More than one toke over the line

Had a prolonged debate the other day with a member of Floyd County’s marijuana advocacy community (yes, there is one).

He, of course, advocates legalization of grass. I oppose it.

Marijuana emerged in public conversations again Wednesday with the revelation that Vincent Lumia had a "considerable amount" of grass in his system when he turned his Ford Explorer into a weapon and created a situation where a Virginia State Trooper had no choice but to shoot and kill him.

Lumia was also bi-polar and reportedly not taking his medication when he went on the rampage. The lack of drugs to control the erratic behavior of bi-polar condition most likely contributed more to his violent behavior than smoking grass but a friend of Lumia told me recently that the young man used grass because he felt it helped control the bi-polar symptoms.

The results of Jan. 12 — when Lumia died after being struck by bullets in the head and other parts of his body — effectively refute that argument for self-medication.

Writes Dr. Alan N. Schwartz on MentalHealth.Net:

I have directly witnessed the tragedy of patients going off of their medications for Bipolar Disorder, using marijuana and ending up re-hospitalized in worse shape than any time prior to the relapse. In fact, it has been my experience that many of these unfortunate patients experienced multiple relapses and were caught in an endless cycle of hospitalizations marked by periods of instability in between.

It is important to keep in mind that there are many intensities of this disorder. There are those people who experience rapid cycling while others rarely become manic. However, when they become symptomatic, they experience Major Depression. Also, there are those who experience Auditory and Visual Hallucinations while others do not. It is possible to have hallucinations at either end of the spectrum: major depression or mania. Then too, there are cases where the illness is so severe that is considered in the realm of schizophrenia and is called Schizoaffective Disorder. It has been my experience with the patients I knew who suffered from severe bipolar disorder and with those who fell into the Schizoaffective domain, that they were not helped by marijuana and were made much worse through its use.

Leaving aside anxiety, those who experience severe depression and who use marijuana end up feeling much more depressed, at least that is what I have witnessed.

There is a lot of denial around the problems of not only marijuana but other drugs of abuse and severe mental illness. In order to break through some of this denial I was, at times, able to get patients to agree to stop their marijuana use for a few weeks just so they could determine whether there was or was not an improvement in mood. These individual were surprised but were willing to admit that they felt real improvement in mood and functioning.

Police found nearly 1,000 marijuana plants at Lumia’s home in what they called an obvious manufacturing facility. That’s sale weight in Virginia and a felony. He was also under the influence when he went to the home of his mother and stepfather and tried to use his SUV to ram through his front door.

He was breaking the law by manufacturing grass and by smoking it. He put his own life and the lives of others at risk by driving while stoned and his actions, fueled by a lack of medication that controlled his bi-polar condition, created a situation that led to his death.

We can argue until the cows come home about whether or not grass should be legalized but the events of Jan. 12 involved the use of marijuana. Was the grass in Lumia’s system a contributing factor to the actions that led to his death? The end result suggests it didn’t help and, in the opinion of some experts, it certainly hurt.

(Updated at 3:50 p.m. to add information from a doctor and clinical social worker)

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16 Responses to More than one toke over the line

  1. Rudi March 13, 2009 at 11:32 am

    Hey Doug, have an Oreo or two on me! Given earlier conversation about your ability to edit posts, it was easy to believe in a conspiracy. Please forgive me for being too quick to judge. I’m familiar with the “threaded” comment system, just not in this format where you can’t readily see that’s what it is.

    Got to find something to drink, my mouth is becoming unexplainably dry!!

  2. Bruce March 14, 2009 at 7:29 am

    Hey Bob, in answer to your request for citations:

    Try:

    “Elevated plasma dopamine metabolites in cannabis psychosis” Bowers MB, et.al.

    “Test of causal linkages between cannabis and psychotic symptoms” Ferguson DM, et.al.

    “Cannabis and psychosis: an update on course and biological plausible mechanisms” Linszene D, et. al.

  3. Doug Thompson March 12, 2009 at 2:58 pm

    No one was suggesting "refer madness" but you are wrong to say a link betwen use of grass and mental disorders is "discredited."  To the contrary, as Dr. Alan Schwartz writes on MentalHealth.Net:

    I have directly witnessed the tragedy of patients going off of their medications for Bipolar Disorder, using marijuana and ending up re-hospitalized in worse shape than any time prior to the relapse. In fact, it has been my experience that many of these unfortunate patients experienced multiple relapses and were caught in an endless cycle of hospitalizations marked by periods of instability in between.

    It is important to keep in mind that there are many intensities of this disorder. There are those people who experience rapid cycling while others rarely become manic. However, when they become symptomatic, they experience Major Depression. Also, there are those who experience Auditory and Visual Hallucinations while others do not. It is possible to have hallucinations at either end of the spectrum: major depression or mania. Then too, there are cases where the illness is so severe that is considered in the realm of schizophrenia and is called Schizoaffective Disorder. It has been my experience with the patients I knew who suffered from severe bipolar disorder and with those who fell into the Schizoaffective domain, that they were not helped by marijuana and were made much worse through its use.

    Leaving aside anxiety, those who experience severe depression and who use marijuana end up feeling much more depressed, at least that is what I have witnessed.

    There is a lot of denial around the problems of not only marijuana but other drugs of abuse and severe mental illness. In order to break through some of this denial I was, at times, able to get patients to agree to stop their marijuana use for a few weeks just so they could determine whether there was or was not an improvement in mood. These individual were surprised but were willing to admit that they felt real improvement in mood and functioning.

  4. Bob March 12, 2009 at 8:53 am

    Manic-Depression(Bi-Polar) is a terrible, terrible affliction. Until very recently it has not been well-understood, and was virtually untreated. The common treatment – lithium, causes mental dulling, which vexes these otherwise naturally mentally nimble and creative people. The end result is that suffers try to find ways to calm the mania, and lift the depression. That is deadly.

    One M-D person in five will commit suicide. A significant portion of the rest will fall to dangerous psychotic behavior. But what is most UNHELPFUL is to feed the otherwise ridiculous, and discredited notion that Lumia was somehow the victim of reefer madness. Any sensible, informed person would know better. There is no other interpretation of the police report stating that Lumia was “intoxicated” by marijuana, than to blunt criticism of the tragic course of events that took place.

  5. Henry March 12, 2009 at 1:23 pm

    I lived with people who smoked dope from waking to sleeping. They were addicted. They couldn’t go a single day without getting high.

    Marijuana is not addictive like cigarettes but you can get addicted to it.

  6. Sean Pecor March 12, 2009 at 10:00 am

    I smoked enough dope in my teens and early twenties to noticeably boost the Jamaican GDP. It never drove me to violence, nor did it ever drive anyone I knew to violence. If a person prone to violent psychosis smokes pot, he will be a person prone to violent psychosis who also happens to be stoned. Being stoned was not a causative factor for this particular person’s violence. The dude was bi-polar.

    I haven’t smoked dope in over 10 years and I doubt I’d ever do it again. It doesn’t mesh with my lifestyle. But unlike cigarettes and alcohol, marijuana is not physically addictive. And while there may be small problems caused by the legalization of marijuana (slight uptick in recreational use), I see huge benefits. Chief among them is a gradual and notable reduction in the number of heroin, meth and cocaine addicts. How so? Well, anyone who has ever bought pot regularly from a dealer has eventually had to “Just Say No” when a “diversified” dealer tries to up-sell you on some coke or heroin. As a teenager, thankfully, I always declined the offer, but I knew of kids in my neighborhood who were tempted by those offers and were ultimately lost to those hardcore drugs. Junkies destroy themselves, their family, most steal and some become felons. Junkies are huge burdens on society. If young adults can, as in Holland, visit a cafe and smoke some weed, and never be exposed to “diversified” drug dealers, we’ll reduce our junkie population. That, on top of tax revenues from marijuana consumption, is money in the bank.

    Sean

  7. Bruce March 12, 2009 at 10:58 am

    Current research indicates that, in some individuals, smoking marijuana overstimulates the production of the neurotransmitter Dopamine in key areas of the brain, and can result in manic and psychotic symptoms.

  8. Jim White March 12, 2009 at 1:29 pm

    What you are saying makes perfect sense to me. When I first read it, it sounded mighty scary, kinda boogie-mannish in a way. But I don’t need a citation, I believe what you say is true, we just need to provide a little context to finish your thought.

    I’ve met and heard of folks who have tried marijuana and experienced uncomfortable feelings of anxiety and/or paranoia after just a few puffs. I’ve always kind of wondered how that could be when 99.99% seem to grin alot and eat oreos by the fistful. After reading (and considering!) your post I would allow that these folks might be experiencing exactly the anectdotal phenomenon that you describe.

    The rest of the story is that these people don’t smoke marijuana they avoid it and who can blame them, I wouldn’t enjoy those sensations either….would you??

  9. Jim White March 12, 2009 at 10:51 am

    It’s a bigger crime to put some one in jail than it is to smoke a joint.

    As if that’s not enough, I concur with Sean on every point and want to add that way too much tax money goes to enforcing these archaic laws.

    While it’s been way too long since I’ve enjoyed the effects of the evil weed, there’s one thing for certain…it’s not humanly possible to sit down and smoke enough to kill you, trust me.

  10. Bob March 12, 2009 at 11:29 am

    How about a cite for that “current research”?

  11. Monica Goad March 12, 2009 at 6:17 pm

    Thank you for that incite Doug. It does in fact shed some light. I will add for the others debating here, that sometimes there is a little more in the pot than just your normal, average, every day grass. Lots are laced with junk and can cause some pretty scary effects on people. I have also seen first hand some heavy duty pot smokers turn into pure assholes trying to come off the stuff. An YES pot/marijuana IS just as addictive as cigarettes if not in some cases WORSE.

  12. Bob March 12, 2009 at 11:42 pm

    Allan N. Schwartz has a doctorate in psychology from Yeshiva University, he is legally and professionally unqualified to prescribe or evaluate medication for mentally ill patients, most particularly those suffering with Manic-Depressive Disorder. Schwartz makes the sloppy jump from patients off meds to relapse and tosses in marijuana self-medication as causal to “worse shape than any time prior to the relapse”, which neatly ignores the terrible outcomes for ANY M-D patient off meds without actually providing any evidence of reefer madness.

    Schwartz appears to be a prolific blogger, but don’t assume that translates to any “expertise”. That title would belong to Kay Redfield Jamison, a Psychiatrist and Medical Doctor who herself suffers with M-D disorder. Give her a call at Johns Hopkins, she is the real expert.

  13. Eric March 13, 2009 at 3:26 am

    Co occurring disorder or dual diagnosis is a term used to explain that a person is suffering from a mental illness as well as a substance abuse problem. Clearly that is the case here. I do not know what came first, the mental illness or the drug addiction. And yes it is an addiction. No casual user needs a home grow of a thousand plants.

    Marijuana was being substituted for FDA approved medications used to treat Bi-polar disorder. Self medicating is not a proven scientific method. It is a guessing game. When someone decides to become their own doctor and treat themselves with illicit drugs, the outcome can be very dangerous. As a person that works very closely with mentally ill people, I have had the opportunity to see first hand the damage and destruction caused by co-occurring disorders and self medicating.

    So please do not turn this blog into a discussion for the legalization of marijuana or we will be sifting through 50 posts a day. The real problem is that too many times illegal, non regulated, substances are being substituted for proven, tested medications.

  14. Rudi March 13, 2009 at 6:41 am

    What is up with the posting time for these comments? When I first read this yesterday there were 4 comments, all in proper temporal order. Now this morning there are several that look like they have been moved around for some reason. Things like this tend to take away from the legitimate discussion of the article, when readers deduce that the author or webmaster has manipulated them, seemingly for his own agenda.

  15. Monica Goad March 13, 2009 at 7:09 am

    Rudi, to shed some light on your question. The reason for the times of posts being off is where someone comments on a post by clicking the reply button under the post they are commenting on/about. A general post/reply to the actual post will fall at the end of the comments. It has nothing to do with the author of this blog or him manipulating the posts.

  16. Doug Thompson March 13, 2009 at 10:20 am

    Rudi:

    Blue Ridge Muse uses a "threaded" commenting system, which means replies that are posted to a specific message appear immediately under that message and not at the end of the line.

    Be careful. Such paranoia might lead one to believe you’re stoned. :)