The Debate Over Marijuana Treatment for ADHD, Autistic Kids
Lately there has been a small burst of media fascination with what by most
accounts is a rare occurrence: Use of medical marijuana recommended by a
physician by patients under 18. Any psychoactive drug, including marijuana,
should be used with caution in children, but there is no reason that these
infrequent cases should be shocking. Indeed, they should be taken as signposts
on the road to urgently-needed research.
Sad as it is to contemplate, kids do get deadly illnesses like cancer and
AIDS. Medical marijuana dispensary operator Charles Lynch faced an enhanced
federal prison sentence for providing medical marijuana to 17-year-old cancer
patient Owen Beck, who survived his cancer partly thanks to Lynch’s help, and
who attempted to testify on Lynch’s behalf but was barred from doing so.
And millions of young
people with attention deficit hyperactivity disorder (ADHD) have been prescribed
stimulants like Ritalin and Adderall, whose side effects can include
psychotic symptoms and interference with growth, not to mention sudden death
when used by patients with some preexisting heart conditions.
Unfortunately, a story in Sunday’s New York Times
looking at marijuana as a treatment for young people with ADHD managed to avoid
shedding much light on the issue. Instead, the focus seemed to be on sensational
quotes (”worst idea ever,” “safer than aspirin”) rather than a serious look at
the science.
Writer Kathy Ellison did briefly reference a study in the journal Schizophrenia Research, but
without properly explaining it. Of the 25 young people with ADHD in this study,
the marijuana users scored healthier than non-users on nearly every measure of
mental functioning, including specific measures of hyperactivity and
disorganization. This was particularly striking because in the same study a
separate group of individuals at genetic risk for schizophrenia were made worse
by marijuana.
The published study includes a discussion of the biochemical
mechanisms by which marijuana might help ADHD. This is consistent with published case reports that have found a
beneficial of THC on ADHD.
Meanwhile, ABC’s “Good Morning America” did a
more respectful job in reporting on the mom of an autistic child who says that a
small amount of marijuana, administered under a doctor’s care, has literally
saved her child’s life. Others have told similar stories.
We don’t know nearly enough yet to state definitively that marijuana is
helpful for youthful ADHD and autism. But we do know enough to say that proper
research is urgently needed, and that this is a serious enough issue that the
media need to treat it seriously.










The Debate Over Marijuana Treatment for ADHD, Autistic Kids
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Advocate Wellness
That marijuana has many medical and psychological applications with numerous anecdotal cases by many people that have been helped should signal,to even the most ardent prohibitionist,that the continued banning of testing and researching is over. But not our drug warriors,as they take another shot of whiskey,to relax from a hard day of busting marijuana users.
And the biggest complaint they have is that people get high. When did it become a crime or a sin to get "high"? Where are they getting the idea that man should go through life under continuous stress and sober? Why does it bother anyone if someone gets "high" on their own time,at a safe location or even in their own home. What business is it of theirs?
Understandably,if someone gets "high" and causes an accident.they should be held accountable,but if a person just sits at home and watches TV or listens to music,why does it bother the prohibitionists so much? And it seems to really make them mad if you use a natural plant,with no alterations or manipulation by man,to get high with.
Remove marijuana from schedule 1 and let science and doctors prove or disprove the many claims of marijuana's medical applications. Too deny and prohibit any medicine ,a natural one or a pharmaceutical one,is cruel and unjust treatment of anyone
needing the medicine.
- Clay
November 24, 2009 12:59PM
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The US Government has the patent already.
http://www.patentstorm.us/patents/6630507/fulltext.html
- Jesterguns420
November 25, 2009 3:26AM
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Personal Reflections...
I know people (plural) with Masters Degrees who smoke or vaporize marijuana . It's actually helped them with their studies, especially in times where they felt frustrated by the work.
- m46607
November 24, 2009 1:00PM
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a couple corrections for you
Hi, Bruce --
For the record, my byline is Katherine, not Kathy. And I guess I can understand your frustration at not having a story that reflects your advocate's view of marijuana as a safe , cure-all drug, appropriate for all ages. However, I stand by my reporting, which I think was a responsible effort to bring awareness to an increasing problem of irresponsible doctors given way too much leeway with an untested drug on adolescents.
- kathyellison
November 25, 2009 10:28AM
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Clarification and Thoughts
First, Katherine, I apologize for using your name as you signed it on your emails to me rather than as published in your byline.
Nevertheless, I find it frustrating that you appear to be deliberately misinterpreting both what I've written here and what I said on the phone during our lengthy conversation.
You know full well that I don't consider marijuana a cure-all and that I do not expect you to endorse my opinions in print. I do expect you, in reporting a scientific issue, to actually address the relevant science in a way that will enlighten readers.
Your story failed to explain meaningful scientific evidence provided to you by both me and Paul Armentano suggesting a positive effect of marijuana on ADHD as well as the biochemical basis for such an effect being plausible. You included a scientifically nonsensical quote from Stephen Hinshaw calling marijuana for ADHD "one of the worst ideas of all time" because marijuana disrupts attention and memory in normal people. But we know that the brains of ADHD patients don't work like those of normal people -- which is why stimulants like Ritalin have a calming effect, the exact opposite of their effect on most of us. Did you even bother to ask Hinshaw this obvious followup question?
You also included a cavalier quote from Edward M. Hallowell claiming that marijuana use "can lead to a syndrome in which all the person wants to do all day is get stoned, and they do nothing else" -- without bothering to note that this so-called "amotivational syndrome" has been debunked again and again. One example that I sent you, and which you apparently ignored, was the 1999 Institute of Medicine report commissioned by the White House [ http://www.nap.edu/openbook.php?record_id=6376 ]
, which states on pages 107-108, "When heavy marijuana use accompanies these symptoms, the drug is often cited as the cause, but no convincing data demonstrate a causal relationship between marijuana smoking and these behavioral characteristics." Many other expert reviews have come to the same conclusion.
I am not asking you to agree with me or to tout marijuana as a cure- all, which it manifestly is not. As a longtime health journalist myself, all I am asking is for you to do your homework as a reporter.
Bruce Mirken, Marijuana Policy Project
- Marijuana Policy Project
November 25, 2009 11:25AM
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IF ONLY
There are so many reporters that I wish would take the advice of investigating and understanding the data they are looking at. Why,for instance,do all the reporters at Fox,even as they proclaim that they don't care if adults use marijuana , support prohibition and arresting people instead of legalization ,which would put a retailer that checks ID's in the place of the dealer,who doesn't.
They all agree that the war on drugs is a failure,but still want marijuana as a schedule 1 drug,which is exactly why the cartels and the criminal element are in business in the first place.
They want their children to be protected from the dealers in one
breath,and rant about the damage to America if pot is legalized
with the next.
How do we explain to people that the prohibition is what put the dealers in business in the first place and anything that continues the prohibition just underwrites their existence?
And please don't go on Fox for any kind of debate,as they have proven time and again,that all they do is wait until the debate is over,then shoot it down with another stupid pot joke.I believe
the marijuana nation should just ignore Fox.
And now,O'Rielly says that pot is the number 1 addiction drug among teenagers. I have smoked for 42 years,and have quit at various times for jobs and drug screens,with no problems from any kind of withdrawal. I just wish cigarettes were as easy to quit
because it took me 2 years and 5 times to finally quit smoking tobacco ,and I still want one every once in awhile.
"Marijuana is addictive to people the same way sex is,anything that good needs repeating,"
- Clay
November 25, 2009 3:13PM
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homework done!
Bruce, I didn't ask that question of Stephen Hinshaw but, because I'm nothing if not thorough, did ask it of Nora Volkow, director of NIDA. I, too, had had the mistaken impression you just articulated about Ritalin having a different effect on ADHD brains. Apparently this has been debunked.
I really do object to your saying I didn't do my homework, and that I "ignored" anything of importance in my reporting. I spent quite a lot of time emailing with you and Paul and read everything you sent. I need to continue the rest of my life at this point, but will just say this: you're implying that I didn't do my job thoroughly, apparently because this article didn't turn out, as you'd hoped, as an endorsement of the wondrous benefits of medical marijuana . I'd like to ask you to take a deep breath and consider the article's limited intended topic: it's about doctors , including Jean Talleyrand, who's being investigated by the Calif. medical board, taking advantage of tremendous leeway now available to them in this odd moment in history, to "recommend" marijuana use to scores, at least, of California adolescents. They don't recommend a dose. They don't do followup visits. They have no treatment plan. There have been no large, respectable clinical trials (however wrong that may be) (and I know you'll say there have been trials, but the only one you guys sent me was small and quite questionable) determining the benefit and safety of marijuana in this case. Would you subject a child of your own to this? Perhaps you would, but I really don't think it would be responsible.
From talking with you even briefly, I had the impression you were fairly intelligent and well-meaning, and have to say I'm surprised at your ad -hominum questioning of my professional conduct and your superficial perspective on this issue. I think your movement would benefit a lot if you'd make clear that you have some limits, and that encouraging kids with serious psychiatric issues to see "pot docs" is not ethical. Happy Thanksgiving!
- kathyellison
November 25, 2009 6:27PM
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Well said, Ms. Ellison
But truly, I see no need for you to defend yourself on these points. No need at all.
- Gina Pera
November 26, 2009 11:21AM
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Little clarification and little thought
Sorry Bruce, but you have some nerve lecturing Ms. Ellison to do her homework. She obviously has.
It's you who is cavalier with the facts.
Does your 1999 study (and I have no time to vet it) examine mj's effect on ADHD? If not, you are comparing apples to oranges.
Dr. Hallowell's quote is not "cavalier" simply because it chafes your cognitive dissonance.
His clinical experience echoes that of every experienced clinician treating ADHD -- not to mention the spouses and partners with untreated ADHD who numb their anxiety (and exacerbate their ADHD symptoms) with marijuana .
Ms. Ellison didn't need to ask Dr. Hinshaw a follow-up question. His statement was sufficient and definitive.
If marijuana advocates truly expect to change public policy, they might do best to step out of the fog (smoke) and grasp the issues more clearly and with less self-referential bias .
Gina Pera
- Gina Pera
November 26, 2009 11:19AM
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correction
Bruce wrote:
"But we know that the brains of ADHD patients don't work like those of normal people -- which is why stimulants like Ritalin have a calming effect, the exact opposite of their effect on most of us. "
----
Actually, we do NOT know that.
To grossly simplify, we know that the human brain requires stimulation (interest, salience) in order to engage, especially the PFC-related so-called Executive Functions (prioritizing, planning, delaying gratification in order to achieve longer-term, larger goals). Motivation and initiation springs from interest and detected salience.
To put it simply, the ADHD-affected brain requires greater-than-average stimulation. http://tinyurl.com/yk47z64
For the same reason that the "average" human (if there is such a creature) often finds a cup of coffee or cigarette helpful in focusing on tedious tasks, a person with ADHD might require stimulant medication in order to focus on the daily tasks of getting through the day and managing his or her life -- managing money , driving safely, managing work and home, etc.
- Gina Pera
November 26, 2009 10:51PM
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There is no "debate" over MJ for ADHD
Pulitzer Prize-winning investigative journalist Katherine Ellison wrote a well-balanced piece. Anyone familiar with the full range of issues can clearly see that.
Moreover, calling "Worst idea ever" a "sensational quote" further betrays what seems to be your blind allegiance to dope at all costs. Dr. Stephen Hinshaw is an internationally respected expert in ADHD, a humanitarian, and a tireless advocate for furthering knowledge about and eliminating stigma around mental illness.
Much as you seem to want a debate about mj for ADHD, there is none. It is clearly a bad idea, as thousands of case studies and every credible clinician and neuroscientist can attest. ADHD includes deficits in motivation, working memory, and initiation -- all of which are exacerbated by mj.
You cannot compare children with AIDS or terminal cancer to ADHD!
We have highly effective and safe evidence- based strategies for ADHD. It is not remotely necessary for adults and especially children to risk damage to their immune systems, DNA, cognitive function, and more by zoning out on mj.
The anxiety that leads many people with ADHD to mj is often the "side effect" of untreated ADHD symptoms. Treating those symptoms typically alleviates that anxiety -- and gives the person a better chance at reaching their life goals instead of living in a stoned stupor.
You also betray ignorant, biased self-interest with this:
"And millions of young people with attention deficit hyperactivity disorder (ADHD) have been prescribed stimulants like Ritalin and Adderall, whose side effects can include psychotic symptoms and interference with growth, not to mention sudden death when used by patients with some preexisting heart conditions ."
Stimulant medications have been studied thoroughly for at least 50 years. "Psychotic symptoms" are infinitessimally rare and, as with most adverse side effects from stimulants, caused by sloppy diagnosis and titration. And in case you are unclear about the danger of pre-existing heart conditions, children who have them die regularly from running laps. Are you suggesting children should instead lounge on the gym's bleachers and smoke pot?
(At any rate, that study regarding heart risks has been misinterpreted, primarily by grandstanders such as cardiologist Steve Nissen, lobbying for FDA chief.)
Beyond medications, there are other strategies for dealing with ADHD. But if someone seeks the mj crutch, they will never seek them out.
The risks to untreated ADHD are considerable, including higher rates of
-- death from traffic and on-the-job accidents
-- STDs, unwanted pregnancies, and absentee parenting
-- high school and college drop-out
-- unemployment and underemployment
-- bankruptcy
-- divorce
-- substance use disorders
-- incarceration for impulsive, thoughtless crimes.
How, with all honesty, can you advocate compounding these risks with mj?
Sorry, but I just have to ask....what are you smoking ?
Gina Pera, author
Is It You, Me, or Adult A.D.D.?
http://www.ADHDRollerCoaster.org
- Gina Pera
November 26, 2009 11:11AM
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Nice list
What study or research did Ms Pera use to determine that marijuana causes STDs,unwanted pregnancies and absentee parenting ? Most people guilty of absentee parenting are that way because they are trying to earn enough money to house and feed their children .
And the traffic deaths caused by marijuana use alone is ridiculous
and unsupported by any statistics available except from prohibition
propaganda studies.
Bankruptcy,not if you grow your own
School dropouts,not too people that have enough intelligence to realize that without education all you will need to learn for your
job is to ask if the customer wants fries.
As said earlier,your list is empty with legalization ,now you say it,L-e-g-a-l-i-z-a-t-i-o-n. Put it beside,each of your detrimental
list subjects and then what is on your list?
- Clay
November 30, 2009 10:29AM
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misreading
Hi Clay,
Perhaps you should re-read what I wrote.
I did not write that marijuana caused that list of adverse events.
I wrote that untreated ADHD is associated with higher rates of those events. This is well-studied.
cheers,
Gina
- Gina Pera
November 30, 2009 11:06AM
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sorry about that
You are right,misread the line above the list,but your list is nearly word for word a list that a prohibitionist used at an earlier debate about marijuana legalization and I jumped the gun. Very sorry.
Still wonder how they came up with STDs and unwanted pregnancies being caused by ADHD,that must have been some study.
- Clay
November 30, 2009 11:52AM
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no problem
Thanks for seeing the clarification, Clay.
That research isn't as interesting as you might think. ;-) The data comes from follow-up longitudinal studies of children diagnosed with ADHD in childhood (and not always continuing treatment).
Actual figures might be higher, because the study does not include children who were never diagnosed. (Those who were diagnosed would seem to have enjoyed some advantages not only from the awareness that they have ADHD but from potentially being from more educated or well-resourced homes, given that diagnosis was pursued.)
Here's one site that cites the research.
http://www.addhealthandwellness.com/hiddenCostsADHD.php
Maybe those "prohibitionists" are confusing association with causation -- in other words, maybe the marijuana users who have ADHD are being thrown in with marijuana users who do not have ADHD (and might not exhibit the same effects).
Gina
- Gina Pera
November 30, 2009 12:54PM
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Stats or People?
In over 40 years of active clinical psychiatric practice, having seen thousands of MJ abusers with and without dependency [during my many years as Medical Director of Chemical Dependency and Substance Abuse Treatment programs], I can report with certainty that some individuals do absolutely become physiologically addicted to MJ.
Some more than others, - yes, not everyone.
Addiction and abuse potentials nevertheless remain a serious concern in this debate. And those that take the next step in denial and claim that MJ is not amotivational, and does not impair working memory, simply have no extensive experience with MJ. I wonder if they have listened to Saturday Night Live?
If you stretch a bit and read the gluten/immunity literature, even superficially, you will quickly see that many individuals can become physiologically addicted to gluten in wheat, and that opiate connections downstream can create significant problems with withdrawal from bread as well.
Why would anyone deny, in the context of abundant clinical experience, that addiction to MJ does not occur?
The neurophysiology for addiction is there, especially if MJ does not address the underlying problem, but simply, as it does, fix some of the symptoms.
My take on this discussion is that studies with small n numbers can tell you a lot about very little, - and controls in those studies regularly do not parallel life experience in the office - do not portray the pain and suffering we have seen for years out on the streets.
Studies rarely deal with individuals over years, simply because those studies are so costly, and those years tell the tale with users that begin in junior high.
The other main point: ADHD itself is often 'only a symptom' of complex underlying neurophysiology, - a complexity often missed even with current excellent ADHD medications. Why would anyone recommend even more superficial thinking and treatments for appearances rather than full investigation of specific neurotransmitter imbalances?
Casual/recreational drugs for complex presentations?
MJ to treat ADHD? More of the same: Not paying attention to paying attention.
- Dr Charles Parker
November 27, 2009 7:08AM
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Addiction
As the percentage of addicts on marijuana are lower than addiction to alcohol and cigarettes per 100 users,and the number of people that voluntarily go to rehab for marijuana addiction are nearly non-existent. The majority of marijuana addicts treated are mandatory treatment ordered by the judicial system or job related
drug abuse programs,which you depend on apparently to make a living. If marijuana was legal ,your statistics would be what?
And the list above of all the problems caused by marijuana would disappear if marijuana were legalized(no piss test for marijuana,no problems with employment. No arrest record for a non-violent victimless crime ,no refused "better" job for milions of Americans .
But you prohibitionists better get active,your fixing to lose your rice bowl.
- Clay
November 30, 2009 10:10AM
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Let's stay focused...
Clay,
My piece, my point, is regarding ADHD, treatment for ADHD, and the inappropriate use of MJ to treat ADHD, esp in children and adolescents - I did not address these other multiple issues that apparently occupy your table, not mine.
The number who go to rehab is not a relevant marker to the problems experienced with ADHD as I did outline. Even mild consistent abuse, even without blunts and 'addiction' per se, can prove very destructive to the lives of children and adolescents.
Your significant disregard for these most relevant issues discussed in the article, whilst focusing only the other legal and punitive issues, seems to completely miss the focus of this entire discussion.
'Prohibitionist' does not well characterize my remarks, appears reductionist and categorical, - two perspectives so commonly found in a closed mind that thinks in labels not solutions.
Black and white thinking over time is a profound relapse trigger.
cp
- Dr Charles Parker
November 30, 2009 7:49PM
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motivation and rehab
Maybe the people who are addicted to marijuana lack the motivation to get themselves to rehab, thus accounting for the lower voluntary rehab rate. ;-)
Gina
- Gina Pera
November 30, 2009 10:24PM
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Denial and World View
When you are smoking the weed, it becomes your friend. Who wants to loose their best friend? Perhaps everyone should have a friend who is so forgiving and so supportive of no direction.
And as you point out Gina "If it's not a problem for me, then perhaps, quite logically, it wouldn't be a problem for a 10 yr old kid."
Personal denial has a pervasive way of becoming a world view - without reasonable barriers, not based on science , and not remotely tied to common sense.
Dr Charles Parker
Author: Deep Recovery
- Dr Charles Parker
December 1, 2009 4:32AM
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Let's help the kids
I would definitely sign my 11 year old up for this study. He is ADHD Bipolar with violent tendencies. I would be willing to do whatever it took to help my son . Any parent who says otherwise and would prefer to force their child to suffer has no heart. My son has chased me with knives and scissors crying the whole time because he didn't want to hurt mommy but he couldn't stop himself.
- baby76
November 27, 2009 3:31PM
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other alternatives
baby76--
Why on earth would you see marijuana as the only alternative to chasing you with knives and scissors?
If you also have ADHD (it is 76% heritable), you need to get your symptoms under control so you can help your child. Otherwise, you risk seeing how important this is, learning how to get help for him, and following through on getting it.
The consequences of untreated ADHD and bi-polar can be severe. Please get help for him NOW.
- Gina Pera
November 27, 2009 11:02PM
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Studies
With the present system in place,the DEA will not allow any studies on marijuana that might show medical applications,and they are the final word on getting the studies done. They control the marijuana used for the study and it is grown in a federal program at the University of Mississippi,and is very inferior to the "medical" marijuana that the dispensaries and clinics are capable of producing,
Only when marijuana is removed from schedule 1,will the necessary studies and testing for the multitude of health applications claimed by marijuana advocates be proven or debunked.
I have a 14 year old boy living next door to me that takes Ritalin
and the Ritalin seems to be doing the job,for him.
I am not acquainted with the side effects if Ritalin,but I can vouch for marijuana being safe enough that if it didn't work,it would have very little,if any damaging effects on the child.
The memory loss problems that prohibitionists claim endanger our society are still unknown to me,and I have never heard of anyone claiming they don't remember what they did while on a binge of marijuana consumption. This is not scientific proof that marijuana doesn't cause memory loss,but after 42 years of smoking marijuana,I have many memories that I wish I could forget,mostly memories of friends losing everything because the gestapo drug cops took everything they owned.
- Clay
November 30, 2009 12:11PM
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PS
The proper way to take marijuana as a medication is to ingest it,it takes less to do the job and bypasses the possible lung damage that prohibitionists are so scared of. And many of the medical marijuana users in the states where it is alloed are eating their medicine ,but you won't hear the DEA or ONDCP or NIDA ever say that eaten marijuana isn't medicine. They only attack marijuana with something they think sounds dangerous. And how could you ever convince anyone that eating 1/2 gram of marijuana would cripple anyone for life?
- Clay
November 30, 2009 12:30PM
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don't judge me
Yes my son inherited his adhd bipolar disorder from his "father". I do get help for him. He is seeing an independant psychiatrist as well as the school psychiatrist. He has been on adderall and strattera. He has several exercises he does when he feels "out of control". He is a good kid with a big heart and he loves his family and his life. My husband (his stepfather) has been an excellent role model. They go fishing , camping, fourwheeling and do alot of male bonding activities. He is number two of four boys and he will tell you he is mama's baby . His problems are purely psychological.
We are living the American dream and he has all the oppurtunities as any other middle class child. I do fear for the younger two boys and myself when my son becomes out of control.
I am not saying that this is the only alternative. I am saying that the others have not worked for him and I would be willing to try this method.
Therefore, do not judge someone without knowing the facts. For that matter, do not judge me at all. You do not know me or my life.
- baby76
December 4, 2009 1:37PM
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