Notes for a Biography

O’Shaughnessy’s • Dr. Tod’s Legacy —15— Notes for a Biography Tod Hiro Mikuriya was born in “One of the best features “I had done real psychiatry Eastern Pennsylvania in 1933 to Anna about [my] rotating internship (Schwenk) and Tadafumi Mikuriya. His was the on-call schedule of ev- on the locked ward at Fort Sam father was a Japanese Samurai who had ery fourth night and no ER. As a Houston —figuring out what it been converted by Lutheran missionar- result I was not operating at the was that had driven people to ies, his mother a German immigrant sleep deficit level that interns end up there and how to help and practicing Baha’i. Tod and his two and residents must endure at younger sisters went to Quaker meeting San Francisco General Hospital them.” —THM on Sundays. with their busy ER. My former “The Quakers were proprietors of the housemate from Philadelphia ward at Fort Sam Houston —figuring underground railway,” Tod reminded chose ‘the General’ because it out what it was that had driven people an interviewer in 1996. “The cannabis Practicing outside the barracks at Brooke Army sounded nice and prestigious. to end up there and how to help them. prohibition has the same dynamics as Medical Center in 1958. After Tod won first prize in When we finally were able to Then I found myself at Temple listening the bigotry and racism my family and the “vocal soloist” category in an All Army contest, get together for a quick supper, to these professors mouthing on about I experienced starting on December 7, the publicity photo at right was made. he fell asleep with his face in toilet training and these strange theories 1941, when we were transformed from his plate.” of behavior. I saw them as believers in normal-but-different people into war- unit in Germantown, PA, and excelled Tod chose to do his residency in the cult of Psychoanalysis. criminal surrogates.” on the pistol team. psychiatry at Oregon State Hospital in “I was impressed with how crazy Tod grew up listening to folk songs No mention was made of cannabis in Salem because it had a program that did analysands [people undergoing psy- on Burl Ives records and learned to play the lectures at Temple, but an unassigned not require him to undergo analysis. “I choanalysis ] became —totally self-ab- them on the guitar. Their lyrics and spirit chapter on the subject in a pharmacology had decided to become a psychiatrist,” sorbed and self-preoccupied. Definitely helped form him. textbook (Goodman and Gilman, 2nd Tod said, “despite my experience at in the grips of a cult that had grabbed the He prepped at the classy George edition) caught Tod’s attention in March, Temple Medical School, where psycho- controls of medical psychology.” School. He was almost expelled for pro- 1959, triggering the interest that would analysis was all the rage. Before that I Until 1964, Tod said, “my social drug testing a decision not to admit the chil- define his career. had done real psychiatry on the locked was alcohol, of course, and cigarettes.” dren of Ralph Bunche, a Black American “I somehow got the message not to He was reintroduced to marijuana by diplomat. “I was one of the few tokens, even discuss it with any of the profes- a resident of Salem —an IBM execu- and I began to see another side of the sors,” Tod said, looking back. “It would tive— with whom he “created a joint Quakers,” he recalled. “They’re tolerant, not have been good for my career to be- grow for experimental purposes.” Their but ‘not in my backyard.’ I became active come known as a person with an interest garden was in his friend’s backyard. “We in opposing universal military training in marijuana.” assumed no one would recognize these and went to lobby in Washington with He read everything on the subject plants,” Tod said, “and no one did. It was Southern Pacific Hospital, across Fell St. a family named Cushmore —liberals available in the library and resolved to from the Golden Gate Park Panhandle, below everybody’s radar.” from downtown Philadelphia. It wasn’t obtain and try cannabis himself —but where Tod was an intern. continued on next page official, the school didn’t authorize it, not in north Philadelphia, where an arrest didn’t approve. In many ways the Quak- could get him thrown out of med school. ers can be very rigid and authoritarian.” See “First Clinical Experiment,” below. Tod’s “Grand Tour” Tod got a scholarship to Haverford Internship and Residency To celebrate finishing his residency “Their attitude was very accepting and College but was expelled in the spring Tod chose to do his internship at Tod took a long trip that started and friendly. I spent two weeks there staying of his junior year after leading a panty Southern Pacific Hospital in San Fran- ended in Germany. He bought a new at cheap hotels in the Casbah.” raid on Bryn Mawr. He graduated in ’56 cisco. The SP railroad ran the hospital for VW in Goettingen, where sister Bev- Tod was told at the American Em- from Reed College, a place he dearly its workforce and also treated employees erly was studying. (Tod had learned bassy in Tangier that “They had never loved, where he studied psychology of Greyhound and a large trucking com- some German from his mother and met a constituent who had mingled with and had a full extra-curricular life that pany. “The coverage of health services studied it in college.) In Geneva he the Berbers as I had.” included playing football and was remarkable compared visited the United Nations Narcotics A consular official made arrange- folk music. with the privatized rationed Commission where an official showed ments for him to visit a mental hospital In ’57 he got drafted. care of today,” according to him an unpublished manuscript about where —according to the International After basic training at Fort Tod. “The physician had UN cannabis-suppression efforts in Bulletin of Narcotics— research had es- Lewis, Washington, he was control over the case and Morocco. Tod said he “used tracing tablished the harmful effects of cannabis. stationed at Fort Sam Hous- the patient could not return paper to trace the map and overlaid it on Tod interviewed the hospital superinten- ton, Texas as an attendant on to work without an OK. All a Michelin map and then I knew exactly dent and others involved in the cannabis the locked psychiatric unit at transportation and housing where to go.” program and “realized that they couldn’t Brooke Army Hospital. expenses were paid for by the On the Isle of Capri he met two have done any medical research at all. Sp4 Mikuriya got an early hospital. There was no limita- medical technicians from Baylor Uni- They didn’t have the capabilities. It was release from active duty to tion or restricted formulary. versity and the three of them continued an institution with 2,000 patients and on to Northern Africa, where they made four doctors.They didn’t have diagnoses attend Temple University Tod, a lanky 6’, played If a test or medication was School of Medicine. As a end (“wide receiver”) in not available it was ordered a shocking trio. Tod said goodbye to the as we know them. reservist he drilled with a high school and college. without question. women in Tangier after getting invited “They didn’t have any psychiatrists to visit a cannabis-growing area called in the whole of Morocco. I had to keep Katama. explaining that I was a doctor of the head “My first clinical experiment” “They had never seen any Western- because the word ‘psychiatrist’ meant In the summer of ‘59 Tod drove to jimson weed. I pulled one out and he ers there before.” Tod recounted. “They nothing to them. They didn’t have an Mexico in his Volkswagen beetle —“one took a few puffs and I said ‘thank you, made dinner for me native-style and I x-ray machine. They didn’t have a rudi- of those rare, new German imports.” He senor.’ He left, I locked the door and slept under the stars and the next morn- mentary laboratory. It was like a prison chose the town of Saltillo, inland from conducted my experiment. ing I had breakfast with the local chief camp without much security. People Monterey, a safe distance from the bor- “I found the experience interesting of police, who said, ‘My policy is, if it’s there were strange for one reason or der. “Obtaining marijuana for my first —fascinating. [Cigarette smokers know under two kilograms, it’s for their own another. It convinced me that what was clinical experiment turned out to be very how to inhale and can initiate marijuana personal use.’ put out in the International Bulletin of simple,” he recalled. “Got out of the car use effectively. Tod had been smoking “There were checkpoints all aound Narcotics was a bunch of crap.” and started walking towards the hotel and cigarettes since age 17.] I had this rush staffed by Berber warlords. The Ber- was accosted by a street entrepreneur of ideas and images. I can remember ber women didn’t wear veils, they all who said, ‘You want a girl?’ looking out the window and wondering carried guns. ‘Only for decorative and Tod asked for marijuana instead. As what it would be like to fly—not that I ceremonial use,’ I was assured by my he recounts the exchange: “‘Si, si, no felt any compulsion to do so, just musing hosts. Cannabis was growing every- problemo. Come with me in my taxi and about the sensation. Of course I wrote where, all along what passed for a road. we’ll go get it.’ ‘No, senor. You go get it down my impressions.” No utilities, no electrification, no run- and bring it here.’ The next day Tod drove on to Mexico ning water, just primitive. I picked this “He came back with a City where he shared the rest beauitful cannabis plant to take with me half-full cigarette pack of of his stash with two friends and a woman screamed. I thought ‘Oh rolled up joints and I told from Reed. In that “group con- my God, I’ve committed some terrible him I wanted him to come text,” he concluded that can- sin.’ But she was saying, ‘Don’t take up to the hotel room. He nabis was “easier to control that, I’ve got some that’s dried.’ looked a little apprehensive than alcohol... and, relatively “They were aware of Interpol and but all I wanted was for him speaking, no big deal.” police sweeps but cannabis was all over to smoke some first. I was a This foray satisfied his the place. You go for a shishkebab in naive gringo and I wanted curiosity and Tod would have the main square and automatically, out to be sure that it was safe, nothing to do with cannabis comes the supsi pipe. It was part of the that it wasn’t loco weed or for five years. deal —the appetizer,” Tod laughed. Hands-on research in Morocco, 1966.

Copyright 2012 by Fred Gardner. All rights reserved. Address reprint requests to [email protected] —16 — O’Shaughnessy’s • Dr. Tod’s Legacy

Notes for a biography from previous page

Whereas Tod had loved Portland communities.” Wisconsin Avenue in Chevy Chase.” while attending Reed, he did not find What the politically sophisticated Tod was assigned by NIMH The “repressed bureaucrats” who many kindred spirits in Salem. He began scientists saw in Tod was a potential to visit Northern California debriefed him upon his return seemed smoking marijuana on a daily basis and intelligence asset —an earnest young “to spy on hippies and find to Tod “obsessed with the image of bra-less hippie chicks.” When it was “experimenting with it surreptitiously in doctor with first-hand knowledge of the out what kinds of influence different social contexts. As in ‘I wonder emerging counterculture. They soon discovered that he had brought back a what it would be like to turn on and then steered him to a job in Washington, marijuana was having on this kilo of marijuana to distribute to fellow not drink any alcohol at this cocktail D.C., with a prestigious title —“director subculture that was perceived users at NIMH, Tod was asked to resign. party?’ So, I tried that — —what an of non-classified marijuana research for as a clear and imminent threat He wasn’t fired outright because NIMH eye-opening experience! Jesus Christ! the National Institute of Mental Health wanted to avoid negative publicity and What a boring bunch!” (NIMH) Center for Narcotics and Drug to national security.” further exposure of their staff. “They In 1965 he left for Mendocino State Abuse.” would have had the Justice Department Reviewing the research grants that the overwhelming majority of marihuana clearing out everybody’s workplace,” NIMH was funding in 1967, Tod was users not turning to ‘hard’ narcotics.” Tod reflected. struck by how much money was going The course of action Tod advocated During his year in Washington Tod to projects that involved spying on mari- was regulation of marijuana under the spent as much time as possible read- juana users —“Drug Use Among College Food and Drug Administration. This ing and photocopying cannabis-related Students,” “Identity and information would “impose a public-health rather material from the National Library of control in social deviants,” “Psychosocial than an enforcement approach to the Medicine. Since 1964, he had been com- networks of young, dangerous drug us- problem. This proposed shift in re- piling a master bibliography of writings ers,” etc. etc. sponsibility would formalize Federal on every aspect of the subject, and trying “They were funding searches for recognition of the dissimilarity between to locate the texts themselves, not just for harmful effects and detection methods,” truly addictive agents and marijuana. his own education but for possible inclu- he would recall, “and some mechanism- Classification of marijuana use as a sion in an anthology that would serve of-action’ studies. No interest in benefi- psychosocial rather than a criminal as a textbook for his fellow physicians. cial effects.” problem will facilitate a more rational In late 1967 Tod decided to depart Tod wrote and submitted to the NIMH and scientific approach to understanding, Washington and “the court of Lyndon higher-ups a six-page, single-spaced education and control. Critical research, Johnson” to finish his anthology in the “Position Paper on Marihuana” calling particularly reliable epidemiologic San Francisco Bay Area. He worked Cover page of the master bibliography for a major change in U.S. government studies, would become possible if there part-time for the Alameda County Alco- Tod began compiling in 1965 and added policy. Tod’s paper was formal and suc- were no legal sanctions against self- holism Clinic and for the state Depart- to throughout his life. He hoped to bring cinct as an abstract; it covered “History identification of users.” ment of Rehabilitation, and faithfully out an expanded version of Marijuana and Description; Pharmacologic Action; on Marijuana Medical Papers. As of Medical Papers to include texts that had Tod’s bosses at NIMH were not October, 1969, he was seeking advice come to his attention since its original Epidemiology; Physical, Emotional and interested in distinguishing between publication in 1973. Social Sequelae; Legal Status; Culture “soft” and “hard” drugs. They ignored from Osmond about a possible publisher. and Mores; Possible Courses of Action.” his practical suggestion for reform. In 1970 he bought a house on a steep hillside above Berkeley. It cost $36,000 Hospital to finish his residency. “This Tod’s position paper stated: “Marihua- Before long he realized that what the and had a view across the bay to San was right before the California mental na is not an addictive drug in that it does higher-ups wanted was “to find anything Francisco. Owning this pleasant dwell- hygiene system was dismantled by not produce physiologic or psychologic that’s wrong with marijuana so that we ing gave Tod a sense of basic financial Ronald Dinosaur [Reagan] and his ilk dependence, or lead to tolerance, defined can develop a propaganda campaign.” security that helped him withstand the in Sacramento,” Tod said. “The superin- as the need for increasing dosage to ob- U.S. military involvement in Vietnam threat decades later when the medical tendent, Ernest W. Klatte, MD had taken tain a pharmacological effect... was escalating in 1967 and so were board sought to revoke his license and LSD as well as peyote and so had some “What is not clear is the extent to protests by civilians and disenchant- fine him $75,000. of the staff. which marihuana precipitates psychiatric ment among GIs. Tod was assigned by Soon after arriving in California Tod “At that point I was increasingly disturbance as contrasted to accelerating NIMH to visit Northern California “to became a pro-cannabis political activist drawn to psychedelia and had read the acute decompensation in an individual spy on hippies and find out what kinds of (as recounted in pieces that follow by ‘The Doors of Perception’ by Aldous whose function is already borderline influence marijuana was having on this Michael Aldrich and Gordon Brownell.) Huxley. I knew that Huxley had been from a psychiatric standpoint... subculture that was perceived as a clear “The relationship of marijuana use In 1970 he began a 21-year stint as an inspired by mescaline administered by and imminent threat to national security to subsequent heroin addiciton was at attending psychiatrist at Everett A. Glad- Dr. Humphry Osmond, who coined the because of their anti-war proclivities... one point the subject of considerable man Memorial Hospital in East Oakland. word ‘psychedelic.’ So, I applied for a “I recognized before I went out there contention. At this time it seems clear See recollections from his longtime position at the New Jersey Neuropsy- that I was really one of them, not one of that there is no causal connection, with the people I was working with at 5151 research assistant, Barbara Schneider, chiatric Institute, a regional treatment on page 18. and research center near Princeton where Osmond was studying the neurological basis of schizophrenia.” The Indian Hemp Commission Report Osmond and other researchers were Tod would refer to The Indian which witnesses answered in writing laziness or habits of immorality or also studying the effects of psychedelic Hemp Drugs Commission Report of and elaborated on in oral testimony. The debauchery?.. Does it deaden the intel- drugs and some used them to induce 1893-94 as ‘my introduction to the responses were quoted at length in the lect or produce insanity? If it produces disorientation akin to mental illness. pre-prohibition medical literature on Report, resulting in a 3,281-page opus insanity, then of what type, and is it Tod was not involved in these unethical cannabis... In 1967, when I was in —“by far the most complete and sys- temporary or permanent?...” projects during his year in New Jersey. charge of setting up research funding tematic study of marijuana undertaken The Commission concluded that He worked in the addiction treatment patterns and priorities for the National to date,” Tod wrote in 1967. “moderate use of hemp is the rule” center, mainly with heroin addicts. Once Institute of Mental Health, I ordered and “Because of the rarity and, perhaps, and “the effect on society is rarely a patient under his care relapsed while received the 7-volume report from the the formidable size of this document, appreciable.” Tod wrote, “The Report on pass and returned to the Institute with National Library of Medicine archives. the wealth of information contained in it recognized the comparative safety of heroin. Tod’s chief nurse called the state For the next six months I carried the has not found its way into contemporary cannabis [and expressed] concern that police, who took the patient off to prison documents with me and photocopied its prohibition would cause the use of over Tod’s objections. selected sections.” more dangerous drugs... It is both sur- Soon thereafter a high-ranking re- British governors in India began tax- prising and gratifying to note the time- searcher named Carl Pfeiffer showed Tod ing cannabis sales in 1793, ostensibly less and lucid quality of the writings of a safe in his office filled with illicit drugs, “to check immoderate consumption, these British colonial bureaucrats. It including hashish and LSD. Tod could and at the same time to augment the would be fortunate if studies undertak- not understand why Pfeiffer and Osmond public revenue.” In 1893, responding en by contemporary commissions, task were so cavalier about contraband on the to reefer-madness-type rumors, the force committees, and study groups Institute premises. House of Commons decided to get the could measure up to the standards of Not until 1986, when Acid Dreams facts about cannabis production and thoroughness and general objectivity by Martin Lee and Bruce Shlain was consumption and to assess its effects embodied in this report. In the current published, did Tod learn that the In- in Bengal Province. The Indian gov- context of violently polarized attitudes stitute honchos had CIA and Military ernment then created a seven-member writings on this subject. This is unfortu- toward marijuana, the prospect of a Intelligence connections. Back in ‘67 he commission and expanded the scope of nate, as many of the issues concerning study of similar stature is bleak.” respected them as leaders in his field of the investigation to include the whole, marijuana being argued in the U.S. today Tod’s 1967 paper on the IHDC Re- special of interest —psychotropic drugs. diverse country. were dealt with in the Report.” port was written with an eye towards He particularly admired Osmond for le- In a year and a half the Commission Among the questions the Commis- interesting a publisher in reprinting gitimizing “the personal- introspective, visited 30 cities in eight provinces and sion asked about hemp: “Does it impair the massive study, but that never hap- scientific-explorative use of psychedelic held 86 sessions at which they heard the constitution in any way? “Does pened. In 1994 he arranged for Last drugs. This was (and is) considered her- from 1,193 witnesses (including 214 it injure the digestion... does it cause Gasp Press in San Francisco to bring esy by the psychological and psychiatric medical officers and 144 cultivators). dysentery, bronchitis, or asthma?... out a condensed, one-volume version. They used a 70-item questionnaire, Does it impair the moral sense or induce O’Shaughnessy’s • Dr. Tod’s Legacy —17—

“Another chapter in our suppressed history...” The Army’s Conquest-by-Cannabinoid Fantasy Tod Mikuriya had been led to believe had ingested THC being Ketchum says the media has by Van Sim, MD, a director of research questioned by an un-threat- at Edgewood Arsenal in Maryland, ening authority figure: conflated the ethical, scientific that classified studies in the 1950s had Q: How are you? drug studies conducted by the established the anti-seizure properties A: Pretty good, I guess. Army on knowing volunteers of marijuana. (See graphic at bottom of Q: Pretty good? page.) Gaining access to the marijuana A: Well, not so good with the kinky, unsafe drug studies done at Edgewood was one of maybe. studies conducted by the CIA many projects on the to-do list that Tod Q: You’ve got a big grin on unwitting civilians. carried through life. on your face. In 2004 he crossed paths with James A: Yeah. I don’t know the ratio of the number of applicants to Ketchum, MD, the psychiatrist who led what I’m grinning about the number accepted increased progres- the classified research program at Edge- either.... sively throughout the 1960s.” wood in the ‘60s. Although Ketchum, Q: Suppose you had to When Ketchum arrived at Edge- who had retired in 1976 as a colonel, get up and go to work now. Major James Ketchum, MD, interviewing a test subject wood in 1961 the detachment of test at Edgewood Arsenal. didn’t shed light on the Army’s studies of How would you do? subjects consisted of 20 men. By 1963 marijuana as an anti-convulsant, he had A: I don’t think I’d even care. Evidently, the dream lives on! it was 50. “Eventually a cohort of 60- other historical info of interest to Tod. Q: Suppose the place was on fire? Ketchum’s presentation to the pro- 80 arrived, requiring the prior review The U.S. Army, in a search for “non- A: I don’t think it would be —it cannabis MDs was followed by a suc- of as many as 300-500 applicants.” lethal incapacitating agents,” tested would seem funny. cinct chemistry lecture by Alexander Some 7,000 enlisted men took part in cannabis-based drugs on GI volunteers Q: It would seem funny? Do you T. Shulgin, PhD. It was Shulgin who the program, most between 1961-70. at Edgewood throughout the 1960s ac- think you’d have the sense to get up gave Harry Pars the idea to synthesize “None, to my knowledge,” writes Ket- cording to Ketchum. Tod invited him to and run out or do you think you’d just nitrogen analogs of THC back at the start chum, “returned home with a significant describe the experiments in detail at the enjoy it? of the ’60s. Later in life Shulgin gained injury or illness attributable to chemical Society of Cannabis Clinicians meeting A: I don’t know. Fire doesn’t seem renown for designing “designer” drugs, exposure. Nevertheless, years later, a March 9, 2007, in Los Angeles. to present any danger to me right now. including MDMA. [Note the realism of the test subject The session Camelot’s ideal weapon: and the scientist’s flight of fancy.] was organized and one that leaves the infrastruc- Q: Can you think of anything now moderated by SCC founder Tod Miku- ture intact and the population which would seem hazardous or worry you or are you just in a— riya, MD, who de- manageable. A: No. No. Everything just seems scribed the talks by funny in the Army. Seems like every- Ketchum and Shul- Ketchum was a young captain fin- thing somebody says, it sounds a little gin as “another chap- ishing a residency at Walter Reed Army bit funny. ter in our suppressed Hospital when he got assigned in 1961 The Dream Dies Hard history.” to be the supervising psychiatrist at When the eight isomers of EA 2233 Only a small frac- Edgewood Arsenal. The new president, were isolated and purified in the years tion of Ketchum’s John F. Kennedy, was enthusiastic about following 1964 they were tested by an work at Edgewood funding the search for non-lethal inca- Edgewood doctor named Fred Sidell involved THC deriv- pacitants (first authorized by Eisenhower (while Ketchum focused on more prom- atives. Ketchum says Many soldiers considered a two-month stint at Edgewood in 1958). Camelot’s ideal weapon: one ising incapacitants, mainly an atropine he was motivated to Arsenal good duty. Some 7,000 enlisted men took part in the program in the 1960s. that leaves the infrastructure intact and derivative known as BZ, and LSD). Two write his memoir to the population manageable. of the THC isomers caused such a dra- distinguish the ethical, scientific drug few former volunteers did claim that the The synthetic analog of THC tested matic drop in blood pressure, according studies conducted by the Army on know- testing had caused them to suffer from by the Army in pursuit of this ideal, EA to Ketchum, that the lab stopped testing ing volunteers from the extremely kinky, some malady.” 2233, was developed by a chemist named all of them. unsafe drug studies conducted by the Those claims came from subjects Harry Pars employed by the Arthur D. Ketchum still wonders if one of the CIA on unwitting civilians. “Chemical exposed to agents other than EA 2233. Little company of Cambridge, Mass. It two potent isomers would work as an Warfare: Secrets Almost Forgotten” is Ketchum questions their validity, noting was a mixture of eight stereoisomers of incapacitant. “The finding that isomers 2 published by ChemBook, 2304 Fairbanks “None of the three careful follow-up the THC molecule (different arrange- and 4 possessed uniquely powerful pos- Drive, Santa Rosa, CA 95403. Learn studies found statistical evidence for ments of the same atoms). EA 2233 was tural hypotensive effects that prevented more at any particular illness, and death rates ingested at strengths ranging from 10 to standing without fainting led Sidell to forgottensecrets.net were lower than expected for every drug 60 micrograms per kilogram of body discontinue testing out of an abundance A chapter of Ketchum’s book is de- tested, except for non-significant higher weight. Although its effects lasted up to of caution for the welfare of the subjects. voted to what we now called “informed rates in those who received atropine or 30 hours, they were not potent enough It later occurred to me that this property, consent.” GIs considered Edgewood scopolamine.” for military purposes. in an otherwise non-lethal compound, Arsenal good duty and volunteered with Ketchum said at the Society of Can- Ketchum excerpts an interview with might be an ideal way to produce tem- alacrity for the two-month stint. Ketchum nabis Clinicians meeting that he and a GI on EA 2233 in a self-published porary inability to fight (or do much else) writes, “We never needed to browbeat, his staff at Edgewood Arsenal had no memoir. The responses are pretty much without toxicological danger to life.” threaten or hint at repercussions for inkling EA 2233 in low doses might be what you’d expect from someone who someone’s unwillingness to participate therapeutic. “We weren’t looking for in a drug test. Invariably, would-be vol- benefit,” he acknowledged. unteers inundated us with applications, Ketchum mentioned that Hitler was year after year. so afraid of chemical weapons being “An abundance of troops were obvi- used against him that he wouldn’t au- ously more than willing to jump through thorize the use of thousands of tons of all the hoops required in order to make nerve gas the Nazis had synthesized and

the list of accepted candidates. In fact, stockpiled. That was news to me. —FG photo by Judy Ketchum Judy by photo

Anticonvulsant potential of marijuana was mentioned in a 1968 paper entitled “Medical Research on Drug Problems of National Importance” by Van M. Sim, PhD, MD, who had directed cannabis research at Edgewood Arsenal 1954-1959. In response to Tod’s request for information about the studies in 1971, Sim said the work was Alexander Shulgin, James Ketchum, and Tod Mikuriya (with videocam, char- classified. One day in the 1980s, Tod said, he got a call “out of the blue” from Dr. Sim, acteristically). Shulgin, a chemist, gained renown as the creator of “designer” drugs, who told him that very promising studies had been conducted at Edgewood in the ‘50s. including MDMA. Back in the ‘60s he had suggested the synthesis of nitrogen analogs Four decades later, in Californi, Mikuriya encountered many patients with epilepsy and of THC —drugs which Ketchum would test on GI volunteers. Photo was taken in 2004 other neurological disorders who reported using marijuana to reduce the occurence when Shulgin hosted a picnic at which he introduced Tod to Ketchum (who recalled and severity of seizures. Tod contacting him back in the ‘70s to ask about his work). A warm friendship ensued.

Copyright 2007, 2012 by Fred Gardner. All rights reserved. Address reprint requests to [email protected] —18 — O’Shaughnessy’s • Dr. Tod’s Legacy Tod in the ‘70s and ‘80s: A Practicing Psychiatrist Under Prohibition Back in 1971 Barbara Schneider thought would benefit from biofeedback answered a classified ad ­—psychiatrist he gave me a detailed set of instructions “If you came to him with a problem that he could treat, he seeking research assistant— that had —what to look for with this patient, what would treat you —and he would treat you with great dignity. been placed by Tod Mikuriya. to work with. I would do that, chart it, That’s how Tod practiced medicine.” —Barbara Schneider Schneider, a Stanford psychology and he would read the chart and discuss major with relevant job experience, ap- it with me.” have remained in the pharmacopaea. to be sent to the hospital for treatment. plied and got hired. She would work for Did Tod ever suggest to patients But because you couldn’t prescribe it for That’s when the other doctors decided Tod for 13 years in various capacities. that smoking marijuana might reduce anybody, he didn’t do that. His interest in that these addicts and alcoholics weren’t In ‘71 Tod’s office was at Everett stress? According to Schneider, “Tod marijuana was on the political side. He so bad after all and started treating them. A. Gladman Memorial Hospital in East always believed that marijuana should did things in the political arena to try to “Tod had been treating them all along. Oakland. “Tod was seeing his own move it towards being legalized, but he He was the kind of doctor who, if you patients and patients admitted to the didn’t use it in his practice.” came to him with a problem that he could hospital,” Schneider recalled in a recent Tod had established a treatment treat, he would treat you and he would interview. “Only Tod and one other program for heroin addicts at Gladman treat you with great dignity. That’s how doctor were willing to treat people with in 1970 —the first such program in Al- Tod practiced medicine. drug-related problems at that time. It ameda County. He wrote the protocol, “He had an amazing, caring attitude wasn’t until the mid- ‘70s that the insur- which involved de-toxing people by pro- towards patients. There are many good, ance companies started reimbursing for viding methadone in diminishing doses caring doctors —I’ve worked with a drug treatment and it became a lucrative until a maintenance level was achieved. lot of doctors in different branches of thing to do.” According to Schneider, “This program medicine— but with Tod there was a Research projects on which Schnei- morphed into Gladman’s chemical de- little bit more. I really respected him as der assisted Tod in the early ‘70s in- Tod with a vintage Studebaker. Mechan- pendency program when the insurance a physician. I don’t know how to explain cluded a collaborative effort with a UC ically adept, for many years he worked on his own cars. He was a licensed pilot, too. companies started paying for people it. He was special.” Berkeley biologist to find a metabolic marker for schizophrenia (shades of Humphry Osmond), and a clinical trial in which schizophrenic patients and a A Pro-Cannabis Political Activist By Gordon Brownell control group were given megadoses of sociation, one of his heros, who resisted Activists in this period were I first met Tod Mikuriya in December, Vitamin C (as part of a large-scale study Harry Anslinger’s efforts to outlaw mainly interested in the rec- being conducted by Linus Pauling). 1971, at a meeting in the Haight-Ash- marijuana through the enactment of the reational use of marijuana. Schneider also did editorial and bury home of community activist Rene Marijuana Tax Act in 1937. Thus began clerical work on “Marijuana Medical Cazenave, where some of the original a friendship which would last for more Tod was virtually alone in his Papers,” which Tod brought out under organizers of the 1972 California Mari- than three decades. focus on marijuana’s medical his own imprint in 1973. juana Initiation (CMI) had gathered to Tod and I made media and speaking It was also in 1973 that Tod and discuss the final language of the initia- history. hospital director Arthur E. Gladman, tive to be submitted to the Secretary of MD, developed a strong interest in bio- State. Leo Paoli, Michael Aldrich, and Steinfeld and Tod had a lively exchange feedback, a stress-reduction technique. other organizers of CMI were present, which ended up being the highlight of Gladman arranged for Tod and him- as was Tod. the evening. self, —and their assistants, Schneider That evening represented my first (Though Steinfeld took the Nixon and Norma Estrada— to get trained by introduction into marijuana politics Administration line in his responses to leading practitioners in the field, Elmer in California after having previously Tod’s questions, in recent years, I under- and Alyce Green of the Menninger worked at the Nixon White House and on stand that he has become a proponent of Foundation. the staff of Governor Reagan’s 1970 re- a patient’s right to use cannabis under Biofeedback involves using de- election campaign. I had moved back to the treatment of a physician, something vices that can measure the tensing of D.C. from California in the late summer which would no doubt please Tod.) a patient’s muscles, skin temperature, of 1971, where I had met Keith Stroup Activists in this period were mainly sweating, brainwave activity, and other and started doing some volunteer work interested in the recreational use of processes that the patient can try to for NORML. marijuana. Tod was virtually alone in consciously control. While I was at NORML, I met his focus on marijuana’s medical his- “Tod used biofeedback to teach Blair Newman, one of the founders of “Acapulco Gold” rolling papers were tory. You could find references to it psychiatric patients to exercise self- Amorphia, the Cannabis Co-op, one of sold by Amorphia to finance the California in text books on the subject, but it was control,” says Schneider, who became the earliest groups formed to legalize Marijuana Initiative in 1972. really unknown. When Tod published certified as a biofeedback technician. marijuana. Blair invited me to fly back “Marijuana Medical Papers” in 1973, “Tod was always interested in things that to California for the December meet- appearances and also traveled together many regarded the subject as antiquated were new and different. Biofeedback ing of the CMI organizers and he later during the 1972 CMI campaign. (San history, not something that was coming was one that stuck. recruited me to return. In April 1972 I Francisco drug treatment expert Joel down the track. Tod was way ahead of “He was one of the first doctors to became the statewide political coordina- Fort, MD, was the principal medical the curve. videotape families and people interact- tor for the CMI campaign and joined the spokesperson.) Tod was a psychiatrist on the staff of ing. He would play the tapes back so staff, board and family of Amorphia in On one occasion we flew to San Di- Gladman Hospital throughout the 1970s they could see how they were relating to Mill Valley. ego in late October of 1972 to attend a and he was the Chair of the Department each other. He was doing that at Glad- big hotel dinner, where lots of physicans of Psychiatry at Eden Medical Center man when I first started working for him. In Tod, I found another lib- and health professionals were present, during part of that decade, in addition to working at several other hospitals. He taught me how to film and edit.” ertarian Republican (not yet and where the Surgeon General of the Tod also developed an interested United States, Dr. Jesse Steinfeld, was Tod also maintained his own private in orthomolecular psychiatry, which is an extinct species) who talked the featured after-dinner speaker. psychiatric and consulting practice at based on the idea that disease results about individual freedom and There was a question period fol- the Claremont Resort Hotel in Berkeley, where he could be found on the tennis from missing elements in the diet — keeping the government out of lowing Dr. Steinfeld’s talk and our goal highly plausible in a country where was to get Tod recognized as someone courts several days a week. the soil has been depleted of essential our homes and private lives. who could ask an after-dinner question After the defeat of CMI in 1972, the nutrients. of him. We were both dressed in suits prospects for marijuana decriminaliza- In the mid-70s Tod and Arthur Glad- Amorphia sold Acapulco Gold ciga- and ties, like the rest of the men in the tion in California seemed pretty bleak. man began seeing patients in an office rette papers and used the proceeds to audience, and Tod raised his hand and Ronald Reagan was Governor and he at the Claremont, a grand old hotel in fund CMI, which had made the ballot as got called upon; then he confronted the had vetoed legislation to reduce the the Berkeley Hills. Schneider worked Proposition 19. Tod was also a member unsuspecting Dr. Steinfeld with a series penalty for possession of marijuana for Tod part-time while setting up and of the Amorphia Board. In Tod, I found of questions about why the Nixon Ad- from a felony to a misdemeanor. But running a biofeedback department at another libertarian Republican (not yet ministration was not implementing the good things were happening on other Gladman Hospital. an extinct species) who talked much of recommendations of its own National fronts. A Consumers Union report and Most of the people for whom Tod the same language I did about individual Commission on Marijuana and Drug the LeDain Commission in Canada came recommended biofeedback were out- freedom and keeping the government out Abuse and whether Steinfeld supported out with recommendations in 1972 that patients with headaches, chronic pain of our homes and private lives. Proposition 19. marijuana be either decriminalized or and other stress-related ailments; some I loved listening to the stories Tod Marijuana was not the topic Dr. legalized. Change was in the air. were psych patients at Gladman. “Tod would tell about cannabis and the British Steinfeld had come to talk about that In early 1973, AMORPHIA decided would do an intake interview and set up Army in India in the 1800s, the Indian night, and many of the conservative- the time was right for California to have a course of treatment,” says Schneider. Hemp Commission, and Dr. William leaning doctors in the audience ap- its own “Marijuana Commission.” Our “When he referred a psych patient he Woodward of the American Medical As- peared shocked by Tod’s questions, but continued on next page O’Shaughnessy’s • Dr. Tod’s Legacy —19— Prop 215: Victory and Disimplementation “A unique research opportunity” is of cannabis to prescriptive availability two cents. how Tod Mikuriya, MD, described the is indicated.” There was consensus among the Cannabis Buyers Club that Dennis Peron Membership in the SFCBC grew drafters that the bill should protect all launched in San Francisco’s Castro steadily in the early ‘90s as people with medical users, says Gieringer. Mikuriya District —then ground zero of the AIDS conditions other than AIDS joined. Tod had documented the wide range of epidemic—in late 1991. continued interviewing members and medical problems that SFCBC mem- Dennis had drafted and successfully updating his master list of conditions bers were using cannabis to cope with. campaigned for Proposition P — a re- treated successfully with cannabis. He suggested wording that conferred quest by San Francisco voters that “Li- The Run-up to Prop 215 protection not just on cannabis users censed physicians shall not be penalized “The movement that had been asleep treating certain specific illnesses but on for or restricted from prescribing hemp for 20 years woke up when the medical those treating “...any other illness for preparations for medical purposes to dimension emerged on the scene,” says which marijuana provides relief.” And any patient.” Prop P passed by a 4-to-1 veteran organizer Pebbles Trippet. Activ- continued on next page margin and the city supervisors passed ists using Dennis’s club as their informal a corresponding resolution that Dennis headquarters helped draft and lobby for would cite as “the authority by which medical-marijuana bills introduced in the buyers club will supply cannabis to 1994 and ‘95 by State Senator John Vas- those who can benefit by it.” concellos (D. Santa Clara). Both times Tod drafted an intake protocol for the bills were narrowed in the legislature the club — a letter of diagnosis from a to apply only to patients suffering from licensed physician was the key require- TOD PLAYING at a rally in front of AIDS, cancer, multiple sclerosis, and ment (which Dennis would waive for ap- San Francisco City Hall in 1992. Dennis glaucoma. And both times the bills plicants 65 and older). Tod also arranged Peron, proprietor of the nearby Cannabis were vetoed by Republican Governor to interview members willing to take Buyers Club, was running for office. Pete Wilson. part in a study. The result was a formal 1, followed by migraine/vascular head- “It’s a good thing Wilson vetoed those paper that Tod eventually posted online, ache 11, cancer/cancer chemotherapy bills,” says Trippet, looking back. “Cannabis Medicinal Uses at a ‘Buy- 10, asthma/cough 9, itching/hiccough Dennis and his allies responded with ers’ Club.” It was based on data from 8, epilepsy 5, glaucoma 4, drusen of the a popular initiative —a ballot measure 57 SFCBC members (41 HIV+). They optic chiasm 1, post-traumatic stress dis- that would legalize marijuana for medi- reported using for multiple purposes, order 1, and pre-menstrual syndrome 1.” cal use and could not be vetoed or legally according to Tod’s abstract: Tod concluded: “Cannabis is not a altered by politicians in Sacramento. “Anorexia/nausea/vomiting/diarrhea new drug. Medicinal applications report- Dennis and Dale Gieringer of California 39, anxiety/panic attacks/depression 39, ed by self-medicating buyers would ap- NORMLwrote a first draft in July ’95. AIDS related illness 35, arthritis and pear to reconfirm descriptions in clinical It was revised in extended discussions Dennis in the doorway of the San Fran- other pain 22, muscle spasm 19, harm re- literature before the drug was removed that included Dennis’s lieutenant John cisco Cannabis Buyers Club, 1444 Market duction: alcohol substitution 12, opioid from prescriptive availability. Further Entwistle, attorney Bill Panzer, Tod, St. From his office on the second floor the Prop 215 campaign was launched in 1995. substitution 6, amphetamine substitution clinical study is warranted. Restoration Valerie Corral, and others offering their Activist from previous page

efforts and those of our key ally, Senate decriminalization bill, SB 95, which was platform. McCaffrey, who had ridiculed Tod’s Democratic Leader George R. Moscone enacted by the Legislature and signed In 1981, I got to spend some special medical marijuana practice and studies of San Francisco, ultimately led to the into law by Governor Jerry Brown in time with Tod. I had graduated from on national television. We ended up not state senate establishing a Select Com- the summer of 1975, ending decades law school in 1969, but was interested pursuing any legal action — I think it mittee mandated to review California of California laws which punished pos- more in politics than practicing law at was a question of time and money, plus laws controlling the use and availability session of as little as a single joint as a that time. When I finally decided to take the Conant v. McCaffrey suit was in the of marijuana. felony by up to 10 years in state prison. the California Bar exam in ‘81, Tod of- works, with lots of resources and some The Senate Select Committee on After SB 95 was passed, Tod con- fered me the downstairs bedroom of his really important goals. But it was fun Control of Marijuana held public hear- tinued to make occasional trips to Berkeley Hills home as a place to study, while it lasted. ings in Los Angeles and Sacramento in Sacramento to help advance marijuana away from the distractions of my San My wife and I visited Tod in August, 1973 and 1974. Testimony was presented reform legislation, including Willie Francisco apartment 2006, which was our last real get- from a wide range of law-enforcement, Brown’s “grow your own” cultivation I spent those few weeks living with together. We spent a few hours having legal and medical experts. Private citi- bill in 1976-1979 and Senator Robert Tod, in May and June of 1981, sleeping lunch at his home, where he showed us zens such as Art Linkletter testified, as Presley’s bill establishing the Cannabis and working downstairs at night while pictures of his recent college reunion at did Michael Aldrich, Tod and I. Our Therapeutic Research Program in 1979- taking Bar review classses at Boalt Hall. Reed and of his son Tada (Sean), and his analysis documented that California 1980, which Tod had a lot of problems Tod and I would share dinners together, daughter, Hero. Tod looked good that day spent about $100 million enforcing its with, but which represented California’s which he prepared, and then I would go and he spoke of his cancer diagnosis and marijuana prohibition in 1972, a year first official steps towards recognizing downstairs and read Bar exam books. prognosis as something which were not in which more than 76,000 marijuana the therapeutic benefits of cannabis. Tod was generous with his home and I going to slow him down, though he had arrests were made in the state. With his short hair, sharp clothes and have very fond memories of those weeks no illusions about how serious his con- Our “Costs of California Marijuana pleasant smile, Tod was a good spokes- we spent together as roommates. dition was. Tod was enthused about his Law Enforcement” study was included person in the legislative arena. He par- After establishing my law practice, upcoming archival and writing projects, in the Final Report of the Select Com- ticularly liked it when he could confront I would see Tod socially and often used along with continuing to see patients. mittee, which recommended “decrimi- a conservative Republican legislator and him as an expert witness or consultant in Tod was a wonderful man, a devoted nalization of marijuana possession for go up to him and say something like “Hi. cases in which my clients had lost their father, a caring and generous physician, a private use.” I’m a medical doctor and a Republican. jobs due to drug testing. fearless challenger of the forces of dark- Sen. Moscone cited both the com- Do you support decriminalization of In January, 1997, Tod asked me to ness and ignorance and a special friend. mittee report and our fiscal analysis in marijuana and getting the government represent him in a defamation lawsuit I know that I am but one among many arguing for passage of his marijuana out of our private lives?” against Clinton’s Drug Czar Barry who miss him deeply. Tod also got in- volved in candidate politics, hosting a NORML-sponsored fund-raising party at his Berkeley home for Democratic Senator Nicholas Petris of Oak- land, a key supporter of marijuana law reform in Sacramento. And, in 1980, Tod ran as the Libertarian Party can- didate for Congress; Hero Mikuriya (above with dad) is now up against Democratic a junior-high school student in the East Tod, Jack Herer and Fred Oerther July, 1984, after Congressman Ron Bay. Tada “Sean” Mikuriya, 35, is a handing in more than 85,000 signatures to put the Oregon Dellums he garnered guitarist who has released Latin-Rock Reggae Roots album and a Dance Hall Marijuana Initiative on the ballot. The Secretary of State then about 5% of the vote and meditation CDs through bludolphin- Dub album with Ralston Grant. His website is pelican pondstudios.com. disqualified enough —illegible signatures, new addresses, on an individual free- publishing.com. He is working on a solo continued on next page registering after signing, etc.— to undermine the effort. dom and pro-marijuana —20 — O’Shaughnessy’s • Dr. Tod’s Legacy Victory and Disimplementation that’s how the initiative was sent to the “In a country that pushes of it spent taking the patient’s history. made plans with his son Sean to reissue Secretary of State. Prozac to shy teenagers, all mari- As a psychiatrist, Tod did not conduct “Marijuana Medical Papers.” He had The Professionals Take Over many visits from his 12-year-old daugh- juana use is medical.” a physical. By the start of 1996 it was becoming Tod also saw patients at his home ter, Hero; they even went cross-country apparent that Dennis’s plan to collect sig- —Dennis Peron office in the Berkeley Hills. skiing one weekend. He attended the natures through a network of volunteers “I lost my office at the Claremont dedication of a laboratory named in was coming up short. A New York based option. And federal officials were threat- Hotel after Prop 215 passed,” he re- his honor at Holy Names University in reformer named Ethan Nadelmann, ening to revoke the prescription-writing counted. “There was a big crush of Oakland. “How wonderful,” he said of backed by George Soros and other bil- privileges of doctors who approved people wanting to see me —patients that honor. “Who would have thought lionaires (Peter Lewis, John Sperling, marijuana use. for certification, journalists for stories, this would happen?” and Laurence Rockefeller), offered to Tod contacted the medical board and police for surveillance or verification.

offered to teach them what he knew.

Hero by Mikuriya fund a professional signature drive that Redwood City police requested of the photo could get the medical-marijuana initia- Tod was not a cynical person —quite management that they keep me under tive on the California ballot... on the the contrary, he thought real-world close observation. That outraged them condition that Dennis Peron be replaced government agents ought to comport but scared them at the same time. So, as campaign manager by a Santa Monica themselves according to the principles after 16 years, since there was a threat p.r. man named Bill Zimmerman. taught in high school civics class. And from the police, it’s ‘Goodbye Doctor Dennis didn’t acquiesce, so there when they didn’t, he expressed dismay. Mikuriya, you’re not part of our mix were two “Yes-on-215” headquarters Tod learned from Investigator Tom anymore,’ to quote the mealymouthed —his club in San Francisco, and Bill Campbell that California law enforce- bureaucratic phrase they used. Benefactor George Zimmer and THM at Zimmerman’s office in Santa Monica— ment officials would be flying back to “By the way, the manager was a man the dedication of the Dr. Tod Mikuriya pushing different lines. Washington to confer with their federal whom I’d given a credit reference to Laboratory in the new Science Building Zimmerman sought to reassure voters counterparts about a coordinated re- when he was new on the job, and played at Holy Names University in Oakland. that if Prop 215 passed, law enforcement sponse to Prop 215. Earnest Tod wanted tennis with. So much for friendship.” could still arrest and prosecute people to take part. Rep. Ron Dellums’s office Tod saw patients at his home office In March 2007 Tod played a key role for growing, distributing, and using tried but failed to arrange an invitation until 2003, when the medical board organizing a Society of Cannabis Clini- marijuana; a doctor’s approval would for him. ordered him, as a condition of his proba- cians meeting at which retired colonel only afford a possible defense in court. Reporter Pat McCartney would tion, to get a commercial space. He rent- James Ketchum, MD, discussed the Dennis saw Prop 215 as a bar to arrest obtain documents showing that at the- ed an office in a mall in El Cerrito and Army’s secret search for a cannabinoid- and prosecution. sessions from which Tod was excluded, carried on the practice. “Many patients based incapacitating agent. Zimmerman decried the “looseness” California lawmakers conspired to block prefer coming here to driving or getting Tod saw patients at his office in El of Dennis’s procedures and said that if implementation of California law. The driven up the hill,” he acknowledged. Cerrito until early May, then his decline Prop 215 passed, such clubs would van- dominant strategists were from the phar- Tod was youthful looking and athletic was very rapid. He died Sunday, May ish from the scene. Dennis saw Prop 215 maceutical indusry, and they pledged to (he played in a regular doubles game on 20, at his home in the Berkeley Hills. as a referendum on his right to operate. fund a renewed anti-marijuana campaign the Claremont tennis courts). His excel- In the final days he’d been in the care Zimmerman made TV ads emphasizing to roll back the reform movement. lent health gave out in the Spring of 2003 of his sisters, Beverly, a doctor from that the beneficiaries of Prop 215 would The Dec. 30 press conference at when he had a heart attack followed by Bucks County, Pennsylvania, and Mary be AIDS and cancer patients, the gravely which Tod was ridiculed by Gen. McCaf- triple-bypass surgery. He was put on Jane of San Francisco, and his friend and ill. Dennis had been declaring “in a coun- frey signaled the counterattack. The drug Lipitor, a cholesterol-lowering drug now assistant, John Trapp. try that pushes Prozac on shy teenagers, warriors had not expected the people of known to cause muscle deterioration. Beverly Mikuriya has been main- all marijuana use is medical” to reporters Caliornia to reject their propaganda after Tod was convinced that Lipitor caused taining the practice by flying out to who observed seemingly able-bodied all those years. “If the other side could the lining of his biliary tract to slough California for several days a month to young men at the buyers club. only hear us...” blurted Paul Jellinek of off, resulting in severe jaundice. He said see patients. Tod admired Dennis and generally the Robert Wood Johnson Foundation. he had three patients reporting similar agreed with his line and his approach. He adverse effects from statins. regarded the SFCBC as “a therapeutic Tod felt a sense of urgency He was diagnosed in early March environment in itself.” In this period about authorizing as many 2006 with cancer that had spread from Tod wrote protocols for dispensaries in his lungs to his liver. Dennis Peron and Oakland, Santa Cruz, Hayward, Arcata, patients as possible. Dale Gieringer threw farewell parties and others that would open after Prop for him. He canceled a trip to Hungary 215 passed. And pass it did, on Novem- Meanwhile, Back in California... where he was to present a paper at the ber 5, 1996, with more than 5 million Tod was in great demand —a doctor International Cannabinoid Research So- Bennett. Shelly by photo Californians voting “Yes.” known via the grapevine and the web to ciety meeting. His office began steering As of November ‘96, many oncolo- authorize marijuana use readily for vari- patients to other doctors. gists and AIDS specialists approved ous conditions. More than three million And then, thanks to a stent that re- marijuana use by their patients, but few Californians were using the herb, some stored his liver function, his condition other doctors were willing to do so. They self-consciously medicating. Very few improved. In late May 2006 Tod attended hadn’t learned anything about cannabis were willing to tell their regular doc- his 50th reunion at Reed College and in medical school and so knew nothing tors they used marijuana, let alone seek sang rounds with his old madrigal group. about what conditions it treats, how it approval. His office geared up again. He wrote the works, appropriate dosage, side effects, Tod felt a sense of urgency about lead section of an article recounting what Beverly Mikuriya, MD, dons a white coat counter-indications, etc. authorizing as many patients as pos- California doctors had learned in the 10 with the insignia worn by brother Tod. She Moreover, they were afraid. The Cali- sible. He was 63 years old when Prop years since the passage of Prop 215. He has taken over his practice. fornia Medical Association had opposed 215 passed, but he pushed himself to Prop 215. The state medical board had travel around the state conducting ad hoc not issued any guidelines for doctors clinics organized by local activists. His interested in cannabis as a treatment exam typically lasted 15 minutes, most The Compassionate Use Act of 1996 (Proposition 215) “The people of the State of California hereby find and declare that the purposes of the Compassionate Use Act of 1996 are as follows: “(A) To ensure that seriously ill Californians have the right to obtain and use marijuana for medical purposes where that medical use is deemed ap- propriate and has been recommended by a physician who has determined that the person’s health would benefit frm 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.” (B) To ensure that patients and their primary caregivers who obtain and use marijuana for medical purposes upon the recommendation of a physician are not subject to criminal prosecution or sanction. (C) To encourage the federal and state governments to implement a plan to provide for the safe and affordable distribution of marijuana to all patients in medical need of marijuana. (2) Nothing in this act shall be construed to supersede the legislation prohibiting persons from engaging in conduct that endangers others, nor to condone the diversion of marijuana for nonmedical purposes. The grand old Claremont Hotel in the Berkeley Hills, where Tod saw patients 1980- Notwithstanding any other provision of law, no physician in this state 1996. Management would not lease him office space after Prop 215 passed and law enforcement asked that he be kept under surveillance... A regular tennis game with shall be punished, or denied any right or privilege, for having recommended other MDs on the Claremont courts was a highlight of Tod’sweek for many years. marijuana to a patient for medical purposes. O’Shaughnessy’s • Dr. Tod’s Legacy —21—

Dr. Tod’s Tactical Suggestion An Audit to Monitor Compliance By John Trapp With the passage of Proposition 215 Dr. Mikuriya’s mantra be- not conflict with Health and Safety Code in 1996, Dr. Mikuriya’s fear was that the section 11362.5 (Prop 215). plain language of the initiative would be came “implementation and Failing to gain support for the audit, suborned by federal and state officials. compliance.” Dr Mikuriya began collecting the neces- With the December 30, 1996 statement sary data himself. Over the next eight released by then Drug Czar Barry Mc- When a patient who had complied years he oversaw the contacting of each Caffrey, Dr. Mikuriya’s fears were real- with the law was arrested —as they often County Board of Supervisors, Sheriff, ized. McCaffrey attempted to bring the were in the early days— Dr. Mikuriya District Attorney, and Health Depart- full force of the federal government to would call the offending office (usually ment (often several times each) request- bear in negating the will of California county sheriffs and district attorneys) ing any implementation documents and/ voters. asking to see their training and informa- or training and information bulletins. In response to this attack, Dr. Mikuri- tion bulletins. He made “non-compliance Rather than interpret these documents, ya’s mantra became “implementation forms” for the patients to fill out and file Dr. Mikurya had them posted directly and compliance.” In order to imple- with offending agencies. He urged the to the Society of Cannabis Clinicians ment the new law, Dr. Mikuriya began patients at every opportunity to demand website. performing clinics around the state. His compliance from local and state officials. Tod Mikuriya and John Trapp Dr. Mikuriya’s pursuit of implemen- stated goal was to create enough legal In February 1997, AG Lungren put at Asilomar, June 2002 tation documents became so repetitive patients that their weight would prevent out the first “Update” to local officials that some county sheriffs would forward the federal government and the state monitoring the progress of medical systematic “audit” to track implementa- documents as they were created rather Attorney’s General office from rolling marijuana cases through the courts. One tion and compliance with the new law than waiting for the inevitable request. back the law. Update asked any sheriff or DA who by agencies at the state, county and Now somewhat outdated, the audit Dr. Mikuriya started holding clinics came across a recommendation from Dr. municipal level. can still be found online at http://ccrmg. in Red Bluff, Eureka, San Francisco Mikuriya to forward a copy to Senior As- Leaders of the drug-policy-reform org/audit. and elsewhere. After his exam he would sistant AG John Gordnier. This request movement were committed to funding This web archive served as an infor- admonish the patient that if they ap- led directly to complaints to the medical medical marijuana initiatives in other mational resource for patients attempting preciated the new law, then it was up to board regarding Dr. Mikuriya’s actions states; none were interested in paying to comply with local regulations, attor- them to fight to keep it. In this manner in recommending cannabis to patients. staff to contact every sheriff and every neys researching local laws, and even for citizen activists were created around the In response to these Updates from child protective service agency in 58 local public officials in developing their state, individuals with a vested interest the Attorney General’s office, Dr. Mi- counties —to use but two examples—to own regulations. in protecting the new law. kuriya pushed the idea of performing a ask if they had revised their guidelines to What Dr. Mikuriya Learned From His Patients Ten years of monitoring patients and efficacy. in 1859: primary use of cannabis, resort- They are all clearly of autoimmune medicating with cannabis brought Tod Cannabis seems to work by promot- ing to opiates for episodic worsening of etiology, difficult to treat. Specific Mikuriya a sense of professional ful- ing homeostasis in various systems of the condition. Efficacy is maximized, metabolic errors such as amyloidosis fillment, but his to-do list kept getting the body. Its salient effects are multiple tolerance and adverse effects are mini- and certain anemias warrant further longer. One project he had planned and concurrent. They include— mized. (Neither cannabis nor human study and may elucidate the underlying was a companion volume to “Marijuna • Restoration of normal functioning physiology has changed since 1859.) mechanisms of the illnesses and the Medical Papers” — “Cannabis Clinical of the gastrointestinal tract with nor- NSAIDs can be particularly insidious therapeutic effects of cannabis. Papers” was the working title— that malization of peristalsis and restoration for those who do not immediately react Multiple sclerosis 340.0 with its would include his own studies and of appetite. with gastric irritation and discontinue range of severity varies in therapeutic those of doctors Tom O’Connell, Jeffrey • Normalizing circadian rhythm, the drug. Chronic irritation with bleed- response to cannabis. Hergenrather and others who had been which relieves insomnia. Sleep is thera- ing may produce serious morbidity. collecting data from California users. peutic in itself and synergistically helps Most often, the dyspepsia produced is Demographic Data: To this end we conducted a survey with pain control. suppressed with antacids or other medi- Male patients: 6,247 (72%) in the Fall of 2006 —the 10th anniver- • Easement of pain, depression, and cations. Many patients tolerate acute Female Patients: 2,437 (28%) sary of Prop 215’s passage. Tod’s own anxiety. Cannabis as an anxiolytic and intermittent use but not chronic use. Two differences were discerned in responses represent a condensation of antidepressant modulates emotional SSRIs, if tolerated, coexist without use pattern. Women are more likely what he (and the others) had learned. reactivity and is especially useful in adverse interaction with cannabis. Some to use cannabis for psychotherapeutic treating post-traumatic stress disorders. SSRI users say cannabis is synergistic in purposes (32% to 18%). Men are more Approvals issued to date: 8,684. Patients treated for ADHD (ICD-9 that it treats side effects of jitteriness or likely to use for harm reduction (4% to 1%). Previously self-medicating: >99% Categories 314.00, 314.01, 314.8): 92 gastrointestinal problems. Patients using cannabis as a substitute Many patients report pressure from A roughly bell-shaped curve de- Category of use: for alcohol: 683. the Veterans Administration, HMOs scribes the age of my patients. Analgesic/immunomodulator 41% The slow poisoning by alcohol with such as Kaiser Permanente, and workers’ 0-18 years 9 (1%) Antispasmodic/anticonvulsant 29% its sickening effects on the body, psyche, compensation contractors to remain on 19-30 1639 (19%) Antidepresssant/Anxiolytic 27% and family can be relieved by cannabis. pharmaceutical regimens. A significant 31-45 3109 (36%) Harm reduction substitute: 4% number describe their prescribed drugs 45-60 3243 (37%) Medications no longer needed? as ineffectual and having undesirable >61 684 (7%) Results reported are dependent on the Opioids, sedatives, NSAIDS (non- effects. “Mainstream” doctors frequently conditions and symptoms being treated. steroidal anti-inflammatories), and SSRI Additional Observations: respond to reports of adverse effects by The primary benefit is control without anti-depressants are commonly used in Proactive structuralism works. Mean- prescribing additional drugs. Instead of toxicity for chronic pain and a wide array smaller amounts or discontinued. These ing: people can create something —and negating the problem, they often com- of chronic conditions. Control represents are all drugs with serious adverse effects. by doing so, set a precedent. plicate it. Prevailing practice standards freedom from fear and oppression. Opioids and sedatives produce de- Medical cannabis users are typically encourage polypharmacy —the use of Control —or lack thereof— is a major pression, demotivation, and diminished treating chronic illnesses —not rapidly multiple drugs, usually five or more. element in self-esteem. mobility. Weight gain and diminished debilitating acute illnesses. With exertion of control, with free- functionality are common effects. Cog- Out of the ordinary conditions? The cash economy works better than dom from fear of incapacity, quality of nitive and emotional impairment and While all pain reflects localized im- the bureaucratic alternative. life is improved. The ability to abort an depression are comorbid conditions. munologic activity secondary to trauma Word of mouth builds a movement. incapacitating attack of migraine, asth- Opioids adversely effect vegetative or injury, the following atraumatic auto- The private sector is handling mari- ma, anxiety, or depression empowers. functioning with constipation, dyspep- immune disorders (listed by ICD-9 code) juana distribution because the govern- Relief from the burden of criminality sia, and gastric irritation. Pruritus is also comprise a group of interest: ment has defaulted. through medical protection enhances a an issue for some. Circadian rhythms Crohn’s disease 555.9 Cannabis was once on the market and salutary self-perception. are disrupted with sleep disorders and Atrophie blanche 701.3 regulated, then it was removed from the Alteration in the perception of and chronic sedation caused by these agents. Melorheostosis 733.99 market and nearly forgotten. Not all that reaction to pain and muscle spasticity is Dependence and withdrawal symptoms Porphyria 277.1 we’ve learned in the past 10 years is new. Thallasemia 282.4 a unique property of cannabis therapy. are more serious than with sedatives. Sickle cell anemia 282.60 Patient reports are diverse yet contain Opioids are undoubtedly the analge- Amyloidosis 277.3 common elements. 100% report that sic of choice in treating acute pain. For Mastocytosis 757.33 cannabis is safe and effective. Return chronic pain, however, I recommend the Lupus 710.0 for follow-up and renewal of recom- protocol proposed by a doctor named Scleroderma 710.1 mendation and approval confirms safety Fronmueller to the Ohio Medical Society Eosinophilia myalgia syndrome 710.5

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