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Christine remembers how she felt when she discovered she was pregnant seven years ago. Absolutely terrified. At first I just pretended the whole thing wasn't happening. Eventually I bought a pregnancy kit, but I just didn't dare use it. I couldn't face knowing. My boyfriend told me if I kept the baby it would shame his family; my stepfather wasn't keen on the idea of a mixed race child and I was told I couldn't live at home. I was completely confused.
But I decided to go through with it. Alice is six now and I still have to cope alone. There have been times when I've regretted taking on the responsibility - sometimes I feel I can't offer Alice enough and wonder if I've done the right thing. I certainly wouldn't wish my own experience on anybody. It is perhaps not very surprising that Christine feels the way she does. She faced a life-altering event utterly unprepared for the physical and emotional consequences. Her trauma will echo with any woman who has found herself pregnant without wanting to be.
Yet in all the current furore surrounding abortion, as the opinion formers attempt to fight their way out of the moral maze, practically no attention has been paid to the ordeal of coping with a pregnancy that's unexpected. Under the Abortion Act, a woman can obtain a termination if two doctors feel that continuing the pregnancy would be damaging to her physical and mental health. What's provoking debate is how these conditions are interpreted and whether abortion is too readily available as a result. More fuel was added to the fire last week as one unnamed gynaecologist defended his practice of giving abortion on demand, while another complained: "A woman phoned me because her pregnancy clashed with her holiday.
Some commentators are also taking a more cautious line. Angela Lambert wrote in the Daily Mail: "Today, many people are re-thinking their position on abortion Perhaps motherhood has influenced this highly vocal generation of baby- boomers who were once so strident. Ann Furedi, director of the Birth Control Trust, finds the change alarming. This reflects a shift in focus from a woman's rights to her responsibilities - where the mother's experience is viewed as a secondary consideration. Women feel they're on a conveyor belt which speeds up and propels them into a situation they feel they have no control over.
Christine also found it extremely isolating. I refused to attend any ante-natal classes because I couldn't bear to be near women who had partners," she says. You can't win. This sense of injustice can continue once the child is born. Sue Wright, a professional line advice manager for Exploring Parenthood, the national parents' counselling service, often discovers that an unplanned pregnancy is at the root of problem relationship between mother and child.
It she never wanted it, she resents it more," she says. It's like, 'I've done this for you and you must give back what I need. There are also psychological factors during the pregnancy itself. Jenny, 32, had an abortion five years ago and was surprised by her response to the event.
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In that first half-hour when the test showed positive I felt this rush of excitement like, 'My body works - I know I'm fertile. What are my reasons for not having it? I had to wait for three weeks during which time I got terrible morning sickness and my breasts ached. I kept thinking, this must be amazing if you want to be pregnant - but when you don't, you dread each physical change taking place.
I felt a complete loss of control; that I was being invaded. Straight after the abortion I felt a tremendous sense of relief that this 'thing' was out of my body. It's hard to imagine how traumatising it would be to continue a pregnancy in this frame of mind, although that would have been unavoidable less than 30 years ago.
When Sonia discovered she was pregnant in the s aged 18 the sole choice was adoption - an option now favoured by pro- life campaigners. For two-thirds of her pregnancy, Sonia lived in a mother and baby home waiting to give birth. I felt my body had been taken over and that my role was that of an incubator on behalf of better people than me. I began to hate myself more and more. They don't know the life-time repercussions of giving away your own child. It's a burden no one should be expected to carry. According to Dr Lorraine Sherr, psychologist and author of The Psychology of Pregnancy and Childbirth, it's this sense of conflict that is so distressing to a pregnant mother.
We also know that pressure or coercion, whichever way, is the worst predictor for mental health problems; it's when she feels pushed or pressurised, wanting one thing but doing another. This is because the actual process of trying to make the right choice can be so traumatic, says Sue Germain, a counsellor for the Brook Advisory Centre. They veer from wanting it to not wanting it and feel they'll never be able to reach a clear decision.
It's a huge decision for every woman I see - they are never flippant about it, whatever stage of pregnancy they are at. Once they have made up their minds, it's often the worst part over. Yet Canadian psychiatrist Philip Ney believes that, on the contrary, a woman's psychological well-being is under threat when she opts for termination. This is what happens, the critics seem to be saying, when women are spoilt for choice: they abuse their freedom. Yet listening to Sonia, it's easy to forget how recently there was no choice at all.
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She is quite clear about her abiding memory of pregnancy. You had so little power; there were no options available and there was nothing you could do personally to change events. I can't forget. It was a nightmare. You can find our Community Guidelines in full here. Want to discuss real-world problems, be involved in the most engaging discussions and hear from the journalists? Try Independent Premium free for 1 month.
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Later studies by Zuardi and his colleagues showed that a large dose of CBD, when given to volunteers who feared public speaking — that is, who suffer from social anxiety — blunted the flight-or-fight response, measured by increases in heart rate, blood pressure and skin conductivity, prompted by having to address others. These were small studies, and the amount of CBD involved, which was milligrams in the social-phobia study, is greater than what users might consume these days in some CBD gummies, for example, but relieving anxiety is nonetheless one of the most widely reported reasons people use CBD.
CBD may also have antipsychotic properties. In susceptible individuals, its sister cannabinoid THC can, in high doses, induce psychotic symptoms, and heavy marijuana use early in life has been linked to an increased risk of developing psychotic disorders, possibly because it alters brain development. The scientists are now testing CBD as a prophylactic to prevent schizophrenia from even emerging. A single milligram dose of CBD given to these patients, scientists at Kings College London have found , can partially normalize regions of the brain that have been shown in fMRI visualizations to become dysfunctional during schizophrenic episodes.
A follow-up study will prophylactically treat a large group of these patients thought to be teetering on the edge of psychosis. Current schizophrenia treatments merely attempt to manage the disorder once it has already emerged. A medicine that slows or prevents the disease from taking root altogether, almost like a vaccine, would address a huge unmet need. And precisely because the proportions between the two cannabinoids have become so skewed — the ratio of THC to CBD has risen to 80 to 1 from 14 to 1 in two decades — lots of modern cannabis is potentially much more toxic for the brain, says Hurd, who is the director of the Addiction Institute at Mount Sinai.
Now she studies how CBD could help opioid addicts kick the habit. THC may also have therapeutic uses, particularly in treating the pain that often puts people on a path leading toward opioid addiction. And opioid-related deaths have declined in states that legalized medical cannabis , suggesting that people who have access to less-addictive options for pain management may not be as likely to become hooked on opioids.
Other possible applications of plant-derived cannabinoids could be just as groundbreaking. Israeli scientists have found that CBD can lessen the incidence of graft-versus-host disease in bone-marrow transplant patients , presumably because the cannabinoid calms the immune system and deters it from attacking the patient. How could one family of molecules help so many maladies? The most obvious response is that they might not; all this research is preliminary and might not pan out. But scientists often propose a counter-explanation: Many chronic disorders, even though they seem distinct, are characterized by dysfunction in the same few pathways.
Inflammation and oxidative stress, for example, occur in schizophrenia, metabolic disorders, heart disease and other ailments. The therapeutic magic of CBD and, in some cases, THC — and maybe some of the more than other cannabinoids in cannabis — may come from the ways that, by tweaking the endocannabinoid system, they push the body away from disease toward the unruffled state scientists call homeostasis.
There are other examples of a single drug being able to help meliorate a variety of conditions. We know aspirin as a treatment for fever and headache, for example, but in low doses it is also used to reduce the risks of stroke, heart attack and pre-eclampsia in pregnant mothers; it even figures as an adjunct treatment for schizophrenia.
Aspirin has its own downsides — an elevated risk of bleeding, for instance — but like CBD, its broad utility may be partly explained by its anti-inflammatory effects. Like CBD, aspirin is derived from a plant. The active ingredient in aspirin, salicylate, was first extracted from willow bark and was a folk remedy for thousands of years before scientists finally made a pill from it in the late 19th century. In early , just a few weeks after Sam Vogelstein returned from Britain, Catherine Jacobson organized a brainstorming session at N.
The neurologists who ran the trials included Orrin Devinsky from N. In June , just five years after that meeting — an instant in drug-development time — the F. And three months later the D. The drug, called Epidiolex, is not the first cannabis-related drug on the market. Marinol, used to suppress nausea and stimulate appetite, contains THC.
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But Epidiolex is the first drug that contains only CBD and the first one derived directly from the cannabis plant itself. The THC in Marinol is synthetic. Epidiolex is also noteworthy for its unusual history. Drugs are typically developed in the lab and go through trials before reaching patients. But in the case of Epidiolex, two mothers of epileptic children experimented on their own sons and then helped push a version of what they discovered into the F. Because so many people already use cannabis and think it helps, patients might be, in effect, pioneering new uses through self-experimentation.
Users, meanwhile, look to the published literature as Jacobson did for guidance on how to use cannabinoids. The end result is that cannabis science and vernacular cannabis use exist in an uneasy symbiosis. CBD is generally considered safe, even at the high doses tested so far — and the quantities in chocolates, teas and other edibles tend to be far below the concentrations tested experimentally. Still, many who have direct experience with CBD, including a few scientists, do not think it should be available only by prescription. They point out that long before the Controlled Substances Act, which made marijuana illegal, people used the plant medicinally.
Cannabis should not only take its place as an F. It should also reclaim its role as a folk remedy. If there is a Patient Zero in the vernacular cannabis movement, that person is a girl in Colorado named Charlotte Figi.
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Doctors diagnosed Dravet syndrome, in her case caused by a spontaneous genetic mutation. By the time she was 5, she was wheelchair-bound, receiving sustenance through a feeding tube, seizing about times per week, and on several occasions she had to be shocked back to life after her heart stopped.
Doctors once recommended a medically induced coma just so her body could rest. Medical cannabis has been legal in Colorado since The seizures almost entirely disappeared. Word of this success spread through the network of medical-marijuana professionals, and early in , someone called on behalf of the CNN medical correspondent Sanjay Gupta. Gupta, who is a neurosurgeon, had previously argued against the legalization of medical cannabis, but he now wanted to do a show on it. After much discussion, Paige Figi and Joel Stanley, the Boulder-based cannabis grower who had produced the extract for Charlotte, decided to invite Gupta to tell their story.
If it came from a skeptic of his standing, people might actually believe it. Gupta visited the Figi home, watched old videos of Charlotte seizing, looked at family photos, and saw the Charlotte before him as a playful little girl of 6. At one point, Paige Figi told me, Gupta, who has daughters of his own, requested that the cameras be turned off, and cried.
Figi fed them. Some stayed a few nights. One family ended up living with them for a year. A community began to coalesce in Colorado Springs, made up of epileptic children and their families. This was also a period of some tension and confusion.
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He kept long waiting lists of hopeful parents. Figi and Stanley eventually left Realm of Caring to avoid conflicts of interest. In , the F. Both say they updated their websites. Where Jacobson and Nussenbaum saw their role as helping a cannabis-derived drug get F. Figi, who says she switched her party affiliation from Republican to Democrat after Donald Trump was elected president, even considered running for elected office and making access to CBD part of her platform.
And that access should not depend on whether recreational cannabis is also legal. Why hold them hostage? One reason some physicians look askance at the vernacular cannabis movement is that it can, in its sometimes quasi-religious devotion to the plant, seem almost cultlike. She had no data at that point on its efficacy and did not recommend it. The Epidiolex trials have provided some evidence of effectiveness, Park told me, but she still frets over the phenomenon. Sometimes parents of patients refuse established epilepsy treatments in favor of cannabis products, she says, because these are perceived as somehow natural and thus superior to standard medicines.
Nor are most drugs completely free of side effects. In the standard drug-approval process, observed side effects are noted on the packaging. If new ones show up after F. CBD has known side effects.
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These issues might be caused by different cannabinoids or terpenes, another type of biologically active molecule produced by plants. CBD can also interfere with how quickly the body breaks down other medications. The greatest concern, however, and one I heard repeatedly from parents and physicians, is quality control.
It sent out a flurry of letters warning companies not to make medical claims. Two years later, a study published in JAMA documented that, in 84 products sold online, 26 percent had less CBD than advertised and 43 percent had more. And the cannabis plant can absorb toxic substances like heavy metals or pesticides as well as carry infective agents.
In , a California man undergoing chemotherapy, whose immune system was weakened, died from a fungal infection that his physicians suspect he acquired from the cannabis he smoked to ease his symptoms. Last year, California legalized recreational marijuana and phased in a series of stringent quality controls, including tests for various microbes, pesticides and heavy metals. This goes for some other states as well. Some states and cities are moving to correct this.
At the same time, confusion about the federal legality of CBD-related commerce remains widespread. The companies that ship CBD products across state lines — an activity subject to F. Yet even though the F.
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Somewhat surprisingly, Catherine Jacobson does not want that to happen. Her thinking on this issue has evolved, she told me. Early on, she thought all medical cannabis products should go through the F. But she realized that her primary concern, quality, could be assured without this expensive, time-consuming undertaking. In Germany, for instance, doctors have been able to prescribe cannabis since , and patients get a pharmaceutical-grade product, because a federal agency oversees the medical-marijuana industry.
Jacobson, who lives in Mill Valley, Calif. What about the uncertainties over whether CBD works for a given illness? When it comes to diseases like intractable epilepsy, she said, doctors often do their own experimenting. Scientists could search for signals on what to study in this sea of self-experimentation. Realm of Caring, still run by Heather Jackson, is already doing this in partnership with academic researchers, sharing data from a 55,person registry that includes information on what people are using cannabis for and what side effects and benefits they see.
One scientist is doing something similar with herself as a subject. In , Diana Martinez, a professor of psychiatry at Columbia University, found out she had breast cancer and started chemotherapy with taxane, a class of drug known to cause nerve damage. Martinez began to hear ringing in her ears, feel pins and needles in her hands and lose feeling in her lower limbs. Eventually she could barely swallow, started to fall while walking and ended up concussed. In up to 80 percent of women who use taxane, these symptoms persist.
Martinez decided that even if the drug helped her beat the cancer, the symptoms, which were likely to get worse, were unendurable. Then a colleague reminded her that she had always wanted to study CBD for nerve pain. Why not try it herself? After about six weeks on the oil, the ringing in her ears disappeared and the other symptoms began to fade. It was gone. It seemed fairly miraculous. It still does.
Martinez, inspired by her own experience, has since started a trial with her colleague, a neurobiologist at Columbia named Margaret Haney, that will target taxane-induced neuropathy in breast-cancer patients with a pill containing both THC and CBD. The cannabinoids may work better together for some conditions, especially when pain is a factor. If it helps, the cannabinoids might save lives not because they cure cancer — although others are studying that possibility as well — but because they might assist women in completing otherwise intolerable courses of chemo.
CBD is not always an unqualified success, even in the best-known case studies. For Sam Vogelstein, the inspiration behind Epidiolex, it helped control his seizures for years, limiting them to around six per day. But in the fall of , Sam began suffering from a new type of seizure. He had taken it before, without benefit, but this time, in combination with Epidiolex, it worked wonders: Sam has been completely seizure free for more than three and a half years.
Jacobson, who like many mothers of epileptic children keeps a detailed diary about seizure activity, disagreed. This disagreement between doctor and mother prompted Jacobson to find a new neurologist who, she told me, took one look at Ben and told her to do whatever she felt might help.
Charlotte Figi, now 12, continues to be almost entirely seizure-free. And she suffers from osteoporosis caused, Figi thinks, by the high doses of steroids she took to control seizures at a young age. But she is otherwise a happy, playful girl, Figi says. Two years ago, Chase, who until then had exhibited no problems, began to have seizures out of the blue. And Chase would now be starting all those drugs. Meanwhile, as the science inches forward, CBD has become a pop-culture phenomenon. Kim Kardashian recently hosted a CBD-themed baby shower. Some scientists are concerned by how far the CBD craze has moved beyond the science.
But Staci Gruber, associate professor of psychiatry at Harvard Medical School, does not think the two are necessarily in conflict. This might seem odd, given her work. She has found that recreational users, particularly those who begin using cannabis earlier in life, exhibit some cognitive difficulties and altered brain structure and function.
In , Gruber started the Marijuana Investigations for Neuroscientific Discovery, or MIND, program to examine the effects of medical cannabis, and so far, she has found exactly the opposite in people who use cannabis as medicine. Their cognitive function appears to improve over time and preliminary evidence suggests that, after initiation of medical-cannabis treatment, their brain activity begins to normalize.
Although Gruber is not certain what accounts for the contrasting effects, she has several theories.