September 23, 2010

Marijuana and Motherhood

Women and Cannabis: Medicine, Science, and Sociology (Journal of Cannabis Therapeutics)

I recently finished reading what was, to the best of my knowledge, the only modern book published on the scientific findings of studies on women's health issues and the use of marijuana.

You're probably wondering, why on earth would I do such a thing?

There's a very simple answer.  There are questions I've had regarding the use of marijuana since well before I became pregnant.  I had a friend who was an avid smoker, and continued to smoke while pregnant and breast feeding.  She attributed her daughter's intelligence, friendliness, and general laid-back attitude to this exposure.  Mind you, this was about six years ago.  You will recall that my children are just now nearing their first birthday.

When I was a teenager, I was arrested for the possession of marijuana.  It being my first offense, and me being both young and obviously scared out my wits, I was sentenced to twenty hours of community service and the writing of an essay about the dangers of marijuana.  I did my research, and concluded that the only danger of marijuana was that it was illegal.  The court thanked me for my essay, and that was the end of my career as an outlaw.

Back pain, insomnia, nausea... all of these are treated in some diseases with marijuana.  But the big question... will it hurt my babies?  There seemed to be no answer.

I never forgot, however, that all of the scientific evidence I could find described marijuana as being essentially harmless.  Even then there was already a growing movement of using marijuana as medicine for treating cancer and AIDS patients, and a well known subset of other conditions that might also benefit from treatment with marijuana.

During my pregnancy, I found myself repeatedly thinking about the use of marijuana to treat my symptoms.  Back pain, insomnia, nausea... all of these are treated in some diseases with marijuana.  But the big question... will it hurt my babies?  There seemed to be no answer.

The information I could find was varied and suspect.  Each article, despite its findings, ended with a warning that because of the illicit nature of the drug, the subject sampling was also probably smoking cigarettes, drinking alcohol, eating poorly, and had little access to medical care.  There was no control.

My queries continued into my months of breastfeeding.  Would marijuana help my symptoms, would it hurt my children if excreted in the breast milk?  I asked my doctor, and she told me that the only information available was that THC did enter breast milk.

Finally, I found this book.  You can imagine my shock that this publication, from New York, was essentially blacklisted in the United States.  To buy it here was going to cost me nearly a thousand dollars!  For a book of less than 200 pages, less than ten years old.  The challenge of procuring it alone was incentive for me to read the entire thing.

Queen Victoria was known to use a hashish tincture to treat her dysmenorrhea.

What I learned was absolutely fascinating.  It's a collection of twelve articles, primary research, personal anecdotes, and historical reviews from institutions of learning in the United States, Canada, England, Israel, Italy, and the Netherlands.  They cover a wide range of subjects from pre-menstrual syndrome, to hyperemesis gravidarum, to multiple sclerosis, to the effects of pre-natal marijuana use.  The major findings in the book that interested me the most were in regards to the use of marijuana while pregnant and nursing, the treatment of hyperemesis gravidarum, and the THC receptors in the brains of infant mice.  Also amazing to me was the information that marijuana, or more commonly hashish, was produced in the United States by pharmaceutical companies until Prohibition.  In fact, these companies continued to stand by this medicine, fighting to continue its use, until the Nixon administration.

Marijuana has been used as medicine for thousands of years, across the entire planet.  Queen Victoria was known to use a hashish tincture to treat her dysmenorrhea.  It was one of the most common drugs in the kits of doctors for delivering babies, used to accelerate and ease labor, particularly in first pregnancies.

A Canadian researcher did a review of studies of children of marijuana smoking mothers, going up to their teenage years.  The only finding that was consistent throughout these research projects was that children of mothers who smoked between five and ten joints a day throughout their pregnancy were more likely to have difficulty multi-tasking between the ages of three and twelve years old.  To cause this sort of effect, that's a daily consumption of up to ten grams of marijuana a day.

The study in the book found that two to four puffs of marijuana, not grams, were sufficient each day to allow the women to eat and drink, to essentially sustain their pregnancies.

Compared to the study of marijuana use to treat hyperemesis gravidarum, that is an extremely excessive quantity.  The women in this study used up to one gram each week.  Hyperemesis gravidarum is particularly cruel condition.  A pregnant woman with hyperemesis gravidarum experiences constant and debilitating nausea for an average of 16 weeks, although occasionally it lasts the entire duration of the pregnancy.  They waste away, unable to consume any food or water, and frequently spend much of their pregnancies being fed via IV and taking a variety of prescription drugs, none of which are considered entirely safe for the fetus.  Many women with hyperemesis gravidarum are advised to terminate their pregnancies, and many more miscarry while attempting to persevere.  The study in the book found that two to four puffs of marijuana, not grams, were sufficient each day to allow the women to eat and drink, to essentially sustain their pregnancies.

A similar quantity of marijuana was used by multiple sclerosis patients in another study to ease their symptoms.  The amount of marijuana then, found to be efficacious in treating these diseases is exponentially less than the amount needed to cause any sort of measurable harm to a baby in-utero.  Also interesting was this it was cannabis sativa that was more helpful as a medicine, while it is  cannabis indica that is gives recreational users a more potent high.

The information that I found the most fascinating, without a doubt, was what pertained to breast feeding.  As an Israeli study in lab mice found, the THC in marijuana stimulates what is essentially the eating reflex.  THC expressed in breast milk stimulates appetite, which encourages babies to nurse, and therefore survive.  This is one of the reasons attributed to the high infant survival rate in impoverished areas of Kingstown, Jamaica.  What's more, the researchers preformed a very interesting experiment.  The research team blocked the THC receptors in day old lab mice.  100% of these mice died.  With no urge to eat, the infant mice could not survive.

The research team blocked the THC receptors in day old lab mice.  100% of these mice died.  With no urge to eat, the infant mice could not survive.

This is not to say that marijuana is harmless, or that I am advising pregnant and nursing mothers to go out and get some.  Most of the researchers agree that using marijuana is generally unsafe because it is unregulated, you never know if your marijuana is diseased, or otherwise tainted.  There is a small chance any time smoke is inhaled for a myocardial infarction.  The concerns regarding lung cancer are poorly understood.  Marijuana has been found to exacerbate some existing psychological disorders.    Artificial THC pills, like Marinol, have been shown to have even more side effects and risks.  What's more, and unfortunately most relevant, is that marijuana is illegal.  This means that the act of procuring marijuana can put a person in danger, both from drug dealers and from the law.  However, as every article agrees, the evidence supporting the medical use of cannabis, particularly for conditions suffered by women, definitely warrants further study.

What I believe this means to mothers is that there might be some other answers out there.  There is apparently a wealth of research about women's health concerns and marijuana that we, the women who might want to use marijuana, do not generally have access to.   We as mothers, as feminists, and as individuals need to take the time to control our own health and lifestyles.  Self education is so important, and more and more we are made to feel helpless by our own health professionals.

One of the authors of the book, Mary Lynn Mathre, RN, MSN, CARN, wrote of the study of marijuana as a harm-reduction tool, "Cannabis as medicine is not a magic bullet that will work for everyone, and is not without potential risks.  Cannabis as a recreational drug is not enjoyable for everyone and is not harmless, but when put in the broader perspective and compared to standard medicines or common recreational drugs, cannabis offers greater benefit with fewer relative risks."

The anecdotes of women in Jamaica and Thailand who routinely use marijuana during pregnancy coincide perfectly with what my friend told me about her marijuana use and her daughter.  The folk-logic regarding marijuana use in these cultures is that it creates calmer, happier children.  The findings of the Canadian study show the opposite, that what we might call excessive use during pregnancy causes attention deficit problems.  Perhaps then, what is truly warranted is moderation.  I have said before, whatever makes you a happier, saner person is good parenting.  If what makes you happier and saner is the occasional marijuana use, you will get no judgment from me.  But please, be careful, and always be informed.

September 19, 2010

Yom Kippur

Yesterday was Yom Kippur, the Jewish Day of Atonement.

I have to be frank.  I'm not a very good Jew.  I don't light the Sabbath candles most Friday nights, I rarely attend synagogue, and I've been known to cook, if not to eat, bacon and shellfish.

Like many fair-weather Jews, I take the high holy days fairly seriously.  That means fasting on Yom Kippur.  Last year I didn't fast, as I was seven months pregnant with twins and really couldn't stop eating.  This year's was the hardest fast I've had in my adult memory.

If you only do something once a year, does skipping it one time make that much of a difference?  I'm not sure if it does, but I do know something.  One kind of frustration becomes other frustrations.  Our sitter, who shits gold as far as I'm concerned, put the girls to bed in clothes that were too light for the early autumn evening.  As a result, they awoke grouchy and spent much of the day unhappy.  To be fair, an unhappy day for the girls is still a pretty okay day, but when you're hungry everything is a little worse.

Like when you're tired everything is a little worse.  Or when you've got a headache everything is a little worse.

So it occurs to me- the reason this fast was so much harder for me wasn't that I was out of practice, it's that I was IN practice.  All too in practice.  I've spent so much of the last year being hungry, tired, having headaches, backaches, and skipping showers that to do it intentionally felt additionally exhausting.  I kept asking myself why I was doing it, hadn't I atoned enough over the year?  Had I really done anything I felt ashamed of, or regretted?

The answer is a resounding yes, and the fact is that most of it was the result of being tired, hungry, etc. 

There have been times in the past year that I've shouted at itsy bitsy babies for acting like babies.  That I've ignored them when I was simply tired or sore.  That I fought with my husband over nothing because I just wanted to pity myself.  I've caught myself doing things that I promised myself I would NEVER do.

I know it doesn't make me a bad mom, having done these things.  At the time it made me feel like a failure of a human being, but all in all I know I've done a good job.

So l'Shana Tova to all of you, Happy New Year my dear readers.  I am sorry I haven't written more for you.  I am sorry that I tend to ramble and forget my point.  I am sorry to occasionally bore you with anecdotes about how excellent my children are, when I'm sure there's something a little more helpful I can say.  So I say this:

Give yourself a break.  Parenting is hard, life is hard in general, and dealing with the day-to-day of being a mom is a mostly thankless job.

This Yom Kippur, I don't think I wanted God or my friends or readers or children to fogive me.  I think this one was all about forgiving myself.  I can't be perfect, but I do try.  And although aiming for perfection gives you plenty of room to screw up, you know your intentions are in the right place.

After all, you're only human.  Here's to another year.


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