Tag: addiction

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Moderation

“The dose makes the poison” – attributed to Paracelsus , Swiss physician and chemist from about 500 years ago. The full quote: “All things are poison and nothing is without poison; only the dose makes a thing not a poison.” Even water and oxygen are poisonous in too large a dose. (1)

Modern chemicals are leading to different types of health problems than the classic understanding of toxicity which considers a substance toxic at the dose that would lead to death or cancer or a visible birth defect. One of the examples provided is BPA a chemical found in plastics and now in our environment which is considered safe in the traditional sense of toxicity – it doesn’t lead to cancer or death at small amounts however it may be acting as an endocrine disrupting chemical at very small doses. (1)

BPA acts as an estrogen receptor activator – estrogen is one of the main female hormones. At what dose of birth differences will society be concerned about the health of male infants? Endocrine disruptors including BPA are associated with differences in male sexual organs at birth. (2)

Returning to a research finding mentioned in the Vaping series (part 1, 2, 3), an experimental dose labeled Acute was 20 minutes of vape exposure each day for one week, and an experimental dose labeled chronic was 20 minutes of vape exposure for 3 weeks. (part 3, ref 4:17) Compared to what might be typical for a human both of those doses are pretty low. A human might smoke a half a pack of cigarettes per day – ten cigarettes taking minimally 5-10 minutes to smoke. Other humans might smoke a pack or two or even three packs per day.

A few humans might only smoke one or two cigarettes once a week during an evening out but that is less typical than the daily half a pack smoker. There may be some health benefits however in the smoking one or two during an evening out, if the time is going to be spent in a smoke filled environment. The lungs will increase protective layers of mucous to reduce entry of toxins when there is smoke exposure. Avoiding the smoke exposure altogether would be safest however.

Chronic cannabis smokers develop lung tissue that is less typical of lung tissue that is not chronically exposed to smoke. Emphysema was not associated with cannabis smoking at a rate much different than not smoking while tobacco smoking with or without use of cannabis was associated fairly closely for macroscopic emphysema risk. (3) Coughing, asthma, bronchitis may still remain risks from chronic smoking of cannabis. Infectious risks may also occur from use of water pipes or other types of pipes that aren’t cleaned regularly. (4)

Cleanliness and moderation – both are valuable. Moderation in all things is also valuable. The dose makes the poison whether smoking tobacco or cannabis, drinking water or alcohol, watching TV or playing video games or surfing the internet, even exercise can become a health risk if done excessively or in dangerous settings. Building up physical skills gradually can make exercise safer in various settings however building up a tolerance to some drugs or activities can just leave a person needing larger amounts to achieve the same dopamine excitement.

Dopamine is the main brain neurotransmitter for feelings of reward. Most major addictive substances cause an increase in dopamine directly (cocaine) or indirectly (most of the rest of common addictive substances) . See: Impacts of Drugs on Neurotransmission, (5), (7) It certainly would take less alcohol than water to harm someone or kill and tolerance can also develop to alcohol so more is needed to feel ‘drunk.’ Cocaine tolerance can build up to a point where the dopamine receptors no longer respond to other rewarding stimuli and the person may no longer feel pleasure except with increasing amounts of cocaine/crack.

In small amounts alcohol can have medicinal effects and reduce the stress of an emotional shock or physical trauma. That medicinal amount may be as small as a third of a typical serving size of alcohol, or up to one to two alcoholic beverage servings per day, for a smaller or larger adult. (G11: Alcohol) Often though, the problem is being able to stop at one or two alcoholic beverages as author James Thurber stated eloquently:

“One martini is all right. Two are too many, and three are not enough.”

― James Thurber (died November 2, 1961)

Having an elevated stress level over time may make people more susceptible to addictive behavior. The stress response can become more likely to occur in the future when it has been chronically active in the past, as calming GABA activity is inhibited by the increased activity of dopamine receptors that occurs with stress or addictive behaviors. (12, 13, 14)

How much TV is too much TV? I heard recently on the radio that people in the U.S. spend on average 7000% more time watching TV than working on their finances – so we’re all financially stable then? Or most of us are behind on balancing the checkbook and planning for retirement? The number seems enormous, 7000%, in hours it means we are spending about 70 hours watching TV for every one hour spent looking into our financial health. See: Americans Spend 7000% more time watching TV than they do on their finances, by Brett Arends, (MarketWatch.com)

How much cellphone use is too much cellphone use? (8) That may involve more than dopamine over-stimulation. Chronic exposure to electromagnetic fields including from WiFi and TV sets may be increasing negative health symptoms beyond an addictive use of the electronic devices. Insurance company white papers have deemed the idea of 5G internet in urban areas as “High risk” with unknown health effects. (9) More than 180 scientists have appealed to the European Union to use caution regarding approving 5G installations which would need to be placed almost every block for reception rather than the current cellphone towers which are larger and can be placed at a farther distance from internet users. (10)

The effects of exposure to electromagnetic fields seems to be accumulative and infertility may result in just ten to fifteen years of exposure. Internet use throughout schools from grade school through highschool and college would be ten to fifteen years of exposure. How much infertility is too large a dose of infertility for a population to survive?

Research is limited and more is available about male infertility than effects on female fertility. Increased cellphone use (self-reported) was associated with decreased sperm count, sperm motility, viability and morphology (shape). Cell phone use was grouped into, No use, less than 2 hours per day, 2-4 hours per day, and greater than 4 hours per day. The researchers questioned the number of hours reported for use, however it has become fairly common to have your smartphone with you at all times – and that category – 24 hours per day, seven days per week was not included – and would represent living in a community with 5G installations. (page 257, 11)

Good news – meditation can help reduce the stress response (15), and while it might not help balance your checkbook, it may be a more beneficial way to increase dopamine levels than shopping or TV watching. (16)

Stay tuned for part two – moderation is too large a topic to take in one dose.

Disclaimer: This information is provided for educational purposes within the guidelines of Fair Use. It is not intended to provide individual guidance. Please seek a health care provider for individualized health care guidance.

Reference List

  1. The Dose Makes the Poison Concept, Toxicity, chemicalsafetyfacts.org, https://www.chemicalsafetyfacts.org/dose-makes-poison-gallery/
  2. Sathyanarayana S, Beard L, Zhou C, Grady R. Measurement and correlates of ano-genital distance in healthy, newborn infants. Int J Androl. 2010;33(2):317–323. doi:10.1111/j.1365-2605.2009.01044.x https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943951/
  3. Aldington S, Williams M, Nowitz M, et al. Effects of cannabis on pulmonary structure, function and symptoms [published correction appears in Thorax. 2008 Apr;63(4):385]. Thorax. 2007;62(12):1058–1063. doi:10.1136/thx.2006.077081 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094297/
  4. Marijuana “bong” pseudomonas lung infection: a detrimental recreational experience. Repirology Case Reports, Vol 6, Issue 2, Feb 2018, e00293 https://onlinelibrary.wiley.com/doi/full/10.1002/rcr2.293
  5. Impacts of Drugs on Neurotransmission, National Institute on Drug Abuse, drugabuse.gov, https://www.drugabuse.gov/news-events/nida-notes/2017/03/impacts-drugs-neurotransmission
  6. Brett Arends, Americans Spend 7000% more time watching TV than they do on their finances. marketwatch.com, Oct. 19, 2019 https://www.marketwatch.com/story/americans-spend-7000-more-time-watching-tv-than-they-do-on-their-finances-2019-10-18
  7. Yanofski J. The Dopamine Dilemma-Part II: Could Stimulants Cause Tolerance, Dependence, and Paradoxical Decompensation?. Innov Clin Neurosci. 2011;8(1):47–53. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036556/
  8. De-Sola Gutiérrez J, Rodríguez de Fonseca F, Rubio G. Cell-Phone Addiction: A Review. Front Psychiatry. 2016;7:175. Published 2016 Oct 24. doi:10.3389/fpsyt.2016.00175 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5076301/
  9. 5G And The IOT: Scientific Overview Of Human Health Risks, Environmental Health Trust, https://ehtrust.org/key-issues/cell-phoneswireless/5g-networks-iot-scientific-overview-human-health-risks/
  10. EU 5G Appeal – Scientists warn of potential serious health effects of 5G. https://www.jrseco.com/european-union-5g-appeal-scientists-warn-of-potential-serious-health-effects-of-5g/
  11. Health Effects from Radiofrequency Eectromagnetic Fields, Report of the independent Advisory Group on Non-Ionising Radiation, (AGNIR report, April 2012) Documents of the Health Protection Agency, https://www.ices-emfsafety.org/wp-content/uploads/2014/11/AGNIR_report_2012.pdf
  12. Sinha R. Chronic stress, drug use, and vulnerability to addiction. Ann N Y Acad Sci. 2008;1141:105–130. doi:10.1196/annals.1441.030 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732004/
  13. Beas BS, Wright BJ, Skirzewski M, et al. The locus coeruleus drives disinhibition in the midline thalamus via a dopaminergic mechanism. Nat Neurosci. 2018;21(7):963–973. doi:10.1038/s41593-018-0167-4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035776/
  14. Van Bockstaele EJ, Reyes BA, Valentino RJ. The locus coeruleus: A key nucleus where stress and opioids intersect to mediate vulnerability to opiate abuse. Brain Res. 2010;1314:162–174. doi:10.1016/j.brainres.2009.09.036 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3274960/
  15. Young SN. Biologic effects of mindfulness meditation: growing insights into neurobiologic aspects of the prevention of depression. J Psychiatry Neurosci. 2011;36(2):75–77. doi:10.1503/jpn.110010 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044190/
  16. Kjaer TW, Bertelsen C, Piccini P, et al., Increased Dopamine Tone During Meditation-Induced Change of Consciousness. Cognitive Brain Research 13(2):255-9 · May 2002 https://www.researchgate.net/publication/11408344_Increased_Dopamine_Tone_During_Meditation-Induced_Change_of_Consciousness
  17. part 3, ref 4, Laube BL, Afshar-Mohajer N, Koehler K, et al. Acute and chronic in vivo effects of exposure to nicotine and propylene glycol from an E-cigarette on mucociliary clearance in a murine model. Inhal Toxicol. 2017;29(5):197–205. doi:10.1080/08958378.2017.1336585 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5553614/
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Medical marijuana is not the same as an addiction

The need for medical marijuana may be a daily need like any other medication and physical or mental withdrawal symptoms may occur when it is not available just like many other medication.

There can be genetic reasons that someone may need an external source of phospholipids or cannabinoids from food sources throughout their lives for best health or the need may arise during an illness or later in life due to changes associated with aging. The cannabinoid system is involved with many other functions of the body so symptoms can be diverse when there is a lack and cravings for something may occur which may be interpreted incorrectly and other substances may be overused in addictive ways. Overeating food, use of alcohol, nicotine and heroin/opiates products may all be problems that occur with an underlying dysfunction in the person’s ability to make cannabinoids internally the way people of normal physiology are capable. I discuss this topic in more detail and include some legal food sources that are naturally better sources of cannabinoids or phospholipids in an section I wrote for my newer website https://effectivecare.info/addiction-or-starvation%3F

which is also copied onto this site with a few additional details about the salad recipe: Is it Addiction or Starvation?

While I am past the age of having babies, and entered grand parent age the need to reschedule marijuana for the purpose of research may be important for the fertility of younger women and men. The cannabinoid system is essential for both female and male fertility, in a U-shape need – too little or too much can be problems. Overuse of medical or recreational marijuana could interfere with fertility but an underlying deficiency could also be a cause of infertility in either gender.

Infertility problems can be caused by a problem with cannabinoid receptors or an excess or inadequate supply of cannabinoids. Research in the cannabinoid system and its effects on physiology beyond toxicity and addiction are limited due to the federal listing of the cannabis/marijuana plant as a Schedule 1 substance, something considered to have no medical value. However the listing is in error and a number of medical officials and organizations have recommended changing the federal listing. An overview of the research that is available on the cannabinoid system’s role in female and male fertility and reproduction is available here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034092/

The system is involved in the fertilized egg successfully implanting in the woman’s uterus and the cannabinoid system is involved in the male reproductive system in a few ways including the motility of the sperm – are they able to effectively get to where they need to go? A variety of cannabinoids exist and some also have effects on hormonal controls that occur within the brain that effect male reproductive health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651943/

The balance of cannabinoids is critical and too much use of an external source such as medical marijuana is linked to male infertility, however again a U shape need exists. Some is necessary, too much or too little is a problem.

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.  

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Pleasure, happiness and a book to avoid

An old song that became part of pop culture as the opening lines of a television show suggests that love and marriage have to do with baby carriages. As a rhyming song lyric it does work well and it was the definition I grew up with – love and marriage was about picking the best person to be your children’s other parent – and be sure to have the marriage first and baby carriage second, that was important in my family even though the wedding itself wasn’t. Recently a book about addiction suggested that in our commercial world marriage seemed to be about large weddings, which some popular reality television shows about weddings have reinforced. Some brides can be very difficult and some weddings can be very large and expensive.

The average marriage that ends in divorce in the U.S. lasts an average of eight years. Children who see their parents divorce are more likely as adults to have a marriage of their own end in divorce so it is something difficult for the whole family. Longer getting to know you courtships may help couples have a better idea of what they are getting into but then who knows how many would never try? (U.S. divorce statistics)(healthy signs & questions to consider for a good relationship)

In my own upbringing it was always made clear to me by my father, who I love dearly but who doesn’t always say things in a kind and gentle manner, that with multiple daughters we were  all to elope – no money would be spent on large weddings. It was meant as a joke but clothes were never important in my family especially clothes to wear only once. In my family nature’s birthday suit was considered beautiful, love the skin you’re in, and any clothing on top of that was just window dressing for society. Elopement was an okay idea with me, and my sisters survived as well – small weddings were our thing, no difficult brides demanding special treatment. My point if there is one is that definitions are different for different people and one person’s impression even if it is in a book may not be correct or may not be correct for everyone.

Today is Veteran’s Day and I honor veterans including my father for their contribution to helping our nation’s safety. Budgeting for elopements versus large weddings seems worth a discussion based on the national budget however. When a bill called a tax reform bill is trimming care for citizens at the expense of health and children’s futures simply to provide more tax savings for a small percentage of the population that seems like a party that is excluding the majority for the sake of a fancy plate wedding that seats only a few. Blaming others doesn’t solve problems and we can’t  just blame President Trump or the Trump administration for the House passing a massive military bill that provides more than was even requested.  http://theantimedia.org/house-approves-700-billion-ndaa/

We can hold him accountable for his Tweeting though:. /twitter.com/

This post is not really about weddings or Veteran’s Day. It is about addiction and endocrinology and the need in my opinion to not blame patients or parents for underlying health problems in themselves or their children, more on that is included later in this post, and to not ever suggest to a sober addict that the addict’s definition of sobriety or description of it is wrong. Words mean different things for different people. Writing a book with a theme is nice but blaming addicts for not fitting neatly into the jargon of the theme in wrong in my opinion. The author includes in his blame game  the use of LSD and the 60s  flower power generation on a rock and roll musician without including a reference which would be difficult because the story he writes about is inaccurate – a slander lawsuit could possibly be filed for that (chapter 8, book).

I read this book to save anyone else the effort:  book that needs to be rewritten.

If interested in neuroscience and behavioral psychology, nevermind the jokes, because who cares, the references are cited thoroughly and accurately I would recommend reading Sapolsky’s Behave. https://www.amazon.com/Behave-Biology-Humans-Best-Worst/dp/1594205078

Sugar is blamed for most of chronic illness and the section on nutrition doesn’t even include carbohydrates as an essential food group. Too much starch and sugar is not good but the brain minimally needs at least roughly 100 grams of carbohydrate per day and it can’t use fat for energy. Protein from muscle mass will be broken down into a form that the brain can use for energy.

After having finished the book, there is some value in it but there are also errors and opinion presented as fact. A dangerous idea is presented, likely meant as a joke but there is no qualifier given that it was a joke and not meant as advice and that the idea shouldn’t be followed. (p125,book includes a maybe slip a mood altering substance in someone’s drink idea – no don’t do that ever, even if it is a legal substance and meant to boost the mood, it is illegal. https://law.stackexchange.com/questions/6158/is-it-an-offence-to-spike-someones-drink

References ideally should be included for all information presented as facts in a book with educational goals. The section on nutrition is simplified to the point of dangerous misinformation and sugar is stressed as the primary problem with our processed food diet. It is a problem but not the only one. Sugar is blamed for most of chronic illness and the section on nutrition doesn’t even include carbohydrates as an essential food group. Too much starch and sugar is not good but the brain minimally needs at least roughly 100 grams of carbohydrate per day and it can’t use fat for energy. Protein from muscle mass will be broken down into a form that the brain can use for energy.

Drinking any calorie containing beverage as a thirst quencher is a problem that I observed and counseled parents about for helping children who were heading upward on the weight to height ratio. Within three months usually, when the next appointment would be typically scheduled, the parents often had such success that they had forgotten that there had been a concern. Children are good at regulating food intake however the intake of liquids is not regulated in the same way as solid food. Our brains expect water for thirst because that is what nature provides. Once a baby is weaned from mother’s milk there is not typically any other calorie beverage in the natural world. As cavemen and women we did not milk wild animals or squeeze juice from fruits. We ate the fruits and wild animals as whole foods which are recognized by the brain as filling due to fiber or fats. Carbohydrates alone do not have the appetite satisfying effect on the brain that fiber and fats provide.

Regarding pediatric or adult endocrinology and the increase in metabolic syndrome and Type 2 Diabetes – sugar can increase insulin resistance but so can an absence of magnesium. Sugary processed foods often are not only deficient in fiber but they are also deficient in magnesium and B vitamins which are needed to process the sugar into usable energy.

More about magnesium deficiency and insulin resistance is available here: Association of Serum Magnesium Deficiency with Insulin Resistance in Type 2 Diabetes Mellitus,  (G3.122)

Diabetics given opiates for pain have been found to not have the same response as non-diabetics, their pain is not relieved – unless magnesium is also given. More importantly to me at least, their pain was relieved simply by giving magnesium alone – why give the opiates then, why not just treat the magnesium deficiency? Read more:  Magnesium ions and opioid agonists in vincristine-induced neuropathy, (G3.101)

I wrote a bit more about the pediatric nutrition issues related to the book in a longer post, so I’m copying the part about pediatric nutrition and endocrinology here as well:

The planet and its nations can’t afford an increasingly ill population. We are not just overweight (or chronically ill) because we eat too much and exercise too little, some do, but why is the better question. A healthy person has a healthy appetite that guides to balanced amount of food without counting calories and a healthy person has a healthy interest in active play or work that exercises the body.

Blaming doesn’t solve problems it just denies responsibility and prevents more helpful answers from being discovered.  A book I just picked up recently written by a pediatric endocrinologist is upsetting for me to read because blaming the patient for not following the doctor’s advice is a theme rather than considering the possibility that the advice itself might be wrong or incomplete. In my experience as a pediatric nutrition counselor I observed that children are the best at self-regulating their intake and generally did quite well at eating enough but not too much and generally had a reasonable height/weight ratio- except for the few who seemed to be overweight no matter how much their parent tried  to help them achieve a healthy weight for height.

Parents have lost custody or risked losing custody of their children when too large or too small and I’ve written about both issues. Undiagnosed congenital (from birth) hypothyroidism can be a cause of a child being tiny, too slim seeming except their bone structure is also slim so proportionally they tiny child can look healthy for their tiny weight. Force feeding wouldn’t help that child. Other children can be overweight even on limited calories, possibly due to an undiagnosed hypothyroid problem that occurred later than birth. Putting either the tiny child or the overweight child in foster homes would not solve an undiagnosed endocrinology problem. (post about the overweight child, Foster Care case) (post regarding tiny child and Foster Care case)

Holding parents accountable for something that is neglect or abuse is important but blaming them for underlying health problems that aren’t being diagnosed in many many people is wrong and there is no reason to expect that a Foster Care family would be able to make the child gain or lose weight if the underlying reason is an actual health problem.

To repeat an important point: When health statistics change as rapidly as they have in the U.S. and an increasing number of other nations then it is not a question of individual choice but of environmental changes.

Returning to the questionable practice of suggesting to a sober addict that their definition of sobriety is wrong (p 282, book) – a sober addict’s definition of sobriety is always adequate if they are maintaining sobriety.

The definition of words is fluid and addiction and who might be considered an addict may also be fluid. The person who is planning to get married just in order to have a large wedding might be considered an addict to weddings and the nation with a military industrial budget greater than half the national budget might be considered addicted to the weapons industry – possibly.

If a number of addicts to more traditional addictions of substances legal or illegal describe their experience while under the influence as happiness and their experience sober as pleasure it seems worth considering what they might mean. The dictionary definition uses the two words as synonyms – meaning some what the same thing. Happiness is further defined as contentment and pleasure could be considered at the verb “to please” not just as an emotional descriptor, the feeling of pleasure.

Opiates are being overused in our current society and are deadly when a powerful street version is used in place of the controlled pharmaceutical version. Our body’s natural painkiller includes internally produced opiate-like substances and the feeling might be described as happiness, or bliss, or absolute dreamlike contentment – but then the body runs out and there is an absent feeling of loss of contentment. The person might be overpowered by an urge to seek more. I experienced a small amount of that feeling a long time ago when I was prescribed painkiller tablets after having some dental work. I wasn’t really warned that the tablets were dangerous but they did leave me wanting more for a few days after I ran out, so I am slightly familiar with the dreamy bliss of opiate based pain killers and I have avoided them ever since.

The addicts who described feeling happy while drugged and feeling pleasure sober might be trying to express the difference between an artificial short term bliss that leaves an unsatisfactory feeling afterwards with the more gratifying experience of sober pleasure – taking pleasure in pleasing oneself or others naturally. Helping others can be a significant form of pleasure, pleasing oneself by pleasing others can be gratifying in a lasting way that a short term felling of contented happiness may not. In our modern world we can have addictions to video games or to shopping or other non-drug related experiences, even social media Likes and reshares may have an addictive quality for some users. Feeling grateful and helping others in a social group may provide long lasting pleasure and short term contentment. https://www.psychologytoday.com/blog/teen-angst/201701/achieving-happiness-helping-others

Definitions are important to help oneself understand one’s own behavior and for trying to communicate with others.

Cannabinoids are also chemicals that are produced naturally in our bodies but there is many more types of them than opiates and the functions the many types play are much more versatile than simply relieving pain. The primary one found in our body during times of health is known by the initials 2-AG and it is not euphoria inducing. The pain killing and euphoria producing one that is similar to the euphoria inducing cannabinoid found in cannabis known by the initials THC is called anandamide, a word that includes a foreign term for the word bliss. Anandamide is not found in large quantities in the body during times of health. It increases in quantity shortly before death and may help us “go gently into that good night” to reverse the meaning of a famous poem. when starvation is severe the body goes into a contented state, a desperate urge to seek food or water is no longer present – this might be when the anandamide levels increase naturally. Attempts by the pharmaceutical industry to synthesize cannabinoids for medical purposes have focused on THC when it might be the non-euphoria producing 2-AG that is more medically helpful for people who are alive.

Definitions are important and not mixing science and moral religious values is also important. Addiction can involve poor choices but it may also involve underlying differences in genetics or metabolism that leave some people needing more excitement to stimulate an increase in neurotransmitters because their body is overly efficient at breaking down the supply of neurotransmitters. It would be more helpful to tell that person that exercising vigorously each day is important for their mental health rather than telling them they are morally wrong for wanting excitement. Some bodies do better with the calm of simple stretching exercises while others need vigorous tiring workouts.

Veteran’s health care choices were recently limited for treatment of PTSD. The use of medical marijuana can be very helpful and safe for the condition while pharmaceuticals that are frequently subscribed instead have been associated with suicide and homicide. Second opinions and a personal right to the pursuit of life, liberty and happiness is in the U.S. Declaration of Independence. It may be time to review that document at the federal level. It has been approved for veterans with PTSD as a treatment choice in New York State. http://auburnpub.com/blogs/eye_on_ny/on-veterans-day-cuomo-oks-medical-marijuana-for-ptsd/article_1166f91c-c708-11e7-9093-079ffabc38d1.html

The strain of medical marijuana can be important for health benefits. THC alone can increase anxiety and is balanced by calming effects from non-euphoric cannabinoids in strains that contain a variety of cannabinoids. Some food substances also contain non-euphoric cannabinoids or the precursor nutrients which include phospholipids. Currently my own PTSD symptoms are being helped by daily large salads which I describe in this post: Is it Addiction or Starvation?

The difference between 2-AG and THC is discussed in the post: What do we have in common with pine trees and ticks?

It is good to find out one’s own definition of pleasure and happiness rather than always trusting other’s definitions. People are similar but we are also different. Some may feel safer with half the country’s budget dedicated to war while other’s might feel safer with adequate prenatal care and a system that supports families with children so that the children are growing up in secure environments that help them become pro-social trusting adults.

Returning to the baby carriage – life worked out in the right order to please my parents and in time for them all to meet. My babies arrived after the small wedding and early enough to get to know their grandparents before they passed on to whatever may happen next. Marrying young may have difficulties however there are also advantages – children have a lot of energy. Would I do things differently if I could start over again? Not when I look at a picture of my babies. Tips for helping an older child adapt to a new baby: New Baby Sibling

Happy Veteran’s Day. May peace reign supreme today and everyday.

~~~~~

 

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

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Is it Addiction or Starvation?

1. Talk Therapy or “Just say no” can’t help a genetic difference.

Talk therapy is also beneficial but can not “cure” a biological difference in metabolism.
  • Looking up the definition of the word “disease” suggests that a genetic difference affecting a body wide receptor system might fit the term “body disease.” “Disease: a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.” – Oxford Dictionaries (I.1.disease)
Redefining the neurobiological underpinnings and genetic risks of the behavior we call addiction could lead to more targeted help for the sufferers of addiction rather than continuing to treat them primarily by focusing on a discussion of their difficulties with motivation or impulse control.
Binge eating disorder for some sufferers may involve a genetic difference in the endogenous cannabinoid system which leaves the person unable to produce the cannabinoids normally and so they are left hungry, starving for the foods that are better sources of cannabinoids naturally.
Chocolate is the richest standard food source that isn’t a controlled substance but it isn’t a low calorie food (hemp oil and hemp seed products are not available in a limited quantity but they are still difficult for farmers to grow in all areas and medical marijuana is still considered a controlled substance at the U.S. federal level.) Less calorie dense foods than chocolate include pomegranate seeds, dark green leafy vegetables and herbs such as oregano and other green leafy herbs. So if binge overeating sounds sadly familiar, consider making an enormous salad and it may be just what your body needs. I use a half a pomegranate worth of seeds on my salad, which is about 1/2 cup of the seeds, and 1 teaspoon each of Italian Seasoning and Basil or Tarragon or some other leafy green herb. The enormous (a full dinner plate size is what I mean) salad might also help sufferers who are trying to resist the urge to over-consume alcohol or a few other addictive substances as well, if an underlying difference is present in their genetic code.

A dinner plate with a soup spoon and regular spoon for size comparison. Salad includes romaine lettuce, cilantro, tarragon, Italian seasoning, carrot, celery, avocado, pomagranite seeds, hemp seed and pumpkin seed kernels, lime juice and hemp oil and sea salt to taste.

The discussion of foods that are good sources of phospholipids or cannabinoids is not to suggest that medical marijuana patients should stop using their medication but simply to point to some food sources that might be available to most people where ever they live. Medical marijuana has significantly more cannabinoids than the foods that I mentioned in the previous paragraph or which will be mentioned later. My own physical symptoms are better helped by use of medical marijuana than by very large salads however the large salads are less expensive and have less effect on my mood. My previous use of the psychiatric medication Olanzapine has changed my withdrawal reaction to the medication and to marijuana significantly. I still have four months supply of the medication Olanzapine and plan to never ever use it again because its physical side effects while using it are very bad and withdrawal from it are much worse, frighteningly worse.
Medical marijuana patients who have never used olanzapine are unlikely to have the negative withdrawal reaction that I now experience within a few hours of my last dose. The strain of medical marijuana or type of synthetic or natural product is also important for any user in order to have a positive mental health reaction. Pure THC or the synthetic version, Dronabinol, can cause increased anxiety. Strains that have a mixture of cannabinoids and terpenes seem to help balance the mental effects in a way that is less likely to cause increased anxiety. Real lemon and lime products that contain the oil is one example of a easily available food substance that provides terpenes which help reduce the anxiety effects of medical marijuana or the synthetic Dronabinol. Terpenes and a link about lemon is included later in this post.
The Endogenous Cannabinoid System holds answers.
Background information:
  • Endogenous refers to something that can be made internally by our body rather than a chemical that is needed to be obtained from an external source on a daily or semi-regular basis. An example such as oxygen from the air we breathe is needed within every few minutes or cellular damage can start to occur; or trace nutrients such as essential fats or fat soluble vitamins may not be needed as often because they can be stored in the fat and membranes of the body. They may only need to be consumed in the diet every few days or weeks without resulting in negative health effects. The body can store extra vitamin D during summer months that can last most of the winter but does start to run out by springtime.
A person with a metabolic difference due to genetics, chronic illness, or the standard changes associated with aging may need an external source of nutrients that other people of average health would be able to make internally – “endogenously.”
  • Cannabinoids are a type of chemical called phospholipids which are formed from a lipid, a type of fat, and the mineral phosphorus.
I have a genetic difference in my ability to phosphorylate (I.2.wikigenes.BHMT) so that I am unable to make phospholiids endogenously and I have found that having an external source of cannabinoids in my diet every day helps my chronic illness conditions and improves my muscle and nerve control. I am registered as a Medical Marijuana patient in a state where it has been legalized for medical use.
     Some of my symptoms that are relieved by the herbal medicine have been troubling me since I was an infant. I had severe eczema throughout my childhood and severe congestion. Rarely could I breathe through both nostrils and nosebleeds were also common. The enzyme the BHMT gene produces when functioning incorrectly is associated with a risk for vascular problems – ie nosebleeds or easy bruising or spider veins or all of them.
     The protein that the gene normally produces is necessary in Glycerophospholipid biosynthesis, metabolism , and Phospholipid metabolism, (so a double mutation in this gene may make it difficult for me to make phospholipids endogenously), among 17 pathways in all – that is an important enzyme: (I.6.genecards.BHMT) And the CDK-mediated phosphorylation and removal of Cdc6 SuperPath involves 97 other pathways which include a Calcium2+ pathway and a Parkinsons Disease pathway and creatine metabolism (important for muscles) and synthesis of DNA and many other metabolic paths/chains of chemical events : (I.7.genecards.phosphorylation)
Phospholipids are found in human breast milk and helps stimulate the infant’s appetite and helps support adequate weight gain. The cannabinoids and phospholipid group perform two main functions – they are flexible and form a significant part of membrane walls, like building blocks or bricks; they can also be released from the membrane and act as messenger chemicals that can activate other systems or be modified slightly to become a different type of messenger chemical called eicosanoids.
  • Eicosanoids include the leukotrienes: Santa Cruz Biotechnology,(I.8.scbt.com)
Phospholipids are a combination of a lipid with the mineral phosphorus. They are important for helping make flexible membranes and play a role in immune health and energy metabolism. Phosphorus is also part of molecules used in energy production (ADP & ATP) and genetic structure, DNA and RNA (nucleotides) when combined with proteins or sugars.
  • Food Sources of Phospholipids and other phospho-nutrients: Hemp seed kernels and oil; Artemisia turanica/wormwood leaf; amaranth seed; asparagus; avocado fruit or the inner kernel, dried and powdered; beans/legumes; cardamom seeds and powder; carrots; celery stalks and leaves; cocoa beans and cocoa powder, baker’s chocolate, dark chocolate and to a lesser amount milk chocolate and chocolate syrup; coconut; cumin seed/powder; fennel seed, flax seed, pine nuts; sesame seeds, pumpkin seed kernels, squash seeds; butternut squash and pumpkin; gingko leaf; grapefruit and orange juice with the pulp; Jerusalem artichoke (this is a root vegetable rather than a green artichoke); lettuce, spinach and mustard leaves and other leafy green vegetables and herbs; nuts/peanuts, cashews, walnuts; oats; okra seeds; onion root, leek leaves, garlic;  parsnip root; pomegranate seeds and pomegranate peel extract;rice, white or brown but the bran is the best source; rosemary; sorghum;  sweet potato or yam; buckwheat (a seed botanically that is not wheat and is gluten free); wheat. (G.26)

2. It might be motivating to learn of an underlying cause to cravings.

It might help a person to learn that for a person with a genetic difference, difficulties with motivation or impulse control are likely due to an underlying deficiency of a substance they are missing, which would likely have helped them have better impulse control and to not have cravings for substances.
Someone without the genetic difference would be making the substances internally which would help them have good impulse control and not crave substances.
     Helping the person with substance abuse problems to find approved external sources of the substance (cannabinoids) seems like it would be more helpful and potentially more motivating for them to be able to view themselves as a worthwhile person with special dietary needs rather than as an unmotivated drug addict who just doesn’t try hard enough to change.
     Substance abusers likely quit using and relapsed again more times than anyone cares to count. every single time a chronic user runs out of their substance of choice they are “quitting” until they get more.
     Do you blame a hungry person for eating breakfast in the morning? Should a person just “quit eating” if they have an overeating disorder? Answer: No.
    • Cannabinoids might help some types of eating disorders and some types of drug or alcohol addictions by providing an essential nutrient that the person might not be able to make.
  • If the body can’t make an important substance or convert substances into active forms then it becomes an essential nutrient – essential for that specific person’s daily diet.

3. Genetics of the cannabinoid system and binge eating disorder, alcohol abuse and drug addiction.

“It is important to note that, as with alcohol, marijuana, and heroin, a human genetic variant of the cannabinoid CB1 receptor gene CNR1 has been associated with susceptibility to cocaine and amphetamine dependence (Ballon et al. 2006, Comings et al. 1997; Zhang et al. 2004).”
  • Behavioral Neurobiology of the Endocannabinoid System; Ch.13: Drug Addiction, (page 334, I.9.Searchworks)
Endocannabinoids: The Brain and Body’s Marijuana and Beyond is a reference textbook available online as a pdf. (I.10.Endo.pdf)  It includes information regarding the genetic differences known to be associated with binge eating disorder and other drug addictions affected by rimonabant, a chemical which inhibits the endogenous cannabinoid system. Use of rimonabant affected craving for food/sucrose and alcohol in animal research, and it was found to reduce rewarding effects of morphine/opioids, amphetamine, cocaine and diazepam in other studies.
  • Rimonabant is not in use for drug addictions because it is associated with a significantly increased risk for suicide. This is an important point to note – blocking the endogenous cannabinoid system is associated with a significant risk for suicide.
The problem with addiction to some substances or to eating excess food for some cases of over eating disorders is an underlying inability to make the cannabinoids but a remaining need for them and a hunger, an urge for “something,” something that is unknown however. And what people choose to consume in order to try to quench that unknown hunger varies from food and alcohol, to the rest of the drugs that are commonly abused.
     Dietary sources are needed instead. However our food supply has limited sources. Vine ripened produce or lemon oil, rich in aroma, are examples of a food containing cannabinoids or a similar group of aromatic and medicinal phytochemicals called terpenes. Chocolate and the herb rosemary are two other food sources. The spices cardamom, cloves, and nutmeg are also sources. Non-euphoric cannabinoids also exist and may have medicinal benefits depending on the patient’s condition. Copaiba oil is a food grade essential oil that can have non-euphoric cannabinoid content with medicinal benefits.
     Wouldn’t it be nicer to tell starving people that they are starving rather than that they are poorly motivated?
    • For more information regarding binge eating disorder, drug addiction and rimonabant: See Ch.3: Endocannabinoid Receptor Genetics and Marijuana Use, (p72-73 & 91, I.10.Endo.pdf) and Ch.13: Behavioral Effects of Endocannabinoids, mentions that research with rimonabant has helped show excessive alcohol drinking behavior and development of alcoholism may be related to genetic differences in the CB1 receptors. (p319, I.10.Endo.pdf)
    • Impulse control deficits may involve the cannabinoid system: See Ch.13: Behavioral Effects of Endocannabinoids, (pp325-330, I.10.Endocannabinoids.Full Text.pdf).
  • Schizophrenia may be related to a deficiency in the cannabinoid receptors themselves rather than being due to a deficiency in cannabinoids: See Ch.15, Neuropsychiatry: Schizophrenia, Depression, and Anxiety,; of the book Endocannabinoids: The Brain and Body’s Marijuana and Beyond: (p378, I.10.Endocannabinoids.Full Text.pdf)
More recently a gene has been identified in binge eating disorder, the gene for the cytoplasmic FMR1-interacting protein 2 (CYFIP2). (I.11.sciencedaily) The gene has a number of known variations and has allso been associated with Fragile X, an autism like condition, ADHD, autism, obsessive-compulsive behavior, and Prader-Willi Syndrome.. (I.12.ncbi.FragileX)
     The enzyme the gene CYFIP2 produces when functioning normally is involved in many metabolic pathways in the body including one that plays a role in myelination of nerve cells and one in phospholipid metabolism. (I.13.reuters) (I.14.genecards.CYFIP2)
     So an external source of cannabinoids might help a person with a problem in their CYFIP2 gene to have normal appetite control and also to protect their nerves from multiple sclerosis – which causes degeneration of myelin.  Myelin is similar to the lipid part of some of the phospholipids of the endogenous cannabinoid system. Multiple sclerosis has been associated with social anxiety and eating disorders (I.15.omicsgroup) which are also conditions associated with gene differences in the cannabinoid system. Myelin is made with sphingomyelin which is made of sphingolipids. (I.16.sphingolipids) Easy right? (I.17.mpcfaculty.lipids) Even easier – coconut oil is about 50% phospholipids and is a good source of sphingolipids. (I.18.coconut)
     I don’t know if I have any differences in my CYFIP2 gene; it was not one of the 30 genes that were included in the Nutrigenomic Screening I had done for my personal use for the “purposes of research.” Genetic screening is only used for certain conditions in standard health care currently and some types of health care claims can not be made by practitioners about genetic screening for other conditions – no guarantees in life or lab tests. The screening I had was designed to test genes commonly found to have differences associated with autism. (I.33.Nutrigenomic Screening) (p22, I.34.example of the genetic screening I had)
     I have a genetic difference in my ability to phosphorylate (I.2.wikigenes.BHMT) The gene I have a double malfunction in, BHMT, is also associated with multiple sclerosis except it seems to be with an over activity rather than too little function. Methionine and homocysteine metabolism and vitamin B12 may be involved. (I.19.BMHT.MS) Hypothyroidism may be associated with over expression of this gene: (I.20.wikigenes)
     The enzyme BHMT/1 (Call – T), Betaine-homocysteine methyltransferase (BHMT), in normal health helps produce the amino acids methionine and Dimethylglycine (DMG).
     DMG has been found helpful in ADHD, autism, allergies, alcoholism drug addiction, and chronic fatigue syndrome among other chronic issues. Methionine has been found helpful in treating depression, allergies, alcoholism and schizophrenia among other chronic issues. Since learning of the difference in my genetics I have been taking the two amino acids in a powder form that I add to a glass of water. It doesn’t taste good but it leaves me feeling more energetic and with a more positive mood.
     What it tasted most like was a tart red wine and the nutrient content of red wine does contain free amino acids, so someone with a problem with the BHMT gene may have problems with unidentified cravings that wine seem to help. While I did love red wine, it didn’t love me. It was one of the first triggers for severe migraines that I identified and started avoiding. A painkiller did help with migraine pain somewhat but zero time spent with a migraine is my goal.
     I found based on the information that is available regarding dose, that a half teaspoon of each of the amino acid powders helped my mood without causing such an energy boost that it caused an increased heart rate or prevented me from going to sleep. I tried one teaspoon of each initially and found that it was too much of an energy boost. Both amino acids can act as activating chemicals within the brain.
     I have early symptoms of neuropathy, I would rather prevent multiple sclerosis than to learn more about it first hand. Taking the supplemental methionine may be helping my body do what it needs to do to prevent an autoimmune breakdown of my myelin.

4. Sometimes people are wrong – Nixon was wrong.

“If the good people, in their wisdom, shall see fit to keep me in the background, I have been too familiar with disappointments to be very much chagrined.” – Abraham Lincoln (1809-1894), (p 634, I.23)
Hemp fiber was essential for rope and strong fabric. Thomas Jefferson grew hemp and is said to have smoked it too. It is time to stop being disappointed in loved ones who are likely suffering from a metabolic deficiency that leaves them susceptible to substance abuse or overeating and instead start accepting that they have needs that a person of average health doesn’t have or may not have to the same extent. Many nutrients are needed in a just right amount, not too little or too much.
     Cannabinoids are powerful and can be consumed in excess however it does not have the toxicity and deadliness of many other substances that are abused, including alcohol.
     The American Medical Association has recommended that marijuana be rescheduled as an herb with medicinal benefits. (I.24.AMA resolution) (I.25.veteransformedicalmarijuana)
     Rescheduling marijuana as a medicinal plant would free academic researchers to study its medicinal benefits. As a “Scheduled Substance” currently research studies are only supposed to assess toxicity and rehabilitation areas rather than design experiments assessing the medicinal value. Currently the synthetic form of the main euphoric cannabinoid, THC, is listed at a “safer” level of risk than the marijuana plant itself.
     The synthetic forms can be even more dangerous as they are more concentrated and are in isolation rather than also providing the non-euphoric cannabinoids that are found in most strains of marijuana and which have calming effects. Synthetic THC or THC in excess can cause paranoia and other mood symptoms that would have been unknown to Thomas Jefferson when he enjoyed smoking marijuana that was milder in the amount of THC it likely contained and more likely to be balanced with non-euphoric cannabinoids.
     The problem with black market development of a product is that it is often being designed to maximize the “buzz” or “euphoria” rather than the medicinal or pain killing effects. However, there is not that much “euphoria” felt by the person with chronic illness who is using a larger quantity of marijuana everyday due to an underlying inability to make cannabinoids because a tolerance is built up and they simply need some of the herb or other concentrated sources of cannabinoids every day just to maintain a state of health and function that is a little closer to everyone else’s “normal function“.    

     The person with a chronic need wants an herbal medicine that has a balanced variety of cannabinoids that treats a variety of symptoms, not just the euphoria inducing THC that can lead to overdose symptoms of a racing heart, feeling very chilled, and paranoia or anger combined with extra energy, so manic behavior might be a risk with an overdose reaction. Real lime or lemon juice products that are concentrated rather than being a watery lemonade may help counteract some of the mood changes associated with an overdose of THC. More on lemon oil is included in the next section. 

(I.26.fastcompany)

5. Medical Marijuana helps reduce opioid use, which can save lives.

     We currently have an epidemic of deaths due to opioid medications, prescription and black market drugs. The increase in deaths is due in part to the over prescription of opioid painkillers by the medical community but it is also due to black market substitutes that have been introduced in recent years. One type is particularly potent and is being sold as something else so consumers wouldn’t even know that they were being given a stronger version of an opioid medication than the prescription medication they were told they were purchasing on the black market – key point – don’t buy drugs on the black market because you don’t know what they might contain.
     This likely seems an obvious point which, honestly, even the drug addict knows that but their need is great enough during withdrawal that they may be more likely to take risks.
     Women may be especially at risk for opioid addiction whether it is due to differences in size or physiology is unknown. Addiction to opioids seems to occur for women at lower doses of the medication that were taken for a shorter amount of time than for men who become addicted. Women may be more susceptible to the cravings for the drug. (I.27.jotopr)
     In states with medicinal marijuana sales of painkillers dropped,which would include the opioids. Physicians are not comfortable with the inability to “prescribe” a set dose. “Take two hits and call me in the morning?” was asked in jest or in seriousness by a psychiatry professor, Deepak D’Souza, who also has researched marijuana. (I.28.npr)
     Deaths due to overdoses of opioids have also decreased in those states. (I.29.nbcnews) The cannabinoid and opioid receptor systems may both be involved in the regulation of appetite. Levels of the hormone leptin may be increased in response to CB1 receptors in the hypothalamus. Leptin and other appetite hormones may then “control opioid-regulated feeding…(Verty et al., 2003).” See Ch.13: Behavioral Effects of Endocannabinoids, (p313, I.10.Endocannabinoids.Full Text.pdf).
     Since marijuana use seems to be saving lives and has low toxicity risks, it doesn’t seem like how big a dose is as big a question as how to get a safe reliable supply to more patients in pain. The answer does exist but it is one a physician or psychiatrist is unlikely to like – the dose varies based on the person’s genetics and metabolism, the supply of nutrients available, tolerance, etc.; the answer is “It depends.” But the medication is so safe that worries about “too much” are really unnecessary, except possibly for more concentrated synthetic sources or extracted cannabinoid oil products.
     Signs of “too much” THC or synthetic THC can include a racing heartbeat, which very, very rarely has caused a couple/very few deaths. To the user first experiencing the racing heartbeat of excess THC, it may be frightening and feel like a panic attack. Relax it slows down again and only people with a pre-existing heart condition may be at risk during the time that the heart-rate is rapid.
     So if you have a weak heart – avoid excessive amounts of THC. The rapid heart-rate doesn’t occur at low doses. It may be accompanied a feeling of being chilled, and suddenly needing a jacket. Anxiety or anger may occur with excess THC or synthetic THC or during withdrawal from an excessive amount.
     The aromatic terpenes in citrus oil can have a calming effect if anxiety is a problem after consuming marijuana. Pinene from pistachio nuts may also be helpful, but a glass of lemonade might help the mood more quickly than eating pistachios because they would take longer to digest. (I.26.fastcompany)
     Artificial lemon flavored products wouldn’t help, only real lemon or lime juice products would help calm a mood unsettled by an excess or imbalance of THC. The plant contains many active phytochemicals which can include terpenes and other cannabinoids that are calming to the mood rather than causing euphoria. THC is the only cannabinoid in marijuana that causes euphoria.
     Opioid medications also cause euphoria – so why is one more socially acceptable than the other? Smoking is dirty and smelly and – the easiest way to not overdose.
     Eating products or the concentrated synthetic dose in one single sitting can leave a person feeling symptoms of overdose about one hour later, far too late to stop at half a serving or a small taste to see how you might handle that particular product and/or the strain that was used in it. Different strains of the plant can cause very different symptoms and help different types of symptoms, so the question of “how much” is less significant than which strain to use and the method to use to consume it.
     Smoking provides fairly instant changes to the mood so it is easy to tell if you’re getting more anxious or developing a rapid heart rate. Strains of marijuana can vary a lot, some types may cause the anxiety symptoms, while others would just cause the stereotypical “couchlock” – falling asleep. While setting fire to the couch might be a very real risk, otherwise, no danger other than possibly drooling a little and looking stupid. Looking stupid is better than looking dead from an opioid overdose – in my opinion – and I am a medical marijuana patient who has experienced these symptoms and read research about safe use.

6. Resources for help or just someone to talk to:

    • National Helpline: Substance Abuse and Mental Health Services Administration: “SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service), is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.” (1.30samhsa.org)
    • Rape, Abuse and Incest National Network, RAINN Hotline: 1-800-656-HOPE, (1.31RAINN.)

Help is only helpful when you accept it. Recognizing that you need it is the first step.

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Links and References:

(I’ll finish this list later, I’ve learned a lazy editing tactic is to skip the footnote numbers until the final draft is complete.)

  1. “Disease,” Oxford Dictionaries (I.1.disease)
  2. “BHMT,” wikigenes.org, http://www.wikigenes.org/e/gene/e/635.html (I.wikigenes.BHMT)
  3. Glycerophospholipid biosynthesis,
  4. metabolism ,
  5. Phospholipid metabolism,
  6. (I.6.genecards.BHMT) [http://www.genecards.org/cgi-bin/carddisp.pl?gene=BHMT] (I.6.genecards.BHMT)
  7. (I.7.genecards.phosphorylation) [http://pathcards.genecards.org/card/cdk-mediated_phosphorylation_and_removal_of_cdc6] (I.genecards.phosphorylation)
  8. “Leukotriene,” (I.8.scbt.com)
  9. Behavioral Neurobiology of the Endocannabinoid System; Ch.13: Drug Addiction, (page 334, I.9.Searchworks)  Behavioral Neurobiology of the Endocannabinoid System, Editors David Kendall and Stephen Alexander (Springer, 2009, Nottingham, U.K.). (I.Searchworks)
  10. Endocannabinoids: The Brain and Body’s Marijuana and Beyond, (CRC Press, 2006, Boca Raton, FL), Chapter Three, Endocannabinoid Receptor Genetics and Marijuana Use, editor and chapter by Emmanuel S. Onaivi, et al., (pages 72-73, 91, and 333), Chapter 15, Neuropsychiatry: Schizophrenia, Depression, and Anxiety, chapter by Ester Fride and Ethan Russo, (page 378), (I.10.Endocannabinoids: FullText pdf)
  11. (I.11.sciencedaily) Genetic risk factor for binge eating discovered. Sciencedaily.com, Oct. 26, 2016,  https://www.sciencedaily.com/releases/2016/10/161026170543.htm (I.sciencedaily)
  12. (I.12.ncbi.FragileX) Sabiha Abekhoukh and Barbara Bardoni, CYFIP family proteins between autism and intellectual disability: links with Fragile X syndrome, Front Cell Neurosci. 2014; 8: 81., ncbi.nlm.nih.gov https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3973919/ (I.ncbi.FragileX)
  13. (I.13.reuters) Pathway Maps: G-protein signaling_RAC1 in cellular process, Life Sciences Research, thomsonreuters.com, http://lsresearch.thomsonreuters.com/maps/383 (I.reuters)
  14. (I.14.genecards.CYFIP2) CYFIP2, genecards.org,  http://www.genecards.org/cgi-bin/carddisp.pl?gene=CYFIP2 (I.genecards.CYFIP2)
  15. (I.15.omicsgroup) Shahla Mohamadirizi1*, Vahid Shaygannejad2, Soheila Mohamadirizi3 and Marjan Mohamadirizi4, Eating disorders in a multiple sclerosis clinical population and its association with social anxiety.   https://www.omicsgroup.org/journals/eating-disorders-in-a-multiple-sclerosis-clinical-population-and-its-associationwith-social-anxiety-2376-0389-1000183.php?aid=82623 (I.omicsgroup)
  16. (I.16.sphingolipids)
  17. (I17..mpcfaculty.lipids)
  18. (I.18.coconut) Handbook of Plant-Based Fermented Food and Beverage Technology, Second Edition, edited by Y. H. Hui, E. Özgül Evranuz  CRC Press, May 17, 2012, https://books.google.com/books?id=5fvRBQAAQBAJ&pg=PA669&lpg=PA669&dq=sphingolipids+in+coconut&source=bl&ots=QlgC46XLn8&sig=Y5AiDM4oUTBp9BS3aOKCtWK0Fbk&hl=en&sa=X&ved=0ahUKEwiQuL-wmdbVAhUG7CYKHXZCCxsQ6AEILjAB#v=onepage&q=sphingolipids%20in%20coconut&f=false
  19. (I.19.BMHT.MS) Naveen Kumar Singhal, et al., Changes in Methionine Metabolism and Histone H3 Trimethylation Are Linked to Mitochondrial Defects in Multiple Sclerosis. J of Neuroscience Vol 35, Issue 45, 2015 PAGES: 15170-15186 ISSN: 0270-6474 https://www.researchgate.net/profile/Rohan_Dassanayake2/publication/283710653_Changes_in_Methionine_Metabolism_and_Histone_H3_Trimethylation_Are_Linked_to_Mitochondrial_Defects_in_Multiple_Sclerosis/links/5693c64508aeab58a9a2aaf3.pdf (I.BMHT.MS)
  20. (I.20.wikigenes)
  21. ( methionine )
  22. ( Dimethylglycine (DMG).
  23. John Bartlett, Familiar Quotations, 14th Ed., 1910, (p 634, I.23)
  24. (I.24.AMA resolution) American Medical Association Medical Student Section, Resolution 2, JUne 8, 2008, http://www.oregon.gov/pharmacy/Imports/Marijuana/Public/AMA_MedStudentSectionResolution.pdf (I.AMA resolution)
  25. (I.25.veteransformedicalmarijuana) AMA Votes to Reschedule Medical Marijuana, VMCA, http://www.veteransformedicalmarijuana.org/node/67 (I.veteransformedicalmarijuana)
  26. (I.26.fastcompany) Chris Dannen, Three Beginner Mistakes to Avoid When Eating Cannabis, fastcompany.com Sept. 10, 2014, https://www.fastcompany.com/3035175/three-beginner-mistakes-to-avoid-when-eating-cannabis (I.fastcompany)
  27. (I.27.jotopr) Karen Barth, New Study Shows Women are Hit the Hardest as Opioid Epidemic Sweeps the Country. Jotopr.com, Feb. 27, 2017, https://jotopr.com/new-study-shows-women-are-hit-hardest-as-opioid-epidemic-sweeps-the-country/?utm_source=ReviveOldPost&utm_medium=social&utm_campaign=ReviveOldPost (I.jotopr)
  28. (I.28.npr) Shefali Luthra, After Medical Marijuana Legalized, Medicare Prescriptions Drop for Many Drugs. npr.org, July 6, 2016, http://www.npr.org/sections/health-shots/2016/07/06/484977159/after-medical-marijuana-legalized-medicare-prescriptions-drop-for-many-drugs (I.npr)
  29. Reuters, Legalized Marijuana Could Help Curb the Opioid Epidemic, Study Finds. March 27, 2017,nbcnews.com,  http://www.nbcnews.com/health/health-news/legalized-marijuana-could-help-curb-opioid-epidemic-study-finds-n739301 (I.29.nbcnews)
  30. National Helpline: Substance Abuse and Mental Health Services Administration: 1-800-662-HELP (4357), (1.30samhsa.org)
  31. Rape, Abuse and Incest National Network, RAINN Hotline: 1-800-656-HOPE, (1.31RAINN.)
  32. U.S. National Suicide Prevention Hotline:  1-800-273-8255, (1.32.suicidepreventionlifeline.org)
  33. Amy Yasko, Nutrigenomic Testing, Holistic Health International, http://www.holisticheal.com/health-tests/nutrigenomic-testing (I.33.Nutrigenomic Screening)
  34. Amy Yasko, Methylation Analysis Pathway: John Doe, Neurological Research Institute, http://www.holisticheal.com/media/wysiwyg/John_Doe_MPA_05.19.17.pdf (p22, I.34.example of the genetic screening I had)