By: Adrian Columb
As a child and teen I was a daydreamer and chronically disorganized. I couldn’t concentrate in class to save myself, or do homework unsupervised. I couldn’t even get to most classes on time let alone do what was required there.
I have a visual disability that allowed me to get extra time for assignments and exams which helped to bridge the gap, however nobody from my teachers, school counselors or doctors ever twigged that I may also have the dreaded and little-understood condition of ADHD – PI (Predominantly Inattentive sub-type).
With the help of a doting grandmother who provided some structure to my chaotic life, and that of a family-friend educational psychologist who helped with planning and sat with me night after night while I enacted those plans, I managed to achieve above average grades in high school, and gained entry to a Bachelor of Arts degree program at one Australia’s leading universities.
I tried cannabis during high school years as most teens do, but had no real fascination with it. One day a friend and I went to class stoned and a whole new world opened up. I found I could participate in class discussions without getting distracted and could think and remain on-topic when speaking.
Equally as astonishing was the fact that when stoned I could do the homework. I also managed to implement a planning process and scheduling system to help meet looming deadlines, an ability which had previously eluded me.
In those early days before I realized I had ADHD, let alone that cannabis is a safe and effective medicine for it; it seemed like a miracle had happened, and it had. (Come assignment time a thick cloud of weed smoke billowed from my second floor college room window but no-one said a thing about it since I was clearly doing the work required to get through.)
I spent the next years functioning much more efficiently than I’d previously dreamed possible, and gradually learned to deal with having to constantly hide my secret weapon, cannabis and its use. Alley-ways and parks became my favorite haunts because most people avoided them, so I could medicate nervously there and quickly scurry away to avoid detection.
In 1996, half a world away in California (it may as well have been another planet), by popular vote Proposition 215 allowed doctors to recommended cannabis for any condition which it could help.
This opened the door for brave exploration of cannabis as a treatment for ADHD by Californian patients, parents, and doctors. To this day the only other medical cannabis program in the USA which allows for ADHD to be treated is that of Massachusetts; which identically provides coverage for any medical condition at the treating doctor’s discretion.
In 2002, a friend suggested I see a physician who might be able to help me to focus better. The doctor diagnosed me with ADHD inattentive and the reason for my troubled academic and general history became very clear. Despite my claims that cannabis helped me cope with ADHD symptoms my doctor implored me to stop using it and instead prescribed methylphenidate AKA Ritalin.
On Ritalin, I was like a missile with a broken guidance system. I achieved new heights of productivity but usually not in the areas I set out to. I achieved some postgraduate studies on it but the side effects included jitters, bug eyes, heart palpitations, insomnia, no appetite, and generally heightened/agitated moods. So it was a double-edged sword… to continue would cost more of my health, but to stop might cost me my studies.
My doctor then prescribed anti-depressants to help me cope with the side effects of the stimulants, which just brought more bad side effects including a liquefied stomach requiring constant access to a toilet. Then, I tried dexamphetamine (similar to the Adderall available in the USA) which was slightly less taxing on my body and mind than Ritalin but was basically the same in terms of side effects.
I eventually decided enough was enough and gave up daily use of all tablets, choosing to use cannabis daily instead, and only using the stimulants as needed for particularly demanding tasks and tight deadlines. Living like a ninja in order to consume cannabis wore on my nerves over the years but I largely accepted my conundrum as an unsolvable problem.
In 2009, I went to Canada on a working holiday and within days in Vancouver I discovered a shop on a main city street selling several different kinds of high quality cannabis.
I was pleased with myself but only for a few hours until I found out the grass was far greener on the other side of a fence I didn’t previously know existed. A fellow guest in my hotel was smoking some serious hashish, which I had never seen before, so, of course I asked where it come from. He had got it from a medical cannabis dispensary for chronic pain, based on a recommendation from his doctor. I was dumbfounded, impressed and a little jealous.
The wheels started turning in my mind… could I get a similar doctor’s recommendation for my ADHD? It took some sleuthing but thankfully the answer was yes. I visited a sympathetic doctor and presented some “in vivo” (animal) research of THC on ADHD mice that showed significant improvements, and explained that I use it every day with great results.
The doctor wrote a recommendation for access to medical cannabis from a local dispensary (of which he only did “one or two a year”) and wrote a prescription for Ritalin which I never filled. He also eventually signed an application for a medical cannabis user license from Health Canada.
I entered the local dispensary (called “The V.I.C.S,”) sheepishly for my introduction appointment not knowing what to expect. I found a clean and professional clinic style setting. I was shown into the medicine room and presented with various types of cannabis flowers and associated descriptions.
There I was informed that there are different strains of cannabis that have various effects ranging from stimulating to sedating, and everything in-between. I found sativa-dominant strains gave the greatest improvement to my ability to focus, while indica-dominant strains did the opposite for focus but helped quiet my racing brain in order to get to sleep.
I had leveled-up my treatment capability, finding new functionality that had previously been hidden by the mostly mind-muddling indica-dominant cannabis available in my own country.
Not only had I finally found appropriate ADHD medicine with acceptable side-effects, I had also at last experienced what it was like to not need to use a large proportion of my time, energy and resources on locating, affording and secretly consuming the only medication that works for me.
The dispensary also offered an alcohol-based cannabis tincture, and I soon discovered what it’s like to not have to sneak into a lane-way to nervously medicate. I could sit in a coffee shop quite happily medicating while I worked on my laptop.
I then found another dispensary with a variety of hashish and edible products, and soon realized that edibles provided a base level of medication, so, I didn’t need to smoke constantly to top up my THC levels.
Armed with a tincture, edibles, hash, and several different strains of flower. I found new functionality; including the ability to focus for longer without needing to smoke to top up my cannabinoid levels. I ate edibles and used the tincture every day, and smoked only for fast situational relief of symptoms as necessary.
One day in Montreal I was discovered rolling a joint in a public park by several police officers who were unaware of medical cannabis. They confiscated several small bags of flower from me that were labeled “FOR MEDICAL USE ONLY” and had the phone number of the club.
The police called the club and were requested to come there to clear everything up. They marched me a few blocks to what they clearly thought was an audacious illegal supplier who they could arrest. They were flabbergasted to find that a beautifully presented dispensary with a big green cross sign right on the street had supplied me.
When they worked out I was a legal medical user they let me go and fled the dispensary, though a photo of the club manager, myself and two officers debating the matter outside the club became the wallpaper on the club’s computer. The club asked me to be part of a press conference happening the next day to tell my story but I declined, a little unsure of my position in all this due to assurances from the police that they were still considering charging me.
The next day the Chief and Deputy Chief of police visited the dispensary manager to apologize for their rookies’ ignorance, and the two beat cops showed up at the house I was staying to sheepishly return the ID card they had forgotten to give back in all their confusion the day before. I felt invincible. I felt vindicated. I finally felt human, no longer a hunted animal. I finally felt free. I felt like I had experienced the future.
Then I went back in the time warp to conservative Australia to share my wonderful news of a brighter tomorrow, but, almost nobody believed me. Even the most enthusiastic cannabis smokers told me I was dreaming to think cannabis treats ADHD and that I should have legal access to it.
I started researching the medical properties of cannabis and the pharmaceutical ADHD medications to try to work out how to prove to my family, friends, doctors and governments that I should be allowed to access and use it legally.
Frustrated by the status quo, at one point I even wrote to the Government of Canada asking if they would allow me to apply for a refugee visa because my medicine is illegal in my country, but they never replied.
Having exhausted most other potential passages to freedom I came to realize that the only thing that could convince doctors and governments that cannabis treats ADHD safely and effectively is double-blind Randomized Controlled Trials (R.C.T.) evidence.
In 2014 my country started to talk about medicinal cannabis, and I decided it was time to try to move things forward for myself and others like me. I started a project to organize and fund a clinical trial of cannabis for ADHD. I began by enlisting the help of some of the world’s best cannabis researchers and doctors.
I then raised some money for the project through crowd-funding at http://www.igg.me/at/cannabisforADHD. Sadly,I still have the funds in my PayPal account having been unable to initiate a study. This failure to launch was largely due to regulatory constraints in most countries, and a general lack of basic clinical evidence supporting the need for a full clinical trial at that time.
The project can proceed when I find expert researchers who want to write and conduct the study, who work in a location where cannabis research in humans is legal and where ethical review board approval for such a study is possible to obtain. Also required are the availability of several million US dollars budget, as well as standardized test medicines with appropriate cannabinoid, terpenoid and flavanoid profiles of sufficient potency.
This situation has proven to be a circular problem since even the most cannabis-friendly places lack at least one of these key elements to this day. However, as the political and legal status of cannabis begins to change there are places where locking in all of these variables may soon be possible.
Simultaneously the basic clinical research that highlights the need for further study of cannabis for ADHD is beginning to emerge, including a recent study in human’s soon to be published. An experimental trial of Sativex spray (THC:CBD 50/50) in 30 adults with ADHD has yielded very encouraging results that beg for further reinforcement in a larger sample group.
Lead researcher on the study Professor of Molecular Psychiatry Philip Asherson at King’s College in London, UK said of this work that “The main scientific issue is that, because the sample size is small, we are below conventional levels of significance. However; effects are moderate to large; and consistent across nearly all measures. It is also worth adding that these effects are seen at very low doses – below doses that give any other effects one spray four times a day was all that was needed.” Professor Asherson also added that “It is of note that cognitive performance increased and did not decline – which runs contrary to previous data on non-ADHD controls.”
Other supporting studies are also emerging such as the recent work of a Psychiatrist in Berlin, Germany Dr. Eva Milz who’s recent research on 30 German Adult ADHD patients who legally use standardized cannabis dispensed by their local pharmacies. The study concluded that “Adult ADHD patients, who are treatment-resistant to conventional pharmacological therapies (methylphenidate, atomoxetine and amphetamine or amphetamine derivatives), may experience an improvement of a variety of symptoms by cannabis flower, including improved concentration and sleep, and reduced impulsivity.” Dr. Milz also commented that “Cannabis seems to me as an etiological treatment for AD(H)D, whereas amphetamines and derivatives help in a symptomatic manner – if I had to put it in one sentence.”
The quest to create the conclusive RCT medical evidence that cannabis treats ADHD safely and effectively continues, and as the overall prohibition weakens, myself and those like me inch ever closer to attaining the basic human right to appropriate medical care without undue persecution from the law.
Meanwhile, the cannabis for the ADHD community is pushing forward with treatment regardless of the lack of clinical trials evidence, since the patient experience (so called “anecdotal evidence”) that it is safe and effective is now abundant.
When I started the project I also launched the info-site http://CannabisforADHD.org and established the medicinal cannabis for ADHD group on Facebook. Before that I was a lone voice in the wilderness screaming about something almost no one could fathom. Now there is a group of almost 2,000 patients, parents and carers sharing their experiences and helping each other get the most from the medicine.
At first the group was populated by lone users like myself, many of whom had previously thought themselves simply drug addicts or at best completely alone in their self medication with cannabis. It was a great relief for many to finally find others in the same situation with whom to share experiences and challenges. Not least of these challenges is that as severely marginalized adults with an “invisible disability” we are not particularly camera friendly or newsworthy enough to get media recognition or public sympathy that could help bring about change.
Nonetheless we continue to share our experiences with each other. To the envy of others, some lucky patients medicate their ADHD legally with access to vast arrays of cannabis strains and products. They are able to accurately monitor their intake of different cannabinoids, terpenes, etc and modify regimes for best effect. Most patients, however, medicate, illegally, usually using low grade sub-optimal products from their local black market, so the patient experiences described vary greatly from place to place.
Over the last year there has also come a second wave of members comprised mostly of parents who desperately want to save their children from the perils of the pharmaceutical medicines. These kids and their parents are both newsworthy and camera friendly. Their plight is real and emotive. These parents just want their kids to be happy, healthy and successful, not stimulant medication zombies on a fast track to heart attacks and mental health issues, and are potentially a strong force for change.
Families range from those in places like Canada or California, where children can be legally treated with THC products, to those living under prohibition elsewhere in the world who are now tentatively experimenting with legal CBD-only products in the hope of finding, at least, a partial solution without breaking the law. Then there are those who use THC in their kids regardless of local prohibition laws, some of whom have already suffered severe consequences including governmental/police intervention.
A notable success story is Canadian ADHD patient, Noah Kirkman, who just completed high school with 80%+ results using high-THC cannabis on school grounds every day. Stimulants were contraindicated with his co-morbid Tourette Syndrome, so two doctors and the school to allowed him to vaporize in the Principal’s office at breaks. His grades speak for themselves.
In most cases patients and parents are using trial and error to work out dosage regimes that provide the best effects and least side effects. They use theirs or their child’s bodies as living experiments because there are no clinical trials to guide them and almost no doctors who will support them. The necessity to act has forced them to try to find what works best.
While the winds of change are definitely already blowing our way, sadly most patients are still using cannabis to treat ADHD illegally. They do so without their doctors’ support, using black market supplies with unknown medical contents of variable purity and potency, and have no legal protection from the supply-reduction efforts of the Drug War.
As conclusive clinical trials evidence that cannabis treats ADHD safely and effectively begins to be generated in coming years, a paradigm shift where cannabis is accepted as safe and effective for the treatment of ADHD will no doubt emerge.