cannabis

http://www.cnn.com/2017/05/30/entertainment/olivia-newton-john-breast-c…

Krebiozen had a pretty good take on Mexican clinics in his last ever comment here.

And if she passes- and sadly that seems likely from what you wrote- the chemo she received two years ago will be blamed by the woonatics.

"not a single scientific paper or clinical trial is presented to justify the treatment, which is called “Autologous Antigen Receptor Specific Oncogenic Target Acquisition” (AARSOTA)". Considering the part of the anatomy the treatment was pulled from, AARSOTA has an appropriate ring to it. But the real target of acquisition is the unfortunate cancer patient given to believe in the crap. Now, if Trump is still hell-bent on imposing trade sanctions on Mexico, I can't think of a better one than the cancer quack clinics sanctioned by the government.

Yvette: yes. Which is why hardly anyone has donated to her GoFundMe page. The woo meisters are not going to pay for her chemo, and she seems to have wised up and realized she needs real medicine.

She's raised a paltry $270 in just under 3 months. Her woo buddies have abandoned her.

She must realize it. I feel sorry for her. Sick, cheated, and probably in hospice care by now.

@Lighthorse #3

"Crap" and AARS are the wrong analogies for a treatment that involves *injecting urine.*

Of course they'll blame the chemo - because it's never the fault of the "alternative" cures themselves....of course, the majority of these "alternative" cures don't do anything on a biological level, so the disease just takes its natural course.

This is really sad.
I clearly recall when she was first diagnosed and the controversy that ensued when she was forcibly treated. My view at the time was that, while intended to save her life, the actions of the State of Connecticut went way too far. Both her and her mother were opposed to chemotherapy, and it seemed (at the time) that Cassandra understood that refusing treatment would lead to her eventual death from HL-and, while she was just under 18, she seemed to understand what the consequences of refusing treatment would be.

I didn't hear that she thought that "alternative treatments" would cure her cancer until she relapsed, and by that point, she was an adult.

The other thing is that, when the state steps in and forces treatment, it makes "us" (that is, proponents of science-based medicine) look bad in the eyes of some, and it probably gives the cancer quacks more fuel to rail against chemotherapy.

Certainly most people would feel uncomfortable with a 17-year old with cancer being taken from her home and family by child services, forcibly treated with chemotherapy, and not be allowed to have contact with her family during that period.

Ultimately, the question is "do the ends justify the means?", and in this case I would have to say that they did not. In cases where the child is younger, I would say yes, but with a 17-year old, I just can't say that they do.

@Lawrence-Yes, they probably will blame the chemo, even though she initially went into remission. Many quacks (especially homeopaths) claim that "conventional" treatments somehow "interfere" with the (nonexistent) ability of their so-called "treatments" to "work".

@Orac-The GoFundMe page you quoted says "in January of 2017 cassandra discovered that now both of her lungs are full of masses along with her surrounding lungs , chest , surrounding heart and neck . Cassandra now has to go through a very intensive 6-9 months of chemotherapy, again in hopes that things clear up."

But at the bottom of your post, you write "every week without effective treatment further diminishes the chances that Callender can be saved. I just hope she takes that chance and seeks real medical treatment instead of quackery as soon as possible."

Doesn't the GoFundMe page state that she finally has sought real medical treatment, and is now undergoing chemotherapy?

Yeah. Somehow an older version of the post posted where I didn't notice that. I changed it to the right version. In my defense, I was writing this crammed in a plane on an overnight flight and the first time through didn't read the GoFundMe page closely as I should have. I couldn't sleep; so I blogged. I don't know what happened. But, yes, thankfully she does appear to be getting treatment. That also explains why Hope4Cancer dropped her like a hot potato from its Vimeo page. I also note that, as I was trying to fix this, I somehow managed to reinstate the original version that was wrong about her seeking treatment. Damn WordPress. Sometimes its saving every version of a post can trip me up. This isn't the first time this has happened.

Be that as it may, this little slip up shows Orac's Tarial cells need recharging. Thanks for pointing out my mistake. I'll now go and contemplate some black holes, as Orac does when his circuits are scrambled. Read the post now. It's much clearer. I also changed the title and the blurb to make clear exactly what's going on.

@Orac/others having gone through the ringer with a loved one i really appreciate these scientific and logical insights on the alternative medicine offerings that make decision making during an escalating health crisis even more challenging. That said the above focuses on how those alternative treatments have not saved her life,

What about sharing your insights on how the original chemotherapy treatment she was apparently forced into doing before she was declared an adult didn't save her life either given the disease progressed? How do we know it actually left her better off vs worse? Is there ever a time when professionals using evidence based treatment approaches should be telling patients we are not likely going to be able to turn this around and you should focus on acceptance and quality over quantity of life? Thanks in advance for any insights on these aspects of the cancer treatment journey.

Her story is also similar to that of Jess Ainscough, whom you've also written about.

@Julian Frost-How are the two cases are similar, besides the fact that both of them fell victim to cancer quacks? Callender has Hodgkin's disease, whereas Ainscough had epithelioid sarcoma.

Also, Ainscough initially underwent isolated limb perfusion (before she fell victim to the Gerson therapy quackery), which appears to have been effective, for a time. Since Ainscough had isolated limb perfusion, it seems tyo me that she may not have been as averse to treatment as Callender is/was, and that Ainscough may have only turned to quackery after her cancer returned and she was told that the only hope for a cure would be amputation of her arm at the shoulder. That's obviously a far more radical intervention than chemo.

@Jonas, #7

I remember her saying she was ready to die as well. At the time I wondered if a seventeen year old could really think that one through. But now I see that we were wrong--she was planning to cure herself with woo all the time. She just said that to get the doctors and judges to leave her alone.

I'd like to see someone charged with manslaughter for this one.

Epithelioid sarcoma is a slow growing cancer, and that's why she believed, for a time at least, that the Gerson "therapy" was "working". In reality, of course, the slow progression was to be expected, and had nothing to do with coffee enemas or any of the other Gerson quackery that she fell victim to (and promoted).

Isn't treating cancer with urine derivatives Stan Burzynski's territory?

@Christine Rose-I think charging anyone with manslaughter in this case is a real stretch, especially since she (against her will) did receive chemotherapy.

But there are other, somewhat similar cases, where people should have been prosecuted and were not. The worst example was in Australia, where a homeopath told a woman with colon cancer that she could cure her cancer, and convinced the woman not to undergo surgery and chemotherapy. Eventually, the poor woman developed bowel obstruction, and even then, when the woman was in extreme pain and would have had just a day or two to live without surgery, the homeopath continued to urge the woman not to have surgery.

At that point, the woman finally ignored the homeopath's advice and underwent emergency surgery, but by then, the cancer had metastasized, it was too late, and the woman died of metastatic colon cancer 2 years later.

In my opinion, the homeopath absolutely should have been charged with manslaughter. But she wasn't.

@Christine Rose-"I remember her saying she was ready to die as well. At the time I wondered if a seventeen year old could really think that one through. "

Some have argued that adolescents are mature enough to make such decisions. Christopher Doig and Ellen Burgess, of the University of Calgary, wrote: "Life and death are concrete concepts clearly understood by adolescents. There is a clear ethical and legal foundation for permitting competent adolescents to decide if they will accept life-sustaining medical treatment."
(Source: Withholding life-sustaining treatment: Are adolescents competent to make these decisions?, Canadian Medical Association Journal, 2000).

Of course, if Callender believed that she could be cured with quackery all along, as it now seems, then she wouldn't have viewed chemotherapy as necessary to save her life, and therefore couldn't be considered competent to make such a decision.

@Julian - Do we know what's happened to Krebiozen?

There is so much to feel about cases like this but really so little to say. It is a life wasted on a delusion. Does it make much difference that the delusion is quackery as opposed to, say, religious zealotry (Buddhists self-immolating in protest)?

When people abandon reason for belief, the result is all too often tragic.

@Windriven-I agree completely. I'd add that, in my opinion, spending one's life as a nun or monk is another example of a life wasted on a delusion.

“Life and death are concrete concepts clearly understood by adolescents. There is a clear ethical and legal foundation for permitting competent adolescents to decide if they will accept life-sustaining medical treatment.”

This analysis fails to take into account understanding of the manner of death.

Does it make much difference that the delusion is quackery as opposed to, say, religious zealotry (Buddhists self-immolating in protest)?

The boldfaced part is far more complicated than you seem to think. Moreover, if the reference is to Thích Quảng Đức, (1) he was a Mahayanist and (2) it was a political action rather than "religious zealotry."* One may as well classify enlisting in the military as a category of delusion under this gloss.

* Robert Buswell does recount some cases of Korean monks engaging in a form of one-upsmanship in terms of who can burn off more fingers. Burning off one was used as a way to avoid military conscription.

^ Or heroism in combat, etc.

Coffee from the coffee enemas (this is not regular coffee that is available in the market!)

No, if you put it that way, it certainly isn't.

@myusrn,

Is there ever a time when professionals using evidence based treatment approaches should be telling patients we are not likely going to be able to turn this around and you should focus on acceptance and quality over quantity of life?

This is not such a case. Orac described the science-based treatment as having an 85% chance of a cure.

I admire your compassion; I guess that’s why you’re a doctor and I wouldn’t even want to be one. I saw the most dismissive, snotty doctor ever today, but I’d see him again if I needed to and there was no one else, before I’d turn to woo. I have a hard time feeling sorry for believers, be it woo or magical sky beings. It might be the “mild autism”, and I do hope this young woman gets well, mostly because then hopefully she will have learned her lesson and spread that anecdote.

What about sharing your insights on how the original chemotherapy treatment she was apparently forced into doing before she was declared an adult didn’t save her life either given the disease progressed? How do we know it actually left her better off vs worse?

Naively, I think most people would file remission under "better off." You'd need to define your terms more carefully to shift it over.

Is there ever a time when professionals using evidence based treatment approaches should be telling patients we are not likely going to be able to turn this around and you should focus on acceptance and quality over quantity of life?

You bet your sweet bippy. I'll be damned if I can really figure out why my mom rejected a home hospice nurse.

@Orac-Thanks for clarifying. I'm glad to hear that she is finally getting appropriate treatment.

Meanwhile, from the Hope For Anna Facebook page postings it sound's like Anna's brain tumor is growing (but Burzynski is calling it inflammation and not tumor growth) and Burzynski has the family flying back to Houston to try some new pill he "discovered" in Europe. Translation: Burzynski needs more $$$.

@Jonas:

@Julian Frost-How are the two cases are similar, besides the fact that both of them fell victim to cancer quacks?

Both had diseases that were treatable with evidence based medicine. Both decided to forego evidence based medicine. Jess Ainscough died, and it appears a virtual certainty that Cassandra Callender will also pay with her life.
@Rebecca, no. I haven't seen anything about what happened to him.
If anyone knows if Krebiozen is still alive, what happened to him, why he's no longer commenting, I would appreciate it if you could tell us.

Also both of them were/are attractive young women, still outwardly healthy, appealing to the generous, and articulate enough to convince the ignorant. And both of them had to admit they were wrong and risk offending their fans. A toddler may tug at more heartstrings, but babies don't have to have that moment when the truth clamps its slimy jaws right down onto what would have saved you two years ago...and belches in your face.

LW: She had an 85% cure rate in the first go round, when she was 17. I'm unclear whether or not she completed that first go round after she turned 18. IIRC she stopped short but was in remission. Now her chances of a cure are a mere 40-60%, and I tend to think more towards the latter end. It gets worse the more she delayed treatment. Metastasis has already occurred; by the time you get this, your chances really go down even with aggressive treatment.

Not impossible. Her age benefits her; younger, healthier people are better able to withstand the rigors of chemo or radiation than older people with other health problems to complicate things.

And while I suspect myusrn is playing the "reasonable approach" argument to supporting woo, she does ask a valid question:

"Is there ever a time when professionals using evidence based treatment approaches should be telling patients we are not likely going to be able to turn this around and you should focus on acceptance and quality over quantity of life?"

The answer to that question is a qualified "Yes." Experienced oncologists and oncology surgeons generally are able to tell when a patient is not responding to treatment, or when treatment is not likely to be successful in the first place, and are able to so accordingly inform, advise, and educate the patient. I say a qualified yes, because physicians are human beings. They may over estimate their ability to help the patient, and recommend a continuation of a treatment that is hopeless. They may hesitate to tell a patient the truth, fearing the patient will lose hope. Or they may under estimate the effect the treatment is having and recommend hospice care too soon. It would be disingenuous to suggest physicians never make mistakes.

But the majority of the time, they don't. Experience counts for a lot. When I worked as a hospice nurse, I got to know a lot of the local oncologists fairly well as they referred a lot of our patients to us. Their patients were going through a lot and they did the best they could for them.

So, myusrn, here's a primer on how fractionated dosing works to answer your other question about why her first round didn't save her. Bear in mind, this is the Reader's Digest version.

Any cell has four stages of growth, including cancer cells. Some forms of chemo will kill in any of the cell cycles, other forms target the cell in a specific growth state. Radiation therapy targets a specific part of the cycle. Giving the patient the whole dose of chemo or radiation would likely kill the patient, since both therapies affect healthy as well as unhealthy cells. So the therapies are given over time, to be better tolerated, and to ensure you get all the cancer.

That's why surgery for solid tumors is essential in many forms of cancer; get the bulk out early enough, follow up with chemo, and the 5 year survival rate gets much much better.

But when you delay treatment, you make it harder to get all the cancer. If it starts to spread, its' even worse. Not impossible but the further you go the more unlikely it gets. Cancers often find their way into the lymphatic system, which is like a highway system for cancer cells. They travel everywhere eventually, and take root in distant parts of the body. NHL is a blood cancer, but it can still do this, and that's what happened to Cassandra Callender. That's why she needed a bone marrow transplant and stem cells.

Problem is if you don't finish the treatment, even if the cancer goes into remission, it tends to come back harder later on. That's why Orac writes about these cases so often . . . they are such tragedies because they are so avoidable, and because they are used to fool people into thinking they can stop EBM when they really can't.

Coffee enemas aren't going to do jack for a cancer of the white blood cells.

And it's a waste of good coffee besides.

@Julian Frost (#32)
Yes there are some similarities. But there are also significant differences. Callender's case is well-known mostly because she was a minor at the time that she refused treatment, and therefore she was forced to receive chemotherapy.

In contrast, Ainscough was an an adult when she was diagnosed, so her right to refuse treatment was never even a question.

Also, Callender was refusing *all* treatment when she was first diagnosed, whereas while Ainscough refused the recommended treatment (amputation of her arm), she was initially treated with isolated limb perfusion, which was effective for a time.

Also, Ainscough promoted herself as a "Gerson therapy" "success story" for years, while Callender hasn't done so.

Finally, the cancers that the two have/had are much different. Hodgkin's disease has a good prognosis, and as mentioned, Callender's chance of survival with treatment was at least 85% in 2014. The prognosis for epithelioid sarcoma is much more guarded, and the treatment that could have cured Ainscough (amputation of her arm at the shoulder, perhaps followed by chemotherapy) is much more radical than the treatment for Hodgkin's disease. Since Ainscough accepted isolated limb perfusion, it seems likely to me that had she had Hodgkin's disease, she would have accepted chemotherapy. It was the fact that she required amputation of her arm-obviously a life-altering intervention-that drove her to seek out quackery in place of real medical treatment.

But I think the biggest difference is that Ainscough promoted herself for years as a "success story" for years, whereas Callender didn't.

@Panacea-BTW, there have been some advances in the treatment of patients with HL, who have relapsed after a bone marrow transplant, in the last couple of years. Treatment with brentuximab vedotin can put some patients with relpased/refractory HL into remission, at least for a time. I don't think that most of those patients remain in remission, though.

Also, the checkpoint inhibitors pembrolizumab and nivolumab have both shown efficacy in the setting of HL that has relapsed after a bone marrow transplant, and some of the HL patients who responded to checkpoint inhibitors have had durable responses (perhaps, some of these patients have been cured, but much longer follow up will be needed before you can conclude that checkpoint inhibitors can cure HL).

Hi, Jonas,

I know. That's why I said I thought her chances were more to the 60% end IF and only IF she gets conventional treatment. If she has delayed, even new treatments aren't likely to do her any good.

Which is very sad. She is much, much too young.

Cassadra Callender's case is complicated not just because she was a minor, but by the role of her mother – who was/is the true vehement woo fanatic driving the alt treatment and the rejection of chemo. There was some evidence that Cassnadra herself was conflicted about her mom in general, and about the treatment choice. When the State tried to force her into chemo she may have blanched because she'd already had her fill of folks telling her what to do, and that may have seemed somehow worse somehow than the familiar entreaties of 'mom', tilting her teenage rebelliousness back toward home. (I speculate wildly, of course...)

I was kind of surprised she continued on the pure woo path after becoming an adult and being able to make her own choices. I'd guess the diagnosis of remission was enough to let her hope she could avoid the very difficult path of conventional treatment for her cancer, and bought into the hope that the cannabis etc. would help prevent it's return. I'd guess further that if she had ever truly gone full-faith in the woo, instead of just cross-you-fingers hope, she wouldn't have abandoned it even after discovering the relapse...

I wonder if she'll make any statements about her story, now that she's trying to raise money to fund chemo. Which, btw, is a crime, as we should have universal national health insurance that covers this. Of course, she has a pre-existing condition, and life-saving treatment in the GOP's Muricah is a privilege for the privileged, not a right for the hoi poloi.
______

For the record, Makayla Sault's family only claimed to be "using indigenous people’s medicine" as a ruse to block any attempt by Child Services to take her into custody. Her parents were born-again Christians, who were actually relying on faith-healing to save her, as she was publicly 'cured' by televangelist Ted Shuttlesworth at a revival in Sarnia. McMaster Children's Hospital also bears some responsibility for her death by going postal when her parents first refused chemo and referring the case to Child Services instead of the State Board that could have placed her under a mandated treatment plan without challenging custody.

There are hundreds of thousands of cases just like Cassandra's among people who pursued only conventional cancer treatments. Many die every single day.

There is no way to know if Cassandra would have been better off had she pursued more of the conventional treatment she received the first time around--the one that pronounced her "in remission"--only to learn nine months later she had more cancer that had already spread.

This story--of "successful" conventional treatment, followed within a few years by relapse with more cancer that is more widespread and virulent--is a very familiar one. For those patients, there is only compassion, and no ridicule for their poor choice of treatment that left them dead.

NWO Troll, why should we care about your uneducated opinion? You are just noise in the ether.

There is no way to know if Cassandra would have been better off had she pursued more of the conventional treatment she received the first time around

Are you kidding me? We have ample data from decades of practise that show that she would have almost certainly been cancer free had she continued with conventional (read "proven") treatment.

the one that pronounced her “in remission”–only to learn nine months later she had more cancer that had already spread

NWO Reporter doesn't know the meaning of the word "remission". Colour me unsurprised.

It would be interesting to have actual numbers rather that pro-woo conjecture, wouldn't it; numbers organized like:
(A) 89% survival after completing full chemotherapy, only.
(B) __% survival after complete chemotherapy + sCAM 'therapy'
(C) __% survival with partial chemotherapy.
(D) __% survival with partial course of chemotherapy + sCAM 'therapy'.
(E) __% survival with sCAM 'therapy' only.
(F) __% survival with no treatment at all.

What would you wanna bet that (A) and (B) are indistinguishable; that (C) and (D) are indistinguishable; and that (E) and (F) are indistinguishable and indistinguishable from 0%?

Hope4Cancer offers quite an assortment of quackery. It also seems to have a large fan base because of Bollinger's Truth About Cancer film.

Interestingly, they offer one treatment modality that might seem more legitimate than a coffee enema to the average person, because it is actually registered as a drug somewhere - Rigvir oncolytic virus, for skin melanoma, which was also praised in Truth About Cancer. But that is only the case if you don't check PubMed, don't know about its background in its home country Latvia, suspicious registration without proper evidence from clinical trials, countless breaches of drug advertising laws, and the fact that oncologist associations in Latvia have asked for its removal from drug register due to insufficient evidence: http://www.twitlonger.com/show/n_1spm0ua

Hope4Cancer is an exclusive partner of Global Virotherapy Cancer Clinic in Latvia. Some time ago I looked at Gofundme.com requests for donations for Rigvir treatments, mostly at "Rigvir certified" Hope4Cancer clinics, but also in Latvia and some German quack clinics. For 79 patients the total value of requested money was well above 3 million euros, people from all walks of life are selling their houses, emptying savings and pension funds just to end up dead or with a progressing disease due to this Latvian "miracle drug".

Based on these prices and pictures on Hope4Cancer website, you'd think this is quite a luxurious place, a bit like a spa. However, recently an alternative medicine fan went on a Mexican clinic tour and wanted to film the clinic. Hilarity ensued, as she was not allowed in. But she filmed the outside and the reception and we can see what kind of luxury setting 50-70k USD will buy you: http://bruisedbanana.travel/2017/05/20/medical-travel-quick-visit-to-th… Not exactly the tropical paradise one expects...

Yeah, one of these days I have to look into Rigvir more, but today is not that day, as you will understand when my post for today goes live. :-)

Oh, a new post coming, great! :)

@Chris H. - that's horrible to hear about Anna.

Based on the posts on "The Other Burzynski Patient Group" page, it sounds like Anna is suffering from the inevitable effects of "non-treatment" and is going down the path of many of his other patients.

NWO Troll: yes, many patients with cancer die every day. Don't remind me: they made up a large part of my hospice client group. I know far more about what it's like to watch someone die with cancer than you ever will (and that includes watching my father die from liver cancer).

What you ignore is that treatments for some kinds of cancer have gotten a lot better. It's getting rare for someone to die of cervical cancer today, and I can see a day when no one does because we'll have eliminated 90% of the cause through vaccination. That means those women won't have to worry about the risk miscarrying their babies because of an incompetent cervix, or ever have to go through surgery, radiation, or chemo.

But when Henrietta Lacks got cervical cancer in the 50's, there wasn't any effective treatment at all, and it was usually caught late, and was a death sentence.

We're doing better with other cancers now as well thanks to routine screening, and early treatment and intervention . . . so well, we now have to be careful not to over diagnose so as to avoid unnecessary treatment and anxiety.

@Julian: NWO Troll doesn't know the meaning of the word relapse, either.

You mean 'we' have figured out people survive longer after diagnosis if the cancer is detected earlier. Shocker. The same would be true without any treatment at all. Just one of the obvious ways the cancer industry manipulates perceptions.

@NWOR (#39). You know nothing. Chemotherapy has saved countless lives. Does it have serious adverse effects? Of course, but without it, the survival rate for someone in Cassandra's situation is 0%.

Numerous forms of cancer, including Hodgkin's disease, acute lymphoblastic leukemia, Wilms' tumor, and
testicular cancer, are highly responsive to chemotherapy and the survival rates for these forms of cancer have improved from essentially 0% before the development of chemotherapy to, in many cases, more than 80% today.

Testicular cancer is often curable with chemotherapy even if it is has metastasized at the time of diagnosis, and more than 80% of pediatric patients with acute lymphoblastic leukemia, the most common form of childhood cancer, are cured of their disease (unfortunately, the prognosis for ALL in adults is significantly poorer).

The prognosis for Hodgkin's lymphoma has also dramatically improved, and the 5-year survival rate for all HL patients is now around 85% (in patients under 20, it is even higher).

Sadly, Cassandra was one of the very unlucky patients who relapsed-but even she still has some chance of survival with real medical treatment (whereas if she had continued with the quackery, she would have had absolutely no chance of survival).

In case you missed it...Cassandra tried conventional cancer treatment first. The cancer industry deemed it a "success"--but nine months later, she had more cancer than she started out with. Seems like any rational person would be less than impressed with the end result.

Since it's likely to be a slow week, I'll add this note.

Olivia Newton-John has had a recurrence of her cancer.

I'm not sure what the natural wellness therapies are, but I hope the photon radiation is gamma radiation and that it works.

"Some have argued that adolescents are mature enough to make such decisions. Christopher Doig and Ellen Burgess, of the University of Calgary, wrote: “Life and death are concrete concepts clearly understood by adolescents. There is a clear ethical and legal foundation for permitting competent adolescents to decide if they will accept life-sustaining medical treatment.”
(Source: Withholding life-sustaining treatment: Are adolescents competent to make these decisions?, Canadian Medical Association Journal, 2000)."

The crucial word in all of that is "competent", which IME of working with adolescents who gave the appearance of wanting to be dead, needs, as per UK-ian law, to be assessed on a case by case and appointment by appointment basis.

I certainly met numerous adolescents who certainly appeared to be competent, but, when one explored their views about death and what it meant in more detailed, actually displayed a whole load of magical thinking, strongly suggesting that they did NOT understand these "concrete concepts".

This is one of those areas where it is almost always more complicated than that...

@Murmur- Well, if someone believes in an afterlife, then in my book they are displaying thinking that is, to say the least, not in touch with reality-so if you look at it that way, the majority of people are displaying thinking about death that is inconsistent with reality (yes, I know, I know, the religious people commenting here will point out that there is no *absolute proof* that there is not an afterlife, but there is zero reason to believe that there is).

I'm assuming that the magical thinking you are making reference to went way beyond just believing in an afterlife, since many people believe in that, but I still couldn't resist pointing out the fact that the majority of people do not understand the concrete reality of death (i.e., that once you die, your brain ceases to function, and therefore there cannot be any consciousness after death-and that since everything that makes a person a person is the brain, once their brain ceases to function, they cease to exist).

Jonas: I'm glad courts don't use your book to decide if someone is competent then.

Panacea, I was saying that, in a way, the majority of people don't have a "concrete understanding" of death, because they believe in an afterlife. Basically, I was using Murmur's comment about adolescents having "magical thinking" around death to make fun of the fact that so many people believe in an afterlife.

It is really obvious that the "magical thinking" that Murmur was referring to goes way beyond belief in an afterlife, and I was clearly not suggesting, in my previous comment, that those who believe in an afterlife are not competent to make their own medical decisions. I was just pointing out that a lot of people have beliefs that could also be viewed as "magical thinking" or something similar.

Yes, Jonas. I get you were making fun of the fact so many people believe in an afterlife.

I believe in an afterlife. What's that got to do with the price of tea in China? Ones belief in an afterlife or a greater power has no bearing on ones ability to understand death, or to make competent decisions on their health care.

And whatever you were trying to say about Murmur's opinion, you said it poorly because you definitely sent the message that anyone who believes in an afterlife believes in magical thinking.

Even if you are not attaching those beliefs to medical decisions, those beliefs still impact health and coping with severe illness. Spirituality, a belief in a higher power, and an afterlife are powerful tools for patients coping with life threatening or altering medical issues.

@Panacea
"And whatever you were trying to say about Murmur’s opinion, you said it poorly because you definitely sent the message that anyone who believes in an afterlife believes in magical thinking."

But Panacea, that is, in fact, accurate. There is no proof of gods or afterlife. Believing in those things is a choice based on supposition. If you don't want to call that "magical thinking" propose another term. But from the perspective of logic and reason ...

Actually, she was in remission, but refused to continue the treatments which would have given her a better chance of not suffering a relapse (she specifically rejected conventional treatment as soon as she turned 18).

I tend not to worry too much about people's internal religious beliefs.

It only worries me when they take that same kind of magical thinking and attempt to apply it to the real world (i.e. a rejection of science).

Windriven: I'm going going to get into a theological debate with you. I believe what I believe, you believe what you believe. I'm not asking you to believe something simply because I do.

The vast majority of my patients have some sort of spirituality that is important to them, and it is a cornerstone of good nursing care to respect that regardless of what I personally believe.

"I believe what I believe, you believe what you believe. I’m not asking you to believe something simply because I do."

Neither am I. But that is the point. There is a difference between belief and evidence. What is belief other than magical thinking?

@ Lawrence #59

Exactly my point.

You mean ‘we’ have figured out people survive longer after diagnosis if the cancer is detected earlier. Shocker. The same would be true without any treatment at all.

Wait, what? Are you saying that earlier diagnosis on its own and no treatment is enough to up survival rates? Seriously?

In case you missed it…Cassandra tried conventional cancer treatment first. The cancer industry deemed it a “success”–but nine months later, she had more cancer than she started out with.,/blockquote>
And how much more cancer would she have had had she not had any treatment?
I'm amazed at you, NWO Reporter. Do you not realise how idiotic your arguments look?

You are so utterly corrupt. "Survival rates" are always measured by a specific time period. Of course someone diagnosed earlier rather than later will survive longer after diagnosis, with or without treatment.

You can speculate all you want about how much cancer Cassandra would have had without the conventional treatment that left her with more of it, but that's all it is--speculation. What a pathetic attempt to tout a treatment than was a spectacular failure.

You are so utterly corrupt. “Survival rates” are always measured by a specific time period. Of course someone diagnosed earlier rather than later will survive longer after diagnosis, with or without treatment.

You can speculate all you want about how much cancer Cassandra would have had without the conventional treatment that left her with more of it, but that’s all it is–speculation. What a pathetic attempt to tout a treatment than was a spectacular failure.

Oh my goodness, no much misinformation in so few words!

" “Survival rates” are always measured by a specific time period." Ya think? We all die. Sometimes we die of cancer that had been in remission. But we measure our progress in treating cancer by noting changes in survival rates at some interval - usually 5 or 10 years. Few scientists ever speak of a cancer as having been cured; there is nearly always some chance of recurrence. But while most cancer diagnoses were death sentences only a few generations ago, today many cancer diagnosees go on to complete remission and eventually die of an unrelated condition.

"You can speculate..." You should understand that it really isn't speculation, it is a judgment based on the treatment of others with similar staging at the time of diagnosis. There are, of course, no guarantees. We all have different genetic profiles and sometimes respond differently to treatment. But to suggest any relationship between survival probabilities with or without treatment is simply wrong.

All this smug condescension and sugar coating...yet still, we have a woman who underwent conventional treatment and wound up with more cancer than she started with.

"No, it wasn't a failure! It was a medical miracle! The statistics prove it! Her only hope for survival is more of the same!" Right. And doctors wonder why so many people distrust the cancer industry and are seeking out alternatives. It's like a dark satire.

"Her only hope for survival is more of the same!” Right. And doctors wonder why so many people distrust the cancer industry and are seeking out alternatives. It’s like a dark satire."

Yes NWO, her only hope is more of the same. Her best hope would have been to stay with the program without interruption.

Doctors don't wonder why some people distrust or fear cancer treatment. Cancer is a terrible disease (actually, a suite of diseases). Cancer treatment usually demands intimidating radiation treatments and/or noxious chemotherapy. It is sometimes horrific and it is never pleasant. How much more inviting to believe that coffee enemas and macrobiotic rice will make it all better. It won't.

Cancer physicians didn't wish cancer on their patients. They are exquisitely trained men and women who have devoted their lives to driving cancers into remission. They don't always succeed. But the odds get better every year.

Whether one let's fear and superstition control their life and death is a personal choice. make it wisely.

No doubt a lot of people think so. Still, anyone who doesn't get at least two or three opinions to confirm their cancer diagnosis and recommend a treatment is taking a serious risk with their life. For every doctor who has been exposed as a cancer charlatan, there are likely at least a 100 more.

@NWOR (#50)-She went into remission after receiving chemotherapy. The majority of patients with HL (typically more than 85%, and, in some subgroups of patients without adverse prognostic indicators, 95%) remain in remission after treatment and never have a relapse(as a matter of fact, I know a guy whose son had HL-he had chemo and is now cancer-free, years later), but unfortunately, Cassandra Callender is one of the approximately 15% of HL patients who will relapse.

I already discussed how the development of effective chemotherapy has improved the prognosis for patients with many forms of cancer in comment #49. I certainly could expand on that comment, and discuss how more recent advances (e.g., the development of the immune checkpoint inhibitors pembrolizumab and nivolumab) have improved the prognosis for patients with advanced cancer who previously had few if any treatment options.

However, based on your comments here, and on your previous comments regarding vaccination, it appears that you are someone who is vehemently opposed to all conventional medical intervention, regardless of the evidence of it's efficacy.

"Remission," eh? Nine months after that pronouncement of "success," her body was riddled with cancer--more than she had before the treatment. It didn't grow overnight. Sounds like that "remission" was more like a coffee break. Obviously, the conventional treatments didn't work well for her. With "success" like that, it's no wonder she sought out alternatives.

Windriven: different standards of evidence.

You can neither prove nor disprove an afterlife because science investigates the natural world, not the supernatural. It doesn't even LOOK at the supernatural world, which is as it should be.

People have experiences that no one can explain using scientific methods. I've had them. That's not enough to convince everyone and that's OK. Something happened to me. I call it spiritual. You can't call it magical thinking simply because you don't understand it.

I'm done with this conversation.

"I’m done with this conversation."

Bu-bye now.

To anyone other than Panacea who might be interested:

"You can neither prove nor disprove an afterlife"

I don't need to prove or disprove an afterlife or the god that would be all but necessitated by the existence of an afterlife. To accept the existence of a god or an afterlife as fact there needs to be clear evidence. There is not. Absent that evidence there is only belief. People believe in ghosts, fairies, yetis, sasquatches, and little green men. And gods. Doesn't make any of them real.

@Windriven (#61). I agree.

@Panacea (#56). It is my view that religion, belief in afterlife, etc, is a psychological coping mechanism. It is much more pleasant to believe that your loved ones are in heaven than it is to accept the reality that they are gone, and it is much more pleasant to believe that you will go to heaven when you die than it is to accept that death=eternal oblivion.

In view of that, belief in an afterlife could be considered to be, basically, a very comforting delusion.

That being said, I agree with you when you say "it is a cornerstone of good nursing care to respect that regardless of what I personally believe", and I will also note that nobody here is trying to impose their atheism on anyone else, nor do I think anyone here has any problem with what anyone else believes, as long as it is not imposed on others.

Hi, Julian,

Yeah, this is why I said in my #47 regards to NWO #39: Ginny doesn't understand what relapse means any more than she understands what remission means.

And Jonas is right: she just was to dis EBM. I hope she never gets cancer.

Your condescension is hysterical. Her body with riddled with cancer only 9 months after the doctors pronounced her conventional treatment a "success." And we should hail it as a miracle. You are a great illustration of why so many people are seeking out alternative treatments. :D

@Panacea-You must be a faster typist than me-I typed the above response before I saw that you'd posted your most recent comment (#65) We'll have to just agree to disagree on this issue (which is fine).

@Panacea-I also hope that she doesn't have kids, since if she does, she wouldn't vaccinate them, and might not get them proper treatment if they are ill.

@NWOR-This is the type of thing that happens when people with cancer listen to people like you. https://www.danbuzzard.net/journal/scammed-to-death-how-francine-scraye…

Cassandra Callender seems to have finally realized that the "alternative treatments" she was getting were worthless, and that she needed real treatment-hopefully, she didn't reach that conclusion too late.

Once again, you 'forget' to mention that she started out with the 'real' treatment she 'needed.' Nine months later, her body was riddled with more cancer than she started out with. I'd call that a spectacular failure. It's hardly a surprise she decided to try alternatives the next time around.

@Jonas #69

"I will also note that nobody here is trying to impose their atheism on anyone else, nor do I think anyone here has any problem with what anyone else believes, as long as it is not imposed on others."

Amen, my brother ;-)

@NWOR-Chemotherapy is not always effective (in this specific case, it was partially effective, in that she did go into remission for a time, but then relapsed), but quackery (you call it "alternative" treatment, I'm going to just call a spade a spade and refer to it as quackery) is NEVER effective, and hasn't saved ANYONE from dying of cancer.

And it is still possible that Cassandra will survive with real treatment-unfortunately, she delayed getting treatment, which has hurt her chances of survival, but there is still some hope.

And it's possible Cassandra would be better off now had she not pursued conventional treatment the first time around. And it's possible she'd be dead by now if she had pursued more conventional treatment instead of alternatives the second time around. Speculate all you want--that's all it is. You can't disguise that in condescending judgments and directives, and it's not your life at stake.

"Speculate all you want–that’s all it is. "

You repeat the same nonsense despite having had the facts explained to you. One wonders if you came by this refractory ignorance through some intellectual defect of if you are simply being an ass.

Probability and speculation are entirely different things. The high probability is that she would have achieved and maintained complete remission had she completed the prescribed therapy and complied with the follow-up program prescribed by her physician.

A similarly high probability accompanies the choice of quackery in place of medicine and that probability is for the disease to run its course culminating in the death of the patient.

There are no guarantees either way. A vanishingly small number of patients spontaneously remit and remain in remission. A relatively small number of patients receiving conservative medical treatment will succumb to the disease despite early diagnosis and appropriate care. The first is like playing Russian Roulette with 6 of 6 chambers loaded and hoping for a misfire.

You can't seriously believe a slew a derision hides the fact you are speaking out of both sides of your mouth. Of course there are no guarantees. Yet you arrogantly dictate choices about someone else's life, as if you are God. I thought you didn't believe in God.

"you arrogantly dictate choices about someone else’s life"

You misrepresent what I've said. I dictate nothing. Each adult - and I'll give this young lady credit for being an adult at 17 - get's to make her own choices. Sometimes we make stupid choices. Sometimes we pay for those choices with our lives.

She never actually finished the treatment regimen - even after remission, oncologists will err on the side of caution and there will be follow-ups to lessen the chance that the Cancer will recur.

In Cassandra's case, she never had the follow-up, so to blame conventional treatments is just another example of your total absence from reality.

So, NWO, what should people with cancer do?
Nothing?

NWOR, do you accept that ANY conventional medicine is effective? Are you so far gone that you wouldn't even agree to take antibiotics if you had a bacterial infection?

I'd like to think you would, but your unwillingness to acknowledge that chemotherapy is effective and your ludicrous attempt to blame Cassandra's relapse on the chemotherapy that she received in 2015, combined with your anti-vaccine statements on another thread, makes me really wonder.

@NWOR (#79). No, actually, that's not possible-there is absolutely no possible way that she'd be better off if she hadn't received treatment in 2015. It is possible (very likely, in fact), that she would have already died of Hodgkin's if she hadn't had chemotherapy in 2015.

Prove it.

NWO @89: Would you take the 5 yer survival rates for HL before treatments were developed?

Or do you want us to go back in time to just before Cassandra had her first chemotherapy treatment and split the timeline so we can compare treated and untreated Cassandra? You would have to do that, I'm not allowed to mess with the timelines any more.

As someone who was actually treated for Hodgkins that didn't respond to front-line treatment, I am incredibly thankful that my oncologist looked me in the eye and said, "you'll be dead in two years if you don't get a stem-cell transplant". That was 9 years ago. If there is an 85% success rate for initial treatment that means, of course, that 15% may need additional treatment. I have completly recovered, although I realize that I face some future risks associated with my treatment. But life is a risk. I wake up every day thankful that I am fit, happy, and on no meds associated with my treatment or transplant! BTW, other cancer patients I met along the way, who post-poned or declined cancer treatment DIED. Sure, I know that is anecdotal evidence, but it still vivid to me.

Untreated Cancer progresses - that's what it does. Eventually, it would have killed her....with treatment, the odds of recovery were high.

Without it, near 100% certainty that she would either be dead by now or well on her way.

Odds don't matter in the slightest here because she DID get treatment and we know how it turned out. She was pronounced "in remission," and nine months later her body was riddled with more cancer.

"She was pronounced “in remission,” and nine months later her body was riddled with more cancer."

First, being in remission doesn't necessarily mean that chemotherapy should cease. It means that the disease is in remission and usually chemotherapy continues for a period after the onset of remission.

Next, what exactly occurred in the none months between remission and the finding of resurgent cancer? She turned 18 and refused continuing medical treatment in favor of a cancer quack. When she finds out she's facing resurgent disease she doubles down on the quackery ... at least for a while. Now she's back to chemo and, one presumes, desperately hoping that she didn't squander her chances for a long life.

And yet you bray on. You live in a fantasy world.

Interesting theory. Do you have access to her medical records? Because there's no indication on her GoFundMe page that she rejected conventional treatments in between the time the doctors pronounced her in remission, and the time they discovered more cancer.

"there’s no indication on her GoFundMe page that she rejected conventional treatments in between the time the doctors pronounced her in remission, and the time they discovered more cancer."

No, I would expect not. I do not get my information from GoFundMe pages. If you do, there is little for us to discuss. Take a bit of time and compare the timeline on the GoFundMe and the timeline on Ty Bollinger's Truth About Cancer page.

Holy cow, that's quite a frightening story--I had no idea how bad our medical police state is becoming.

Anyway, I can't find any support on Bollinger's page or elsewhere for your contention that conventional treatments were recommended but rejected from the time she was pronounced "in remission" at age 17, to the time they discovered more cancer, at age 18. So my tentative conclusion is you are being deceptive, again. But by all means, clear it up with substantiation for your claim.

Oh FFS, what part of "discontinued treatment" don't you understand, dunderhead?

All of it, I guess.

You mean discontinued when she discovered her body was riddled with cancer again?

Ginny: "You mean discontinued when she discovered her body was riddled with cancer again?"

Finally, the little light bulb goes on for Ginny!! Congratulations! Cassandra gave up on cannabis oil and other types of wishful wooful thinking when she discovered that they had done nothing to slow down her cancer. She returned to the only treatment which demonstrated ANY results: chemotherapy, aka evidence-based medicine.
.
For the longest time I thought you were pretending to be incredibly stupid, but now that you've established tangential contact with reality I see that it was no act.

Nice try, Opie. The issue was when she discontinued the CONVENTIONAL treatment she started with. You know--the one that left her body riddled with more cancer than she started with. It was after that debacle with conventional treatment that she tried alternative treatments. But then, you know that. ;)

"It was after that debacle with conventional treatment that she tried alternative treatments."

Your reading comprehension is as abysmal as your reasoning skills. She abandoned conventional care upon reaching 18 years of age, shortly after the cancer was in remission. Being in remission DOES NOT mean that treatment stops. It means that treatment is working and needs to continue.

But then, you know that. ?

Nope, doesn't sound that way. Sounds like she underwent the complete course of recommended conventional treatment (forcibly), was pronounced in remission, and 9 months later, when a mass was discovered in her lung, she rejected more conventional treatment.

"Nope, doesn’t sound that way."

Only to you, Tinkerbell. The facts are what they are. Timelines don't lie.

Post a link to the timeline.

I can save us both the time. READ ORAC'S

Is your link finger broken or something?

Are you illiterate?

@NWO Distorter #97
Sorry, my mistake. You really ARE that stupid.
.
In # 70 you say that she was riddled with cancer nine months after stopping treatment. By comment #97 she stopped treatment because it left her riddled with cancer.
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Behold the woonatic mind at work: believing two contradictory 'facts' on the same day on the same forum.
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Ginny: here's a pro tip from my grandmother: "If you don't lie you don't have to try to keep your stories straight."

Nope. Nine months after being pronounced "in remission" after her (forced) conventional treatment, a mass was discovered in her lung. At that point she declined further conventional treatment.

Better go back to skipping rocks in Mayberry, Opie--you're not very good at this deception thing. :D

There is no proof of gods or afterlife. Believing in those things is a choice based on supposition. If you don’t want to call that “magical thinking” propose another term.

There is no "proof" of the ontological accuracy of monist materialism, either.

Be careful about discarding elements of traditional medicine, would you laugh at treating someone with a bacterial infection with bread mould or externally with the oil of the tea tree, insect infestations with a chrysanthemum, perhaps a headache and fever with white willow bark or even constipation with the leaves and fruit of the senna plant, pain with poppies, or burns with bandages impregnated with silver. Each of these natural treatments are common and proven medical realities. There is NO doubt that some natural substances help with some cancers, tea tree oil for some skin cancer for example. Capsicum (capsicum)shows some efficacy in the lab against cancer, as does ginger and garlic probably due to antiviral/ antibacterial /anti fungal properties where cancer is related to a pathogen.. Willow bark (aspirin) has been shown in some studies to reduce the incidence of metastasis. Other things can make cancer worse, for example estrogenic compounds, possibly condroitin. Modern medicine isn't foolproof either, the common biopsy procedure is suspected of inducing metastasis. While I would never counsel avoiding modern medicine altogether, there is no doubt that diet and general health plays a major role in long term survival and maintaining a sense of order and hope for the patient. Does that excuse outright quackery, well no, but a real scientist would look for adjucts that help the patient even in small ways.

"This page has been set up to help raise money for Cassandra’s 2nd battle against Hodgkin’s lymphoma . In 2014 she was diagnosed and pronounced in remission after 6 months of chemotherapy in 2015. 9 months later in 2016 Cassandra had found out she relapsed with a mass in her left lung and surrounding neck/chest. She spent the whole year using alternative treatments / cannabis oils but unfortunately the cancer became more aggressive."

So, after convention treatments, she went into remission.

She relapsed & tried "alternative" treatments - and after a year, her Cancer got worse.

Spin that one, nitwit.

Yeah, that's the point. She wasn't too impressed with her forced conventional cancer treatment, given that only nine months after it was pronounced a "success," she was riddled with more cancer again. Can't really blame her for deciding to try alternatives instead.

I'm not sure I understand why Jonas "couldn't resist" pointing out his opinion of beliefs pertaining to an afterlife, but it definitely derailed the thread a little; kudos to Panacea for walking away.

@NWOR

Cancer can relapse in spite of successful treatment. This is known. There isn't anymore to discuss beyond that simple fact.

Chemo increases the risk of developing more cancer. This is well known. So yes, there is much more discuss.

She wasn’t too impressed with her forced conventional cancer treatment, given that only nine months after it was pronounced a “success,” she was riddled with more cancer again.

It wasn't ever "pronounced a 'success'," you fυckwit. She only had five months of treatment for stage III–IV HL.

^ G-ddamn blockquotes.

Still, anyone who doesn’t get at least two or three opinions to confirm their cancer diagnosis and recommend a treatment is taking a serious risk with their life.

Um, she did get a second opinion. Are you just scooping shіt out of your ass here, Ginny?

How many people who have undergone ONLY conventional cancer treatment are lying on their death bed right now? There must be hundreds at least, probably thousands.

Think how comforting it would be for them to read an article about how they did the right thing--how they made the right choice by avoiding all those alternative and complementary treatments. Just think--this blog could be used to provide them comfort in their time of greatest crisis. Instead, it's used to attack a young woman in her time of crisis for her personal health care decisions. You'd think her medical arrest and forced chemo would be enough punishment for a lifetime--it's truly a horrific story. But we all know that wouldn't sell the agenda quite as well.

Narad . . . Windriven . . . Lawrence . . . c'mon guys. You know NWO is a flippin TROLL.

Don't feed the trolls.

Just so. I'm done with it.

So, NWO, what would you have chosen to do if you were diagnosed ? Lotsa and lotsa coffee enemas? Organic juicing? Bleach?

How would you have done it differently? Just curious.

And it’s possible Cassandra would be better off now had she not pursued conventional treatment the first time around.

Oh, really? Says who? An clueless asshat like you?

Chemo increases the risk of developing more cancer

Citation needed.

@Julian Frost, #124: Of course it does. If you're dead from a first cancer, your probability of a second cancer is 0. OTOH, if chemo, radiation, and/or surgery allowed you to survive that first one, you have a probability of a second one that's greater than 0.

I fully aware she is a thick-headed dullard & troll....I just wanted to see how stupid she would get, and she didn't disappoint.

@122: Well, dying from one kind of cancer unquestionably makes it rather unlikely to get cancer again... Correlation and causality, the claim is still an exercise in statistical sewer diving (increase from dumpster diving).

Correction to my 127: Reference should be @124 Julian Frost (number changed for some reason)

@NWO Reporter: Yeah, I know you're a troll, but I still want to respond: Your arguments against evidence-based medicine are so vile to patients like me who had to make decisions about cancer treatment. I faced an onslaught of information about how chemo would kill me. Every time I walked in a grocery store there would be some free "Natural Awakenings" magazine telling me that Cannaboid Oil would be curative. Or coffee enemas, or mushrooms, or Vitamin C, or some other "woo of the month". The internet was filled with websites offering every form of BS. It was a terribly frightening period for me. I didn't want chemo and I sure didn't want a stem-cell transplant, but I had to face the facts: I didn't want to die in a year or two. Looking back, 9 years later, I am SO GRATEFUL that this technology was available to me. And I am SO annoyed when I see hucksters trying to sell BS that "cures cancer" either for their direct profit or to just flip off "the medical establishment" , "the man", "Big Pharma".
NWO Reporter: you probably wouldn't be alive today, if it weren't for the progress made in the last 50 years by medical science.

Well said, @Marie #131.
If it wasn't so tragic for the girl involved, NWO reporter's mangled concepts of lymphoma remission and relapse would be very amusing.
I wonder what his/her take on "remission" as defined by Burzinski and fellow snakeoil merchants would be?

Lymphoma will go into remission with conventional treatment.

(number changed for some reason)

When people irritatingly use the nested "reply" function, which doesn't appear on the Web site proper but only in the E-mail notifications, all of the following comments get renumbered. Oh, and one has to scroll back through the whole freaking thread to find the damn reply.

Just think–this blog could be used to provide them comfort in their time of greatest crisis. Instead, it’s used to attack a young woman in her time of crisis for her personal health care decisions.

Where, precisely, is that part, fυckstain?

This is how we know that NWO is a full-on troll: they don't have any suggestions. At least our idee fixee trolls have a suggestion (even if it is the same thing every time), but NWO just says "NO!" to everything.
There is nothing that NWO likes or wants except an opportunity to be contrarian.

I've got to learn to quit trolls.

Talking ABOUT a troll is totally different from interacting WITH a troll, right?? I'd never want to feed a troll. . .
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Narad said "Where, precisely, is that part, fυckstain?"
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Which got me thinking. Fuckstain Ginny would be a wonderful band name, topped only by:
.
APPEARING TONIGHT!!
FUCKSTAIN GINNY AND THE STONERS</b
Performance art based on the premise that talent, expertise, education and hard work can be replaced with bullsh!t and a sneer.

Borked the tags. . . Oh, well.

Instead, it’s used to attack a young woman in her time of crisis for her personal health care decisions.

She volunteered as a Bad Example of self-responsibility. Her Bad Example is being discussed as—guess what—a bad example. With any luck, her self-imposed crisis will help others avoid her fate.

Perhaps she should be thanked, but I suspect her demise will be due mostly to the misinformation she got from the woo industry, which includes you.

So the thousands of people dying right now after dutifully undergoing their 100% conventional cancer treatment...they volunteered as 'Good Examples' of self-responsibility, I suppose. Their 'Good Example' is certainly not being discussed--from this discussion, you'd think a cure for cancer was as easy as following doctors' orders, when in fact cancer is the second leading cause of death. With any luck (from your perspective), their self-imposed crises will encourage others to blindly follow in their wake. Ching ching! $$$

Perhaps they should be thanked for giving a dose of reality to humanity, but I suspect their demise will be due mostly to the arrogance and hubris they got from the cancer industry, and people like you and the others in this den of vipers.

In case of confusion: the antecedent of 'you' in my previous comment is NWOR, not any of the reasonable, civilized people here.

NWO Reporter, I'm writing this down not to convince you (you're beyond convincing) but to point out to any lurkers the huge gaps in your argument.
Cassandra Callender was diagnosed with cancer at 17 and initially refused treatment. Because she was legally a minor she was forced to undergo treatment.
Her cancer went into remission.
When Callender reached 18, she refused to continue the treatment and was able to because she was no longer a minor.
Without treatment the cancer came back. Nine months later it was detected again.
Callender decided to use quackery to treat her cancer. The cancer spread further.
Callender now seems to have realised that she blundered badly by refusing treatment and embracing quackery, and is restarting chemotherapy.
You are insinuating that it was the chemotherapy that caused her cancer to return. It wasn't. It was her not finishing her course of treatment that caused that.

"Her cancer went into remission. When Callender reached 18, she refused to continue the treatment and was able to because she was no longer a minor." -- As much as the vipers on this blog are fond of repeating this, I have yet to see a single piece of evidence to support the contention that after her cancer went into "remission," any conventional treatment was recommended and refused. That is, until she underwent testing 9 months later (which indicates she was doing follow-up visits) and found she had more cancer. So either post the evidence it happened, or admit you are making it up to support your agenda.

While you're at it, why don't you explain why cancer is the second leading cause of death, if the conventional medical system is doing such a bang-up job. Maybe when you get it down to the 10th or 20th leading cause of death, people will be more inclined to believe you know what you're doing.

Actually, the overall cancer death rate in the US has been declining since the 1990's and dropped 13% from 2004 to 2013.

But that is reality and has nothing to do with NWO's babblings.

https://www.cancer.gov/about-cancer/understandic.f.ng/statistics

It looks like cancer incidence rates per 100,000 have been falling on average 1.1% each year over the last decade. Death rates have been falling on average 1.5% each year. This hardly indicates any miraculous advances in treatment. Most of the declines in mortality are due to the decline in incidence.

Please link sources to substantiate those numbers.

You can find them here: https://seer.cancer.gov/

You really ought to dig a little deeper. Incidence of some cancers has dropped substantially due to screening - colon cancer comes to mind. On the other end we have too many lung cancer deaths in females because of the uptake of smoking among females in the 70s and 80s.

There are similar stories on the treatment end with some - melanoma comes to mind - having rapidly increasing longevity owing to more effective treatments while others - pancreatic cancer, for instance - proving very difficult to crack.

Really, NWOR, if you clear your head of preconceptions and follow the evidence, you'll find yourself in a very different spot from where you are today.

While you’re at it, why don’t you explain why cancer is the second leading cause of death

"Cancer"* isn't a single disease, pudding head, and it's a f*cking disease of longevity.

* Or "malignant neoplasms," if you hadn't been too lazy to look at the primary source.

An interesting point of fact, just about every man in the world will eventually get colon cancer - it's nearly inevitable.

Of course, in the old days (and even today), most men don't actually reach the age at which the Colon Cancer would present itself. So, men die of many other things before they ever get to the Colon Cancer part.

^ Oh, dear, it would totally stink if the overwhelming majority of those were filed under "trachea, bronchus, and lung," now wouldn't it, Ginny?

An interesting point of fact, just about every man in the world will eventually get colon cancer – it’s nearly inevitable.

Are you sure you don't mean prostate?

Dammit Narad - thank you for correcting me. It's been a long week.

“Her cancer went into remission. When Callender reached 18, she refused to continue the treatment and was able to because she was no longer a minor.” — As much as the vipers on this blog are fond of repeating this

Pretty ironic coming from a tapeworm.

I have yet to see a single piece of evidence to support the contention that after her cancer went into “remission,” any conventional treatment was recommended and refused. That is, until she underwent testing 9 months later (which indicates she was doing follow-up visits) and found she had more cancer.

Here is the timeline through April 1. She was released at the end of April.

By August 16 (not "nine months later," BTW), her GoFundMe page had been revised to state that she was in "questionable remission" and would have another scan on September 1 to "determine if she is actually cancer free."

It was not subsequently updated, but in her interview with Ty Bollinger,* that she had no intention of pursuing conventional treatment past her September 30 birthday.

She announced in mid-April of 2016 that she had a mass in her lung and had "known about this for a while, but it's been hard going public with it."**

Nowhere but nowhere can your fantasy version of events be unearthed here. In fact, I can't even find any boundary that corresponds to your drearily intoned "nine months later."

* ht[]p://www.nde.life/god-and-life-articles/factory-farming-vegetarian-nutrition…
** E.g., ht[]p://www.dailymail.co.uk/news/article-3546167/Teen-forced-undergo-cancer-tre…

NWO,

To paraphrase from (in my belief) the best TV show ever: Colonel Potter to Hawkeye: Rule 1 is young men die in war, Rule 2 Doctors cannot prevent Rule1.

In real life rule one people die (in the last 3 years I've come close with cancer and a heart attack. Rule 2 doctors can't prevent rule 1 but they have gotten ever so much better at lowering the number of people who die.

More than likely as little as ten ago my heart would either outright killed me or left me in very poor condition. Even today less than 6 percent of people survive the type of heart attack I had. I am in an even lower percentage because I didn't suffer any heart muscle damage.

Most of the declines in mortality are due to the decline in incidence.

Weren't you just squealing like a stuck pig for "evidence," Gindo?

^ Oh, man, I failed to fully appreciate this Teen Talk Barbie moment:

It looks like cancer incidence rates per 100,000 have been falling on average 1.1% each year over the last decade. Death rates have been falling on average 1.5% each year.

Does anyone here know about intra arterial chemotherapy for DIPG? I've been following a local girl who is currently in Monterrey, Mexico receiving this treatment. I tried reading up on it, but I'm not a doctor. If anyone has a more informed opinion, I'd be interested to hear it.
Thanks!

@C.C.-There is a clinical trial of intra-arterial Melphalan for DIPG at Johns Hopkins-. https://clinicaltrials.gov/ct2/show/NCT01688401

I'm very sorry to hear about her situation-DIPG is terrible.

For whatever reason-my comment posted before I was finished typing-I must have hit "submit comment" by accident. In any case, I was just going to also say that I would be extremely skeptical of anything run out of a clinic in Mexico-quacks oftentimes will set up bogus clinics in Mexico or elsewhere in Central America to evade FDA regulations.

And I didn't see anything about trials of intra-arterial chemo for DIPG in Mexico-all I saw was the one clinical trial at Johns Hopkins.

Sorry about the weird link.

For the full story, check out the SEER report.
https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djx030

If you can't read all the way through, at least check out Figure 1.

From 1999 to 2008, the death rate was declining faster than the incidence among men. The incidence rate for women has remained flat.

Since 2008 the incidence rate for men has declined more steeply.

But 5 year survival rates for many (unfortunately not all) types of cancer have improved steadily and the number of people still alive after a cancer diagnosis continues to rise.

And none of that change is due to cannibis oil, vegan diets, or coffee enemas.

@squirrelelite-While unfortunately the prognosis for some forms of cancer (e.g., pancreatic cancer) have not improved much in the last 20 years, the prognosis for others has improved significantly in just the last 5-7 years. I'm thinking in particular of metastatic melanoma-7 years ago, the only approved treatments were IL-2 (and the adverse effects of IL-2 are too severe for many patients to tolerate) and dacarbazine.

Today, some metastatic melanoma patients are attaining durable complete responses with immune checkpoint inhibitors (i.e., nivolumab and pembrolizumab). A few years ago, it was reported that 17% of metastatic melanoma patients were still alive at 7 years-and I imagine that the same results-or better-will be observed with nivolumab and pembrolizumab. 7 years ago, ipilimumab wasn't even approved for the treatment of metastatic melanoma yet. Of course, the targeted drugs (e.g., vemurafenib, dabrafenib) have also been approved since then, but unfortunately resistance to those drugs usually develops, and they haven't produced the same kinds of durable responses that the immune checkpoint inhibitors have (plus they only are effective for the subgroup of patients with the BRAF V600E mutation)

The prognosis for ALK mutation positive lung cancer has improved significantly in just the last 7 years, too. It was just announced at the ASCO conference that alectinib is significantly more effective than crizotinib in the treatment of ALK-positive NSCLC patients. Alectinib was more effective in treating brain mets and there were also fewer adverse effects in the alectinib treated patients than in crizotinib treated patients.

Of course, NWOR ignores all this, instead choosing to focus on the areas where there hasn't been progress.

Submitted for y'all s approval
https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and…

70 pages or so of cancer incidence and mortality going back about 80 years, and covering different types of cancers.

NWOReptile isn't completely wrong. Year to year improvements aren't big numbers, but they do look to be steady. 50 or 60 years of (more or less) 1.5% decline in cancer mortality would suit me just fine. If all of that decline was on the prevention side and not the treatment side, well, I'd be even more happy (I'm a great believer in preventive maintenance).

This document says on page 3 that 595,690 are expected to die of cancer in 2016. If 1.5% of their deaths can be prevented, that's close to 9000 people. After a few years, that's gonna add up. I dunno why NWOR wants these people to die, but I guess she has her reasons.

Maybe she knows of something out there that works better that real medicine, and thinks we should use that. All I can say is 'bring your numbers'.

"I can’t even find any boundary that corresponds to your drearily intoned “nine months later.”

Thanks, now I've got this Fuzztones earworm:

https://www.youtube.com/watch?v=V9Xrs2-GHyI

Because she wants the one "TRUE - 100%" cure for all cancers, don't you know....

" she wants the one “TRUE – 100%” cure for all cancers"

A .45 will do. It isn't a cure, exactly. But you won't die of cancer. Meanwhile, most of the rest of us are willing to accept less certain odds and standard oncological care. We're such fools.

Well, I want drive-thru 5 cent beer stands, but I've come to terms with the disappointment that it's not likely to happen.

NWOReptile isn’t completely wrong. Year to year improvements aren’t big numbers, but they do look to be steady.

I'd say that when one mindlessly subtracts contemporaneous incidence rates from mortality rates, yes, one is completely wrong whether or not the result turns out to be in crude qualitative agreement with a rational analysis.

@ Narad

You know I don't go for the endless wrangling with trolls, but I have to say the "viper" —>"tapeworm" one-liner was some A+ smack, and I chuckled out loud. That one goes in Narad's Greatest Hits for sure. :-)

@Windriven;

she wants the one “TRUE – 100%” cure for all cancers”

A .45 will do.

Were you thinking of this, perhaps?
https://xkcd.com/1217/

Precisely!

While the Ninny Woo Order whines about limitations of "conventional cancer treatment", there's hope for significantly improving the chances of those with the type of tumor that killed Steve Jobs. We're apparently on the threshold of approval of a targeted drug for neuroendocrine tumors. It involves attaching a radionuclide to an octreotide molecule that binds to tumor cells, so that a radiation dose much more directly hits those cells, largely sparing surrounding normal tissue.

http://fortune.com/2017/03/16/steve-jobs-cancer/

It'll be terrific when we can offer these patients an expanded arsenal of options against such tumors, as opposed to the juice fasts, colon cleansing, acupuncture and psychic interventions offered to Steve Jobs (and which may have shortened his life).

Ty Bollinger did give $10K to Cassandra, see ... https://thetruthaboutcancer.com/wp-content/uploads/2015/12/TTAC-Charity…, but that wouldn't cover a week at the Hope4Cancer clinic in Mexico ... http://rationalwiki.org/wiki/Hope4Cancer

that wouldn’t cover a week at the Hope4Cancer clinic in Mexico

A Gazoogle check for "gofundme + Hope4Cancer" returns about 4200 Ghits. Which is an indication that the Hope4Cancer money-extraction machine provides its victims with advice on how to set up GoFundMe pages, thus turning them into franchises of the scamming. As is standard practice now in the Tijuana cancer-exploitation industry.

I struggle to come up with comparisons from parasitology that describe just how vile these humans are. Ghouls and leeches and vultures and vampire bats all have a valuable role in the eco-system.

Ty Bollinger did give $10K to Cassandra

He may or may not be receiving a kickback from the clinic for pimping them with such enthusiasm.

Here is a guy that generated *hope* for himself:

On Monday June 19 I got an infusion of ipilimumab which is an immunotherapy drug. 2 days later I got a series of 3 radiation treatments (21st thru 23rd). Dosage, 3 fractions of 9gy xrays from Varian Trilogy set at 9MV. These treatment we unusual in that instead of irradiating the whole tumor, I asked that they just burn a disk in the center of the main tumor leaving the rest of the tumor undamaged. This request was very counter intuitive in radiology because they are trained to kill every cancer cell they can possibly hit and it took a lot of work to get them to deliberately leave tumor undamaged.

But that was important because I was turning the tumor into a school, not a battlefield, where I was teaching my immune system what the cancer looked like (antigens) and classify it as an enemy. By using partial radiation I created an environment where white blood cells in my immune system could interact with dead cancer and learn it.

http://www.dvorak.org/blog/2017/07/04/did-i-just-cure-cancer/#more-1037…

It is adenocarcinoma of the lung -- supposed to be pretty devastating pretty quick. He claims that he is three months past his 'sell by date' and is still doing four miles of walking up and down a hill. He claims that he is not caughing up secretions anymore.

Could it have worked? He's had no follow up imaging yet.

Could it have worked?

I'd say certainly not on the terms hypothesized, but then again, Orac is the oncologist. It seems to be based on the notion that ionizing radiation will somehow leave the "good parts" of the tumors. At the center. And as some sort of chemotactic road map.

It seems to be based on the notion that ionizing radiation will somehow leave the “good parts” of the tumors.

Hmm. I don't see the leaving of the 'good parts' of the tumor there at all. He had immunotherapy then added the radiation to where the "good parts" are the dead parts so the components of his immune system got to learn of these *parts* -- To me, it seems that many killed virus vaccines work on this same principle.

the notion that ionizing radiation will somehow leave the “good parts” of the tumors. At the center.

Are you saying that the ionizing radiation would mess up the 'good parts' so that they are so scrambled that the immune system has nothing pertinent there to recognize?

Are you saying that the ionizing radiation would mess up the ‘good parts’ so that they are so scrambled that the immune system has nothing pertinent there to recognize?

It's more that I just don't get what is being advanced. What's supposed to happen? Radiotherapy is targeted because it kills cells, and part of this is scrambling the machinery, which is the whole problem in the first place. How is simply blasting the inside of a tumor* supposed to generate a useful immonuological response? Compare Herceptin, which has a specific mechanism.

* Why not a torus?

1) It certainly pounds like there would be a torus left.

2) Hasn't Orac's oncologist friend told us that tumors tend to die inside leaving live cells around the outside? This would seem to indicate that just poking a hole through the tumor mass wouldn't kill much that wasn't a;ready dead, anyway.

I also hope that this isn't sockputtetry, but whatever:

"Mitzi Dupree","tiM", "Tim", "TIm", "Timmeh", "\u00c9lan Vital (there are some who call me, Tim?)"

Etc.

Hasn’t Orac’s oncologist friend told us that tumors tend to die inside leaving live cells around the outside?

Yah, in the sense of Scamislaw, and it's been told here, too. Along with "not a single disease." The mustachioed and pig-eyed sack of shіt plays here with gliomas.

@ ORAC: "Unfortunately, the chemotherapy regimens for childhood leukemias and lymphomas are long for a reason. Oncologists don’t give up to two and a half years of chemotherapy because they like poisoning children. "

What a load of disingenuous bovine scat!

1. The real motive is all the lovely MONEY that can be pounded from bones of the patient, his/her family (often bankrupted without mercy) and/or his/her insurance company (if the "mark" is lucky enough to have that, especially in the good old USA where the so-called "health-care industry", more accurately described as The League of Extraordinary GREED™ and now they can really run riot because those of their mind-set are now infesting/infecting the White House and "own" both houses of Congress...shudder!).

2. What should also be considered is not only the "green" that can be "harvested" from the cancer therapy, but all the money that can be sucked up treating all the devastating complications of treating people with what are nothing more, nothing less that supremely/obscenely over-priced POISONS.

3. As a professional biochemist, who knows what's involved in manufacturing these "medications" I can tell you right now there's absolutely NO EXCUSE for what Big Pharma is reaming out of this unfortunate souls, as they literally and figurative "capitalize" on their fear of death >> I have NOTHING but contempt for these completely heartless profiteers (or should I say buccaneers!)

4. Now let's have some numbers:
Out of the nearly $374 billion Americans spent on prescriptions in 2014, $32.6 billion – about 9 percent – was spent on oncology drugs, according to the annual report by IMS Health Informatics. Another $11.1 billion was spent on supportive care treatments, which help with the side effects of strong chemotherapy drugs.

Newly approved cancer drugs cost an average of $10,000 per month, with some therapies topping $30,000 per month, according to ASCO, which discussed the costs of cancer care at a recent meeting. Just a decade ago, the average cost per month of new drugs was about $4,500. Patients typically pay 20 to 30 percent out of pocket for drugs, so an average year's worth of new drugs would cost $24,000 to $36,000 in addition to health insurance premiums.

(SOURCE: http://health.usnews.com/health-news/patient-advice/articles/2015/07/01…)
-----behold the League of Extraordinary Greed at "work"!----

4. Now there's one other thing to consider in Cassandra's case, namely that all the physical/psychological stress generated as the result of her being forcibly abducted (I know the goons who did it were "just following orders, eh?!) and then forced by that pack of sadists to undergo painful/disgusting therapy she never wanted may have been a factor in the failure of the "therapy", IOW has anyone thought to consider that this kind of stress may actually have aided/abetted the survival of the cancer?

5. Then we have all the concern-pearl twisting over the fact that she fled into the waiting arms of the quacks...now, guys and dolls, why would you expect her to do anything else given the crime committed against by the state/the so-called" reputable medical community (yes, yes, I know those sadists who forcibly implanted the drug-port, infused her with grotesquely expensive poisons against her will were "just following orders"...I get it, really I do).

6. IOW, why would she EVER, EVER trust the any part of the "establishment" , what I'm going to call the "regular medical authorities", who she probably views as nothing but a pack of heartless/egotistically arrogant (but WE know what's best, submit or else!) torturers.

Finally i want to say that my real beef here is the fact that she was forced to submit to treatment against her will (she was plenty old enough to make this decision, i.e., she probably could have had an abortion at a much younger age with far less "oversight" and concern-pearl twisting over her "adulthood", so why is this any different?).

Again, why would she NOT go to quacks given the way she's been treated (I don't ever see anyone of you goody-two-shoes medicos ever asking this question) and why did no one consider that the forcing someone to undergo treatment might generate physical/psychologial factors that would almost guarantee it would FAIL (slashed/poisoned this girl to no avail!).

Again, why would she NOT go to quacks given the way she’s been treated

She's been treated to medicine (the stuff that works) by people who were and are working to save her life. Then she bailed and spent a lot of money, time, and effort on quackery from someone who only wanted her around so he could sell more quackery, and has abandoned her. She's back with the people who may be able to undo the damage caused by time and quackery: it appears that the quackery has reduced her likelihood of survival from 85% to 40% or so.

(I don’t ever see anyone of you goody-two-shoes medicos ever asking this question)

Open your eyes. That discussion is ongoing here and elsewhere.

and why did no one consider that the forcing someone to undergo treatment might generate physical/psychologial factors that would almost guarantee it would FAIL (slashed/poisoned this girl to no avail!).

How would the handling of her case by the medical and legal communities "generate physical… factors" that would interfere with her treatment? These might be some psychological factors, but they would be minor in context.

So, Mr. Varga, why do you think the answer to expensive cancer care (in the case of Hodgkin's lymphoma, commonly effective and curative care) is costly and useless quackery?

@Se Habla Espol
"She’s been treated to medicine (the stuff that works) by people who were and are working to save her life."

1. ROFL! She was FORCED to undergo horrific treatment against her will by a bunch of egotistical, sadistic PRATTS who when they look in a mirror probably see themselves as "superheros" swooping in to save her from herself (she's NOTHING to them but the "mirror" before which they strut and preen in their I'm-too-wonderful-for-my-shirt fantasies, handsomely paided fantasies to the tune of slopping up nearly 18 cents out of every GNP dollar, the highest in the bloody world...sweet!)

2. What's frightening to me is that you are obviously all on-board with having the long arm of government swooping in on a person's life and taking away his/her right to make his/her own decisions under the pretext of "but it's for your own good" and using the letter of Da Law that you're aren't an "adult". Remember that she could have had an abortion at a much younger age with far less concern pearl twisting over her age...can you say hypocrisy/double-standards out the ying-yang, Se Habla Espol (SHE)?

3. Can you also say "slippery slope" here? IOW what's to stop self-righteous jerks with egos that dwarf the Grand Canyon (I usually find they're also under the delusion they have a mandate from their alleged God-s?) from eventually mobilizing the government to tell YOU/other "legal" adults they must undergo obscenely expensive/horrific treatment they don't want using the "excuse", but "it's for your own good" (as we, the members of Legends-In-Our-Own-Minds League™, see it, we're are saving your life we've ever so graciously deemed no longer belongs to you, aren't we ever so wonderful!)

4. Now a reminder of this "treatment" that you are support with such enthusiasm:
A. Under cover of darkness Cassandra's home was surrounded by multiple goon squads (why so many, one would think they were arresting a dangerous drug dealer/serial killer and yes, yes, I know they were "just following orders") who then broke down her door dragged her off at gun point,like a criminal and then delivered to her torturers, again under cover of darkness (they also made sure she was "alone", classic strategy employed by many sadists who, not surprisingly want no witnesses and who's goal is complete subjugation of their target).

B. She was then assaulted by a pack of self-righteous medical goons (again, they were "just following orders", with great enthusiasm) who held her down while she was forcibly anesthesized so they could cut her up/slamming in a drug-port to make easy for them "infuse" (nice euphemism for what's nothing but a form of rape) to her repeatedly with drugs she never consented to.

C. IF she didn't submit to their "kindness", they threatened to starve her (the drugs would be given to her after she was forcibly sedated, sedation that would require she not have eaten before the "procedure" done for 5 days out of every 7, now that's a horrific threat and nothing will ever make it anything else!).

D. She was isolated from all caring human contact (don't count ANY of the "people" involved with her "treatement" as qualifying) >> no friends, her mother was only "allowed" to see her on rare occassions, under the strictest supervision for a very short time, she was locked in her room like a criminal and denied any contact with the outside world (no cell phone, no land line out).

E. I gather you would have no problem if you found YOURSELF in a similar situation forced upon you, amirite, SHE? (Spanish Inquisition eat your heart out!).

F. I must confess I have to fight back the wish that all who are so approving of the way this young lady was "treated" also find yourselves in the very same situation (have your personal sovereignty ripped from you as you are forced to have your body so rudely invaded day after day for months, all with the self-congratulatory, self-appointed/supremely self-righteous "authorities" who, of course, are "doing what's best for you"), but I'm not a savage (wouldn't wish that on my worst enemy).

"Then she bailed and spent a lot of money, time, and effort on quackery from someone who only wanted her around so he could sell more quackery, and has abandoned her."
1. Indeed, I agree, but you are running like a mad cow from the fact that the "approved" authorities did absolutely NOTHING to gain her trust, indeed they robbed her of her right to make her own decisions, her personal sovereignty to force treatment upon her.

2. And yes, I think that her personal sovereignty trumps all, even if her decision would endanger her life because who are YOU or anyone else to PRESUME that you/they have the "right" to invade her life, IOW who appointed YOU/them as the Final Arbiter(s?)™ of all that's right/good...must have missed your coronation to such a lofty "post" (do you guys fight of who wears the "crown" or agree to parcel out the wearing of it?).

3. Again how would you like that done to you, but I usually find the squad cheer-leading what's nothing but a crime against humanity IMO, are usually only into the "dishing end", i.e., they're dishing out their self-proclaimed "moral authority" to run rough-shod over the rights of others (strutting/preening in front of that old mirror as the Defender-of-Life Superhero, boy that superhero underwear must get raggity awfully fast!). Bet you'd fight like a tiger if you ever got on the "receiving end" (forced to do something that such an invasion of your person as this "therapy" is/was).

"She’s back with the people who may be able to undo the damage caused by time and quackery: it appears that the quackery has reduced her likelihood of survival from 85% to 40% or so"
What you keep AVOIDING is now this is her decision, freely given, and I've got no problem with that.

"How would the handling of her case by the medical and legal communities “generate physical… factors” that would interfere with her treatment? These might be some psychological factors, but they would be minor in context."
"Minor"? Talk about head in the sand, read what she endured, there's NOTHING "minor" about that or does being kidnapped and medically raped (a perfect word for what happened to her IMO, her body gruesomely and with great malice of forethought invaded with horrific/poisonous treatments she never consented to) really "ring your bell" (imagine yourself in her situation, if you're actually capable of such empathy that is, something I very much doubt!).

Emilio, I think thou doth protest too much.

Medicine doesn't have to be pleasant to be good medicine. It does have to work to be good medicine, which is why medical scientists are constantly trying to come up with new treatments that work, and hopefully are better tolerated.

Medicine will ditch treatments that create more risks than benefits. Medicine will ditch treatments when something better comes along, or at the least relegate it to a minor or back up role.

Hence digoxin (derived from the foxglove plant) was a wonder drug when we figured out it reduced blood pressure, relieved edema from CHF, and improved certain cardiac arrhythmias. However, digoxin can be toxic, and has a very narrow therapeutic range. So blood levels have to be checked on a regular basis.

Since then, however, we've come up with much better drugs that don't have the toxicity of dig, or the narrow therapeutic range (meaning the risk of under or overdosing the patient isn't the huge problem it is with dig). So we use drugs like calcium channel blockers, beta blockers, and anti-arrythmics to treat CHF and Afib because they are much, much safer and generally more effective.

Every once in a while I still see someone on digoxin. Not like I used to, and it's not the go to for Afib the way it was. Diltiazem and amiodarone have largely taken over that role.

I have never met anyone who's Afib has resolved by drinking water that supposedly had some herb in it once upon a time.

I'll agree that patients do have the right to refuse treatment. It doesn't make them smart if their reasoning is to use quack treatments. In no universe is taking fake medicine on the advice of a scam artist like a naturopath smarter than taking real medicine from a physician.

"Under cover of darkness Cassandra’s home was surrounded by multiple goon squads (why so many, one would think they were arresting a dangerous drug dealer/serial killer and yes, yes, I know they were “just following orders”) who then broke down her door dragged her off at gun point,like a criminal and then delivered to her torturers, again under cover of darkness"

Is there evidence for this having occurred? It sounds like the standard bile-spewing paranoid ravings we hear from certain alties (i.e. the crowd at NN) whenever alt quacks and scam artists get busted for preying on marks.

@Dangerous Bacon
"So, Mr. Varga, why do you think the answer to expensive cancer care (in the case of Hodgkin’s lymphoma, commonly effective and curative care) is costly and useless quackery?"

1. Where did I said any such thing as the strawman you waling the living daylights of here (never promoted quackery, whose muck really shouldn't be dignified with the term "medicine", over standard medicine", for lack of a better phrase) >> QUOTE ME!

2. As far as I'm concerned, quackery and standard medicine are just two sides of the same "coin",i.e., the calculated exploitation of the pain, suffering and dying of other beings for obscene profit, profit and even MORE PROFIT >>> WHERE is the "justification" for the breath-takingly exorbitant costs of these poisonous drugs (they are poisons, let's not try to gloss that FACT over, shall we), that one has to hope poisons the cancer before the poison takes out the some vital function(s, often destroys more than one) that will kill the patient just as dead as the cancer ever would?

3. Let's not overlook all the additional cost of drugs/therapies developed in an attempt to counteract/ameliorate the awful side-effects that often make a person wish he/she was dead and/or abandon the treatment prematurely.

4. AGAIN, in the US is now close 18 cents out of every GNP dollar goes into, the pockets of the so-called "health-care industry", the highest by far in the world.

5. We have by far the most expensive "health-care" (really "for-profit-care", let's call that spade a spade) system in the world, but our "investment" is NOT commensurate the quality of care:
A. U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries
http://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-d…

B. Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally (it doesn't justify the magnitude of the "investment").
http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirr…

C. Comparison of costs by country as percentage of GNP (US the highest in the world, over 17% in this Table, with the only good thing to be said is that costs are rising as FAST as they thought it would)
http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS

D. Major Findings for National Health Expenditures: 2012-2022 (if you do the math, that means we're heading for over 1/5 of the GNP going into "health care industry" pockets by 2023):
Health spending is projected to grow at an average rate of 5.8 percent from 2012-2022, 1.0 percentage point faster than expected average annual growth in the Gross Domestic Product (GDP). Man, I can see why so many students want to be doctors, "invest" in hospitals/clinics/drug development, it's profits, profits and yet more profits.

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Tren…

QUESTION: So, tell me, Dangerous Bacon, WHY are this costs so bloody high? (I'm a biochemist so I know how these drugs are made/from what/how manufactured and there's NO reason for the jaw-dropping cost to the customer, really not patients, but customers, but pure unadulterated GREED on the part of what's nothing more than a monopoly, with all the attendant EVILS that come with it).
-----

6. IMO as long as doctors/hospitals/drug companies/other "health-care givers" can make such obscene profits by selling false hope (hey buddy, you don't want to die to ya!...you've still got a "chance"....yeah, righttt!) to the dying, we will never have the right do for ourselves what we can now do for any suffering dog or cat (if I want to die rather than submit to therapy, WHY would any one stop me, oh, that's right in their HUBRIS they're going to "rescue me from myself", "know what's best"...gag-a-maggot arrogance)

7. Of course there's always the cadre of self-appointed/anointed control-freaks who really get off on dictating to others how to live their lives which would necessarily includes when to die (as much a part of living as anything else) and often use their religious affiliation as an "excuse" for outrageously interfering in other people's decisions (many of whom are also raking in all those profits by prolonging the DYING, calling it "prolonging life" to continue conning the mugs out of every last farthing).

8. My issue here is that Cassandra had your precious treatment FORCED upon her, something she was plenty old enough to refuse and IMO the fact that it was forced upon her is one reason why it failed. IOW do you really think that once she reach 18 she would just continue to submit to something she NEVER consented to, a thoroughly vicious, immoral act on the part of the state/disgustingly arrogant doctors, that I am convinced stampeded her into the arms of the quacks, just licking their chops to take her in

9. Those quacks simply capitalized on her now compounded, understandable lack of trust in the therapy that MIGHT have succeeded IF she had consented to it, but NO, her so-called "doctors" just had to throw their weight around, and enlist the all-too-willing jackboot of the state to stomp her down into therapy, a perfect example of this "joke" about doctors:

"What's the difference between God and a doctor? Why God doesn't think He's a doctor!"

Mr. Varga's ranting about "false hope" would resonate a little better if he wasn't referring to Hodgkin's lymphoma.

"The cure of Hodgkin lymphoma in the 20th century is another one of cancer's biggest success stories. Breakthroughs in radiation therapy and chemotherapy paired with careful clinical research transformed an invariably fatal disorder into one that is routinely cured. The impact of this success story was, however, much greater because it created optimism for the treatment of cancer in general, and demonstrated the potential for a multidisciplinary approach to diagnosis and management. In the vanguard, Hodgkin lymphoma investigators conducted rigorous, randomized controlled clinical trials as a means to advance therapy. Another important lesson from the Hodgkin's experience was the price of cure. The recognition of late adverse effects from radiation therapy and chemotherapy in the form of second cancers, heart and blood vessel disease, and sterility shaped subsequent research efforts to maintain or improve cure rates with fewer complications, an important goal in a disease that primarily affects individuals in their 20s and 30s. Today, as more than 80 percent of patients are cured after primary treatment, a major emphasis is now placed on survivorship."

http://www.hematology.org/About/History/50-Years/1528.aspx

Is there any evidence quackery has even a .0000008% cure rate for Hodgkin's (never mind greater than 80%)?

There was nothing vicious about making sure Cassandra Callendar got appropriate medical treatment when she was under age. There's a reason why minors don't have the full rights of adults: they lack the understanding and maturity to make adult decisions.

It's neither vicious or cruel to put the health of a child before their wishes when their reasoning capacity is not fully formed.

It's unfortunate she didn't understand or appreciate the effort. But it wasn't vicious. Her physicans did not do that to her for the sake of being cruel; they did it because they valued her life and thought it tragic she could kill herself through refusing treatment for a treatable disease.

The real villains here are the quacks who convinced her and her parents they could cure her cancer without chemotherapy.

Her parents failed her by not insisting on real medicine. They love her, but they failed her by enabling it.

The decision of those physicians to go through the courts was dicey on an ethical basis, for the reasons Orac himself notes in his article. I'm no more sure I could have gone down that road than he is, but her doctors were sure, and guess what? They were right!

I hope it's not too late for her.

Now granted, we've got some real problems with the profit motive in our health care system/industry. However, you need to show that her physicians were motivated by a profit motive and not her best interests before you go around slamming anyone. That's a pretty serious charge to bring and you need a little more than general disgust with health care overall to bring it.

@Panacea
"Emilio, I think thou doth protest too much."
Why do you think so?

"Medicine doesn’t have to be pleasant to be good medicine."
WHERE did I ever say or even hint that only "pleasant medicine is good medicine" and by inference, that "unpleasant (LOL! at the understatement) medicine is bad medicine" (if I may interpret you)?

"It does have to work to be good medicine, which is why medical scientists are constantly trying to come up with new treatments that work, and hopefully are better tolerated."
Why is it that the above reminds of this question from Buffy the Vampire Slayer,"does the word 'duh' mean anything to you?"

"Medicine will ditch treatments that create more risks than benefits. Medicine will ditch treatments when something better comes along, or at the least relegate it to a minor or back up role."
1. "Creates more risks"? Ah yes, those awful PGUs (profit generating units) might sue, but that's not very likely given that doctors have a "code of SILENCE" when it comes to outing bad medicine/bad practice by colleages/hospitals that would make any of Mafia don's Wise Guys cry in his vino (see no evil, hear no evil, and above all speak no evil against what's really a bad doctor/crap hospital).

2. IMO that decision to "ditch" often rests on how all those millions of lab rats...err "patients", populating doctors' offices/hospitals, "respond" to those treatments (especially true for all the plethora of psychoactive drugs)...I mean what better "laboratory" could be had and with those stupid "rats" not only none the wiser, but paying for "privilege" of being experimented on as well!)

---snip interesting narrative about drugs for atrial fibrillation and congestive heart failure---

"I’ll agree that patients do have the right to refuse treatment."
1. How very magnimous of you!

2. The real truth is that many doctors rarely let patients "refuse" treatments with a very common form of retaliation being to throw them out as patients (HOW.DARE.YOU! question my pronouncements from on high! If you don't do what I demand, when I demand it, how often I command it, then get thee gone to another doctor, you damned, filthy, disobedient gomer!)

3. I had a friend (call her "Lyra") who refused to have a stereotactic breast biopsy when a mammogram showed microcalcifications, something NOT unexpected given her age, the FACT that she had had a small, benign tumor removed from a duct (the surgeon removed the ducts while he was "at it") and also was one of those women who developed fluid-filled cysts that needed draining (leading to scarring, hence more microcalcifications, something very painful to her as her breast tissue was very refractory to the anesthetic given).

4. Now anyone who's familiar with a stereotactic breast biopsy knows that the instrument used is reminiscent of an apple-corer on steroids (sinks it's metal talons into a piece, twists/yanks it out, sucks it up, then resets and dives in for another piece, YIKES!) and that the "anesthesia" fails very often (horror stories all over the web about this humiliating procedure where one is required to lie on a table with the breast hanging through a hole for up to an hour or more, waiting for the machine to "calibrate"/waiting on his/her royal majesty, Herr/Frau Doktor, to waddle in and hope that the anesthesia works (cases where doctors keep on jabbing even if the patient is screaming in agony, plenty of stories on the web, but wait, they must all be lying drama-queens, right?).

5. Below is an image of this apple-corer on steroids and a video (can't believe women actually submit to this humiliating procedure!)
http://www.chsinterventional.com/product/112-eviva-stereotactic-guided-…
https://www.youtube.com/watch?v=JYKZCb7wrvM

6. The bottom-line is that Lyra received a blackmailing letter in the mail telling her she had 30 days to find another physician because of her "non-compliance" (hey, you didn't been over and grab your ankles for the doc, baby, shame on you!), with her now erstwhile doctor graciously consenting to care for her if any emergency arose during that time. What's revealing is that Frau Doktor was too much of a lily-livered COWARD to say this to Lyra's face, in something that also included a very blatant attempt to blackmail the Lyra into undergoing "treatment" she didn't want (the Frau Doktor also "graciously" said that if she had the biopsy within the 30-day period Lyra could remain her patient...Lyra very wisely went elsewhere and is very much alive, very well and still kicking butt, 7 years later).

7. Oh and data now shows that billions of dollars are WASTED on these biopsies/mammograms, but docs just keep on racking 'em up (cha-ching!, cha-ching! the wifey-poo needs a 100th pair of Gucci heels to go with her $30K Zuhair Murad frock!).

Mammograms Are a Mixed Bag - Too much money is wasted on unnecessary breast cancer screenings.
https://www.usnews.com/opinion/economic-intelligence/2015/07/23/many-ma…

When Breast Biopsies Aren't Necessary
https://well.blogs.nytimes.com/2008/05/08/when-breast-biopsies-arent-ne…

"Mr. Varga’s ranting about “false hope” would resonate a little better if he wasn’t referring to Hodgkin’s lymphoma."
There you go again, misrepresenting what I said. AT NOT TIME did I say that the standard treatment for Hodgkin's lymphoma was a "false hope" nor assert that it wasn't the right treatment for her condition.

But all that is just a red herring you're furiously slapping to desperately avoid the FACT that a young lady who just "shy" of a very artifical legal definition of adulthood, was FORCED against her will to undergo treatment (medical kidnapping and medical rape, nothing more, nothing less, all with the "blessing" of the state and many here...The Spanish inquistion using the "excuse" they were saving souls, but it was for their own good, engaged in similar barbarity).

Better hope no one decides you aren't acting very "adult" and does the same to you, but hey you're reached that magical artifical legal definition for an adult and are now soooooo safe from any such depredation of your bodily integrity/personal liberty, amirite, DB?

(snip blather about 80% success rate, so what, she didn't want the treatment, her right, end of story).

"Is there any evidence quackery has even a .0000008% cure rate for Hodgkin’s (never mind greater than 80%)?"
The fact that quackery is just that is NOT an excuse for the predatory disregard for someone's right to decide was does or does NOT happen to his/her body and I find the fact that so many here are soooo comfortable with this "excuse" as a "justification" for what happened to Cassandra to be quite terrifying (slippery slope, MUCH, where do we stop or does the "excuse" but "its for your own good" justify any violation of personal liberty? Who gets to make that decision, you, DB or you, Panacea and based on what?....do get over yourselves, hard to do with such egos that need to exercise their "muscles" by pushing others around, I do understand, really I do.)

A little ditty for Mr. Varga:

Trollin' Trollin' Trollin'
Trollin' Trollin' Trollin'
Trollin' Trollin' Trollin'
Trollin' Trollin' Trollin'
Rawhide!
Trollin' Trollin' Trollin'
Though the threads are swollen
Keep them comments trollin',
Rawhide!

Cherry pick!
(Head em' up!)
Move goalposts!
(Move 'em on!)
More insults!
(Head em' up!)
Rawhide!
Make stuff up!
(Paste 'em in!)
Change topics!
(Cut em' out!)
Whine some more!
Paste 'em in,
Rawhide!
Keep trollin', trollin', trollin'
Though they're disaprovin'
Keep them comments trollin'',
Rawhide!
Don't try to understand 'em
Just rope, laugh, and ignore 'em
Soon we'll be discussin' right without 'em

Emilio Varga @189: Clearly you're not familiar with the record keeping and testing requirements of FDA-approved medicine.
Also, clearly you are unfamiliar with the even more intense regulatory requirements for biologics.

Have you ever done GMP? Because if you talk about "costs" and only talk about the raw materials and not the clean rooms, the trained manufactures, the testing and validation involved in actual GMP, well then you don't really know what you're talking about.

Wow...that is a STUNNING number of strawmen and evidence-free claims up there.

Just STUNNING.

—snip interesting narrative about drugs for atrial fibrillation and congestive heart failure—

Of course it had to be snipped out. Doesn't fit your narrative Mr Varga :D

<b(snip blather about 80% success rate, so what, she didn’t want the treatment, her right, end of story).

Here we go again, doesn't fit your worldview either...

Alain

I posted this in the Starchild thread, but it looks like it was flushed out before any one noticed. An old friend makes an appearance-

Choosing alternative cancer therapy doubles risk of death, study says
http://www.cnn.com/2017/08/17/health/alternative-vs-conventional-cancer…

Still waiting to see documentation of Varga's claim of multiple "goon squads" spiriting Cassandra away at gunpoint in the dead of night for ghastly medical experiments.

Dangerous Bacon>>"Still waiting to see documentation of Varga’s claim of multiple “goon squads” spiriting Cassandra away at gunpoint in the dead of night for ghastly medical experiments."

1. AGAIN you have this nasty habit of putting words in my mouth I never uttered >>>I NEVER said that Cassandra was subjected to "ghastly medical experiments" (QUOTE ME!).

2. The evidence is actually contained in her interview with that quack and every time I try posting it (with a link to source), it has gotten deleted, so I'm just going to try quoting from the interview and hope this THIRD posting is "permitted" (Bollinger's a quack, we know it, so what is the moderator afraid of?):

"[W]hen she was alone in the house, Cassandra’s home was surrounded by a dozen of “Hartford’s finest” (police cars) and workers from the Connecticut Department of Children and Families (DCF). They banged on the doors and windows and terrorized the 17-year-old while she hid in a closet and cried.

Later that day, Cassandra was kidnapped by DCF workers and the police and was taken back to the hospital to begin chemotherapy. Amazingly, it took a dozen police cars surrounding her home to capture this “hardened criminal” named Cassandra (yes, sarcasm intended). I assume that there were no robberies or rapes that day in Hartford, as they had so many police cars available to surround the house. Or maybe there was a donut shop down the street…

Within a few days, Cassandra was back in the hospital and scheduled to begin forced chemotherapy. But even then she wasn’t ready to submit to this gunpoint medicine. It took no less than 12 workers to strap her wrists and ankles to the bed and control her while the nurse stuck a needle in her neck to sedate her. She woke up in the recovery room with a port in her chest. Had this horrific abuse taken place on the streets of Hartford, the assailants would have been guilty of assault and battery.

However, since these human rights violations occurred in the hospital, the assailants will never be charged with the crimes that they committed against Cassandra. In her own words,

“At that point, I didn’t feel like a human anymore… I feel like I’ve been violated… My ankles and wrists were bruised when I woke up.”
---------
3. Now what I do expect is attacks on Cassandra from people like you and your fellow-travelers as per this from another "champion" of her being brutally cast down against her will into the Center-of-Hell that Medical Inferno aka The Connecticut Children's Medical Center (hat-tip to Dante):

"a grossly immature spoiled ingrate, "a whiny little brat ", "an attention whoring drama queen jonesing for sympathy", someone "who can't be trusted or believed" -- your lot, DB

4. Furthermore, these personal attacks were coupled demands for video of her arrest, PLUS "at least 6 eyewitness accounts from her neighbors or no dice! >>> right, like she was going to be able to do that!).

5. So do I think you're ever going to believe her account of what happened, no matter how reliable the source? NO!! it doesn't "fit" your rosy picture of all those involved as God-sent Angels of Mercy with only her best interest at heart, with only the best of intentions (Someone once said that the "road to HELL was paved with Good Intentions" and this blatant, vicious, cruel violation of human rights is a perfect example!)

6. Do I think you would EVER, EVER believe it if Cassandra were her and told you face-to-face? NO! (she's just lying drama queen to those on your side-of-the-fence, amirite, DB?)

so odd that you "suddenly" can't post a link to a bunch of wild claims, while every one else can.

It take a lot for a physician to fire a patient. "Lyra" would have had to do a lot more than be non-compliant, so I call BS on this entire anecdotal story.

“a whiny little brat “

A very good description of Mr. Varga.

My issue here is that Cassandra had your precious treatment FORCED upon her, something she was plenty old enough to refuse and IMO the fact that it was forced upon her is one reason why it failed.

Others have addressed your other points, but I'd like to take a shot at this one.

Cassandra was forcibly treated at 17, and, while I think it's a darn shame that her parents weren't smart enough to force her to take her medicine, leaving that job to others, you seem to be saying that at 17, she's 'old enough' to make life changing medical decissions.

I disagree. There are many things adults can do that children cannot. Here's a few things we don't allow children to do, that adults are allowed to do (and many of them I have). I wonder, in addition to making life treating medical decisions, which you would also allow all 17 year olds the unrestricted ability to do -

Apply for and be given credit
Open bank accounts
Buy and consume alcohol
Buy and consume tobacco
Join the military
Buy and sell firearms
Have full, unrestricted, drivers license
Buy and sell motor vehicles
Buy and sell real estate
Get married
Adopt children
Vote
Run for office

If you would restrict all 17 year olds form doing anything on this list, could you explain why that thing requires a higher level of maturity than making life throwing medical decisions?

Panacea
August 18, 2017

It take a lot for a physician to fire a patient. “Lyra” would have had to do a lot more than be non-compliant, so I call BS on this entire anecdotal story.

ROFL! I expected you to call me a liar, well actually you're calling my good friend a liar, using the flimsiest of pretexts....

1. IOW, just because it may "take a lot", a "quantity/quality" very, very conveniently undefined by you (define "a lot") to "fire a patient" as you put it in your neck-of-woods, DOES NOT mean that your situation ("it takes a lot", undefined?) is going to be the "standard" (whatever "a lot" means in Panacea-verse) everywhere else (really bad logic, but you have no case, so no surprise to see you fleeing running the Bad-Logic-Rabbit-Hole).

2. AGAIN, We don't know what "it takes a lot" means, there now do we? However, I DO know what it took HERE and you've simply made a fallacious assumption that what may be true in your situation NECESSARILY must be typical of ALL other situations of the same type.

3. If ever there was a Herr/Frau Doktor's idea patient it was DR. Lyra (Phd, theoretical physics) who obediently showed up for all exams, took her yearly flu shots without protest, i.e., the Doktor demanded it, she did it, something that makes a laughingstock of your childish attempt to insinuate that she must have been some a difficult patient (I almost expected this former West-Point graduate/veteran to SALUTE whenever she saw FRAU Doktor, guess this kind of willingness to take orders/ascent to authority was an outcome of her military training, for all the good it did her in this situation, apparently she was still was groveling in drooling, worshipful submission enough to suit Frau Doktor).

4. I've read what I'm going to call Lyra's Frau Doktor letter which is very clear that IF she did NOT comply (woman, submit to that biopsy within 30 days) she would be "fired" (begone you, YOU, disobedient PGU!), but to quote from it Frau Doktor graciously said, "I will continue to care for you if an emergency should arise within said 30-day period">> how very, very magnimous of that arrogant piece of blackkmailing trash (wouldn't let Frau Doktor touch me with a 20 ft. barge-pole, shudder!)

5. What I also observe is that you've avoided like the plague the data from your own vaunted medical science authorities, which shows that my friend, who refused the biospy only because of her past experience with anesthetic failure (something Frau Doktor refused to even speak with her about before swing the Ban-Hammer) had excellent grounds to refuse a procedure that is very NOT warranted (as was the mammogram) but has also been shown grossly over-proscribed (to the tune of BILLIONS of dollars, but hey, that's to point, ain't it >>> cha-ching!, cha-ching! let those cash-registers ring!>> for sea, to shining sea!)

Panacea is 1M times smarter than me, so I'll take the low hanging fruit:

1) Uh, makes no sense? Human behavior isn't easily quantified, it's one of the problems with us. Panacea never claimed it was standard and it was clearly based on her experiences.

2) What it took here is an N=1, which is what you JUST complained about in #1.

3) Thanks for the info - but since no one here has any proof (and you clearly lean toward, shall we say hyperbole), I'll remain skeptical as well.

4) Great! Can you scan the photo, omitting personal details, and show it to us? Otherwise, see #3

5) WHAT DATA? How can she avoid data you never presented. Also, over-perscribed needs a citation and, oh look, another claim it's all about money (and ignoring government overstate). I suggest people start referring to this gambit as the "purely for profit" fallacy - although I'm open to suggestions.

Johnny
127.0.0.1
August 18, 2017

Emilio Varga: My issue here is that Cassandra had your precious treatment FORCED upon her, something she was plenty old enough to refuse and IMO the fact that it was forced upon her is one reason why it failed.

Others have addressed your other points, but I’d like to take a shot at this one.

Cassandra was forcibly treated at 17, and, while I think it’s a darn shame that her parents weren’t smart enough to force her to take her medicine, leaving that job to others, you seem to be saying that at 17, she’s ‘old enough’ to make life changing medical decissions.

What load of supremely arrogant, paternalist twaddle! (why I think so).....

First, just because her parent (just her mom) didn't agree with the pronoucements of the recognized medical exstablishment doesn't mean she was stupid ("not smart enough"? according to whom, YOU, the so-called medical establishment?...boy does your lot need a OverblownEgoectomy, but double quick!)

Second Cassandra was just shy of an ARTIFICiAL legal definition of adulthood, so are you really going to tell me that suddenly, in a few months, she would be magically be "transformed" (on the "threshold" of her 18th birthday) in a completely functional adult by the passage of this short period time...you're really going to try and lay that laughable bunk on me, are you?

IOW, do you have any actual scientific data that would support a hypothesis claiming that unless one has reached a physical age of 18, he/she must necessarily be deficit in adequate decision-making skills PLUS you would need data showing that one breached that "barrier", decision-making skills are most likely to be fully "up and running"....so where's the "beef", Johnny?

I disagree. There are many things adults can do that children cannot. Here’s a few things we don’t allow children to do, that adults are allowed to do (and many of them I have). I wonder, in addition to making life treating medical decisions, which you would also allow all 17 year olds the unrestricted ability to do –

Apply for and be given credit
Open bank accounts
Buy and consume alcohol
Buy and consume tobacco
Join the military
Buy and sell firearms
Have full, unrestricted, drivers license
Buy and sell motor vehicles
Buy and sell real estate
Get married
Adopt children
Vote
Run for office

What a load of red herring and a very disingenuous "dish" of it that it is, too (why)....

1. What you somehow failed to do is mention the fact that all of what are defined as adult responsibilites vary greatly in the age at which they are granted, time-frames that are often very individual state-by-state as well (timeframes vary from 18 to 21, depending on the activity and the state).

2. NONE of these involve consent to undergo a medical procedure, so let's take an actually RELEVANT example, the ability to obtain an abortion and I going to use Conneticut's laws only because it under Conneticut law she was deem to be incompetent (not an adult).

First, Cassandra at a much younger age could have availed herself of birth control without parental consent and should it fail, obtain an abortion in the state of Conneticut under the following conditions (rights of minors given HERE):

Sec. 19a-600. Definitions. For the purposes of sections 19a-601 and 19a-602:

(1) “Counselor” means: (A) A psychiatrist, (B) a psychologist licensed under chapter 383, (C) a clinical social worker licensed under chapter 383b, (D) a marital and family therapist licensed under chapter 383a, (E) an ordained member of the clergy, (F) a physician assistant licensed under section 20-12b, (G) a nurse-midwife licensed under chapter 377, (H) a certified guidance counselor, (I) a registered professional nurse licensed under chapter 378, or (J) a practical nurse licensed under chapter 378.

(2) “Minor” means a person who is less than sixteen years of age.

(P.A. 90-113, S. 1; P.A. 95-116, S. 7; 95-289, S. 9; P.A. 96-180, S. 63, 166; P.A. 06-196, S. 150; P.A. 07-217, S. 82.)

History: P.A. 95-116 changed reference to certified independent social workers to licensed clinical social workers and made a technical correction to refer to physician's assistants as licensed rather than certified; P.A. 95-289 echoed technical changes in P.A. 95-116, changing “certified” to “licensed” in references to marriage and family therapists and physician assistants; P.A. 96-180 made a technical change in definition of “counselor”, substituting “marital” for “marriage” in “marital and family therapist”, effective June 3, 1996; P.A. 06-196 made a technical change in Subdiv. (1), effective June 7, 2006; P.A. 07-217 made a technical change in Subdiv. (1)(C), effective July 12, 2007.

Cited. 24 CA 541.
(Return to Chapter Table of Contents)
(Return to List of Chapters)
(Return to List of Titles)

Sec. 19a-601. Information and counseling for minors required. Medical emergency exception. (a) Prior to the performance of an abortion upon a minor, a physician or counselor shall provide pregnancy information and counseling in accordance with this section in a manner and language that will be understood by the minor. The physician or counselor shall:

(1) Explain that the information being given to the minor is being given objectively and is not intended to coerce, persuade or induce the minor to choose to have an abortion or to carry the pregnancy to term;

(2) Explain that the minor may withdraw a decision to have an abortion at any time before the abortion is performed or may reconsider a decision not to have an abortion at any time within the time period during which an abortion may legally be performed;

(if you want to read to whole thing, too long to post all here, please click on the link)

Well, well would you just look at that! >> A "minor" in this case is defined as someone less than SIXTEEN, so guess when it comes having an abortion, that "magic ticket" granting adulthood just plummetted, and here y'all are asserting that EIGHTEEN MUST inviolable "end all, be all" for granting "adulthood"....ooops!

Furthermore, Cassandra would NOT have been required to notify her parents because Connection has no parental involvement law!

POINT: So tell me, Johnny, WHY would Cassandra be allowed to have an ABORTION (something many regard as murder of another human being) at SIXTEEN, without parental notification/involvement of any kind AND with no involvement with the list of "counselors" required (only a "minor" must be counseled under Conneticut law) BUT when it come to her refusing chemo at SEVENTEEN PLUS, she's suddenly completely bereft of the necessary mental judgement to make that decision?

OH wait it couldn't be that the Herr/Frau Doktor saw their cash cow escaping and quite literally set the "dogs" (the long arm of Da Law, the bully-boy cops) on her to round her up and and drag her back so they could finish the "milking', all while polishing their egos with grand delusions of "hero-hood" that THEY, the Great and Power Doktors, were saving her life....I'm mean absolute power slathered with money, it doesn't get better than that, now does it?

This is addictive for me:

"First, just because her parent (just her mom) didn’t agree with the pronoucements of the recognized medical exstablishment doesn’t mean she was stupid (“not smart enough”? according to whom, YOU, the so-called medical establishment?…boy does your lot need a OverblownEgoectomy, but double quick!)"

That's a total misrepresentation of what was said, they said, "smart enough to convince their daughter" not smart enough to udnerstand the science. But while we're here, "yes, you are stupid if you ignore the medical evidence (which you slur by calling the medical establishment)

"Second Cassandra was just shy of an ARTIFICiAL legal definition of adulthood, so are you really going to tell me that suddenly, in a few months, she would be magically be “transformed” (on the “threshold” of her 18th birthday) in a completely functional adult by the passage of this short period time…you’re really going to try and lay that laughable bunk on me, are you?"

that sounded to me like an artificial LEGAL definition. Some people can make sound decisions before then, some can't make them after then. So the law picked a point.

the rest is just strawmen.

No, Emilio, I'm calling YOU a liar, because I have no evidence this Lyra person actually exists.

But what would I know about physicians firing patients. I've only worked in health care for 32 years and taken care of the non-compliant patients who won't quit smoking, won't lose weight, won't eat healthy, and constantly being readmitted under the same physician time after time.

If this person exists and she was fired, she did something more than refuse a biopsy. She made the doctor worry he would get sued.

But truth is, I really don't think she exists. I think you're making the whole thing up.

Wipe your chin. The drool is showing.

CJTX: Thanks for the compliment :) But I think you are much smarter than you give yourself credit for :D

Aw, thanks. So terribly sweet of you say so.

Most of my cousins are scientists/medical people of one kind or another; I'm fascinated with it, but just don't comprehend it as intuitively as they do. (i'm more a man of letters, if anything).

To give you a chuckle, it reminds me of an EdX course I took on basic statistics. During one lecture, the professor said, "well, it's obvious here that [blah, blah, blah]." I said to myself, "It wasn't obvious to me!"

First you say:

Panacea:No, Emilio, I’m calling YOU a liar, because I have no evidence this Lyra person actually exists.

BUT then you say:

Panacea:But truth is, I really don’t think she exists. I think you’re making the whole thing up.

Now let me see what's the word for someone who makes things up? Oh yeah, he/she's a liar, so not only did you manage to contradict yourself, you most certainly did call me a liar, not once but twice ("making the whole thing up", i.e., a liar by any other name is still a liar).

Oh and just what evidence would actually satisfy you that Dr. Lyra actually exists?

Why is it that I don't think ANYTHING will because no matter what I posted (a photo, video, birth certificate, the letter "firing" her, what?) you could and I have absolutely no doubt would, hand-wave them away as frauds and keep on raising that old evidence bar to maintain your assertion that she doesn't exist and was "fired" by her doctor for exactly the reason I related.

Furthermore, tell me why I should violate my friend's confidence and privacy by posting such private, sensitive information on a potential dangerous place like the Internet in an attempt to satisfy demands that I'm confident are only going to escalate beyond all reason, so you can continue to pretend she's doesn't exist.

So NO I'm not about to gratify your overblown ego by dancing to your or your fawning lap-dog's tune (you two really do need to get room, make it real!).

But what would I know about physicians firing patients. I’ve only worked in health care for 32 years and taken care of the non-compliant patients who won’t quit smoking, won’t lose weight, won’t eat healthy, and constantly being readmitted under the same physician time after time.

Let's put the "proof-shoe" on the other foot, shall we! Where's any evidence to support your claims 1) that you've worked in health care for 32 years (doing what, emptying bed-pans, mopping hospital floors, what?) and 2) taken care of the non-compliant patients who won’t quit smoking, won’t lose weight, won’t eat healthy, yadah, yadah (taken care how, again emptying bed pans, bathing them, lecturing them what?).

Until I get conclusive proof that what you've claim is true and clear (your job description/education, if any, where you've worked, photo, birth certificate etc., etc., and etc.), as far as I'm concerned you are simply "making the whole thing up".

If this person exists and she was fired, she did something more than refuse a biopsy. She made the doctor worry he would get sued.

Now just how would a person you're determined to believe doesn't exist, do that? For that to occur, Doktor Blackmailer would have to have treated her for some condition and screwed that up, something NEVER alleged by me in the description of the case.
So do tell me, Panacea, just what would Dr. Lyra be suing Frau Doktor over? Come on, strut your alleged stuff ("only worked in health care for 32 years and taken care of the non-compliant patients") and tell us just what Dr. Lyra could possibly be suing Frau Doktor Blackmailer about (did the doc screw up the mammography, what?, give us clue as to the basis for that alleged lawsuit?).

Wipe your chin. The drool is showing.

ROFL! Given the above, you must have been mirror-gazing when you typing that kindergarten-level play-ground taunt. What next? >>a chorus of "Neener, neerer! boo! boo! from the alleged 32 year veteran in health care (again doing what? >> no evidence <<< why should I believe you?).

Nope, more obfuscation. (Philosophical debates on the nature and existence of reality aren't needed here, just a few links and some photos).

"Oh yeah, he/she’s a liar, so not only did you manage to contradict yourself, you most certainly did call me a liar, not once but twice (“making the whole thing up”, i.e., a liar by any other name is still a liar)."

Either on purpose or accident, you omitted her "BECAUSE."

"you could and I have absolutely no doubt would, hand-wave them away as frauds and keep on raising that old evidence bar to maintain your assertion that she doesn’t exist and was “fired” by her doctor for exactly the reason I related."

Remember how you complained about Panacea's judgment call based on her 32 years in medicine. You're doing the same thing based on 2 days of internet comments.

"Furthermore, tell me why I should violate my friend’s confidence and privacy by posting such private, sensitive information"

No one asked you too and I SPECIFICALLY said omit the personal details.

"So NO I’m not about to gratify your overblown ego by dancing to your or your fawning lap-dog’s tune (you two really do need to get room, make it real!)."

So no evidence, GOT IT.

CJTX: Don't sell yourself short. Some of us just have to work harder at it. I had to work very hard to learn nursing; as much as I love science, it did not come naturally to me. I have to work at it. But once I know something, I KNOW IT.

Emilio, this is getting tiresome. You're the kind of self righteous guy who talks for the sake of hearing his own voice. You're hear because you want to say to yourself, "Yeah, I got them with that one!" never realizing that no, you aren't doing anything more than making yourself look like an emotionally driven fanatic.

I've got science on my side. You have opinion. It's really no contest.

Have a nice life.

Thanks Panacea!

Mr. Varga: "Oh and just what evidence would actually satisfy you that Dr. Lyra actually exists?"

PubMed case report link... or in the fact of her actual existence, just a local news report of her plight.

Just curious: is the name "Varga" Hispanic or Hungarian? Because I did mistake a Hungarian Varga for the former. Or did you just make it up?

Or is your name actually Miles:
https://sciencebasedmedicine.org/the-sad-but-unexpectedly-hopeful-cance…

Since Emile Varga / Miles Vega is making up identities on the spur of the moment, we can safely assume that the other astronomical name "Dr Lyra" is a fabrication as well.
I eagerly await further anecdotes about Mr Rigel and little baby Betelgeuse O'Ryan.

Chris
Mr. Varga: “Oh and just what evidence would actually satisfy you that Dr. Lyra actually exists?”

PubMed case report link… or in the fact of her actual existence, just a local news report of her plight.

"Pubmed case report link"? Why on earth would there be a report of her case there?

I'm mystified as to why a doctor rejecting a patient, (she's only one of hundreds of thousands in this particular major US city) become "grist" for a report in a scientific database? (no harm to her, just an inconvenience, with this cavalier, high-handed rejection most certainly disabusing her of all of her illusions about the vaunted magnanimity of doctors)

IOW, in newsland parlance since her story "doesn't bleed" so it's damned sure not ever going to "lead", meaning it won't become the topic of any news story/journal article.

Furthermore, EVEN IF there were one, why would I post something containing information that would make it a slam-dunk for any predator to target her and/or steal her identity, i.e., satisfying the outstandingly ill-bred/bad-faith curiosity of you/your fellow-travelers (raised in barns were you?) is soooo NOT worth that risk to a dear friend.

"Just a local news report"? WHY would a doctor rejecting a patient end up in the local newspaper (slow newsday, MUCH!), especially in a major Us city with quite a few "local papers"?

Her case was NOT "fodder" for a story since the result of this "firing" only meant that Dr. Lyra had to find another doctor, which was not a problem since she was and is very fit and healthy, very low risk, only taking her 48 hours to find one, especially in a major city of this size (lots of doctors here on the "care-for-profit" gravy-train only too willing to accept a usually compliant patient with and good health insurance plan).

And NO, I'm not going to reveal her hometown to what is IMO a pack of egotistical nosy-parkers who for some strange reason seem to be under the delusion that their disgustingly ill-bred/bad-faith curiosity should be satisfied at all costs, regardless of the risk to my friend (oh and let me mention again that I'm under no illusions that your "request" for "proof" is made in "good faith" >> you have no intention of believing me, no matter what, no way, no how!).

In case, the lot of you STILL haven't "gotten it", I'm not risking having her identity becoming known, especially since I am completely convinced that anything I might post as "proof" would be rejected (that old "Evidence-Bar" will be jet-propelled to the Oort Cloud and beyond!) because it's very obvious all of your kind don't want to believe cases like hers exist and have already decided she doesn't, no matter what, because it doesn't validate your image of doctors as pure-of-heart, always-caring Angels-of-Mercy/Infallible Fonts of All-Wisdom-Knowledge.

Just curious: is the name “Varga” Hispanic or Hungarian? Because I did mistake a Hungarian Varga for the former. Or did you just make it up?

More ill-bred curiosity, i.e., why it this your business, how is it relevant to what is IMO, the vicious, premediatated gang-raping of Cassandra's right to physical/personal autonomy? (gleefully supported by so many, gag-a maggot!)

Or is your name actually Miles:
https://sciencebasedmedicine.org/the-sad-but-unexpectedly-hopeful-cance…

Wow, yet another "dish" of ill-bred/no class curiosity on your part. Do tell me why I should be under any obligation to answer such questions for someone with posts whose "caliber" is exemplified by the following:

EXHIBIT A

Chris
June 6, 2017

NWO Troll, why should we care about your uneducated opinion? You are just noise in the ether.

EXHIBIT B

Chris
August 18, 2017

“a whiny little brat “

A very good description of Mr. Varga.

EXHIBIT C

A little ditty for Mr. Varga:

Trollin’ Trollin’ Trollin’ Trollin’ Trollin’ Trollin’ Trollin’ Trollin’ Trollin’ Trollin’ Trollin’ Trollin’
Rawhide!
Trollin’ Trollin’ Trollin’ Though the threads are swollen Keep them comments trollin’,
Rawhide!
Cherry pick!(Head em’ up!) Move goalposts!(Move ’em on!) More insults!(Head em’ up!)
Rawhide!
Make stuff up!(Paste ’em in!) Change topics! (Cut em’ out!) Whine some more!(Paste ’em in,)
Rawhide!
Keep trollin’, trollin’, trollin’
Though they’re disaprovin’ Keep them comments trollin”,
Rawhide!
Don’t try to understand ’em Just rope, laugh, and ignore ’em
Soon we’ll be discussin’ right without ’em

Tell me why I should answer the questions from someone who posts consists ONLY of example of ill-bred/bad faith curiosity (evidence above), hurling grade-school insults and a lame attempt at ridicule (lathered with copious hypocrisy as exemplified by all the pearl-twisting over insults, changing the topic,etc.), all IRRELEVANT to the actual topic of this thread (is there an actual argument for or against the decision to force chemo on Cassandra, anything of value at all?)

"Tell me why I should answer the questions from someone who posts consists ONLY of example of ill-bred/bad faith curiosity (evidence above), hurling grade-school insults and a lame attempt at ridicule (lathered with copious hypocrisy as exemplified by all the pearl-twisting over insults, changing the topic,etc.), all IRRELEVANT to the actual topic of this thread (is there an actual argument for or against the decision to force chemo on Cassandra, anything of value at all?)"

Wow. Describes you perfectly.

JustaTec:
Emilio Varga @189: Clearly you’re not familiar with the record keeping and testing requirements of FDA-approved medicine.

Glaring by it ABSENCE is evidence from my post (link given for your convenience) substantiating your characterization (do realize that your no-evidence "say so" DOES NOT "make it so").

Also, clearly you are unfamiliar with the even more intense regulatory requirements for biologics.

Again we're treated to your no-evidence "say-so", so what!

Have you ever done GMP? Because if you talk about “costs” and only talk about the raw materials and not the clean rooms, the trained manufactures, the testing and validation involved in actual GMP, well then you don’t really know what you’re talking about.

I going to assume that the "GMP" you're banging on about is Good Manufacturing Practice and again I have to ask so what?

IOW how does any of the above even come close to justifying the predatory, exorbitant costs of the chemotherapy drugs, JustaTec?

Let's see some actual numbers eccruing from these things that would actually show that the costs are warranted, otherwise, I've got absolutely no compunction in thinking that the ONLY "justification" for this astronomically high cost is to feed the equally astronomically obscene, predatory GREED of the owners/shareholders of the companies that manufacture them (CEOs large and in charge of The League of EXTRAORDINARY Greed™).

Now let's have some MORE evidence that these cost are NOT warranted and that "Big Pharma" long ago abandoned doing any real science, parasitizing innovative research products/result of scientists, funded by NIH grants and from small biotech companies, in addition to sucking up tax-payer money:

How Taxpayers Prop Up Big Pharma & How to Cap That

The taxpayer not only shells out at the pharmacy but often plays a critical role in funding these drugs in the first place. In other words, the public pays twice.

Although the pharmaceutical industry justifies routine overcharging by pointing to the huge, and uncertain, costs of research, the truth is that the government historically took, and continues to take, the greatest risks.

Since the 1930s, the National Institutes of Health has invested close to $900 billion in the basic and applied research that formed both the pharmaceutical and biotechnology sectors, with private companies only getting seriously into the biotech game in the 1980s.

Big Pharma, while of course contributing to innovation, has increasingly decommitted itself from the high-risk side of research and development, often letting small biotech companies and the NIH do most of the hard work. Indeed, roughly 75% of so-called new molecular entities with priority rating (the most innovative drugs) trace their existence to NIH funding, while companies spend more on "me too" drugs (slight variations of existing ones.)

But if Big Pharma is not committed to research, what is it doing? First, it is well known that Big Pharma spends more on marketing than on R&D. Less well known is how much it also spends on making its shareholders rich. Pharmaceutical companies, which have become increasingly "financialized," distribute profits to shareholders through dividends and share buybacks designed to boost stock prices and executive pay.

Take Pfizer. Economist William Lazonick has shown that from 2003 to 2012, it spent $59 billion on share buybacks and $63 billion on dividend payouts — for a total payout to shareholders of 146% of net income. All the while, Pfizer benefited immensely from U.S. government spending on life sciences research and drug development.

Rather than making patient, long-term investments, large shareholders in Big Pharma companies are looking for a quick, easy, guaranteed return.

As evidence that Big Pharma is spending less on research becomes irrefutable, the pharmaceutical industry has used other excuses to support high prices. It has, for instance, argued that prices are proportionate to the intrinsic value of the drugs.

"Price is the wrong discussion," Gilead Sciences' executive vice president, Gregg Alton, declared in response to criticism over the price of Sovaldi. "Value should be the subject."

However, studies looking at cancer treatments have shown no correlation between the price of cancer drugs and the benefits they provide. Peter Bach, a renowned oncologist, has found that, for most drugs, a value-based cost is actually lower than the current market-based price.

This state of affairs is not simply a huge failure of the so-called free-market; it is a long con. The supposed partnership between public and private sectors is increasingly parasitic, hurting innovation and fueling inequality through reduced investment, exorbitant prices for consumers and more money siphoned off for shareholders.

So let's see those numbers, JustaTec, that would even come close to "justifying" the $10,000 cost/per month (average chemo-drug cost) for a course of treatments that may last for YEARS (example would be the chemotherapy for Hodgkin's lymphoma described in Orac's article here). Also remember than insurance companies DO NOT cover all the costs, so the patient will end up being the "debt slave" of the doctor/hospital until or EVEN IF he/she can pay off the staggering debt (of course, the therapy, depending on the cancer, may not work and the patient dies anyway with an outstanding debt that's usually passed on to their survivors who will be mercilessly pursued for payment as the "health-care givers" help themselves to every last penny they can wringe for the grief-stricken survivors).

"So do I think you’re ever going to believe her account of what happened, no matter how reliable the source? NO!!"

Given Ty Bollinger's grotesque unreliability when it comes to cancer treatment, any accounts of Cassandra's "medical kidnapping" appearing on his website are extremely dubious as well.

Panacea
August 18, 2017

Emilio, this is getting tiresome. You’re the kind of self righteous guy who talks for the sake of hearing his own voice. You’re hear because you want to say to yourself, “Yeah, I got them with that one!” never realizing that no, you aren’t doing anything more than making yourself look like an emotionally driven fanatic.

1. ROFL! Mirror-gazing again while you were typing, I see.

2. Not a surprise given the gobsmackingly obvious FACT that so many here seem to so very much in love with themselves, as evidenced their PRESUMPTION that their assessment of a situation is so correct, so on-the-side-of-the-angels that ENTITLES them to either be part of and/or cheerlead the FORCIBLE abduction and FORCIBLE medical "treatment" of a young girl on the laughably transparent FICTION that she wasn't old enough to have the requisite mental skills to decide for herself what medical treatments she will or will not undergo, now that really really takes an ego makes the Grand Canyon look like a rocky puddle >>>> Narcissus, eat your heart out!

3. But wait you've made this unsupported claim:

Panacea: I’ve got science on my side. You have opinion. It’s really no contest.

Let's explore that claim and see if it actually holds water.......

A. First, let's remember that in the state of Connecticut she could have obtained an ABORTION WITHOUT parental involvement/notification and WITHOUT professional counseling since according this law, she was NOT a minor, with "minor" defined as someone less than 16 years old. The EVIDENCE for what I've said above can be found HERE in detail in Post #207 to Johnny.

B. QUERY >> So IF she deemed competent to obtain an abortion at SIXTEEN (absolutely no oversight from anyone required in Connecticut if one is 16 or older), then show me the "science" that would make EIGHTEEN a requirement for being able to make a decision on whether or not to undergo a chemotherapy?

C. Now since you're asserting you have the "science" do give us the empirical evidence that would support the designation of EIGHTEEN YEARS as the inviolable LIMIT defining the acquisition of a fully developed decision-making capacity , IOW:

---WHERE is your data documenting the failure/flaws/success in decision-making by those at SEVENTEEN versus the track record of failure/flaws/success in decision-making by EIGHTEEN year-olds? (choosing these limits because of this situation, Cassandra 17 ruled incompetent vs Cassandra 18 = fully competent decision-making adult)

---If one can't show there's any significant difference in the decision-making skills between these two age groups then that simply guts the use of this age-limit by you, the court, the doctors in denying her the right to make that decision for herself.

---WITHOUT any data to support the position that turning 18 is a reliable “benchmark” as to whether or not someone can make a valid/correct decision, then we're really down to the FACT that what really happened was that a pack of disgustingly arrogant STRANGERS arbitrarily appointed themselves as the ABSOLUTE Arbiters of the "proper" course to take and used the court system to force their will on an unwilling patient.

POINT: It doesn't get more frightening that, folks and I'd bet the farm that if someone arbitrarily took any of you fine, upstanding "cheerleaders" to court, stripped you of your right to decide whether or not YOU would undergo this or that medical procedure, you'd fight like tigers to stop that (it'd be Hell NO, I won't GO!)

BOTTOM-LINE
It looks like the ONE, the ONLY criterion for determining her competence in this instance was whether or not her decision goose-stepped to that of her doctors/the medical establishment, who were simply slobbering at the bit to continue treating her, even if that meant forcibly abducting her/forcibly implanting a drug-port (for their convenience) and then FORCIBLY infusing grotesquely over-priced poisonous drugs into her (under threat of starvation/further isolation) against her will.

I guess the opportunity stroke those gigantic egos by playing The HERO™ (buttt, but we're saving her life...admire us, we sure as HELL do!) at her expense was just too, too tempting!

Dangerous Bacon
August 19, 2017

“So do I think you’re ever going to believe her account of what happened, no matter how reliable the source? NO!!”

Given Ty Bollinger’s grotesque unreliability when it comes to cancer treatment, any accounts of Cassandra’s “medical kidnapping” appearing on his website are extremely dubious as well.

1. Right on cue and as I expected, you rejected the account based solely on its origin, but unfortunately for you what's there as well is the VIDEO of Cassandra saying what's in the synopsis or are you going to proclaim the VIDEO account (Cassandra, "in the electronic flesh" so to speak) "unreliable" because of where it's posted >>> Can you say "genetic fallacy", DB?

2. One other thing, IF Bollinger or anyone else issued a FALSE account of how she was treated by the Hartford cops/DCF goons, Cassandra herself would most likely have protested such a falsehood (of course one could always fallback on just asserting that she was nothing but an "attention-whoring drama queen jonesing for sympathy", so, of course, she’d never do the right thing and protest the false account, eh, DB).

3. Furthermore, what we DO NOT have is any DENIAL by the Hartford authorities (the police/DCF) of Cassandra's account (WHY!) that she was apprehended using a show of force (12 cars full of cops/DCF goons) usually reserved for extremely dangerous criminals --- IF her account was false, then why haven't the Hartford authorities issued a DENIAL and set the record straight, DB? (now if someone finds such a denial, please post it).

4. IOW, if I were the police chief I certainly wouldn't want people to think my officers were such bullies, using this kind of force to arrest a sick, unarmed, alone, 16 year old girl (not a public image I'd want for my department, but that's just me I guess).

5. However, here's yet ANOTHER source:

Connecticut Teenager With Cancer Loses Court Fight to Refuse Chemotherapy (The New York Times)
The police were banging on the doors and the windows of her home while she cowered in the closet, a 17-year-old girl recounted. She remembered clutching her phone, crying, calling her mother.

“I was scared,” she wrote of the experience.

It may sound like a drug raid, or the climax of a movie. But in fact, the police, along with representatives of Connecticut’s Department of Children and Families, had come to take the girl for chemotherapy.
[....]
About a week after running away, Cassandra came home. In her essay, she wrote that she had returned because she was afraid her disappearance might land her mother in jail. In December, she was hospitalized.

“I was strapped to a bed by my wrists and ankles and sedated,” she wrote in the essay, which was accompanied by a photo of her in the hospital. “I woke up in the recovery room with a port surgically placed in my chest. I was outraged and felt completely violated.”

“How long is a person actually supposed to live, and why?” she wrote. “I care about the quality of my life, not just the quantity.”

I can't wait to see what excuse you have for pooh-poohing this source/her account.

*Yawn*

Strangely (but not surprisingly) there is nothing in the N.Y. Times story supporting Vargas' claim that a dozen police cars surrounded Cassandra's house, or that "multiple goon squads" "broke down her door dragged her off at gun point,like a criminal and then delivered to her torturers, again under cover of darkness”.

The Times story is a sober and balanced account of the issues involved. You could learn from their example.

As for stress impeding successful treatment, it must be highly stressful for patients to hear loons ranting and slavering about "medical rape", "torturers", etc.

Good catch. Notice also, the other parts Vargas mentions are from the account of the girl at the center of this.

I'm in NO WAY discounting her account out of hand, but additional sources would help her on the issue. Extraordinary claim, extraordinary evidence, etc.

Strangely (but not surprisingly) there is nothing in the N.Y. Times story supporting Vargas’ claim that a dozen police cars surrounded Cassandra’s house

It's from the Bollinger interview. Bollinger then embellishes it.

Now, given that she was, by her own account, hiding in a closet, one might wonder how she knew that there were "about 12 police squad cars surrounding [her] house and the block." Whatever.

"the other parts Vargas"

It is "Varga." There is no "s". Due to an in-law I have learned it is actually a Hungarian name. Though I would not be surprised if it was used in Spanish countries. Spain was part of the Hungarian/Austrian Empire for quite a while:
https://en.wikipedia.org/wiki/House_of_Habsburg

Let's give the troll a little respect for his sock puppet's name.

I think thou doth protest too much.

Given the tedium of the "professional biochemist," I may as well note that the verb in the second person is 'dost'.

A reminder that it is standard practice for altie news outlets to claim that the infrequent sanctions/arrests that target quackery and assorted other consumer threats are carried out by "goon squads", SWAT teams, military raids and so on. Just relating that a couple enforcement officers conducted a search, served papers or made an arrest doesn't sound as chilling.

Example from NutcakeNews:

"The federal government is becoming increasingly militarized, with numerous agencies now employing their own SWAT teams to conduct raids on raw milk producers, beekeepers, lemon growers - or anyone else who runs afoul of agency policies."

Given the level of craziness these "news" outlets encourage, I wouldn't blame the USDA if they took such precautions as carrying sidearms and wearing bulletproof vests.

Let’s give the troll a little respect for his sock puppet’s name.

Does that mean "Lizardo" is out?

A swat team seems perfectly appropriate for dealing with angry insects.

"and is unfortunate enough to have a parent who either . . . lacks the guts to tell the child that he’s getting treated for his own good and he doesn’t have a choice in the matter," This "for your own good" crap in the article disgusted me! This article author didn't even mention that Cassandra was OK with dying! What if the kid knows that it's best for him/her but doesn't want it even though it's best for him/her? Also, what is in a person's best interest physically is not always the same as what is in a person's best interest emotionally. If I were blinded in one eye in an accident as a kid and had the eye surgically removed against my wishes, physically I would avoid going blind in the other eye, but emotionally I would be unable to accept myself, engage in self-loathing for having a glass eye, and live the rest of my life in resentment. If the doctor respected my wishes, however, physically I would eventually go blind in the good eye from sympathetic ophthalmia, but emotionally I would calmly accept myself, knowing I still had both my eyeballs in their sockets. And right there is a flaw with the "But being a minor is only temporary argument!" too: even after I turned 18, 21, 25, 30, 50, 75, or even 100, I could never get that other eyeball (albeit a blind one) back.

@James Landau: it's too bad that you think that people go through life filled with self-loathing for having a glass eye and being able to at least see out of one eye. Perhaps some do. But then, how many go through life filled with self-loathing because they *didn't* have the eye removed and are now blind? Personally, I'd take the glass eye - or an eye patch - over being blind. Because knowing I took every chance to save my sight, my life, whatever, makes me feel better about myself, rather than filling myself with loathing. I don't loathe myself.

This article author didn’t even mention that Cassandra was OK with dying!

Yah. Then again, she seems to have changed her mind on that front pretty quickly. The kids these days!

James you forget to mention that SO is very rare. Most people who injure an eye don't develop it.

But when you do, surgery is the best way to keep what vision you have left. I've met plenty of people who lost an eye due to trauma. None of them loathed themselves.

if you do, you need professional help.

Real life got in the way for a while, but thank you CJTX for having my back at #208.

Emilio seems to be suggesting that because it's legal for Cassandra to have an abortion at her age that she should be able to make all her own medical decisions.

I would note that while 'many regard (it) as murder of another human being', for the most part it is relatively safe for the patient, and, like all the items I listed, seldom lead to death. Still, I'm glad that we restrict children from engaging in those activities, including deciding to skip life saving medical treatments.

We know what happens to people with untreated lymphoma - they die, and they die ugly, and they do it nearly 100% of the time. Treatment may not be fun, but according to our host, it works 85% of the time.

Emilio seems happy with 'let them die'. If there is a h3ll, there is a special place reserved for him.

And, yes, also Cassandra's parents, as well as Starchild's. All the parents who want to be a friend first and parent second, and let kids skip their medicine because they don't like it, are all guilty in my eyes.

First, let me say that since I've been called all kinds of names and now even have had someone fantasize about my being tortured eternally is his idea of Hell (evidence below), I can and will now certainly respond "in kind"....

Johnny: August 21, 2017

Real life got in the way for a while, but thank you CJTX for having my back at #208.

Emilio seems to be suggesting that because it’s legal for Cassandra to have an abortion at her age that she should be able to make all her own medical decisions.

I would note that while ‘many regard (it) as murder of another human being’, for the most part it is relatively safe for the patient, and, like all the items I listed, seldom lead to death. Still, I’m glad that we restrict children from engaging in those activities, including deciding to skip life saving medical treatments.

1. Cassandra was NOT a child, though it's glaringly obvious that your kind desperately need it be so, otherwise the lot of you just might have to deal with the FACT that you/your fellow-travelers are here cheerleading a CRIME (kidnapping and assault with intent, just for starters).

2. You and the rest of the "cheer-leading squad" are simply desperate to ignore the fact that the state would allow her to make medical decisions that include having an abortion at a much younger age (in her case she could have walked in to a clinic, gotten one with no parental involvement and no nanny-state breathing down her neck, as a "minor" in this case is someone less than 16 with Cassandra being over 17).

3. It looks like the state is quite inconsistent as to when someone is classified as a "minor" and when he/she is "adult" and those arrogant, egotistical doctors callously used that "inconsistency" to FORCE someone who just a few months short of what I'm going to call "the other magic boundary" defining adulthood to force THEIR WILL on an unwilling patient.

4. IOW these unbelieveably arrogant control-freaks (aka her "doctors") didn't gave a rat's patootie for her as a human being with any right to self-determination, their egotistical WILL trumped all and they simply used the power of the state to enforce it, more shame to them, but neither them nor the state officials seem "afflicted" with conscience, hence, no sense of shame at ordering nothing but a criminal assault (just for starters!) on another human being.

We know what happens to people with untreated lymphoma – they die, and they die ugly, and they do it nearly 100% of the time. Treatment may not be fun, but according to our host, it works 85% of the time.

Emilio seems happy with ‘let them die’. If there is a h3ll, there is a special place reserved for him.

ROFL!
5. "We"? who's this "we" and who are "they" such that "they" have become so "entitled" to trample all over someone else's rights?

6. But the "we" are simply egotistical nannies who get off on controlling others, deluding themselve that because it's for their target's "own good" with their wishes (they're always RIGHT!) abrogating the personal autonomy of the target their sucking their "control-freak fix" from (and they can pretend they're so holy and righteous because they're "saving her from herself", sucking up a I'm-A-Superhero fix, in the bargain, truly intoxicating stuff this!).

7. But you don't really have any "justification" other that it's all about what YOU want, what YOU think is right and what YOU want done, so it doesn't surprise me at all that you would sink to accusing me of "being happy to let them die" >> QUOTE ME where I ever said or came within a light-year of implying.

8. But wait, your little revenge fantasy (get you all "hot-n-bothered" does it?) of imagining me tortured forever in some God-botherer hell says far more about you than it does about me and I have to ask does your God "speak" to you (from His lips to your pearly ear, eh?!(maybe you're a member of this guy's God's Favorite Saint Club, a membership that allegedly endows it's members with "spiritual discernment" and given license "to judge the world"...inquiring minds want to know!)

And, yes, also Cassandra’s parents, as well as Starchild’s. All the parents who want to be a friend first and parent second, and let kids skip their medicine because they don’t like it, are all guilty in my eyes.

And who are YOU, again, that these people you're dumping on should care what YOU think?

Oh, I forgot, you seem to know what "God(-s? humans have invents so many such "Authorities" to justity/excuse their evil) would do", so did He tell you that they were the scum that you must obviously feel oh-so superior to, otherwise, what's your "basis" for sitting in judgement?

Dangerous Bacon, August 19, 2017
Strangely (but not surprisingly) there is nothing in the N.Y. Times story supporting Vargas’ claim that a dozen police cars surrounded Cassandra’s house, or that “multiple goon squads” “broke down her door dragged her off at gun point,like a criminal and then delivered to her torturers, again under cover of darkness”.

1. Cassandra's account, but as it's in her interview video with Bollinger, you deliberately ignore that and then you say the following:

The Times story is a sober and balanced account of the issues involved. You could learn from their example.

2. YET here you bleat:

As for stress impeding successful treatment, it must be highly stressful for patients to hear loons ranting and slavering about “medical rape”, “torturers”, etc.

3. I guess that this is your idea of a "sober and balanced" response to someone not agreeing with you, in addition to falsely attributing to me words/positions I never made as documented HERE in Post #188 and HERE in Post #200 (this is NOT a comprehensive list).

4. Considering the above, I have to ask, DB, does the word "hypocritie" mean anything to you?

5. Now as for describing her treatment as medical rape, let's have Cassandra's own words (funny, how you just keep right on ignoring the victim, you know the one you're all here, wringing the living daylight out of your "concern" pearls over), in light of the FACT that it took 12 workers (oh wait, she didn't video it, take name badges, so she's a liar, eh, DB?) to strap her down and shove a needle in her neck to sedate her so they could slice her open and implant the for-their-convenience drug port (now the above sounds like scenario right out of Marquis de Sade), so let's have Cassandra's (remember her?) reaction, shall we:

“At that point, I didn’t feel like a human anymore… I feel like I’ve been violated… My ankles and wrists were bruised when I woke up.”

6. "I felt like I've been violated"..now the verb "violated" PLUS the sadistic scene of strapping her down/stabbing her with a needle, slicing her up, gosh, that kind of FORCIBLE RESTRAINT is typical of rape, especially coupled with the FORCIBLE INSERTION of foreign objects into her body against her WILL, now sure sounds like RAPE to me and she obviously thinks so, as per being "violated" and no longer "feeling human".

7. But wait when her "captors" shot her up with poisons through the foreign object forcibly inserted into her body, maybe she should have just closed her eyes, laid back and thought of England, eh?

8. Now let's have a "sober" description of this HORROR from one of your very own:

Then there are practical matters. Let’s go back to a post I wrote about a similar case of a chemotherapy “refusenik,” in which I noted that, while it may be possible to physically restrain a teen in order to place permanent intravenous access and then, every so often, to give her chemotherapy, it would be very difficult, and there would be nothing to stop her from trying to rip the intravenous access out to prevent further doses, potentially hurting herself, unless she were kept under constant surveillance and possibly even put under anesthesia for her chemotherapy dose. In other words, she would in essence need to be imprisoned for therapy. Then there was the issue of radiation therapy, which requires the cooperation of the patient, who must lie still on the table and do so every day for 30-40 days, depending on the radiation therapy regimen. Sure, Cassandra could have been sedated for each session, but there’s nothing good about sedating someone five days a week for six weeks or so. As I pointed out before, oncologists have a real problem doing this, and for good reason.

In any case, part of the above was basically what happened to Cassandra, although fortunately anesthesia wasn’t necessary except for her port placement, for which a combination of local and IV sedation are routinely used. She was locked away in a hospital and is not allowed to see her mother more than once a week, and then only under supervision. DCF took away her cell phone, and the hospital removed her room’s land line. Fortunately, she was cooperative, but imagine if she hadn’t been.

9. Shudder! Yes, just "imagine" IF she hadn't SUBMITTED, what would have been done to her and how would any of your kind like the above done to you against YOUR will or hasn't that occurred to any of you here (oooppps! my bad! I keep for getting self-entitled, purse-lipped control-freaks always, ALWAYS plan on being on the "dishing end").

10. Oh and I don't for a red-hot nanosecond believe that the relief expressed at her sumbitting is anything but a sigh of relief that a martyr wasn't created as a consequence of her injury and/or death that most probably would have happened if she had resisted.

11. Just imagine how the Woo-Meisters could and would have "spun" that, talk about a PR nightmare for the traditional medical establishment! (sigh of relief that such a"quack-spoitation" opportunity did not occur, no concern at all for the girl herself as far as I'm concerned).

Varga is confusing disgust with his bizarre rhetoric and unsupported claims, with agreement that 17-year-olds should be compelled to undergo cancer therapy against their wishes. There are few if any here who'd endorse that position without qualification.

Given his evident lack of knowledge about cancer treatment, he exhibits the classic triad of fervent wooism: ignorance, confusion and belligerence.

Dangerous Bacon
August 22, 2017

Varga is confusing disgust with his bizarre rhetoric and unsupported claims, with agreement that 17-year-olds should be compelled to undergo cancer therapy against their wishes.

1. "Bizarre rhetoric"? "Unsupported claims"? Absent are any examples that you show to be either "bizarre" or "disgusting" (did remember that disagreeing with you doesn't rank as evidence warranting your characterization).

2. I don't see ANY disagreement with forcing this treatment on Cassandra, something doomed to failure from the get-go (will give reasons why later).

There are few if any here who’d endorse that position without qualification.

1. What "qualifications" and should you actually deign to list these "qualifications," so what?

2. She was still was subjected to treatment against her will ("I fell VIOLATED"..."did not fell human") so whatever those "qualifications" were, they look suspiciously like rationalizations people make in order to silence any possible pange of conscience or personal queasiness when facing what they would never, ever permit to happen to them ("I have reservations, BUT , , yadah, yadah")

Given his evident lack of knowledge about cancer treatment, he exhibits the classic triad of fervent wooism: ignorance, confusion and belligerence.
1. Glaring by its complete ABSENCE is any example where you actually show this "evident lack of knowledge about cancer treatement" (if such a "lack" is "evident", you should have no problem coming up with an example).

2. At NO TIME have I ever once said standare cancer treatments didn't work, realizing that "working" here actually means the cancer is eradicated before those powerful poisons take down one or more vital functions that will kill the patient just as dead (there's no escape from this for you).

3. Unfortunately for now the above therapy "as good as it gets" and all there is with a proven track record and IF you're going to continue to insinuate that I've ever taken any other position, then do QUOTE ME (know you can't...but hey, continue to put words in my mouth I NEVER said, what does that make you?).

4. Furthermore, at not time have I ever once supported any of the so-called "alternatives" to standard treatment and if you are going to continue to imply that I have with your accusations of "wooism", again, QUOTE ME, however, I know you can't because this no-evidence characterization is nothing more than a transparent dodge, used as a "justification" for summarily hand-waving my arguments away.

5. Here's why forcing chemo on Cassandra was the ULTIMATE-Exercise-in-Futility:
--A. Cassandra, who was diagnosed with stage III-IV Hodgkin’s disease, was 17+, just months SHORT of the legal definition an adult under the law, 18, remembering that in the same state, at her age she could have decided to have an abortion with NO parental notification/involvement and NO "oversight" from Big Brother (state only requires counseling for those considered a "minor", defined for this law as someone under 16).

--B. Hodgkin's lymphoma is a cancer that can requite up to 2.5 years of repeated cycles of treatment to enable that success rate of 85-90%, with Cassandra's advanced stage dropping that rosy prognosis down to between 65-80% as given HERE, so let's have a description:

Unfortunately, the chemotherapy regimens for childhood leukemias and lymphomas are long for a reason. Oncologists don’t give up to two and a half years of chemotherapy because they like poisoning children. Decades ago, they learned that if they didn’t give such prolonged courses of chemotherapy, the cancer was likely to return, even if it had gone into remission after only one or two courses of intensive chemotherapy.

--C. Cassandra did NOT believe or trust her doctors' plan for treatment, with this lack of faith/trust only being magnified by her cavalier treatment (would you trust someone who sees to it that you're dragged from your home/forced to undergo treatment you didn'consent to?).

--D. She was FORCED to undergo traditional treatment by powerful strangers (this includes her doctors) who used a law very inconsistent on when it allows a person to make decisions regarding his/her medical care (the Legal Adult Schtick = 18 but at the same time IF one is older than 16 she can get a no-questions-asked abortion, the word "schizophrenic" comes to mind).

--E. Since she was only months away from that "magic boundary" used by total strangers to force their will upon her, the fact that she abandoned a therapy she declared made her feel "VIOLATED" and "not human" as soon as she turned 18 should come as no big surprise (of course, all those cheerleading this state-mandated treatment, just "know" her decision-making faculties "suddenly" became fully capacitated the moment all her brain-cells became properly "aged", right, guys?).

--F. What doesn't seem to have occurred to those I'm just going to call "The Cheerleaders" is that the very fact that she was forced to undergo treatment people I sure she viewed as "the enemy" would only solidify and harden her distrust of any claims of efficacy for that treatment, so abandoning it the first chance she got was almost assuredly a foregone conclusion (it doesn't look like anyone actually tried to persuade her, but the likelyhood of doing that under such circumstance would make winning the lottery more probable!).

--G. Not surprisingly, Cassander was an easy mark for quacks who exploited her complete lack of trust in the medical establishment, with these predatory fleecers promising her an easy cure, noozling up her money and shamelessly using her as an advertising tool to attract more "marks" into their con game.

--H. The cancer returns with a vengeance! Big surprise?!(NOT!)

CONCLUSION
Forcing chemo on Cassandra was unwise because any probability of her continuing the treatment for the length of time required for it to be effective was doomed from the very start for the following reasons
--a) the advanced stage of her cancer,

--b) for the treatment to have real chance of working would have required state-forced chemo to continue for up to 2.5 years, but she was only in their "custody" for a few months, resulting in what I'm going to call a "maybe-remission", with her stopping the minute the state jackboot was no longer on her neck and

--c) worst of all, now that her trust in all the "legal" adults/medical establishment who orchestrated her forcible treatment had been completely destroyed, she, not surprisingly, fled into the waiting arms of predators who dropped her like a hot potato when her cancer returned/they had taken all her money, costing her precious time in the bargain.

BOTTOM-LINE
This FAILURE was easy to predict primarily due to the FACT that as soon as Cassandra reached 18 there would be no way to enforce completion of a treatment regime that actually could require up to 2.5 years to complete, i.e., the abject stupidity of the "legal" adults here in NOT having thought this matter through and considering this obvious limitation attended with an even more obvious outcome, is simply mind-boggling IMO (if she dies, part of the blame can be layed at their door for this attempt to stampede her into treatment rather than take the time or have the patience to try to persuade her instead, i.e., actually treat her like a reasoning human being).

Lots of banter about "quackery", that is easy from a chair in your living room but vastly more difficult to substantiate. Clearly Chemotherapy does not work with a proven 2.5% overall success rate documented by The Australian Study. You will never see statistics come out from the US cancer industry identifying survival by stage of disease. You attack Hope4Cancer on a number of fronts so lets start with coffee enema's - https://www.youtube.com/watch?v=uBlDTLvHi34 here Dr. Nicolas Gonzalez explains how they work. There are many videos going back for years describing the benefits of coffee enemas for everyday illness let alone cancer. Then lets dig into the battle that is waged between small business owners like the owners of Hope4Cancer and the cancer industry. The industry needs to be held as accountable, you are discussing one patient here that was treated in both the Cancun location and in Tijuana. Clearly there is a difference between the brand new clinic in Cancun and the older clinic in Playas de Tijuana.

You discuss cancer like you understand it, well lets dive in a little and see if you do. Cancer is a disease, the truth about cancer is you are battling with the body to get it back to ease. Disease to ease, kind of understandable. You cannot poison anything back to good health so why would anyone allow themselves to be bathed in chemotherapy. We as human beings are about 100 trillion cells and more than 70% water by volume, more than 99% water by molecule count. A vast majority of cancer patients are dehydrated, they lack water in their cells or the water in their cells have become increasingly toxic. The blood (mostly water) is trying to move nutrition around while it is becoming more and more viscous. The heart is beating faster to pump viscous blood around to keep the brain happy. The cancer continues to simply survive in this malaise because that is what it likes best, a viscous, acid filled environment where the cells are weak and easily invaded. So, what is the answer? Well it is not poison the system and see if the patient lives.

In my years of watching the industry here in the states and in Mexico I can say in Mexico you will be treated like a human being. Here you are greeted, and put through a system that breaks you down in nearly every way then poisoned. The practitioners in Mexico and frankly around the world are much better at battling to find homeostasis than we are here. Layering non-toxic treatments is the only long term strategy for success against cancer. Viral therapies and boosting the immune system are legitimate. Most importantly people need to remember that you do not get cancer overnight, it cannot be treated overnight save a miracle, which there are many reported.

Look at the world rankings of medical care you will find the United States way down the list for quality of care and at the top for cost of care. I am not saying if I broke my leg I would not want to be here in the states but if I had a disease I would definitely be traveling for care.

For patients reading this I would also strongly recommend understanding diet and detox, these two areas are critical first steps in your decision tree. Here is a little more on the decision tree https://www.mindmeister.com/566315473?t=ME5nTRLk7A

Prayers for those that are in the battle and their families, for those working to destroy competition for the cancer industry I can only say karma is your worst nightmare.

Chemotherapy 2% gambit? Yawn. It's BS that I covered a long time ago. That Australian study shows nothing of the sort:

http://scienceblogs.com/insolence/2011/09/16/two-percent-gambit-chemoth…

Here's a better estimate of the contribution of chemotherapy to survival:

http://scienceblogs.com/insolence/2011/12/07/so-chemotherapy-does-work-…
http://scienceblogs.com/insolence/2013/10/30/so-chemotherapy-does-work-…

Dr. Gonzalez? His treatment was ineffective quackery that failed in clinical trials:

http://scienceblogs.com/insolence/2009/09/14/the-gonzalez-protocol-wors…
http://scienceblogs.com/insolence/2009/09/17/nicholas-gonzalez-response…

And cancer is not a disease. It is many, many diseases. You clearly have no clue what you are talking about when it comes to cancer. In fact, you have negative clues and negative knowledge.

"You discuss cancer like you understand it, well lets dive in a little and see if you do"

Gotta love someone who tells a breast cancer surgeon about cancer.

Not just a breast cancer surgeon. A cancer biologist with a PhD who runs his own lab.

Whoops, apologies for the omission Doc.

Disease to ease, kind of understandable.

Has anyone ever been convinced by the Proof by Crap Etymology?

Look at the world rankings of medical care you will find the United States way down the list for quality of care and at the top for cost of care.

And those places with better-quality care achieve it with the same medical procedures combined with a less-crappy funding method.

Breast cancer surgeon -

The one way to cure cancer is surgery prior to metastasis. Unfortunately the biopsy spreads the cancer then surgery spreads the cancer then treated with chemo you are using a carcinogen to treat cancer - that would be a substance that causes disease (cancer).

Surgeon is just a person that puts his pants on one leg at a time just like the rest of us. Certainly there are good surgeons and there are great ones.

Chemotherapy 2% is simply truth. I have heard some remarkable new treatments like Gazyva but this is nothing like first line chemo for breast cancer.

Dr. Gonzalez left us with one of the best documented records of treating cancer patients of any doctor in the United States.

It is many diseases indeed, however they are all simply an abnormally formed cell. Sure one is a ovarian and one is a breast and so on but at the end of the day it is simply a malformed cell.

I do like your references right here in this single forum, seems very open minded.

The one way to cure cancer is surgery prior to metastasis. Unfortunately the biopsy spreads the cancer then surgery spreads the cancer then treated with chemo you are using a carcinogen to treat cancer – that would be a substance that causes disease (cancer).

This has been extensively studied. Breast cancer biopsies do not spread breast cancer.

Chemotherapy 2% is simply truth. I have heard some remarkable new treatments like Gazyva but this is nothing like first line chemo for breast cancer.

No, it is a distortion based on a single crappy study from over 15 years ago. I explained why in my link. I can provide more because I've described why on more than on occasion.

Dr. Gonzalez left us with one of the best documented records of treating cancer patients of any doctor in the United States.

?????

I'm sorry, that is too funny. It's also just not true.

It is many diseases indeed, however they are all simply an abnormally formed cell. Sure one is a ovarian and one is a breast and so on but at the end of the day it is simply a malformed cell.

Seriously, do you even know how scientifically ignorant this is?

"Cancer is a disease, the truth about cancer is you are battling with the body to get it back to ease."

Likewise, the truth about illness is you are fighting ill to get back to ness.*

With a malformed cell, all you need to do is eliminate the mal and the body is back in formation.

Kill the fung, and us is doing just fine.

It's subtle profundities like these that our medical establishment ignores to its peril.

*the proof: Eliot Ness died of a heart attack, not cancer.

Very compelling argument.

And chemo? is it poison, does it cause cancer?

Will you provide a link to the cancer statistics by diagnosis by stage? Do you have them for your practice?

Scientifically ignorant? Seriously, do you know how barbaric current treatment is for malformed calls, and if cancer is not a malformed cell how would you characterize it.

http://cnx.org/contents/CYZpmedR@7/Cancer-and-the-Cell-Cycle

Any cell in any tissue of the body... from Khan Academy
https://www.youtube.com/watch?time_continue=2&v=RZhL7LDPk8w

A little defect ... malformed cell.

I am not going to argue, clearly you are part of the system that has been killing us for years. A majority of people are going to listen to you and continue to get the results we are all so familiar with.

I am just a guy that has watched and listened as people like you with PhD. and a lab, use the latest greatest treatment of the week or chemo cocktail on my family members. Causing their death in nearly unimaginable inhuman ways. I would expect you to be very proud of your education and I am hopeful that you are someone like you will not be responding to a blog post, but will find a way to treat cancer more effectively. I would say our future will deem the current methods barbaric and we will find the answer in our study of water.

It is many diseases indeed, however they are all simply an abnormally formed cell.

Broken legs and ruptured spleens are both caused by falling out of trees, which is why we treat them both the same way.

we will find the answer in our study of water.

Del Giudice never recovered his health and sanity after his attempts to reconstruct the Waterbox ("probably the most delicate and fragile instrument ever made by human hands") -- invented but poorly-documented by de Selby as a way of diluting water to a point where it could be handled safely. "There is more to water than meets the eye," wrote de Selby, by way of explaining why three heavy coal-hammers were destroyed during its construction.

Pat: "I am not going to argue, clearly you are part of the system that has been killing us for years"

And failing miserably at that, since the average American lifespan has increased ten years since 1970 to almost eighty years old. It would be better if we had better health care and states like Texas did not muck things up by increasing maternal deaths:
https://www.google.com/search?q=usa+life+expectancy&ie=utf-8&oe=utf-8

Why don't you focus your anger on this:
https://www.texasobserver.org/texas-worst-maternal-mortality-rate-devel…

Disease to ease

Whenever I read this phrase, it immediately brings to mind the mangling of the origin of words that is part and parcel of Freemanism.

It has the effect of me wanting to dismiss everything written as being the product of an incurably small and incurious intellect.

She's still alive. Did intensive chemo. Posted today.

https://www.facebook.com/MooshMoosh101/posts/1551068

Gah.... full link: https://www.facebook.com/MooshMoosh101/posts/1551068758256650

Did cannabis oil save Deryn Blackwell's life?

oracknows — Mon, 03 Apr 2017 01:12:47 +0000

Did cannabis oil save Deryn Blackwell's life?

It's been a while since I've written about the burgeoning business of selling marijuana as a cure for whatever ails you. As I've written before, there exists a mystical faith that is very much like herbalism that marijuana is a magical plant that can cure, well, almost anything, including cancer, glaucoma, autism, ADHD, and many other conditions, when in fact the evidence is rather shaky for most, if not all, of these claims. Regarding cancer, the usual claim is not that smoking marijuana cures the disease, but rather that cannabis oil isolated from marijuana cures cancer, a claim that Rick Simpson has profited from after claiming to have cured his skin cancer with cannabis oil in 2003.

Over the years, I've examined a number of "cannabis cures cancer" (or, truth be told, "cannabis cures" this or that condition) testimonials (e.g., Stephanie LaRue's story). Like most alternative cancer cure testimonials, when you take a closer look, inevitably the case being made that it was the cannabis oil (or whatever derivative from marijuana was used) cured the cancer (or saved the patient's life after complications of therapy) is nowhere near as convincing as the advocates making the testimonial claim. Usually, there is another explanation for how well the patient is doing and/or the link between starting cannabis oil and clinical improvement is not nearly as convincing as it seems on the surface. As with the case of the belief that vaccines cause autism, human beings mistakenly attribute correlation to causation. Add to that a dash of confirmation bias, something we human beings all suffer from, and it's very easy to come to develop an unshakable belief in a post hoc ergo propter hoc fallacy in which something they observed or did before something else happened must have caused that something else to happen, be it vaccines "causing" autism or cannabis "curing" cancer.

I bring this up because there is a new "cannabis cures" testimonial going around the UK that was brought to my attention yesterday. It was about a boy named Deryn Blackwell, who beat leukemia and the very rare Langerhans sarcoma through multiple bone marrow transplants (BMT). The cannabis comes in during his last BMT, when his mother gave him cannabis oil to relieve his symptoms as his transplant appeared to be failing and was overjoyed when her son recovered after having been in hospice for over a month. Her story portrays cannabis oil as being responsible for bringing Deryn back from the brink of death. Predictably, the British tabloid media is portraying his story as a "cannabis cures cancer" story, even though, even taken at face value, it is not. I had already started a post on another topic when I saw this, and it grabbed my attention to the point where I abandoned what I was writing before to take a look at this testimonial. On the surface, it is a very convincing testimonial, which is why I decided, as Seth Myers would put it, to take a closer look.

The story of Deryn Blackwell, as told in the media

Deryn Blackwell is a 17-year-old boy whose story appeared in The Daily Mail a week ago in an article entitled (at the time) "I gave my little boy CANNABIS to help cure his cancer: Mother reveals how her teenage son who was given days to live made a miracle recovery when she gave him the drug behind his doctors' backs." (As an aside, besides its being a tabloid rag, it's always irritated me how The Daily Mail loves ridiculously long headlines.) Other papers featured basically the same story with long similarly long headlines like "'I GAVE MY BOY CANNABIS' Mum reveals she gave her cancer-stricken son CANNABIS in bid to ease his pain… and now he’s made a miracle recovery." Basically, Deryn's story was all over the UK press over the weekend. The Daily Mail story is an excerpt from a forthcoming book (of course) chronicling Deryn's battle with cancer entitled The Boy In 7 Billion, by Callie Blackwell with Karen Hockney, to be released on April 6. The description of the book reads:

The powerful and moving true story of a remarkable relationship and a tenacious fight for survival. Callie reveals her son's struggle through the physical and mental torment of battling cancer against impossible odds, and the truth behind her son's 'miraculous recovery' that she has held secret for years.

And it's true. Deryn's story is indeed remarkable, as you will see. The "secret" that Callie Blackwell has never revealed—until now!—is that it was cannabis that saved her boy when he was on the brink of death due to a failing bone marrow transplant. But was it? Let's take a look at that excerpt. It starts out with this heart-rending description of Deryn as he got sicker:

The pain was getting worse. The tips of my son Deryn’s fingers were hard and black from a superbug infection. His nails were peeling away and any remaining live flesh was covered in weeping sores.

Every day, he begged me: ‘Please tell them to cut my hand off, Mum. I can’t take this any more.’

Deryn was nauseous and, worse, had become addicted to his anti-sickness drugs. He was allowed a dose every seven to eight hours but within an hour of being given some, he would press the buzzer to call the nurses back in.

What mother wouldn't be utterly distraught watching her son suffer like this? What mother wouldn't start to consider things that she normally wouldn't, if only she could ease her son's suffering. So Callie Blackwell did this:

Deryn had suffered enough. In 2010, when he was just ten years old, he had been diagnosed with leukaemia.

Eighteen months later, he was told he had a secondary cancer, the extremely rare Langerhans cell sarcoma. Only 50 cases have ever been recorded and only five people in the world currently have it. But no one had ever been found to have the two cancers combined, making Deryn unique. One boy in seven billion people.

By 2013, after nearly four years of hospital treatment, it seemed that the only thing left for him were opiate drugs to ease the pain as he reached the end of his life.

Like any mother would be, I was desperate to find something to alleviate his suffering.

I spent hour after hour researching on the internet, and that’s where I came across reports of a substance called Bedrocan, a cannabis-based painkiller that wasn’t available in the UK. Surely Bedrocan had to be a better option than mind-numbing morphine?

But the doctor told me that while it was effective, it had not been tested on children and she couldn’t prescribe it.

So Simon and Callie Blackwell, in an effort to ease their son's suffering, sought out cannabis. Simon nobly took responsibility for obtaining some marijuana, using the rationale that if anyone were to go to jail for this he wanted it to be him and didn't want Callie to be away from their son. The two of them did what most people who've decided to use alternative treatments do and read extensively on the Internet, where they learned to make cannabis extract suitable for a vaporizer pen using a rice cooker and vegetable glycerin, noting that in 2013, when they first decided to use cannabis:

Back at the hospital, meanwhile, our son’s latest bone marrow transplant had failed. Staff were giving up on him. It seemed Deryn’s death was a done deal and now all we could do was wait until he drew his final breath. If there was no improvement in two weeks, he would be placed in palliative care.

So what happened? Callie Blackwell went through with her plan. She brought her son the vapor pen:

Deryn sucked on the pen, breathed in and blew out a massive cloud of vapour – and we frantically waved our hands around trying to disperse it, although there wasn’t the smell of cannabis. It smelt more like popcorn. After ten minutes, Deryn said that the pain had decreased a little and he felt more relaxed – the words we had been longing to hear.

Alas, his condition continued to worsen. By December 2013, Deryn had moved out of hospital and into a hospice, where he planned his own funeral. His bravery attracted national attention and some of his favourite celebrities, including Paul Hollywood, Pauline Quirk and Linda Robson came to meet him.

I note that, here, despite Ms. Blackwell having started to sneak a cannabis vapor pen to her son for an unclear number of times, her son continued to deteriorate, and the vapor pen was only providing him with modest relief from the pain. He went to hospice, as far as I can reconstruct, two weeks after his mother started to sneak him puffs of cannabis. This is hardly the sort of "cannabis saved my child" story that sounds promising, at least not to this point.

Further deterioration...and then a "miracle"

What happened next is that, as Deryn's condition continued to deteriorate during the two weeks after Callie Blackwell started to give him cannabis oil. Because he complained that he didn't want any more morphine because it made him "feel like I'm not here," she wanted to provide better relief and started wondering whether she could achieve a higher dose of cannabis by giving it to him orally. In actuality, she was almost certainly providing him a higher dose through the vapor pen, but she nonetheless decided to try. So on New Year's Eve in 2013, roughly five weeks by my reckoning after she started sneaking her son cannabis oil by vapor, she tried it:

I was sitting next to him, a nightly vigil, and held his hand. Once again, the situation seemed quite desperate. What would happen, I wondered, if I gave Deryn a small amount of golden cannabis tincture directly in his mouth? The vaporiser had brought him some relief but could a higher dose have better results?

I took a small, empty syringe from the medicine cupboard in the hospice and quickly checked that there was no one outside. It was New Year’s Eve so staff levels were minimal. I drew up 5ml of the honey-like substance, which had a sweet, floral flavour.

Still sobbing uncontrollably, Deryn opened his mouth and I popped the syringe underneath his tongue. Deryn held it for a minute before swallowing. Half an hour passed. He was no longer having a panic attack. He looked peaceful. I asked him how he was feeling.

‘I feel relaxed,’ he told me. ‘I’m aware of everything. I just feel at peace, Mum. It’s beautiful.’

It's a powerful story. No wonder it's so compelling. Indeed, it's an archetypical story, that of the parents who will go to any length to save their child from a deadly disease and succeed in doing so. Ms. Blackwell further relates that, after he swallowed the 5 ml of cannabis oil, he refused a dose of cyclizine, the antinausea drug upon which he had become dependent and that he virtually never refused. If there's one part of this anecdote that puzzled me, it was the part about the cyclizine. Basically, cyclizine is painted as this powerful, addictive antinausea medicine when in reality it's a histamine blocker and anticholinergic that is pretty well tolerated, with the usual adverse events of anticholinergic drugs, like dry mouth, and, less commonly, constipation, urinary retention, and double vision. Yet in this excerpt, the drug is painted as if it were a powerful, addictive opioid.

Be that as it may, the story certainly makes it sound as though 5 ml of cannabis oil beat cyclizine for nausea, although certainly there could be significant placebo effect here given his mother's care and her giving him something new. Convinced it was working, Ms. Blackwell continued to give her son cannabis oil whenever he "felt a twinge somewhere." Then, one evening:

One evening, I heard Deryn yell: ‘Mum – look!’ The bandage on his middle finger had worked its way loose and completely come off, showing his third finger – which had been blackened and dead – had now healed. How on earth had a child with no immune system and no way of fighting infection managed to heal himself after being off medication for more than three weeks?

I called Deryn’s team to tell them what had happened. Not one of them could give me any answers.

We knew his bone marrow wasn’t functioning and it was not scientifically possible for his wounds to heal. Deryn had spent months in isolation because a common cold could be fatal – yet, somehow, he had overcome three catastrophic infections.

Hundreds of people had been praying for Deryn, blessing him in their own ways. Was this a miracle?

Later that evening, the hospice doctor arrived. ‘We’re no longer sure Deryn is dying,’ she admitted.

The doctors were not sure whether or not the hospice was now the best place for us.

The story sure makes it seem like a miracle. One can only imagine the delight and relief, mingled with confusion and fear, that the Blackwells experienced, as their son, to whom they were preparing to say goodbye forever, made a sudden and unexpected recovery. Human nature being what it is, not surprisingly, Ms. Blackwell started looking for a cause for her son's good fortune, and, human nature being what it is (and confirmation bias being what it is in all of us), she soon found one:

When we’d arrived four weeks earlier, he’d been given three days to live. Now here he was a month later, in far better health than when he’d left his hospital room. They had no idea how this was possible.

Then it dawned on me. Only one thing had changed since Deryn started to recover: the cannabis tincture. I couldn’t tell the doctors what we’d done.

Now, three years later, she's revealing to the world what she did, and presenting it as a case of cannabis saving her son's life. But did it? There is considerable reason to doubt. Those of you who are regular readers can probably identify the issues in this testimonial that make it less than convincing as evidence that cannabis salvaged Deryn's failing bone marrow transplant. See if you can identify them before reading the next section.

The forthcoming book based on Deryn's story aside, I'm very happy to report, Deryn returned to school and appears to be doing quite well now. Until now, his story popped up every so often as a human interest story in the UK press of a boy who beat what seemed like insurmountable odds to beat two different forms of cancer after "four failed bone marrow transplants," while religious groups present him as a miracle. He even wants to study biochemistry, although he still suffers from sequelae of his disease:

"Deryn still struggles with mobility a bit and he gets very tired.

"But the main reason for going back was so he can develop emotionally and socially in that way teenagers, particularly boys, need to at that age.

"He has spent two years in a room by himself with just a nurse or me around, so it is good for him to just be normal for a while."

Even after defeating cancer Deryn has had to confront other serious threats such as aplastic anaemia.

The family has also set up a charity, Do Everything, although currently the website is listed as Under Construction.

Did cannabis save Deryn's life? It's doubtful.

Remember how Ms. Blackwell discussed visits by celebrities to see Deryn around December 2013, as things looked very grim and doctors thought that Deryn's final days were upon him? The beauty of his brief celebrity back then was that there are contemporaneous accounts of what was happening then that we can compare to Ms. Blackwell's account today. It also turns out that Deryn and his family had a fairly robust social media presence (for 2013 back then, with a Twitter feed, Facebook page (which appears to be no longer there), and website. Although the website turns up as "Under Construction," fortunately the almighty Wayback Machine lets us see what was on it as recently as 2015, which will be helpful in my discussion. Deryn's Twitter feed has no Tweets since this one:

Please everybody go and follow my mums page about me :) @_DoEveRYthiNg

— Deryn Blackwell (@DerynChemoKid) March 25, 2014

Perusing this Twitter feed and Ms. Blackwell's recently set up author Twitter feed, I didn't see any mention of cannabis until this flurry of weekend stories. For instance, the announcement of the book didn't mention cannabis:

Some incredibly exciting news for @DerynsMum - You can now pre-order Callie's book 'The Boy in 7 Billion' https://t.co/5mlL9e24fV Exciting! pic.twitter.com/hDz62pm2D8

— 1in7billion! (@_DoEveRYthiNg) February 20, 2017

I found all this very curious, how Ms. Blackwell said absolutely nothing about cannabis until this weekend, even when her book release was announced and as she provided updates on her progress on her personal Twitter feed. Maybe the publisher made her keep it a secret. Be that as it may, I found it instructive to fire up the almighty Wayback Machine and look at what the Do Everything Foundation website said. Helpfully, it provided a timeline, which was not nearly as clear in the book excerpt published by The Daily Mail. I think it's worth posting the entire timeline from his last bone marrow transplant, which encompasses the time when Deryn went into hospice:

On 17th October 2013, his own cells failed because of extremely rare complications.

Thankfully Deryn had one more chance left, he had one more bag of his own cells.

The Dr's gave Deryn more chemotherapy and on the 29th of October 2013, Deryn has his own and final bag of cells transplanted into his body.

Three days after the transplant, Deryn trapped his fingers and suffered TWO catastrophic infections in his hand.

He had Cellulitis and Herpes whitlow in his hand and he also had Klebsiella in his mouth, another catastrophic infection.

40 days after a bone marrow transplant, the Dr's told us that it is highly unlikely that someone will graft if they haven't already - after 50 days there is no way someone can graft.

In their experience, no one has ever grafted after 50 days.

On December 11th 2013, at day 46, we were moved to a hospice where it was expected that Deryn would die within a few days.

We were told that Deryn's fourth and final transplant had in fact failed and there was nothing more they could do, it was believed that once they took away the life supporting drugs that Deryn would leave us very quickly.

Deryn had NO immune system and NO way to fight off even a simple cold.

After two Christmases, one New Year's Eve and quite a few worrying moments, on day 78 Deryn's bandages accidentally came off his fingers and he was - infection free!

Deryn continued to improve and he started to produce his own blood products.

On day 104 - Deryn officially engrafted!

Not one Dr can explain how Deryn fought off THREE catastrophic infections with NO immune system and then went on to engraft with what recent tests said was empty bone marrow!

On February 25th 2014, Deryn had his line removed from his chest and was officially 'Off treatment."

After coming to terms and accepting that he was going to die, Deryn was finding it harder to accept that maybe he wasn't.

It all happened so quickly.

His future is still very uncertain and he is still poorly.

BUT

We are for the first time, starting to plan for a future with Deryn.

Thank you so much for visiting Deryn's page and for reading his wonderful story.

** Miracles do happen and dreams can come true **

It's not entirely clear exactly when Ms. Blackwell started giving Deryn cannabis oil, but it was clearly some time before he went into hospice on December 11, 2013. In the excerpt above, in the context of giving Deryn his first dose of cannabis, that the doctors would give him two weeks to improve and then, if he didn't, move him to hospice, which suggests that she started dosing him in late November 2013. Then, by her own account, she didn't start giving Deryn oral cannabis until New Year's Eve 2013. Day 78 after his transplant would have made it January 15, 2014 when the bandages came off his fingers and revealed that he had healed much of his ulcers, and Day 104 would have been February 10, 2014.

One can see how this timeline might have led Ms. Blackwell to think that what had saved her son was the cannabis oil. She started giving him oral cannabis oil about two weeks before the ulcers on his hands unexpectedly healed. However, there are a number of reasons to doubt that it was the cannabis. For one thing, from this account we have no idea what strain of cannabis was used, making it difficult to estimate the cannabinoid content of the oil and therefore how much and what types of cannabinoids were in the actual oil Ms. Blackwell used. We don't know the cannabis to oil ratio. We don't even know the regularity of the dosing except that she gave it to her son "whenever he had a twinge." Given the experimental data I've discussed before that shows that the various cannabinoids only have a modest anti-cancer effect, it's hard to conclude that the doses Ms. Blackwell was giving her son were high enough to have had such a dramatic effect. For another thing, what Ms. Blackwell is claiming is not so much that "cannabis cured her son's cancer," but rather that cannabis somehow fired up his immune system so that it could fight off the infection and his cells could actually engraft after three times the length of time it normally takes. In reality, the evidence regarding cannabinoids and the immune system is mixed, with at least one study showing that they can suppress immune function. Indeed, cannabinoids are being studied more as a potential treatment for autoimmune diseases rather than as any sort of means of increasing immune cell engraftment. Basically, it's not very plausible at all based on what we know about cannabis that Ms. Blackwell's secret treatment of her son resulted in such a dramatic turnaround.

So what happened? Did cannabis really rescue Deryn Blackwell's bone marrow transplant?

What probably happened is that Deryn Blackwell was a highly unusual case in which his last stem cell infusion took a far longer amount of time to engraft than the doctors at the hospital treating him had observed before. It just so happened that, as Deryn was deteriorating, his mother, anguished at watching him suffer and desperate to do anything possible to alleviate his suffering, decided to give vaporized cannabis oil a try to help his symptoms. Unfortunately, her son continued to deteriorate and entered hospice. She decided to give him the cannabis oil by mouth three weeks after he entered hospice, and it seemed to relieve his symptoms somewhat more effectively. Two weeks later, the "miracle" occurred, and the bandages fell off. Deryn's rare and unexpected recovery, happily, manifested itself. The rest, as they say, is history.

Deryn's recovery was unexpected, but unexpected and rare recoveries do occur in medicine. Given what we know about cannabis oil, its rather modest effect on cancer, and the tendencies of cannabinoids to be, if anything, immunosuppressive, it strains credulity on a strictly scientific basis to attribute Deryn's turnaround on homemade cannabis oil. That's not to say it's impossible that cannabis oil was responsible for Deryn's recovery, only that it's incredibly improbable. Remember, we know a fair amount about cannabinoid activity against cancer and its activity in the immune system, and what we know doesn't support the plausibility of Ms. Blackwell's testimonial. However, as is the case with a lot of other alternative cancer cure testimonials, the all-too-human tendency to want to attribute cause, combined with the form of selective memory known as confirmation bias, which leads all of us to tend to remember what confirms our beliefs and to forget what does not, has led to a conclusion that is almost certainly not correct. Remember again, Ms. Blackwell seems not to remember the several weeks she was giving her son cannabis oil via vapor stick and he was continuing to deteriorate to the point of entering hospice. I repeat that again because it is important. This testimonial is almost certainly a case of confusing correlation with causation.

But what about this claim:

Yet there was a direct correlation between Deryn having the cannabis tincture and his improved blood counts. Whenever he didn’t have it, they dropped. It was enough hard evidence to suggest that cannabis tincture was playing a vital role in his recovery. I hadn’t imagined in my wildest dreams that it could have saved Deryn’s life.

Without very detailed record keeping in which Deryn's counts were listed by date and then correlated contemporaneously with whether or not he was taking cannabis oil and at what dose, it's impossible to support or refute this claim. It's probably more confirmation bias.

Be happy for Deryn Blackwell, but be skeptical

Although I highly doubt that cannabis oil had anything to do with Deryn Blackwell's "miraculous" recovery, I am very happy that he did recover. Nothing pains me more than seeing children die of diseases like cancer. I can also understand why Callie Blackwell and her husband Simon have come to believe that cannabis cured their son. They are human. They have all the cognitive quirks that lead humans to incorrect conclusions that we all have, and those tendencies are only magnified when it is someone they love deeply that is the object of their hopes and prayers. Confirmation bias is a very powerful thing indeed under these circumstances. Unfortunately, the timeline that I have been able to reconstruct is thin gruel indeed to support Ms. Blackwell's belief that cannabis oil saved her son by somehow helping his immune cells engraft in his bone marrow.

Unfortunately, what I fear is that a combination of love for Deryn, confusing correlation with causation, and confirmation bias have led the Blackwells to become true believers on the order of Rick Simpson, but with an even more dramatic story in which cannabis is portrayed as having literally pulled their son back from the brink of death. Consider this. Deryn's story is quite inspirational without the cannabis angle. Yet what excerpt did the publisher decide to release first as part of the book's publicity campaign? Yes, it released the part describing how Callie Blackwell surreptitiously dosed her son with cannabis oil, and the Daily Mail and the rest of the UK tabloid media responded predictably with stories portraying Deryn Blackwell as proof that cannabis can cure cancer, even when his story shows nothing of the sort. If you want to get an idea what I mean, check out this interview last week in The Mirror in which Deryn's story is used as a starting point to tout medical marijuana as a treatment for multiple sclerosis, glaucoma, epilepsy, arthritis, Alzheimer's disease, anxiety disorders, stroke, inflammatory bowel disease, and cancer. In fairness, Ms. Blackwell didn't say any of these things, but The Mirror spun her son's story this way. This is intentional.

In case you don't believe that it was intentional from the beginning to spin Deryn's story as a "cannabis cures cancer" testimonial and sell it to the media that way, consider Ms. Blackwell's co-author, Karen Hockney. It turns out that she's heavily into the woo herself. After undergoing conventional surgery, chemotherapy, and radiotherapy for breast cancer, she became an advocate of the "alkaline diet" to treat her cancer. Why would Ms. Blackwell's publisher choose such a co-author for a neophyte author if the plan wasn't to emphasize the cannabis all along?

Unfortunately, the narrative that is being spun has the potential to influence patients with cancer and parents to try unproven and quack treatments, like cannabis for cancer and who knows what else. In seeking to do good, I fear that the Blackwells could actually make it less likely that future Deryns actually survive their cancers. It saddens me to say it, but it has to be said.

oracknows Sun, 04/02/2017 - 21:12

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Skepticism/Critical Thinking

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http://www.nature.com/icb/journal/v78/n1/full/icb20006a.html

Betteridge's Law says no.

But then you knew that.

In other news anti-vaxxers are still killing babies.

I've noticed that it is common for alt-med types to argue from anecdote: "Treatment Z cured my condition X!" But the people making these testimonials usually don't have any medical training, so they may well be unaware of alternate explanations, or they are making a post hoc ergo propter hoc argument. Ms. Blackwell is no exception to that rule. And of course, the plural of "anecdote" is not "data".

I am old enough to remember the Reagan administration, and in particular Reagan's habit of using apocryphal anecdotes as arguments. Typically there would be a small grain of truth to the anecdote, e.g., the "Chicago welfare queen" who would pick up her welfare check in a Cadillac was based on an actual case, but Reagan never pointed out that the woman in question got caught and went to jail for her fraud. I have no evidence that the Blackwell case is in any way similarly apocryphal, but I remain skeptical. Extraordinary claims like this one require extraordinary proof.

Not here to debate this specific cannabis claim but just to call you out on the statement "Rick Simpson has profited from after claiming to have cured his skin cancer with cannabis oil in 2003". Unless you are using "profit" non-literally, Simpson gave away his oil for FREE until police raids forced him to buy his own cannabis. He also documented exactly how it was made so that anyone could do the same (in truth, he did not invent the process even though it is called Simpson Oil). So stop trying to equate him with charlatans that make dubious claims in the interest of enriching themselves.

Oh, and here is a great article (one of hundreds of peer reviewed studies) for you to read: http://www.ukcia.org/research/AntineoplasticActivityOfCannabinoids/inde…

Synergism = Science-based medicine and integrative medicine.

Did the parental oil-treatment enhance immune system function in Deryn?

Thankfully for Deryn, a synergism (not miracle) may have occurred although by happenstance in this case.

In the future, will science-based medicine tolerate integrative medicine in the spirit of surprising and unexpected results?

#3 – Seriously – a reference from 1975? For a treatment with a good evidence base there would surely be something a little more recent than 42 years ago.

Fuck off, Travis.

Though it is unlikely that cannabis oil cured this boy's cancer, is it possible that it did in fact make him more comfortable and relaxed, thereby allowing his body to more easily do what it needed to do in conjunction with the conventional treatment he received?

is it possible that [cannabis oil] did in fact make him more comfortable and relaxed

Possible, yes. I have heard stories of people who use cannabis for pain relief. The trouble is that it's anecdotes, not data.

I'll stipulate that this is not entirely the fault of the pro-cannabis faction. For decades US politics has made it anywhere from difficult to impossible to actually do any kind of medical cannabis trial. Having Jeff Sessions as Attorney General does not help. But we have reached the point where we need the studies in order to have an informed debate on the subject. We have the testimonials, and unlike with many forms of woo, we have a causal mechanism which is at least superficially plausible to a layman. But that isn't enough to get marijuana accepted as a medical treatment. We need to make sure that the movement is not an overreaction to the (IMHO) decades of unduly harsh legislation against cannabis. Otherwise we would be trading one form of Reefer Madness for another.

Add to that a dash of confirmation bias, something we human beings all suffer from, and it’s very easy to come to develop an unshakable belief in a post hoc ergo propter hoc fallacy in which something they observed or did before something else happened must have caused that something else to happen, be it vaccines “causing” autism or cannabis “curing” cancer.

I would argue that the euphorogenicity of the drug exacerbates confirmation bias and likely also placebo effects. The problem with messing up the cognitive functioning of your brain is that you mess up the cognitive functioning of your brain.

I would argue that the euphorogenicity of the drug exacerbates confirmation bias and likely also placebo effects.

This would be more plausible if that confirmation bias were coming from the actual patient.

This would be more plausible if that confirmation bias were coming from the actual patient.

The point I have been trying to make is that in most cases (though I will stipulate, not in this particular case) the confirmation bias is coming from the actual patient. We hear about the cases where marijuana is alleged to have helped the patient's pain. We don't hear about the cases where it didn't, and we especially don't hear about the cases in which the patient died. (That's true of many other forms of woo; Stanislaw Burzynski comes to mind.)

And of course it's plausible that a euphorogenic drug would have a higher placebo effect. Users take such drugs because such drugs make the users feel good--whether it's merely a recreational high, or whether there is some (alleged or actual) medical purpose for it.

#5 Really not sure what the "Fuck Off Travis" is all about.

Just in case you missed the point of the link, it was indeed more than 40 years ago when there was scientific evidence of the anti-cancer properties of cannabinoids.

Here's something that is from 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791144/

There are many more peer reviewed studies as well.

(Also there was no suggestion of a treatment modality in my post. Just pointing out that there IS solid evidence of antineoplastic activity with cannabinoids).

I'm with everyone else on doubting cannabis cured him. Though we could be missing another property of cannabis.

It does enhance the appetite and if he was suffering from dry mouth from the anti nauseants... maybe it helped him eat?*

*Am not a doctor obviously.

https://www.theguardian.com/uk-news/2017/apr/03/baby-at-centre-of-life-…

On a similar note, who else smells a rat with the US doctor involved here, whose name apparently can't be revealed for 'legal' reasons. It breaks my heart that the parents have been led to believe that an experimental alleged treatment - never tried before on humans or on animals - might somehow be the cure they long for. The mother says that it is 'taken orally' so won't cause discomfort in the baby.
Now that the case is back before the courts it even seems that the US doctor is trying to back away, not having realised the seriousness of the situation he or she has got involved in - or its enormous public profile.

@zach His site has a donate button and he sells a number of books. Back in 2016 Simpson founded a small, independent publishing company too (Simpson RamaDur LLC).

Marc Emery has called him out in the past: ''I find Simpson a bit of an odd fellow. When he was raising money to travel across North America to promote his "oil", they claimed to need $300,000 to do the tour, and they raised only $3,000, so it was called off. I couldn't believe this $300,000 figure they claimed to be trying to raise. Jodie & I traveled to 30 Canadian cities across Canada for about $17,000 over 2 months from St. John's to Victoria, and I told them this amount of money they claimed to need was outlandish for a tour, and absurd to try to get this amount raised for what would be a simple speech at the public library in selected cities." https://www.icmag.com/ic/showpost.php?s=e3af33e618c8ff90834668370b4880d…

For those who have not read the previous post on the same topic at Science-Based Medicine, I would suggest doing so before commenting here. The comments from the mother of the patient are revealing.

"I found all this very curious, how Ms. Blackwell said absolutely nothing about cannabis until this weekend"

The most charitable explanation would be that she was afraid of legal ramifications, but figures now is a relatively safe time to do so what with Deryn's condition improving and the possible fat advance on book royalties to fund a defense if necessary.

Marijuana as a treatment for anxiety disorders? I had to stop taking dope - in any form - many years ago because it was consistently triggering my panic attacks. They were eventually cured by a combination of CBT and that horrible, evil, Valium.

The comments from the mother of the patient are revealing.

Brava to Ms Blackwell for her contribution to the discussion in that thread.

Completely independently of direct anti-cancer properties of cannabis, relieving the side effects of chemotherapy seems to be one of the better evidenced applications.

And as for #17: THC != CBD and those are only two out of a big zoo of (potentially) active components present in different ratios depending on strain and growth conditions. Besides, not every treatment option for a condition is suitable for every patient.

@ Jay #12: Actually, appetite enhancers, and good oral care, are key components of good medical and nursing care in this client group. Doctors use a drug called Megace that serves the same purpose. It works better for some patients than others, and some patients do use medical marijuana for appetite enhancement.

Good oral care also makes patients feel better and want to eat; no one wants to eat when they have a bad taste in their mouths.

@ NZ Skeptic @#13: I don't read it the way you do. The article is poorly written; similar articles are rehashes of each other. I think the British news is all reinforcing the same bad reporting. Your article indicates the NHS docs can't be identified; that makes sense--protects them from crackpots. There is no reason not to identify the US neurologist.

Jay@12: What I got from the article (though I could be wrong) was that the US treatment, whatever it is, won't do anything to prolong the child's life. He is now completely unresponsive to any stimuli, has no muscle movement, not making any sounds and probably not hearing anything. If the treatment works, all it will do is give him a litle muscle movement and make him esponsive to stimuli. In which case, he'll almost certainly feel more pain and discomfort for the remainder of his short life (assuming he has any degree of consciousness of course).
His parents are doing it because they "want to see him smile". Dear Jeebus...
As a parent myself, I can understand their desperation. But it sounds like nobody has fully explained things to them.

@James Peters: thanks for the link. It's from 2009 with a dead link that refers to Grinspoon on Simpson. I haven't really kept up to date with Simpson's shenanigans and certainly don't abide anyone peddling cannabis as a cure for cancer. But that's a side issue and I'm not really interested in Rick Simpson, all he did was popularize a particular method for extracting & concentrating cannabinoids.

Instead I googled Grinspoon THC Cancer and found this interview 2015: http://www.mintpressnews.com/MyMPN/marijuana-reconsidered-an-interview-…

" I am glad that you bring that one up. I hear a lot of people talking as if cannabis can cure cancer, and that worries me. People who are not sophisticated about this will not go to a doctor and they will miss chemo treatment, radiation or surgery and just rely on cannabis. By acting like this they lose a lot of time because with cancer you want to go as fast as you can to the doctor. So I think you can not say that cannabis cures cancer.

However there are some properties of cannabis which in my view make it very important that those patients use marijuana alongside the modern western oncological treatment. In case of chemotherapy for instance they can use cannabis to combat the side effects of the treatment like distressful nausea. Cannabis can help as well to diminish the size of tumors which can be important when the tumor causes an obstruction, it stimulates appetite and in vitro it stops cancer cells from spreading, kills cancer cells and leaves healthy cells untouched and interferes with the blood flow in the tumor.

So there are a number of effects which shows that marijuana pushes back cancer. This makes it important to use marijuana but along with the modern medicine. Nobody has proven to me so far that cannabis cures cancer but for sure it is a very good adjunct."

Grinspoon would be #1 on the list to say "we should be studying the hell out of cannabis".

@James Peters: thanks for the link. It's from 2009 with a dead link that refers to Grinspoon on Simpson. I haven't really kept up to date with Simpson's shenanigans and certainly don't abide anyone peddling a cannabis as cure for cancer. But that's a side issue. I'm not really interested in Simpson, all he did was popularize a particular method for extracting / concentrating cannabinoids.

Instead I googled Grinspoon THC Cancer and found this interview 2015: http://www.mintpressnews.com/MyMPN/marijuana-reconsidered-an-interview-…

Grinspoon would be #1 on the list to say "we should be studying the hell out of cannabis".

@Mrs Grimble: I wouldn't have thought so either, but have a family member who suffers from anxiety and uses cannabis to combat nausea and to stimulate appetite but also experiences a positive effect on the anxiety.

Everybody's different.

Personally, I can think of quite a few highly speculative ways how cannabinoids might have helped with engrafting, but all of those make them also somewhat unsuited for normal cancer treatment. Heighten the lifespan of free cells, maybe inhibiting apoptosis and facilitate adhesion and remodeling of surrounding tissue. Well, AFAIK I basically just described metastasis.

On another note, we already know there are cannabinoids (in the chemical sense, not in the "binding to CB1 and CB2" one) with wildly differing profiles, and if we go for synthetic compounds acting on the endocannabinoid system and somewhat related "orphan" GPCRs it gets even more confusing. My personal stance would be to strive for somewhat selective agents or at least try to remove likely harmful ones (e.g. THC in quite a few psychiatric indications), but we get little of that from those testimonials.

On another note, IIRC from a talk about CB-knockouts some years ago, there are some biphasic effects in the endocannabinoid system, e.g. low levels of cannabinoids sometimes have opposite effects to larger ones, similar to some dopamine receptor ligands, e.g. apomorphine is sedative in small dosages and induces hyperactivity in bigger ones. IMHO also quite important, though I see little discussion about it.

The woman is a fraudster FACT. She allowed the her children to smoke at 12 and 14. She is a disgrace!

Jason Eacups is the scammer exposed on the film Project Storm, he is responsible for Callie and her family having to flee the UK after he threatened to report her to the UK police for administering cannabis oil to her son

https://youtu.be/wyMAsWr4KOw

It seems the author will not accept anecdotal evidence of a drug's effectiveness but he will quite happily launch a thinly veiled attack on a parent of a child that was seriously ill using....what? Anecdotal evidence.

Cannabis will not be tested as long as large pharma companies wield such massive influence over funding of drug trials and national governments.

Recent trials for the treatment of dementia with cannabis had to moved from the US to Germany for this very reason. I find this article extremely bias towards established medicine and you don't have to spend to look on google to see where some of those tried and tested drugs led humanity.

Dave Kavanagh claims that "Cannabis will not be tested as long as large pharma companies wield such massive influence over funding of drug trials and national governments. "

Dave is peddling the common altie trope that nasty old Big Pharma is blocking Natural Cures because they can't be patented, or because they're just plain Evil. Dave, meet reality.

'...there are now 90 cannabinoid drugs in development worldwide, according to a November whitepaper from market analysis firm GBI Research. The firm explained that 74, or 82%, of those drugs haven't made it to in-human testing yet, with 60 in pre-clinical investigations and 14 under discovery. Phase 1 and Phase 2 each claim six drugs in the global pipeline, while just two candidates – GW Pharmaceuticals' Sativex (nabiximols) and Epidiolex (cannabidiol) – are in Phase 3."

http://www.biopharmadive.com/news/cannabinoid-market-pharma-fda-investo…

*the same people who tell us Big Pharma is blocking Natural Cures, assure us in the same breath that Big Pharma is attempting to monopolize those alleged cures, or triumphantly announce that X high percentage of modern drugs are derived from herbs/plants. You have to wonder if there's a cannabinoid drug to treat such defects in critical thinking capacity, or to at least make them less annoying. :)

Inside big pharma's fight to block recreational marijuana:
Pharma and alcohol companies have been quietly bankrolling the opposition to legal marijuana, raising questions about threats to market share

https://www.theguardian.com/sustainable-business/2016/oct/22/recreation…

Evidence prevails: No medical marijuana for autism in Michigan—for now

oracknows — Fri, 28 Aug 2015 06:30:46 +0000

Evidence prevails: No medical marijuana for autism in Michigan—for now

I must admit that I'm surprised. Pleasantly surprised, but quite surprised. The reason is that yesterday the Department of Licensing and Regulatory Affairs Director Mike Zimmer rejected the recommendation of the Michigan Medical Marijuana Review Panel to add autism to the list of qualifying conditions for which cannabis can be prescribed in the state of Michigan. I didn't expect this outcome, but I am pleased.

Although I've changed my mind over past stands and am now in favor of legalizing marijuana for recreational use, I have been harshly critical of the "medical marijuana" movement. Indeed, I have referred to it as the "new herbalism" because when it comes to evidence for the efficacy of marijuana in the myriad conditions that cannabis is claimed to be able to treat, its proponents' hype far outweighs the actual medical promise, at least when you look at the evidence objectively. As I've pointed out before, for example, cannabis does not cure cancer, passionate testimonials otherwise notwithstanding, and the state of the evidence supporting the use of medical marijuana for almost anything is, at best, weak and contradictory. That's not to say that cannabinoids, the active compounds in cannabis, don't have some medical uses, but, again, a dispassionate look at the medical literature suggests that the hype far exceeds any realistic promise.

Three weeks ago, I wrote a post likening the use of "medical marijuana" for autism to a form of quackery that I have written about many times over the years, namely so-called "autism biomed." As I mentioned, a certain segment of the "autism biomed" movement has enthusiastically embraced medical cannabis, to be added to the other dubious treatments used to "treat" autism, such as chelation therapy, various supplements, hyperbaric oxygen, homeopathy, Miracle Mineral Solution (MMS, a.k.a. a form of bleach), and the like. (I'm talking to you, "Thinking Moms.") As I detailed in that post, the parallels are unmistakable. In the case of cannabis for autism, there is the same evangelical embrace of cannabis as the next big thing that can help autistic children and the same dismissal of the extreme lack of evidence supporting the use of medical cannabis for autism and the lack of knowledge of the effect of long term cannabis use in very young children on their neurological development. Remember, we're talking about children as young as three years old here and the use of cannabis over potentially many years.

Three weeks ago, I was concerned that the Michigan Medical Marijuana Review Panel, an advisory panel that makes recommendations to the Michigan Department of Community Health regarding what conditions qualify for medical marijuana use, had voted 4-2 in favor of adding autism to the list of qualifying conditions for medical marijuana, specifically in this case cannabis oil, can be prescribed. The panel was apparently impressed by some very dubious evidence and testimony, specifically a paper by Joe Stone and Dr. Christian Bogner, "The Endocannabinoid System as it Relates to Autism." Basically, this "paper' was not peer-reviewed or published anywhere reputable. More importantly (given that blog posts and articles, when referenced and written properly, can be quite compelling from a scientific standpoint), the article cherry picked studies and massively oversold weak preclinical results in cell culture and animal studies. The panel appeared also to be particularly impressed by the testimony of Dr. Harry T. Chugani, the head of pediatric neurology at Children’s Hospital of Michigan, who, despite the lack of evidence, has apparently become convinced on the basis of testimonials and personal observation despite the lack of anything resembling rigorous scientific and clinical evidence that cannabis is an effective treatment against autism.

Kudos to Mike Zimmer for seeing through the flimsiness of the evidence and not being blinded by eminence when evaluating Dr. Chugani's testimony:

Department of Licensing and Regulatory Affairs Director Mike Zimmer, in a final determination released Thursday, cited a "concerning" lack of scientific evidence regarding medical marijuana use by autistic patients, specifically by children.

"While the record is replete with sincere and well-articulated testimony on the potential benefits of medical marihuana to autism patients and, in particular, parents of autistic children, several troubling concerns remain," he wrote.

Reading the final determination, I was impressed at how Zimmer saw through the tactics of the medical marijuana movement. First, he noted the overbroadness of the petition to add autism as to the conditions that qualify for medical cannabis:

The petition under consideration lists "autism" without limitation as the medical condition proposed for inclusion as a qualifying condition under the MMMA [Michigan Medical Marijuana Act]. Although "severe autism" is referenced in the petition, the petition does not limit the proposed qualifying medical condition to "severe autism," nor is the term "severe autism" defined anywhere in the petition. Thus the petition seeks to add autism without limitation as a qualifying condition under the MMMA.

Nice catch there. Advocates of medical marijuana frequently go beyond what the scientific evidence will support and seek the broadest possible indications for the use of their favorite weed (or extracts thereof). Here's another good catch:

In the justification section of the petition, the petitioner indicates that "medical marijuana has been used successfully in Michigan to treat the syptoms of severe autism in patients who also suffer from epilepsy." (emphasis added). It is, therefore, important to examine the petition's illustrative linking in the justification section to epilepsy. In fact, many of the parents who participated in the public hearing indicated that their severely autistic children suffered seizures as a result of that condition. An examination of the language in the MMMA, however, establishes that these may already be eligible.

Of course, as I've noted before, the evidence that cannabis is useful for epilepsy is also pretty weak, but it is—shall we say?—considerably less weak than the evidence supporting medical cannabis for autism.

Noting that the MMMA explicitly allows the use of medical marijuana for seizures and citing the appropriate section of the law, Zimmer goes on to state that "our discussion on this petition is focused on autistic patients without associated seizure disorders" and then does just that, citing how the state's Chief Medical Executive Eden Wells had "bemoaned that there were not more clinical trials to provide checks and balances on the benefits versus its possible ill-effects." He even cited Dr. Chugani himself, noting that he "would not support a general recommendation for cannabis to treat all children with autism, as little scientific evidence exist to demonstrate gains in skill acquisition and research is still needed to assure children would not suffer short or long term psychotropic effects.

Zimmer also saw through the petition's claim that requiring two doctors to sign off on prescriptions for medical marijuana for autism would protect children:

At public hearing, several suggested that the lack of scientific supportive research could be offset by strict certification practices by a patient's physician. Mr. Michael Komorn, an attorney for the petitioner and ardent advocate, stated that under current law, two doctors must sign off on approval for the use of medical marihuana by minors and that "obviously in the case of minors these doctors will likely be their doctors, their autism specialist (5/27/15 Hrg. Tr., p. 17)." Similarly, Dr. Harry Chugani, in his letter to the panel, stated that "I also highly recommend that determinations of which patients may be appropriate should be made strictly by a highly skilled, experienced medical doctor, with significant experience in treating autism." Unfortunately, there is no such requirement in the MMMA. MCL 333.26426(b)(2) simply requires written certifications from two physicians and does not contain any requirement that those physicians be expert, comply with certification practices, or even be trained in the treatment of autism."

But, then, many of the advocates who promoted this petition probably already knew that. Basically, any physician who wants to can prescribe medical marijuana, no special training or expertise necessary. That's the way the law was written, and intentionally so. Ironically, Zimmerman also noted that the way the law has been written and interpreted by Michigan courts almost certainly precludes the use of cannabis oil because it probably does not fall under the definition of "usable marihana" outlined in the MMMA, but cannabis oil is what the petition was for.

Medical marijuana has always been a blatant back door strategy to legalize marijuana for recreational use, so much so that most advocates don't even bother to deny it. While I support legalization of marijuana, I do not support the corruption of medicine and medical evidence inherent in the claims of the medical marijuana movement. In other words, I do not support the loosening of the standards of medical evidence that is required to justify widespread medical cannabis use for conditions for which there is little or no evidence of efficacy. When it comes to cannabis, preclinical evidence is routinely touted as indicating clinical efficacy, and studies are blatantly cherry picked to justify its use. Worse, poor quality evidence that, if used to support the approval of a pharmaceutical drug, would provoke justified howls of outrage from the very same people advocating medical marijuana for autism, is touted as convincing scientific evidence that autism should be added to the list of qualifying conditions for medical marijuana. As always, I advocate for one standard of medical evidence. Unfortunately, advocates of medical cannabis, like advocates of "complementary and alternative medicine" (who not infrequently include the same people), advocate for a weaker standard of evidence for their favorite herb.

If you don't believe this is far more about advancing an agenda leading to legalization, witness the reactions to the decision by advocates, for example, of Robin Schneider:

Zimmer’s order also said there was insufficient scientific research to justify using cannabis for autism. That’s a concern about many of the conditions that are clearly aided by the drug, since marijuana research has been largely illegal to conduct under state and federal drug laws, said Robin Schneider, a spokeswoman for the National Patients Rights Association, a medical-marijuana advocacy group based in Grosse Pointe Farms.

“But in this circumstance, the petitioner did an incredible job of putting together a great deal of scientific information,” Schneider said. The petitioner was Lisa Smith of Van Buren Township, mother of Noah, a 6-year-old boy with autism.

Of course, if it is true that cannabis research has been made very difficult by drug laws, the correct order of business would be to work on repealing those drug laws to allow the research to proceed. Advocates instead just assume that medical marijuana "works" and then cherry pick the evidence to try to support that assumption, ignoring its extreme lack of quantity and quality.

Elsewhere:

"I'm disappointed and I'm frustrated. I think that obviously he used a lot of words to explain an inconsistent and subjective decision in opposing the panel's recommendation," said Komorn.

The goal of the petition was to extend legal protections of the medical marijuana law to parents who want to treat their autistic children, he said.

"If these parents know or believe that it's working, they're going to do it," he said. "We're asking them to be removed from the battle field of the losing war on marijuana."

This is a ridiculous argument, even coming from Komorn, but very telling. For one thing, Zimmer's decision was far clearer and more consistent than any argument I've heard from Komorn in support of medical marijuana for autism. More tellingly, Komorn doesn't appear to care much whether medical marijuana has any beneficial effect whatsoever in severe autism. The "tell" is how he just can't help himself and has to justify his argument by referencing the "losing war on marijuana." To Komorn, fighting for medical marijuana for autism is simply a a tactic in the larger war to legalize marijuana, nothing more. From my perspective, he doesn't really care that much about autistic children and their parents, per se. Rather, he sees them as weapons to use in his wider war.

Let's just put it this way. His argument is that parents are going to use marijuana for their autistic children anyway; so he wants to "make it legal," so to speak. I wonder if he'd accept the same argument for MMS enemas (a.k.a. bleach enemas) for autistic children. Some parents are going to subject their children to this treatment anyway. It's a ridiculous argument unless, as Komorn does for medical marijuana for autism, you were to see MMS as a battle in a wider war. I've seldom seen such a blunt, bald-faced admission that the main reason for medical marijuana is as a means of legalizing recreational use of marijuana. Sure, he didn't say that, exactly, but taken in context his meaning is clear. Medical marijuana for autism is a battle in a wider war.

Collateral damage in this war includes parents like Dwight Zahringer, whom we met before the last time I discussed this topic. He only wants to do what's best for his son Brunello and, because of the hype, has come to believe that medical marijuana is what his son needs to help him. Consequently, he joined the movement to add autism to the list of qualifying conditions, and he is very disappointed in this ruling:

“I’m going to have to keep looking at more treatment options and to be part of the movement to educate these people in Lansing,” Dwight Zahringer said.

“I feel like we’ve had a lot of politics involved in decisions like this,” Zahringer said.

Zahringer is correct, but not in the way he thinks. It was a ton of politics to twist the thin evidence for marijuana into a petition that got through the Michigan Medical Marijuana Panel by a 4-2 vote. Now that it's been rejected, he understandably feels betrayed, as though a major source of hope for his son has been taken from him.

Unfortunately, I doubt that this is the end of the story. I have little doubt that advocates like Komorn will be back. It Zimmer rejected this petition because it is too broad, expect advocates to be back in the near future with a more carefully crafted petition this more narrowly defines "severe autism."

oracknows Fri, 08/28/2015 - 02:30

Categories

http://www.ncbi.nlm.nih.gov/pubmed/16961428

What seems to be a defining feature of a lot of marijuana users is the ability to spontaneously delete information in their brain that isn't in accordance with their ideas.
You could have a long debate with them that ends up with them not knowing what to say or saying: "well, it's just something that I've read somewhere". But then, a month later they would start the debate again at exactly the same place they started it the first time, as if your previous conversation never happenned.
They also seem to think that everything is better with marijuana, and that they are better at everything while under the influence of marijuana. Wouldn't surprise me if the vast majority of those advocating for the treatment of autism with marijuana are heavy users themselves.
Yeah, I don't think we've seen the last of them.

Cheers and Hoorays for Mr (Dr?) Zimmer!

It's hard enough constantly refuting the claims of "complementary" medicine and "too many too soon"; now we are bombarded with a slew of anecdotes and the "lack of research because it's illegal" rot. It's good to have a solid decision to stop this back door strategy to legalize pot.

I fear you are correct that this won't be the end of it, however. In the meantime, I shall bask in one small victory for science.

I was dismayed reading the comments. There too is the only concern getting marijuana legalised. There was almost no consideration for the children who would be and are subjected to cannabis oil.

Yeah, I forgot to mention the comments. They are depressing.

What seems to be a defining feature of a lot of marijuana users is the ability to spontaneously delete information in their brain that isn’t in accordance with their ideas.

That's hardly unique to marijuana users. There is this Canadian MP named Harper, and several like-minded politicians this side of the border, who are not known to partake of C. sativa. Closer to topic, you have anti-vaccination activists who insist mercury (which has not been in childhood vaccines for more than a decade) causes autism, homeopaths who ignore the finite value of Avogadro's number, et cetera.

It's true that we stereotypically associate marijuana use and delusional beliefs ("What is he smoking, and where do I get some?"). Paranoia is a known side effect in some users. But just because you're paranoid doesn't mean they aren't out to get you, and conversely, lots of people suffer from delusions without any help from marijuana.

It’s good to have a solid decision to stop this back door strategy to legalize pot.

I'm personally of the opinion that marijuana should be legal, subject to the same sorts of restrictions that apply to alcohol and tobacco. But I agree that if we are going to legalize it, we should be up front about legalizing it, and not go down the rabbit hole of using it to treat conditions for which there is no evidence of efficacy.

Garou: "They also seem to think that everything is better with marijuana".
I don't know about everything, but White Castle and Pizza Hut sure are.

Rimshot!

Science Mom says,

...almost no consideration for children who would be and are subjected to cannabis oil.

MJD says,

Adults with autism, if you have experienced marijuana what are your thoughts about giving such a material to autistic children?

Old Rockin' Dave -- And "In a Gadda da Vida".

"Marge, remember when we used to make out to this hymn?"

One... (something, something)... over the line...

There is a wonderful and hilarious video of this "modern spiritual" being performed on The Lawrence freaking Welk Show, just by the by.

@palindrom: Hey, this sounds like rock and/or roll!

@Old Rockin' Dave
#6
"Have you seen the back of a 20 dollar bill?"....."Have you seen the back of a 20 dollar bill.....on weed?"

jonnybdead,

Ha! I was just looking up YouTube vids of the very same thing. Wanted to get the complete 'different kinds of smokers' but was only able to find individual ones and they're still a bit long.

Per your reference https://www.youtube.com/watch?v=hkA9rz-1YoA

The movie is as corny as the day is long but it's one of my favorites.

I suppose methylphenidate is on the approved list for autistics demonstrating ADHD? How does Ritalin work, anyway; Take an already hyper-stimulated mind and push it over the edge?

as little scientific evidence exist to demonstrate gains in skill acquisition and research is still needed to assure children would not suffer short or long term psychotropic effects.

Well, maybe someone should just ask the kids how they *feel*. Perhaps it is time to evaluate the benifits of cannabis over Ritalin et al. for ADHD, in general.

Naa, ^^ that wouldn't be prudent or so lucrative.

Perhaps it is time to evaluate the benifits [sic] of cannabis over Ritalin et al. for ADHD

That would be the way to provide evidence that it's effective. Can you show that it's plausible that cannabis can treat ADHD? Enough to show to an IRB?

Broken link Orac.
Link to cannabis for autism blog is broken.

There was a study on ADHD and crime.
Found double the crime rate. Half of the crime was for possession of illegal versions of ADHD meds,. Go figure.

"demonstrate gains in skill acquisition"

And this is relevant to cannabis/autistics how? In such a rigid, pigeonholed society, I suppose one may be deprived of learning the skill of repackaging old lightbulbs for the phone-solicitation resellers, should they fail to please the piss-testers.

How does Ritalin work, anyway; Take an already hyper-stimulated mind and push it over the edge?

Gee, it's not like it takes all of two minutes to find a starting place. What does this have to do with the post at hand, again?

Magnets - how do they work?

@14:

I suppose methylphenidate is on the approved list for autistics demonstrating ADHD? How does Ritalin work, anyway; Take an already hyper-stimulated mind and push it over the edge?

An extremely oversimplified version is "Ritalin boosts dopamine levels, dopamine makes it easier to pay attention". This ignores other factors at play, admittedly, but it's a pretty important one regardless.

OK, Narad.

So; take a full-on revvin' mind and stall it by leaning it out; starving it of the proper ratios of neurotransmitters ( by exausting stores glucose... demand>>>supply altogether????)-- When I do this to the chainsaw, it burns holes in the piston.

So; take a full-on revvin’ mind and stall it by leaning it out; starving it of the proper ratios of neurotransmitters ( by exausting stores glucose… demand>>>supply altogether????)– When I do this to the chainsaw, it burns holes in the piston.

You can lead a horse to water, but you can't make him wash his armpits.

@ MJD #8: As an adult with Asperger's, my view on it is very dim. Basically the parents want to dope up their kids to eliminate behaviors in autistic children than are difficult to deal with.

Panacea: As another, I agree with you. If they hadn't latched on to marijuana, they would probably be looking at barbiturates or benzodiazepines. Anything not to engage with their less-than-perfect child whose very existence fills them with shame. Pump them full of the latest quackery so they can pretend they really care and are "doing everything" for the kid they really want to lock up in the attic.

@Panacea, it's lucky for you that adults like me are here to tell you that you're wrong. I have asperger's too. My view on your attitude is very bright.

It seems to me that there are a lot of generalizations being made, and not enough looking at research going on here. I am reading a lot of opinions on ADD/ADHD is. As well as (im no neurologist but here is my opinion that is backed by whatever i have made up in my head.)

just because you dont know how the drugs work does not mean they are all bad. or perhaps you have a better solution based in science?

There was a study on ADHD and crime.
Found double the crime rate. Half of the crime was for possession of illegal versions of ADHD meds,. Go figure.

"Go figure" what? Why someone would be so mentally lazy as to idly expect other people to dig up random disgorgements?

Gilbert @14: As a person with ADHD, I know that I feel better on my medications than off (I don't take Ritalin or Adderal). I've never had pot because it only recently became legal and I still don't know if consuming it could get me fired.

My medications have never made me feel like a 'zombie', but having watched some stoned people, I'm afraid that it what pot would make me feel like.

Esther, you just contradicted yourself. Do you agree with me or not?

jonnybedead: ADHD sometimes goes hand in hand with autism, at least on the higher end of the spectrum, to a mild level that often doesn't require medication, so the comparison really isn't that far off.

http://www.ncbi.nlm.nih.gov/pubmed/7413719
yeah small sample size i agree.

http://www.cifas.us/sites/cifas.drupalgardens.com/files/1988_NewbornOut…
http://www.ncbi.nlm.nih.gov/pubmed/1957518
pfft jamaica.

http://www.ncbi.nlm.nih.gov/pubmed/22350104
yeah yeah...

you asked about pica and cannabis in a previous comment, i remembered reading one parents' anecdotal evidence of treating their autistic child with cannabis.

http://www.slate.com/articles/double_x/doublex/2011/05/why_i_give_my_au…
"The pica that had him literally eating clothing, and which plagued and worried us for so long, stopped completely after his first dose of cannabis, though no one seems to understand why."

herbalism? i guess broccoli is not a herb...
http://www.ncbi.nlm.nih.gov/pubmed/20388854
https://clinicaltrials.nlm.nih.gov/ct2/show/NCT01753908
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059031/
http://www.ncbi.nlm.nih.gov/pubmed/17516858
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579766/
eat your broccoli raw, kids!

IDK, Leo T. From Narad's link:

Either direct or indirect attenuation of dopamine and norepinephrine neurotransmission

On second thought, don't ask the kids how they feel. Don't dare risk discovery or dwell on the fact that *getting a grin, again and again* is not scientific and deserves penitentiary max.

Some politicians and lawmakers would rather destroy the lives of children than stand up to their corporate masters. Cannabis legalization is just another crystal clear example of how our lawmakers bend over for corporations.

Tobacco, alcohol and pharmaceutical drug companies make 100s of billions in profit every year. Our politicians take their money, do their bidding, and so it goes. Corporations who are scared witless of losing their long term deadly stranglehold on the US public due to cannabis legalization. Massive citizen outcry is required to make this gigantic lie right.

All the information to make an informed decision about cannabis legalization has been at the Center for Disease Control for decades . Data from the US Center for Disease Control supports cannabis legalization. It is absolutely clear that cannabis is safer than the legal serial killers tobacco, alcohol and pharmaceutical drugs which kill over 650,000 US citizens annually. Nothing the least bit complicated or hard to understand about these statistics taken directly from the CDC dot gov web site:

Numbers of deaths per year in the USA
* Prescription Drugs: 237,485 + 5,000 traffic fatalities
* Tobacco: 390,323
* Alcohol: 88,013 + 16,000 traffic fatalities
* Cocaine: 4,906
* Heroin: 3,365
* Aspirin: 466
* Acetaminophen (Tylenol): 179
* Marijuana: 0, none, not a single fatal toxic overdose in all medical history and almost no traffic problems

So, which is safer?

Legalize, regulate and TAX!

NO Panacea I do not agree with you.
Nor do I agree with your guesswork.
Nor do I agree that simply having asperger's gives you any more credibility than a radish.

http://www.ncbi.nlm.nih.gov/pubmed/26282273
Neurotherapeutics. 2015 Aug 18.
"Cannabinoids and Epilepsy."

My university only has a subscription to that journal up to a year ago; so I cannot look it up. The abstract, however, does not suggest that cannabinoids for epilepsy are ready for prime time.

Esther @42:
Orac asked for adults with autism to post about their experiences with dope; Panacea did so; he has exactly as much credibility as you.
Or me, for that matter, as an adult with Aspergers. I gave up on dope because it gave me paranoia and panic attacks, perhaps because I was misreading signals and picking up on random background visuals and sounds even more than usual.

Panacea says (#24),

Basically the parents want to dope up their kids to eliminate behaviors in autistic children that are difficult to deal with.

MJD says,

It may be that parents of autistic children want to safely and effectively use cannabis oil to increase their child's signs of well-being including laughter, affected appetite, and sociability.

What's wrong with that if such behaviors are triggered by said oil? Medically prescribed and monitored of course (e.g., THC expression in blood).

It may be that parents of autistic children want to safely and effectively use cannabis oil to increase their child’s signs of well-being including laughter, affected appetite, and sociability.

What’s wrong with that if such behaviors are triggered by said oil? Medically prescribed and monitored of course (e.g., THC expression in blood).

People like you make ludicrous claims that there are no safety studies of vaccines and they are the devil's spunk. But, safety and efficacy studies go completely out the window when it comes to trying to "fix" or "recover" your autistic children.

@ Freedom Fighter (#34)

I've long since thought that "big pharma" and "big tobacco" have more interest in seeing cannabis legalized than not. There are quite a lot of potential lead compounds for drug development in cannabis, so pharmaceutical companies could stand to make a profit there.

I've never met a person who interchanges marijuana usage with tobacco usage, and due to the popularity of smoking marijuana with tobacco in many places it seems to me "big tobacco" also stands to gain from legalizing cannabis.

As for "big alcohol," I don't see why they would stand to lose from legalization either. Would people just drop the bottle and pick up a joint if marijuana were legalized? Considering how dissimilar the two drugs are, I tend to doubt it.

the word 'marijuana' is considered a derogatory term used by those who still want it to be illegal. What some of us are trying to do is to always refer to it as 'cannabis'. Medical cannabis. Please join us :)

No thanks, I'll decline. I see no problem calling it by its name nor do I see any reason to change.

#32 notadoctor, racist?

the word ‘marijuana’ is considered a derogatory term used by those who still want it to be illegal.

According to whom?

I suppose they really don't like it when I occasionally use the term "weed" to describe marijuana. :-)

Anyone who refers to cannabis as 'dope' has no credibility.

Those who wish to boost their credibility by claiming to have used cannabis, good luck.

@Den!s - I'll consider using the term "medical cannabis" when someone is able to show:
- What's the difference between medical and non-medical cannabis; and
- That there is strong evidence that cannabis is a safe and effective treatment for some medical condition.

Precisely.

Meph O'B, How strong is the evidence that Sativex is a safe and effective treatment for MS?

Why call it 'cannabis' or 'medical' cannabis? Why not use the product name to describe it? Bedrocan? Cesamet? Nabilone? Marinol? Bedica? Bedrabinol? These are all standardised medications.

"Orac asked for adults with autism to post about their experiences with dope"

For my anecdote please see other anecdote.

What seems to be a defining feature of a lot of marijuana users is the ability to spontaneously delete information in their brain that isn’t in accordance with their ideas.

I'm late to the party, but I'd say this is a defining feature of humanity in general - including skeptics. Skeptics just try to be more aware of and to actively combat the tendency.

How strong is the evidence that Sativex is a safe and effective treatment for MS?

Apparently strong enough for it to be approved in 15 countries. However, that wasn't what I understood was meant by "medical cannabis".

There's a kind of invisible prejudice. It's like racism, but towards cannabis users, and maybe towards 'druggies' in general.
Their language is so fraught with it, do they even realise they're doing it?
Will they look back on this in 50 year's time and realise it looks bad, a bit like suggesting that Jamaican studies can't be credible looks today?

Sativex is cannabis.
Plus ethanol, peppermint, and ethylene glycol.

In other anti-vax/ autism news:

although Dan hasn't posted anything on Saturdays as he was wont to until recently, something interesting has occurred on John Stone's post about DeStefano:

an MPH, PhD, Joel Harrison, has been allowed to post highly critical comments that explain research and critique woo-ful objections SEVERAL TIMES.
IIRC, he may have been around here.

Sativex is cannabis.

Is this more true than saying that digoxin is foxglove or that taxol is a yew plant?

If you don't like Sativex then use Bedrocan which is cannabis flower heads. Every plant is a clone grown under standardised conditions. You can find out which conditions it is approved for in Holland here http://www.ncsm.nl/

Sorry the English version of the website doesn't have the information you need so I've asked a Dutch friend to translate it for us. Please be patient...

Sativex is a mixture of a full spectrum CO2 extraction of the oils from the flower heads of two different cannabis sativa cultivars.
Like Bedrocan, every plant is a clone grown under standardised conditions.

So no, nothing like a single chemical extracted from a plant.

Lovely! So in Holland your GP can prescribe you 'medical cannabis' (Bedrocan) and your insurer will pay for it and buy you a medical grade vaporiser *grin emoticon*

The list of conditions:

- Ailments with spasticity in combination with pain (Such as MS, bone marrow damage)
- Chronic pain (More specifically, that of neurological origin)
- Nausea and vomiting caused by chemo therapy or radiation in order to treat cancer, HIV combination therapy or accompanying medication for the treatment of Hepatitis C
- Palliative treatment for cancer and AIDS: For improving the appetite, and decreasing pain, nausea and weight loss
- Gilles de la Tourette Syndrome
- Therapy resistant glaucoma

Science Mom says (#40),

People like you make ludicrous claims that there are no safety studies of vaccines and they are the devil’s spunk.

MJD says,

In contradiction, both of my autistic children were fully vaccinated and as adults-with-autism I support their use of vaccines and cannabis oil when applicable.

@Orac,

When are you going to have a Respectful-Insolence conference?

I'd suggest having it on a whaling ship wherein the Oracian pod (i.e., Orac's minions a.k.a. The Borg) can laugh together, in respectful insolence, and chew on strips of whale blubber fried in a 55-gallon steel drum of cannabis oil.

@ Esther Knight
I'm not going to translate the whole piece. The website is by an organisation to promote medical cannabis, so hardly a neutral organisation. Besides the organistation doesn't exist anymore.
Not all insurers are paying for it, and mostly in very specific circumstances.

http://www.ncbi.nlm.nih.gov/pubmed/23867051

It wasn't the cannabis that caused their psychosis. It was your systematic bullying!

Renate my Dutch native here says you're being economical with the truth, and misleading this mostly monolingual English-speaking audience.

Nou, dat lijkt me een beetje vergezocht.
Je herhaalt dus letterlijk wat de website aangeeft alsof het wat bewijst. Verzekeraars hebben ALTIJD voorwaarden.
Als je Nederlandstalige bron net zo sterk is als je denkt, kan het ook geen enkel probleem zijn dat ik deze reactie in mijn moedertaal aanbiedt.
De organisatie aangehaald werkt nauw samen met de overheid, en de overheid heeft haar eigen departement om toezicht te houden op medicinale cannabis. Men is zeer nuchter over wat het wel en niet doet, en het is zeker geen propaganda, daar het de mythe dat "cannabis kanker geneest" meteen de grond inboort met studies.

Maar goede bluf, desalniettemin.

the word ‘marijuana’ is considered a derogatory term used by those who still want it to be
illegal.

Yes, Den!s #42.. but *racist*, #44? It is no less racist nor more stereotypical than poor translations of ebonics or jive.

Prior to 1910, “marijuana” didn’t exist as a word in American culture. Rather, “cannabis” was used, most often in reference to medicines and remedies for common household ailments. In the early 1900s, what have now become pharmaceutical giants—Bristol-Meyer’s Squib and Eli Lilly—used to include cannabis and cannabis extracts in their medicines.

https://www.leafly.com/news/cannabis-101/where-did-the-word-marijuana-c…

I see no problem calling it by its name nor do I see any reason to change.

What's in a name, Orac? For your profession was derped back then as they were late to the prohibition party having not yet associated the name of the evil weed, marihuana, with their medical use of 'cannabis' -- Your soul AMA emmisary sent to oppose the agregeous farce, the kickoff of eighty years of draconian cruelty, berated and hung out to dry as a warning to other 'doctors'.

What is in a word, Orac?

=============
Dr. Woodward: I use the word "Cannabis" in preference to the word "marihuana", because Cannabis is the correct term for describing the plant and its products. The term "marihuana" is a mongrel word that has crept into this country over the Mexican border and has no general meaning, except as it relates to the use of Cannabis preparations for smoking. It is not recognized in medicine, and I might say that it is hardly recognized even in the Treasury Department.

Dr. Woodward: We cannot understand yet, Mr. Chairman, why this bill should have been prepared in secret for two years without any intimation, even, to the profession, that it was being prepared.

The Chairman: If you want to advise us on legislation, you ought to come here with some constructive proposals, rather than criticism, rather than trying to throw obstacles in the way of something that the Federal Government is trying to do.

The Chairman: The fatal marihuana cigarette must be recognized as a deadly drug, and American children must be protected against it.

http://www.druglibrary.org/schaffer/hemp/taxact/woodward.htm

Wow. ^^ There really are a lovely bunch of cocconuts, in that one!

It is rather silly that you seem to be attributing the attitude of a doctor from nearly 80 years ago towards marijuana to me given that I said more than once in this post that I support legalization.

Gilbert. My comment #44 was referring to the

"pfft jamaica."

Racist comment at #32 by notadoctor

It wasn’t the cannabis that caused their psychosis. It was your systematic bullying!

"High" (or, depending, "stoned") and "coherent" are not mutually exclusive categories, BTW. You might want to try out the combination.

Gilbert. My comment #44 was referring to the

“pfft jamaica.”

Racist comment at #32 by notadoctor

Impressively, you can't even identify sarcasm or, more precisely, someone who is vaguely agreeing with you. I guess actually reading the link was too much effort.

Narad maybe you are right @#70 ?
My autism might render me vaguely blind to vague agreement.

What is that word-salad at @#69?

Was reading the article in notadoctor's post #32 and found this:

But it's alleviated some of his severest symptoms so that he, my husband, and I can actually enjoy each other, rather than being held hostage by his autism in a house full of screams, destruction, and three very unhappy people. [emphasis mine]

mlMore or less the attitude I expected. I'd hazard that it's more about her and her husband enjoying the silence than any consideration for the child.

Also, what was the point of notadoctor's link farm?

"...given that I said more than once in this post that I support legalization.

Orac, you could start referring to yourself as 420 friendly. That's a term they should understand.

Of course, that term applies to equally to supporters and users so I can see where identifying as such would be problematic for you.

Je herhaalt dus letterlijk wat de website aangeeft alsof het wat bewijst.

The evidence base for CINV is pretty thin, as well, but this has nothing to do with the topic at hand.

Esther Knight, #47
"Anyone who refers to cannabis as ‘dope’ has no credibility."
How dare you? I could bet the reference is right, on such authorities as Gilbert Sheldon's Fabulous Furry Freak Brothers!!!
https://en.wikipedia.org/wiki/The_Fabulous_Furry_Freak_Brothers

Narad,

Not understanding sarcasm goes with the territory.

https://www.nlm.nih.gov/medlineplus/ency/article/001549.htm

Yes, Ester; It was 'sarcasm'. from *Conclusions* of the Jamaican study:

Clearly, these results suggest that we examine the caretaking environment that has the capacity to
overcome the potentially adverse effects of marihuana.

The community based field studies and home interviews reveal that the sharing and smoking of ganja... In Jamaica as an overture and confirmation of frienship and mutual assistance... The lifestyle of ganja users suggests a lively houlsehold with many child caregivers, more infant stimulation and playfulness.... the differences in infant scores at 30 days is most likely attributable to the differences in the richness of the environment...

Well, I'd still not recommend Showtimes' Shameless as the definative replacement for 'Dr. Benjamin Spock' for raising children; But I am fireing up to the idea.

How dare you? I could bet the reference is right, on such authorities as Gilbert Sheldon’s Fabulous Furry Freak Brothers!!!

I've actually had reason to invoke this in all seriousness not too long ago. (I'm not sure I totally agree; the anxiolytic effect is certainly welcome, but the general distractability isn't so helpful overall.)

I'm mildly surprised that I'm not turning up an image of "no gas, no grass, no ass, no ride." In any event, I use whatever euphemism I feel like,* depending on context.

"The free, playful entertaining flight of ideas is bullshіt; and more often than not will be found afterwards to accord perfectly with universal truth."

I am wholly indifferent to random, blanket babbling about "credibility" based on vocabulary.

* Some quite obscure. I happened to be on a mission to the Puget Sound this week, which has its very own. One curiosity was that one of my hosts showed me his collection of (now legal) grass; it was all in the 20%-and-up THC range, except for the one that was open, which was <2% THC and around 18% CBD.

The effects were... interesting (don't let anyone tell you that CBD isn't centrally active), but I wound up trying to figure out a way to sidle up to the question "Um, D—, how did you happen to pick this?" D. is no novice but was completely unaware of the distinction. I'm quite curious what's going to happen when the next variety comes out of the cigar box.

What is that word-salad at @#69?

Maybe your Dutch native there can explain it to you.

I happened to be on a mission to the Puget Sound this week, which has its very own. One curiosity was that one of my hosts showed me his collection of (now legal) grass; it was all in the 20%-and-up THC range,

I always knew the weed back in Olympia was crazy strong. I'm totally jealous, btw. Well - I'll be making a trip back that way this winter, I'm sure.

One… (something, something)… over the line…

There is a wonderful and hilarious video of this “modern spiritual” being performed on The Lawrence freaking Welk Show, just by the by.

Lawrence Welk reruns on Saturday evening from a distant public TV station were a great way to ease coming down from the Supreme Sacrament back in the day.

A long time ago, in Guitar I or II at the Old Town School, I put in "One Toke" as a class selection, which was promptly embraced by the instructor. But anyway, I think that Tarkio is underappreciated as an album. It's nothing like Melanie's Gather Me, which is criminally given short shrift, but it holds together OK.

I always knew the weed back in Olympia was crazy strong.

The word I got was that the supply chain originated in British Columbia in the pre-prohibition days. I'm not sure how it's regulated now. (The only security in the priority line SEA–ORD last Wednesday, for whatever reason, was being sniffed by a dog.)

I'm over 21 and live in Washington state, which means I can legally and without a prescription buy any of the following (among many other things): vodka, acetominophen, aspirin, vitamin D, marijuana buds, THC extracts, tobacco, coffee, and Sudafed.

Knowing that doesn't tell me which, if any, of them might be helpful for a given symptom or chronic condition. Sometimes the answer is "none of those, but chicken soup won't hurt" or "rest, ice, compression, elevation."

What a number of people don't seem to realize is that "if cannabis won't solve this, what's better?" isn't actually evidence in favor of cannabis. The argument is equally valid, or rather equally invalid, if someone says "but if tobacco won't cure my cousin's cancer, what will?" or "how dare you say rum won't cure the common cold? Have you got something better?"

Yes, legalize it; but if I did get cancer, I'd like to be able to ask my doctor whether THC is likely to help, harm, or neither and get an evidence-based answer.

Gilbert how was I to know?
There actually ARE people on this blog who really DO think Jamaican studies are somehow inferior to white american studies.

Your parody of racist words was a parody, and the words were racist. Is it funny? Should it be seen as a joke or a problem here?

Funny, when I hear the topic of debating the merits of the legalization of pot, all I can think of is this classic from the 70's:
https://www.youtube.com/watch?v=ZhedkY_TmXI

There actually ARE people on this blog who really DO think Jamaican studies are somehow inferior to white american studies.

You arrive at this freakishly specific conclusion how?

As an aspie who spent a significant amount of my 20s enjoying or at least trying to enjoy cannabis in its various forms, I have to say that (1) it turned just about anything into a near-orgasmically sensual experience, at least if I was left to experience it in my own head, but (2) as for social anxiety, a distinct symptom of my aspie-ness, it only made it worse. Far worse. I gave it up because, frankly, people scared me while I was on it. Stoner paranoia is a thing, and it led to some seriously bad experiences.

Everyone on the autism spectrum is an individual. It might well be true that cannabis could be helpful in some cases. But I can easily imagine it being a horrible experience in others. Giving it to a child without knowing what the reaction will be seems borderline abusive to me.

Narad, this blog is racist. Don't cry.
Actions speak louder than words.

If there is a single person amongst you who wants ME to be criminalised for using cannabis to reduce MY autism symptoms, come out and say it and explain yourself.

"This blog is racist"? WTF are you talking about?

As for the "criminalization" part, no one has said that, so, really, WTF are you talking about? Note that there is a huge difference between adults and children. I generally support the right of an adult to use pretty much any treatment he or she desires (or to refuse any treatment he or she desires), but children are a different matter, and a much higher standard is called for. Children are autonomous beings who have the right to be protected from potentially harmful decisions by their parents with respect to their medical care.

There actually ARE people on this blog who really DO think Jamaican studies are somehow inferior to white american studies.

Oh, really? Who? And on what basis do you draw this conclusion? It's easy to cry "Racism!" Proving it, not always so easy.

No Orac not you, you just tolerate it.

Your title: Evidence prevails
Should read: Lack of evidence doesn't prevail.

To you and me, details matter.

To you and me, details matter.

They matter to other people too. That's why they're asking for any evidence for your "here actually ARE people on this blog who really DO think Jamaican studies are somehow inferior to white american studies.".

I would hazard an opinion that to the regulars here it is irrelevant where the study originated, because what is evaluated in a study is the content.

As for my opinion on the topic - legalize and regulate like alcohol, with growing for personal use allowed, ease up regulations for study but require adequate studies before prescribing it medically. Adult anecdotes for cannabis, like for any other potential drug, do not adequate studies make.

"Evidence" prevails is correct because the totality of the existing evidence does not even come close to supporting the use of cannabis oil for autism, period.

How on earth can you find it remotely acceptable to continue to risk giving Risperidone to autistic children or adults in MI when you know perfectly well that cannabis is much less risky and may be more effective?

In my humble opinion, may be more effective is inadequate for medicating children. With anything (with the possible exceptions of chicken soup and ice cream).

And yes, I am concerned about over-prescription of psychotropic (and other) drugs, and would prefer alternatives but adding another psychotropic drug to the list without showing efficacy isn't the answer - and replacing a drug that has evidence of efficacy with one without is irresponsible. In my honest opinion.

That for children. For adults, they're free to make their own choices about what medication or medical interventions they take or not. But that said, for Cannabis to be paid by the local national health care service, for example, I'd except evidence of efficacy too. But even if not compensated, I'd legalize it and leave it to adults to indulge responsibly and/or self-medicate with it if they so chose.

How on earth can you find it remotely acceptable to continue to risk giving Risperidone to autistic children or adults in MI when you know perfectly well that cannabis is much less risky and may be more effective?

Because I "know" nothing of the sort. There is zero reliable evidence that cannabis is more effective than Risperidone. Zero. Not even the anecdotal evidence is that convincing.

Esther, I don't want to criminalize you using cannabis to treat your autism symptoms. I'm fine with any adult using cannabis just for the hell of it, or if (they think) it helps their medical issues; that doesn't mean I think it's a good idea to give it to autistic eight-year-olds who may not be able to express that they feel worse after being given it. (I assume you agree with me that autistic children shouldn't be kept drugged with opiates in order to give their parents peace and quiet.)

If you want to organize a separate campaign to stop giving Risperidone to autistic children, in Michigan or anywhere else, show the evidence that it's harmful and we might even back you up. But that is a separate issue from whether to give cannabis to children.

If there are two or more actually helpful treatments, a patient (or their parent/guardian) and their doctor can reasonably consider "this one has fewer nasty side effects" or "let's see which one I can tolerate better." If there's only one useful treatment for a problem, the comparison becomes "is this better than no treatment?" That a drug or herb is useful for one condition doesn't mean it will help another; I don't expect ibuprofen to help a cough or stomach ache, or take an antibiotic for a viral infection.

Orac says (#90),

Children are autonomous beings who have the right to be protected from potentially harmful decisions by their parents with respect to their medical care.

MJD says,

Great, so let's have free and easy medical care for every child in this country so a distressed and uninformed parent doesn't have to rob a bank to manage their child's eye cancer.

Great, so let’s have free and easy medical care for every child in this country so a distressed and uninformed parent doesn’t have to rob a bank to manage their child’s eye cancer.

While I don't see how the one statement follows from the other, there are certainly people who support paying for all health care via tax dollars and countries that have done so. Work on convincing the taxpayers that it's a good idea, and they'll convince Congress to act.

There was a study on ADHD and crime.
Found double the crime rate. Half of the crime was for possession of illegal versions of ADHD meds,. Go figure.

I'm old enough to remember when hyperactive kids with poor impulse control were just regarded as behavior problems, and treatment was limited to being ostracized by their peers and beaten by their parents.

A lot of them ended up as addicts and petty criminals. Briefly. Before dying young. Long before the prescription of stimulants became commonplace. Go figure.

Meds don't work for everybody. And nothing works all that well for any child, with or without ADHD, who doesn't have support at home. But for a kid who otherwise could not sit still long enough to learn to read or make a friend, meds are a help and a benefit.

It's really kind of vile of you to be banging that gong to advance your own interests without sparing a thought for that. Do you want people who find it beneficial to take meds to suffer for your prejudices?

Before I do, just do yourself one favour.

Google 'cannabis tourettes youtube' and you may see some Europeans with severe 'problems' and those problems appear to disappear almost immediately upon vaping Bedrocan.

If you can look at those videos and see only charlatanry, please explain?

@#102 --

"Charlatanry" and "miracle drug" are not the only potential explanations. You realize that, right?

I watched a video of a very tic-y guy in Germany. If that's the one you mean, it's impossible to say what's going on there. A lot of people with Tourette Syndrome can voluntarily suppress their tics without any medication at all. But it makes them tense. So it's possible that he's alleviating the tension, not the tics per se.

That might be incredibly helpful for some people. And it wouldn't be charlatanry. But it also wouldn't be a miracle cure.

But, you know. Anything's possible. It's a four-minute video on the internet.

Yes Ann you are right, and if motivated enough you can actually make friends with people with Tourettes who find cannabis useful. Then things will either become more or less clear.

My final offer to Orac: Sir, can I help you find some cannabis-using autistic adult friends in Detroit if you wish?

you can actually make friends with people with Tourettes who find cannabis useful.

I am a regular cannabis user who also has Tourette. I live where marijuana is broadly legal. You know what? Cannabis most certainly makes my Tourettic symptoms worse. As much as I love cannabis, I can only consume while also taking meds to manage my tics.

Esther, if motivated enough you can actually make friends with people with Tourettes who don't find cannabis useful too...

AdamG most medicines don't even work for half of all people with the same diagnosis!
We know people like you exist too, and we are sorry to forget to include you. Thank you. I've known two people with Tourettes and never noticed cannabis effecting them one way or the other.

AdamG most medicines don’t even work for half of all people with the same diagnosis!

What percent of children with autism is cannabis effective for? We don't know. That's why it should not be approved for this use given the current knowledge base.

@#104, #106 --

OK. Now I'm confused.

I've known two people with Tourette's well enough to have some sense of what the disorder was like for them. It was co-occurring with an assortment of other stuff for both.

One of them was able to live with it, in part because of psychotropic meds. But I believe he took those mostly for the OCD. So he had no use for cannabis.

One of them had schizophrenia. He also took psychotropics, but neither the voices nor the tics were completely controlled. And whatever else cannabis may or may not do, I'm pretty sure it's kind of a risk for people with psychotic disorders.

^^That's anecdotal. So is the evidence that cannabis works for Tourette's.

So reality is basically:

Smoking pot makes some people feel good.

If that's the case, and smoking it doesn't interfere with other aspects of their lives and functioning, more power to them. But that doesn't mean that pot has medical value. You could say the same thing about alcohol.

And it's not always the case. Some people smoke pot because it makes them feel good until it leads to years of social isolation and not being able to get anything done. You could, again, say the same thing about alcohol.

There's a big difference between that and -- for example -- stimulants as a treatment for ADHD. Like so:

On the one hand:

Stimulants reduce the symptoms of ADHD eighty percent of the time. Not forever, not completely, and not without side effects. All three of those things is a significant drawback. But as far as it goes, it's proven to be an efficacious treatment.

On the other:

Some people like smoking pot. They find it helpful in a wide variety of non-specific ways. Others don't.
_____________

Is there some reason why that's not satisfactory to you?

most medicines don’t even work for half of all people with the same diagnosis!

Citation needed.

...

If you mean neuropsychiatric disorders, it's true that for some, meds either don't always work or don't always work well or only work at a very high cost, side-effect wise.

That still doesn't mean that cannabis is a treatment. It just means that there are not very effective treatments for some neuropsychiatric disorders and that smoking pot still makes some people feel good.

You could say the same thing about alcohol.

ann #108; Sometimes, you certainly can:

Benign essential tremor is treated with alcohol in moderation. Beta-blockers or primidone are also used.

http://patient.info/doctor/abnormal-involuntary-movements

Hmm. I wonder if some cases develop as a response to the brain being Ritalin-'leaned-out'; I wonder if there would be fewer of these types of palsey if the hyper brain had been cannabinoid 'chilled out' instead?
==========

I did not indend to seem "rather silly", Orac #67. You saw no problem calling calling cannabis 'marijuana'; I only sought to edify by demonstrating the M-word was deliberate conflation that also hoodwinked doctors. This history of the word was not known to yourself, I trust? A forgivable oversight because, as you say, the blog is not 'racist'.

The article I linked notes:

others insist that the term has now lost its prejudiced bite

However, The M-word was promoted throughout america and on the 'Big Screen' (Reefer Madness) by a flamming racist; Presumably to play to other racists throughout the populace but especially to those in positions of power (the kids were never fooled.. Marijuana -- The Assassin of Youth, LoL).

Most marijuana smokers are Negroes, Hispanics, jazz musicians, and entertainers. Their satanic music is driven by marijuana, and marijuana smoking by white women makes them want to seek sexual relations with Negroes, entertainers, and others. It is a drug that causes insanity, criminality, and death — the most violence-causing drug in the history of mankind.

and

“Reefer makes darkies think they’re as good as white men…the primary reason to outlaw marijuana is its effect on the degenerate races.”

-- Harry J. Anslinger, The first director of the Federal Bureau of Narcotics.

Mrs. Grimble #38: actually MJD asked the question, but yes my response was in answer to it.

MJD: in response to when you said, "It may be that parents of autistic children want to safely and effectively use cannabis oil to increase their child’s signs of well-being including laughter, affected appetite, and sociability.

What’s wrong with that if such behaviors are triggered by said oil? Medically prescribed and monitored of course (e.g., THC expression in blood)."

Please prove to me that cannaibis oil does any of those things. Please prove to me it does so safely, without causing addiction or problems with higher brain function that we KNOW is a side effect of chronic marijuana use in younger people (before the age of 21).

Esther: I find your comments on marijuana treating your symptoms of autism to be hysterically funny, and I call BS on it. Other than stimming, which can sometimes result in self injurious behavior, the "symptoms" of high functioning autism are primarily perception in communication. So what you're really telling me is pot alters your perceptions and somehow improves your communication skills? Or maybe it just alters the perceptions of others in some way? Makes you easier to deal with?

In any case, I don't think I have any symptoms of Asperger's that require any form of treatment. This is simply who I am. There's nothing wrong with me. All I've ever had to do is focus a bit more when communicating with others to try and understand how they might be perceiving me, to avoid social conflict. Every other Aspie I know is the same way, not a single one I've ever known would ever say they needed medication to treat anything.

Either you're a parent of an Aspie who's having trouble coping, or you just want to get high.

And even if I'm wrong on that (not impossible), see my answer to MJD: where is the evidence that cannibis oil does anything beneficial for kids or adults with autism at any point on the spectrum? Describe that benefit.

I wonder if some cases develop as a response to the brain being Ritalin-‘leaned-out'; I wonder if there would be fewer of these types of palsey if the hyper brain had been cannabinoid ‘chilled out’ instead?

And I wonder if heaven got a ghetto. And also who wrote the book of love. Plus when you stopped beating your wife.

If you want what you said to make more sense than that, you could start by explaining exactly what "a hyper brain" is and what "a chilled out" brain is.

Because you seem to be confusing vaguely conceived and not necessarily pathological mood states with neurology.

@Adam G #107 a conservative lower bound would be to guess that cannabis works with less than 1 in 40 with autism.

That way we will always be fucked. Thanks.

The lady who wanted a citation for meds working with less than half, I'm changing that to a third and you can still go get your own citation for that, it's closer to a quarter actually.

Sorry for f*
It's bank holiday me and dinny are drunk

That's fascinating. How everybody must envy you.

Panecea says (#111),

...where is the evidence that cannibis oil does anything beneficial for kids or adults with autism at any point on the spectrum? Describe that benefit.

MJD says,

Briefly, it is well documented that humoral immunity (e.g., hyper-adaptive immunity) has been shown to affect the incidence and atypicality of autism spectrum disorders.

Medical research indicates that cannabis oil has an immunosuppressive effect on humoral immunity.

http://www.marijuanalibrary.org/JOPD_Immunity_Hollister_92.html

Therefore, cannabis oil may be a useful treatment that inhibits the progression of regressive autism based on its immunosuppressive characteristics.

Esther: no guessing, please. This is science. We operate on facts, not guesses.

You're the one making the claims. Sober up and do your own research. It's not up to us to prove that marijuana does NOT work. It's up to you to prove that it does.

Good luck with that.

No, if marijuana (in any form) doesn't work for people with autism, researchers will keep looking until we find things that do. Marijuana won't cure strep infections, either: that doesn't mean nothing will.

Heck, even if it is proven to help, people will look for alternatives, because some people get unpleasant side effects from cannabis, some actively dislike being stoned, and some would like a treatment that they can use and still drive a car.

@Esther Knight --

I realize that you and Dinny are having a very important drunk and everything.

But WTF are you talking about? Antidepressants work for about a third of the people who take them. However (a) anti-depressants =/= meds; and (b) a lot of that is because antidepressants are over-prescribed to people who don't need them.

They' also don't work for everybody who needs them. But neither does anything else. That's not because antidepressants are evil. It's because depression is difficult to treat.

May I just say again that while it's great that smoking pot makes you feel good, it's really kind of vile of you to be parading around demanding that the whole world bow down to your preferences? Because it is.

I mean, if the pot is really working, how come you still need to go to such lengths to make yourself feel big by looking down on others anyway?

@Adam G #107 a conservative lower bound would be to guess that cannabis works with less than 1 in 40 with autism.

I'm certain that your showing your work will be fascinating.

*A very hungover essie will get you citation later.
not 1 in 40 that's a mistake. It's 1 in 1200.

Here is the article: http://www.medscape.com/viewarticle/453220

Making pot does not make me feel good. I feel great without it and feel just a little bit worse with it. The reduction in autism symptoms is worth having so I put up with the mild side-effects.

No pot: feels 11/10
On pot: feels 9.5/10 and never get crap off anyone for having an orgasm face at a funeral.

@Esther Knight --

OK. In that case, I think it's great that smoking pot works for you in some circumstances without making you feel more than a little worse, in much the same way that it does for every other pot aficionado -- ie, as a social aid.

And the rest of what I said still stands. That doesn't mean it's a medication, or that it has medicinal value.

I don't blame you for disliking meds either, btw. If they don't help you, they don't.

It's the generalizing of your experience to a universal truth that I have a problem with.

Therefore, cannabis oil may be a useful treatment that inhibits the progression of regressive autism based on its immunosuppressive characteristics

MJD, the evidence demonstrating that immunosuppression inhibits the progression of regressive autism would be what, exactly?

MJD @ 116
I find it's best to ignore someone like Panacea,who clearly would not know regressive autism,if it crawled out of the sewer and bit them on the rear end.

I read your link about marijuana and immunity,and the first thought that came to mind was that for regressive autism,cannabis,is,at best,a band-aid solution.One that would only possibly treat symptoms,but not get to underlying causes.Not to mention cannabis is a treatment with many heath risks that would not justify the questionable,benefits for a child with immune and metabolic impairments.

Individuals with severe or regressive autism often are found to have inborn disorders of folate metabolism,and disorders of redox metabolism and mitochondrial dysfunction.These can be inherited through family history,or the results from exposures,and deficiencies,while the child is in the womb.The latter is usually what is meant by "environmental exposures" in autism,not vaccines.

Folate
http://www.jimmunol.org/content/173/5/3186.full

Redox/CoQ10
https://www.grc.com/sr6dev/misc/coq10/Q10%20-%20Gene%20and%20Metabolic%…

Correcting these deficiencies often normalizes mitogenesis,and immune function.It is much safer than marijuana.I need only to look at my history of one regression after another,triggered by acute infection,or undiagnosed metabolic crisis,from the time I was an infant,until well into my 40s.These regressions were stopped,and well as my immune issues,like frequent pneumonia and lower respiratory infection,were reversed by treating these metabolic problems.

As a social aid? We are not talking about passing a joint round hippy friends.
We are talking about passing for someone who always has red eyes in the office instead of a total freak.
I smoke in the morning, I smoke before I go to work, I smoke at lunch, I smoke after work, I smoke in the evening.

If you stop taking your meds regularly they say you are 'not compliant' and you get all sorts of recreational effects creeping in.

To be clear, we are not 'cancelling out your idea of autism symptoms with your idea of recreational pot effects'. No.
We are reducing core symptoms of autism. While we quickly develop a tolerance to the recreational effects (side effects) we continue to get the same reduction in autism symptoms.

Individuals with severe or regressive autism often are found to have inborn disorders of folate metabolism,

Interesting, Roger Kulp #127. Your link seems to indicate the use of *pteroylglutamic acid*; The synthetic *folic acid*?
As

However, folic acid is a synthetic oxidized form, not significantly found in fresh natural foods. To be used it must be converted to tetrahydrofolate (tetrahydrofolic acid) by dihydrofolate reductase (DHFR).

and

Their biological availability to the body depends upon dihydrofolate reductase action in the liver. This action is unusually slow in humans, being less than 2% of that in rats. Moreover, in contrast to rats, an almost-5-fold variation in the activity of this enzyme exists between humans. Due to this low activity, it has been suggested this limits the conversion of folic acid into its biologically active forms "when folic acid is consumed at levels higher than the Tolerable Upper Intake Level (1 mg/d for adults)."

and

Folic acid therefore enters via a different carrier system from naturally occurring folate, and this may have different effects on folate binding proteins and its transporters. Folic acid has a higher bioavailability than natural folates and are rapidly absorbed across the intestine

It *may* seem plausible that increasing unmetabolized synthetic *folic acid* stores (generally, believed to be not so
good) further downregulates the production and processing of the bioactive form, 5-methyltetrahydrofolate

in the absorptive cells of the small intestine from polyglutamylated dietary folate.

https://en.wikipedia.org/wiki/Folic_acid

With what is known now, would it not be prudent, following the precautionary principle, to recommend that autistics and others with known folic acid metabolism deficiencies (such as the elderly) be advised to avoid it?

^^In practice, The distinction cannot be determined from food labels directly such that this is an arduous request given the ubiquitous nature of the petroleum-derived *folic acid* and its conflation and confusion with *folate* in this age of mandated fortification.

Back in my late teens in the early Seventies, I smoked a fair amount of what we called "dope" back then, no apologies for using the word.
It did not improve my social functioning, stimming, klutziness, or focused interests. On the other hand, my friends were all so stoned that no one noticed any of it.

I smoke in the morning, I smoke before I go to work, I smoke at lunch, I smoke after work, I smoke in the evening.

It shows.

RE: MJD's idea that immuniosuppresion may be useful in slowing the progress of regression, why in the world would anyone suggest using marijuana as the immunosuppressant when there are well characterized, FDA approved immunsuppresants like rapamycin and cyclosporin available for use?

@34 Freedom Fighter. Then please post the link to the CDC page to back your claims up. Like this http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

@50 Esther Knight. Sativex is an oral spray that can help with some of the symptoms of MS. A meta-analysis showed there was a trend towards a reduction of spasticity in the illness, but it wasn't significant, statistically that is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2793241

Also, and I quote: ''Due to low bioavailability of oral THC formulations, alternative routes of drug administration, including oromucosal or sublingual dosing, vaporization of product and inhalation, and rectal administration, have been developed to improve the amount of delivered cannabinoids.'' http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689518/

@130

ORD,

There you have it! Cannabis use in others greatly reduces awareness of autism symptoms! Now if only someone could design a study...

Narad, that's your little imagination showing you things.

How can you see my orgasm face? Are you hacking my webcam?

Guys, we use it in secret to pass as non-autistic amongst sober people where we work. There is no hippy party, just forget about your hippy party / friends too stoned to notice hypothesis.
If you want out anecdotes please don't derail the thread with your fantasies and throwback memories.

Narad, that’s your little imagination showing you things.

How can you see my orgasm face?

How can you? Mirrors don't seem to be your gig.

Narad, face to face interaction matters to girls.
Someone please explain him, I have to go to work.

Actually, Esther, I'm not interested in your anecdotes. Should you ever have something resembling evidence in support your claims to offer, on the other hand, I'd certainly be interested in considering it.

We are reducing core symptoms of autism.

What you're describing doing is altering your subjective perceptions of yourself and/or what other people think about you. Or that's what it sounds like, anyway.

We are talking about passing for someone who always has red eyes in the office instead of a total freak.

People who regard others as total freaks are...Well. I don't know what they are. F*cked up people.

To regard oneself as a total freak (or to fear being seen as one) is obviously a very painful thing. So I don't want to presume you feel that way. But fwiw, I'm sure you have no reason to. Because there is none.

I think that might be one of those things that suddenly becomes self-evident after you've already wasted a decade or two being pointlessly miserable about it (aka "the wisdom of age.")

But oh, well. Say ooh la la.

You need to change the name of this blog as you have no idea what science is. There is plenty of research to support the use in autism. You chose to believe a bureaucrat instead of the medical review board that approved the use in Autism by a vote of 4 to 2.

There is plenty of research to support the use in autism.

And your citation list would be...?

Give Orac a break. He's never known autistic people who use cannabis so he's correct to say that he, himself, has no evidence.

Ann, I had to phone a friend.
Autism is a behavioural diagnosis, so referring to the legal version of successfully medicating as 'reducing symptoms' while referring to the illegal version as 'masking symptoms'? Possibly makes sense with your emotional bias but not in my real world.

Perhaps your unicorn would like to teach my co-office workers all about autism?

I didn't say "masking symptoms." I also didn't suggest that cannabis had that effect.

I said that what you were describing sounded like an alteration of your subjective perception of yourself and/or how other people think about you.

Or if that's too hard to follow: It sounds like you're describing a change in how you feel about yourself and/or how you think other people feel about you.

And just in case it isn't clear:

I'm not saying that's what's happening. I'm obviously not in a position to know, one way or the other. How could I? I'm just saying that's what you seem to be describing. I base that on your descriptions.

Meaning these ones, right here:

On pot: feels 9.5/10 and never get crap off anyone for having an orgasm face at a funeral.

We are talking about passing for someone who always has red eyes in the office instead of a total freak.

How can you see my orgasm face? Are you hacking my webcam?

Guys, we use it in secret to pass as non-autistic amongst sober people where we work.

So. I do see mention of one symptom.

But what you're literally describing is a perceived change in other people's behavior, not yours. If that's not what you intend to convey, describe the symptom reduction.

Perhaps your unicorn would like to teach my co-office workers all about autism?

^^I missed that one.

I mean, I assume that your co-workers are not keeping careful records of your facial expressions under pot and non-pot conditions,

But beyond that, I'm not sure exactly what you're saying. How are you gauging their response to you?

Ann, I have to concentrate continuously to avoid adopting an open-mouthed appearance. This is to the exclusion of any other task, for example a job in an office. I am not aware of my mouth opening when it decides to happen.

When I have cannabis I can keep my mouth in the normal closed position without any effort whatsoever.

Do you suffer from open mouthed appearance Ann? Can you relate? I was teased for it in school a long time before I smoked cannabis and my cannabis smoking friends noticed I stopped acting weird when I was stoned. That was before I was diagnosed.

It's wrong to suggest that stoned people are any better at tolerating me when I am not stoned. If anything they are more sensitive to the abrasive side of one's autism.

http://www.cell.com/neuron/abstract/S0896-6273(13)00361-9

http://www.cell.com/neuron/abstract/S0896-6273(13)00453-4

http://www.cell.com/neuron/abstract/S0896-6273(13)00225-0

Um, no. These papers are not evidence that cannabis is an effective treatment for autism. I dealt with this particular paper the last time I discussed this issue:

http://scienceblogs.com/insolence/2015/08/06/medical-marijuana-for-auti…

It’s wrong to suggest that stoned people are any better at tolerating me when I am not stoned. If anything they are more sensitive to the abrasive side of one’s autism.

It's also wrong to suggest that I was suggesting it.

...

It's probably futile, since you seem kind of determined not to believe it:

But I swear to you that I was not only not suggesting that, or any other judgmental, harsh, critical thing you care to name, but -- in fact -- not suggesting anything at all beyond what I said.

What I said includes that I think it's great that smoking pot works for you, and that I'm not in a position to know what your experience is apart from what you tell me about it.

Therefore:

When I have cannabis I can keep my mouth in the normal closed position without any effort whatsoever.

I'm happy to hear it. How could I not be?

If you had anything to add, I'd also be both happy and interested to hear it.

Do you suffer from open mouthed appearance Ann? Can you relate?

Forgive me if I'm wrong. But that seems to me more like your way of saying that I couldn't possibly know how you suffer than it does a sincere question. And I don't really see the point of competitive suffering. Seems to me that there's plenty to go around.

So apart from to say that I'm sorry for your suffering, I'm going to take a pass on that.

I was teased for it in school a long time before I smoked cannabis and my cannabis smoking friends noticed I stopped acting weird when I was stoned. That was before I was diagnosed.

That's awful. You deserve better. I'm sorry.

Orac to Greg Carrick RPh: "I dealt with this particular paper the last time I discussed this issue:"

Mr. Carrick, a little hint for you: use the search box near the top of this page before citing a paper. This way you will know if it had been discussed earlier.

@Greg, as our host has noted, not impressive and also how are three citations of mouse studies "plenty" of research to support cannabis use for autistic children?

Good morning Ann! Yes we deserve better, no we don't have that in our offices in the UK. I didn't disclose, they don't know, they can't all be educated because I have to interact with external customers. I have to hide the autism or loose my job, Job hunting with disclosure seriously restricts the jobs you can get.

Perhaps you can relate to this 'symptom' - when listening to people, you find yourself totally avoid eye-contact in order to understand their words, but this can make the other person uncomfortable. If you look at their eyes, your mind spins or freezes or derails onto a different topic or tries to begin formulating a reply instead of listening?
Cannabis alleviates that.

I can relate to that because I can relate to most things by analogy if I try. But I didn't mean to be misleading. I'm not on the spectrum myself.

I have a question, though. To what do you....Hm. Rats. I'm not really sure how to ask this. But what I'm wondering is whether you'd say the cannabis changes the way you act because it changes the way you think and feel, or whether you'd just say it changes the way you act.

That's not a trick question. Cognitive and emotional benefits are real benefits. That's frequently what meds and therapy aim to deliver, in fact. So there are not hidden implications. I'm just wondering how you'd characterize it.

Now we are getting into strange territory and I have no idea how to answer that without leaving the possibility that it is misunderstood.
Can you understand life in terms of mean-time-between-failures?
The cannabis is not making me happy, but it is preventing the unhappiness that comes with repeat failures.
I sometimes decide I can do fine without it. I am always wrong.

I sometimes decide I can do fine without it. I am always wrong.

How are you able to determine that this is not a result of withdrawal? What's the longest you've been abstinent?

Gilbert@129

Yes you are right.For those of us that have this problem,you must avoid all food with folic acid.Eating food with folic acid can cause anything from cognitive problems,to seizures and temporary autistic regression,depending on how much is eaten.Further proof of the gut-brain connection.

AdamG

No it's not the result of withdrawal. It's autism.
Autism is not cannabis withdrawal any more than it is mercury poisoning.

What symptoms of cannabis withdrawal have you personally experienced when you've decided to go without?

Adam G: What percent of children with autism is cannabis effective for? We don’t know. That’s why it should not be approved for this use given the current knowledge base.

Also, I don't believe that the parents who are lobbying for this have their kids' best interests at heart. It seems to me to be just another attempt to turn the kids into lab rats. I wish I had more faith that people could be good parents to autistic kids, but the good, intelligent parents are so few in number!

Esther Knight: Yes we deserve better, no we don’t have that in our offices in the UK. I didn’t disclose, they don’t know, they can’t all be educated because I have to interact with external customers. I have to hide the autism or loose my job, Job hunting with disclosure seriously restricts the jobs you can get.

Doesn't the UK have non-discrimination policies similar to the American Disabilities Act? As far as I know, in the US, you couldn't be fired if you disclosed. You could also maybe request some position that doesn't require being the public face of the company.

As for eye contact, I have a simple trick to avoid it. I'm short, and I never wear heels, so as long as my eyes are in the general vicinity of their face or even their shoulder, I can easily converse with them.

Oh, joy, someone's brought up Wakey's theory.

Can you understand life in terms of mean-time-between-failures?

Yes.

The cannabis is not making me happy, but it is preventing the unhappiness that comes with repeat failures.

Honestly, if there was any drug -- licit or otherwise -- that people could take for happiness, I'd be all for it. But since I'm under the impression that there isn't, I wasn't suggesting that the cannabis made you happy. I just wondered if you had any opinions about how/why it worked.

I sometimes decide I can do fine without it. I am always wrong.

That's a drag. But at least it works.

AdamG the only symptoms of 'cannabis withdrawal' I get are:
- Decreased appetite for two days.
- Increase of tobacco consumption for the duration of cannabis cessation.
- Remembering nocturnal dreams.

Ann my guess on why it works would be to guess that some action on the endocannabinoid system is behind it?

@Esther Knight --

Well...Yes. But that's not really saying a lot. The endocannabinoid system is not implicated in autism. However, that doesn't necessarily mean anything, one way or the other. Low serotonin levels don't cause depression. But taking a pill that boosts them potentially alleviates it for some people for reasons that aren't really clear.

And....That's not really completely analogous, but never mind. Sometimes I just think that the human brain is too complex to be understood by the human brain, tbh. It is by mine, certainly.

So. Be that as it may. I can understand why it pisses you off to read things that appear to invalidate your experience. And I personally have no trouble believing that it's valid and believing that there's no evidence that cannabis has any efficacy for autism, at one and the same time. Because those things can both be true.

But I'm pretty sure that means we just disagree. .

Politicalguineapig--

Yes, the law says that you can't be fired, or refused a job, because of a disability. The problem is enforcement: especially at the job-hunting stage, it's difficult to prove that the reason for not being hired is discrimination, and bringing any kind of lawsuit against a discriminatory employer takes time, energy, and money that the disabled job hunter may not have.

I can't make sense of medical science papers much, but I know for sure I saw one that found that the average autistic person has more cannabis receptors of the second type?
That may be it?

Yes you are right there is no evidence for cannabis being effective in treatment of autism but that surely doesn't necessarily mean that it isn't?

I can't see anything we disagree on so far? Remind me?

E Knight: Believe me, I'm aware of the soulsucking void that is job-hunting. The thing is- you already HAVE a job. Which, I assume has an HR department. So, presumably, you could ask HR if they could arrange a transfer to another department which doesn't force you to interact with the public, which in turn means you don't have to resort to drugs.
Frankly, it sounds to me like your problem is not, in fact, Aspergers, but an anxiety disorder. Which leads us back to our thesis: marijuana might not be the best treatment for autistic people, especially if people are using it as a treatment to deal with the wrong problem.

Anxiety disorders are often found in autistic people. An autistic adult may misidentify the problem, and parents of autistic children generally tune out their verbal kids (or kids who use assistive tech) and won't be able to tell if marijuana is affecting a non-verbal kid, or a kid who can't use technology. And again, like with most 'cures' a marijuana cure would be entirely the decision of the parents, who, are, generally, a gullible lot.

Oh, and I'd like to point out, before the 'you don't know what it's like' card gets played that while I do not have Aspergers, I do have an anxiety disorder, and I'm aware of how much they suck.

Off topic- Orac, could you shut down the trainwreck that is Torquemada's thread? I hate to complain, but it does bad things to my computers.

Hi Pgp, Vicki is right and so are you. There are laws, the laws do nothing for us. No we don't have an HR dept or even a dedicated HR manager.
I personally don't suffer from anxiety so if that answers your question?

What cannabis most certainly does not do, is give us that spooky telepathic kind of emotional mind-reading that non-autistics take for granted. While it may make it easier for us to calmly observe others, we still have to try to deduce the meaning of body language consciously all the time.
Another thing it does not do is give us that ability to remember lots of things about other people that non-autistics take for granted.

I can’t make sense of medical science papers much, but I know for sure I saw one that found that the average autistic person has more cannabis receptors of the second type?
That may be it?

You're right that there is such a paper. And I can't really follow all the twists and turns in it either.

But fwiw, it's my understanding that findings of that kind in small samples are almost always very tentative because there's so much natural individual variation that nobody really knows what "normal" is -- ie, if you tested the CB2 levels in lots of people with and without autism, you'd get a number cross-overs in both directions.

Still. A finding is a finding. You're right.

I can’t see anything we disagree on so far?

Maybe we don't. I take it back.

While it may make it easier for us to calmly observe others, we still have to try to deduce the meaning of body language consciously all the time.
Another thing it does not do is give us that ability to remember lots of things about other people that non-autistics take for granted.

I don't know if you'd like CBT, or find it useful. Or interesting. Or if it's even an available option in some reasonably tolerable form where you are, ftm. But I think you'd be good at it.

Forgive me if that's presumptuous. You know yourself, and I don't. Obviously.

Esther Knight: How do you know the laws don't apply to you? Or that you can't talk to someone about making your work life a bit more pleasant?

And for someone who says she doesn't have anxiety, you put a lot of emphasis on how you appear to other people, to the point of needing a mind-altering substance to cope with day to day life.

Social skills aren't a 'spooky telepathic kind of emotional mind-reading.' They're learned reactions, nothing more. Again, not autistic, but I had to learn everything for myself and hide the process from people, so I do understand your reaction.
But really, same-gender interactions aren't all that complicated- most people just want a set of sympathetic ears in their life. And, by your own admission, you have friends and a significant other, so I think you're a lot better at socializing than you think you are.

I haven't been able to read all of the comments posted yet, but @24 and @25, Just because a mother is researching the effects of cannabis doesn't mean she is shameful of her child and wants to dope them up!!!! How dare you. I am researching to improve his quality of life. I have been to doctors all over the state of Ohio, not being able to pin point what is wrong with my child. I have tried behavioral therapy, had behavioral specialists in my home. My son has multiple diagnosis, Cerebral Palsy, Epilepsy, Autism, and Bi Polar disorder, and as his mother I am not even sure of the Bipolar, he has had genetic testing, and I was a mother who said she would never put her child on medicine, but now he takes 5. He was verbal until he was 3, now he only says a handful of words. It is like my child left. I want to help my child's quality of life, before meds he would have episodes of staying awake for 5 days straight, and I guess I just want to dope him up so I don't have to deal? I guess it has nothing to do with his well being? Have you ever stayed awake for 5 days? I give him meds to help him too, not to dope him up. During these days his heart would race, eyes dilate, black circles around his eyes. How dare you say something like parents just want to dope their kids up so they don't have to deal. I am just looking for ways to improve his quality of life. Not sure if I would ever do cannabis, but meds make him tremble, not eat, now he sleeps at school. So if there is a chance to research something, I try to educate myself to see if there are better possibilities for his quality of life.

@Orac,

You are correct that there is a significant dearth in scientific evidence for the therapeutic efficacy of marijuana in treating autism. Why? Scientific research is always guided by sociopolitical forces. Pro-lifers were successful in holding back embryonic stem cell research in the U.S. until recently, but it has set back research considerably.
Regarding research into the link between cannabinoids and autism, it is scientific researchers who are holding back the research, because they refuse to do it. This is probably because they're biased to believe marijuana cannot attenuate symptoms of autism, or if it can, the negative side-effects outweigh the good. What better incentive could there be for researchers to start taking interest, if there are parents out there who are giving their autistic children marijuana on a regular basis without knowing the potential harm?

As for the anecdotal accounts online from parents of autistic children, there are three points to consider:

1.) In all the accounts I've read, the parents detailed everything they have tried before resorting to giving their child marijuana. Since it's anecdotal evidence posted online, it could all be lies. But if they were all being honest, it would indicate the parents have nothing but the best intentions for their children's safety.

2.) The resources available for autistic children are usually very expensive, leaving out many who come from poor families. It's not surprising then for parents to give their child marijuana to calm him/her down, instead of paying a therapist $300 an hour for behavioral training or use expensive pharmaceuticals, which may not produce any significant changes in the child's anxiety, or it could make things even worse.

3.) We allow physicians and psychiatrists to prescribe antidepressants and stimulants for autistic children, as autism is typically comorbid with other mental-health conditions. Are they going off of extensive scientific research when they prescribe a medication to an autistic child? Or are they taking anecdotal suggestions from their colleagues or from what they read online?

In short, parents of autistic children feel they are completely on their own. I do agree that they shouldn't put their blind faith into marijuana. But if no one wants to do the research, and there are autistic children who are still suffering crippling anxiety and commit self-harm, even after extensive behavioral therapies, using potentially hazardous pharmaceuticals prescribed off-label, or have tried several special diets, are the parents to do nothing but keep plugging away with therapies that pass public consent, and hope for something good over time?

it is scientific researchers who are holding back the research, because they refuse to do it.

Do you have any evidence for this aside from your own feelings?

@AdamG

There is a lack of research into palliative treatments for autistic people alive today. Most research on autism is only concerned with either preventing or curing it.

There is still a stigma attached to marijuana in the scientific world; scientists are not imperturbable to societal influences.

@AdamG

For what it's worth, I did a quick google scholar search for "cannabis+autism," and all I found were studies on the prevalence of drug abuse in autistic teens and adults, nothing focused on autism and cannabis. I couldn't even find one study about any palliative treatment for symptomatic relief of autism: it's all about preventing or curing it.

The lack of studies, is evidence that researchers refuse to touch the subject.

Eric @173: In the United States it is generally illegal to do research with marijuana because it is a schedule I drug. No university would dare try to do research for fear of losing all federal funding. Researchers who want to do marijuana research must petition the ATF, and permission is rarely granted.

If you want the research done, don't complain to researchers who can't do it, complain to the "War on Drugs" that won't let them do it.

Also, it is only the "cranks" who are pursuing "curing" autism - the real research being conducted is primarily focused on helping those with autism better cope with the symptoms of their condition.

@AdamG

Ok I just found a review published this year (link to abstract below, full article available as PDF), and the conclusion fits with my premise: there is not enough research to officially condone using marijuana to treat developmental disorders like autism, but there are enough anecdotal accounts to strongly suggest that marijuana as a therapy should not be ruled out.

"Given the current scarcity of data, cannabis cannot be
safely recommended for the treatment of developmental
or behavioral disorders at this time. At best, some might
consider its use as a last-line therapy when all other conventional therapies have failed."

For some autistic children, no conventional therapy has helped them.

http://journals.lww.com/jrnldbp/Abstract/2015/02000/Medical_Marijuana__…

there is not enough research to officially condone using marijuana to treat developmental disorders like autism, but there are enough anecdotal accounts to strongly suggest that marijuana as a therapy should not be ruled out.

So then what is your specific disagreement with what Orac wrote?

@JustaTech

You're right that there are huge legal obstacles preventing researchers from procuring grants to research marijuana for any therapeutic application. But the only way to change those laws is if the public agrees to it, and the only way that will happen is if more researchers take the risk and apply for federal grants. People would read about it in the news, which would then start a public discussion on using marijuana to treat developmental disorders. The public doesn't even know they have an Endocannabinoid System, something we discovered in 1990. How else are they going to learn about the medical research, if researchers don't ruffle a few feathers?

@AdamG

My specific disagreement with Orac's argument, is we shouldn't bar parents with autistic children to try cannabis after they've tried everything else, just because there is a lack of scientific evidence.

*grammar corrrection

My specific disagreement with Orac's argument, is we shouldn't bar parents from giving cannabis to their autistic children after they've tried everything else, just because there is a lack of scientific evidence.

I guess you'd also agree with the statement - "we shouldn't car parents from giving their children Lupron, Industrial Chelation Agents or Bleach to their autistic children, after they've tried everything else, just because there is a lack of scientific evidence."

sorry - "stop parents."

I said the Endocannabinoid System was discovered in 1990, but that's only part of the story: cannabis receptors were discovered in 1990, but it was in 1992 when anandamide, an endocannabinoid, was discovered.

http://www.beyondthc.com/wp-content/uploads/2012/07/eCBSystemLee.pdf

Eric @179: There is a huge difference between "ruffling a few feathers" and shutting down the entire University of California system.

Yes, I agree that a lot more research needs to be done and the feds need to stop restricting researchers this way.

But you should know it could likely be decades before any results of that research makes its way into practice. Or the research may show that marijuana and marijuana-derivatives have no beneficial impact on children or adults with autism.

we shouldn’t bar parents with autistic children to try cannabis after they’ve tried everything else, just because there is a lack of scientific evidence.

Why?

@Lawrence

All the more reason for scientists to step in and investigate the matter in order to establish what works and what doesn't work.

I agree that parents shouldn't try just anything. There may not be enough research yet to show marijuana is safe for autistic people, but there is enough data on the functions of the Endocannabinoid System, and the therapeutic effects of phytocannabinoids, to strongly suggest the Endocannabinoid System could be a potential target for palliative treatment.

Those quackery-treatments you juxtaposed with marijuana have no supporting data whatsoever to suggest they do anything.

And yet, really neither does giving cannabis to autistic children either....

@AdamG

Two reasons why:

1.) For some parents, cannabis is the only thing which seems to calm their child down, and make them want to engage and bond with others. The same is true with autistic adults, as they are trying cannabis as well. There are mixed results all around, and some do experience paranoia. We should be researching why some benefit from cannabis and others don't, and allow those who do benefit, to continue taking it.

2.) Unlike the quackery treatments like bleaching or using Lupron or chelation-agents, there is actual scientific evidence connecting symptoms of autism with a deficient Endocannabinoid System, which is more than the aforementioned quackery can offer.

It is a risk, let's be clear, when parents decide to give their autistic child marijuana. But for those who have, and have had good results, we weren't there when their child held eye contact with them for the first time in the child's life, or became calm enough to be comfortable with being touched, even wanting to reach out and give affection to others.

Yes it is a knee-jerk reaction when parents decide to try marijuana, if it's because they read personal accounts from other parents online. But there are a lot of personal accounts, written in great detail, and they all seem to have the same experiences: their autistic children are more relaxed, more willing to engage in imaginative play, are more comfortable with holding eye contact and carrying a conversation, can eat again, and generally wish to socially engage people more often than they had before they tried cannabis.

@JustaTech

Researchers are presented with a Catch-22 then: they aren't allowed to research marijuana because it's considered a harmful drug, but in order for it to be considered safe, it has to be verified through scientific studies. I agree that researchers who wish to study marijuana, and I'm sure there are some out there, are faced with an unfair situation.

If research does eventually show marijuana is harmful, even for those who gain benefit from it, I'll be glad to learn it. Ruling out ineffective treatments only brings us closer to effective treatments.

Eric--

A few thoughts: the first is that if you want to lobby, talk to either President Obama or current presidential candidates about taking marijuana off schedule 1.

Second, the world is larger than the United States, and most of the world's population lives outside North America; what research into marijuana for people with autism is going on elsewhere? (Maybe someone should set up a research institute in Uruguay.)

Third, there are a lot of adults with autism. An autistic adult trying marijuana to help them deal with symptoms is a different question, ethically, from a parent giving it to an autistic child. (The things you're talking about, like problems with social interactions, don't magically fix themselves on a person's 18th birthday.)

@Vicki

Marijuana should definitely be taken off Schedule 1. One of the major obstacles I see standing in the way is the insurance industry: no doubt they'll lobby to keep it a schedule 1 drug, because they don't want to cover work/home injuries or medical problems if marijuana is involved, like they have to with alcohol-related incidences.

There probably are studies underway outside the U.S. Marijuana is being studied as a treatment for other mental-health conditions as well, which will undoubtedly provide insights as to why manipulating the Endocannabinoid System with cannabis, has an effect on symptoms of autism.

I should have mentioned earlier I'm a high-functioning autistic myself. You're right about the social difficulties not magically disappearing after I turned 18. I'm 29 now and I've been vaping cannabis oil on a regular basis since spring. Conceptualizing general concepts is much easier now than before I started, background noises are tolerable, and it's easier to let go of ruminating thoughts. Personally, it's better than a cure: it helps me enjoy life as I am!

I know not all autistics can benefit from marijuana, but I've read enough personal accounts online to be convinced there's at least a pattern. Correlation≠causation, I know, and I'm willing to admit I could be doing more harm than good to myself in the long term.

At least I'm avoiding the carcinogens.

Lawrence @176

I'm sure there are studies underway focused on treating symptoms. It's frustrating the research is so slow though, and I wonder if part of this is because we still don't have a unifying theory on what the pathophysiology of autism is. Risperidone and Aripiprazole are currently the only two medications approved for ASD, but it only treats irritability.

Marijuana should definitely be taken off Schedule 1. One of the major obstacles I see standing in the way is the insurance industry: no doubt they’ll lobby to keep it a schedule 1 drug, because they don’t want to cover work/home injuries or medical problems if marijuana is involved, like they have to with alcohol-related incidences.

You think that workers' comp covers on-the-job injuries caused by being drunk? For that matter, a quick check suggests that fewer states prohibit health insurers from denying claims based on the presence of alcohol in one's system than those that explicitly allow it.

Researchers are presented with a Catch-22 then: they aren’t allowed to research marijuana because it’s considered a harmful drug, but in order for it to be considered safe, it has to be verified through scientific studies.

ORLY?

@Orac

I forgot to address two of your chief complaints about the Michigan initiative: no defining guidelines on dosage, and no measure of marijuana toxicity. Parents giving their autistic children marijuana, typically give them a tincture to dissolve underneath their tongue. This is one of the most precise and easiest methods to measure out doses, by the milligram. As with Adderall and Ritalin, the dosage needed depends on the individual. There is a limit to how much THC is needed before it impairs their ability to function, but again, this limit largely depends on the individual. If, however, the strain used has a high Cannabidiol (CBD) content, the CBD actually treats the negative side-effects of THC*. Research so far has shown CBD taken by itself presents no danger of toxicity, even after acute, long-term administration (the combination of CBD/THC taken in the long term hasn't had a lot of attention, but it's being studied now).

As far as toxicity, it's still undecided if THC can actually damage the developing brain. Evidence strongly suggests it can impact those genetically predisposed to schizophrenia. But no one has concluded THC causes any lasting or permanent brain damage, even for chronic users who started early and later developed schizophrenia. For those who do develop bad side effects from THC, they could take a smaller dose if they still derive benefits from it, or just take Cannabidiol if THC stops working.

One major difference between this and prescribing children conventional pharmaceuticals, which is a stark contrast, is the absence of a physician to monitor and guide the administration of marijuana. I agree we need more research done. But in the meantime, these parents will most likely not stop giving their children marijuana, even if it remains illegal for them to do so. If the Michigan initiative had passed, families would have been more inclined to seek out professional medical advice, and fewer of them would be keeping their child's treatment a secret. This secrecy, no matter how it's looked at, is a major problem, and I believe the benefits of transparency trumps the potential unknown risks yet to be discovered.

*http://dmd.aspetjournals.org/content/23/8/825.short

the CBD actually treats the negative side-effects of THC

See Eric, this is why I can't stand people who have fooled themselves into thinking marijuana is anything other than recreational fun. That's not a bad thing...I use regularly recreationally and support full legalization. But which part of the study you cited has anything to do with treating negative side effects in patients?

Here's an exercise in skepticism for you. How do the concentrations of THC and CBD used in the study you cited compare to what's observed in humans after marijuana consumption?

Eric,

Did you happen to read that particular comment of mine:

http://scienceblogs.com/insolence/2015/08/06/medical-marijuana-for-auti…

Did it occur to you that marijuana is more harmful to me (and yes, the comment I made is about myself first, other autistics too) as compared to the prescription meds who saved my life. Do you know about the hypocratic sermon?? The one for which all the medical doctors supervising my health status are bound to obey wouldn't condone using marijuana because there is not enough data about its benefit while the harm I and others autistics have endured made them sure that they will never prescribe marijuana until there's better evidence that it doesn't cause cardiac and/or anxiety issue in their patients and the benefits outweigh the harms. Now do you get this picture or I have to use stronger language to insert these concern in your brain???

Alain

Medical marijuana for autism and autism biomed quackery: One in the same and on the verge of approval in Michigan

oracknows — Thu, 06 Aug 2015 07:00:59 +0000

Medical marijuana for autism and autism biomed quackery: One in the same and on the verge of approval in Michigan

When I first started writing about the claims made for medical marijuana and the cannabis oil derived from it, it didn't take long for me to characterize medical claims for cannabis as the "new herbalism," as opposed to pharmacognosy, the branch of pharmacology devoted to the study of natural products. The reason is simple. Although I support legalization of marijuana for recreational use, when I look at how medical marijuana has been promoted as a "foot-in-the-door" prelude to legalization, I see testimonials and flimsy evidence ruling over all. I see all the hallmarks of alternative medicine herbalism and none of the hallmarks of pharmacology. Here's what I mean. Pharmacognosy examines an herb, plant, or other natural product and seeks to identify the chemicals within it that have pharmacological activity against a condition or a disease, the better to purify and isolate those chemicals and turn them into drugs. Herbalism, on the other hand, emphasizes the use of whole plants or extracts from plants, rather than the isolation of the most active compounds. Thus, herbal remedies often contain hundreds, or even thousands, of different compounds, of which only one or a few are active. Even extracts, such as cannabis oil, contain many compounds.

In contrast to pharmacognosy, herbalists often make the claim that whole herbs and plant components possess a a sort of magical synergy that is missing from the purified active constituents and/or that the mixture is somehow magically safer than the pure components because one compound can reduce the side effects of another without reducing therapeutic efficacy. When looked at closely neither claim stands up to scrutiny. Synergism between plant constituents is rare and very difficult to demonstrate, for example. In essence, herbalism turns back the clock 200 years to a time before scientists had developed the techniques and abilities to isolate active ingredients with pharmaceutical activity. Moreover, herbalism, in contrast to pharmacognosy, emphasizes anecdotes over scientific evidence.

Indeed, in my previous posts in this series on medical marijuana, one theme has emerged, which is that cannabis—specifically, a class of active chemicals in marijuana known as cannabinoids—has potential for some diseases but is not the panacea claimed by its proponents. It does not cure cancer, for instance, contrary to glowing testimonials promoted by people like Rick Simpson. For other conditions, the evidence is either not particularly compelling or only mildly promising. The answer to the question of whether medical marijuana is good medicine is, as far as I'm concerned, mostly "no" and "we don't know."

So I reacted with considerable dismay last Friday night when I saw this news report on the 11 o'clock news, "Michigan panel recommends allowing marijuana for autism":

video platform video management video solutions video player

And, indeed, there have been stories all over the local news in Michigan like the one above and this one:

Note all the hearty cheering from the audience when the vote tally was read.

Here's what happened:

Michigan would become the first state to allow medical marijuana for children with severe autism if a senior official follows the recommendation made Friday by an advisory panel.

The state's Medical Marijuana Review Panel voted 4-2 to recommend autism as a condition that qualifies for the drug.

Supporters say oil extracted from marijuana has been effective in controlling extreme physical behavior by kids with severe autism. Pot wouldn't be smoked.

The panel was influenced by comments received earlier from some Detroit-area doctors, especially the head of pediatric neurology at Children's Hospital of Michigan, and parents desperate for relief. Many of the three dozen spectators cheered and applauded after the vote.

This is an utterly horrible idea, but it looks as though our state is nonetheless about to take the plunge into the Brave New World of treating autism with cannabis oil. Indeed, Michael Komorn, the President of the Michigan Medical Marijuana Association and the attorney who brought the petition before the board, basically admitted in the first news clip above that there was no science behind the board's recommendations when he said: "It's a no-brainer. And you heard the testimony of these people. They just want a little hope. That's all they're asking for." Notice the distinct lack of any mention of strong science as a rationale for adding autism to the list of qualifying conditions. Komorn even went so far as to tout how the parents "are responsible for growing the plants or acquiring the cannabis, and they are in charge of dosing, frequency of use, and method of ingestion."

Think about this for a moment. Is there another regulated drug for which this is the case? The board didn't even provide, along with its recommendation for approving autism as a qualifying condition for treatment with cannabis oil, anything resembling recommendations for dosing, method of ingestion, or frequency of use, very basic recommendations that, for example, the FDA includes in its approvals and even those evil drug companies provide for their poisons. (I do so love my sarcasm.) Yet, here, in the fantasy world of medical marijuana, apparently parents are as knowledgeable as physicians—more so, even, given that most physicians here have no idea how to prescribe medical marijuana—and no guidelines for use are needed. The lack of dosing recommendations is another powerful indication that there is no science behind this recommendation, because if there was science behind it we'd know the optimal dose and method of administration to use cannabis oil to treat autism. Clearly, emotion, not science, ruled the day on Friday. Indeed, how Dr. Harry T. Chugani, the head of pediatric neurology at an institution as respected as Children's Hospital could testify in favor of this nonsense is beyond me, but apparently he did:

"It seems to work. ... Wouldn't that be better than giving them all these psychiatric drugs?" Chugani said. "Not every autistic kid would take this, but if your behavior is wild and you have to be institutionalized, I as a physician would prefer to try medical marijuana. I have at least 50 patients on multiple drugs and still their behaviors are not controlled."

Notice that Dr. Chugani, too, didn't cite anything other than anecdotal evidence. How, for instance, did he know that the child isn't calmer because he's high on cannabis? And if we're going to drug autistic children to make them behave, why not use opioids or other sedatives as well?

In any event, if you want evidence that medical marijuana is far more akin to herbalism than pharmacology, we need look no further than my state's dubious position of becoming a "pioneer" in something that no state should be a pioneer in. That's why I'll first examine how the Medical Marijuana Review Panel got to where it is now, then the general claim that cannabis is a useful treatment for autism. Finally, I'll evaluate the existing scientific evidence, which is pretty thin.

Misguided activism advances cannabis herbalism

As has been the case with virtually all uses of medical marijuana sanctioned by states, the road to the Michigan Medical Marijuana Review Panel recommending approval of cannabis for autism began not with doctors and scientists clamoring for it based on evidence, but with parents becoming politically active to lobby for it based on emotional anecdotes. Such was the case in Michigan, and, if you've been paying attention to the "autism biomed" movement, this quote will sound very familiar:

The review panel voted 4-2 in favor of a petition submitted by Lisa Smith, a Michigan mother who has said cannabis oil has helped improve her severely autistic 6-year-old son's behavior, sleep patterns and eating schedule.

"The parents I've talked to are passionate and adamant that this represents a dramatic improvement in the quality of life for them and their affected children," said David Crocker, a medical marijuana doctor and member of the panel.

What other treatments for autism have we heard the same claims for? Let me think... Oh, yes. We've heard them for quite a few "autism biomed" treatments, with parents being just as passionate. Unfortunately, the vast majority of "autism biomed" is rank quackery. Examples include "Miracle Mineral Solution" (MMS, a.k.a a form of bleach fed to autistic children and administered as enemas for which miraculous results are claimed), chemical castration with Lupron, chelation therapy, GcMAF, and many, many other pseudoscientific "treatments" featured at quackfests like Autism One. I've even seen glowing testimonials touting homeopathy for autism and the IonCleanse® "foot detox" bath. As regular readers know, homeopathy is, as I like to say, The One Quackery To Rule Them All, and "foot detox" baths are a scam. Not surprisingly, segments of the autism biomed movement have embraced medical marijuana. For example, the "Thinking Moms' Revolution" (TMR) has numerous posts on its blog extolling the alleged virtues of medical marijuana for treating autism and advocating "freedom of choice." If you doubt the increasing embrace of medical marijuana by the autism biomed quackery movement, look no further than this ad for an Medical Marijuana for Children with Autism eConference, sponsored in part by TMR. Indeed, Jeff Bradstreet, the longtime antivaccine autism biomed quack who committed suicide a month and a half ago after the FDA raided his clinic was a speaker! So was a key supporter of medical marijuana for autism in Michigan, Lester Grinspoon.

Does this striking resemblance between autism biomed rhetoric and medical marijuana rhetoric mean that cannabis is useless for autism? Not necessarily, but it raises red flags. In any event, it would be more accurate to say that we don't really know whether cannabis oil is efficacious for treating autism. I mention this similarity between the autism biomed movement and medical marijuana movement to emphasize how anecdotal evidence is incredibly unreliable, particularly for a complex condition like autism spectrum disorder (ASD). If you don't believe me, consider this. Equally glowing testimonials for the rank quackery that is homeopathy to treat autism are not difficult to come by, which is one reason why testimonials are insufficient evidence upon which to base public policy; yet, that's just what is happening in Michigan—and has been since medical marijuana was first approved. Remember, autism is a condition of developmental delay, not stasis, and autistic children frequently improve as they get older. Some even improve sufficiently to lose the ASD diagnosis.

I understand (at least as much as someone who hasn't actually experienced having a child with special needs can) how parents would be desperate to do everything they can for their children, but personal experience and anecdotes, contrary to what is claimed, can be extremely misleading, as we've described here many times before. That's why anecdotes are not enough, and carefully controlled randomized clinical trials are needed, which, contrary to the claims of advocates, don't really exist. Indeed, the science cited in the petition, as we will see in the final section of this post, is inadequate to make such a major policy change, consisting as it does of mainly preclinical evidence and case reports.

How Michigan got to where it is today

With that in mind, it's useful to note that the road to this "victory" began years ago and actually represents a rebound from a defeat two years ago. In 2013, the Michigan Medical Marihuana Review Panel voted against adding autism to the list of indications for medical marijuana by a 7-2 vote:

Jenny Allen, whose 6-year-old son was diagnosed with autism several years ago, has tried giving him "mind-bending" medications, signed him up for behavior therapy and changed his diet. But his problems, including self-destructive behavior and biting, continue.

Now the 32-year-old Lansing mom wants to try giving him part of a brownie -- a pot brownie -- but was brought to tears Tuesday when the Michigan Medical Marihuana Review Panel rejected a petition that would have given her the legal means to do so.

The panel, in a 7-2 vote, gave a final recommendation against adding autism to a list of debilitating conditions suitable for treatment under Michigan's voter-approved medical marijuana law.

"I'm incredibly disappointed," Allen told MLive after the hearing, going on to question whether all panelists had thoroughly researched the topic. "I'm pretty shocked, actually, that nobody even brought up what the base condition is. It's rather appalling."

The panel made this decision in 2013 based on a correct assessment of the state of the evidence, which is that there is "not much quality, peer-reviewed research exploring marijuana as a treatment for autism," that the case for adding autism to the list of approved conditions for which medical marijuana can be prescribed consists almost entirely of anecdotes and testimonials, and that not enough is known about the effects of long term use of cannabis on the developing brain. This assessment was correct in 2013, and nothing has happened in terms of the existing science during the intervening two years to change that assessment. So what really happened to reopen the case?

Not surprisingly, it was litigation that forced the Department of Licensing and Regulatory Affairs to submit a new petition for autism to the Medical Marihuana Review Panel. It was submitted on behalf of a woman named Lisa Smith for her son Noah, who has severe autism:

Lisa Smith says her son's behavior was dangerous: hair pulling, kicks, punches, all related to a severe form of autism. But it began to change more than a year ago when he was given daily oral doses of oil extracted from marijuana.

"That's all stopped. He's more focused, he's calmer," Smith said of 6-year-old Noah. "He sleeps better through the night. He has a better appetite. You can tell he's growing, gaining weight."

Another parent who features in several of the news stories about this issue is Dwight Zahringer:

Dwight and Ixchel Zahringer's son Brunello is going on 4 but has yet to speak. Last fall, his parents heard the chilling diagnosis — autism.

"We've had a hard, fast education in this for the last nine months," Dwight Zahringer said. "Think of it like always being at a rock concert — everything really loud — and then you're trying to have conversations or focus on things but you can't because everything is overwhelming," he said.

The dealings with health professionals form a familiar tale — advice to use powerful prescription drugs that are costly and may have worrisome side effects, the failure to see that those drugs are helping and the decision to stop them.

The Zahringers have thus far been disappointed with the progress their son Brunello has made with conventional therapy, such as Applied Behavioral Analysis. Seeking faster progress, they found medical marijuana and latched on to it for hope:

"We've been watching a lot of videos, a lot of documentaries, and we've seen proof that it can help," said Ixchel Zahringer.

"One family had a kid who was very severe" with autism symptoms, "and they started giving him some of that (cannabis) oil, and they saw the child calming down."

Dwight Zahringer came to his belief that he needs medical marijuana for his Brunello the same way that many in the autism biomed movement come to the conclusion that their child needs, for example, MMS. He pored over Internet sites and marijuana-themed literature, which convinced him that he needed to try cannabis on his son ASAP. He started using hemp oil, which apparently gets around the state's current ban on treating autism with marijuana, but really wants the real thing. Parents like the Zahringers and Lisa Smith are clearly loving parents who want the best for their children, just as most parents who fall for "autism biomed" quackery love their children and want the best for them. Unfortunately, as we have seen and will see, the pro-cannabis literature and websites that tout cannabis as a treatment for autism provide a very biased and cherry-picked view of the medical literature.

Cannabis for autism: The evidence (or, more correctly, the lack thereof)

Perusing the news reports on the vote of the Michigan Medical Marijuana Review Panel, one point I've seen is that the reason why this vote came down in favor of adding severe autism to the list of qualifying conditions and the vote in 2013 did not is because the science was so much better described in the petition this time around. Indeed, advocates tout having bolstered the petition with "over 75 peer reviewed articles with over 800 pages of research on the issue of cannabis as a viable option for the treatment of autism" in addition to the "nineteen families, as well as physicians from MI and around the country." Apparently, two advocates had a major hand in picking these articles:

The individuals who navigated the deepest into the science behind Autism's riddling labyrinth of theories are without doubt Joe Stone and Dr. Christian Bogner. They were able to provide peer reviewed evidence that cannabis not only has the potential to provide palliative relief of symptoms related to autism, but may also have the potential to target the underlying causes of autism itself.

Note that nowhere in this report is mentioned evidence from well-designed clinical trials. In any event, I could not find the exact petition text, but there is a MoveOn.org petition to add autism to the list of qualifying conditions for medical marijuana in Michigan posted by Joe Stone and signed by Dr. Christian Bogner, Chad Carr, Dr. Harry Chugani, M.D., Dr. Lester Grinspoon, Michael A. Komorn, and Joe Stone. At the end, it lists links to research, specifically a paper written by Stone and Bogner that, one notes, was published online on the Cannabis for Autism blog rather than in a peer-reviewed medical journal, entitled "The Endocannabinoid System as it Relates to Autism". This paper is also available on Scribd, with a complete list of references. It is clear to me that this discussion, along with its references, was the basis of the science presented to the panel.

Before I address this paper, which appears to be the best evidence advocates can put forward, let me just refer you to a good solid analysis of the state of the evidence for cannabis for neurological disorders by Skeptical Raptor. You can read the whole thing if interested, but the point I want to emphasize is that there is weak evidence that cannabis could be useful for epilepsy, as I discussed in my first post on this topic, but that a Cochrane review concluded that high quality evidence was insufficient to recommend it. There is also some evidence for the use of medical marijuana for spasticity and pain. The reason that this is relevant is because advocates for using medical marijuana for autism frequently point to cases where cannabis is used to control seizures, which many autistic children suffer from. This is a separate issue than whether cannabis is specifically therapeutic in autism, but the two issues are often conflated.

Sadly, Stone and Bogner's "paper" is one of the most blatant examples of cherry-picked research I've seen in a long time, and that's saying something. Indeed, plowing through the list and looking up key papers was a tediously predictable endeavor. Basically, Stone and Bogner take papers that look at some aspect of cannabinoid function, whether it's about autism or not, and extrapolate to autism. Let's take a look at their most convincing piece of evidence first (to me, at least). In this case, by "most convincing," I mean least unconvincing:

"Rare mutations in neuroligins and nerexins predispose to autism" (Földy 2013). Neuroligin-3 is the only known protein required for tonic secretion of endocannabinoids that include AEA and 2-AG (Földy 2013). Neuroligin-3 mutations have been shown to inhibit tonic endocannabinoid secretion (Földy 2013). These alterations in endocannabinoid signaling may contribute to autism pathophysiology (Földy 2013, Krueger 2013, Onaivi 2011, Siniscalco 2013). These finding have in part prompted researchers to apply to conduct research with nonhuman primates in order to further elucidate this link (Malcher-Lopes 2013).

Endocannabinoid system deficiencies are suggested to be involved in the pathophysiology of a growing number of diseases (Marco 2012, Russo 2003). Pacher and Pertwee both cover the endocannabinoid system in detail (Pacher 2006, Pertwee 2010). The number of functions that endocannabinoid signaling regulate in the human body is extensive and beyond the scope of this paper (Pertwee 2010). For sake of brevity only a few potentially relevant aspects will be listed:

So what are these elements? Basically, Stone and Bogner cite a whole bunch of papers supporting the conclusions that endocannabinoids:

Modulate synaptic function
Regulate GI functions
Suppress proliferation and cytokine release in the central nervous system (CNS)
Regulate stress responses
Increase cerebral blood flow
Modulate neural and glial cell function

…you get the idea. So, yes, cannabinoids are important molecules in the CNS and elsewhere. No one argues against that. It's also true that it was recently shown that mutations in neuroligins and nerexins appear to predispose children to autism and that neuroligin-3 mutations inhibit endocannabinoid secretion, suggesting that bolstering endocannabinoid secretion might antagonize or reverse the abnormalities associated with such mutations. (A decent overview of this research suitable for a lay person can be found here, and the original paper is here.) Let's just put it this way. This is a rodent model, and right there it's a question of how relevant it is to real, human ASDs. This is very preclinical evidence, meaning that it might or might not turn out to be relevant to human ASDs. At best, it justifies further study. Moreover, the primate model referenced in Stone and Bogner's paper appears to be merely a proposal presented to a conference in Qatar. This is thin gruel indeed, as a recent review article on medical marijuana published in the Journal of Developmental & Behavioral Pediatrics by Hadland et al. points out:

Many advocates cite scientific literature regarding benefits of cannabis for the treatment of pediatric behavioral conditions, but often, data cited are from animal model-based research that does not yet have translation to human subjects. For example, a 2013 study ⁸⁰ from Stanford University showed that mice with a specific and rare gene mutation linked to autism showed altered endocannabinoid signaling in the central nervous system. These data were then cited by online and print media supporters of medical marijuana (e.g., the High Times ⁸¹) as evidence that cannabis could be used as a treatment for autism. As another example, when another recent study ⁷² based on a mouse model of Fragile X syndrome (described earlier in this review) showed alterations in endocannabinoid signaling pathways, these data were referenced (in this case, by more mainstream media outlets, such as the Huffington Post ⁸ and Fox News ⁸²) as evidence for a promising role for cannabis as treatment. Although these and other high-impact studies share important insights into the pathogenesis of autism spectrum disorders (ASD) and Fragile X syndrome, based on their results alone, it is erroneous and potentially harmful to conclude that cannabis should be used as treatment for either of these disorders at this time.

Indeed. Not surprisingly, Stone and Bogner's article references that very same study on Fragile X syndrome as well. Much of the rest of their article boils down to the list I enumerated above plus other correlations, their arguments reduced to, in essence, this:

The endocannabinoid system is important in [insert important CNS function or signaling pathway here] in preclinical cell culture and animal models.
Autism and ASDs involve abnormalities of this important CNS function or signaling pathway.
Ergo, cannabinoids can be used to treat autism and ASDs.
Q.E.D.

In other words, there's a whole lot of confusing correlation with causation and assuming pathogenesis when what is being observed might just be an epiphenomenon. There might be a direct role for these correlations in causing autism, and some of the signaling pathways might even represent promising targets, including the endocannabinoid pathway or a subset of it. Stone and Bogner go wrong by assuming all of these studies indicate a critical role for endocannabinoids in autism, such as elevated cytokine levels. For instance, take a look at this list of effects of cannabidiol (CBD):

CB1/CB2 agonist blocker (can inhibit overstimulation of CB1 by THC)
FAAH inhibition increases endocannabinoid levels (including AEA, 2-AG)
AEA reuptake inhibitor
5-HT1a agonist
Suppressor of tryptophan degradation
PPAR alpha and gamma agonist Positive allosteric modulator at glycine receptors
TRPV1 and TRPV2 agonist
Adenosine uptake competitive inhibitor
Antagonist at abnormal-CBD receptor
Regulator of intracellular Ca 2+ T-type Ca 2+ channel inhibitor (Izzo 2009)

This is a wide range of effects, some of which could be relevant to autism/ASD. The problem, of course, is that we don't know which ones are the most relevant and which ones actually involve promising therapeutic targets for intervention.

Extrapolate, extrapolate, extrapolate!

Whenever writing a research paper that is basic science that could potentially be translated into a treatment for a disease, it is generally considered mandatory to speculate at the end just how this could come about. For instance, when scientists write about cannabinoids in the context of models of neurodevelopmental disorders, after all the basic science, cell culture, and animal model work, naturally they try to describe how their results could be pursued so that they translate into a clinical treatment. It's known as showing clinical relevance to your findings, no matter how basic science they are. Stone and Bogner quote several of these sorts of speculative statements in the discussion or introduction of papers as though they were Gospel truth, then conclude:

Given the known role of the endocannabinoid system in ASD it seems entirely possible, if not likely, that cannabinoid rich botanical extracts from cannabis can be utilized as useful agents targeting the pathophysiology of ASD, as well as the many debilitating symptoms and conditions associated with it. The wealth of options that cannabis has to offer those that suffer from ASD in MI is not currently legally permitted. We believe that needs to change.

As I said before, Q.E.D. (Yes, that's sarcasm.)

Where's the beef (i.e., the clinical evidence)?

What all these 75 references really mean is that there is some correlative evidence that the endocannabinoid system is abnormal in autism. However, it's not at all clear whether these abnormalities are causative or downstream effects from the true cause or causes, whatever they might be. What this evidence means is that it's probably worthwhile to study the endocannibinoid system in autism and whether modulating its activity can have an effect on autistic symptoms. What it most definitely isn't is compelling evidence to authorize any doctor in the state who wants to do so to use cannabis oil to treat autism. Yes, because the law states two doctors have to sign off for use of medical marijuana in children, parents will have to find two doctors, but, really, does anyone think that will be very difficult?

To recommend a treatment for general use, we need high quality clinical evidence. Is there any such evidence for cannabis oil for autism? The answer is a resounding and unequivocal no. Indeed, an excellent indication of the paucity of evidence regarding cannabis oil and autism is the way Stone and Bogner dance around the issue by citing anecdotal reports about the use of cannabis oil and cannabinoids to treat epilepsy:

How can combinations of cannabinoids be put into practical use by individual families? For our purposes let's review the anecdotal reports of cannabinoid based treatments currently being utilized in MI (and around the world) for pediatric epilepsy. I think this is a good comparison due to the range and complexity of both conditions. CBD continues to prove its effectiveness in treating many types of epilepsy, but not all (Porter 2013). Anecdotal reports provided in online groups with families that share dosing and other related information to cannabinoid based pediatric epilepsy treatments reveal that in many cases parents (and physicians) find that an increased ratio of THC is required to increase the efficacy of treatment. The range seems to vary significantly from 24:1 to 1:1 (CBD:THC). Some partial explanations for this might include the ability of THC to increase GABAergic transmissions via CB1 activation, its modulation of ion channels, and that it's a PPAR gamma agonist which is neuroprotective in epilepsy (Stone 2014).

Due to the range of ASD it seems possible that, similar to cannabinoid based epilepsy treatments, varying ratios of cannabinoids (specifically CBD:THC) will prove to have a greater efficacy overall when compared to individual cannabinoid based treatments (like Dronobinal). This concept has been further supported by the research and clinical use of Sativex, a 1:1 (CBD:THC) botanical extract marketed for use in a range of treatments throughout the world (Hazekamp 2013, Russo 2006). The ability to specifically tailor cannabinoid ratios in botanical extracts from cannabis in a case specific manner may prove an even greater efficacy.

This is nothing more than handwaving, comparing two different conditions and assuming that what is observed in one condition will apply to another condition. Worse, as Skeptical Raptor reminds us, despite these anecdotal reports of benefit due to cannabinoids or cannabis oil in epilepsy, a recent Cochrane Review concludes that "no reliable conclusions can be drawn at present regarding the efficacy of cannabinoids as a treatment for epilepsy." In other words, there's no high quality evidence that cannabinoids are efficacious in treating epilepsy. There's even less evidence that cannabinoids can be used to treat autism. Indeed, as the aforementioned review by Hadland et al. notes:

Regarding human data on use of cannabis for developmental and behavioral conditions, to the best of our knowledge, the only available data are from small case series or single studies. For example, one 6-year-old boy with autism was treated with daily dronabinol for 6 months and was noted to have improvement in hyperactivity, irritability, lethargy, stereotyped behaviors, and speech, as measured by the Aberrant Behavior Checklist.⁸³ This single case study was uncontrolled and unblinded. In another single case study ⁸⁴ of a cannabis-using adult male with attention-deficit hyperactivity disorder (ADHD) off stimulants, the subject's driving skills in a simulated test during a time of abstinence improved after smoking marijuana (What is unclear is whether this subject may have actually been experiencing cannabis withdrawal from his abstinence, with alleviation of his symptoms through subsequent use of marijuana.⁸⁵). Another small case series ⁸⁶ showed an improvement in self-injurious behaviors among adolescents after dronabinol therapy, but to date, the study has not been published, leaving protocol details scarce. In sum, none of these studies provides sufficient, high-quality data to suggest that cannabis should be recommended for treatment of ASD or ADHD at this time.

And neither does Stone and Bogner's analysis, which was the basis of the evidence submitted with the petition to the Michigan Medical Marijuana Review Board to add autism as a qualifying condition for medical marijuana treatment. Their analysis is the very definition of cherry picking studies and extrapolating wildly from preclinical cell culture and animal studies and studies that address other conditions to conclude that cannabinoids are efficacious treating autism, while ignoring the dearth of evidence that counts: Actual clinical trial evidence. As the Cochrane review I cited pointed out, there were four randomized trials including a total of 48 patients using cannabinoids to treat autism. One report was just an abstract; another a letter to the editor. None of the trials provided randomization details, and there was no description of whether the control and treatment groups were equivalent. The studies were thus of incredibly low quality. All there are, are a handful of uninformative single patient case reports like this one.

Yet, when this this incredibly thin gruel was combined with emotional testimonials of distraught parents of severely autistic children, it was the emotional testimonials of distraught parents that won out. There isn't another drug for which the FDA or a state would give doctors the go-ahead to use to treat humans for conditions like autism or cancer based on such slim to nonexistent evidence.

Approving the use of cannabis oil for autism: "Premature" doesn't even begin to describe it

There is no doubt that the approval of medical marijuana for various medical conditions is driven far more by politics than science or clinical observations. For no condition is that more true than autism, for which even the anecdotal evidence is weaker than it is for other qualifying conditions such as chemotherapy-induced nausea, chronic pain, and epilepsy. Moreover, in this case, the Michigan Medical Marijuana Review Panel abdicated its responsibility to interpret existing science with respect to medical marijuana and autism. It is a travesty that the panel could take the cherry picked list of studies annotated with unjustified extrapolation of preclinical studies and conclude that there was a compelling case for adding autism to the list of qualifying conditions. The panel failed even to require that only relevant specialists, such as pediatric neurologists, be allowed to prescribe cannabis oil for autism and instead let any licensed physician (OK, two licensed physicians) do it. Worse, these physicians don't even have to monitor how often or how much is given to an autistic child for whom they prescribe medical marijuana. They can leave it all up to the parents, the vast majority of whom have no medical training.

This lack of oversight is a big deal because, contrary to what medical marijuana advocates claim, science still doesn't have a good understanding of what the long term effects of chronic daily cannabis use are on the developing brain. We do know that teenagers who were found to be dependent on marijuana before age 18 and continued using it into adulthood lose IQ points. One can argue that IQ is a poor surrogate for intelligence, but nonetheless such findings are worrisome. We do know that marijuana use is associated with abnormalities in the brain in young users in an exposure-dependent manner. There are other potential adverse health effects as well. In any decision to use a drug, there is a risk-benefit analysis, and thus far in autism there's almost no evidence for benefit and troubling evidence of risk when cannabis is used long term in children.

Fortunately, the recommendation of the Michigan Medical Marijuana Review Board is not binding. That recommendation will now go to Mike Zimmer, director of the Michigan Department of Licensing and Regulatory Affairs. He will have the final say over whether autism is added to the list of qualifying conditions. We in Michigan can only hope he realizes what a massive mistake the review board made and overrules their recommendation. Although new evidence might change this in the future, at present, medical marijuana for autism is unscientific herbalism, not pharmacognosy, and has no place in science-based medicine or state policy.

oracknows Thu, 08/06/2015 - 03:00

Categories

Brain and Behavior

So here's the question yet unanswered despite the length of this post:

If you favor legalization "for recreational purposes", what prevents someone from blowing (legal) pot smoke into their autistic child's face, or some other variation on the theme with extracted oils?

You have this very parochial way of framing these issues which doesn't help your argument. Much like the vaccine business, where you have expressed amazement that the mandate passed in California, you don't appear to have a very good understanding of human nature.

The American Academy of Pediatrics (AAP) has a clear, recent policy statement against the medical use of marijuana for pediatric patients (https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/American-A…), which is better than the policy statement they don't have regarding "alternate" vaccine schedules. But since the AAP has no spine when it comes to speaking out on anything that might give them backlash, I wouldn't hold breath waiting for them to speak out against this ridiculous recommendation that defies logic, common sense and science.

My closest friend uses cannabis for the relief of very severe chronic pain.

#1: It seems to come down to claims vs results. Does recreational use of marijuana produce a high - usually, thus the claimed "benefit" is achieved. Does medical use of marijuana achieve a medical benefit in any situation - maybe, but that requires evidence.

The reason false (or at best unproven) claims are harmful is they might: a) preclude other therapies that might be more effective, or, b) produce side-effects that could be harmful. Both these issues are tested in trials but not with just anecdotal evidence.

I think, zebra, that without legalization of this for children (which I oppose same as Orac), most parents pondering "blowing smoke" would correctly fear intervention by their state's child protective services agency and being charged with child abuse/neglect.

#4 douq millar

No, it comes down to making a fuss over the issue because pot is a "regulated drug"

Komorn even went so far as to tout how the parents “are responsible for growing the plants or acquiring the cannabis, and they are in charge of dosing, frequency of use, and method of ingestion.”

Think about this for a moment. Is there another regulated drug for which this is the case?

...while at the same time advocating that it be de-regulated.

Makes little sense to me.

#5 Chris Hickie,

So how about people who smoke tobacco in the house or give their teenager a beer? Or don't have their kids vaccinated?

Not sure where this is going #7. It is illegal in all 50 states in the US for teenagers to consume alcohol and some states have additional laws for prosecuting adults who knowingly give alcohol to minors. I don't know if there are any laws about tobacco smoke exposure to children in their homes but I have seen CPS called for children with severe asthma if home tobacco exposure is felt to be causative. Vaccination laws? Unless you've been in a vacuum, you know three states in the US allow only medical exemptions for attending school without being vaccinated whereas the other 47 states allow some sort of either personal or religious belief exemption.

Again, you give your kid a pot brownie or blow marijuana smoke in their face--that is child abuse/neglect. Period.

how about people who smoke tobacco in the house or give their teenager a beer? Or don’t have their kids vaccinated?

I wasn't aware of laws prohibiting smoking in a private home with or without presence of children? I know there are few states that prohibit smoking in a car with minor, though.

Nor is not vaccinating your children a crime.

Giving alcohol to minors in a crime, albeit one not rigorously enforced.

Currently, blowing cannabis smoke into the face of a minor is a crime.

The fact that a minor crime isn't enforced doesn't make it legal, even if the chances of getting caught doing it were minimal, and even if you try to compare legal and illegal acts, it doesn't make one the other.

Was there a point you were trying to make?

Orac's second link for TMR is written by Poppy whose 'nym derives from her interesting theory about opiates; IIRC she's the one who wrote about her son's 'parasites' going mad around the time of the full moon causing him to behave badly.

Another TM, Thalia Michelle Seggelink ("Tex') has recently helped create a group advocating MJ for autism in Austin, Texas ( see texasmamma.org).. They're "conservative Christian activists" and include a quote: Genesis 1 " Then G-d said, ' Behold, I have given you every plant yielding seed that is on the surface of the earth...'." I'm sure.

Disclosure:
I don't use cannabis and haven't really since university days- rarely then but I'm never one to stop a party.

I have no problem with it being legal. I personally know people who have used it recreationally since the mid- 1970s who have families and careers with no apparent damage to their psyches. And sure, I've met those who used it for physical illness. I don't think that it should be regarded as panacea for every problem though as a way to make it more 'respectable' and acceptable to the general public.

As a side note, I have traipsed around Mendocino County where its semi-legal. Supporters say that laws have led to an economic boom in depressed areas which have lost farming, fishing and forestry income in the past several decades.

I have no idea if this were true but they seemed rather happy to me. There are no angry drivers there either.
-btw- I didn't get any MJ but I did gather oakmoss which is an important ingredient in perfumery.

Forgot the quote from my last post.

"Even where the drug is legal, parental pot-smoking can be considered as a factor in child-neglect cases, just like alcohol. As a result, some parents have been accused of endangering their children and had them taken away by child protective service agencies."
(Source Washington Post)

Zebra @ 7
In at least 18 states, courts have ruled that subjecting a child to tobacco smoke is a factor which should be considered in deciding custody.

http://ash.org/custody-and-smoking.html

Vaccines and custody

As for alcohol

http://www.nbcnews.com/id/42807670/ns/health-childrens_health/t/letting…

http://www.huffingtonpost.com/2012/09/21/parents-still-mistakenly-belie…

#8 chris hickie,

Not sure where you are going either.

See my #6.

If pot is legalized, then the situation will be similar to alcohol, tobacco, and no vaccination-- it will be a high bar to intervene.

For the morbidly curious:
to read Poppy's articles- see TMR/ blogs by author/ Poppy
you may especially enjoy:
" Voodoo Magic Sugar Pills" and
" Bugs, Moon Cycles and Lunacy"

You know, if it's possible the high in marijuana means that kids might feel calmer and have more appetite...

... giving it to children, especially ones who are still developing communication skills, especially with a complete lack of dosage guidelines, strikes me as unwise. At least with other drugs, there's at least the pretense that folks care about the difference between 'totally stoned' and 'dialing down the symptoms with minimal side effects'*.

(Also, once again, I reflect on the fact autism is presented as a condition of un- or barely communicative children, rather people of all ages, may of which have developed communication skills as they grow up**. If cannabis for autism is so good, why are we getting the parents of autistic children and not the autistic adults? I assure you, we can write things on the Internet. )

* Whether or not this translates in practice is a different matter.
** As all humans do.

You blather on, at length, questioning synergy,( proposed by Sanjay Gupta, among many other researchers) "valid" pharmacognosy,which isn't even allowed per your friendly federal gvt., and yet you never ask the question that is so simple: Does it work ?

Honestly we have no idea "how" Cannabis is so effective on Dravet's syndrome. We do know it works, and has incredibly little in side effect.

Before we knew "how" alcohol sterilizes, by cell dehydration, membrane disruption, and protein coagulation, we knew alcohol was "good for wounds"

So while you want to be all upstairs in the ivory tower with your lab coat,and know why,or how, which undoubtedly has a grand place in medicine, lets not forget efficacy, and harm caused, or the lack thereof are top priority.

@CH #8 I believe it is legal to consume alcohol WITH your teen (16+) in Wisconsin. Certainly not endorsing the idea.

Although I'm on my way out of the door:

Becca, I seem to recall reading somewhere that use of MJ by children/ adolescents has deleterious effects on the development of skills like those called executive functioning and something else about applying themselves academically.

So you're an autistic adult: according to Ann Dachel, you aren't really here.

It is illegal in all 50 states in the US for teenagers to consume alcohol

Not exactly.

So was a key supporter of medical marijuana for autism in Michigan, Lester Grinspoon.

Zoiks, Grinspoon's still around? It was the annotated bibliography to Psychedelic Drugs Revisited (the only really valuable part of the book, as I recall) that set me on a quest to find a copy of Millbrook.

I seem to also recall there being an increased risk of schizophrenia among young regular users of marijuana. But hey, at least they won't be a hand full for their parents.

And Becca, thank you for commenting. While I'm sure that a lot of parents do want to do what's best for their kids, I would guess that there is also a not insubstantial personal motive among parents/caregivers to relieve their own stress. Calmer, less violent children improve the parents' quality of life, but I'm wondering how the children's quality of life is measured, particularly among nonverbal kids?

Let’s take a look at their most convincing piece of evidence first (to me, at least). In this case, by “most convincing,” I mean least unconvincing

They manage to cite one paper (Földy 2013) four times in the space of four sentences. TBF, there are other references in the quoted passage, but that strikes me as being a bit heavily reliant on a single reference. I'm not familiar with citation standards in medical journals, but the review paper by Hadland et al. is closer to what I am accustomed to than the Stone and Bogner paper. The latter authors' style of providing citations for every. single. sentence. comes off as being paranoid[1] about plagiarism charges.

[1]Which, I hear, is a side effect of marijuana use (not that I know this firsthand).

Another thought that crossed my mind as I read this: what effects would cannabis (whether in oil, brownie, or smoke form) have on an individual with pica, a disorder can be comorbid with autism? Would it increase their ingestion of non-food items? I did a quick search on PubMed and was unable to find any studies using the search terms "marijuana pica" or "cannabis pica".

As for the differing treatment of marijuana, tobacco, and alcohol, there are historical reasons. Several former English colonies in the Americas were founded for the purpose of growing tobacco and other crops (such as sugar cane) which are not suitable for the climate of England. Marijuana was not specifically grown for its intoxicating properties; rather, the purpose was to be a source of hemp fiber (i.e., rope), although some growers (including, allegedly, George Washington) did partake of the leaf. Alcohol of course has the history that beverages containing ethanol could be safely consumed, unlike water in most parts of the world--the other option was to boil the water to make tea or coffee. And in the US there was a concerted propaganda effort over several decades (most notoriously the mid-1930s film Reefer Madness) to demonize marijuana use--that's how it ended up on Schedule I when the Controlled Substances Act was passed ca. 1970. Other countries followed the US lead on marijuana; IIRC it was Paul McCartney's marijuana arrest in Japan that precipitated the breakup of Wings. Meanwhile, tobacco smoking was an unremarkable vice among my parents' generation; it has been mainly during my lifetime that it has fallen out of favor in the US, and it is still very much in favor in many other countries (most notoriously China and Japan).

And in the US there was a concerted propaganda effort over several decades (most notoriously the mid-1930s film Reefer Madness) to demonize marijuana use–that’s how it ended up on Schedule I when the Controlled Substances Act was passed ca. 1970.

A lot of it had to do with race panic, as I understand it.

Todd W.,

Recently published study contradicts some prior marijuana research

http://www.apa.org/news/press/releases/2015/08/marijuana-use.aspx

zebra, we hardly agree but I like the way you think is intriguing.

I don't know why Orac mentioned his support of legalization of marijuana for recreational use because I don't think it is germane to his point, but I also don't see your issue with it.

He's being entirely consistent with his other views when he writes:

"...at present, medical marijuana for autism is unscientific herbalism, not pharmacognosy, and has no place in science-based medicine or state policy."

Sorry. Bad html cut off Orac's quote in my last comment.

#28 see #6

A somewhat OT note but a tiny bit of sanity albeit not exactly logical in the drug world. Why under 12 is a really interesting questions that Health Canada does not seem likely to answer.

http://news.nationalpost.com/news/canada/labelling-on-homeopathic-produ…

@Not a Troll (#27)

Interesting. Though the studies I linked put the increased risk in the context of genetic predisposition to schizophrenia, rather than being a causative factor in its own right. Essentially, if one is already at increased risk of a psychotic disorder due to other factors, cannabis use can increase that risk a little bit more.

@Todd W.

Were you linking to multiple studies or just one? There is only one link.

Thanks for pointing out the context of a genetic predisposition. I should have clarified.

The reason there is no data is because it has been illegal and the DEA has hammered very severely anyone trying to get data on it.

It doesn't fit the "Pharma business model", where things like Oxycodone do.

From my experience (as someone with Asperger's and an extremely constricted affect from PTSD due to childhood abuse), it helped me a lot. I haven't used any in 25 years. I appreciate that my experience is an anecdote, and when I was using it, I also had senior clinician psychotherapy.

It is very unlikely to be a one-size-and-dose-fits-all-miracle, but it doesn't have to be to be helpful.

@Not a Troll

Ah, the second link was broken. Here's the other paper.

@daedalus2u

Agreed that the classification of marijuana as a controlled substance has definitely hampered research into its pharmacological effects.

That said, it's premature to start recommending it as a treatment for anything in the absence of evidence that it is a) efficacious and b) safe. What is the safest and most effective route of administration? What is the best dose? What duration of use strikes the best balance between safety and efficacy?

It ought to have been studied long ago, but that isn't a reason to give it a pass now, as many advocates would argue.

It is interesting that a scientifically studied subject (vaccination) needs to become political but a political policy (on marijuana) apparently requires no scientific study

zebra, I think your point in #6 would carry more weight if it was within the debate of medical marijuana in general and not confined to its use in minors for autism.

You lost me on why people breaking the law to blow smoke into their autistic kids' faces has any bearing on Orac's stance. They are freely able to do this now although there are legal consequences for doing so.

I'm glad that Todd W. clarified the role of genetics.

ALSO I wonder how much parents of kids with ASDs believe that MJ serves as a calmative or induces sleep?

#38,

Why would my point carry more weight if it "was within the debate of medical marijuana in general and not confined to its use in minors for autism."?

He started using hemp oil, which apparently gets around the state’s current ban on treating autism with marijuana, but really wants the real thing.

Why would anyone use hemp oil when the concentration of either THC or cannabidiol (CBD) is minute? I suspect that what the individual is referring to is not pure hemp seed oil, but the oil adulterated with added cannabidiol (CBD) derived from the leaves and stalks of hemp, which is otherwise known in the online marketplace as "CBD oil". To my knowledge, these products are virtually devoid of THC. They are also extremely expensive and illegal for sale as foods or dietary supplements in the U.S. for the simple reason that such high levels of CBD have not previously been consumed in foods in the general marketplace and therefore require safety studies beforehand, along with submission of the data to the FDA for approval as a New Dietary Ingredient.

As indicated by Orac, to assume that either CBD or THC are safe for use in ASD is clearly premature and tantamount to experimenting on people without established safety or efficacy beforehand. For that matter no one has fully established that either cannabinoid is responsible for the anecdotal accounts of improvements in children with ADS administered cannabis – a plant also known to contain numerous terpenes with pharmacological activity. Still, it wouldn't be the first time that anecdotal accounts and case reports of a plant product for a given medical condition led to a well controlled clinical study.

Assuming that endocannabinoid receptors are viable targets in the treatment of ASD, other non-THC phytocannabinoids might also be considered, as they are in cancer research: http://www.ncbi.nlm.nih.gov/pubmed/26179998

To muddy the waters further, there may be other experimental treatment options, including legally available extracts of non-toxic plants. In any case, they would also need to be tested in well controlled clinical trials, rather than relying on testimonials and anecdotes from either genuine sources or those disguised by marketers and others with an agenda.

oil adulterated with added cannabidiol (CBD) derived from the leaves and stalks of hemp, which is otherwise known in the online marketplace as “CBD oil”. To my knowledge, these products are virtually devoid of THC. They are also extremely expensive

Is this the stuff you have in mind? Tried (unsuccessfully) in NZ on a one-off basis to treat status epilepticus.
http://www.radionz.co.nz/news/national/276424/teen-receives-first-dose-…

There was also talk of a pure CBD extract approved for a clinical trial for seizure disorders.

Recently published study contradicts some prior marijuana research
http://www.apa.org/news/press/releases/2015/08/marijuana-use.aspx

I know that this is a press release and that the APA is going to puff its publication as much as possible, so they have an incentive to describe the results as "a little surprising", but aren't the researchers just replicating Shedler and Block's results from 25 years ago?

So here’s the question yet [sic] unanswered despite the length of this post and my failing to pose it until now

Is anyone else starting to miss the dental student?

You have this very parochial way of framing these issues

"Parochial" in what fashion?

which doesn’t help your argument.

Yes, Z.'s petulant quest has devolved into fantasizing about being a 10th-grade English teacher.

Much like the vaccine business, where you have expressed amazement that the mandate passed in California

Where's this, precisely? Do collate your sources so that you can properly contextualize them.

you don’t appear to have a very good understanding of human nature.

To the Moon, Alice Orac, to the Moon!!!

^ Eh, I wish I hadn't b0rk3d the last blockquote.

@ her doktor bimler #42:

Yes, that would appear to be it, although there are other similar products available. Basically, we're talking either a solvent or supercritical CO2 extract of hemp leaves and stems for a CBD-rich fraction mixed with hemp seed oil readily obtainable from China or Canada. The immediate market is parents of epileptic children residing in states where marijuana is not legal. Otherwise, they would be able to obtain CBD-rich marijuana products popularly touted as effective.

You may already have seen this:

https://www.aesnet.org/sites/default/.../cannabis%20release%20vfinal.pdf

The British League of Nerds podcast did an episode on Cannabis Quackery with respect to cancer, the comments from the guest (Cancer researcher Vicky Foster) are well worth hearing:

https://www.youtube.com/watch?v=ieIshXCOHe4

@herr doktor bimler #43

I am not qualified to answer that question so I asked someone. If they get back to me, I will let you know their answer.

Meanwhile, I found an outline of the debate of impacts of MJ use in the general population. It has been going on a long time and I don't expect it will resolve anytime soon.

http://medicalmarijuana.procon.org/view.questions.php?issueID=000029&su…

@zebra #40

To clarify, I find the discussion here to be concerning the regulation of medical marijuana. If Orac accepts both a social use and a medical use, then I don't see why he can't discuss the regulation of each independently.

For the interaction between the two, it isn't that you can't have an argument about allowing social or medical use or both or neither but that is a different discussion. And, that is where I think you're at.

Regarding the association between cannabis and psychosis: https://www.ncbi.nlm.nih.gov/pubmed/11185941

This is an old review, but I'm not sure current thinking is terribly far from their conclusions.

There is definitely a correlation between schizophrenia and marijuana use, but schizophrenia also correlates with use of most other drugs, and the causation is probably from schizophrenia to drug use, though how direct is uncertain.

As for marijuana causing schizophrenia, the evidence is unclear, and interpretations less so. In a person with no history and low risk factors for psychotic episodes, the increased chance of developing schizophrenia from marijuana is as close to zero as anyone can detect.

If you specifically look at individuals with genetic predisposition for schizophrenia, a risk seems to appear, though it's unclear how to interpret this. It may be the case that marijuana is a risk factor for schizophrenia only given certain genetics, or it may be that marijuana can trigger psychotic episodes in undiagnosed schizophrenics.

To put that latter hypothesis into context, imagine someone takes marijuana and has a psychotic episode. After he comes off his high, he suffers further drug-free psychotic episodes in the future and is eventually diagnosed with a mental illness. Now of course the psychotic episodes could be totally unrelated to the drug except by coincidental timing, but there is another possibility: This user would have developed his illness anyway, but five years later. We would never know, and a study would have to be carefully designed to even look for this at the population level.

These more recent reviews may prove useful:

Psychosis and cannabis:
http://www.ncbi.nlm.nih.gov/pubmed/26235479

Schizophrenia and cannabis:
http://www.ncbi.nlm.nih.gov/pubmed/26235754

Adverse effects of cannabis:
http://www.ncbi.nlm.nih.gov/pubmed/25287883

OT: On epilepsy and cannabis (Epidolex; GW Pharmaceuticals):

The link I posted above ("You may already have seen this") is to a press release you can find online under: Three Studies Shed New Light on the Effectiveness of Cannabis in Epilepsy. American Epilepsy Society, October 14, 2014.

I can't be the only one who kept reading their names as "Stoned and Bonger"

As an attendee at a large cannabis club with many hundreds of members from the ADHD and high functioning autistic categories, myself dyslexic and ADHD, I can categorically state that reducing stress via cannabis, has been a lifesaver to many who are sufferers of these neurological complaints.
Other peoples ignorance of these disorders, especially including med-staff, are a major cause of stress for sufferers.
Hell is of other people.
'Ganga' literally means in Sanskrit: stress leaving body.

re Bob a few comments up.

A study was released this week showing no correlation with cannabis and psychosis. The main risks are from first timers freaking out, respiratory health for long term heavy users, and cadmium build up from smoking carbon based material, any carbon based material....
Cannabis users become reflective, which can trigger questioning, guilt, shame or a spiritual and existential crisis.

http://www.independent.co.uk/life-style/health-and-families/health-news…
No matter how much marijuana you did in your rebellious youth – or how little because you were a good lad – it will not come back to haunt you as an adult much at all.

That is the surprise finding of US researchers in one of the only studies to have tracked teen users of marijuana over two decades.

First surveyed at 14 years old, the 408 young men were followed until their 36th birthdays by the University of Pittsburgh Medical Center, a leading American healthcare provider, and Rutgers University in the US.

Even though 22% of the participants were chronic users of marijuana – smoking the drug regularly every week – they were no more likely than their old schoolmates to experience depression, anxiety, psychosis or asthma by their mid-30s, said the report...............cont in link

The link I posted above (“You may already have seen this”) is to a press release you can find online

Many thanks.

#49 Not a troll,

"For the interaction between the two, it isn’t that you can’t have an argument about allowing social or medical use or both or neither but that is a different discussion."

If pot is made legal, how would you distinguish between "social use" and "medical use"? How would you "allow" or not "allow" "medical use"?

See #1.

re Bob a few comments up.
A study was released this week showing no correlation with cannabis and psychosis.

The Independent journalist there is churnalising the press release from the APA linked by Not a Troll in comment 27.

If pot is made legal, how would you distinguish between “social use” and “medical use”? How would you “allow” or not “allow” “medical use”?

The distinction would be on how it could be marketed, sold, and paid for. If it were legalized, but not for medical use, then it could not be sold with specific health claims, would not be available by prescription, and it would be unlikely to be covered by medical insurance plans. It could also be possible to legally restrict its purchase and use to an arbitrary subset of the population (example: cannot be purchased or consumed by anyone under 21) without an exception to treat a medical condition. It would not, of course, be possible to prevent people with using it with the goal of treating a disease, real or imagined, based on rumor or science.

...prevent people from using it ...

I think I'd rather take Sanjay Gupta's word over this author. I mean he works for CNN and turned down the position of Surgeon General of the United States.

Just because this author is a surgeon doesn't impress me. Being a surgeon is not that uncommon, being writing speeches for Hillary Clinton. And having your own show on CNN while you still perform neurosurgeries is. Tell me this author, do you think you're smarter than Sanjay Gupta?

This is such a pointless debate. It is so hard to study cannabis in this country, this would be like debating genetics the a few months after sanger sequencing was invented.

There are little to no facts, and trust me if you know medical marijuana patients there are 2 types. Some just enjoy the drug to relax after work (nothing wrong with that.). But some people are actually getting relief. You tell me, Author, if it's quackery how come I've seen the same woman with MS painfully make her way back to the dispensary each week?

Do some real research, don't just sit behind you're computer and write biased articles.

#59 M O'Brien,

Hence my comment #1.

@Joseph - based on his reading of marijuana research, Orac has concluded that there is very little good evidence that it provides a significant medical benefit. It is irresponsible to prescribe an unproven drug to treat a condition, whether it's marijuana or the latest offerings from GlaxoSmithKline.

If you have evidence to the contrary, please share.

If some day a good study is conducted, possibly in a country that has legal marijuana, that shows a significant clinical benefit, I'm sure everyone would be interested.

So Orac is a lesser doctor than Sanjay Gupta. Got that.

Joseph: if you'd actually bothered to read this post, and many of Orac's other posts about marijuana - he's not opposed to recreational use and has said so many times. What he IS opposed to is all the groups that have jumped on cannabis in various incantations and claim it's a "cure". It may help in some medical cases, but the research is too inconclusive or not there.

Hypothetical situation, Joseph: I created this GREAT medication, my friends and family have all tried it and are getting results. We're losing weight, looking younger, never get sick. My autistic cousin is calmer and even speaking words now. My aunt with cancer's mass went away! I can even point to some very basic studies that show it isn't toxic at the recommended doses. No, I have no studies that show it really works...but everyone who's tried it says so, so it must work!

I'll sell it to you cheap, to give to your child. Would you buy it?

#65 MI Dawn,

I have no dog in the fight WRT joseph, but the answer is of course I would give a non-toxic substance to someone, if it made them feel better or gave them otherwise unavailable hope.

That's probably why those French GP don't get all wound up about providing homeopathic stuff on occasion:

http://www.ncbi.nlm.nih.gov/pubmed/25921648

"If pot is made legal, how would you distinguish between “social use” and “medical use”? How would you “allow” or not “allow” “medical use”?"

zebra, you're in luck. Four states have worked/are working on that very thing. We'll see how it goes.

For your observation that Orac doesn't appear to have a very good understanding of human nature, I am inclined to think that you do not.

It's not earth-shattering news that people break the law or that MJ is not already widely available. However, not all who avoid risky behaviors do so because there is a law and not all who obey a law do so out of fear of being caught. Some obey it out of common sense and principle and there is principal here. It is that if a substance is claimed as a medicine it needs to abide by similar regulations as other medicines regardless of its availability legally or illegally. While you're pondering that, also consider how I can defend Orac's POV while not supporting legalization of marijuana.

I would give a non-toxic substance to someone, if it made them feel better or gave them otherwise unavailable hope.

Chicken soup?

zebra, well if you're giving it away and not selling it, that's a plus. But why not offer them love and compassion instead of lying to them? A ride to the doctor's office, clean their house or cook them a meal?

#67 Not a troll,

"...not all who obey a law do so out of fear of being caught. Some obey it out of common sense..."

Then they are not "obeying the law", they are just acting out of common sense-- the same as if there were no such law on the books. There's no law against touching a hot stove...

Some people "obey the law" not out of fear of the actual punishment dictated by the law, but because they have an Authoritarian psychology-- that is, they experience negative feelings if they "break the rules". That's how "morality" often works.

Not sure which category you are talking about; maybe the latter is what you mean by "principle/principal"?

Agghh.. Epic spell check fail. Should have been "principle" always.

Common sense follows a law just one that the precedent may or may not be on books. I obey the law in the eyes of the law and society whether out of fear or common sense so the pragmatist in me doesn't care.

@Bob #50,

Thanks! Your summary was very helpful for me in understanding where we are currently at in this debate.

I'm tired of how people don't understand that autistic people have reasons for a lot of their behaviours. It would help if they actually ASKED autistic people about these things. There are many autistic adults, even non-speaking ones, who can give a lot of insight into autistic behaviours but no, we can't have autistic people having a say about autism, can we? No, it's all about forcing things like ABA that a lot of autistic people consider abusive and unhelpful or forcing all kinds of nonsense on them. I hate that.]

Though, i do wonder if reefer would cause me to calm my tits and not get so constantly obsessed with things that frustrate me like this concept of tormenting autistic people for their own good.

#71

Well, I think you should read #59, which is a very clear statement of the situation. This stuff you are saying about

"It is that if a substance is claimed as a medicine it needs to abide by similar regulations as other medicines regardless of its availability legally or illegally."

doesn't really mean anything to the individual, who may or may not want to use pot whether from "common sense" or "principle".

doesn’t really mean anything to the individual, who may or may not want to use pot whether from “common sense” or “principle”.True enough. As a doctor or a pharmacist, though, there is an ethical dilemma when recommending something that may not hurt but is not shown to help. A legislator should (but probably won't, as she/he is a legislator after all) also have issues in backing legislation justified by flimsy evidence, or which is clearly intended to be pure subterfuge.

^ Just because it is not a necessity doesn't signify that it has no meaning. It means a great deal to me and I wish it mattered to more.

Which is why I hold Orac in high regard. I'm sure we disagree on many things but he is attempting to hold the line in defense of his profession and I find that very admirable.

#73
Yup, definitely works at calming tits, with few to no side effects to boot! Give it a try if you can.
Plus stoners are more accepting of autistic people, so the companionship within a club environment is fantastic.

Compared to the disappointment and frustration of mainstream medical services for autistics the difference was like night and day.

It was the supportive family I never had, and I miss it greatly.

Becca @ #16
Adults with autism who use cannabis: There are xillions* of us but we don't have autism (because of the cannabis) and it's completely obvious why you don't get to hear about it.
You wont find us on your autism forums and in your autism groups because we are just getting on with life amongst the human race instead of hanging out in rainbow jigsaw land.
You wont find out about us because cannabis is illegal, duh, and we don't have autism so we are not going to loudmouth it everywhere.
You wont find out about us because moderators love to censor autistic adults. Ditto talk of cannabis.
You wont find out about us because if we were to boast that cannabis was fixing our autism, we would be admitting to having autism, and that defeats the object, which is not to have autism, which is why we use cannabis.
Any questions?

I share some of the same concerns as other readers here. In an ideal world we would absolutely have multiple independent clinical trials. Unfortunately, we don’t live in an ideal world, and evidence based medicine doesn’t dictate that doctors wait in extreme situations. It’s also not as if Marinol isn’t being prescribed commonly off label in these situations anyway. THC is obviously the concern being cited in terms of brain development. Unless there is a claim that these oils (often with greater amounts of CBD than THC) are potentially more harmful than pure THC itself, then these arguments in regards to brain development are somewhat moot. Additionally, there may be evidence that isn’t being considered within this discussion. This seems likely to be the reason that pediatric neurologists working with many of these parents including Dr. Harry Chugani, and Dr. Jules Constantinou, both support this policy. It’s possible that they support this policy because they’ve witnessed successful turnarounds and they seek legal protection for a greater level of involvement on their behalf. These aren’t “friendly pot docs”, these are respected experts. The denial of this policy only serves to ensure that their involvement remain limited, which stifles the possibility for sound research to be conducted, and guarantees that families are truly on their own.

This policy is currently being framed within this discussion as a giant leap into the “brave new world”. Flimsy preclinical evidence leading to mass experimentation. From an outside perspective I can appreciate how this policy might be interpreted this way. However, the fact is that the supporters of this policy aren’t suggesting that everyone on the spectrum explore these therapies. Rather, legal protections for families choosing to explore these options as a last-line therapy when two certified physician with bonafide relationships with the patients have agreed that it may provide palliative relief is being
sought.

Entirely overlooked, albeit with some sound reasoning that’s been provided, are the families that are currently utilizing these therapies with success. Chugani and Constantinou have provided care to some of these patients, and their support for this policy is based off of their clinical expertise combined with the next best external source of evidence. In this case that happens to be preclinical research by in large. A large number of families currently utilizing these therapies have been willing to come forward. They’re already procuring oils that have been analyzed to ensure a known level of
active constituents are present, and self-titrating with success. Due to a lack of legal protections it’s often parents helping parents at this point with these aspects. Undoubtedly, a greater level of involvement from experts would be preferred. That’s what this policy would permit.

Denying this policy won’t stop the therapies that are currently claimed to be fostering improvements. It only prevents the experts from playing a larger role in these therapies. Many parents aren’t willing to wait decades for multiple clinical trials of specifically tailored cannabinoid ratios to become available when they already have access and success utilizing them now. Should they be arrested for that?

Once again, anecdotes don't show that something works. I can provide anecdotes about homeopathy providing near=miraculous results for autism, and homeopathy is nothing but water. This is not limited to parents, but to physicians who have been fooled as well. Clinical expertise without clinical trial evidence often misleads, and clearly Dr. Chugani doesn't realize that. A lot of doctors don't, unfortunately. What Michigan is on the verge of approving is, in essence, legalizing what is currently a form of autism biomed quackery. Bogler and Stone's recounting of the "evidence" for medical marijuana for autism is risible in the extreme, purely cherry picked. At best, it's evidence for further preclinical study. At worst, it's a justification for quackery, prematurely extrapolating from preclinical evidence that might or might not be relevant to autism.

Nobody is denying that clinical trials are the gold standard, but to suggest that off-label meds aren't commonly in use that haven't been studied with autism the way you're describing would be inaccurate, or disingenuous. Also, we’re not just talking about just Dr. Chugani, Dr. Constantinou is also an avid supporter. Not giving any weight to the parents on their own is one thing, but when the specialists involved with providing care agree that the cannabis therapies delivered undoubtable value, you at the very least expect them to be able to exclude any other interventions being utilized. You’re right in that this still isn’t sufficient evidence to recommend everyone on the spectrum to try cannabis therapies, but none of the supporters are suggesting that. However, in similar situations that these experts have witness these therapies work in the past, very severe cases, as a last-line therapy they should be granted access to the same pharmacopeia that’s being safely utilized by other segments of the population, including minors. This is being framed as mass experimentation when in all reality that’s simply not the case. This policy ensures the role of two qualified physicians in these therapies, rather than the families doing this on their own as they have been up to this point.

Are your homeopathic examples accompanied with preclinical evidence suggesting a role for them in targeting the system involved in the pathophysiology of the condition? Has the water been documented preclinically to reduce cognitive deficits associated genetic variances commonly associated with the condition it miraculously treated? Is there clinical and preclinical evidence describing the physiological mechanisms involved with this underlying system, and the pharmacological usefulness of your water in targeting the system in order to provide palliative relief for the most common ailments associated with the condition? Are there multiple experts that specialize in their field that have concluded that the water is of therapeutic value through the act of providing care for individuals that have utilized water therapies? Are people being arrested for using that water? If so, I’d take another look at the policies on that water.

Nobody is denying that clinical trials are the gold standard, but to suggest that off-label meds aren’t commonly in use that haven’t been studied with autism the way you’re describing would be inaccurate, or disingenuous.

Apples and oranges. Off-label use is defined as using a drug that is already FDA-approved for an indication other than the one that the FDA approved it for, usually based on clinical trial evidence suggesting its efficacy and safety for the off-label indication. Since cannabis oil is not FDA-approved for anything resembling autism and, even if it was, there is no good clinical evidence that cannabis oil is efficacious in autism, your use of an analogy to off-label prescribing is what's disingenuous, not my post.

lso, we’re not just talking about just Dr. Chugani, Dr. Constantinou is also an avid supporter. Not giving any weight to the parents on their own is one thing, but when the specialists involved with providing care agree that the cannabis therapies delivered undoubtable value, you at the very least expect them to be able to exclude any other interventions being utilized. You’re right in that this still isn’t sufficient evidence to recommend everyone on the spectrum to try cannabis therapies, but none of the supporters are suggesting that.

They're suggesting that parent who can get two doctors to sign off on it should be allowed to use medical marijuana on their autistic child without anything resembling what I would consider proper medical oversight. As for doctors other than Chugani, the same thing applies as what I said above. In a condition like autism, personal clinical experience can be very misleading, thanks to confirmation bias (remembering what supports your belief and forgetting what does not, or remembering the "hits" and forgetting the "misses"), placebo effects, observation bias, etc. It is because, especially for conditions like autism, even experts can be fooled, that randomized clinical trials, preferably double-blinded, with outcome measures as objective as possible are needed.

As for your bit about homeopathy, you're misunderstanding Bayes' theorem and exaggerating the quality of the preclinical evidence for medical marijuana in autism, which is thin gruel indeed. But if you want another example, I can find glowing testimonials in autism for secretin, chemical castration by lupron, bleach enemas, and a wide variety of supplements.

Based the fact that one of those off-label drugs is pure THC, I think my analogy is perfectly acceptable. Unless the claim is that botanical extracts with greater CBD:THC ratios is of more concern than THC itself. Even NIDA publicly cites the safety and efficacy of CBD. In large part, CBD is the additional cannabinoid being added in comparison to current Marinol treatments.

Yes, two physicians are required for approval. If physicians aren't qualified to diagnose, and/or don't have a bonafide relationship with the patient then that seems like an issue with those physicians and not this policy. We seem to agree that more research should be conducted. This policy provides the legal framework for more robust research.

While the paper being cited doesn't fully delve into the specific mechanisms involved with each individual type of palliative relief that the cannabinoids present in botanical extracts from cannabis can provide in symptoms associated with autsim, that doesn't mean that more evidence isn't available. The preclinical evidence in regards to the genetic variances has been provided, and preclinical in vivo experiments have documented CBD as reducing the cognitive deficits associated with FXS in mice.

It seems to me that you likely take issue with the MMMA itself. Medical cannabis laws allow for the use of non FDA approved cannabinoids for the purpose of providing palliative relief in a number of medical conditions. It seems that possibly by your standards that none of the currently accepted conditions that qualify for medical cannabis should be allowed. This too seems to be a separate issue from this policy specifically.

MMMA is a compassionate law enacted to protect patients, families, and physicians that participate in cannabis based therapies for the purpose of palliative relief.If you don't approve that's an issue to take up with the voters. The fact still remains that there is ample evidence in regards to cannabinoids therapeutic value in terms of palliative relief in symptoms associated with severe cases of autism. As the director of the Autism Alliance of Michigan, Stephen D'Arcy, stated in written testimony provided to the panel: "It is unreasonable to deny them the same access to pharmacological treatments presently afforded to many others in the community. This is in fact a form of discrimination against our citizens with autism. As with other pharmacological products we expect that physicians authorized to prescribe medical marijuana will pursue appropriate medical pathways in exploring the possible use of this drug in the autism community."

Really Orac?
You can find glowing testimonials for 'secretin, chemical castration by lupron, bleach enemas,' coming from autistic adults, not just your darling parents?
Sceptical now, impressed later maybe?

13 years ago: http://www.letfreedomgrow.com/articles/poll021120.htm

'It begins 'While conceding that Internet website polls are hardly scientific.." and ends "Finally, we note an astonishing ten patients (2%) using cannabis for the treatment of autism."

Medical cannabis laws allow for the use of non FDA approved cannabinoids for the purpose of providing palliative relief in a number of medical conditions.

No $#!+.

See http://www.unitedpatientsgroup.com/resources/illnesses-treatable

It seems that pot will treat everything from diabetes to hypoglycemia, anorexia to obesity, and constipation to diarrhea. Truly a wonder drug.

I'd say the bigger story is the fundamental role that the endocannabinoid system plays in human health and disease. It's an absolute fact that its discovery is leading to a greater understanding of the pathophysiology of a number of conditions, and appears to be a potential therapeutic target in the treatment of many of them. Additionally, natural compounds that target the endocannabinoid system are vastly prevalent throughout nature, not just cannabis. Though this paper is now outdated (2006), it's provides a decent overview: http://pharmrev.aspetjournals.org/content/58/3/389.short

http://www.ncbi.nlm.nih.gov/pubmed/26216231

Neurotherapeutics. 2015 Jul 28.
Endocannabinoid Signaling in Autism.
Chakrabarti B, Persico A, Battista N, Maccarrone M.

Can anyone access the full paper and tell us what it means please?

So, a very interesting discussion all around, and we still don't have an answer to the underlying logical flaw in Orac's position:

If, as Orac would like, pot is legalized, then the major impediment to his parade of horribles, with parents experimenting and so on, is removed.

Now, I doubt pot is a "universal wonder drug", but that's irrelevant. What's relevant is that Orac is not arguing for the benefit of the children involved, but for some (poorly conceived and/or articulated) principle or concept to which he is obsessively attached.

Oh boy, look who showed up!

zebra@89

If, as Orac would like, pot is legalized, then the major impediment to his parade of horribles, with parents experimenting and so on, is removed.

Except it wouldn't. In fact, there would likely be additional legal impediments. If marijuana was legalized, any responsible law doing so would restrict children from using it (much like is currently the case with alcohol). A parent giving their child marijuana would likely face similar consequences to a parent supplying minors with alcohol.

Now, I doubt pot is a “universal wonder drug”, but that’s irrelevant. What’s relevant is that Orac is not arguing for the benefit of the children involved, but for some (poorly conceived and/or articulated) principle or concept to which he is obsessively attached.

We do not have a great understanding of the effect of cannabis on the development of children. It's entirely possible that this treatment could have negative effects and there is no good evidence that there is benefits. Experimenting with such a treatment, especially in a particularly vulnerable population is highly unethical. It seems to me that Orac is the only one who has the childrens' welfare in mind.

What’s relevant is that Orac is not arguing for the benefit of the children involved, but for some (poorly conceived and/or articulated) principle or concept to which he is obsessively attached.

My understanding of Orac's underlying principle or concept is that of science based medicine. Medical treatment should be that most likely to produce a positive outcome; the way we know what treatments provide the most positive outcome is through science.

A second principle is one of professionalism. Part of professionalism, as I read it, is not lying. Telling people that, say, marijuana has proven medical uses - based on his reading of the research - untrue.

That is my understanding as a layperson.

#90,

"additional legal impediments"

"any responsible law doing so would restrict children from using it"

Got it. It's legal now to give your children pot, right?

sigh

#91,

I don't see a principle there. You need to articulate it in a way that we can test its application-- compassionateobserver [in the future to be referred to as CO] makes good points about off-label drugs and the fact that there are qualified MD participating as much as possible given legal constraints.

What's the principle? "No doctor should be able to act without Orac's approval"?

zebra@92

Got it. It’s legal now to give your children pot, right?

Well, no. But that seems to be what these quacks are advocating with using marijuana to treat autism and what Orac is against. You seemed to suggest that Orac's position on legalizing marijuana is at odds with his position that using it to treat autism is a bad idea. There would be additional legal impediments relative to a world where it is legal to give children marijuana in the name of treating autism. Apologies for not being more clear that that is what I meant.

You, really are disappointing in the way you portrayed me and my family. More from the aspect of trying to place words in my mouth and the simple conclusion of any research I've done, or steps I've taken to vet the possibility of treating my son with sever autism. You left out that I also stated it may not be a silver bullet, it may not help him and I'll continue to seek other alternative treatments as well. It took my family a lot to just come out and speak and advocate for the option - that we currently don't have legally. My wife was very brave in doing so and yes, it made us vulnerable to selfish, outspoken egotistic people like you.

It's easy to armchair an opinion on what I think or should be doing or where I get my information from behind a computer and I can see you have some real passion for the topic. Maybe try to put it to good use? Maybe you should have come to the meetings and expressed your concerns and support publicly and have it on record. But that would involve more effort on your part that would also open you up and make you vulnerable to other trolls of the opposing sides.

YOU don't have a child with autism, so YOU CANNOT walk in my shoes. You CAN'T FEEL what I feel. But I'd love to invite you over to do so, let me know. Then you can come away with some real experience as a part-time parent and voice judgement on those who only wish to help their child's development, communication and pain.

Be very careful which cage you poke a stick in, you don't know me apart from what journalists crafted for they're audience.

Mr. Zahringer: Although I haven't encountered you personally before, I have encountered many parents like you with autistic children who are desperate to do anything they can to help their children. Unfortunately, many of them fall under the spell of what is commonly known as "autism biomed," which consists of alternative treatments with little or no evidence behind them that range from supplements, to hyperbaric oxygen chambers, to chelation therapy, to secretin, to bogus stem cell therapies, to homeopathy, to, yes, what are in essence bleach enemas. I linked to some of my posts about such quackery before in my post above, but here are a handful of examples. Note that, if you read only one other posts, please read the one at the very end of this comment, because it is the most relevant to what I'm trying to communicate. If you are willing to read more, I offer these three in addition to the one at the end:

http://scienceblogs.com/insolence/2012/05/25/selling-bleach-as-a-cure-f…
http://scienceblogs.com/insolence/2009/11/23/the-chicago-tribune-tellin…
http://scienceblogs.com/insolence/2007/08/23/justice-may-yet-prevail-in…

As I discussed in depth above, medical marijuana for autism has been embraced by the autism biomed movement. It is not surprising, given that there is no convincing evidence that it works, and it is basically another herb or supplement that parents in this movement have pinned some of their hopes on. In your story, as portrayed in the news and as you relate it now, I see you in these parents. You describe yourself as investigating medical marijuana and other alternative treatments, just like these parents investigate a variety of treatments. Indeed, medical marijuana has become quite firmly part of the autism biomed movement.

Now, please don't take this the wrong way. You might be insulted by what I'm about to say next, but that's not my intent. What I am about to say applies to every single person alive on this planet today, including myself. We all make these mistakes because that's how our brains are wired. The main difference between a skeptic and the rest of humanity is that a skeptic knows he has these cognitive shortcomings that lead to error and can thus try to avoid them. Unfortunately, for most people it is very hard to hear this. Most people take this information as insults or personal attacks. The reason is simple. When people invest so much into something (as parents doing autism biomed do for the sake of that which they love the most, their children), it's very hard for them to separate their identity from the decisions they've made. I've made the same mistake myself on occasion, lashing out at people who, I later realized, had brought up legitimate criticisms of my words or actions.

That being said, every parent using the treatments I mention above believes that he or she has thoroughly researched it and come to a rational conclusion to try it. Every single one of them thinks he or she has become knowledgeable enough about the science to render a valid judgment, regardless of whether he or she has the background necessary to understand the science. Every single one of them. Many of them come to believe that these treatments work, even though many demonstrably do not. That's because people confuse correlation with causation, tend to remember the times when something appears to have worked and forget the times it has not. There are placebo effects. There are so many confounding effects that lead parents to believe that something has worked when it has not.

Even physicians are not immune to this, which is why a depressing number of physicians come to believe that autism biomed works and offer it. Indeed, physicians can be among the worst, because they sometimes fall under the illusion that their training inoculates them from these cognitive shortcomings and their clinical observations are not affected by the same problems that we all are. I should know. I'm a doctor, and I constantly struggle with this issue. I also struggle to get other physicians to understand and admit that they can fall prey to this too.

The bottom line is that nowhere near enough evidence, preclinical or clinical, exists to support the use cannabis oil or medical marijuana in children with autism. I don't think you're a bad guy. I know you love your children, just as much as the many parents doing autism biomed love their children. But this is the wrong way, in my opinion, and I won't stop voicing this opinion. There's a reason why the autism biomed movement so easily embraced medical marijuana; the two are basically the same.

I'll conclude with this. If you won't believe me, listen to one of my inspirations years ago, a man named Jim Laidler. He is a physician with two autistic children. Read his story. See what finally brought him out of the autism biomed movement. See if you don't recognize yourself in him:

http://scienceblogs.com/insolence/2015/05/11/the-road-to-alternative-me…

You're not alone, nor are you unique in your love for your child. I have seen you before in many other parents.

capnkrunch94,

You still aren't making sense.

Go back and read #59. I know you don't want to agree with me about anything but that is M O'Brian giving a good analysis.

The question is, is it more likely in a world where pot is legal that someone will experiment with treating their severely autistic child somehow, with oils or whatever. The answer is obviously yes.

And I wonder, how exactly would "the law" find out? Randomly test all autistic kids for pot?

In traditional chinese herbal medicine there are many contraindications for paediatric herb use. Ditto ayurveda.
Both trades used cannabis with people of all ages.
One wonders why there ware no paediatric contraindications for cannabis in the fossil record?
Could it be that xillions of children treated with cannabis over thousands of years did ok?

Disclaimer: I have autism so you can ignore me, thanks.

Mr. Zahringer: "YOU don’t have a child with autism, so YOU CANNOT walk in my shoes"

Is it okay for me to say that giving children with autism untested drugs, especially the types that affect the brain? My son has autism, and there are many more who post here that either are autistic or have family members who are autistic.

I was going to mention that in my reply to Mr. Zahringer. Indeed, I implore Mr. Zahringer to listen to my readers who do have autistic children. There are quite a few of them who read and comment here. Ask them about my history. Just because I criticized medical marijuana for autism and the Michigan Medical Marijuana Review Panel's decision harshly does not in any way mean I was attacking parents.

Ms. Knight: "Could it be that xillions of children treated with cannabis over thousands of years did ok?"

Please provide the PubMed indexed verifiable statistics of these case studies. The plural of anecdote is not data.

Chris @99
I confess to not having the data to hand and don't feel inclined to go looking for the references for you. Let's talk about something else?
Why don't you reply to one of my other comments instead?

From the article: "The Zahringers have thus far been disappointed with the progress their son Brunello has made with conventional therapy, such as Applied Behavioral Analysis. Seeking faster progress, they found medical marijuana and latched on to it for hope:"

Newsflash, Mr. Zahringer: it takes time. We are not talking weeks or even months, but years!

My son could not speak as a three year old, and it wasn't until he was five when he could utter a short sentence. He started speech therapy when he was two and a half, special ed. preschool when he was three, and started intensive twice a week speech therapy when he was four years old that went until he was eight, and once a week until he was twelve. So at least ten years of speech, plus the special ed. services.

He does speak, but it is not quite normal. When he was twenty three years old he ended up in the hospital with what we thought was a stroke (he also has a genetic heart disorder), but fortunately turned out to be a complex migraine. After he recovered the hospital staff flagged his speech, and he was referred for six weeks more speech therapy.

It will take lots of work, and there are no shortcuts. Giving your child drugs needs to be done with the utmost caution. Though I speak as someone whose child has a history of seizures (and migraines). One of the seizures was while he was sick and very dehydrated, which really screwed up his electrolytes. Trust me you do not want to muck with your kid's brain chemistry.

So are you going to ignore me because, choose one:

1. I speak as a parent of an adult with autism, one who has had several EEGs, a couple of head CatScans, and a brain MRI (plus several EKSs, echocardiograms and one cardiac MRI).

2. You don't like what I said.

Where can I find the list of FDA approved medications that are OK for adults but cannot be given to children because of the deleterious effects those drugs have been proven to have on developing minds?

Ms. Knight: "Why don’t you reply to one of my other comments instead?"

Because that was the only one I understood. You made a claim, therefore you need to provide verifiable evidence for those claims. As the article said, you don't just give kids some random chemical without any clinical trials.

So you made this speculative claim: “Could it be that xillions of children treated with cannabis over thousands of years did ok?”

There is no reason to discuss it or believe it has ever happened until you cough up the evidence. You just can't make stuff up and try to make us believe it is true.

Ms. Knight: "Where can I find the list of FDA approved medications ..."

Have you tried searching www.fda.gov ?

It's so sad that we have teenage girls with autism drinking 10 or more cans of Monster energy drink every day. Is it more dangerous than cannabis?
Is it less dangerous than xanax?
Is that less dangerous than alcohol?

Chris #103,

"So are you going to ignore me because, choose one:

1. I speak as a parent of an adult with autism, one who has had several EEGs, a couple of head CatScans, and a brain MRI (plus several EKSs, echocardiograms and one cardiac MRI).

2. You don’t like what I said."

The reason to ignore you is, according to Orac:

That being said, every parent using the treatments I mention above believes that he or she has thoroughly researched it and come to a rational conclusion to try it. Every single one of them thinks he or she has become knowledgeable enough about the science to render a valid judgment, regardless of whether he or she has the background necessary to understand the science. Every single one of them. Many of them come to believe that these treatments work, even though many demonstrably do not. That’s because people confuse correlation with causation, tend to remember the times when something appears to have worked and forget the times it has not. There are placebo effects. There are so many confounding effects that lead parents to believe that something has worked when it has not.

Now, Orac, as he says, does not intend to insult or disparage parents with that observation. But it does indicate how much he values your opinion, right?

Nice try. I value Chris' opinion because Chris can always back that opinion up with facts and science.

Esther Knight: Personally, I would make many of those energy drinks illegal for children. They don't need the caffeine.

And I would agree. Too much caffeine.

Orac 109,

Chris provided personal anecdote. I see zero difference from what people "on the other side" have provided.

More than a "nice try", I think. Your lack of scientific objectivity is showing.

MI Dawn there is so much that doesn't make sense. We positively encourage children with autism to do horse riding which has no evidence to back it up and is far more dangerous than cannabis, not to mention elitist and inaccessible.

Same example again but instead of Monster energy drinks, the teenage girl has a different choice: Cutting or Cannabis?
Which is safer? Cutting is legal. Long term harms of cutting are unremarkable. Is cutting effective?
We don't see this but it is there Master Chris.

@zebra: Seriously? Chris has been a commenter here since almost the beginning, over ten years ago and has taught me things. I've observed Chris's contributions and ability to back up assertions with evidence many years before you ever darkened this blog's comment section.

Sadmar, I have reading Orac's writings for well over ten years, starting at misc.health.alternative. I have learned not only to use facts and science, but also how to separate the good from the bad.

Ten years ago I took what I learned from reading Orac (plus the JREF forums and the Heathfraud listserv) to write a "Chelation is Bad" email to the disability listserv where that was being heavily promoted for our kids. I received lots of nasty grams, and no support from the moderators. So I unsubscribed from that list.

Then one week later this happened:
http://oracknows.blogspot.com/2005/08/sadly-it-was-only-matter-of-time…

My question on why Mr. Zahringer was because it seemed he presumed all parents with disabled children know what is best for their children. Actually many of us do not have a clue. I am willing to admit that. Which is why I value learning how to evaluate claims from Orac, Dr. Novella, Dr. Hall, etc.

Thank you, Orca.

Ms. Knight, please try a bit more coherence. You have now made another testable claim: "We positively encourage children with autism to do horse riding which has no evidence to back it up and is far more dangerous than cannabis."

Please provide the PubMed .... you know the drill.

Thanks.

Oy, looking at that link, I wonder if I should get rid of that horrible old template on the original home of Respectful Insolence. A generic Blogger template would be better than that. :-)

Stupid tablet autocorrect: Thank you, Orac.

Now I need to be one with a serger. (ah, autocorrect struck again, should I have typed overlocker? Nope, autocorrect struck yet again, obviously the spellcheck folks aren't big on sewing vocabulary)

Neurotherapeutics. 2015 Jul 28.
Endocannabinoid Signaling in Autism.
Chakrabarti B, Persico A, Battista N, Maccarrone M.

Can anyone access the full paper and tell us what it means please?

I confess to not having the paper to hand and don’t feel inclined to go fetch it for you.

Chris,

I'm not going to ignore you and I'm not looking to take a shortcut.

Yes it's perfectly safe for you to say what you want. Yes, you have a right to your opinion on treatments, your journey and what has brought you success and why. You clearly have me beat on mileage in terms of dealing with autism as a parent. We've been doing 36+ hours of ABA a week for the past 10 months, special ed through public school 5x/week, occupational therapy 4 hours a week for over a year and same with speech. We've altered the diet and removed refined sugars and gluten. I've had the EEGs, the brain MRI and head CatScan and full expanded genetics too.

I also believe that everything takes time. Should it take years as a baseline? I'm hoping not, at a minimum I'm hoping to see some progress from efforts. Since it is a spectrum of disorders your assessment is not fair, in my opinion to say it will take a dozen years. I hope you are not right in my case however, I'll roll with whatever comes my way.

"Giving your child drugs needs to be done with the utmost caution."

I agree 100% and also believe that if there are new options then I need to be open to considering them. As not being a user of any illicit drugs I'm highly concerned. I've invested a lot of time and money to vet this and am not 100% sure it is a viable option however, I deserve the option with oversight by people like Orac, my son's neurologist, his pediatrician and other doctors and therapists, much like his IEP. This way there is a group of professionals with a wide variety of education and background to help guide me. This may not be a viable option for you for whatever personal reasons you have.

As I see it now there is a substantial lack of FDA-related studies on the use of cannabis on young children. This cannot happen until $$ is placed on the research and testing; short and long term. I'm sure the schedule 1 legality of it has some reasons more research $$ is not spent here (let's not turn that stone here). Unfortunately until that is viable I'll have to research more, speak to more patients who use, parents who treat and see where I can see and draw a conclusion. That and the research of those like Jim Stone and Dr. Bogner, Dr. Chugani and Dr. Constantinou - three who are all very reputable physicians. I want to also mention that three physicians, many accredited like Orac who voted to pass this as a treatment here in Michigan. Some work at hospitals a stone's throw away from his medical center. Confusing signals right? All of them made their determination from years of schooling, experience with patients and countless 100's of hours of ongoing training? I mean, where else would they draw their conclusions from- not just the 800+ pages of petition evidence. It's an illegal drug so they would not have any other interests to benefit from. Was it just compassion? How would they put their name allowing a schedule 1 narcotic to treat a young child with autism out of just compassion alone?

I'm no scholar but I'd venture to say that all of this has some weight, even if it's just to be looked at further. Bring it out of the back rooms and closed parent groups fearing CPS and search and seizure. There are an unbelievable amount of parents with adult children on the spectrum that also advocate and want to try too.

Lastly I haven't "found medical marijuana" as the articles claimed. I've yet to try on my son but I'm interested enough to advocate for a better, safer opportunity within the confines of the law. Maybe if it's signed in to law you'll give it more consideration too.

Chris #115,

"My question on why Mr. Zahringer was because it seemed he presumed all parents with disabled children know what is best for their children. Actually many of us do not have a clue."

I don't assume anything of others and never said I knew what was best. I'm learning just like you are.

Mr. Zahringer

Thank you for giving your perspective on this matter. Clearly you are fighting hard for what you feel is best for your child.

Ms. Knight, you make some excellent points. While we don't know the long-term negative effects on a child's brain, we can reasonably conclude that they are less harmful than many treatments we routinely dispense to children these days. Less than alcohol almost certainly.

It does seem as if those who seek legal permission to try untested remedies are harangued by medical authorities who object to their making such attempts. It seems quite inappropriate to the potential for harm involved. Cannabis oil seems about as likely to be harmful to children as Lorenzo's oil.

Mr. Zahringer:

Could you tell me what research Dr. Chugani has done regarding cannabis and autism? I just searched PubMed and haven't been able to find a single scientific paper by him addressing the question. Indeed, a search for his name and "cannabinoid" also revealed zero citations. I'm not playing "gotcha." I really want to know. By PubMed criteria, Dr. Chugani is not an expert in cannabis and autism. I also searched ClinicalTrials.gov for clinical trials by Dr. Chugani. None of the clinical trials he's done involves cannabis. So I really want to know what research he's done in this area.

As for Joe Stone and Dr. Bogner, I described in great detail above why their "research" is an utterly unconvincing bunch of cherry picked studies not to be taken seriously. I mean, really. I haven't seen such a clearly biased, cherrypicked "review" in a very long time, and they extrapolate far beyond what the preclinical data support.

"...Orac is not arguing for the benefit of the children involved,"

Orac, please correct me if I am wrong:

He is arguing for the benefit of the children at the hands of his profession and out of the responsibility he has taken on in accordance with his knowledge of science.

He is not omniscient to know at any given point who is going to break the law. None of us are for any law. If he wants to factor in the increase (which I am not convinced of) in availability of marijuana to children (for any reason) if it becomes legal for adults for recreational use then that is a separate issue.

For the real world/human nature thing, if an adult who thinks that his child needs marijuana to function better but doesn't give it to them because it is illegal now then why would they give it to their child when it becomes legal only for adults - and it is still illegal for children? It may or may not make it easier for them to break the law (see my next paragraph) but I don't know this translates into that they WILL break the law..

You claim availability but, real world again, I call BS on that. Give me some money and one night and I could deliver more MJ than you could smoke in a month (I'll concede a week if you're already a massive pothead). It is that ubiquitous and if you haven't figured that out perhaps you need to get out more.

@Beth,

While we don’t know the long-term negative effects on a child’s brain, we can reasonably conclude that they are less harmful than many treatments we routinely dispense to children these days. Less than alcohol almost certainly.

1. If we don't know the negative long term effects, how can it be reasonable to conclude anything about the relative harm?

2. Does your comment about alcohol mean that you believe that children routinely drink alcohol? Is alcohol routinely prescribed to treat any medical condition, particularly to children? Thanks.

Orac #96

Thanks for the reply and clarifications. I am a skeptic like you however, there are too many of your colleagues that say maybe it can be tried. 3 on the board gave it the pass, that has to speak to some credibility, much like those that gave comment on the petition

I was raised in a society like many that you are just supposed to believe the white coats and their recommendations for treatments. If I was to follow my upbringing I'd say there were three there that day that said, with caution too, that it should be considered. Two said NO citing many of the same things you did in regards to research and long-term studies.

Society has changed dramatically over the years. Today you have to wrestle with what the truth really is, or who you should get that from. As a parent in this instance, I have to be extra cautious and make sure that I have the trusting team in my corner and in the confines of the law. I'm sure my education will be lifelong in regards to my son. I can confidentially tell you that I won't be quick to jump in any direction.

"Even physicians are not immune to this, which is why a depressing number of physicians come to believe that autism biomed works and offer it. Indeed, physicians can be among the worst, because they sometimes fall under the illusion that their training inoculates them from these cognitive shortcomings and their clinical observations are not affected by the same problems that we all are. I should know. I’m a doctor, and I constantly struggle with this issue. I also struggle to get other physicians to understand and admit that they can fall prey to this too."

Scary statement there, and not reassuring to the public with private healthcare. Wish there was more being done to get this centrally aligned and uniform. If it's all science then that should be followed.

Again,

I live in Washington, which means among other things that I am aware of our marijuana regulations. It's illegal to give or sell marijuana to anyone under 21; if I go to the friendly neighborhood cannabis shop, they check my ID before letting me in.

I have one of the conditions that is explicitly listed in the state's (older) medical marijuana law: multiple sclerosis. I tried asking my neurologist for advice on using small amounts of THC for treating anxiety, and the best she could tell me was that nobody really knows, but she was willing to write me an authorization letter.

When I went back at a later visit and said I was getting good results using it for spasticity, we agreed that I could just stick to that for the time being. I'm getting a THC-containing liquid on the recreational market, and using significantly less than it would take to get me high. (So, closer to pharmacognosy than herbalism, with the advantage of known dosages.)

Right now, I'm on vacation out of state, and just hoping I don't have that symptom while I'm traveling. None of the prescription options strike me as preferable, except that I could bring them with me to Canada, or New York, or any number of other places. .

(Orac, I hope the anon is okay; I'd rather not have a web search connect my real identity with my medical issues.)

Same example again but instead of Monster energy drinks, the teenage girl has a different choice: Cutting or Cannabis?
Which is safer? Cutting is legal. Long term harms of cutting are unremarkable. Is cutting effective?

WTF? Cutting has never been put forward as a treatment for autism or anything else. It's a behavior that's indicative of pretty severe emotional disturbance. Actually, I'd be willing to bet that teenagers who cut are more likely to use drugs or alcohol or both, since both behaviors are often a sign of underlying issues. Possibly in a minute I'll go find any relevant studies on the matter.

In any case, if autistic adults find that marijuana helps them cope with things, I'm fine with that. I think it should be legal for adult use in general, and I know several people who smoke pot to deal with social anxiety, as a way to relax, etc., the same way many people use alcohol. And yes, it is considerably less dangerous, as a drug, than alcohol is.

But when parents are giving it to kids, especially when they're more or less just coming up with the dosage on their own, it smacks more of chemical restraint to me than anything else. Sure, it might make the kid seem calmer and more relaxed, but especially if he or she is non-verbal, how is one to know whether the experience is even subjectively pleasant, let alone beneficial? Anybody who's ever been way too stoned knows that it can curb behavior of many sorts, like anything beyond breathing and staring fixedly ahead, but it's not a fun thing to experience, even if one probably seems pretty chill from an outsider's perspective.

In traditional chinese herbal medicine there are many contraindications for paediatric herb use. Ditto ayurveda.
Both trades used cannabis with people of all ages.

Traditional Chinese herbalists never noticed that they were killing their patients with aristolochia. Ayurvedic practitioners seem to think that arsenic, like bacon, makes everything better. Do we really want to go down the road of going through the entire self-contradictory corpus of gibberish from both 'tradiitons' looking for confirmatory evidence of anything?

Why yes, self injury and substance abuse are associated. "Cannabis or cutting" isn't even coherent as an attempted analogy.

Oy, looking at that link, I wonder if I should get rid of that horrible old template on the original home of Respectful Insolence. A generic Blogger template would be better than that. :-)

No, I love it!

JP no, your experience of cutting isn't relevant to this debate.

Pretend you are a teenage girl with autism and a job in an office. Only three things make you feel level-headed enough to perform:
1) Stimming. 30 mins of stimming. Not possible at work.
2) Cannabis. 1 joint. Not possible at work.
3) Cutting. 2 cuts. Possible at work in bathroom in less than 3 minutes.

Ms. Knight, you make some excellent points.

Really? You must have a greater facility for decoding seemingly aimless, disjointed remarks than I do.

While we don’t know the long-term negative effects on a child’s brain, we can reasonably conclude that they are less harmful than many treatments we routinely dispense to children these days.

How does that work? Perhaps some specificity about the "many treatments" routinely dispensed to children "these days" that you're "comparing" with would help.

Less than alcohol almost certainly.

What does EtOH have to do with the price of tea in China?

Oh, and it turns out that I do have easy access to Chakrabarti et al. As for "what it means," the answer is "not much" from the perspective of cannabis fetishism – it's just a short review paper. In fact, I have no idea why they omitted the meat of it from the abstract:

"Accumulated evidence suggests that the eCB system constitutes a relatively less investigated piece of a puzzle that brings together 4 phenotypic features known to be atypical in autism: 1) social reward responsivity; 2) neural development; 3) circadian rhythm; and 4) anxiety-related symptoms."

I might be persuaded to make it available after I've had some coffee.

JP no, your experience of cutting isn’t relevant to this debate.

What experience with cutting? I don't have any. I'm talking about data.

Pretend you are a teenage girl with autism and a job in an office. Only three things make you feel level-headed enough to perform:
1) Stimming. 30 mins of stimming. Not possible at work.
2) Cannabis. 1 joint. Not possible at work.
3) Cutting. 2 cuts. Possible at work in bathroom in less than 3 minutes.

False trichotomy; there are other ways to cope with stress. Cutting is maladaptive and leaves scars, poses the risk of infection, etc., etc. Getting stoned to get make it through the work day isn't functionally any different from drinking to make it through the work day, and I don't think either one is a very good idea, regardless of legality. They're both indicative of a substance abuse problem, really.

Given that a teenager doesn't need to work to put a roof over her head, a better idea might be to quit the job and find one that's less stressful, or maybe do some CBT to learn ways of coping with stress during the day, or one of many other options out there.

^ Given that a teenager probably doesn't need to work to put a roof over her head, that is. My experience was slightly different from the norm.

JP @130.

I like it too. Perhaps for a different reason. To me it has a nice retro look that makes me somewhat nostalgic.

#123 Orac,

I think you should have gotten involved with the public hearing or shown up on July 20th or the 31st. As for the clinical trials with Dr. Chugani and others, as a local physician who is obviously passionate about cannabis and autism I can't understand why you have not reached out to him yet and questioned his testimony? He's right around the corner from you in town and you are both respectable Dr's in this field. I think that would give you an opportunity to collaborate as two physicians who come together to form stronger, evidence based conclusions.

Regarding PubMed and other traditional science resources I already addressed this. You'd know better but there does not seem to be a ton of funded research on cannabis as it is a schedule 1 narcotic. But maybe this is where you come in to advocate for more testing and get the funds to do so. You'd have the opportunity to lead the way. Then your opinion turns in to research for all to benefit from.

Point one: I am not "passionate" about cannabis and autism in particular. What I am passionate about is science-based medicine, and this new Michigan policy with respect to medical marijuana for autism is anything but science-based, hence my post here and at my other blog. I see autistic children in my state potentially being subjected to a non-science-based application of cannabis oil to autistic children. That is why I have written about a variety of topics of this type. As for why I didn't speak out about this sooner, well, to be honest I didn't know about it until the news reports of the July 31 meeting. Mea culpa. Somehow I missed news reports of the meetings a few months ago (which should show you that I don't routinely follow medical marijuana news, although I do pay attention to the science).

Point two: Just because there is not a lot of funded research on cannabis and autism (an understatement, if ever there was one!) is not an excuse to skip the requirement for well-designed clinical trials and go straight to treating children with autism. I'm sorry, it doesn't (and shouldn't) work that way. There is a real potential for harm here with chronic use of substances that modulate the activity of a very important set of signaling pathways (cannabinoids) that, no one disagrees, are important in neurologic function. This is a horrible idea.

^ As far as general eCB reviews go, this looks much more promising, but I've only skimmed it.

^^ Also, who smokes an entire joint at once, let alone at work? It's puff, puff, pass, man.

^ "Don't bogart that joint, my friend"

Provides nothing to the conversation; I just couldn't resist.

Chris@ 103

I have read a lot of your posts,and I see a lot of similarities to my own condition in your son.The moderate to severe autism,the developmental delays,the cardiomyopathy and cardiac conduction disorder that started in the teenage years.I would love to be able to compare histories,if you had a Facebook page or blog.I don't know if your son has had all the medical tests I have had.The stroke like episodes can either be due to mitochondrial disease,or abnormalities in folate metabolism.I have both.I have been involved in a couple of clinical trials not generally available to autistic adults in these areas.Same tests and treatment,same doctors,but because of my age,they chose not to include me in the published studies.

Chromesthesia @ 73
Do you head bang? Do you cut yourself?Tell us why you do these things.

I can tell you my head banging was related to undiagnosed seizures.As this web page* describes.It also addresses a number of reasons autistics might cut themself.

Esther Knight @ 77

This gets to my point up here ^ There are different types of autism,and they can be treated in different ways.I am not judgmental,if cannabis works or you,and allows you to function normally,that's great.Especially if you are an adult.It sounds like you are pretty high functioning,with no other medical issues.I am not so lucky.I was low functioning,with many regressions and medical issues.I had to suffer until I was in my late 40s,before science found the genetic and metabolic causes for my autism and medical issues.It takes a very complex cocktail of supplements and prescription drugs to keep my autism and other brain issues under control so I am able to function normally.But I am still too sick to hold a job.

Esther,if you are using cutting to control behavior and to function normally for few minutes,that is not normal,and it is not "autistic" either.It is a now recognized condition called Non Suicidal Self Injury,often associated with Borderline Personality Disorder.BPD may or may not be a comorbidity of Asperger's,or it could be something misdiagnosed as Asperger's/HFA.There is quite a bit of debate about this.I could post more links,but I would rather not go into moderation.

*I know this is from the ARI,but it is still the best explanation for self-injury on the web.JP@ 127,129 you might want to read this too.As well as the article about NSSI

Also, who smokes an entire joint at once, let alone at work?

I had a next-door neighbor one summer, a very pleasant undergrad from Bahrain by way of London, who would routinely go through entire spliffs of high-test reefer on the back porch. Indeed, sometimes she'd wander off to class and leave them burning in the ashtray. I'm surprised she could remember her name and address.

She left some stuff with me in storage, but when I periodically checked in, it appeared that she wasn't going to be returning to finish the degree.

My own system seems to be wired such that one or two puffs are more than adequate to remind it of how this works.

But as for availability, I could probably get you a QP on 24 hours' notice.

It's amazing that many of the parents who are willing to experiment on their kids with mind-altering substances based on a handful of in vitro and animal studies are the very same ones who accuse the National Vaccine Program of using children as guinea pigs, in spite of the fact that vaccines have to go through 10 - 15 years of preclinical and clinical trials before they're approved.

Mr. Zahringer, I do feel for you. One of my children is neuro-atypical and it isn't easy.

Here's a question for you - if there was a scientific trial on cannabis and autism would you enroll your son?

Here's a question for the scientists - is there enough plausibility to make such a study worthwhile? (I recognize that designing, funding, getting review board approval, none of those things are trivial matters.)

Tool of the state
Big Pharma
Mandate

Whores of Babylon
Try in on

Pass the bong

A teenager can be age 13 or 19 or any age in between.
Teenagers can have jobs. Teenagers can have no parents that they can live with.
Here in the UK, a teenager (18 or 19) can legally buy alcohol at lunchtime at her office job. A sixteen year old girl can legally have the same job.

Does anyone here have first hand experience and data on:
Cannabis
Autism
Cutting
Teenage girls?

JP do you have a daughter? Do you use pubmed as a parenting manual?

Here in the UK, a teenager (18 or 19) can legally buy alcohol at lunchtime at her office job. A sixteen year old girl can legally have the same job.

Ergo, 16-year-olds should be able to be President in the U.S., or something.

Anyway....

You're going to have to ask more nicely.

This is what I get for not keeping up. Halfway through the comments.

I know people with my illness that have tried and encourage everyone to try CBD oil, insisting that since it is from hemp it isn't pot, is legal everywhere, etc. Have also come across a lot of articles about "CBD oil" which had nothing resembling cannabidiol or even hemp extracts in it. One acquaintance, desperate to manage the pain of her illness and either unwilling or unable to deal with her pain management doctor about it, is now smoking kratom since medical marijuana is not available in her state. Many patients I know keep telling me I need to try marijuana. Unfortunately, it isn't legal in any way in this state, so I can only wonder if I would try it if it became legal.

This, of course, makes me wonder about some of these parents - are they sure they are getting real product? Are they sure it is consistently the same batch to batch?

It absolutely aggravates me that in some cases there are parents out there that "don't want to poison their child with psych meds" that are completely willing to sedate them naturally when investigation is beginning to show possible brain development issues when a young person uses cannabis consistently. The level of inconsistency in some of these people is baffling.

I know what I see with other people with my disease, though. They don't want to be "better" (reduced symptoms, improved quality of life), they want to be well, and living every day in less will make them desperate enough to do anything.

I don't know if I am too practical, too skeptical or if I have given up, but I wouldn't try marijuana without a lot more knowledge of how it might work and what long-term effects there might be vs what I do now. I suspect that if this was about my child I would be even more cautious.

Oh Narad, please?

One acquaintance, desperate to manage the pain of her illness and either unwilling or unable to deal with her pain management doctor about it, is now smoking kratom since medical marijuana is not available in her state.

*blink*

I don’t know if I am too practical, too skeptical or if I have given up, but I wouldn’t try marijuana without a lot more knowledge of how it might work and what long-term effects there might be vs what I do now.

It's an interesting quandary from where I sit. I first tried cannabis toward the end of my freshman year in college (about three weeks after my first beer, a Foster's oil can, for heaven's sake). My reaction after about two hours was something along the lines of "this is the most interesting thing ever, what time tomorrow?"

Whereupon everyone stared at me and probably remembered as a single man that I was also a fan of the eponymous debut LP of Huey Lewis and the News.

Set aside the physiological issues: Has anyone looked at whether effectiveness – with some sort of objective measure – decays with chronic use?

I suspect that if this was about my child I would be even more cautious.

Yah, this is at the level of trying to get your cat stoned. But, perhaps unsurprisingly, there are two different things being confused: The new magic power of cannabis lies in CBD, which has... "unexpectedly high potency as an antagonist of CB1/CB2 receptor agonists in CB1- and CB2-expressing cells or tissues," (emphasis added), or something.

That's a pretty lazy, dated reference, but the new selling point is that CBD "doesn't get you high." (If I recall correctly, the pathway is CBD → THC → CBN, the latter of which seems to get awfully short shrift.)

The problem here is that this is a rather sloppy paraphrase of "is not centrally active," which means that one needs (1) a peripheral hypothesis of action* or (2) a need to get the story straight on that whole sativa/indica routine.**

Oh, and the Zorse predictably loses again.

* Immune system, digestive, that sort of thing.
** h[]tp://medicalmarijuana.procon.org/view.answers.php?questionID=000638

^ G-ddammit.

It's one inadvertently giant link to Leon Gussow's blog, and then another around "or something" at the end.

151 Narad

Effectiveness of all herbs and medications drops away in time. Nothing lasts forever, even love is generally short lived except in propitious circumcixions.

Once the stress of having to deal with moronic health systems has been sublimated, the need to use cannabis is unnecessary. Unless money grubbing morons still surround you, and continue to harm you, due to your being reliant on them because of your damaged genes, probably caused by industrialisation or poor maternal incubation, toxins, parenting, society etc.

Weak offspring probably have it better in some ways compared to the past when infanticide was more common, but society may be making more of them, due to polluted bodies from modern living.

Sadhus in India sit around and smoke ganga everyday. They are old men who have disorders or are now less able members of society.

Let them eat cake I say.
Meds make them worse, as does grog and junk food.
Cannabis is a lesser evil, in the overall scheme of things.
Sure its not ideal.... but neither is being a stressed out reject.

Shakespeare was possibly a stoner, but didnt like cocaine!

http://news.nationalgeographic.com/news/2001/03/0301_shakespeare.html

http://www.hempforfuture.com/2014/03/31/new-ruling-finds-cannabis-to-be…

Frank, 'Ganja' is from Gan (thought) as in jnana and Ja (born) as in jiva. Literally 'fertile thought'.

Ganga is the name of a river. Ganja is the Sanskrit word for cannabis flower heads.

Frank, ‘Ganja’ is from Gan (thought) as in jnana and Ja (born) as in jiva. Literally ‘fertile thought’.

Ganga is the name of a river. Ganja is the Sanskrit word for cannabis flower heads.

I'm calling Poe.

155 Thanks Esther.
Thats my dyslexia for you.... and cannabis actually makes it worse!
But I can't use that excuse as I haven't had any for months, as its still illegal in NZ!

Cannabis for Autism is on Facebook

Ganja, GaNjA, गञ्जा - The Sanskrit word for cannabis flower heads.
Formed from the Sanskrit root gaN, meaning to imagine, evaluate or compute, and the word jaa meaning born, produce, or offspring.
Literally, 'fertile thought'.

Cannabis for Autism People with autism may struggle with social imagination and social play.
Cannabis has been known for thousands of years to increase imagination and creativity.
Autistic people in Vedic times would have been given cannabis to ameliorate their symptoms....

https://www.facebook.com/CFourA/posts/565053890184125

@Esther Knight #128

In the older records on Chinese traditional medicine, cannabis was classified as a toxic plant. Apart from hemp fiber from the stalks and hemp seeds for oil, constipation, and sundry other problems, what possible uses are you referring to?

@Frank Collete #154

Maybe it was mummy dust.

So Orac, you go on and on about clinical trials. Let's get away from the personal anecdotes of your loyal followers and do some first-approximation science:

What would an acceptable clinical trial of cannabis as a treatment for autism be like? How would you determine that there was no long-term cognitive impairment, and how would you ethically justify the experiment?

And remember, this is for children with serious cases.

@Zebra the FDA managed to find a way to approve Aripiprazole for irritability in children with autism.

It's a fact that the long term effects of Aripiprazole on the developing brain are unknown.

I guess it's a case of showing them the money maybe? Certainly there is no logic to it.

I fully appreciate why there is concern in regards to a perceived lack of standardization, guidance in regards to dosages, and the overall fact that cannabinoids derived from cannabis have not been FDA approved which makes their use an exception to a certain set of standards within the medical field. This isn’t an issue regarding this policy as much as it is a failure on the part of the federal government to change its current policy of prohibition and schedule 1 status of cannabinoids derived from cannabis. The assumption that if this policy is approved there won’t be standardization practices in place, guidance in regards to dosages, and expert oversight seems erred, especially considering the support of Chugani and Constantinou, each the respective heads of their pediatric neurology departments specializing in treating epilepsy and autism at Children’s Hospital and Henry Ford. I’m not certain which field of medicine you practice, but I’d venture to guess that you’re not a leading authority on this subject much the way that both of these individuals are.

I notice you reference the Cochrane study as an indicator of the efficacy of cannabinoids in treating epilepsy. It’s noteworthy in my mind that that was isolated CBD, without any varying ratios of CBD:THC used in the trial. This indicates to me that you may not be familiar with the current practices amongst families utilizing cannabinoid based therapies. You may not give this statement any merit, but the majority of families that utilize these therapies are using varying ratios of cannabinoids. Neither THC nor CBD on its own show as much promise as the two of them combined.

Generally families follow particular protocols, but these protocols would be undoubtedly strengthened by the involvement of a professional. Cannabis chemotypes with known CBD:THC ratios are commonly used in autism and epilepsy therapies, are widely available, and the genetics often traded freely. The most commonly used are near 10:1, 5:1, 1:1 ratios. Analytical labs are used to ensure a verifiable amount of cannabinoids are present in a botanical extract used in these therapies.

This notion that we have so much of a greater understanding of the long term effects of Risperdal and/or Klonopin, or that they’re safer than these botanical extracts seem unfounded. The fact that THC is cited here as the compound of most concern, while it’s often used in many of these therapies in the form of Marinol suggests that the real issue is in regards to the perceived lack of regulation of botanical extracts, and not the active compounds present within them. Unless the claim is that higher CBD ratios present a greater level of concern.

Cannabinoids from cannabis can provide palliative relief in symptoms associated with severe cases of autism. This notion doesn’t seem to be contested here, or anywhere else. This is why the panel approved this recommendation. According to the pediatric neurologists that have been a part of these types of therapies over the past seven years their impression is “very favorable”. These men have specialized in treating autism for decades utilizing an array of off-label drugs. According to their expertise, without exception to the concerns cited here, they feel that these botanical extracts of cannabinoids offer a relatively safe set of options compared to conventional drugs which often do not provide therapeutic value in the types of scenarios being referred to. My guess is if they had a variety of clinically available ratios of CBD:THC they might prefer that, but we’re easily decades away from that, and they see the value these botanical extracts are bringing to therapies today. Parents say they can’t and won’t wait decades for something that they already have access to and success using now. Should they be arrested for that? If people are going to utilize these therapies regardless, would we rather more or less expert involvement? Should the decision to initiating a therapy of this nature be solely that of a parent, or would we rather two separate physicians weigh in?

I have an autistic friend who has written some about stimming. One thing I remember is that they can use music (headphones when out in public) and perfume and other scents to help them cope. They also sometimes fiddle with jewelry: people may wonder a little why someone keeps playing with a pendant, bracelet, or watch, but it's within the range of behavior that's accepted in a lot of circumstances.

zebra, I would suggest that you pose that question to people who are actually advocating medical marijuana: they have a better idea of what they want to test/discover. However, you are (like so many people) forgetting that not all autistic people are children. If there's reason to think that THC, CBD, or any other extract or form of Cannabis sativa is useful for handling autism, the ethical way to study that would be to recruit autistic adults. If you try to limit it to "children with severe cases" you're stacking the deck in ways that make me think that you don't expect or want an answer, but are looking for an excuse to justify drugging children who can't explain that they don't like being high.

Cannabis for Autism is on Facebook

Yes, Julian Pursell has earned himself quite a reputation here in the past.

HTH. HAND.

1 in 3 children with autism also have some form of epilepsy or seizure disorder.
Cannabinoids for these disorders will end up in the hands of auttistic epileptic children!
Of course, no apparent reduction in their autism symptoms as a consequence will ever happen again. Sorry that it happened so many times already.

JP do you have a daughter? Do you use pubmed as a parenting manual?

No, but I was a teenage girl less than a decade ago. Do you have a point?

You know my good Dr Orac I agree with what you say. However when I see these claims I am forced to take a bit of the attitude of the "shruggies" you talk about in other posts. Why?

Because, bottom line? Prohibition has failed, it has failed so hard that it didn't even roll a 1 in D&D it rolled a -10 on its chance to hit.

We have been subject to so many years of so much propaganda that has just so steadfastly cemented the social image that one person, smoking one puff, of one joint, once, will immediately go from Leave it to Beaver to Charles Manson or Ted Bundy forever.

I am of the believe we should legalize cannabis recreationally and decriminalize the harder drugs (with emphasis put on public health treatment and rehabilitation as opposed to punitive approaches.)

It's just that, when I argue with these anti-drug advocates, they are unflinching. No argument about the constitutional use of police to "protect us from ourselves" works, no argument about the failure of alcohol prohibition works, no argument regarding the success of portugal or other countries work.

Flat out, the only, and only thing I have seen sway these people's opinions are the ideas it might have legitimate medicinal purposes.

So with that I have to ask you, as a doctor who has an awful lot more knowledge then me, what would you recommend I use in my future strategies? Because I need a way to convince these utterly brainwashed Zombies that no, prohibition is what truly kills, not just the addicts but the society, through organized crime and the rise of the police and military's power to usurp our civil rights and civil liberties all in the name of The War on Drugs.

I know you're a very busy physician, so I won't blame you if you don't respond. But seriously, I plea for your help. I don't want to make medically dubious arguments, but they're all that seem to work. Thank you in advance. :)

It’s an interesting quandary from where I sit. I first tried cannabis toward the end of my freshman year in college (about three weeks after my first beer, a Foster’s oil can, for heaven’s sake). My reaction after about two hours was something along the lines of “this is the most interesting thing ever, what time tomorrow?”

Whereupon everyone stared at me and probably remembered as a single man that I was also a fan of the eponymous debut LP of Huey Lewis and the News.

If we're swapping anecdotes, I tried it for the first time when I was 18, back home visiting a friend, after an afternoon of spelunking, with no effect as far as I could tell. Ditto the second time, which was at a party in my second year of college. Third time was a charm, but I got waaaay to stoned and didn't enjoy it, although the next day I felt pretty good. I think I didn't really touch it again until I'd moved to Portland after college and was hanging out with some hometown friends on the regular - that stuff was homegrown, though. I've been known to indulge on occasion socially since then.

I've always preferred alcohol, though, TBH, which is sort of unfortunate, really. Now, psychedelics I can get behind, although I understand the effects are blunted when one is on an SSRI.

I actually am uncomfortable dosing developing bodies/brains with any medication. My parents were told to medicate me when I was eleven and adamantly refused. I don't know, of course, if medication might have made things easier, but an educational psychologist I was referred to in my early twenties said that I learned coping mechanisms to deal with a brain that didn't work like everyone else's. Since my son shows some of my characteristics, it was recommended a few times when he was younger that I get a psych consult for meds. I knew I learned self-control and coping, and decided to watch and wait instead. His grades aren't what mine were, but he is much better with people than I ever was.

Narad, my doctor and I have discussed medical marijuana. He says one issue with it is that with multiple active substances and even possible synergy between some of them, they can't be sure when isolating compounds if it is one active compound, another or a few that might be addresses a particular problem (pain vs seizure vs hypersensitivity to stimuli, etc.). The difficulty getting marijuana to research also reduces the opportunities to study.

I tried pot for an entire week. I found it affected my job performance at the time (still wet behind the ears and selling electronics), so I lost interest in it pretty quickly.

Vicki #165,

I'm trying to stick to the topic and also honor the idea of "science" as supposedly promoted by Orac. But apparently Orac doesn't want to discuss how to do the science to deal with his concerns, rather he wants to repetitively write some version of "but woo" or "but bleach" and so on.

Kind of like that stimming people talk about....

If you don't think it is ethical to do drug studies on autistic children, you should be very upset with conventional medicine. As Esther Knight points out, anti-psychotics have been tested.

I assume those children, as you say, were unable to communicate their displeasure.

But I think the inability of anyone to propose an alternative to what CO is talking about demonstrates the silliness of this particular post.

Orac favors legalization, which will inevitably lead to (more) unsupervised experimentation as purity and consistency improves, but complains about doing it now with the input of MDs. Again, it makes no sense to me.

Roger Kulp:

The moderate to severe autism,the developmental delays,the cardiomyopathy and cardiac conduction disorder that started in the teenage years.I would love to be able to compare histories,if you had a Facebook page or blog.I don’t know if your son has had all the medical tests I have had.The stroke like episodes can either be due to mitochondrial disease,or abnormalities in folate metabolism.I have both.I have been involved in a couple of clinical trials not generally available to autistic adults in these areas.

Sorry, we are not going to compare histories. His sociability is not quite at that level, especially since he has been bullied online. So now he just avoids it.

As noted above, he was given a genetic screen specifically for his specific type (link to company the performed the scan).

The university's genetics doctor specializes in autism, and also thinks there may be a connection. But I doubt the health insurance company would pick up the tab for a full screen, and we are not going to pay the five figure price tag (yes, the price has gone down, but not the type used in medical research). She is welcome to son's DNA when she gets a grant.

As you must know from personal experience there are no short cuts to figuring everything out, including how to cope in this world. Good luck to you, and to your health.

Why should developmentally damaged peeps with compromised detoxification pathways be further poisoned with more toxic substances as well as common environmental pollutants, that put extra strain on said damaged detoxification abilities??

Revolving door medicine and chasing the almighty dollar?
A curse upon your houses!

@Frank Collette,

I don't know about anyone else, but I can't make heads or tails out of what you're against or why you don't like my house.

Yes, LET'S talk about ABA.
We want to work together. ABA works better with cannabis.
ABA providers are not convinced (by the reports of autistic kids having cannabis and mainstreaming it all the way without the help of the accursed houses of ABA) perhaps?

Let's talk about the risks of ABA too.

ABA works better with cannabis.

How do you know?

Whoa Frank, whatever you're into is NOT mellowing you out. :(

@176 Meph O'B
Because being an autistic person around regular humans always goes better with cannabis.
Unless we can get ABA off of a robot, then we don't need the cannabis.

@Esther Knight - ah, so it's the obvious reason. The same reason I play pool better after a beer. Thanks.

178 danger bacon

I'm detoxing and doing a full rebuild, and clean as a whistle.
Its the mercury in my system from amalgam removal, making me cranky.

Even so, it needs to be said.
Profit focused housing, medical and education can never do a good job for recipients of these services.
Look at private prisons, they just want them to keep coming back!
Massive fail!!
Big Pharma dont want to lose $$$ by promoting effective and safe remedies....
Even Sativex has propylene glycol in it. Why? Tinctures are fine without it.
Eat the battery chicken, become the battery chicken.

Mercutio:
I am hurt.
A plague a' both your houses! I am sped.
Is he gone and hath nothing?

Romeo And Juliet Act 3, scene 1, 90–92

Frank:

I'm on your side on at least some of this--the prison-industrial complex is a scandal and a massive human rights violation, though unfortunately not forbidden by the 13th Amendment. But listing several things you object to doesn't create a connection between them. Vegetarianism won't open the prison doors, and socialized medicine doesn't prevent global warming.

Are you really quoting that bullshit study with a ridiculous sample size and methodology as reliable evidence that "marijuana use is associated with abnormalities in the brain"?
There was only one subject who showed a volume difference and that person alone skewed all the data. The study was heavily criticized by scholars who have never been involved with marijuana advocacy.
Please be more rigorous and less biased when selecting your sources. We do not "know" any of those things you claimed we do, at least until cannabis remains as a schedule 1 drug

Complementing what I posted earlier with sources:
"We do know that teenagers who were found to be dependent on marijuana before age 18 and continued using it into adulthood lose IQ points. "
Do we really? Turns out the study you linked is flawed, which was proven by a follow up study from the same university and another one from Univ College of London:
http://www.washingtonpost.com/news/wonkblog/wp/2014/10/22/no-marijuana-…

"We do know that marijuana use is associated with abnormalities in the brain in young users in an exposure-dependent manner. "
Do we really? If you take a moment to read what is possibly the most detailed analysis of the study you linked, by Berkeley professor Lior Pachter, you'll see how embarrassed you should be for referencing it.
https://liorpachter.wordpress.com/2014/04/17/does-researching-casual-ma…

"There are other potential adverse health effects as well. "
The study you linked to back that claim is extremely vague - its only conclusions are the most obvious issues such as "marijuana impairs driving", and basically just complains about the lack of research.

I'm with you when you say we need solid evidence before prescribing any medicine, but when you go on bashing cannabis, you just sound as the most 'anti-science' science blogger out there. You didn't even need to write that to support your main claims.

One notes that, for all your complaints, you haven't provided (1) one sliver of evidence that cannabis helps autistic symptoms or (2) that it is safe for long term use in children. Note that the children here are not young adults, as were the subjects of the study referenced. They are children as young as three or four years old. Can you honestly say that long term cannabis use is harmless from that age range on?

In the meantime, here's another summary:

http://www.nejm.org/doi/full/10.1056/NEJMra1402309

de Silva,

In the arena of dueling research papers, here's a new one.

http://www.ncbi.nlm.nih.gov/pubmed/26249266

It is in young adults and with an even smaller sample size but I am curious to know if the research is solid. I am unable to reach the full text and even if I could, I would not be able to vet it. That's why I ask.

@NaT:

I'm too beat at the moment to go fetch the full text and read it, but I do find it curious that they used such a small sample size. One imagines it should be pretty easy to procure plenty of cannabis-using and non-cannabis-using undergraduates or grad students, especially if lured with a little money.

Unless we can get ABA off of a robot, then we don’t need the cannabis.

Yah. I would echo Chris in the suggestion to "try a bit more coherence."

I've already blown a couple of hours trying to wrestle the Chakrabarti et al. PDF, and I'm disinclined to pursue the task if this and this are the reckoning points, if you get my drift.

@ JP:

Yes, strange that. My only guess re: the tiny sample size is that it may be what is now considered adequate when using fMRI.

Thanks just the same for the offer to fetch it. It's funny that I even asked here. One of the physicians I connected with over the internet is a psychiatrist who works for the Hazelden Betty Ford Foundation. If he wasn't on vacation this week, I'm sure he would have provided me with a perspective and couple of good, solid references on this topic within a few days.

Esther Knight, August 9, 2015, #179:

@176 Meph O’B
Because being an autistic person around regular humans always goes better with cannabis.

The autistic person writing this reply did not find that to be true: your 'always', at least, is false. Lacking any evidence, I can't speak to the possibility that the rest of your statement is consistent with reality.

I would be surprised if there are ANY long-term studies of cannabis in children. If there are, I don't recall them from a search I conducted a year or so ago on – among other aspects – the safety of cannabis. Granted, there are some short-term studies in children with epilepsy, but they can hardly be applied to autism in any age group.

Although not the first to show error processing dysfunction from cannabis, the recent study cited above (#186) in 30 young adults in their late teens and early 20s was poorly balanced for gender, being largely composed of male subjects (n=24). The results suggested that chronic users of cannabis fail "to learn from negative feedback" and "have poorer learning from errors".

I do find it curious that they used such a small sample size. One imagines it should be pretty easy to procure plenty of cannabis-using and non-cannabis-using undergraduates or grad students, especially if lured with a little money.

Yah, there's a campus lab that churns this stuff out. (Irritatingly, they make it trivially easy to find them at clinicaltrials-dot-gov to see the exclusion criteria but have to have the flyers they plaster the neighborhood with [when they're hard-up] preapproved by the IRB, which is an invitation to wasting people's time if one doesn't bother thinking through the designs in advance.)

Anyway, I suspect the limiting factor here is cost of the fMRI. I think I've already recounted winning a gold star for the most voluminous post-scan urine sample ever in the PET lab as part of a fenfluramine study. That was a production number.

#174
Frank Collette

August 9, 2015
Why should developmentally damaged peeps with compromised detoxification pathways be further poisoned with more toxic substances as well as common environmental pollutants, that put extra strain on said damaged detoxification abilities??

Revolving door medicine and chasing the almighty dollar?
A curse upon your houses!

Sir, a society is measured by how they treat and care for their lowest favoured member so how about I sue you for libel given your statement?

You see, your opinion is that we are toxic.

My science based opinion is that our brain is different.

According to current snake oil peddler who have medical training is that we're toxic.

According to science based medical doctors, we features 23% more neurons and a specific brain architecture which enable us to have better perceptual abilities and yet, disabilities in social situations.

You sustain that we are toxic. Can you reasonably that this toxic situation should account for 23% more neurons and increased perceptual skills while handicapping social awareness? If so, tell me because otherwise, I could sue you :)

Alain

@176 Meph O’B
Because being an autistic person around regular humans always goes better with cannabis.
Unless we can get ABA off of a robot, then we don’t need the cannabis.

Oh great. Now how about the regular humans take cannabis so they better understand the autistic person? How would that fly?

Alain

Ps.s as I've said, the measure of society so how they treat the lowest member of said society.

Now how about the regular humans take cannabis so they better understand the autistic person? How would that fly?

My immediate reaction is that this could run a strong risk of the adverse event "Irritating the Hell Out of the Autistic Person," but maybe that's a neighborhood thing.

the tiny sample size [...] may be what is now considered adequate when using fMRI.

Never mind the tiny unrepresentative sample, look at the pictures!!

Narad,

Regular human being irritate the autistic member of society commenting here. I'll have to check with other member with the same diagnose or any others diagnose on the same spectrum but I guess I have 95% of obtaining the same opinion. And that is, without any of the post's substance being ingested by the bothersome peoples here.

Side thing, autistic members can bug the hell of other autistic members but that's just because no member look the same or had the same upbringing as other member of the guild.

Never mind the tiny unrepresentative sample, look at the pictures!!

I really should have paid attention to the title of the journal in the first place.

^ And yes, I saw that blockquote fail unfold in slow motion.

Typo about personality:

Regular human being harbouring fixing the autistic without considering the ethic of cannabis on autistic without considering cardiac or any harmful condition triggered by cannabis on autistic human being.

Its the mercury in my system from amalgam removal, making me cranky.

If removing amalgam gives you mercury poisoning then you are doing it wrong.

Never mind the tiny unrepresentative sample, look at the pictures!!

A picture is worth a thousand test subjects?

Nah.

Anyway, I suspect the limiting factor here is cost of the fMRI.

I thought about cost but isn't the equipment the bulk of the cost and not the running of it? And, in my tiny unscientific mind, if the sample size is too small to return anything of value, then didn't a whole lot of money just get flushed down the drain?

This is science people. I don't expect it to act like business!

If removing amalgam gives you mercury poisoning then you are doing it wrong.

Walter James Palmer, DDS, who attracted the indirect ire of AoA about petitions and a lion or something, specialized in cosmetic and mercury-free dentistry and amalgam removal.

Connect the freaking dots already.

Alain
'we features 23% more neurons'
All of we? I thought everyone had 21% more.
http://www.windeaters.co.nz/assets/articles/education/Heavy-Metal-Toxic…
Many more studies show autistics to have heavy metal toxicity too, just google!

Herr Doktor
'If removing amalgam gives you mercury poisoning then you are doing it wrong.'
Completely wrong Doc. Ask any biological dentist before you comment.

If one doesnt want an elephant in ones kitchen, dont make friends with an elephant trainer.

Hey I'm off, too much unscientific and money grubbing bollocks here for me.
Peace and happiness to you all.

PS Please dont sue me Alain, I was not cursing, really I wasn't. Just cussing..... it was my dyslexia.

"...winning a gold star for the most voluminous post-scan urine sample ever in the PET lab.."

That sounds painful (and gives me visions of Austin Powers).

I hope they reimbursed you well.

Orac 185,

And what would convince you "that it is safe for long term use in children"?

This has nothing to do with whether any evidence exists for benefit-- it's about your claim of being scientific.

Tell us what would constitute an ethical, valid, clinical trial, that would establish "safe for long term use in children".

You claim expertise in this area; it should be an easy exercise.

And what would convince you “that it is safe for long term use in children“?

This has nothing to do with whether any evidence exists for benefit– it’s about your claim of being scientific.

Tell us what would constitute an ethical, valid, clinical trial, that would establish “safe for long term use in children”.

You claim expertise in this area; it should be an easy exercise.

You want an ethical study on children for a substance without prior evidence of efficacy?

It's glad to know some things in life remain the same, even if it zebra's lack of understanding.

zebra
August 10, 2015

Orac 185,

ObInman.

Keith Bell was the most recent exemplar, right?

Ok, you all win. Running fMRIs are hella expensive, and those researchers with small sample sizes are acting like business people.

http://neurochambers.blogspot.com/2014/01/tough-love-for-fmri-questions…

Completely wrong Doc. Ask any biological dentist before you comment.

I deal only with robot dentists, which can be programmed not to talk.
Reading the strange emissions from "biological dentists" puts me in mind of the mystical doctrines of the philosopher-dentist R. King Dri in Mathew's novel "Tlooth".

Walter James Palmer, DDS [...] specialized in cosmetic and mercury-free dentistry and amalgam removal.
Ah, no wonder he has acquired so much money to travel around the world slaughtering megafauna. I did not realise that he he was aboard the mercury scamwagon.

Running fMRIs are hella expensive, and those researchers with small sample sizes are acting like business people.

I get the impression that the pressure to publish is even greater in neuroimaging than in other fields of research. Once the university have coughed up the money for a new 8-T scanner they want to see results right now.

Does anyone compile comparative rankings of research fields, to see which ones produce the greatest proportion of publications that are never replicated and never formally retracted and just fade quietly into oblivion?

Two other fMRI studies suggesting "diminished capacity for detecting errors" in cannabis users:

http://www.ncbi.nlm.nih.gov/pubmed/19553917

http://www.ncbi.nlm.nih.gov/pubmed/15795138

#208

http://www.ncbi.nlm.nih.gov/pubmed/22592735

Face it, your fearless leader is not such an expert as he claims. Good at repeating "but bleach" and "but woo", though.

@zebra 214: and this shows safety how? Given the adverse effects, I'm not convinced.

#215

????

Where did I say this shows safety?

I think you are not following the comments I was just making.

Surely no one is seriously suggesting that aripiprozole is less harmful than Bedrocan? Or Bediol?

Does Europe Exist?

@ Lighthorse #191, #213.

Thank you!

It sounds like Zebra is asking for a study design which would determine whether a drug is safe for use in children, assuming efficacy is already established. Said design would need to be ethically acceptable, provide conclusive safety evidence, and deal with long term effects.

As someone who has no experience with developing medical study designs, I'm going to leave it there.

Does Europe Exist?

Last time I looked it did. I don't have direct evidence for the last several months, though.

I'm guessing that #216 is meant to say "hey, look, evidence that cannabis helps autistic symptoms. Where are your mad pubmed and research skills now, monkey boy?"

http://www.telegraph.co.uk/finance/newsbysector/pharmaceuticalsandchemi…

'Mr Gover said the company would start research programmes into further targets in the course of the year. He told the Telegraph last month that GW would investigate whether a cannabis-based medicine could be used to treat severe autism.'

Mephistopheles O'Brien,

Does Europe Exist?
Last time I looked it did. I don’t have direct evidence for the last several months, though.

Part of it is visible as I type this which may or may not be helpful depending on your philosophical bent.

I’m guessing that #216 is meant to say “hey, look, evidence that cannabis helps autistic symptoms. Where are your mad pubmed and research skills now, monkey boy?”

Your guess is as good as any. I have given up on trying to decipher zebra and his superior communication skills. He seems to think a succession of people failing to understand his blather while he accuses them of stupidity constitutes "a very interesting discussion all around". I don't.

@Esther Knight - I look forward to the results of their trials.

@Mephistopheles O'Brien - Yes, and while we wait can someone please explain what drove such a serious pharmaceutical company to make such an announcement?

Was it the pseudo-science or was it the anecdotes that persuaded GW pharma to back cannabinoids for autism in the Telegraph?

Yes, and while we wait can someone please explain what drove such a serious pharmaceutical company [sic] to make such an announcement?

The failure of their cannabis-based product for cancer pain in a Phase 3 trial?

Was it the pseudo-science or was it the anecdotes that persuaded GW pharma to back cannabinoids for autism in the Telegraph?

Presumably they think they have something. On the other hand, they thought they had something with their cancer pain drug as well, and this was not proved in their trial (though they remain hopeful and believe in their product). The company, GW Pharmaceuticals, seems dedicated to creating and selling drugs derived from cannabis. They currently have one product approved for use in 27 countries. I'm sure they want more, since one product is hardly enough for a company to be profitable with.

Lots of companies start testing drugs they believe in strongly due to preliminary research (or folklore). Not all prove useful, at least not at first. See Resveratrol for an example.

Was it the pseudo-science or was it the anecdotes that persuaded GW pharma to back cannabinoids for autism in the Telegraph?

They have invested a lot of money in that solution so now they will work their way through the list of potential problems..

I don't think GW would risk huge amounts of shareholder's money if the 'pseudoscience and anecdotes' route get laughed at on an important forum like this.
They must know more, or have done more?
Could they have given some cannabis to some autistic people already?
How does it work in the UK? Does anyone know?

@Esther Knight #225

I would hardly say that GW is "backing" cannabis for severe autism; only that they plan to examine the potential for any possibility of its treatment with one or another of their products.

I don’t think GW would risk huge amounts of shareholder’s money if the ‘pseudoscience and anecdotes’ route get laughed at on an important forum like this.
They must know more, or have done more?

Call me a hater, but I do not share this blithe faith in the altruistic motivations of the pharmaceutical industry.

If there is one thing this thread has done, it has revealed how cannabis affects thought processes.

Chris that is a very unscientific thing to say (#232)
There is no evidence that anyone here has been using cannabis.
Stick to your own rules or don't complain when others break them.

@Esther Knight - you said above "Adults with autism who use cannabis: There are xillions* of us". Common usage would mean that you include yourself in the group of adults with autism who use cannabis. That's not science, but it is at odds with your statement that "There is no evidence that anyone here has been using cannabis."

Poor Ms. Knight, she now knows how seriously I take her incoherent statements. Also my observation was about more than one person.

OK so my self-reported anecdote is a start.
How about those thought processes? How are they affected?

Am I autistic? What if I was misdiagnosed? What if I have an undiagnosed thought disorder?

Basically, let's stick to one set of standards and point out the hypocrisy along the way?

Sorry Chris but as far as I can tell, Zebra has been taking something I've never heard of and Frank is on something a bit stronger than weed.
That only leaves me. I don't know what those others are doing here, I really don't.

Frank is on something a bit stronger than weed.

Crank magnetism is one helluva drug.

I had a stoner roommate in college for a month. He got pretty incomprehensible at times, though so far as I know he was doing OK in his classes (but then, the first two semesters were all pass/no credit).

I have a friend who grew up in the sixties/seventies. Her parents were "cool" and had parties where they smoked pot. They would talk and talk, and they would think themselves quite brilliant, especially how they would make the world better.

Even when she was very young she thought they were talking nonsense. So she decided to stay away from marijuana.

Ok but the friends we have growing up or in college are not completely selected at random. Birds of a feather...

Even when she was very young she thought they were talking nonsense. So she decided to stay away from marijuana.

A similar reason lies behind the Doktorling Sonja's decision to abstain from beer.

hdb: "A similar reason lies behind the Doktorling Sonja’s decision to abstain from beer."

Were you providing the example? Youngest child has also made the decision to abstain from alcohol, similar reasons. She has also decided to never have children, as she sees what happens to people when they become parents.

Well, to share in the manner of the crazy/drug (ab)use boards, SWIM takes modafinil and 5-htp as needed.

Modafinil, yes, the "smart" drug. Except (n=1) if you really need it, it doesn't make you smart; it barely gets you passing as a functioning human being while also keeping you from falling asleep at the wheel.

But SWIM tells me that taking it as needed is always a gamble since you need to take it in the morning before you know how bad your day is going to be. In addition, it has an inexplicable half life that allows sleep 4 hours after taking it on some days and other days it is more like 17 hours. One never knows how long one will be awake after taking. Also, it causes bruxism on some days but not on others. [And, it costs around $400/month, probably because the military is competing with you for the same drug, but who knows.]

The 5-htp is for deep sleep and provides vivid (but luckily, most often comical dreams). How? I have no idea. SWIM generally keeps that on the low-down because it sounds crazy.

Note: Both are legal for SWIM to use. Do not try this at home without a Rx and/or consult with your doctor.

Were you providing the example?

"If you can't be a good role model, aim to be a bad example."

Esther Knight

Would you care to elaborate what you believe the risks of ABA are?I know there are a lot of parents who swear by it,and say it helped their child greatly,but I have seen just as many stories of parents who say ABA did nothing for their child one way or another.So what are the risks you see?But please,spare me the usual neurodiverse BS about how treating the autism would take away your individuality,and erase who you are as a person.

The 5-htp is for deep sleep and provides vivid (but luckily, most often comical dreams). How? I have no idea. SWIM generally keeps that on the low-down because it sounds crazy.

It's a serotonin thing. I'm on 150 mg of Zoloft right now, up from 100 mg a week ago and on the way to 200 in a week. I've started having the long, involved, vivid and memorable dreams again that I remember from the last time I was on an SSRI. Last night I had a dream about diving for treasure, except when I got to where the treasure was, it was a purple dragon plushie with comically small wings. The great thing is that I was not disappointed, as this dragon was very important and meaningful for reasons I cannot explain in a waking state.

I know about the 5-htp because I once bought some as a sleep aid, and found out serendipitously just before taking it that it shouldn't be taken if you are taking an SSRI, as it can cause serotonin syndrome.

The Zoloft actually is causing some bruxism as well, but them's the shakes, I guess. With any luck it'll pass.

A similar reason lies behind the Doktorling Sonja’s decision to abstain from beer.

I haven't had a drink in days, so now I am having two, because I've decided that's how it works.

@ JP:

I had rater disappointing results with 5-htp and melatonin
( separately) for sleep.

Treasure and a plushie purple dragon? Did he sound like Mr Cumberbatch?

RATHER disappointing

Treasure and a plushie purple dragon? Did he sound like Mr Cumberbatch?

Nope, it was mute; literally a toy stuffed animal. Search me.

JP,

I'm happy to hear that you're having enjoyable dreams, and good advice on the 5-htp interaction with SSRIs.

Btw, you made my night. You're the first person to ever know what I'm talking about with the dreams. All I have ever read about (or heard about from my friends) have been the nightmares.

On that note, it's past time for bed on this coast. Perhaps I will run across your purple dragon plushie tonight.

Pleasant dreams....

(Note: Earlier I meant to write '"on the down-low" not "on the low-down". I do know the difference. Grrr.)

I’m happy to hear that you’re having enjoyable dreams, and good advice on the 5-htp interaction with SSRIs.

Btw, you made my night. You’re the first person to ever know what I’m talking about with the dreams. All I have ever read about (or heard about from my friends) have been the nightmares.

Oh, I've had some of the nightmares too, and they were truly awful. I only had them was when I was on Lexapro, if memory serves. Just really, really f*cked up dreams. There's one in particular that's seared into my consciousness forever, but I am not going to relate what happened here.

So far so good with the sertraline, though.

Roger I would love to oblige but why reinvent the wheel? TGPA on facebook seem to have it covered already - https://www.facebook.com/thinkingpersonsguidetoautism/posts/36747052662…

Let's talk about the risks of the neurodiversity movement!

I often wonder about the rights of all children. Whether it is bleach enemas or the effects of marijuana on young brains, the rights of these children are being abused. Using untried woo does not help children who have autism. It is a bit like saying that "my child is not learning quick enough at school, maybe I should try marijuana so he can know everything at six years of age". Use of standard applied behavioural analysis may not work instantly, but it can have long lasting good effects. Marijauna can have terrible effects on the adult brain, never mind on the brains of children aged three or four.
at 6 years of age"

Here in the UK we have somehow managed to approve riperidone for autistic children, despite the risks.

Is anyone here seriously suggesting that it's safer to give a child risperidone over cannabinoids?

http://sfari.org/news-and-opinion/news/2014/risperidone-use-in-children…

@esther knight

From your article: ''More worrisome, however, are the side effects, the most significant of which is weight gain from an increased appetite.''

Because that doesn't happen with marijuana, right?

@Garou you'd think so but paradoxically no.
Long term cannabis users are less likely to be obese.
These are, however, self-selecting recreational users.
We might see a different effect in a clinical population?
We won't know until we allow it as long term medicine for a large enough population to study.

http://www.icsdp.org/cannabis_claims

Seems like you could really use some real science. The link above will help you see that your points on MJ impairing IQ or damaging the brain in general are based on very bad science.

What the writer of this article fails to understand is that the marijuana will not be used to treat the core symptoms of autism, but to help alleviate some of the severe co-occurring challenging behaviours that cause pain and great suffering to both the child who is seriously impaired by autism and his or her family or care givers.

Oh, I understand that quite well. I argue that there's no good evidence that cannabis can do that either, because there isn't.

@Oughtism you fail to understand that some of us have autism with no co-morbidities and we are using cannabis to reduce symptoms of autism.

Orac if you were to design a trial of cannabinoid treatment for autism, which co-morbidities (if any) would you exclude?

#263
'some of us have autism with no co-morbidities'

Impossible!

Access to drug comes at high price
http://nzh.tw/11379959
Jade Guest's life has changed since she has been able to access medical marijuana in Colorado to treat her severe epilepsy, but it meant her family just spent their first Christmas separated.

Marijuana Stops Child's Severe Seizures
http://endingcannabisprohibition.yuku.com/sreply/667

New York Nine Year Old Girl With Dravet Syndrome
Dies Without Medical Marijuana
http://endingcannabisprohibition.yuku.com/sreply/881
Some things you should know about seizures
http://endingcannabisprohibition.yuku.com/sreply/891

Cannabis For Autism & Seizures.
http://endingcannabisprohibition.yuku.com/sreply/855

zebra, this one's for you.

^ Follow-up to my link above.

It looks like the Medical Innovations Bill (Saatchi Bill) has been revised to be the Access to Medical Treatments (Innovation) Bill. that is claimed to disallow the use of ‘quackology’.

There appears to be a war, on Facebook.
The cannabis for autism page and some anti-vaxxers appear to be at war.

facebook.com/CFourA/reviews

@ Esther Knight

you fail to understand that some of us have autism with no co-morbidities

Seriously I do not believe you.

Meanwhile measles is merrily spreading its way across Queensland.

Orac, a glaring inaccuracy!
That Stone & Bognor essay was self-published on Scribe first then, tellingly without comment, simply reproduced on the 'cannabis for autism' blog.
One gets the distinct impression that the blog owner isn't particularly keen on pseudoscience, albeit possibly vulnerable to it?

One gets the distinct impression that the blog owner isn’t particularly keen on pseudoscience, albeit possibly vulnerable to it?

Julian Pursell is somewhere around the level of Philip Hills.

Has Philip Hills not worked for the last five years either?
Struggling to see any similarity. Help.

Got it!
Julian is a patient who uses exercise as therapy.
Philiip is a 'therapist' who sells woo.

Level-wise, which is lower?

to Cruz #260
From your study "state of evidence cannabis use and regulation"
"There are concerns that cannabis use, especially when initiated in adolescence, may lead to various forms of cognitive impairment. For example, a recent Health Canada advertisement flashed “loss of memory” and “learning problems” on the screen (Health Canada, 2014). The U.S. National Institute on Drug Abuse has warned parents that cannabis use “has negative effects on attention, motivation,
memory, and learning that can persist after the drug’s immediate effects wear off – especially in regular users” (NIDA, 2014). While there is moderate evidence to support a general claim that early-onset and sustained cannabis use is associated with certain cognitive deficits,
there remain important gaps in our knowledge regarding the full range of effects and their reversibility."

So they basically admit that marijuana consumption impairs cognitive function (which is kind of obvious), but hey, it might be reversible! We don't know exactly to which extent you're impaired!
I'd tend to agree that the effects are reversible, having seen people fully recover myself, but we're talking about children of school age that would be "treated" with marijuana on a regular basis here. Pretty safe bet that it's not ideal for their success. Not to mention the whole "giving a psychoactive drug to non verbal children that can induce badtrips and other unpleasant experiences.

@Garou,Cruz
If aspects of autism can be described in terms of 'over-memorising' and 'over learning' then perhaps cannabis is reducing these?

Having a child with autism is truly nothing you can understand unless your child has autism. The whole point of medical marijuana for autistic children is not just calm them down so that they are easier to manage, but to calm them down and center them so that they have the ability to focus and learn that they wouldn't have otherwise. There are very few "regulated medicines" offered to children with autism and even less that have been proven to work or have any long term benefit. It is absolutely heartbreaking to see your child change from one thing to another almost over night. You do feel alone and hopeless and don't have any answer to your a million burning questions. While I do think that there should be regulation in doses and frequency, you have to remember that not one autism is the same as any other. A standard dosage and frequency level would not work for every kid, defeating the purpose of legalization. As long as parents are safe, responsible and doing something legal it should not matter to anyone else, especially not someone who has no personal experience and probably watches youtube as a reference.

Kaila

The whole point of medical marijuana for autistic children is not just calm them down so that they are easier to manage, but to calm them down and center them so that they have the ability to focus and learn that they wouldn’t have otherwise.

Does it work for that? What's the evidence for that? Thanks.

@Kaila #278

So, are you implying that Orac is watching youtube videos for reference? Maybe you should look up who he is before making these kinds of claims.

Although nobody doubts that your situation is not an esay one to be in and that you really love your child / children, that doesn't give you any kind of credentials when it comes to treating them for their autism.

Having been an extensive user of marijuana a couple years ago, I can tell you it doesn't rhyme with "focus and learn" as you say. In fact, quite the opposite. The claims on marijuana "curing" or helping with autism are not just unsupported by any kind of evidence or study, they don't even make sense in the perspective of what the drug does to the user.

@Esther knight #277

Is there such a thing as "over learning"?

@Garou

Yes, the 'restricted interests' leads to learning a lot.
The 'inappropriate speech' is when that info gets dumped.

Whether we fail to learn a lot or avoid infodumping, the goal is not to infodump. What's the point of learning a lot if you have autism? It's not like anyone will listen?

P.S Orac may not be using youtube for evidence but he is using facebook in a cherry-picked way,.

@Esther Knight

By infodump, do you mean speaking with great detail to someone about something you are very knowledgeable about, but the person is not interested in hearing it?

Even if your "restricted interests" lead you to a lot of knowledge about something that you might not be able to share with many people, that doesn't mean that knowledge has no value. You can always find people with whom you share interests, especially with internet today.

@Garou you're very kind and I'm sure that happens to some of us but we can't rely on that for all of us.
Even now that the beauty of my youth gives way to the wisdom of my old age, not even the guys listen to my dumps.

@Garou,Cruz
If aspects of autism can be described in terms of ‘over-memorising’ and ‘over learning’ then perhaps cannabis is reducing these?

Esther,

The only situation where there's no need for overlearning is in case of PTSD. Now would you please support overlearning for everything else?

The use-case is when I used to read a book three time in the same amount of days would I remember the text of the entire book _and_ the picture of ALL the pages in said book (and in my case, I used to remember over 1000 books in THAT details before 2004).

Only reason I no longer remember these books is because I met a few psychopath and ended up with a complex PTSD.

That kind of memory is incredibly useful in creating a good life for all the number of autistics in the world and I just absolutely can't figure out why you'd want to deprive them of this ability. And yes, I'm dead serious.

Alain

Alain you are right.

Being unable to learn the hard stuff I concentrated on the soft stuff instead. So when I met a few psychopaths I didn't end up with a complex PTSD.

Essie

Esther,

Please accept my excuses regarding your motives. I failed to consider that your comment did not suggest using cannabis to treat overlearning in all cases.

That was a reading comprehension failure which is unusual for me because, I usually assume that I'm not understanding what is written unless I worked out all the possibilities of the meaning of your (or anyone else's written or verbal) statement.

You can see why I ended up with the complex PTSD; I work out all the implications of what's being said to me or at me.

Today, what's different is that I know what I'm worth and thus, keep the same method of deducting whatever is said to me or about me without it affecting me in any emotional manner.

Thanks you very much and please have my best regards,

Alain

Science, "the systematic knowledge of the physical or material world gained through observation and experimentation."
Thousands of people have observed the effects of medical cannabis on medical problems specific to them or their loved ones. Thousands of experimented. Let the voices be heard. Science is not exclusive to scientists who have to wait for funding, grants, approval and pretentious pious politicians and their self-serving agendas.

Nicoli, science is a bit more than random observations and random "experimentation". It requires care in determining just what you are observing. "[M]edical problems specific to them or their loved ones" shows a total absence of care in determining just what is being observed.

"Thousands [have] experimented" with exactly what, under what conditions: what have they actually observed? GFunding and approval embodies the criteria that allows the answers to be medically useful, rather than just random grabs at a sandpile.

"Science is not exclusive to scientists"

Surgery is not exclusive to surgeons.
Designing buildings and bridges is not exclusive to architects and engineers.
Police work is not exclusive to police.
Fighting wars is not exclusive to the military.

Things tend to turn out better when amateurs recognize their limitations and professionals are allowed to do their jobs

As a person who has seen DIRECT and IMMEDIATE improvement of severe autistic symptoms, with medical cannabis compounds. I have to say, you're absolutely wrong. Your arguments do not add up. You cite, "cherry-picked arguments." All the while, you constantly employ that tactic yourself. Do you care for any autistic children or interact with them daily? Would you care to explain to them, that trying a plant, (not big pharma, which reportedly has you in their pocket,) to treat their soul crushing symptoms, is "premature?" The first search hit for your name describes you as, "The ultimate quack of all time, ORAC from National Geographic funded "ScienceBlogs.com"

I am very glad that even the weak minded will have a hard time buying into your nonsense.

Justin: "As a person who has seen DIRECT and IMMEDIATE improvement of severe autistic symptoms, with medical cannabis compounds."

Please get your robust study of the "DIRECT and IMMEDIATE improvement of severe autistic symptoms" with the astounding study size of N=1 published in a PubMed indexed journal, and then come back to astound us with your brilliance.

I don't know what Justin used for search terms, but *I* certainly didn't come across The first search hit for your name describes you as, “The ultimate quack of all time, ORAC from National Geographic funded “ScienceBlogs.com” as MY first Google hit. Under Orac, there are several references to the Original, a Wikipedia entry about the Hadron Collider, and some references to posts on RI. Nothing on the first page had what Justin found (unless he used quack as one of the search items).

Under the NSSON, an AOA post does come up on the first page. Even there, however, I am not finding Justin's search results.

Oh, found it. It's the extremely important Farce*book* page "exposing" Orac with a few words dropped. Justin, didn't anyone ever tell you that when you quote something, if you drop words you are supposed to use an ellipsis (aka ...) to indicate missing words? You fail grammar today.

Justin,

Just what the f*ck are you smoking??

Which symptoms, care to name any?

Did you f*ck!ng know that some autistics used cannab!s a few decades ago and left them seriously numb; which trigger a lot of anxiety??

Yeah, they feel numb and that cause anxiety. Is that what you want?? But hey, they're numb so you don't have to take care of the _ONE_ which you just submitted to the treatment...

Now, do tell me a$$hole, do you care enough about their anxiety to conclude that cannabis is not the answer you're looking for? If not, shame on you. You should never care for autistics.

Alain

Medical marijuana and the new herbalism, part 3: Cannabis does not cure breast cancer

oracknows — Wed, 25 Mar 2015 06:00:59 +0000

Medical marijuana and the new herbalism, part 3: Cannabis does not cure breast cancer

It's been a while since I discussed medical marijuana, even though it's a topic I've been meaning to come back to since I first dubbed medical marijuana to be the equivalent of herbalism and discussed how the potential of cannabinoids to treat cancer has been, thus far, unimpressive, with relatively modest antitumor effects. The reason I refer to medical marijuana as the "new herbalism" is because the arguments made in favor of medical marijuana are very much like arguments for herbalism, including arguments that using the natural plant is superior to using specific purified cannabinoids, appeals to how "natural" marijuana is, and claims of incredible effectiveness against all manner of diseases, including deadly diseases like cancer, based on anecdotes and testimonials. Now, as I pointed out before, not only am I not opposed to the legalization and regulation of marijuana for recreational use, even though I've never tried it myself, but I support it. What I do not support are claims for medical effects that are not backed up with good scientific evidence, and for medical marijuana most claims fall into that category. That's why I tend to view medical marijuana as a backdoor way to get marijuana legalized. Personally I'd rather advocates of marijuana legalization drop the charade, argue for legalization, and stop with the medical nonsense.

The last time around, I discussed the evidence supporting claims that "cannabis cures cancer" and found them to be wanting based on science. I didn't however, discuss the "cannabis cures cancer" testimonial machine that drives the claim that marijuana is useful for treating cancer; at least, I only touched on it by discussing briefly Rick Simpson, who claims that his hash oil cures approximately 70% of patients with terminal cancer and a published anecdote in which it was claimed that hemp oil was effective in treating acute lymphoblastic leukemia. (It wasn't. At least, the evidence presented was not convincing.) Since then, I've wanted to revisit the topic of "cannabis cures cancer" testimonials, and, for whatever reason, now seems like a good time to do it, not the least of which because there was recently a BBC news report by Alastair Leithead that presented a desperate patient with stage IV presenting cannabis as her last hope for survival. It also featured a cancer patient by the name of Stefanie LaRue who claimed that cannabis had been highly effective against her stage IV breast cancer, even going so far as to add an additional claim, namely that she used only cannabis, no chemotherapy. In this, the news story was horrible and highly misleading, because LaRue's story, as you will see, is far more complex than what is presented, and while it's true that LaRue hasn't had any chemotherapy in the relevant timeframe, that does not mean she did not receive conventional treatment, as you will see.

Stefanie LaRue

AFter seeing Leithead's story, I decided to look into the "cannabis cures cancer" testimonial of Stefanie LaRue. Hers is a sad story in that she was diagnosed at a young age (30 years old) after her boyfriend found a lump in her breast and misdiagnoses by three different doctors. In many ways, her story is an inspiring one based on her will to fight and her activism, which have led her to have served on the Board of Directors for the Los Angeles Susan G. Komen for the Cure, Southern California’s Breast Cancer Network of Strength, and the USC Norris Cancer Center’s Cancer Survivorship Advisory Council. Near and dear to my heart, she also is very much into rescuing and fostering many wounded, mistreated and special needs dogs. Indeed, I approach this particular testimonial with more than a little trepidation because there's an incredible amount to admire about LaRue and, more importantly, her involvement with Komen and other breast cancer charities means that people I respect and admire (who might read this) very well might know her—or even be friends with her. Still, given the direction her story has taken, I feel obligated to discuss it.

Here's a video of her from 2007 when she was still undergoing chemotherapy:

Notice the themes we see so often in cancer patients, particularly young cancer patients: Why me? There must be a reason. It can't have "just happened". Breast cancer is a disease of older women. (Indeed, the mean age at diagnosis is around 61.) There must have been something in the environment. Possibly. As has been discussed before, for breast cancer, environment- and lifestyle-attributable causes account for a much smaller fraction of cancer diagnoses than most people believe, and 1.8% of cases of breast cancer occur in women 34 and under. Given that there are approximately 233,000 new cases of breast cancer diagnosed every year in the U.S., that means that close to 4,200 women under 34 are diagnosed each year with breast cancer. Still, being diagnosed with breast cancer at age 30 is unusual; so it's understandable that LaRue would wonder why it happened to her.

Worse, LaRue was diagnosed with Stage IV disease, as described in an article by Sonja Renea published on the Medical Jane website entitled "Meet Stefanie LaRue: Cancer Survivor and Medical Marijuana Advocate":

Stefanie was sent home several times with several rounds of antibiotics, which is quite telling of younger folks being misdiagnosed. By the time she could be tested thoroughly, the cancer had spread to her bones. Doctors diagnosed her with Stage 4 Metastatic Breast Cancer, which is cancer that has spread beyond the breast to other organs in the body. The prognosis was grim: she was given a year to live, at most.

Three weeks later, Stefanie began her first round of chemotherapy. To make matters worse, she had to to [sic] cope with her employer, who showed little sympathy for her situation. Despite her job in commercial real estate being very stressful, she was expected to work through her cancer treatment.

This is a big problem with health care in the U.S. besides the difficulty many people have affording health insurance, a problem only partially alleviated by the Affordable Care Act (a.k.a. Obamacare), which didn't exist in 2005. You can be diagnosed with metastatic breast cancer and still be screwed as far as work goes. It happens far too often in this country.

So LaRue ended up quitting her job and filing for disability. She underwent six rounds of chemotherapy and then a mastectomy. At this point reading her story I had a question. If LaRue had bone metastases, it's not clear to me why her surgeon and oncologist would recommend that she undergo a mastectomy. Three possible reasons suggest themselves to me as a breast surgeon. One is that it was done to prevent the primary tumor from growing through the skin and turning into en cuirasse disease, although usually such surgery is not done right after chemotherapy but when the tumor has started to grow again. Another is that she had a complete radiologic response to the chemotherapy, meaning that all her breast and bone disease disappeared. When that happens and the patient has been rendered "no evaluable disease" (NED), we will often treat her as though she were not stage IV and undertake surgery with curative intent. The final possibility is that surgery was done with the intent of prolonging survival even though metastases were still present. It's been an ongoing controversy in breast cancer over whether removing the primary tumor prolongs survival in stage IV disease or whether the apparent improvement in survival due to surgery is due to selection bias; that is, bias towards healthier patients with less aggressive disease who are chosen to undergo surgery preferentially. More recent evidence suggests that removing the primary probably doesn't improve survival, but that was not at all clear back in 2005. (To be honest, it still isn't quite clear.)

On her website, LaRue reports that her tumor was 8 cm in diameter (which is big). Apparently her tumor didn't shrink enough to be removed in a lumpectomy; so she needed a mastectomy:

After chemo she had surgery to remove the cancer. But her margins were not clear, so another surgery followed. She was left with only skin and a nipple on the right side of her chest. Her breast surgeon had scraped all the way down to the chest wall removing all the breast tissue possible but sparing the skin. Despite the advanced stage of her cancer, she got to keep the outside of her breast because she had a skin-sparing mastectomy. A plastic surgeon was later able to reconstruct her breast, restoring her shape, her femininity and her sexuality.

At this point in my reading, I was unclear as to why a surgeon would do a skin-sparing mastectomy in a patient with stage IV disease. Most plastic surgeons are reluctant to do reconstruction in such a patient because reconstruction can be a big operation, and if the patient isn't expected to live more than a year it just doesn't make a lot of sense to have the patient spend a significant chunk of her remaining time recovering from surgery, having additional surgeries to "touch up" the reconstruction. The willingness of her surgeon and plastic surgeon to undertake a skin sparing mastectomy and reconstruction suggests to me that she had a very good response to the chemotherapy and/or that her prognosis as a stage IV patient was viewed as being considerably more favorable than usual.

Whatever the case, during the chemotherapy that she underwent before her surgery, LaRue looked to alternative medicine to ease her symptoms:

She found help with an integrative oncologist at UCLA, where she learned how to make changes to her diet, use natural supplements, get acupuncture, and work on personal fitness; all of which are integrative, complementary, and alternative treatments to go along with chemotherapy.

Now here's the thing. As a patient with stage IV disease, LaRue did really well for eight years. It's hard to find a good detailed description of what happened between November 2005 (when she was diagnosed with breast cancer) and 2013, but she didn't start using cannabis oil until 2013, which means that conventional oncology is what got her through nearly eight out of the nine and a half years she's survived with her stage IV cancer. It's important to remember that when looking at a lot of the articles about LaRue, because before 2013, although she had gone all in for "integrative oncology," she hadn't yet discovered cannabis and was still being treated with mostly conventional medicine. So, between 2006, when she finished her initial treatment, and at least September 2013, when she posted a series of images to Instagram of her hospitalization for thoracoscopic surgery, conventional medicine is what kept LaRue alive. So when Sonja Renea of the Medical Jane website writes that "Stefanie LaRue was 30 years old when she was diagnosed with Stage 4 Metastatic Breast Cancer and given the dismal prognosis of less than a year to live" and follows it up with, "That was nine years ago," she is being deceptive.

This is how it's described in the Medical Jane:

In 2013 Stefanie had a Video-Assisted Thoracoscopic Surgery (VATS) and the results were not good. This was now her third reoccurrence of cancer. The chemo sensitivity testing concluded there were five lines of chemo treatments that would work on the tumors.

Stefanie declined the treatment. “I did my homework. I researched as much as I could. I watched. I listened. I read. I contacted. I prayed. Most of all, I believed. I weighed my options, which were essentially chemotherapy or cannabis oil, and I decided to take the natural route this time…” she says.

Stefanie followed the Rick Simpson Oil (RSO) protocol until she was cancer-free. “Cannabis oil killed all of the tumors in my body. My monthly lab and quarterly scan results are proof that the cannabis oil treatment worked,” she says. Her doctor, who had previously been skeptical, now credits these “alternative” treatments as the reason for her speedy recovery.

On Instagram, LaRue described it thusly in a posting dated October 2, 2013:

Dear cancer, as we both know, yesterday was a big day of news. And sadly for you, you lost. You lost your "upper hand" you tried to claim in that you were potentially showing up again (unwelcomed in my body) not as a metastatic reoccurrence, but as a possible new primary cancer. Which would have been a much more challenging ass kickin match between you and I. None the less, I would have enjoyed. But since you are now known as the same initial metastatic breast cancer reoccurring, I hope you are preparing for what is coming to you. Because now I have the upper hand. When the chemo sensitivity tests are complete on my biopsy tissue at Caris Labs we will know exactly what to come after you and all your little friends with! Poor you. I know your still cowardly hiding in my body but you have pissed off some pretty important people that care a lot about me and guess what... Now they too are coming in to whip your ass!!!

We've encountered Caris Labs before in the context of discussing Stanislaw Burzynski's incompetent "personalized gene-targeted cancer therapy." Basically, Caris is a company that will do various genomic tests and immunohistochemistry on a tumor sample to try to identify which targeted agents it might be sensitive to. I've basically discussed how the routine use of such a test is premature, given that there isn't any good evidence that using a test like the one from Caris or other competing tests results in better response rates or prolonged survival, but such tests have still proliferated and their use is not uncommon, even in academic medical centers.

In any case, at this point in the fall of 2013, LaRue was facing her third recurrence of cancer. Unfortunately, this is a story very much like the many alternative cancer cure testimonials I've deconstructed over the years in that we lack a lot of key information, which means that I can only speculate. First, we don't know how extensive a cancer recurrence LaRue had. Given that she underwent thoracoscopic lung surgery (a thoracoscope is like a laparoscope, except that instead of letting a surgeon operate in the abdomen it allows the thoracic surgeon to operate in the chest with minimal incisions), presumably she had a lung nodule. In a patient with stage IV disease, most such lesions would be biopsied using a core needle under CT scan guidance, rather than excised surgically through a laparoscope. Why did the surgeon choose this course?

A couple of possible reasons suggest themselves from the story. First, perhaps she did undergo a CT-guided core needle biopsy and the diagnosis was uncertain. Certainly LaRue's Instagram posting, in which she gloats over her tumor for not being a new primary tumor but just the same as the other recurrences of her original tumor, suggests that this could be the case. After all, a new suspicious lung nodule in a breast cancer patient is usually considered a new metastasis until proven otherwise. In any case, in patients with metastatic disease, a tissue diagnosis is always imperative before beginning treatment if at all feasible. Another possibility is that this tumor, whatever doctors thought it was before surgery, was the only site of disease detectable. In such a case, particularly in a young patient who had been doing well for nearly eight years even if she did have stage IV disease, strong consideration would be given for excising the cancer and eliminating the only known site of disease even though the evidence that metastasectomy (removing the metastasis) will prolong survival in breast cancer is mostly without controls and thus prone to selection bias. (Metastasectomy of liver and lung metastases can definitely prolong survival in colorectal cancer.) Still, there is evidence that in select patients removing pulmonary metastases can result in significant survival benefit. Whether LaRue is one of those select patients is unclear.

So here's what I think probably happened. After surgery LaRue (understandably) did not want to undergo further chemotherapy. For whatever reason, she latched on to Rick Simpson's hemp oil as the treatment that would control her cancer. How she found out about it and why she became convinced it would cure her, it's hard to say from publicly available information. In the Medical Jane story, LaRue proclaims that "cannabis oil killed all the tumors in my body" and that her "monthly lab and quarterly scan results are proof that the cannabis oil treatment worked." It is, of course, impossible to confirm or dispute this assessment without knowing what all her scans showed.

There is, however, a photo on Instagram of LaRue receiving a shot, which she identifies as Xgeva, which LaRue described as "bone mets maintenance." And so it is. It's a monoclonal antibody against the RANK ligand, a protein that acts as the primary signal for bone removal, and it prevents fractures in patients with bone metastases. So this implies that LaRue still has bone metastases. It also makes one wonder what other non-chemotherapy conventional therapy she might be taking. There's also a post by her on Twitter asking about Afinitor (everolimus):

New treatment protocol side effects (third reoccurrence) should I take or seek other alt options? #cancersucks pic.twitter.com/hlAbCaa462

— Stefanie LaRue (@stefanielarue) October 28, 2013

Afinitor is a drug that inhibits an enzyme called mTOR and is used in cancer that is positive for the estrogen receptor after it develops resistance to anti-estrogen therapy. Apparently she did not take Afinitor, because on March 14, 2014 LaRue posted a photo on Twitter:

This is about the time when getting #treatment really sucks! #zoladex #injections #stomach #fuckcancer pic.twitter.com/MwNIqvwm0k

— Stefanie LaRue (@stefanielarue) March 8, 2014

In the photo, LaRue is receiving an injection of Zoladex (goserelin), a drug used to suppress production of sex hormones. In other words, six months after her thoracoscopy, LaRue was receiving conventional medical therapy, specifically a treatment to shut down her ovaries' production of estrogen. Thus, LaRue appears to be the case of a cancer patient who chose unproven alternative medicine but at the same time continued to receive conventional medical therapy for her cancer and did very well. As is the case with most such patients, she attributes her excellent outcome, at least after her most recent relapse, far more to the alternative treatments (in this case, Rick Simpson's hemp oil) than she does to the conventional therapy she is also taking, even after her discovery of hemp oil. I also can't help but point out that the very fact that LaRue survived nearly eight years with stage IV cancer before discovering hemp oil is a pretty strong argument that from a biological standpoint her tumor is pretty indolent, as some tumors positive for the estrogen receptor are; so it's not surprising that she would still be alive a year and a half after her thoracoscopy on Zoladex and Xgeva alone (plus whatever other conventional medical therapy she is receiving). Only LaRue and her oncologist know for sure, though, and her oncologist can't tell anyone without her permission.

Finally, there's the claim that LaRue is now cancer-free, without having undergone chemotherapy this time around, a claim repeated in Leithead's credulous interview. There's even a brief scene showning a radiology report, which, if you freeze frame, indicates that there are still lesions in her spine that could be consistent with healing metastases, but there are no new ones. What does this mean? Who knows? Without her full clinical history and full knowledge of what she is taking in addition to the cannabis, it's impossible to tell.

Cannabis versus breast cancer

As much as I admire the grace and determination with which Stefanie LaRue has endured over 9 years after her cancer diagnosis, as a cancer doctor it bothers me profoundly that she has allowed herself to fall under the spell of the "cannabis cures cancer" alternative medicine crowd, in particular Rick Simpson. I discussed Simpson the last time I wrote about cannabis and cancer. As I said at the time, Rick Simpson is just like cancer quacks the world over, who have no firm evidence to back up their miraculous-sounding cure rates and excuse their failures by blaming the treatment patients had before they started the quackery. Quacks like Rick Simpson do those who think that cannabinoids have promise in treating cancer no favors.

I also discussed how the vast majority of studies touted by the "cannabis cures cancer" advocates tend to be preclinical studies in cell culture or animal models that show relatively modest antitumor effects due to various cannabinoids. Indeed, this article on Medical Jane, "Studies Show Cannabinoids May Help Fight Triple-Negative Breast Cancer", fails to provide particularly convincing evidence that they do. Before I look at the studies, I can't help but note that triple negative breast cancer is breast cancer that makes neither the estrogen receptor (ER), the progesterone receptor (PR), nor overexpressed HER2. Yet the article invokes Stefanie LaRue, who clearly has ER(+) breast cancer.

Another thing that needs to be pointed out. Every single one of the studies invoked by Medical Jane has nothing to do with hemp oil, be it Rick Simpson's hemp oil or some other type. Each of the studies examines either purified cannabinoids or, in the case of this study, a chemically modified cannabinoid. This study cited in Molecular Cancer, for instance, looks Δ9-tetrahydrocannabinol, the most abundant and potent cannabinoid in marijuana, and JWH-133, a non-psychotropic CB2 receptor-selective agonist. Both inhibit the growth of HER2(+) breast cancer cells in cell culture and in mice, but the concentrations needed are pretty high, with an IC50 (concentration that is 50% of maximum inhibition) in the range of 5 to 10 μM, concentrations achievable with injection of purified compound but certainly not by smoking pot

You are also unlikely to achieve these levels by drinking hemp oil, which, by the way, usually contains so little THC that it is below the limit of detection for common assays and manufacturers brag that it's impossible to fail a drug test if you're consuming hemp seed oil because "THC levels in our products are barely measurable." Of course, I do realize that Rick Simpson calls his oil hemp oil even though it's really cannabis oil derived from the buds rather than the seeds, but even he brags that "following the dosage previously described, many people can take the full treatment and never get high," which implies that his oil achieves nowhere near the concentration of THC in the blood necessary to be active against cancer. Moreover, oral bioavailability of THC from such oils is notoriously low, between 4-20%, making it unlikely that concentrations well above the 10 μM necessary to inhibit or kill more than 50% of the cancer cells are achievable with oral dosing.

Thus, the various studies cited, such as this one, which shows inhibition of the epidermal growth factor pathway by purified cannabidiol (CBD), a non-psychotropic cannabinoid; this one, the aforementioned study that examines purified Δ⁹-THC and JWH-133 against HER2(+) breast cancer; and this one, which also examines CBD in breast cancer, are interesting and very preliminary. Moreover, they all examine cannabinoids purified from cannabis, and one even examines a chemically modified cannabinoid. In other words, even if cannabinoids make the jump from preclinical models to humans, these studies do not support the use of medical marijuana, either smoked as the plant or ingested as an oil, to treat breast cancer. They also do not suggest sufficient activity to produce miracle cures of stage IV cancer as described by Rick Simpson. Indeed, a recent review concludes that "current preclinical data does not yet provide robust evidence that systemically administered Δ⁹-THC will be useful for the curative treatment of cancer," although CBD might have a role based on preclinical data.

Neither cannabinoid, however, is likely to be curative for advanced cancer. It's possible that specific cannabinoids might have a role to play in the multimodality treatment of cancer, but, given what we know about them from preclinical studies, it's highly unlikely that cannabinoids, medical marijuana, or Rick Simpson's hemp oil can cure stage IV cancer of any kind.

Hope versus hype

I have no doubt that Stefanie LaRue honestly believes that Rick Simpson's hemp oil is the reason why she's still alive today and doing so well. I can't help but point out that Stanislaw Burzynski's patients, for example, also honestly believe that his antineoplastons are what saved their lives, even though even Burzynski can't produce good evidence that they have antitumor activity. Depressingly, it just goes to show how even such an accomplished woman can fall prey to the same human cognitive shortcomings that we all share and confuse correlation with causation. If it were just her, I wouldn't have felt obligated to write this post, but LaRue makes it very clear that not only does she believe that Rick Simpson's hemp oil allowed her to heal herself of her longstanding metastatic cancer:

Did you know that the Rick Simpson hemp oil is being used to treat cancer patients? I'm one of them. And it's working pic.twitter.com/XGX9tzJHTo

— Stefanie LaRue (@stefanielarue) July 4, 2014

But she plans on becoming an evangelist for Rick Simpson's hemp oil and medical marijuana:

In this video she notes that she's had multiple recurrences and they're all gone, after which she challenges the viewer to "explain that." Believe it or not, personally, I'd be overjoyed if something as simple as hemp oil could treat stage IV cancer so effectively. I really would, as it would mean that I'd rarely have to see a breast cancer patient die. However, although I can't be sure without a lot more information (which is highly unlikely to be forthcoming) and I do have to concede the possibility, albeit remote, that Rick Simpson's hemp oil is the reason why LaRue has survived a year and a half since her last new metastasis, I nonetheless suspect that it is far more likely than not that it is the Zoladex and the Xgeva (not to mention whatever other conventional treatments that LaRue may be taking that she hasn't mentioned on social media) that are keeping her going now, combined with her disease's already-demonstrated indolent biology.

And long may they continue to do so!

For nearly eight years, Stefanie LaRue fought a battle with courage, inspiring intelligence, and grace. Her story was (and still is) a story of hope for women with stage IV cancer that they can live a long time with the disease with good quality of life. Unfortunately, a year and a half ago her story took a turn into pseudoscience, becoming a cautionary tale of how even the most intelligent, ambitious, and determined person can be subject to magical thinking. This would not be an issue with me were it not that, inadvertently, and with the best of intentions, LaRue has declared her determination to promote Rick Simpson's hemp oil as a cancer cure, using her own story as an example of what it can do. Given her proven history of advocacy and her numerous accomplishments with organizations like the Komen Los Angeles County Affiliate from 2008 to 2010 (before she discovered hemp oil), I can't help but be worried that she will in her quest to save women from stage IV breast cancer end up doing exactly the opposite for some women.

I still hold out hope that, given her history, LaRue will eventually realize that her true story is far more a cause for hope for women with stage IV disease than her current belief that cannabis is what has kept her alive.. Thanks to advances in breast cancer care, more and more women with stage IV disease are living a lot longer than expected, even ten years, all with no need to resort to unproven treatments promoted with testimonials, like Rick Simpson's hemp oil.

That's the real reason for hope.

oracknows Wed, 03/25/2015 - 02:00

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Thank you for such a thorough, rational, and compassionate piece.

"Cannabis healed me". I'd like to just chalk it up to having been pummeled silly by all the years of conventional therapies. I can only hope that she'll eventually give appropriate credit to the doctors and the drugs and the sharp, shiny instruments that brought her to this place

And I will note, I agree with Orac's sentiment that doctors, especially Oncologists, that have to deal patients through the worst experiences of their lives & see many of these patients die, even with the best standards of care available, would give their right arm for a "miracle cure."

...where she learned how to make changes to her diet, use natural supplements, get acupuncture, and work on personal fitness; all of which are integrative, complementary, and alternative treatments to go along with chemotherapy.

Did I miss the memo? When did nutrition and exercise become complementary or alternative medicine, rather than standard-of-care science based medicine?

I assumed Bob Marley's case would have been the "ne plus ultra" regarding the efficacy of cannabis Tx for cancer.

As a former breast cancer patient who was familiar with Stephanie LaRue's story, I read this piece with particular interest. Definitely, a remarkable young woman facing her disease with grace and courage.

But I was dismayed (although not surprised) that she has become an advocate for Rick Simpson Oil. After all, the stress of living with Stage IV cancer - however well you are doing - has to be incredibly stressful and multiple recurrences would certainly highlight your vulnerability to
"miracle cures".

Although I am going into my fourth year NED, I still belong to an on-line community for breast cancer patients and one of the major discussions on the alternative therapy treatment boards is about Rick Simpson Oil and how it can "cure" cancer. How, after taking the oil for a number of weeks, you feel so wonderful, that you KNOW it just has to be working, destroying the tumor inside of you. It amazes me that few on the thread suspect that that "wonderful" feeling has nothing to do with your tumor being cured and everything to do with the fact that you're probably high.

Sorry, but it is mean and bullying to take issue with a nice-looking young woman who is recommending woo for cancer.

Didn't we learn anything from the Ainscough debacle?

@ #6 DB: Yes... Why are these celebrated altie testimonials always by a gorgeous babe?! And the tear jerking "vaccine injury" & death cases are invariably described as a precious, joyful, loving, beautiful, intelligent & talented child too! Never an HPV "injury" story about a drug addled teen runaway street prostitute that was sexually abused by their stepfather!

Dangerous Bacon, Jess Ainscough's case is quite different from Stefanie LaRue's case. LaRue has been deeply involved in breast cancer advocacy and raising funds for breast cancer research. IMO, LaRue likely has a good knowledge base about sham "miracle cures", yet she's done a U-turn and is now advocating for the all purpose medical marijuana cure (for "sugar diabetes" and a variety of cancers).

I'm relying on Orac to fill in the multiple omitted pieces about Stefanie LaRue's breast cancer staging and disease progression, which somehow are missing.

Really really sad that she fell for that deluding freak! Hope that she will realize the truth.

I was in a double blind study-I was shocked when I learned I had a placebo effect. Really a skeptic now!
Patients should be educated about placebo effects.

@#6 Give me a break with this. It may be mean and bullying to call out a person publicly for the choices they've made in their personal lives, but when that person starts publicly advocating that other people make the same choice it becomes 100% appropriate to call them out on it.

Dangerous Bacon, Jess Ainscough’s case is quite different from Stefanie LaRue’s case. LaRue has been deeply involved in breast cancer advocacy and raising funds for breast cancer research

Unfortunately, she still is, although she hasn't been on the board of Komen LA County for several years. Her Instagram and Twitter accounts not infrequently show her giving talks using Komen slide sets. That's part of what bothers me. After eight years of being a fantastic role model for enduring stage IV breast cancer with grace, knowledge, and hope, she's become a spokesperson for Rick Simpson's hemp oil quackery while still engaging in her previous breast cancer advocacy activities, although it's not clear if she is more or less active than she was before on that front. I rather suspect it's less, with the rest of her advocacy energy being taken up promoting Rick Simpson's hemp oil nonsense. It's the kind of "integration" that could do great harm, particularly if she convinces women with earlier stage, potentially curable breast cancer to choose Simpson's hemp oil instead of standard of care treatment. It's the kind of activism that will lead to preventable death.

Basically, she's got such a large store of good will built up from her previous activities and her longstanding bravery in the face of stage IV cancer that her word carries a lot of weight among women with breast cancer.

It’s the kind of “integration” that could do great harm, particularly if she convinces women with earlier stage, potentially curable breast cancer to choose Simpson’s hemp oil instead of standard of care treatment. It’s the kind of activism that will lead to preventable death.

Yeah, it both bums me out and raises my hackles, as a friend of a close friend basically went that route - cannabis oil instead of real medical treatment for what would have been curable breast cancer - and died from it not long ago.

Although the cases are *very* different, I think the fact that these women are conventionally attractive is important. Their appearance is a huge factor in the marketability of their advice.

These three faces lend themselves very well to peddling all things natural-whole-pure-clean-nontoxic-ancient-balanced-intuitive-cleansing-nutritious-organically-grown-detoxifying.

I know someone who is privately smoking marijuana to "cure" her recently diagnosed early stage breast cancer. I think it might be DISC (is that right for ductal in situ carcinoma?). She has said nothing about whether she will pursue conventional treatment, so I suspect she may have decided this is a superior substitute from having been a champion of hemp products for a while.

This is not looking good, and so far I can't figure out how to challenge her without alienating her. She seems blissfully convinced that she has found a secret cure. I am feeling very, very not-good about this situation.

@ John Danley:

Whilst I know that you're joking...
unfortunately, Mr Marley wound up taking woo for his cancer at the infamous Josef Issels clinic in Germany: there's even a documentary of his last days. It was truly heart-rending to watch how he shivered in the frozen landscape when he could have been at home amongst friends, family and... er..
lush tropical greenery.

AFAIK he never advocated for c@nnabis for cancer.

@Sara

If I recall correctly, and Orac can correct me if I'm wrong, people diagnosed with DCIS have a reasonable chance that they will never develop invasive cancer. It's possible that the person you know won't ever progress. And, because she's choosing marijuana, may convince herself that her chosen treatment is what kept her healthy, rather than the nature of DCIS itself.

Search this blog for DCIS to get some more info that might help you out.

"Personally I’d rather advocates of marijuana legalization drop the charade, argue for legalization, and stop with the medical nonsense."

Exactly this. Counterproductive laws should be changed, rather than BS 'science' used to sneak drugs in the back door. Marijuana is a generally pleasing recreational drug, not a fecking panacea, and it's frustrating to advocate for legalization and find oneself surrounded by the crunchy alt med types (like I'm not surrounded by them enough already).

I attended two Komen luncheons in Los Angeles for Metastatic patients where this young woman was a moderator/speaker/prancer. Oh, the prancer part. Silk cami short shorts, stiletto heels. She is so full of herself she does not inspire, she turned me off so much I will NEVER go to another Komen event. Not that i wanted to but it should not be because the other participants are offensive.

Stefanie LaRue is confusing/conflating the tranquilizing effects of her daily CBD tincture doses and her rescue inhaler (CBD vape pen) with her recent clean bone scan. Could we state that correlation does not imply cure?

#6 - I, at least, read this as sarcasm. Such poopyheads we all are, amirite?

Emma Crew
yes, I was waiting for the call to recalibrate sarcasm meters.

@#20 and#21 I think it just goes to show how lame people that sincerely post that kind of thing really are that some of us (who shall go unnamed *cough cough*) can't tell sarcasm from sincerity in a post like that.

Nothing useful to add, so let me wish Ms LaRue many more years.

Not that I don't disagree with a majority of the way this topic presents, pot as being promoted as a "cure," but I tend to disagree with the summation in one paragraph.

Orac: "What I do not support are claims for medical effects that are not backed up with good scientific evidence, and for medical marijuana most claims fall into that category. That’s why I tend to view medical marijuana as a backdoor way to get marijuana legalized. Personally I’d rather advocates of marijuana legalization drop the charade, argue for legalization, and stop with the medical nonsense."

From my home state (CO), we weighed this from some big picture items. Pot was mainly seen as a palliative, still is, but not really a curative against cancer.

Also, kids/young adults were also showing up at the ER under the influence of Spice (-- why not just use the real stuff without risking your life on that crap?). Terrible stuff.

We didn't see medical m. as a replacement for evidence-based medicine, but more as an effective palliative for cancer, burn, chronic pain patients without nearly the deleterious effects of other drugs like opioids. So, the activists & voters (and some in the medical community as well, and not a small number of medical professionals, either) pressed for a change in policy to gamble on a medical designation.

There are problems in that it's not pharmacy regulated. But, what can we do without a better research classification. Doing the holistic route for distribution was a bad idea, yes lucrative for some, but we have a drug being distributed by individuals with no professional oversight. Pros & cons on that, for sure; it's not perfect.

Another point, there are clinical trials underway for evidence-based uses in cases of Dravet's in pediatrics. Granted, for a refined product. The big problem in research and finding evidence-based uses has been with a misapplied control substance rating that has been more political than medical. Now, we have it as a class II for research.

Going a step further into recreational use -- once a cartel from Mexico gunned down someone enjoying a jet ski on a lake, the voters pretty much decided to immediately marginalize the cartel economic base, and at least try to put the market in the hands of a state taxing authority. Obviously, we'd much rather have non-violent manufacturers willing to work with a taxing & enforcement authority. At least at the local/state level.

Going back to what evidence-based means. Not entirely a charade when it comes to research. More trial work needs to be performed, it's not backed up because of the overly restrictive class policy. Maybe we will see a change in favor of more medical uses in neural pathology. But certainly yes, there is no basis to say that this drug is curative against any cancer pathways, only palliative.

We don't have a really good handle on what percentage of pre-invasive breast cancer (ductal carcinoma in situ, or DCIS) will progress to invasive tumor.

"The percentage of DCIS that is ‘nonprogressing,’ that is, would not develop into invasive disease even if untreated, is unknown. A recently published Markov model that incorporates data from multiple mammography screening trials estimates the incidence of DCIS that will progress into invasive breast cancer if untreated at 100–270 per 100,000. The model estimates that women can survive with nonprogressing DCIS for over 30 years while the average time prior to progressing from DCIS to invasive cancer is 3 months. The model further assumes that these invasive breast cancers will remain in a preclinical state, on average, for 2½ years. Thus, women with progressing DCIS have slightly less than 3 years between DCIS incidence and clinically detected invasive breast cancer."

http://www.ncbi.nlm.nih.gov/books/NBK32580/

One problem with assuming that DCIS will remain in situ and treating it with cannabis, mushrooms or whatever, is that DCIS can co-exist with invasive carcinoma, and the biopsy may only sample the in situ part. This argues strongly for evidence-based therapy and followup.

“Personally I’d rather advocates of marijuana legalization drop the charade, argue for legalization, and stop with the medical nonsense.”

Exactly this. Counterproductive laws should be changed, rather than BS ‘science’ used to sneak drugs in the back door.

Unfortunately, the tactic seems to have been the only effective approach to date.

@Dangerous Bacon #26

I think that quoted statement is kind of vague. To me that implies that ~200 women out of every 100,000 in the general population will develop a case of DCIS that will end up progressing. It says nothing about what percentage of biopsy-diagnosed DCIS will progress without treatment.

A quick Google search turned up a small 2005 study that found progression to invasive cancer in 13 of 28 women with low grade DCIS who did not have their DCIS excised or otherwise treated. These women, based on their low grade DCIS, probably fit into the lowest risk cohort for progression.

Based on the Early Breast Cancer Trialists Collaborative Group metaanalysis, after excision of DCIS, about 30% of women will have a recurrence of disease after surgery alone; around half of these recurrences will be DCIS and the other half will be true invasive cancer. Radiotherapy can reduce this risk by about half (about 15% recurrences within 10 years, again with half of recurrences as DCIS and half as invasive cancer).

Based on this, I suspect that, among all women with DCIS, at least half, probably more, could expect progression to true cancer without treatment. Even among the very lowest risk, untreated DCIS would have a very high risk of progressing to cancer.

Unfortunately, the tactic seems to have been the only effective approach to date.

I don't believe either Washington or Washington, DC went through the legal "medical" marijuana stage. There's a proposed constitutional amendment in Ohio that would also bypass that argument and go straight to recreation (much like the Ohio casinos bypassed the larval riverboat stage).

Washington (state) had medical marijuana starting in 1998, actually.

And DC had it starting in 2010.

the Ohio casinos bypassed the larval riverboat stage

Now I am trying to imagine what a larval riverboat would look like.
In the ideal world, H.R. Giger would have illustrated Martin's "Fevre Dream".

MOB@28: Washington state had/has a real half-baked (if you'll forgive the pun) approach to 'medical' MJ, in that it wasn't illegal, but it wasn't exactly legal either. And when recreational pot was legalized the state didn't do anything to address the disparities in the law between recreational and medical pot. So it's been a real mess.

On a more useful front there has been work in WA to get formal permission from the Feds to study pot. Basically the state research institutions (the big universities) want to be 100% sure that they won't lose federal funding if they study pot. Fear of losing funding has been a big issue for getting good scientific data on pot.

There’s a proposed constitutional amendment in Ohio that would also bypass that argument

The remaining one (the other failed to get 1000 valid signatures) is competing with HB 33.

D.C. had medical marijuana with Initiative 71. Washington state allowed medical marijuana in 1998.

Washington state had/has a real half-baked (if you’ll forgive the pun) approach to ‘medical’ MJ, in that it wasn’t illegal, but it wasn’t exactly legal either.

It was a pretty standard situation, actually, in that it was still illegal on the Federal level (of course) but legal for medical use only within the state. It was never decriminalized during the "medical only" period, if that's what you mean. I do recall the state police making a statement at some point, I think when I was in college, that they basically weren't really going to bother with enforcement anymore.

The point that I should have made more clearly in the first place – individual jurisdictions aside – was that medicalizing the issue actually succeeded as the thin edge of the wedge. The overt-legalization dominoes maybe could start toppling or something once some concrete, positive fiscal results show up from states that have gone whole-hog, but it just wasn't going anywhere on its own.

I can't remember whether I've mentioned this, but maybe over a space of six to seven years ago, I shared a back porch with neighbors who – after being really secretive for a long time after they moved in – turned out to be stoners of the first water, seemingly as a primitive way of, ah, managing marital stresses, and engaging company when taken individually.

One fine afternoon, I was chatting with the wife on the porch, and she expressed a desire to move to California so that she would have easy access to "medical" marijuana. I mentioned that this wasn't exactly the idea and (naively) that flagrant abuse – given her list of "indications" – of the law could, you know, undermine access to people who could at least make a plausible case.

The husband eventually came from whatever chores or Burning Man esoteric duties he had been attending to, and even he concurred. The only obstacle they seemed to have was the mercurial nature of home-delivery services.

^ Grumble.

"The husband eventually came from whatever chores or Burning Man esoteric duties he had been attending to, and even he concurred. The only obstacle they seemed to have was the mercurial nature of home-delivery services."

Seriously, he went through a very late night phase of bow-drilling that lasted for weeks. I'd love to catch up with him, but I never heard back after returning a phone call he left about a year ago.

I have a very good friend back in Washington - he's about 80 years old now - who got a medical card quite some time ago, I think for arthritis, but I'm not sure. He used to bus up to Tacoma to pick up some "boo" every so often. (I think this was all through the VA, oddly enough. He served in the period between Korea and Vietnam and has some very interesting and entertaining stories to tell about the experience.)

Speaking of noisy neighbors late at night, I lived on a sailboat for a time in college - money issues, basically I knew a lady who didn't feel like paying moorage so I paid it, like a hundred bucks a month, and lived on the boat.) There was a Vietnam vet who lived in the boat next to me - it turned out, oddly enough, that he knew a woman who'd taught in my high school and died quite suddenly of a brain aneurysm - and he was a banjo enthusiast, but pretty much strictly between the hours of 2 and 4 in the morning.

Speaking of noisy neighbors late at night

Oh, no, making fire was very quiet, and I kept later hours myself. I just didn't interrupt him.

and he was a banjo enthusiast, but pretty much strictly between the hours of 2 and 4 in the morning

I will confess that I have once committed long-form, rule-free banjo "exploration" during such hours, but I at least had had a couple years' training in how to mechanically operate the device.

I'm at risk of wondering whether Bela Fleck and Easley Blackwood have ever been seen together.

Well, he was actually pretty good, so I didn't mind too much. I'm not a terribly good sleeper, myself, and have been keeping increasingly odd hours now that I'm on fellowship and not teaching at 9 am every morning.

He was a lot better, in any case, than a guy I lived with in my last year of college. It was a house of (I believe) 7 people, and I was the only female on the premises. One of our housemates - Sebastian - was big into the banjo, but he only ever played two freaking songs over and over again. "King of the Road" and "Big Rock Candy Mountain." I used to like those songs.

He wasn't even supposed to be living there originally in the first place, but our a**hole housemate Mike (who I actually like anyway) moved him into the attic that his room opened into so he could split his rent with him.

I remember when Sebastian's girlfriend at the time broke up with him; he was caterwauling all day and night, and at one point emoted, "She doesn't even like my banjo playing!" We were all like, "Sebastian, nobody likes your banjo playing."

I remember, actually, walking upstairs and seeing him, Sebastian hanging around one day - I knew the guy from various situations - and I said, "What are you doing here?" And he goes, "Aw, I live here now, dawg." He was forever ending every GD sentence than way.

Seb was just a harmless, if obnoxious, idiot, anyway. My buddy, the one who's about 80 these days, used to chide me about my digs:

"You're living with a bunch of barbarians over there."

"Yeah, pretty much."

"Do they even know who Ornette Coleman is?"

"Nah, but maybe I'll play him for 'em some day."

Wolfbeckett @23 - no need for self-reproach: you might not come here so often. Regular lurkers know it could only have been sarcasm from Narad.

is there any other chemical compound that any one knows of that causes apoptosis in cancerous cells? If there was would you take it if all conventional treatments had failed to halt your cancer?

Also given the fact that cannabis is a shedule 1 class B drug in the UK , how is it possible to obtain pre clinical human data ? have you actually met anyone who has successfully shrunk tumors , say an astrocytoma....would you like to ? would you like to have access to Bio chems work at madrid university showing THC to cause apoptosis (automated cell death) ...

@john green - don't be coy. If you are aware of published research showing that cannabis is an effective anti-cancer drug, please share a link to it. Thanks.

Re: "given the fact that cannabis is a shedule 1 class B drug in the UK , how is it possible to obtain pre clinical human data ?" - There certainly are issues with doing legal studies in the UK and USA, however these are not the only countries with first class research institutions. Perhaps some researcher in The Netherlands, Spain, Portugal, or Germany would have an easier time. Uruguay could also become a center for cannabis research.

In regard to my comments above about Washington - clearly I remembered wrong. I should check my facts before posting. I retract my statement.

Given that according to Encyclopedia Britannica "Apoptosis also may occur when a cell becomes damaged or deregulated, as is the case during tumour development and other pathological processes. Thus, when functioning properly, the body can induce apoptosis to rid itself of cancer cells." it seems evident that cannabis isn't the only chemical on the world able to induce apoptosis in cancer cells. And ten there is also this, "apoptosis-inducing therapies may actually select for cancer cells resistant to apoptosis."

have you actually met anyone who has successfully shrunk tumors [?]

Why yes, I have. I know several persons who have had their tumors shrink via conventional cancer treatments. Depending on ones interpretation it might be the persons with the cancer, the radiologist or the doctor prescribing or the nurses administering the chemo who you were asking about.

If you have good quality evidence provide it, rather than hint its existence.

"is there any other chemical compound that any one knows of that causes apoptosis in cancerous cells?"

There's nothing special about inducing apoptosis - it's long been a property of anticancer drugs. For instance, here is the abstract of a paper from 1992:

"Most of the cytotoxic anticancer drugs in current use have been shown to induce apoptosis in susceptible cells. The fact that disparate agents, which interact with different targets, induce cell death with some common features (endonucleolytic cleavage of DNA, changes in chromatin condensation) suggests that cytotoxicity is determined by the ability of the cell to engage this so-called 'programmed' cell death. The mechanism of the coupling of a stimulus (drug-target interaction) to a response (cell death) is not known, but modulation of this coupling may affect the outcome of drug treatment. This review surveys the recent evidence which supports the idea that the drug-target interaction per se is not the sole determinant of cellular sensitivity of cytotoxic drugs. Studies of the signals which might engage apoptosis, the genes which modulate it and the biochemical process of drug-induced apoptosis itself are described, where possible, for glucocorticoids, topoisomerase inhibitors, alkylating agents, antimetabolites and antihormones."

http://www.ncbi.nlm.nih.gov/pubmed/1327566

The big difference with cannabis, of course, is that it hasn't been shown to be an effective anticancer drug.

I find it rather shocking that anyone can think they are informed about this topic, yet consider inducing apoptosis to be a unique property of hemp oil. Simply amazing. That other cancer therapies include apoptosis is not exactly a secret. The paper Dangerous Bacon linked to has been cited over 800 times, a quick search finds reams and reams of papers written on the apoptotic properties of various treatments.

There's a big unspoken problem here, and I see it clinically out here in the wild west. These medical marijuana dispensaries act as unregulated quasi-pharmacies. Imagine a pharmacy staffed with untrained techs who were competing with their local neighbors, so encouraged to say less and less honest things about their products. So, not a surprise that the dude with the dreads at "Surreal Medical" (yes, this really exists) is telling a cancer patient that his dank can treat her cancer. And, as some of you point out above, it's not a shock that a desperate or uninformed patient may believe it.
Right now in the US, any healthfood store person / reiki therapist / pot dispensary person can say whatever they want about anything they sell. Licensed providers have to stay within informed consent and full disclosure about the risks and benefits of their treatments. This tilts the playing field in a scary way, and it needs to get fixed right away.

There are a few other substances that induce apoptosis.

"That’s why I tend to view medical marijuana as a backdoor way to get marijuana legalized."

Come on, David, it's not like you to hold back! "Tend"? A year or so after Michigan's MM voter proposition went into effect, the Kalamazoo Gazette did a story on a local doctor that opened a MM practice. He stated that he charged, IIRC, $190 per "patient" and he insisted that he didn't just blindly hand out the cards to everyone and that he "only" approved people's requests 90% of the time! Now, if the DEA found out that were you handing out Oxycontin scripts to 90% of the people that walked through your door and asked for one, how fast do you think they'd shut you down!

"...would you like to have access to Bio chems work at madrid university showing THC to cause apoptosis (automated cell death)"

In a test tube or in situ?

Matt @51: On Rainier, or on Lake City Way?

I've found that the recreational pot shop (between the church and the bar) has done way more to improve the neighborhood than anything else that had been on that site. And with the bouncer outside it's a lot safer too.

The "medical" shops are all really sketchy, probably at least in part because the owners don't want to put a lot of money into a store that might get shut down at any time.

"He stated that he charged, IIRC, $190 per “patient” and he insisted that he didn’t just blindly hand out the cards to everyone and that he “only” approved people’s requests 90% of the time"

That's another beef I have with 'medical' marijuana. It's just a racket for docs to hand out weed cards. I suppose it's better than the money going to cartels, but it still grates on me. If this is the way we have to go to get to legit legalization, so be it, but let's move in that direction sooner rather than later. I hope CO's outcomes will help with the momentum.

Also, because.
youtu.be/U4r1hUXeRA0

There are a few other substances that induce apoptosis.

I took a quick look, and didn't see this listed…
https://xkcd.com/1217/

On the other hand, I'd imagine that Gerson doesn't induce much apoptosis.

On the other hand, I’d imagine that Gerson doesn’t induce much apoptosis.

It does, but it does it all at once. When it's too late to do any good.

@Narad, back when I was a music grad student in Chicago, I had to get some stuff out of the storage area behind the recital hall and accidentally walked in on Easley Blackwood playing the piano shirtless. I'm not sure which of us was more embarrassed. Never saw him with a banjo, but he did have an awesome party trick of performing a Bach two part invention by whistling one part and singing the other.

Thanks for addressing this, Orac. I haven't read it or the comments fully yet, but looking forward to doing so tomorrow.

I plan to continue taking cannabis extracts, before and after surgery. It helps me sleep, it helps me stress less about having breast cancer, it improves my mental well-being overall (not just when I'm high) and if it happens to cause apoptosis and impede metastasis and tumor growth as well, all the better. And if I decide to go with chemo, radiation, hormone therapy and targeted therapy, it'll help me get through all that crap as well.

Ken: "I was in a double blind study-I was shocked when I learned I had a placebo effect. Really a skeptic now!
Patients should be educated about placebo effects."

No, you're still a gullible tool, a living placebo effect.

I agree with the fact that medical marijuana has no proof that it can cure cancer, but I do disagree that it is only being said to be used for medical purposes to become legalised, the use of marijuana for the treatment for cancer patients is a vital role due to the fact that it helps relieve pain in a natural way and helps patients relax and sleep better.
u15067841

I agree with the author. There has been no scientific evidence supporting the claim that medical marijuana cures cancer. Legalising it for medical purposes has its advantages and disadvantages. As much as it will help the patient, it will also lead less educated patients into believing that it cures cancer, when that is not true.

Marijuana cannot cure cancer. I agree with the notion that it may ease the pain that patients who suffer cancer feel.

For being a scientist and surgeon, it looks like you have not done your through research. It looks like you are going off of your opinion on the situation instead of actual research and science of the plant.
No matter what you look for you are only going to look for the negative side effects of this plant.
Can you tell me how many people have died from cannabis?
Now, tell me how many people have died from radiation therapy and chemotherapy?
Tell me, what are the side effects of cannabis versus the side effects of chemotherapy?
Are you not aware of the research conducted on cannabis? or the patent held by the federal government for cannabis for not only cancer but also for HIV/AIDS? I feel bad for people like you that misguide others and continue the "reefer madness" psychological programming.
You are a surgeon, you should know the research behind things before you make assumptions that are misguiding to the whole public and do not have, what you call, "science" to back it up.
You mention that there are no trials out there looking at cannabis, however there are.
You do not want to think that plants are a good medicine to use, because the FDA does not approve them, but yet the FDA has approved additives and other ingredients such as aspartame, food colorings, BPA, etc..that clearly cause cancer which you should know being a surgeon.

Holy hell. "Reefer madness"? Seriously? Did you even frikkin' read the post? I said I was in favor of outright legalization of marijuana. What I don't buy are the claims that cannabis can cure advanced cancer, and I was very clear about the reasons why based on the research.

As for there being no trials about cannabis, there is one, but it's not convincing and only applied to brain cancer, as I discussed in this post:

http://scienceblogs.com/insolence/2014/08/18/medical-marijuana-and-the-…

If there are any other clinical trials of cannabis as a cancer treatment (not as an adjunct), then, please, show me. If there are, they aren't published yet.

Seriously, you only serve to reinforce all the negative things I think about naturopaths.

Holy hell. “Reefer madness”? Seriously? Did you even frikkin’ read the post? I said I was in favor of outright legalization of marijuana.

doncha love it when someone goes off onto a canned rant without really having heard what you said.
I've experienced it a lot from skeptics - not you personally, but many times.
It's like I'm talking to a vending machine, not a person. I say something - whirr, blatt ... out comes Canned Skeptical Speech #42.
One wants to kick the "vending machine", maybe it would turn back into a person if kicked.

Breast Cancer

A study published in the US National Library of Medicine, conducted by the California Pacific Medical Centre determined that cannabidiol (CBD) inhibits human breast cancer cell proliferation and invasion. They also demonstrated that CBD significantly reduces tumour mass.

“Cannabidiol (CBD), a cannabinoid with a low toxicity profile, down-regulated Id-1 gene expression in aggressive human breast cancer cells in culture”

http://www.ncbi.nlm.nih.gov/pubmed/20859676

A study published in The Journal of Pharmacology and Experimental Therapeutics determined that THC as well as cannabidiol dramatically reduced breast cancer cell growth. They confirmed the potency and effectiveness of these compounds.

“Cannabidiol is the most potent inhibitor of cancer cell growth.”

http://jpet.aspetjournals.org/content/early/2006/05/25/jpet.106.105247

A study published in the Journal Molecular Cancer showed that THC reduced tumour growth and tumour numbers. They determined that cannabinoids inhibit cancer cell proliferation, induce cancer cell apoptosis and impair tumour angiogenesis (all good things). This study provides strong evidence for the use of cannabinoid based therapies for the management of breast cancer.

“Δ9-tetrahydrocannabinol, the most abundant and potent cannabinoid in marijuana…reduce tumor growth, tumor number, and the amount/severity of lung metastases in MMTV-neu mice.”

http://www.molecular-cancer.com/content/9/1/196

There is also many studies out there in regards to lung cancer, prostate cancer, pancreatic, brain, liver and oral cancers.

As a matter of fact, the US Government holds a patent on “cannabinoids as antioxidants and neuroprotectants.”

http://www.google.com/patents/US6630507

Huh, did you read the post? Or maybe this post as well?

http://scienceblogs.com/insolence/2014/08/18/medical-marijuana-and-the-…

I discussed several of those studies, all of which are preclinical and should be treated as such, namely as highly preliminary.

As a matter of fact, the US Government holds a patent on “cannabinoids as antioxidants and neuroprotectants.”

ZOMG, you mean... it's just like antineoplastinoids?!??. Let's see:

"We claim:
"1. A method of treating diseases caused by oxidative stress, comprising administering a therapeutically effective amount of a cannabinoid that has substantially no binding to the NMDA receptor to a subject who has a disease caused by oxidative stress."

Well, not exactly, if memory serves.

Remember, all patents on products of nature have been fully and finally nullified by Association for Molecular Pathology v. Myriad. Of course one can patent synthetic cannabinoids. So?

A study published in the US National Library of Medicine

Oops.

Then again, it's always nice when someone tips a cut and paste.

Why go the expensive treatment in hospitals whereby Marijuana/Cannabis oil is here to clean you from cancer and many more illnesses …

That would be because there's actual evidence in teh form of large scale, porperly dewsigned and controlled clinical trials which demonstrate the medical interventions available in hospitals are actually effective treatments for various types of cancer, while there is no evidence demonstrating Marijuana/Cannabis oil represent effective treatments for cancer.

Next question?

@James - I believe the FDA would like to have a word with you.

Medical Marijuana Policies Are Kind Of Childish

aardvarchaeology — Mon, 09 Feb 2015 13:20:33 +0000

Medical Marijuana Policies Are Kind Of Childish

Medical marijuana is just a backward strategy to get recreational marijuana legalised. It's like the potheads twenty years ago who would praise hemp's excellent properties as a fibre and fuel source. They didn't care about any other fibre crops. It was a transparent ruse.

A medical intervention's legality should be pushed by worldwide medical consensus, not by a regional cultural predisposition to enjoy the compound's recreational use. Medical marijuana is a non-issue in European medicine.

That said, I believe the enormous public money put into the customs, legal and punitive systems to combat marijuana is pretty much thrown into the sea. A society with legal hard liquor will not have much comparative trouble with legal cannabis. Legalise it, tax it and put the money into alcoholism prevention & rehabilitation, I say.

So, USA: your medical marijuana policies are kind of childish. You're transparently not promoting them because of any greater medical insight than the rest of the world has. You're promoting them because you have a century-long solid cultural tradition to smoke weed recreationally. Just own it, OK?

This outburst was inspired by the current episode of the excellent Planet Money podcast from NPR.

aardvarchaeology Mon, 02/09/2015 - 08:20

Tags

I'm a Scientist with a strong interest in Cancer research. The evidence of the value of Marijuana as a life saving medicine is now so strong that the need to remove Marijuana from Schedule 1 has become a moral imperative.

This weekend over 3,000 Americans died, in pain, of Cancer. Today, tomorrow and every day after that, 1,500 more Americans will die, after suffering horribly, from it. Every single minute another American dies of Cancer. Every American Cancer patient deserves the right to have safe, legal, and economical access to Medical Marijuana. Every single one.

Americans who need Medical Marijuana shouldn't be used as "Political Footballs" Please call the Whitehouse comment line at (202) 456-1111 and ask that the President take immediate action to remove Marijuana from Schedule 1 so American Physicians in all 50 states can prescribe it.

Oncologists have know it for more than a quarter of a Century that Marijuana is a "wonder drug" for helping Cancer patients.

The American Society of Clinical Oncologists wants Marijuana removed from Schedule 1. So does the American Medical Association, the professional society of all Physicians. A strong majority of Americans want Physicians in all 50 states to be able to prescribe Medical Marijuana. So do their Physicians., Cancer patients can't wait.

The need to immediately, completely, legalize Marijuana throughout the world is one of the most pressing moral issues of our time, because of its medical benefits and because of the damage prohibition causes to America and to the world.

Complete legalization is critical -- its vital that there aren't "strings" or "hoops" that Cancer patients and others who need Medical Marijuana are forced to jump through.

"Charlottes web" is NOT the solution. Cancer patients and people who suffer from chronic pain need THC, not just CBD. The "Berkeley study", where 96% of stage 4 Cancer patients who had a wide variety of Cancers achieved remission, used high dose Medical Marijuana oil, 72% THC, 28% CBD, 1 gram/day (oral) over a 90 day course of treatment. It was a small study, and not placebo controlled, but those kinds of results are clearly remarkable, have been widely reported on in the press, and demand the need for immediate large scale clinical trials.

More and more present and former members of law enforcement agree about the need to end prohibition, and have formed a rapidly expanding group of current and former undercover cops, FBI, DEA, prosecutors and Judges, from all over the world, called

LEAP -- Law Enforcement Against Prohibition

because they've seen the damage prohibition causes to America and the world.

See http://www.leap.cc/

I'm a Scientist. Not a politician, not a cop.

But as a Scientist with a strong interest in Cancer research, I feel even more strongly about the need to ensure that no Cancer patient is denied it, because I'm so impressed with its benefits for Cancer patients.

I urge everyone reading this to PLEASE call and email the Attorney General, the press, Congress and the President today.

Medical Marijuana helps with Alzheimer's, Autism, Cancer, seizures, PTSD and chronic pain, and has helped many Americans, including many veterans, stop using Alcohol, and hard drugs, both legal and illegal ones.

Every minute an American dies of Cancer.

Every 19 minutes an American dies of a prescription drug overdose.

Many vets become addicted to prescription opiates and die from them.

NOBODY has ever died from smoking too much pot.

Cancer patients are seeing remarkable results using high dose Medical Marijuana oil, in many cases achieving complete remission, even for stage 4 cancers -- there are many excellent articles on the web, and videos on youtube with patient's personal stories about their experiences with it -- and every Cancer patient that uses Marijuana to ease their suffering benefits greatly from doing so.

It is immoral to leave Marijuana illegal, for anyone, for even a second longer.

For Cancer patients, its a matter of life and death.

Cancer patients can't wait.

Medical Marijuana has an unmatched safety profile, and for people who suffer from so many diseases, of so many kinds, its a medical miracle -- and the scientific evidence behind it is rock solid.

For Cancer patients, Medical Marijuana encourages apoptosis and autophagy of Cancer cells, while leaving normal cells untouched, is anti-angigogenic, anti-proliferative, and is anti-angiogenic.

Its also synergistic with chemotherapy and radiation therapy, making both more effective.

For many Cancer patients its meant the difference between life and death.

For everyone else, its a far safer alternative to Alcohol, and infinitely safer than Cigarettes.

Either take them off the market too, or legalize Marijuana right now.

2016 is too far away, Its too long to wait. Every year we lose more Americans to Cancer than died in WWII.

Between now and the 2016 elections, roughly 1 MILLION Americans will die of Cancer.

And Its a horrible way to die!

No. It really is medicine. I've submitted a more detailed comment, which is awaiting moderation.

Regardless of marijuana's medical properties (that are not apparent to medical researchers outside marijuana-smoking cultures), the US political push for med-MJ legalisation is driven by the recreational demand.

The US was down this road before, with Prohibition: a constitutional ban on the sale of alcoholic beverages. It was repealed after people noticed that all it did was encourage lawlessness. People who wanted to drink were going to find ways to drink, no matter what.

But the no-fun crowd has to have something to oppose. Shortly after Prohibition was repealed, they started to campaign against marijuana use. Reefer Madness was first released in 1936. I've never seen that movie myself, but many people put it in the "so bad it's wonderful" category.

Fastest growing industry in America? Legal Marijuana, coming to your town very soon....#1 crop in California and LEGAL in ALL west coast states.....#$$$GrowsOnTrees

not just winning, DOMINATING

The legalisation drive in the USA may at least in part be motivated by the need to push back the ludicrous consequences of the "war on drugs" that has seen a militarisation of the police force, grotesque high sentences for carrying small amounts of cannabis, the tendency of the police to "stop and frisk" african-americans at a much higher rate than whiites et cetera.
Cannabis is mostly a poor peoples' drug, unlike alcohol, so the great disparity in how society treats users of different mildly addictive drugs has a social dimension.
"Medical marijuana" is seen by many as a wedge strategy to shift an issue that is otherwise too inflamed for rational debate.

Marijuana (the plant) *is* more effective for some people at relieving pain than things like the spray that's legal in Sweden, for example. Whether that's because they expect a spliff to work better than a spray, I don't know. But cancer sufferers have enough shite to deal with - if it works for them I don't see why it shouldn't be legal. The fact that a substance is abused by some people shouldn't be a reason to deny it to others who really need it.

Particularly when none of the United States' many problems seem to be due to the fact that so many of their citizens already smoke weed regularly.

I think maybe the very first step to turn this into an honest discussion would be to call it by its real name - "cannabis".

Jane,
Seconded. Cancer is the crappiest way of dying. And even for the surviving patients, it is no walk in the park.

"Stoned drivers much safer than drunk drivers, and setting legal limits for pot basically useless" http://www.rawstory.com/rs/2015/02/stoned-drivers-much-safer-than-drunk…
-I suppose stoners mainly hurt their own brains, while alcoholics can seriously mess up people around them.
I would want to un-invent *all* addictive substances, but this is not an option. If people are determined to ingest psychoactive substances, maybe cannabis is less damaging than ethanol.

I agree with jane, naturally! Epilepsy, glaucoma, or chronic musculoskeletal problems are no fun, either, and plenty of pharma drugs - including drugs used primarily for prevention of future harms rather than relief of current suffering - can cause substantial cognitive impairment. In my book, suffering people should be able to do pretty much whatever it takes to relieve their suffering.

In my book, medical research should (and does) find out what can alleviate their suffering.

Medical cannabis is very much an issue in Europe and elsewhere, and there is substantial research about the medical potential and applications.

http://www.cannabis-med.org/index.php?lng=en

We've had medical marijuana stores out here in Washington State for a while. More recently we've added a number of recreational marijuana stores, some more ambitious than others. One is just a local smoke shop, selling tobacco, pipes, and now marijuana. The local BBQ joint, sort of a smoke shop, has closed and will reopen selling marijuana, hemp and MJ themed tee shirts. Perhaps out of state tourists will stop and grab a few joints on their way to Olympic National Park.

The situation is a lot like that the mid-1920s when a number of states basically gave up on Prohibition. I know New York State officially stopped prosecuting alcohol users in '26, though they'd sometimes add an alcohol charge to another indictment e.g. for racketeering.

Marijuana is still illegal at the federal level, and our local border patrol is on the watch for small boats bringing in bales of marijuana from, presumably British Columbia, even as local farmers and the county land use managers are negotiating the guidelines for marijuana cultivation. Given our weather, it has to be grown in greenhouses. It's controversial so the zoning is probably going to be industrial rather than commercial.

Given our weather, it has to be grown in greenhouses.

I find this surprising given the reputation of "BC Bud", which is grown in the Fraser Valley, a bit north of you. But I've never been further upriver than Surrey (outer Vancouver suburbs), so I don't know how they actually grow it in the Fraser Valley (and of course I am no expert at cultivating it). Perhaps it needs a minimum amount of sunlight equivalent, in which case there will be places in Washington state where it can grow (climate goes from rainforest to desert in the space of 300 km). Or maybe it's more frost sensitive than I thought. Or people are sufficiently afraid of the DEA that they have to grow it indoors.

The decriminalization of marijuana is inevitable, but there are folks suffering NOW. Many of them are probably being forced to risk jail time by purchasing it ilegally, in order to find relief from pain and suffering caused by any number of diseases, including, but not limited to, marijuana. We need a movement. We need cohesive leadership by reputable, trusted folks who have the courage to stand up and say "I smoke pot, and I believe it should be legalized. NOW!

Medical marijuana and the new herbalism, part 2: The cult of "cannabis cures cancer"

oracknows — Mon, 18 Aug 2014 05:00:29 +0000

Medical marijuana and the new herbalism, part 2: The cult of "cannabis cures cancer"

About five weeks ago a month ago, I finally wrote the post I had been promising to write for months before about medical marijuana. At the time, I also promised that there would be follow-up posts. Like Dug the Dog seeing a squirrel, I kept running into other topics that kept me from revisiting the topic. However, recently the New York Times gave me just the little nudge I needed to come back and revisit the topic, first by openly advocating the legalization of marijuana, then by vastly overstating the potential medical benefits of pot (compare the NYT coverage with my post from last month), and finally a week ago by running a story lamenting the federal law that makes research into medical marijuana difficult in this country.

I stated my position on marijuana last time, which is that marijuana should be at least decriminalized or, preferably, legalized, taxed, and regulated, just like tobacco and alcohol. I also likened the cult of medical marijuana to the "new herbalism," because it (1) vastly inflates the potential of medicinal uses of marijuana and (2) ascribes near-mystical powers to smoking or making extracts out of marijuana, rather than identifying and isolating constituents of the plant that might have medicinal value. All of this is very much like herbalism in alternative medicine. Indeed, promoting laws legalizing medicinal marijuana is such an obvious ploy to open the door to full legalization that some advocates don’t even bother to disingenuously deny it any more. Given that I tend to support legalization, as a physician this sort of deception irritates me. It also has consequences, particularly when overblown claims are made for what cannabis can do. Perhaps the best example of this is the claim that cannabis cures cancer, which pops up all over the Internet in memes such as the one in the image above.

Don’t believe me? Just Google "cannabis cures cancer" or "marijuana cures cancer." To my relief, you’ll find the National Cancer Institute’s page on cannabis and cannabinoids, which, as I discussed last time, dwells more on whether cannabinoids are useful for pain relief, nausea, and cancer cachexia than on whether they can be used to treat cancer directly. However, you’ll also find pages like 20 Medical Studies That Prove Cannabis Can Cure Cancer, a Facebook page Cannabis Cures Cancers!, and articles like Rick Simpson’s Hemp Oil Medicine, which resembles a lot of articles for various alternative medicine and quackery in terms of providing lots of testimonials of cures for skin cancer, diabetic ulcers, and other skin diseases and conspiracy mongering but no hard evidence. Indeed, a commenter by the ‘nym of "Danman" showed up here and proceeded to make hilariously bad arguments for the healing power of cannabis and how my original post was a "prohibitionist hit piece," even though it expressed the opinion that marijuana should be legalized. Meanwhile, others are recommending hash oil for gliomas with a near-religious fervor, touting the same sort of evidence that Stanislaw Burzynski uses to claim he can cure gliomas with antineoplastons.

So what is the story, really?

Cannabinoids versus cancer: Hype versus science

The first problem one encounters when examining the evidence concerning the effect of cannabinoids on cancer is that the vast majority of studies touted by advocates claiming that "cannabis cures cancer" are either in vitro or animal studies. In vitro and animal studies are what we in the biz call "preclinical data," meaning data obtained before trying a treatment in the clinic. As the American Cancer Society put it:

More recently, scientists reported that THC and other cannabinoids such as CBD (cannabidiol) slow growth and/or cause death in certain types of cancer cells growing in laboratory dishes. Some animal studies also suggest certain cannabinoids may slow growth and reduce spread of some forms of cancer. However, these substances have not been tested in humans to find out if they can lower cancer risk. There is no available scientific evidence from controlled studies in humans that cannabinoids can cure or treat cancer.

This basically says it all, and it’s tempting to wind up this post right there, but, as Han Solo said after being urged to be quiet while taking out some storm troopers, "Hey, it’s me." Besides, you, our SBM readers, expect science in addition to my self-absorbed blather, as amusing as it might sometimes be. So you shall have it. As good a place as any to start is, as you might imagine, 20 Medical Studies That Prove Cannabis Can Cure Cancer. After all, I assume that Arjun Walia, the person who put this list together, wanted to provide the very best evidence that could be found, particularly given the emphasis that "this is a short list." I perused the papers in the list and was—shall we say?—underwhelmed. I’ll divide my discussion into tumor types, the way the list does. First, you have to understand that CBD, one of the cannabinoids found in marijuana, is viewed as particularly promising because it does not produce the same psychotropic effects as Δ9-tetrahydrocannabinol (THC), making it a particularly attractive for developing treatments whose side effects don’t involve being stoned all the time.

Glioma. The first thing that jumped out at me is that one of these papers has nothing to do with cancer, specifically this study that suggested that cannabinoids could protect the brain against neurodegeneration in neonatal rats caused by the toxin ouabain (an Na⁺/K⁺-ATPase inhibitor). The vast majority of the other studies were in human cell lines, such as this one studying the effect of cannabidiol, a nonpsychoactive cannabinoid, on glioma cell lines. As a cancer researcher, I noted that the IC₅₀ (the concentration that produces 50% of maximal inhibition of the parameter being measured), was 25 μM, which is a bit higher than we like for an anticancer compound. I was thus not particularly impressed, although in fairness subcutaneous injection of CBD was able to inhibit the growth of glioma xenografts implanted subcutaneously in athymic nude mice, although no dose-response was demonstrated, and a dose of 0.5 mg per mouse is a pretty generous dose (25 mg/kg for a typical 20 g mouse). So while there does appear to be antitumor effect against the glioma cell lines tested, it was, at best, modest. Certainly it wasn’t the sort that would knock my socks off as a cancer researcher. A different study, which combined THC and temozolomide, produced more impressive results, not for the THC, which produced at best modest antitumor effect, but for the combination, which looked a bit more promising. Of course, one also must note that this is not hash oil or smoked pot, but the purified THC component. That THC might be useful against glioma does not tell us that hemp oil or smoking the weed will be useful against glioma any more than the fact that digoxin works in congestive heart failure tells us that it would be a good idea to ingest foxglove leaves.

Skeptical Raptor puts it in perspective:

In one study, the researchers determined that it would take a concentration of cannabinoids of approximately 10 µmol/L to cause the death breast cancer cells in cell culture. This converts to around 3.14mg/L of THC. So, you’d have to assume that to kill any breast cancer cells, you’d need at least a blood level of 3.14 mg/L to achieve breast cancer cell death. So how close to that 3.14 mg/L can we get by just smoking a joint or two? According to research, smoking one joint will give you a blood level of THC of around 1.3-6.4 ng/mL serum, or about .00013-.00064 mg/L. In other words, to get an anti-cancer effect, you need to light up around 1000 joints per day.

The IC₅₀ values in these studies were higher than 10 μM.

Finally, there was one human study in the list of glioma papers. Basically, this was a phase I trial testing a method of administering THC. This was also some strange science in that nine patients with recurrent glioma had their tumors resected, but a catheter was left in the cavity left behind after surgery, and then:

Each day an aliquot of the THC solution (100 mg ml⁻¹ in ethanol) was dissolved in 30 ml of physiological saline solution supplemented with 0.5% (w v−1) human serum albumin, and the resulting solution was filtered and transferred to an opaque syringe. This process was performed at the Department of Pharmacy of the Hospital Universitario de Canarias. Owing to the high hydrophobicity of THC, we controlled by gas chromatography/mass spectrometry (see below) the actual concentration of THC in the final solution. The THC solution was administered to the patients for different times starting at days 3–6 after surgery at a rate of 0.3 ml min−1 with a syringe pump connected to the subcutaneous reservoir. In the case of Patients 1 and 2, who received THC for 30 and 26 days, respectively, biopsies were also taken after the THC-treatment period and various tumour-cell parameters were evaluated.

As you can see, this is very different from smoking marijuana or ingesting hash oil. It involves directly infusing THC solution at a high concentration directly into the brain cavity where the tumor had been, in the hope of killing off any remaining tumor cells surrounding the cavity. Let’s just put it this way. There’s a reason why direct intratumoral injection of any drug is generally frowned upon, and that’s because it’s invasive and rarely works. Moreover, no one generally bothers with intratumoral infusion of a drug unless it requires a very high concentration to work. Mean survival was 24 weeks, and two patients survived approximately a year. The authors try (rather like Stanislaw Burzynski, actually) to argue that this is better than would be expected based on other studies and controls, and to claim that some patients responded. I find no convincing evidence of this in the paper, and in a cohort of nine patients though, it’s pretty darned hard to conclude this. I agree with Harriet. There is nothing "earth shattering" about these results. They could be consistent with an antitumor effect, but they could just as easily be consistent with no effect. Worse, this was not simply ingesting, smoking, or being injected with cannabinoids. The study involved having catheters sticking out of the subjects’s heads and having THC infused directly into the brain.

Breast cancer. I’m a breast cancer surgeon; so I’m going to go out of order here. There are four breast cancer studies listed. The first study examines CBD activity against a mouse breast cancer cell line 4T1 (another cell line I’m quite familiar with, having used it in my lab and because it was a cell line developed by a now retired investigator whom I know), and the breast cancer cell line MDA-MB-231 (which I’m more familiar with than I’d like to be). Basically, the study showed a modest effect against these two cell lines in vitro and in mouse models using 1 mg/kg and 5 mg/kg CBD. The second study looked at five different cannabinoids and found that CBD was the most potent inhibitor of breast cancer cell growth in vitro (IC₅₀ between 6.0 and 10.5 μM) and that CBD and "CBD-rich oil" could inhibit the growth of MDA-MB-231 tumor xenografts. In this study, the effects of THC on cancer cell growth were weak (IC₅₀ between 14.2 and over 25 μM, depending on the cell line). The third study showed similar results for HER2/neu(+) tumor cell lines using THC and specific synthetic agonists (activators) of cannabinoid receptors CB1 and CB2 (Win55,212-2 and JWH-015, which activate CB1 and CB, respectively) except that THC was not as weak. The fourth study didn’t look at marijuana cannabinoids at all, but rather the endogenous cannabinoid anandamine, with similar results.

Lung cancer. The next set of three studies look at lung cancer. The first study used a cell line with which I’m quite familiar, A549 lung cancer cells, using both cell culture and mouse xenograft models. I must say that I was singularly unimpressed with the effect sizes, at least in the in vitro studies, which also required fairly high concentrations (15 μM) of THC. In a mouse tail vein injection model of lung metastases, 5 mg/kg of THC decreased metastases by 50%, which is not bad, and in a straightforward xenograft model resulted in a 50% growth delay of the tumors, which is also not bad. The next study found similar results testing CBD against lung cancer cell lines and tumor cells from a patient in cell culture and mouse models. The third study showed that stimulation of cannabinoid receptors (CB1 and CB2) with synthetic agonists, Win55,212-2 and JWH-015, which activate CB1 and CB2, respectively, inhibited the growth and invasion of A549 lung cancer cells in vitro and their growth and metastases in mouse models.

And so it goes. Nearly all of these studies look at purified cannabinoids, usually either THC or CBD, but sometimes the endogenous cannabinoid anandamine (which isn’t even in marijuana), as with the breast cancer study above and this prostate cancer study. Some use synthetic agonists, such as the breast cancer and lung cancer studies above, or this study of mantle cell lymphoma that tested R(+)-methanandamide in addition to Win55,212-2, or this study of non-Hodgkin’s lymphoma, which also used R(+)-methanandamide. With the exception of the glioma study, all were preclinical studies looking at cell culture models and mouse models. One was a review article. One, as I pointed out above, had nothing to do with cancer, and I suspect the author included it to round up his list of studies to 20.

Unfortunately, it’s a highly intellectually dishonest list of studies if your goal is to provide evidence that "cannabis" (as in the plant or extracts from the plant) can cure cancer. Unfortunately, this is not the first time Arjun Walia has constructed such a list. Last year, Liz Ditz nailed him for constructing a similarly intellectually dishonest list of studies that "show vaccines cause autism." Let’s just put it this way. In 2013, Walia was still citing some highly discredited studies, such as studies by Mark and David Geier.

The intellectual dishonest of representing this list of studies as evidence that cannabis cures cancer aside, it is a group of moderately interesting papers that suggest that purified cannabinoid receptor agonists can produce reasonable, albeit by no means spectacular, antitumor effects in preclinical models. As a whole, they suggest that some of these purified cannabinoid agonists, whether naturally occurring, such as THC, CBD, or synthetic, such as R(+)-methanandamide, or specific to CB1 or CB2, such as Win55,212-2 and JWH-015, might be worth investigating further. Again, we’re talking about pharmacology, isolating active substances and purifying or chemically modifying them to improve their activity and safety profile, not smoking weed or using hash oil. Cancer Research UK concludes:

But claims that this body of preclinical research is solid "proof" that cannabis or cannabinoids can cure cancer is highly misleading to patients and their families, and builds a false picture of the state of progress in this area.

It’s also noted that the best results in the lab have come from using a combination of highly purified THC and CBD, but that there have also been positive results with synthetic cannabinoids, such as a molecule called JWH-133, just as I’ve described, through mechanisms that include:

Triggering cell death, through a mechanism called apoptosis
Stopping cells from dividing
Preventing new blood vessels from growing into tumors
Reducing the chances of cancer cells spreading through the body, by stopping cells from moving or invading neighbouring tissue
Speeding up the cell’s internal ‘waste disposal machine’ – a process known as autophagy – which can lead to cell death

Unfortunately, as good as that sounds, it’s not all good. There is also evidence that cannabinoids, under some circumstances, can stimulate cancer cell growth and possibly contribute to tumor progression. They can also have different effects depending on dose and the level of cannabinoid receptors on the tumor cells being treated. For instance, this study suggests that cannabinoids only induce apoptosis in cells that express low levels of receptors that couple to a signaling pathway called ERK1/2 but don’t induce apoptosis in cells that have high levels of receptors because they then couple through a survival pathway known as AKT. Interestingly, cannabinoids also seem able to induce cell death through pathways that don’t involve cannabinoid receptors. In other words, it’s complicated, because cancer is complicated, and cancer drugs tend to work only against certain cancers. If cannabinoids do have anticancer effects in humans, it will likely only be against certain cancers, most likely combined with existing chemotherapy and targeted drugs. We also know from the preclinical work that has been done that it will take purified THC and/or CBD and/or synthetic cannabinoid receptor agonists to produce even the modest effects observed thus far, effects that are too modest to expect cannabinoids to be any sort of cure for cancer on their own. Smoking weed or using hash oil just isn’t going to cut it.

But what about the anecdotes?

On that other blog that you all hopefully know and love, one of the commenters, Justin Kander, cited a case report that’s been going around social media as "proof" that cannabis cures cancer. This case report describes a 14-year-old girl, PK, who presented with symptoms of "weakness, shortness of breath and bruising when she was taken to the Hospital for Sick Children, Toronto, Canada, on the 10th March 2006." She was diagnosed with acute lymphoblastic leukemia (ALL) and underwent standard chemotherapy for ALL for six months. Upon analysis, she was found to be positive for a mutation in the Philadelphia chromosome, which is found in 2-10% of pediatric ALL cases. Philadelphia chromosome-positive ALL tends to have a poorer prognosis than other ALL. PK underwent a bone marrow transplant but was noted to have blast cells six months after treatment and therefore underwent aggressive chemotherapy along with a tyrosine kinase inhibitor. After more recurrences and more treatment (such as radiation therapy to the brain for a presumed, but never completely documented, infiltration of the brain by leukemia, it was stated in the case report:

On the 4th February 2009, blood was noted in the patient's stools and a blood cell count revealed the presence of blast cells. As a result, all treatment including the disatinib was suspended and the patient's medical staff acknowledged failure in treating her cancer. It was charted by the patient's hematologist/oncologist that the patient ‘suffers from terminal malignant disease. She has been treated to the limits of available therapy… no further active intervention will be undertaken’. She was placed in palliative home care and told to prepare for her disease to overwhelm her body and from which she would suffer a stroke within the next 2 months.

The family found articles on how cannabis supposedly cures cancer, and found their way to Rick Simpson, who has been featured in utterly credulous articles in High Times and SF Weekly (the latter of whose editors really should have known better) as the man who can cure cancer with hemp oil, who provided her with hemp oil mixed with honey (because of the bitter taste and viscous nature of hemp oil). This was administered in daily doses. It is claimed in this case report that there was a strong correlation between increasing dose of the hemp oil and decreases in PK’s blast count (a measure of leukemia cells in the blood), but looking at Figures 1, 2, 3, and 4, I have a hard time seeing it. Figure 1 shows increasing doses of hemp oil from what was called the "chronic" strain. That’s the closest we see to decreasing blast counts correlating with hemp oil dose. By day 15, the chronic strain was gone, and PK started taking Hemp Oil #2 from an outside source. In actuality in Figure 2, we see the blast count increasing with increasing dose until day 27, when it starts falling. Figure #3 shows Hemp Oil #3 (Afghan/Thai strain) from days 44 to 49. Given that the blast count stayed the same one can’t say much about this. Then Hemp Oil #4 was tried from day 50 to day 67, and her blast counts started rising. Finally, Hemp Oil #5 was tried and PK’s blast count fell between days 69 and 78. During that time, PK suffered the psychotropic effects of the hemp oil, including euphoria, disoriented memory, and the like.

Unfortunately, PK developed gastrointestinal bleeding and bowel perforation with peritonitis on day 78 and passed away. So, basically, she lived two and a half months after being placed on hospice. The authors assert that a dose-response curve was achieved, but to my eye I really don’t see it, except perhaps at the beginning, nor do I really buy the claim that the bumps in blast counts correlate with using "lower potency" strains. They also assert because PK was treated for tumor lysis syndrome (a syndrome in which the waste products of tumor breakdown, often seen after intense chemotherapy in hematopoietic malignancies, injure organs such as the kidneys), it must mean that the hemp oil was effective.
Unfortunately, even if a mild dose-response effect was observed that would not rule out spontaneous remission. Spontaneous remission is known to occur in ALL, although it is usually temporary, and spontaneous tumor lysis syndrome has been reported, although it is rare. In any case, one has to wonder whether the patient’s bone marrow was petering out near the end, something that is hard to determine because almost no laboratory values other than blast counts are presented, except at the end, when she had a very low platelet count (8K; normal 150K to 450K), a low white blood cell count (1.4, normal 4.5-13.0), and severe anemia (hemoglobin 8.2; normal: 13 to 16). It wasn’t established how the diagnosis of tumor lysis syndrome was made other than that the patient had elevated urate levels. Indeed, the entire case report seemed to have been written with the belief that it was the hemp oil that accounted for the decrease in blasts. A lot of information has been left out about the patient’s clinical course. All we know is that, after being placed in hospice, she was fortunate to have her blast count fall, developed a central line infection, and was treated for tumor lysis syndrome. We can also infer that she was still having considerable issues with her gut because she was on total parenteral nutrition (being fed by vein) and had trouble when they started to try to feed her orally again.

It should also be remembered that, whether or not hemp oil was responsible for the decline in blasts (which is possible but not convincingly demonstrated by this case study) or whether it was "burnout" of the bone marrow in the terminal phase of the disease or even spontaneous remission, the patient still died. She still developed GI bleeding and a GI perforation with peritonitis and died of it only 78 days after going on hospice. There’s no way of knowing whether hemp oil prolonged her life. Probably it did not, as a two to three month survival after going into hospice after being declared terminal for leukemia is well within what is expected. In other words, this case report is mighty thin gruel indeed.

Of course, the sad story of PK and the treatment of her terminal relapsed ALL with hemp oil is probably the highest quality cancer cure testimonial out there, and unfortunately its quality is not that high at all. The rest of the anecdotes I ran into tended to be about as convincing to someone familiar with cancer as nearly all the other alternative cancer cure testimonials I’ve found; i.e., not very. If you don’t believe me, take a look at this article, in which Rick Simpson claims his success rate for patients with terminal cancer is around 70% and says:

"The ones that can’t be saved are usually the ones who’ve had the most chemotherapy and radiation, or wait too long to start the treatment," he says. "They have to be able to stay alive long enough for the oil to start to work." In fact, most patients who undergo chemotherapy die from the treatment, not the disease.

No, it is not a "fact" that most patients who undergo chemotherapy die from the treatment, not the disease. It’s a lie. In any case, Rick Simpson is just like cancer quacks the world over, who have no firm evidence to back up their miraculous-sounding cure rates and excuse their failures by claiming that the treatment patients had before prevented the quackery from working. Quacks like Rick Simpson do those who think that cannabinoids have promise in treating cancer no favors.

Conclusions

There’s a lot of interesting research about the role of cannabinoid receptors in cancer and whether targeting them with cannabinoid agonists from marijuana or other natural sources, synthetic agonists, or endocannibinoids will be a useful tool to add to the armamentarium of anticancer therapies. From what we know now, it is quite clear that cannabis does not cure cancer, at least not by itself and certainly not ingested or smoked as marijuana or ingested or applied topically as hemp oil. Even in purified form, naturally-derived or synthetic cannabinoid agonists show relatively modest antitumor activity in preclinical models, which means that they will have to be combined with existing chemotherapeutic regimens. If they do find their way into the routine clinical treatment of cancer, it will be through rigorous pharmacological studies and rigorous clinical trials, the latter of which, in particular, are painfully lacking. Indeed, if you search ClinicalTrials.gov, you’ll quickly find lots of trials of cannabinoids to treat cancer-related symptoms and side effects, but precious few to treat cancer itself. There’s this phase I trial of Dexanabinol in Patients With Advanced Solid Tumors, which has been open two years and is still accruing patients, as well as this one of Dexanabinol against brain cancers. It’s not a lot, and suggests that there is not much interest in even synthetic cannabinoids as a treatment for cancer. After all, there are so many other promising avenues that a class of drugs that show the modest effects that the cannabinoids I’ve discussed do just don’t excite researchers that much.

In any event, the claims of advocates that "cannabis cures cancer" are nothing more than herbalism infused with the magical thinking of the naturalistic fallacy. Just because it’s "natural" does not make it better. In the case of cannabis for cancer, the only potentially promising way forward is to isolate the active components and figure out which of the hundreds of different cancers in which these components have activity against.

Finally, I have no objection to lobbying for the legalization of marijuana for recreational use. I would support such measures myself. However, trying to use hugely exaggerated claims of medicinal benefit as a back door path to legalization gets my skeptical antennae all a’twitchin’ about all the other claims made by advocates and provides ammunition for critics whose real goal is prohibition.

Next: More testimonials analyzed.

oracknows Mon, 08/18/2014 - 01:00

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