ice. Different people with different levels of tolerance will react differently to the same dosage.
But Vicodin and Benadryl are not the center of fierce and emotional debates about driving. Antihistamines and prescription opiates alter subjective states. They can impair performance on the road, too, but their subjective effects decrease after a few doses. Notice that you don’t see widespread debate about how much of each of these drugs you’re allowed to have in your blood when you sit behind the steering wheel. Why should cannabis be any different?
As an aside, roadside sobriety tests that require actually doing something (standing on one foot, walking a straight line) are a good indicator of how well people can drive. They certainly beat the number of nanograms of metabolites of cannabis, Vicodin, or Benadryl per unit of blood. They’re also sensitive to conditions that have nothing to do with drugs, like fatigue or illness. But if the media mention any of these points, color me surprised.
What will the media do instead? I’m guessing here, and I hope I’m wrong. But I bet they’ll scream, “Tolerance! Oh no! That means THC leads to dependence.” This little logical leap is quite elegant. Alarmists might use these data to say that THC must be likely to cause dependence. Of course, one symptom does not make a dependence diagnosis. And we might actually have to think a minute about why tolerance is a symptom of dependence in the first place. With toxic drugs like alcohol and tobacco, the more you ingest, the more you hurt yourself. So tolerance to these drugs means people take more to get the same subjective effect, leading them to more and more damage. For alcohol and tobacco, this means greater risks of cancer, for example. But THC’s toxicity has been hard to find without elaborate equipment looking intensely at dinky portions of the brain after multiple years of use. And some of these studies end in big surprises. For example, two years of exposure has made rodents more likely to stay alive and less likely to get tumors, which is the exact opposite of toxicity.
So, we’ve discovered that the subjective effects of THC decrease after repeated doses. The finding’s unambiguous, but the stories people will tell about it could be as different as responses to an ink blot. Unfortunately, this ambiguity could end up having serious implications as states continue to experiment with alternatives to marijuana prohibition.
Dr. Mitch Earleywine is Professor of Clinical Psychology at the University at Albany, State University of New York, where he teaches drugs and human behavior, substance abuse treatment and clinical research methods. He is the author of more than 100 publications on drug use and abuse, including “Understanding Marijuana” and “The Parents’ Guide to Marijuana.” He is the only person to publish with both Oxford University and High Times.
I am 63 years old and a Vietnam veteran. What a cannabis circus I have observed over the years as I watched the walls of ignorance, the walls of fear and the walls of lies concerning marijuana slowly come down. I have come to admire and respect the power of the lie and it’s ability to become truth if you say the lie enough. The lie would still live if were it not for the internet and the even more powerful truth it provided. It seems that lies are like vampires and have a problem with the light of day that the internet emits. ” Using marijuana causes white girls to lust after black men and musicians”. This was one of the many lies that our government perpetuated for over 70 years as a reason for prohibiting marijuana. Scare us, lie to us, juke us, bob and weave….it is over. Next month at least one State in this sorry ass nation will step up and say enough. The wall is coming down. Horticultural freedom is coming! We need to stuff this assinine idea that the government belongs in our daily lives and choices back down the dark hole it came from. I am a responsible adult and I can make make my own choices based on facts and truths…and I will, regardless of what my very bought and paid for government wants me to believe otherwise. I would suspect that there is little credibility left in our government’s ability to do anything else but continue the lies all the way to the end. 70+ years of lies are not easy to just stuff back in the bottle. The “gateway theory” is another lie we love to throw at the masses. Or the “highly addictive” lie, or the “what about the children” hesteria we are fond of envoking. I say…what about my freedom as a responsible adult in this land of the free? What about my civil rights, my right to be secure in my home and property, what about my government taking my home because I use a harmless plant? My government has no right to concern istself with what is going on inside my home or what I am eating or drinking or smoking there. Run our Country and get the hell out of my home and my personal life. You might save a buck or two.
I agree with Denbee and I am a 66 year old Viet Nam Vet surviving still………….and see thru ALL the BS now, been watching how the good ole boy network is destroying our country bit by bit, revangers trying to get one more payday before the fall….
I’ve never understood why dependency is considered a bad thing. After all, everyone’s survival is dependent on air, water and food (in that order). Babies are dependent on adults for survival. Many medical conditions require people to be dependent on medication for the rest of their lives. But ‘dependent’ becomes a dirty word when applied to Cannabis? It is absurd and makes no sense to me.
I have consumed between 1 and 3 grams of high quality Cannabis everyday for more than 20 years. In the beginning, I thought I was just using it ‘recreationally’, but in fact I had undiagnosed complex PTSD which I discovered years later, so actually was self-medicating without realizing it. At first I smoked joints, then after several years switched to water pipes and vaporizers. For the last two years I only eat it, heating the buds in olive oil and using that for baked goods.
So, you might say that I have become dependent on Cannabis to improve my quality of life, but so what? During those 20 years I earned two university degrees, a B.A. with distinction, and a LL.B., which is a law degree. My grades were good enough to be accepted into the graduate Law program, though I took a different direction. Cannabis did not hinder me, it helped me achieve that. And by the way, I was also a professional driver, supporting my studies by driving limousines, passenger vans and buses, and I have a clean driving record.
For me, Cannabis is a miracle drug, which I can grow myself extremely cheaply and safely, but am persecuted and prosecuted if I do so, even though I cause no one harm, not myself, my neighbours or society. I am criminalized for a victimless ‘crime’.
The prohibition of Cannabis is the true crime. The drug war is an immoral war against some citizens (poor & minorities) who use particular drugs, sometimes because its the only medication they have access to. Nothing brings greater disrepute to the rule of law than prohibition laws that millions of citizens simply ignore.
God bless you both, Denbee and jon jonzz! Thank you SO much for your service. I can’t tell you how sorry I am for the atrocities you must have suffered. I certainly hope you are as healthy today as you can be.
You gentlemen are the true heroes, rock stars, and celebrities. You are the ones we should be honoring. Your knowledge and insight of what this country is supposed to be all about, and how far we’ve come from that.
The tide is turning. We kindred spirits are finally realizing we have to quit being the silent majority. It’s well past time to not just speak up but yell from the roooftops that we, the people, HAVE to take this country back and get back to treating the Constitution as sacred as written. The government MUST be beaten back to its Constitutionally enumerated size. The American people MUST step up and take back responsibility for ourselves and our own families and communities.
Power corrupts. Absolute power corrupts absolutely. Government is NEVER the answer.
I meant to end the 2nd paragraph with “, is priceless.” LOL!
I wonder why my comment about my personal use of Cannabis for 20 years was rejected?
I am an 81-year-old Korean War vet. I think this whole cannabis thing is a tempest in a tea pot. And talk about tolerance! Nothing develops tolerance as fast or as completely as LSD. After taking it for 3 days in a row, it loses all effect. Does this cause dependence? Of course not! The user simply does something else (pun intended).
I agree with everything everyone has written. The right of self-ownership pre-dates the Constitution, but the Constitution put it down in writing. If the sovereignty of the individual is recognized, then all the problems of political privilege evaporate. Just one note: the complete quote of Lord Acton was: “Power corrupts, absolute power corrupts absolutely, and great men are often evil.”
Thank you veterans! I am a baby (only 43 yrs old) and the older I become the less I am able to listen to BS (media) or politics (poly means MANY and ticks are bloodsuckers…so many bloodsuckers=politics)…..On marijuana? What a riot. If those in power want it illegal (to support police and DEA…aka lots of $$$) AND the drug dealers (really Mexican cartels) want it illegal……..should we really trust either side? My favorite comedy is that even though our “war on drugs” continues foolishly, is POT is a schedule I drug…the worst of drugs and has no medical value???????????…then why does the United States hold a patent for “cannabinoids as antioxidants and neuroprotectants” with patent #6630507 Oct 2003? The ultimate irony? When is the revolution? It is far past just pot…taxes, freedoms lost, lies, etc. My neice was almost expelled from school…she is 9 years old…..get this…for having a plastic knife to use for her apple pie…….school regulations deem that a knife could be used as a weapon……..have we lost our minds people? I love our country but dispise what our government has become………….
I am a veit vet also.I am still wating for the freedom we went over there for.Everyone needs to read {The exception to the rulers} by Amy Goodman.It will show you how corrupt our goverment really is. I wish I knew the way to stop it all but every person we send to washington jumps on the money wagon. The only thing we can do is vote for the right person and hope it does not come to FIGHTING again…
I am glad to find a venue where I am one of many who feel the same way. I too am a 63 year old viet nam vet. We were over there doing our duty to our country while tricky dick nixon was ignoring his duty to uphold the constitution by passing the controlled substances act. The commission authorized by the act, the shafer commission, was charged with suggesting placement of drugs within the list of schedules, and sentencing guidelines for drug offenses. When they came back after two years and said that cannabis should not even be illegal at all, nixon would have none of it. He had his own war to fight, and it is against us, all the people who know cannabis should not be illegal. Keep teaching the truth and fighting the lies.
Consuming 120 mg of THC/day is way beyond anything I would wish to do on a continuing basic. Do you think there would be any mention of tolerance if we were talking about doing half a joint/once or twice per week?
I’m a 65 yr old Vietnam vet, i strongly agree with denbee. I take a certain amount of pride in knowing the role we vets played in bringing cannabis to America.
One more Namvet, this one 64, is starting to realize that this herb is going to be legal, nationwide, in my lifetime!
Perry, please know that you have our best wishes for your health.
If you would like to help gain safe and legal access to medical marijuana, you are uniquely positioned to make a difference by testifying before health and medical associations and state legislatures, as well as talking to the local media and writing letters to legislators. If you would be willing to speak out publicly in any of these ways, we would very much like to work with you. Please contact us at info@mpp.org to let us know if you would like to be contacted about these opportunities in the future, and in your response, please include your contact information, especially your ZIP code and phone number.
By the way, a great way to stay informed about marijuana policy reform and how you can make a difference is by subscribing to our free e-mail alerts. If you aren’t subscribed already, please visit http://www.mpp.org/subscribe to receive breaking news updates and opportunities to use MPP’s online system to e-mail your state legislators and members of Congress on important legislation.
This study was designed to mislead as the dose given far exceeds the maximum dose of 20mg a day with most taking 2.5 – 5mg twice a day at lunch and dinner as when taken early in the day the test subject did experience more unwanted side effects.
The pure THC has shown to cause mental and physical dependence but addiction is rare and seen only with subjects that took prolonged high doses.
They had several people with previous histories of drug abuse but saw no patients that had addictive tendencies even after using the drug for 5 months at prescribed levels.
The studies showed that withdrawals occurred when subjects took 210mg for 12 – 16 days straight and were over in 48 hours; these were the typical loose stool, anxiety and the things we know can happen when absurd doses are taken for months on end.
In severe overdoses subjects had panic attacks slurred speech and were not coordinated, some had a lowering of blood pressure so IV fluids should be given; the person should lay with their feet elevated 30% and if they are really anxious a valium is recommended along with assurance that everyone does silly things once in a while.
The estimated lethal human IV dose is 2100mg for a 70 kilogram human but if the person did not like shooting up their weed a serious overdose by mouth is 28mg for a 70 kilogram human.
The last 2 paragraphs shows how WORTHLESS and misleading the mentioned study really is and the only conclusion the media could come to is that The Survival of the Fittest applies which would make Darwin a true man before his time.
Not being from the media gene pool I conclude that if given the chance some idiots will turn a non lethal medication into an $8 pill that is not IDIOT proof and nature can often do it better than any corporation.
You can read the prescribing information at http://www.rxabbott.com/pdf/marinol_PI.pdf
Great little article Mitch. I am asking (pleading actually) for any of you Americans in states who are proposing changes to Marijuana Law to do as much as you can can to initiate change. I live in Western Australia where we the conservative government has made the laws on marijuana extremely repressive. So repressive I recently saw a case in my local newspaper where a guy was given a $1000 fine for 1g of pot, yes that is one gram!! Here is a link if anyone wishes to be shocked about the laws I live under. oh by the way drink driving in this state is considered less of a crime than smoking pot
http://www.police.wa.gov.au/Yoursafety/Alcoholanddrugs/Illicitdrugsandthelaw/tabid/1468/Default.aspx
I am a family physician, addictionist, and provide medical pain management. On occasion I recommend the medical use of marijuana. In that context it is no different than standard meds and the need to address risk, benefits, and alternatives. Tolerance is well established with THC and specifically Marinol. This study adds no new information really but it does amplify it. There is no question that per se limits will be arbitrary and blood challenging to obtain to make any judgements about impairment. MJ use increases motor vehicle crashes 2-3 times (Ramaekers et al. Drug and Alcohol Dependence 2004;73(2):109-19), even more so fatal crashes (Grrotenhermen et al. Developing per se limits for MJ. DUIC Report, 2005). It is no more appropriate to present a spin on selected article to push for widened use, just as it is inappropriate to be reefer mad in the other direction.
“Dependency” just means being used to something and having a withdrawal response. It is not what addiction is. MJ addiction exists (8-10% of users) and it can be really bad. Limited information does not mean cancer is not associated – there probably is an association with lung (Berthiller et al MJ and risk of lung cancer in men. J Thoracic Oncology. 2008;3(12):1398-403) and head and nec cancer (Tomar et al. Carcinogenicity of MJ. http://oehha.ca.gov/prop65/hazard ident/pdf zip/FinalMJsmokeHID.pdf).
I am willing to follow science on this. Anyone else?