Tuesday, April 24, 2018

The Shalala Shuffle: Former HHS Chief "Evolves" on Marijuana

Former US Secretary of Health and Human Services Donna Shalala has become the latest Drug Warrior to "evolve" on marijuana.

Shalala, who is now running for a Congressional seat in Florida, tweeted on 4/20: "Decriminalizing marijuana shouldn't just be a policy priority — but a moral imperative." The tweet links to a page on her website where you can sign up for her campaign, and donate!

Yet, although Shalala once admitted to smoking pot in college in an interview with Diane Sawyer, as H&HS chief in 1996 she stood with Attorney General Janet Reno and Drug "Czar" Barry McCaffrey threatening to revoke doctors' licenses for recommending medical marijuana (a successful civil challenge later backed the government off). "Marijuana is illegal, dangerous, unhealthy and wrong," Shalala said at the time. "It's a one-way ticket to dead-end hopes and dreams."

Her own pot smoking didn't seem to have hurt Shalala's ambition. She also chaired the Children's Defense Fund before being appointed by Bill Clinton to the top H&HS post. After she served as president of Hunter College in New York City and in 1988, she was named chancellor of the University of Wisconsin-Madison, the first woman ever to head a Big Ten school. She then became President of the University of Miami.

According to an article in the Miami Herald, as recently as 2013, Shalala was on record questioning her own party for its support of a medicinal marijuana market in Florida.

In a statement made last week, Shalala's campaign said the candidate remains worried about the effect of marijuana on children, but cited new research, public perception, and criminal justice statistics for her change in thinking on marijuana. The statement cited "strong evidence showing real medical benefits of marijuana when used properly," statistics showing states that have legalized medical marijuana have seen a drop in opioid deaths, and the overwhelming support for Amendment 2 in Florida two years ago.

"Donna's thinking and understanding of marijuana has evolved, just as the general population's perspective and the science has evolved," the statement said. "She believes that we must reschedule cannabis to allow the government and the scientific community to work together to thoroughly study its effects and potential benefits. And, we must decriminalize cannabis because for far too long we have witnessed families and lives being destroyed over marijuana, especially individuals of color. We must follow the science and look at the facts."

Commenting about Shalala's former stance against medical marijuana, former Surgeon General Jocelyn Elders told Playboy magazine, "She has a Ph.D. in political science. That's the kind of science she practices." Let's hope, this time, she's practicing the real kind.

Saturday, April 14, 2018

SSRIs increasingly prescribed during pregnancy, without much study on their effects

Lead researcher Claudia Lugo-Candelas
Researchers from Columbia University, the Keck School of Medicine, and the Institute for the Developing Mind in Los Angeles, have published a new study on how infants' brains are affected when their mothers take SSRIs for depression during pregnancy. SSRIs include Celexa, Lexapro, Prozac, Luvox, Paxil and Zoloft, and are used by 1 in 10 adults in the US.

Excerpts from the study:

Selective serotonin reuptake inhibitor (SSRI) use among pregnant women is increasing, yet the association between prenatal SSRI exposure and fetal neurodevelopment is poorly understood.

A cohort study conducted at Columbia University Medical Center and New York State Psychiatric Institute included 98 infants: 16 with in utero SSRI exposure, 21 with in utero untreated maternal depression exposure, and 61 healthy controls. Our findings suggest that prenatal SSRI exposure has an association with fetal brain development, particularly in brain regions critical to emotional processing....To our knowledge, this is the first study to report increased volumes of the amygdala and insular cortex, as well as increased WM connection strength between these 2 regions, in prenatally SSRI-exposed infants.

Lugo-Candelas C, Cha J, Hong S, et al. Associations Between
Brain Structure and Connectivity in Infants and Exposure to
Selective Serotonin Reuptake Inhibitors During Pregnancy. 

JAMA Pediatr. Published online April 09, 2018.
PMD = Prenatal Maternal Depression; HC = Healthy Control
The prescription of selective serotonin reuptake inhibitor (SSRI) medications for pregnant women has accelerated over the past 30 years. To some extent, this rise may be attributable to increased awareness of the detrimental effects of untreated prenatal maternal depression (PMD) on women and children, along with early studies failing to document immediate effects of SSRI exposure in offspring (although later rodent studies document postpubertal alterations). However, little is known about the association between prenatal SSRI exposure and human fetal neurodevelopment. Serotonin (5-hydroxytryptamine [5-HT]) plays a vital role in neurodevelopment.

In the fetal brain, 5-HT signaling affects cell proliferation, differentiation, neuronal migration, network formation, and synaptogenesis. Perinatal SSRI exposure in rodent studies is associated with delayed motor development, reduced pain sensitivity, disrupted thalamocortical organization, reduced dorsal raphe neuronal firing, reduced arborization of 5-HT neurons, and altered limbic and cortical circuit functioning.

Literature on prenatal SSRI exposure in humans is limited and mixed. Studies have most consistently reported that prenatal SSRI exposure is associated with a shorter gestational period, lower birth weight, lower Apgar scores, and neonatal abstinence syndrome....Consistent with animal studies, a recent national registry study (including 15 ,000 prenatally SSRI-exposed offspring) found increased rates of depression in early adolescence in youth with prenatal SSRI exposure.

Brain imaging provides a window into neurodevelopment, yet human infant and fetal imaging studies of prenatal SSRI exposure are scarce....
The study highlights the need for further research on the potential long-term behavioral and psychological outcomes of these neurodevelopmental changes.

One of the references the authors cite, a 2007 study titled, "Increasing use of antidepressants in pregnancy," says:

The proportion of pregnancies with antidepressant use increased from 5.7% of pregnancies in 1999 to 13.4% of pregnancies in 2003. The increase was mostly accounted for by increases in selective serotonin reuptake inhibitor exposures....There is an urgent need for further studies that better quantify the fetal consequences of exposure to antidepressants.

Thursday, April 12, 2018

Cynthia Nixon Advances Marijuana Legalization in New York

Sex in the City star and New York gubernatorial candidate Cynthia Nixon has stepped up her support of marijuana legalization, after news reports trumpeted her position, at first reporting she was behind it for financial reasons.

Nixon has now released a video articulating the human rights reasons for her position: her concern that people of color are disproportionately punished for marijuana.

She even tweeted after former prohibitionist John Boehner turned potrepreneur, "Now that public opinion has shifted on marijuana, rich white men like Boehner and companies like Monsanto are trying to cash in. We can’t let them rake in profits while thousands of people, mostly people of color, continue to sit in jail for possession and use."

And just in time for 4/20, she's asking supporters to chip in $4.20 a month for her campaign against sitting Governor Andrew Cuomo, who remains opposed to recreational pot.

Sex in the City was criticized for promoting alcohol use to young women, and co-star Kristin Davis has admitted that she is a recovering alcoholic. The show had some pot smoking in it, though not with Miranda (Nixon's character, a workaholic attorney who becomes a single mom until she marries her bartender boyfriend). Rather, it's sexy Samantha who is the procurer of the pot that Carrie (Sarah Jessica-Parker) is busted for after smoking on the streets of NYC.

Samantha (Kim Cattrall) is perhaps punished for her freewheeling ways by being the character to get breast cancer, but as a new Mother Jones exposé reveals, it's alcohol that is the link there.

Let's hope Nixon is sincere in her embracing of legalization, and will look deeper and harder into the issues for the greater solutions, including coming to grips with all of our so-called addictions (like to sex and alcohol).

Wednesday, April 11, 2018

Lily Tomlin as Good Grandma Ganja

Lily Tomlin chillin' with silver fox Sam Elliott in Grandma
Almost as surprising as when I expected "Private Benjamin Goes to Kabul" from Tina Fey and instead got the excellent Whiskey Tango Foxtrot, I finally got around to watching Grandma (2015) with Lily Tomlin, and it's the best movie I've seen in a while.

Don't get me wrong, I'm a huge Lily fan. I laughed at her in "Laugh-In," and can
still recite much of the "Sister Boogie Woman" bit from her Modern Scream album (on which she tells a great pot joke). And I saw her emerge as an actress in that
single, unforgettable scene in Nashville where she listens to Keith Carradine singing "I'm Easy."

I think I was afraid Tomlin's Grandma would be a little too much like her character in Netflix's "Grace and Frankie," where she's ridiculed and made to look ridiculous by the alcoholic Jane Fonda character. But no, in Grandma, Lily as the feminist poetess Elle is back in all her power, signified by the "Violet" tattoo she wears on her arm (the name of the character she played in 9-5, wherein she smoked pot with Jane).

Nat Wolff (Stuck in Love) proves no match for Grandma
This Grandma isn't just there for her kids: she's living her own life, falling in love (with Judy Greer as Olivia), and dealing with her anger issues and her past, even while confronting her granddaughter's crisis pregnancy. Elle is still alive and kicking, like when she takes down her granddaughter's asshole boyfriend, who wears a huge pot leaf on his hockey jersey. Afterwards, she steals his stash.

Elle makes good use of her find in the next scene with Sam Elliot: two old friends (and flames) who share a joint for old times' sake. It's a great scene, as are the ones Tomlin plays with Greer and Marcia Gay Harden as her equally angry, caffeine-chugging daughter.

There's no discussion about pot with the granddaughter (as there was with Lily
and her son in 9-5). It's just a part of Elle's life, and not something that rules or defines her.

With appearances by John Cho (Harold and Kumar), Lauren Tom (Joy Luck Club), Missy Doty (Shameless), and Judy Geeson (To Sir with Love),  the film even has a bit of a poem by Tokin' Woman Anne Waldman, plus a final appearance by Elizabeth Peña (La Bamba), who died of cirrhosis of the liver at the age of 55 in 2014. (One more reason to be more like Frankie than Grace.)

Grandma was filmed in 19 days at a cost $600,000, and made $8.7 million. The film was named among the top ten independent films of 2015 by the National Board of Review, and Tomlin was nominated for a Golden Globe Award for her performance.

Friday, April 6, 2018

Un-Debunking the Queen Vic Myth?

Queen Victoria with five of her nine children
Several authors of late (e.g. James H. Mills in Cannabis Britannicahave sought to debunk the persistent reports than Queen Victoria used cannabis to treat menstrual cramps.

The rumor started when it was discovered that John Russell Reynolds, M.D. wrote an article published in The Lancet in 1890 extolling the virtues of cannabis for cramps and other ailments, while credited as "Physician in Ordinary to Her Majesty's Household."

Cannabis researcher Ethan Russo, M.D., co-editor of Women and Cannabis, wrote in that book that Reynolds was Victoria's "personal physician" and that "it has been widely acknowledged" that she received monthly doses of cannabis for menstrual discomfort throughout her adult life. However, Russo now concurs with Mills's assertion that we have no proof of this.

Reynolds was appointed as physician to the Queen's household in 1878, when she was 59 years old, well past the age when she would have experienced menstrual cramps. Further, his appointment did not make him Queen Vic's personal physician, but rather one of at least 200 physicians, apothecaries and other attendants in her "medical household," to treat her staff of over 800 persons at her 12 residences. However, she often consulted with various members of her medical staff, and also physicians who were not part of the household. (A. M. Cooke, Queen Victoria's Medical HouseholdMed Hist. 1982 Jul; 26(3): 307–320.)

Famous for her prudishness, Victoria never hired a female physician and was appalled that female medical students performed dissection alongside their male counterparts. Yet, she was surprisingly experimental when it came to her own medical care. She was an early adopter of chloroform for childbirth, using it in 1853 while giving birth to her eighth child, and again in 1857 for her final childbirth, "despite opposition from members of the clergy, who considered it against biblical teaching, and members of the medical profession, who thought it dangerous." (Wikipedia)

The physician who gave the Queen chloroform for each of these births was John Snow, an eminent epidemiologist and pioneer in anesthesia, who "does not appear to have had any appointment to the Medical Household" (Cooke). So Victoria consulted with an outside specialist for a relatively unknown treatment.

It's possible, then, that Reynolds also treated the Queen while not yet one of her official physicians, possibly when she was a younger woman. He was certainly prominent enough to have caught her attention:

John Russell Reynolds (Yale University Library) 
Sir John Russell Reynolds was an eminent and highly influential physician in the Victorian era who held the Presidencies of the Royal College of Physicians of London, and of the British Medical Association. He was the protégée of the great experimental physiologist, Marshall Hall, who discovered the reflex arc, and succeeded to Hall’s clinical practice in London. Reynolds’ thought and clinical activities linked the emerging British neurology of the first half of the 19th century with its blossoming, particularly in London, from 1860 onwards. In his writings Reynolds was the first English author to apply the approach to classification of neurological disorders that is still often used, though now in modified form. 

(M. J. Eadie, The neurological legacy of John Russell Reynolds, Journal of Clinical Neuroscience, April 2007)

In his now-famous Lancet article, Reynolds writes that in 1848, a lecturer at medical school spoke of the potential of Indian hemp in medicine, but found it too variable in dosage to avoid toxic effects. Seven years later, Reynolds recounts, he made a connection with Peter Squire, the pharmacist who also supplied W. B. O'Shaughnessy, the physician who brought cannabis to the West. Squire was able to provide Reynolds with a reliable tincture of Indian hemp, with which he began experimenting in 1855 when Victoria, born in 1819, was only 36.

Reynolds recounts his experiments of over 30 years, describing carefully where he found cannabis useful and where he did not. He writes, "In senile insomnia, with wandering; where an elderly person, probably with brain-softening, in the 'delirium form' (Durand-Fardel) is fidgety at night, goes to bed, gets up again, and fusses over his clothes and hid drawers; thinks that he has some appointment to keep, and must dress himself and go out to keep it; but may be quite rational during the day, with its stimuli and real occupations. In this class of case I have found nothing comparable in utility to a moderate dose of Indian hemp—viz., one quarter to one-third of a grain of the extract, given at bedtime. It has been absolutely successful for months, and indeed years, without any increase of the dose."

By contrast, "In alcoholic delirium it is very uncertain; but has very occasionally been useful. In melancholia it is sometimes of service in converting the depression into exaltation; but I have long since discontinued its use, except when the case has merged into that of senile degeneration. In mania I have found it worse than useless, whether that malady has been chronic or acute...."

Reynolds continues, "In almost all painful maladies I have found Indian hemp by far the most useful of drugs....it is a most valuable medicine in the nocturnal cramps of old and gouty people; it in some cases relieves spasmodic asthma, and is of great service in cases of simple spasmodic dysmenorrhoea [menstrual cramps]."

Even in her youth Victoria barely had time to menstruate: she bore 9 children in 18 years. The Queen reportedly hated being pregnant and suffered from postpartum depression and "hysteria." I think it's likely, if Reynolds did use cannabis to treat Victoria, he may have done so for nervous disorders later in her life.

Reynolds "devoted himself from an early period to the study of nervous diseases" and began publishing on the topic in 1855, with Diagnosis of Diseases of the Brain, Spinal Cord, and Nerves. He "was often consulted in difficult cases of nervous disease." (Wikipedia)

He wrote, "Indian hemp, when pure and administered carefully, is one of the most valuable medicines we possess," 12 years after he joined the Queen's household medical staff.

If Victoria used Indian hemp late in her life, it might help explain her attachment to an Indian servant in her last years, as depicted in the movie Victoria and Abdul. Maybe he brought more than curry with him to England.

Sunday, April 1, 2018

The Voice and The Vipers

I've become a fan of TV's The Voice, since being introduced to Halsey's song "The New Americana" by contestant Moushumi on the 2016 season:

We are the new Americana
High on legal marijuana...

This year, the show's 14th season, features the addition Kelly Clarkson as a coach, along with returning coaches Alicia Keys, Adam Levine and Blake Shelton.

And I've found a marijuana connection to all four of them.

First and I suppose foremost, Adam Levine sparked headlines like "World’s Biggest Killjoy Sues Universal Over Adam Levine’s Alleged Weed Habit" in 2013, after a security guard at Universal Studios, where The Voice is filmed, filed a lawsuit alleging that Macy Gray and others including Levine "began visiting the premises with drugs in hand and oftentimes offering drugs to [her].”

The plaintiff claimed that her complaints to management were met with “a blind eye,” including an incident when she smelled marijuana smoke coming from a recording studio. Her manager allegedly responded, “It’s Adam Levine. You know from Maroon 5 … He can do whatever he wants …" Ah, to be a musician.

Also in 2013, Levine was named People Magazine's Sexiest Man Alive, joining the ranks of other pulchritudinous partakers Brad Pitt, Matt Damon, George Clooney, Matthew McConaughey, Pierce Bronson, Harrison Ford and JFK Jr. 

As part of Maroon 5, Levine has won three Grammy Awards, two Billboard Music Awards, two American Music Awards, an MTV Video Music Award and a World Music Award. The winners of the first, fifth and ninth seasons of The Voice were on Levine's team. What a lazy pothead he is (not).

Country Singer Blake Shelton, Levine's nemesis on the show, somewhat surprisingly recorded "Ready to Roll" in 2011. The song is full of references to smoking pot:

We gonna burn all afternoon 
like it's something to smoke 
We gotta whole lot of 
nothing to do 
and nowhere to go 
So baby I don't know about you 
but I'm ready to roll 

No other word on whether or not Shelton has been on Willie Nelson's bus, or if he's a true Oakie from Muskogee, but he did say one singer's blind audition this season made him feel like he was "riding a unicorn." He's coached five winners on The Voice.

Kelly Clarkson, the OG vocal contest winner on American Idol in 2002, told USA Weekend magazine five years later that she ate a marijuana cookie while in Amsterdam. "It is legal there, and it is not legal here [in the US]," she noted.

"I don't ever do anything illegal here," Clarkson added. "I wouldn't do anything that would cause holes in your brain or your nasal cavity. Call me Texan, but I don't think of marijuana like that." Shortly thereafter, Blender magazine's profile of Clarkson presented her as a bit of a rebel, documenting her rift with 74-year-old BMG Chairman/CEO Clive Davis. "I can't stand it when people put out the same record over and over again," Clarkson told Blender. "Life is too short to be a pushover." Spoken like a true pothead.

Clarkson has sold over 25 million albums and 36 million singles worldwide and scored a total of over 100 number ones on the Billboard charts. She's won three Grammy Awards, three MTV Video Music Awards, four American Music Awards, and two Academy of Country Music Awards. In 2012, she sang the National Anthem at the Super Bowl.

The stellar singer recently revealed that she was hospitalized during a "horrible" pregnancy due to severe nausea and vomiting. It's likely she suffered from hyperemis gravidarum (HG), a debilitating ailment that afflicts 1-2% of pregnant women globally, including Princess Kate. Since cannabis is the safest and most effective anti-emetic known to man, with a non-oral delivery system (smoking) that offers immediate relief, it would make sense to study it as a remedy for mothers with severe morning sickness. Maybe now that it's legal in many states of the US, Clarkson will consider trying it again, for medicinal or recreational purposes.

Finally, Alicia Keys, who coached the winner on her last appearance on the The Voice two years ago, is so spectacularly soulful she probably doesn't need any herbal assistance to fly high. Not so, perhaps, her fans. In the 2006 "Drug Testing" episode on TV's The Office, Michael attends an Alicia Keys concert and says, "I think I might have gotten
high accidentally by a girl with
a lip ring."

A viper, for you cats and kitties who don't know, was slang for a pot smoker in the Roaring 20s. 

Monday, March 19, 2018

Hey Hollywood: How About an "Inclusion Rider" for Weed?

Frances McDormand
Picking up her second Best Actress Oscar, Frances McDormand left us with two words "Inclusion Rider." I wonder: how about an Inclusion Rider for marijuana fans?

Because so many industries needlessly and pointlessly drug test their employees, it's left to Silicon Valley and Hollywood to hire cannabis consumers, while benefiting from the extra creativity that pot provides. So we ought to be sure that every movie has a requisite number of staffers who enjoy their joints.

Also, in the same way that ethnic and disabled activists are advocating for depictions of them in movies to be authentic, so we must demand that Tokin' Women be played by actress who really know how to act stoned.

Miley Cyrus
Despite once appearing on the cover of High Times and outing herself as a pot smoker, McDormand has never played a good Tokin' Woman role. She did smoke in the dismal Laurel Canyon (were she wasn't much of a role model); I liked her better in Almost Famous where she convinced her 15-year-old son not to smoke pot (which was appropriate for a kid his age).

My casting suggestion: McDormand could play a post-comeback jazz singer and marijuana fan Anita O'DayMiley Cyrus could act, and sing, as the younger O'Day. Don't they all look alike?

Anita O'Day

Of course we have had some matching casting to date. Meryl Streep was spot-on as Isak Dinesen in Out of Africa, and she even toked up while playing Karen Silkwood. Kathy Bates nailed Gertrude Stein in Midnight in Paris (although there was no partaking of any pot brownies made by her lover Alice B. Toklas).

Bette Midler won accolades on stage portraying a pot-puffing Sue Mengers, and the next thing you knew, she was cast as Dolly on Broadway. But Nicole Kidman as Gertrude Bell and Queen Latifah as Bessie Smith suffered from bad scripts (with no marijuana mentions).

At the Oscars, McDormand had all the female nominees stand up and enjoined everyone present to enable them to tell their stories. I have a few that could be told (with casting suggestions): Susan Sarandon could play a bitchin' Tallulah Bankhead, for example. And how about Jennifer Lawrence as Lila Leeds, the actress she resembles who was arrested with Robert Mitchum for marijuana in 1948.

Jennifer Lawrence
Lila Leeds