Nearly 10 years ago, as Californians were debating whether to legalize cannabis for recreational use, I spent a considerable amount of time reporting on weed.
I immersed myself in cannabis culture. I visited growers in the state’s far northern reaches, where illegal farms had allowed many families to lead comfortable lives in a place where the logging industry had shriveled. Remote towns had restaurants with incredible wine lists.
I hung out at the annual Emerald Cup in Sonoma County, a mellow country fair where cannabis and its various iterations were sold, consumed and judged amid panel discussions about growing techniques, how to get a pot conviction expunged and touchy issues such as whether legalization would be a good thing for farmers who’d spent their careers dodging the law (and, of course, taxes.)
Feelings about legalization ran so high that a screaming match once broke out between two growers on opposite sides of the question.
I interviewed experts, pro and con, military veterans who told me cannabis was the only thing that helped them cope with post-traumatic stress disorder, former football players whose physical trauma only became bearable with the help of a daily joint or two, and cancer patients whose nausea and pain were mitigated only by marijuana. I talked to doctors who’d found stunning success using a component of cannabis to treat young patients with intractable epilepsy.
I met people who told me, literally, that pot was going to save the world.
I’m not sure California voters agreed with that, but they did, by a wide margin, pass the legalization measure in 2016.
The ensuing decade has been a mixed bag for many who believed that legalization would bring an end to the many woes caused by prohibition: a lack of access to banking and capital, the disproportionate prosecutions of people of color despite usage rates that are uniform across races, no reliable way of knowing whether a product was tainted, unfettered access by minors. Sadly, the state’s complex patchwork of regulations that vary by city and county, and extremely high taxes have put a damper on the incipient industry. The black market for cannabis continues to thrive.
It also seemed that legalization on the state level would force the federal government’s hand, which has classified cannabis — preposterously — as a Schedule 1 narcotic similar to cocaine and heroin, with high abuse potential and no accepted medical use.
A step in that direction occurred on Dec. 18, when President Trump signed an executive order reclassifying cannabis as a Schedule III controlled substance, putting it on par with drugs that have accepted medical uses and a lower potential for abuse, such as ketamine and Tylenol with codeine. Trump’s order also creates a Medicare pilot program for CBD, the non-psychoactive component of cannabis, which is often used by seniors for chronic pain, anxiety and sleep issues.
Oddly, this comes at a moment when some researchers are throwing doubt on the efficacy of pot.
Last week, addiction psychiatrists who reviewed 2,500 marijuana studies conducted during the last 15 years announced in the Journal of the American Medical Association that they found little evidence to support the claim that pot is an effective treatment for pain, anxiety or sleeplessness, and that nearly a third of medical marijuana patients meet the criteria for cannabis use disorder.
While cannabis and some of its components have been shown to be helpful treating chemotherapy-induced nausea, HIV/AIDS-related anorexia and pediatric seizure disorders, “The evidence does not support the use of cannabis or cannabinoids at this point for most of the indications that folks are using it for,” UCLA addiction psychiatrist Michael Hsu recently told The New York Times.
This, of course, flies in the face of what millions of Americans experience when they reach for a joint or a gummy. Cannabis is now a $32-billion industry. About half the states now allow the recreational use of pot, while 40 allow it for medical purposes.
I wanted to hear what David Bienenstock, author of the 2016 book “How to Smoke Pot (Properly),” and one of my favorite cannabis thinkers, had to say. He was not impressed by the JAMA analysis, which has been presented uncritically in the news media.
“I don’t give any benefit of the doubt to addiction specialists when they have both an ideological and more importantly a vested financial interest in portraying cannabis primarily as a drug of abuse rather than as an extremely effective therapeutic plant with a very low profile of abuse with no known lethal dose,” he told me from Portland, where he hosts the podcast, “Great Moments in Weed History.”
Dr. Hsu rejected the idea that he is biased against cannabis, and noted that JAMA has safeguards against that, including conflict of interest disclosures.
“I can understand when people feel upset that their personal experience with cannabis may not align with what the science might be saying, or what the doctor in front of them might be telling them,” Hsu told me. “I think that all of us as providers need to recognize that the science is evolving. The field urgently needs higher-quality research and fewer barriers to conducting rigorous studies. There may be benefits we haven’t discovered yet.”
For decades, the government has made it very difficult to study cannabis (which is still illegal under federal law), until recently allowing only marijuana that is grown at the University of Mississippi — and of notoriously poor quality — to be used in research projects.
The pharmaceutical industry, which has fought legalization tooth and nail, has developed a handful of drugs by isolating certain cannabis compounds to treat ailments such as epilepsy, nausea, appetite loss and spasticity. Marinol, a synthetic form of the psychoactive compound in pot, was approved by the FDA for nausea. But many chemo patients would much rather take a puff or two off a joint of high-quality weed than swallow a pill.
“There are many reasons for this hostility to whole-plant cannabis,” Bienenstock said. “But underpinning it all, if I could grow six plants, I could provide this medicine to many people for pennies.” Humans, he noted, have been using cannabis medicinally for thousands of years.
Bienenstock considers the change in the drug schedule to be “a partial move away from outright Reefer Madness and toward obvious reality.”
But, he adds, “it still places cannabis under the restrictive control of the government in many ways that don’t reflect the plant’s actual benefits or relative harms. By what measure can cannabis be considered a scheduled substance when alcohol and tobacco are not? And why is nobody in the media even asking this question?”
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