MAR 1998-b
Therapists Talk 
Shrink Rap 


    Michael E. Holtby, LCSW, BCD


by Lee Cantwell

First published in Resolute!, March, 1998

What follows is an account of my experience with the use of marijuana to alleviate some severe symptoms caused by cryptosporidiosis complicated by immune dysfunction due to AIDS. After you've read my story you can decide the validity of the movement to legalize marijuana for medicinal use.

First, some background information. I'm a 36 year old PLWA who has just gone through a period of 15 months of illness that kept me bedridden for much of the time and almost cost me my life. My current condition is stable and I'm holding steady at a normal weight of about 170lbs. In June '94 I contracted cryptosporidiosis after drinking some tap water in NYC during a severe allergic reaction to bactrim. Over the next 18 months I battled the constant and sometimes severe diarrhea caused by the crypto, losing an average of 2lbs/month. During that time I had smoked marijuana(pot) to stimulate my appetite a few times but in general I tried to stay away from it because of the potential for respiratory problems and immunosuppression.

In February '96, I spent a week in Mexico. I must have picked up some bug that exacerbated the crypto because 2 weeks later I ended up in the hospital due to dehydration brought on by severe diarrhea, nausea, and loss of appetite. I was hospitalized twice that month and twice in March and twice in April. A viscous cycle of decline was in progress (diarrhea causes dehydration and an increased need for food/water; dehydration causes extreme fatigue, loss of appetite, and nausea; fatigue, loss of appetite and nausea causes a decrease in food/water intake, and, paired with diarrhea you get dehydration.) This type of cycle is very hard to break and the decline that results is swift and dangerous since a component of dehydration is a depletion of your potassium stores, and , if your potassium gets too low the result can be heart failure. That was probably why the doctors at the hospital were so insistent on knowing whether or not I wanted to be resuscitated.

In May I was taking so many pills that I was constantly nauseous, my appetite was poor, and I was having diarrhea about every 30 minutes. I had not smoked pot since I was in Mexico. A friend of mine asked me if I wanted to smoke a joint, more as a social thing than for medicinal purposes. I somewhat reluctantly agreed, not sure whether the pot would have a negative or positive effect on my health. The results were staggering. My appetite became ravenous and the nausea disappeared. I got an entire body high which caused relaxation of my nerves and a suppression of the need to go to the bathroom that lasted for 3 to 4 hours. After that I used marijuana regularly to aid in my condition. The benefits continued throughout the duration of my illness.

I smoked about 1/3 to joint at a time or about 3 joints/day. The pot helped to slow the decline that was occurring but did not stop it. I ended up in the hospital again in July and twice in August. The true value of the marijuana became apparent during my August hospitalization. I was taken to the hospital in an ambulance and I did not remember to bring my pot with me. My friends were out of town so I was unable to get any pot to help my condition. My weight had dropped to 107 lbs. and I was losing 12 to 14 liters of fluid/day through my bowels even though I was only taking in about 7 to 8 liters/day through IV, eating, and drinking. The gastroenterologists had never seen anything like it, even in third world countries, and they had no idea how to stop it. I had to face the fact that this was probably my last week of life.

I got in touch with another friend who was able to bring me my pot. Since pot is not legal medicine in this state, and smoking is not allowed in hospitals, I had to drag myself, along with my IV pole and several bags of fluids, down 10 floors. In my condition this was no easy task. I got to the front of the hospital ready to light up and discovered I had no matches. I asked an elderly woman for a light and she handed me her lit cigarette to use. So I lit the joint while explaining that it was medicinal. I'm sure she had no doubt as she looked at this walking skeleton dragging along his IV pole. I sat down and smoked about half the joint. My body relaxed and for the first time in over a week, I was able to enjoy the moment and breathe in some fresh, non-hospital air.

After several trips outside, I decided to smoke in my room since I did not have the energy trek downstairs as often as I needed. I had to blow the smoke out the window because of the smoke detectors. This worked pretty well except for when I almost pulled out my PICC line. But, that's another story. Let's just say smoking marijuana in a hospital room was quite difficult.

My condition improved and that turned out to be my last hospitalization. The next 10 months were filled with ups and downs as I fought to recover. I moved back east to be with my family since it was not clear whether I would be alive much longer. In October my weight was up to 145lbs. In November my weight dropped to 118lbs. By Christmas, I was at 124lbs. As I said, up and down. During this time my saving grace was the use of marijuana to help me eat and to lessen the effects of the crypto.

Perhaps the best testament to the medicinal value of marijuana are the converts from non-believers to true believers. My parents, my grandparents, my friends, my acupuncturist and others who witnessed the effects firsthand. Now you need to understand that I come from a family that was strongly against using pot. In fact, my parents kicked my brother out of the house and refused to help either of us through college because at the time we were pot smokers.

In Feb '97 I took my grandparents on a cruise. They saw me smoking pot before meals and they took my word for it that the drug was helpful. But, it wasn't until they saw what eating was like for me when I didn't smoke pot before a meal that they really believed. On a cruise, meals are timed, so if you're too late, you can't eat. We were running late and I didn't have time to roll and smoke a joint so we went to dinner without me smoking. I couldn't eat. I was nauseous with no appetite, and when I tried to eat anyway, I felt as though I was going to be sick. From that time on, my grandparents were constantly encouraging me to smoke before meals. The last part of that vacation was spent in Key West, where, I ran out of marijuana. While I was calling around to local AIDS support organizations to see if I might find some pot, My 87 year old grandfather was ready to hit the streets to find me some. He probably wouldn't have had a problem, but I wasn't about to let him get arrested.

My acupuncturist saw that marijuana was helping me, so she sent a woman my way who was suffering from horribly painful and debilitating MS. Unfortunately, due to the illegality of the drug and the difficulty I had acquiring it, I was not able to help her.

In May '97 I went to stay with friends in California so they could support me while I started my antiretroviral therapy. I had asked my friend to pick me up some marijuana since I was about out. She didn't realize I needed the pot right away, so I ended up running out before she was able to get more. My friend Nicole witnessed as the frequency and severity of my diarrhea increased and I was unable to eat. She was able to get me some pot the next day, but since my body had already started the cycle of dehydration, it took 3 days to recover. Nicole told me she was very sorry and that she had no idea that when I said I needed the pot, that I REALLY needed the pot. After I stabilized I was able to get to, and join, the local medicinal marijuana buyers club. Being able to acquire marijuana easily and legally, once proof of my condition was submitted, was both comforting and civilized. No longer did I have to worry about getting caught purchasing pot on the streets, or worse yet, running out and not being able to obtain more before my condition severely deteriorated.

By June '97 the antiretroviral therapy had begun working and my condition improved. The diarrhea stopped, I gained weight, and by July I no longer needed the IV therapy I had been on since December. My appetite returned and I no longer needed to use marijuana medicinally. So I stopped. I was very happy to discontinue using marijuana, for though I do enjoy getting high, being forced to smoke day in and day out to maintain your health has many downsides. Pot used regularly destroys your short term memory and tends to make you lazy and lethargic. It is also immunosuppressive, causes respiratory weakness, and very expensive, although I am planning on including the cost under medical expenses on my tax returns.

In November '96 California and Arizona approved measures that legalized marijuana for medicinal use. I remember when I was on vacation with my grandparents and the drug czar from the Clinton administration was on CNN talking about the measures and saying that there was no proof that marijuana had any medicinal value. Some people need to believe this is true because it fits their paradigm that drugs are bad. In many cases, this may be true, but as for the medicinal use of marijuana, it is not. I know better, for I have no doubt that using marijuana medicinally saved my life.

Also See Accompanying Article: "Legalizing Reefer Madness"



Last messed with November 15, 2001

Copyright(c) 2001 Michael E. Holtby, LCSW. All rights reserved.