The Double Standard On Depression
by Fred Gardner, (19 Jul 2006) Anderson Valley Advertiser California
The San Diego District Attorney doesn't know -or just can't stand it- that California law authorizes doctors to approve the use of marijuana as a treatment for "any condition for which marijuana provides relief." After raids that closed five local dispensaries July 6, DA Bonnie Dumanis said "Our office has no intention of stopping those who are chronically ill with AIDS, glaucoma and cancer from obtaining any legally prescribed drug, including medical marijuana, to help them ease their pain." Deputy DA Dana Greisen complained to Channel 10 News that profiteering doctors were approving marijuana use too readily: "The doctors, because they're giving it to so many people, are basically legalizing marijuana one doctor and patient at a time... It's being recommended for insomnia, depression, anxiety... The law is being abused on a massive scale."
Actually, the law is being implemented on a limited scale, given how many Californians are using pharmaceutical antidepressants and how afraid/uneducated most doctors are when it comes to cannabis. The way to deprive cannabis specialists of revenue, if that were really law enforcement's goal, would be to remove the fear that constrains other doctors from approving their patients' use of the herb -mainly, fear of being investigated by the state medical board.
So why has SDDA sent a letter to the medical board requesting investigations of four doctors who allegedly issue approvals too freely?
The investigations will undoubtedly have a chilling effect on every doctor south of Capistrano Beach who might be considering a more liberal approach.
Patients, instead of asking their regular doctors to approve their cannabis use, will continue to seek out the docs who advertise their cannabis consultation services in the San Diego Reader. The cost of lawyers will justify the cannabis consultant's fee, and the system will grind grimly on.
Are Bonnie Dumanis and her deputies totally ignorant of the relevant history? In 1994 and again in 1995 the California legislature passed and Governor Pete Wilson vetoed bills that would have legalized marijuana for the treatment of AIDS, cancer, glaucoma, and multiple sclerosis -a finite list. After Wilson's second veto, Dennis Peron gave up on the politicians and decided to change the law by ballot initiative. The measure he crafted, with input from Tod Mikuriya, MD ( and over the opposition of most activists ), left it entirely up to the doctors which conditions cannabis could be used to treat. Thus Prop 215 was and is much more liberal than the bills Wilson had vetoed.
There was nothing misleading about what appeared on the ballot: the very first sentence of Prop 215 establishes "the right to obtain and use marijuana for medical purposes where that medical use is deemed appropriate and has been recommended by a physician who has determined that the person's health would benefit from the use of marijuana in the treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief."
The Voters Handbook "Argument Against Prop 215" clearly stated the opposition of the California State Sheriffs Association, the District Attorneys Association, the Police Chiefs Association, the Narcotics Officers Association and the California Peace Officers Association. "Prop 215 DOES NOT restrict the use of marijuana to AIDS, cancer, glaucoma and other serious illnesses," they reminded us. "Read the fine print: Proposition 215 legalizes marijuana use for 'any other illness for which marijuana provides relief.' This could include stress, headaches, upset stomach, insomnia, a stiff neck, or just about anything."
It wasn't fine print, it was the first sentence of the measure that we, the people, read and passed by a 56-44 margin.
The district attorney of San Diego ought to read it because it's the law she's supposed to uphold.
When Depression is Serious
"It's open drug dealing with legitimacy," says DDA Greisen of the medical marijuana industry.
The same could be said of the pharmaceutical industry's marketing of antidepressants. Why hasn't the San Diego DA's office gone after Eli Lilly or Pfizer or Glaxo for making inordinate profits by selling Prozac, Zoloft and Paxil? The pills cost pennies to manufacture. The high retail prices are justified in the name of "research," but an investigation would establish that the corporate owners have been pocketing millions. Evidently, depression is a serious illness when treated with corporate drugs, and pharmacists who sell corporate drugs and doctors who prescribe corporate drugs are too legit to indict.
A doctor's diagnosis of "clinical depression" is based on criteria set forth in the Diagnostic and Statistical Manual, the so-called "bible" of the American Psychiatric Association. The drug companies influenced the drafting of the DSM so that the definition of depression would apply to as many people as possible -i.e., would maximize the number of potential customers. ( See "The Selling of DSM-III," a great book by Kirk and Kutchens. ) Doctors are taught to detect depression based on patients' responses to a simplistic questionnaire:
"The presence of depressed mood ( 5 ) or loss of interest ( 6 ) and at least four other symptoms over a two-week period is required for the diagnosis of a major depressive episode.
1 ) Changes in appetite and weight
2 ) Disturbed sleep
3 ) Motor retardation or agitation
4 ) Fatigue and loss of energy
5 ) Depressed or irritable mood
6 ) Loss of interest or pleasure in usual activities.
7 ) Feelings of worthlessness, self-reproach, excessive guilt
8 ) Suicidal thinking or attempts
9 ) Difficulty thinking or concentrating.
Is there a single adult in America who could not qualify for a diagnosis of depression? The criteria are vague and all-embracing. Losing weight?
You're depressed. Gaining weight?
Sleeping too little?
You're depressed. Sleeping too much? You're depressed.
Going too slow? You're depressed. Going too fast? You're depressed... The all-important fifth criterion -"Depressed or irritable mood"- used to define depression is a syllogism. And even when the external causes of a patient's "depressed or irritable mood" may be obvious - -loss of a job, a relationship on the rocks, kid trouble, etc.- the resultant diagnosis, "Clinical Depression," will imply that his or her internal psychological condition was causal!
Is there such a thing as a double syllogism?
"Loss of interest or pleasure in usual activities" can be associated with physical aging and/or deteriorating quality of life. For example, you may no longer take pleasure in swimming at a beach after you've noticed human shit bobbing in the waves.
You may not find driving as pleasurable now that there's bumper-to-bumper traffic and the ride that once took less than 20 minutes takes more than an hour.
The definition of "clinical depression" can never be rigorous and the whole concept -the medicalization of unhappiness-is a misdirection play, pointing away from the real causes, insecurity and loneliness. Insecurity is a function of the rich/poor system, compounded by looming ecodisaster and personal health problems.
Loneliness is almost everybody's lot in a socioeconomic system that breaks up families geographically. Prevention -which nobody ever talks about-would involve changing the system to encourage social stability.
But in the meantime....
In this mean time, marijuana is the anti-depressant and anti-anxiety medication of choice for millions of Americans. That's the statistical fact at the heart of Dennis Peron's famous line, "In a society where they give Prozac to shy teenagers, all marijuana use is medical!" Prop 215 explicitly established the right to obtain and use marijuana in the treatment of any condition for which it provides relief.
The medical profession and the government recognize depression as a serious, disabling illness for which Prozac, Wellbutrin, et al can be prescribed to provide relief -and were prescribed to some 2.5 million Californians last year. "What's sauce for the goose is sauce for the gander," as the old saying goes. Californians have every right to use marijuana in the treatment of depression.
This may be a winnable fight. U.S. employers were losing $3,000 per year per depressed worker, according to the 1994 MIT study.
The biggest impact of depression, more costly to employers than absenteeism, was "the effects of poor concentration, indecisiveness, lack of self-confidence," i.e., dawdling. Most employers probably assume that widespread marijuana use would lead to even more dawdling.
Just wait till they find out it's a performance enhancer!