**** Dr. Pomeroy @Article - Legalization of Marijuana in Treatment of ADHD?

Medical Marijuana approval being considered for treatment of ADHD in WA; State Medical Board Hearing, Jan 11, 2011, in Renton, WA. http://www.doh.wa.gov/hsqa/MQAC/Files/MMJHearing.pdf

In response to the use of medical marijuana for the treatment of ADHD, Dr. David Pomeroy, Board Secretary of ADD Resources, has written the following statement outlining the reasons he emphatically oppose efforts to legalize the use of marijuana in the treatment of ADHD.

  1. ADHD is not simply a behavioral condition, it has neurobiological basis, with altered dopamine transport in the prefrontal cortex area of the brain. Often this is genetically mediated.
  2. THC compounds, the biologically active parts of marijuana, affect brain function, but not specifically in the prefrontal cortex; in other words they do not target the defect which leads to ADHD. Prescription stimulant medications do.
  3. For people with ADHD, stimulants actually often have a calming effect, as the brain function is closer to normotypical, and fewer distractions are bombarding the executive function area of the brain, namely the prefrontal cortex. Simply because marijuana may createa similar feeling in many people does not mean it is acting in an appropriate biological fashion to "treat" ADHD.
  4. Sharing or diversion of prescription stimulant medications is already a concern; I have much more concern about possible use of marijuana by those who do not have ADHD, provided by those who ostensibly do have it, if it were "officially" available.
  5. THC triggers dopamine release to the reward center (nucleus accumbens) area of the brain; this is the basis for addictions; it is human nature to continue to seek out pleasurable sensations. Stimulant medications for ADHD, used appropriately as prescribed, do not do this, thus when used in the fashion intended, they do not pose a risk for addiction.
  6. There is no way to measure a specific dosage of THC when taken as marijuana smoked or vaporized or eaten. While some people may feel an activation from low "dosage" mj, this level is often exceeded, resulting in somnolence, lack of motivation, and clouded thinking.
  7. Anyone driving under the influence of marijuana should be considered to be an impaired driver; it affects reaction time as well as judgment. Stimulants have been proven to improve the function of those with ADHD while driving.
  8. THC affects thinking, testosterone levels, brain function in many areas (as demonstrated by SPECT and other functional neurological imaging techniques). There is an absence of normal metabolic activity in the brain of those who use marijuana. Stimulants on the other hand restore to normal appearance the images altered by the presence of ADHD.
  9. Adolescent brains are in a tremendous process of growth and development, until past the age of 20. The effects of ongoing exposure to THC (marijuana) during teen years are unknown; why should the state allow anyone to experiment with their brains? We legislate that bicycle riders protect their brains with helmets. The State should not allow potential harm to brain function by allowing use of marijuana in the treatment of ADHD.

Dave Pomeroy MD
ADD Center of Bellevue
425 454-8684