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What Weed Means for the Future of Sustainable Healthcare

Is it finally high time to take "cannabinopathic" medicine seriously?

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Ever since Colorado's first recreational marijuana stores opened for business on January 1, the media has been largely fixated on the vast fortunes to be made legally selling that once illicit herb. Turns out, a lot of people want to buy pot, and they prefer to be treated like customers, instead of criminals. Who knew?

Of course, while reefer reform's lately all the rage among the chattering classes, nobody's exactly eager to explain how the government's rapidly crumbling big lies about marijuana ever managed to survive for so long in the so-called information age. CNN's Dr. Sanjay Gupta came closest with his hugely influential on screen mea culpa last August, telling millions of viewers around the world that “we have been terribly and systematically misled for nearly 70 years in the United States, and I apologize for my own role in that.”

Specifically, Gupta admitted to ignoring studies conducted outside the US showing cannabis's tremendous healing properties; trusting the government's pronouncements on the drug's purported dangers without examining the underlying science; and being “too dismissive of the loud chorus of legitimate patients whose symptoms improved on cannabis.”

And all it took to change his mind was the kind of miraculous healing typically encountered in the New Testament.

“Take the case of Charlotte Figi, who I met in Colorado,” Gupta continued. “She started having seizures soon after birth. By age 3, she was having 300 a week, despite being on seven different medications. Medical marijuana has calmed her brain, limiting her seizures to 2 or 3 per month.”

But that was only after the poor girl endured more than five years of failed pharmaceutical cocktails, and a series of terribly painful procedures that left her unable to walk, talk or eat. Which means a series of highly-paid, highly-educated doctors and epilepsy experts wasted a staggering amount of time and money on risky, ineffective, invasive, and expensive approaches that didn't work, while steadfastly ignoring a safe, painless, inexpensive, all-natural alternative.

And how, you might ask, did Charlotte Figi's parents finally learn that cannabis has shown incredible promise in treating pediatric Dravet's Syndrome, the rare, extremely debilitating form of epilepsy that so violently tormented their daughter for years on end? By watching a reality TV show.

The Father of Cannabinopathic Medicine

One day, Dr. Lester Grinspoon expects that cannabis will be fully integrated into allopathic (or modern Western) medicine. But despite the herb's incredible safety record, and wide-ranging utility, he's not holding his breath.

In the meantime, the professor emeritus at Harvard Medical School (who authored Marihuana Reconsidered and Marihuana: The Forbidden Medicinesmoked a lot of pot with his buddy Carl Sagan, and recently implored the head of the NFL to support research into combating concussions with cannabis) believes we're already witnessing the birth of an all-new branch of medicine based around the use of cannabis as a combination wellness supplement, preventative nutraceutical, first-line defense, and highly potent medicinal drug.

Highly-paid, highly-educated doctors and epilepsy experts wasted a staggering amount of time and money on risky, ineffective, invasive, and expensive approaches that didn't work, while steadfastly ignoring a safe, painless, inexpensive, all-natural alternative.

As Grinspoon writes in a new essay describing the phenomenon, “All of this is developing outside of allopathic medicine; in what may be called cannabinopathic medicine. Cannabinopathic medicine is being practiced all over the country, openly in the states which have made it legal, and clandestinely in those which have yet to do so. It joins other alternative schools of medicine such as naturopathic medicine, homeopathic medicine and osteopathic medicine.”

In the essay, Grinspoon explains that marijuana has been used for healing since at least 3,000 BC, and was commonly prescribed by physicians in the United States as an alcohol-based tincture until the 1937 Marijuana Tax Act made cannabis in any form a highly restricted controlled substance. "Then in the 1960's," he writes: 

...as large numbers of people began to use marijuana recreationally, claims of its medical utility began to appear, not in the medical literature, but in the form of anonymous letters to popular magazines like Playboy. Typically these accounts were written by surprised recreational users who had serendipitously discovered that marijuana relieved one or another of a variety of symptoms and syndromes. Over the next several decades, word of these rediscovered medical utilities continued to spread. 

In the 1970's, Dr. Jeffrey Hergenrather became perhaps the first licensed MD to practice cannabinopathic medicine, albeit secretly, and with far less knowledge of the plant's true medical potential than we have today.

As house doctor for legendary counterculture commune The Farm, Hergenrather tended to a flock of more than 1,000 stone cold hippies, who all felt perfectly comfortable confiding in their long-haired physician that smoking a joint helped relieve their chronic pain, insomnia, anxiety, menstrual cramps, migraine headaches, and a slew of other ailments.

The Hergenrather's at The Farm. Photo courtesy Jeffrey Hergenrather.

“I’m surprised at how slowly attitudes have changed amongst physicians,” Hergenrather told High Times in 2011. “I’ve come to realize that I had unique life experiences, and that I’m also fairly unique in my willingness to say, 'I don’t care what the Feds think—this is medicine, and I’m going to recommend it to people.'”

Today, Hergenrather serves as president of the Society of Cannabis Clinicians. He no longer resides at The Farm, but the commune remains perfectly viable, rolling on into its fourth decade in Summertown, Tennessee. 

Family Practice

At the 2011 National NORML conference, during an extended question and answer session with the venerable pro-pot organization's membership, Grinspoon reflected on his more than forty years as a physician, an academic, an author, and a leading marijuana legalization advocate.

And then he brought many to tears with a description of how cannabis helped ease the suffering of his son, who died of leukemia at age 15:

On a normal day of chemotherapy, I hoped we could make it home from the hospital before Danny’s vomiting would start, and we always had to put a big bucket next to his bed. But after trying a few puffs prior to this round of treatments, he got off the gurney and said, “Mom, could we have a sub-sandwich on the way home?” And all I thought was, “Wow.”

By allowing certain of his colleagues to witness this phenomenon firsthand, Grinspoon eventually convinced the head of the oncology department at Boston Children's Hospital to undertake a 1975 study, published in the New England Journal of Medicine, that for the first time demonstrated the efficacy of cannabinoids for nausea and vomiting associated with chemotherapy.

In response, the pharmaceutical industry and the government started working together to develop Marinol, a prescription pill that's 99 percent synthetic THC. Available by prescription since 1985, it was rushed through approval as a treatment for nausea and vomiting associated with chemotherapy in patients who fail to respond adequately to conventional drugs.

Grinspoon believes this fast track for Marinol happened primarily to give Big Pharma a patentable, profitable response to increasing popular demand for herbal cannabis. Particularly with the advent of the AIDS epidemic, and the discovery of marijuana's seemingly unsurpassed ability to reduce severe nausea and weight loss associated with that syndrome.

Keep in mind, because a natural plant can't be patented, private industry has absolutely no incentive whatsoever to develop “raw” cannabis as an FDA-approved drug. To the contrary, if a few puffs of pot can potentially replace (or reduce the need for) a slew of incredibly profitable pharmaceuticals, that's a serious, looming threat to the industry's bottom line. So no wonder your doctor doesn't know the promise within pot, never mind the subtle differences between Super Silver Haze and Bubba Kush.

“Physicians of one and a half centuries ago knew much more about cannabis than do contemporary physicians, whose education about new drugs comes largely from the pharmaceutical industry,” Grinspoon laments. “Today's physicians are often introduced to therapeutic marijuana by their patients, but even those physicians who become educated about this drug may be afraid to recommend what they know to be the best treatment out of fear that they might lose their reputations, licenses, and careers.”

Unfortunately for Big Pharma, an overwhelming majority of users continue to rate raw cannabis as vastly superior to Marinol, which contains only one component of a plant that relies on a complex interplay of dozens of unique compounds to effectively engage the body's endocannabinoid system—a collection of receptors located in our brains, organs, connective tissues, glands, and immune cells that fit the plant's cannabinoids like a lock fits a key. These receptors in turn play a vital role in regulating the body's most basic functions, which explains how one all-natural botanical can provide so many seemingly unrelated health benefits.

Explore the endocannabinoid system in High Country, Motherboard's doc on the future of weed. 

“For the most part, my generation of doctors has no idea what’s going on,” Hergenrather admits. “There was no recognition of the endocannabinoid system until the mid-’90s, and they didn’t start teaching it in medical school for another decade, so many physicians just don’t understand that cannabinoids found in the marijuana plant activate and modulate an important natural system in the body in a way that logically accounts for all the varied benefits people claim to get from ingesting cannabis."

"Otherwise,” he continued, “it just doesn’t sound right when you start talking about all the great things marijuana can do to help heal people. It’s so unbelievable, many doctors just kind of say: 'No, thanks—I don’t want to get involved.'”

And so Marinol remains on the market, albeit unpopular to the point of obscurity. Which hardly means the end of corporate cannabinoids, or what Grinspoon terms the coming pharmaceuticalization of cannabis.

Certainly not when, right now, at an undisclosed location in the South of England, GW Pharmaceuticals is cultivating thousands of cannabis plants in a heavily secured greenhouse, under special license from the British government. Once fully mature, the plants' naturally-occurring THC and CBD will be extracted into a solvent, blended together in a 1:1 ratio, and sold under the trade name Sativex—a prescription-only sublingual spray that's already available in 11 countries as a treatment for spasticity related to multiple sclerosis.

There was no recognition of the endocannabinoid system until the mid-’90s ... so many physicians just don’t understand that cannabinoids found in the marijuana plant activate and modulate an important natural system in the body​.

Despite costing the average MS patient in New Zealand more than $16,500 (USD) per year, Sativex contains relatively modest doses of THC and CBD, and no other active ingredients—an incredible marijuana mark-up that gives GW a strong incentive to help maintain cannabis prohibition at all costs, especially since whole-plant cannabis can be smoked or vaporized, bringing near instantaneous relief due to rapid absorption in the lungs, while Sativex takes an hour or longer to start working.

“Needless to say, the pharmaceutical industry is increasingly devoting its massive resources to the development of cannabinoid analogs or other products which can compete with herbal marijuana,” Dr. Grinspoon writes. “None of these products will be as inexpensive or useful as herbal marijuana. Legality, not efficacy, is their major appeal.”

He does acknowledge that the drug companies may come up with unique preparations and blends of cannabinoids that will provide optimal results for certain, targeted uses, and wishes them best of luck in doing so—just as long as the trade-off isn't a prohibition on the cultivation, possession or use of raw cannabis, the “herbal gold standard.” 

Farm vs. Pharm 

Despite a mountain of evidence to the contrary, the US federal government maintains that “marijuana has a high potential for abuse, has no accepted medical use in the United States, and lacks an acceptable level of safety for use even under medical supervision.”

But very quietly, in response to unyielding demand from parents following Dr. Gupta's special, the Feds have just approved a study to determine if marijuana-derived medicine can perform as well in a clinical trial with pediatric epilepsy patients as it did for Charlotte Figi on CNN. GW Pharmaceuticals will provide a high-CBD “whole plant” cannabis extract for the study, specially formulated for epileptic patients.

The significance of this development, though it's gone largely unreported amid the media's recent fit of marijuana mania, can't be overstated. As such, it bears reprinting the extended crux of Grinspoon's essay: 

Two powerful forces are now colliding: the growing acceptance of cannabinopathic medicine and the proscription against any use of the plant marijuana, medical or non-medical. As a result, two distribution systems will emerge for medical cannabis: the conventional model of pharmacy-filled prescriptions for FDA-approved cannabinoid medicines, and a model closer to the distribution of alternative herbal medicines.

The only difference, albeit an enormous one, will be the continued federal illegality of whole cannabis. In any case, increasing medical use by either distribution pathway will inevitably make a great number of people familiar with cannabis and its derivatives. As they learn that the plant's harmfulness has been greatly exaggerated and its usefulness greatly underestimated, pressure will continue to build for drastic changes in the way that we as a society deal with this drug...

In the meantime, in the face of the ongoing prohibition and the standoffish attitude of allopathic medicine, cannabinopathic medicine will continue to grow and develop. It will collect data to help it discover new medicinal uses (like its recent discovery as a treatment for Dravet's Syndrome); develop new strains to more effectively target particular symptoms and illnesses; generate new modifications of herbal products to facilitate topical application, ingestion and smoking or inhaling; and continue to train people in the newest and best ways to use these products.

Which is to say, not if the Drug Enforcement Administration has anything to do with it. Just this week, the counternarcotics agency's deputy administrator told the House Oversight Committee that "every single parent out there" is against cannabis legalization. It seems somebody didn't speak with Charlotte Figi's parents.