The Brain on Cannabis

What You Should Know about Recreational and Medical Marijuana

Rebecca Siegel, Margot Starbuck

• Publisher: Citadel Press
• Year: 2021
• ISBN:
  9780806540870
• Topic: Medicine
• Subtopic: Alternative & Complementary Medicine

For more than 25 years, the renowned Amen Clinics has been a front line resource for brain health ... NOW theY TACKLE all your questions about how marijuana affects your brain—and the brain of your child. Since marijuana became legal in many states, people of all ages are using it for pain relief and treatment of a variety of illnesses and ailments. But is it safe? In this comprehensive book, renowned psychiatrist and licensed prescriber of medical marijuana Dr. Rebecca Siegel delivers the most complete guide yet about the benefits and risks of using marijuana today. Based on the latest scientific research, this easy-to-read book busts all the myths and helps you navigate the sometimes confusing and often-changing world of marijuana. Within these pages you'll discover a wealth of invaluable information, including: •Why medical marijuana is vastly different than CBD and recreational marijuana—especially when it comes to children and teenagers •Evidence-based information on how cannabis is being used to treat an array of ailments and conditions •The difference between various marijuana delivery systems, including edibles •Why marijuana-induced psychosis has risen 450% among current pot users, resulting in increases of depression and suicide •How to talk to teens or young adults about recreational marijuana use in a way that brings you closer •How marijuana affects mood, productivity, and overall brain health •Long-term vs. short-term risks for teens, adults, and older adults With a foreword by renowned psychiatrist and brain health expert Dr. Daniel Amen, The Brain on Cannabis reveals everything you ever wanted to know about marijuana so you can make informed decisions for yourself—and your loved ones.

MARIJUANA AS MEDICINE

7

WHAT’S THE HISTORY OF MEDICAL MARIJUANA? IS IT NEW?

The Myth of Harmlessness:

Marijuana has been used to treat ailments
for thousands of years, and it clearly does
more good than harm.

The Myth of Harmfulness:

Because using marijuana to treat medical ailments
is new, we don’t yet know the dangerous effects.

“So what med school did you attend?” I asked the patient sitting in front of me.

David, a retired spine surgeon who’d recently moved to the city with his wife to be closer to his grandchildren, answered, “I attended UNC Chapel Hill. Go Heels!”

“Hey,” I warned. “Watch it. I attended Duke undergrad.”

“I’m sorry to hear that,” he quipped.

Smiling, I decided to let it slide.

He continued, “I understand that you are certified to recommend medical cannabis, and I’d love to discuss that today.”

His query surprised me.

“Honestly,” I explained, “I don’t see a lot of doctors in my office who are interested in discussing medical cannabis.”

“I’m sure you don’t,” David concurred. “When I was in college, marijuana was only for the hippies who attended Woodstock and followed the Grateful Dead around!”

“I know a lot of people think that. And what’s so interesting is that hippies and stoners using marijuana to get high is just the thinnest sliver of the history of marijuana.”

“I believe you,” David conceded, “but I guess I just never considered that marijuana had a history earlier than the 1960s.”

“You’re not alone. Most people—even physicians—don’t realize that throughout history, and across many diverse societies, the medicinal properties of the cannabis plant have been recognized and utilized. It’s actually only been during the last hundred years or so in the United States that the plant has been illegalized and stigmatized. The unfortunate effect of that is that with the rapid advances in so many areas of medicine, we just haven’t been able to do the kind of research needed to discover all we need to know about this fascinating little plant.”

“Because some states are legalizing the use of medical marijuana now, do you see that tide turning?” he asked.

“I want to say yes, but as long as marijuana is listed as a Schedule I substance, research efforts will be stymied. Until the federal government can see the potential benefits, researchers’ hands are tied. Anyway, as fascinating as that is, that’s not why you came today. What brings you here?”

“Back pain,” he said with a wry smile.

“Okay,” I quipped, “now I’m curious, since you made a life’s work out of helping people suffering from back pain.”

“I did,” David admitted. “And I loved seeing people find relief! But surgery isn’t the right option for everyone.”

I nodded.

He continued, “Based on my own limited reading, I have a suspicion that medical cannabis might be a good option for me. What do you think?”

“I think if I were in your shoes, I would be considering the same thing.”

David smiled. “Sounds like we’re on the same page, then. I’m actually excited to learn more.”

A Global Look at Cannabis

David’s perception that marijuana was just for hippie stoners, and possibly rebellious teens over the last fifty years or so, is very common. Few Americans, including medical practitioners, are aware of the ways that use of cannabis has been threaded throughout recorded human history.

Cultures around the globe have utilized the cannabis plant for thousands of years. While evidence shows that cannabis was farmed as far back as six thousand years ago, the earliest record of it being used as a medicinal drug was in 2737 B.C. in China, where the Emperor Shen Neng acknowledged its efficacy treating over a hundred ailments, including gout, rheumatism, and malaria.⁴¹ Originally, hemp was grown in the ancient world as an agricultural crop that produced high-protein seeds, oil, and fiber that could be used to craft clothing and rope. Eventually, though, across various cultures, cannabis was used to treat tumors, jaundice, cough, blood clots, nausea, and more. After people in China discovered the medicinal properties of cannabis, its use to relieve pain and treat medical conditions spread throughout Asia and into the Middle East and Africa.⁴² In 200 A.D., a Chinese surgeon named Hua Tuo became the first physician on record to use cannabis as an anesthetic during surgery.⁴³

Cannabis reached the West at the turn of the 19th century. When Napoleon brought cannabis back to France from Egypt in 1798, it was used to treat tumors, cough, and jaundice.⁴⁴ But an Irish doctor named William O’Shaughnessy is credited for introducing cannabis to Western medicine when he formally introduced it to Britain in 1841 after learning of the plant’s therapeutic effects while studying in India.

Marijuana in America

In the 1700s, American medical journals were reporting that hemp seeds and roots were being used to treat a variety of health problems, including incontinence and skin inflammation.⁴⁵ Cannabis was also was commonly used as an over-the-counter medication to treat nausea, rheumatism, and labor pain. The National Institutes of Health (NIH) reports, “In the U.S., cannabis was widely utilized as a patent medicine during the 19th and early 20th centuries, described in the United States Pharmacopoeia for the first time in 1850.”

During the 19th century, opiates and cocaine were largely unregulated in the United States. In fact, in the 1890s, the Sears, Roebuck and Co. catalogue—the early equivalent of Amazon, reaching millions of American homes—sold a syringe with a small amount of cocaine in it for $1.50.⁴⁶ Whether ordered through the mail or prescribed locally by physicians, cannabis as a therapeutic treatment was widely accepted throughout North America.

The Tide Turns

National and international sentiment toward the use of a variety of drugs began to shift at the turn of the 20th century. In response to a morphine addiction crisis in the United States, the U.S. Food and Drug Administration (FDA) was created in 1906 to regulate morphine and other drugs. Though the FDA wasn’t yet interested in marijuana, the establishment of the FDA signaled changing attitudes toward drug use and regulation. This drug crisis was not limited to the United States. During the Spanish-American War of 1898, the United States took possession of the Philippines, where opium addiction was causing problems, from Spain. An American Episcopalian bishop of the Philippines named Charles Henry Brent convened the Brent Commission, which ultimately recommended that narcotics should be subject to international control. And in 1906, the same year the FDA was established, U.S. president Theodore Roosevelt proposed the International Opium Commission, which finally convened in 1909.⁴⁷

American sentiment toward drugs shifted further in 1914 when the Harrison Narcotics Tax Act imposed a tax upon those who produced, imported, manufactured, sold, or distributed opium or coca leaves.⁴⁸ Attitudes in the United States about drug use, including the use of marijuana, were also tainted by systemic racism. In 1900, The Journal of the American Medical Association (JAMA) announced, “Negroes in the South are reported as being addicted to a new form of vice—that of ‘cocaine sniffing’ or the ‘coke habit.’”⁴⁹ Chinese immigrants to America were being blamed for bringing the opium-smoking habit to America from the East. And at our country’s southwestern border, fingers were being pointed at Mexican immigrants. Dr. Malik Burnett and Amanda Reiman report an influx of Mexican immigrants to states like Louisiana and Texas following the Mexican Revolution (1910). They explain, “Not surprising, these new Americans brought with them their native language, culture and customs. One of these customs was the use of cannabis as a medicine and relaxant.”⁵⁰ Many posit that the increasing legislation and regulation was a response to American fears about an influx of “disruptive” Mexican immigrants who were bringing with them a plant called “marihuana.” ⁵¹ These concerns, and others, led to a movement to limit the distribution and use of marijuana. Statements made during hearings in the 1930s posited that cannabis caused men of color to become violent and solicit sex from white women.⁵²

Contributing to the hysteria around marijuana in the first half of the 20th century was the film Reefer Madness. Originally financed by a church group, the movie was produced as a morality tale to herald the dangers of cannabis use. The film portrays the lives of teenagers who’ve been lured by aggressive drug pushers to try marijuana. Results include “madness” (mental illness), attempting rape, hallucinations, manslaughter, suicide, and a hit-and-run car accident. At the end of the film, a concerned high school principal points to random parents at a Parent Teacher Association meeting, warning, “The next tragedy may be that of your daughter . . . or your son . . . or yours or yours . . .” It’s likely this fear-evoking, sixty-eight-minute film shaped more of our nation’s attitudes toward marijuana than we can measure.

Ongoing concerns about marijuana led to the passage of the Marihuana Tax Act of 1937, which taxed the sale of cannabis. At the time, the Marihuana Tax Act was opposed by the American Medical Association (AMA) because physicians—who were regularly prescribing cannabis—and pharmacists would bear the tax burden imposed by the legislation. What most Americans didn’t realize is that most of the medicines in their homes already contained cannabis. For a variety of reasons, marijuana was being demonized in America before we even understood it. In addition to racial fears, some suggest that the Marihuana Tax Act of 1937 was related to the fact that hemp, a cheap substitute for pulp used in the newspaper industry, would threaten the timber holdings of business moguls Andrew Mellon, Randolph Hearst, and the DuPont family.⁵³

The regulation that began in the United States in 1937 eventually led to the Controlled Substances Act of 1970. This legislation was what first labeled marijuana a “dangerous” Schedule I substance. Joining cannabis on this list are heroin, LSD, and ecstasy. In endorsing this legislation, President Richard Nixon ignored objections from the Shafer Commission that cannabis did not belong in that highly restrictive category.

While marijuana possession, sales, and use have been regulated in the United States since 1937, we didn’t yet have the science at that time to understand how marijuana affected the human body and brain. In fact, THC wasn’t identified and isolated until almost three decades later. In 1964, a chemist at Israel’s Hebrew University of Jerusalem named Raphael Mechoulam identified THC as the key psychoactive compound in the cannabis plant.

In the 1980s, Allyn Howlett’s research lab at Saint Louis University made the groundbreaking discovery of the existence of cannabinoid receptors.⁵⁴ Since then, we’ve learned that the body’s endocannabinoid system includes endocannabinoids, which are molecules made by our bodies that help regulate internal bodily functions and are produced as needed, cannabinoid receptors, and the enzymes that synthesize and degrade endocannabinoids.⁵⁵ The endocannabinoid system is active in your body even if you don’t use cannabis. It regulates body processes such as appetite, pain sensation, mood, and memory.⁵⁶

Despite the federal restrictions keeping marijuana as a Schedule 1 substance, in 1996, Cali...