Medical Marijuana

Description

An essential guide to understanding the health benefits of marijuana and CBD

Marijuana has been used for thousands of years as a medicine, but pot has been illegal in the United States for most of our lives. Almost all states have now legalized its medical use, and many consumers and physicians are exploring it as an alternative to conventional treatments. There’s substantial evidence that marijuana (cannabis) is a safe and effective treatment for chronic pain, chemo side effects, sleep and mood disorders, MS, and Parkinson’s disease, among others. But there’s also misinformation about marijuana on social media. And most physicians have limited knowledge on the subject, while dispensary staff (aka “budtenders”) lack medical training.
 
Mikhail Kogan, MD, a renowned expert on medical marijuana, has found that cannabinoids (THC, CBD, hemp, and other cannabis products) can often be more beneficial, have fewer side effects, and be safer than many conventional medications, including opioids and other painkillers. But different ailments require different strains, doses, and routes of delivery. Medical Marijuana demystifies marijuana and other forms of cannabis in a user-friendly guide that will help readers:
 

   • Understand how marijuana morphed from the days of “Reefer Madness” to being hailed as a wonder weed
   • Navigate the complex medical and legal world of marijuana
   • Understand the risks and benefits of THC, CBD, and other cannabis products
   • Evaluate the pros and cons of inhaled and other routes of delivery: edibles, topicals, and even suppositories
   • Find a doctor who can recommend medical cannabis
   • Choose a reliable dispensary
   • Learn how to evaluate labels on cannabis products
   • Discover cost-saving strategies since medical marijuana isn’t covered by health insurance 
With real-life patients’ stories woven throughout the book, simple explanatory graphics, and the most up-to-date information, this is the definitive guide to the wide-ranging benefits of medical marijuana and other forms of cannabis.“Medical Marijuana is the book we have all been waiting for. A coherent, no-nonsense, scientific book that maps out A-Z the history, the science and the myriad applications for human health of this much maligned and misunderstood herbal medicine. It is essential reading for physicians, patients and consumers alike.”
–Mark Hyman, MD, New York Times best-selling author of The Pegan Diet

“This book offers a clear, well organized, and easily digestible explanation of the most up-to-date research from across the globe.”
–American Sociological AssociationMikhail Kogan, MD, is the medical director of the George Washington University Center for Integrative Medicine and Associate Professor of Medicine at the George Washington University School of Medicine. Dr. Kogan has recommended medical marijuana to thousands of patients and is a frequent lecturer on medical cannabis to professional audiences across the nation. Joan Liebmann-Smith, PhD, is a medical sociologist and an award-wining medical writer who specializes in health promotion and substance abuse prevention. She is the author of five medical self-help books, including Body Signs, which has been translated into twenty-eight languages.
  

Chapter one

The Long and Winding Road

Marijuana, which is derived from the Cannabis sativa plant, has had a very long, convoluted, and controversial history. In fact, the term marijuana wasn’t even used until the early twentieth century. Before the mid-eighteenth century, the plant was referred to as hemp (or Indian hemp) in English, and by a variety of names across the globe. The ancient Greeks referred to it as kannabis, which means canvas, because the plant was primarily used to make cloth. But it wasn’t called “cannabis” in English until 1753-when it was officially christened Cannabis sativa by the Swedish botanist Carl Linnaeus.

Depending on what part of the plant was used, it was either turned into industrial fiber or consumed for medicinal or other, more controversial purposes. In fact, since ancient times, cannabis has been either revered as a sacred shrub, promoted as a panacea, or damned as the devil’s weed.

In just the past one hundred years, marijuana has gone from being a common household cure, to being denounced as a dangerous drug, and finally to being declared illegal. But now it’s being resurrected as a wonder weed and, once again, making its way into mainstream medicine. Just how this happened is worth exploring. The past not only can inform us about the potential benefits of medical marijuana, but it also can and should inform medical research. As cannabis researcher and historian Dr. Simona Pisanti explains, “It is surprising that most of the pharmacological properties of Cannabis that only now are being studied were indeed already known and used in medicine for the treatment of numerous pathologies in ancient times.”

The Ancient Eastern World

Medical marijuana’s long journey started in ancient China, where archaeologists have dug up evidence that hemp was used for fiber, food, rituals, and medicine as far back as 4000 BC. Around 2700 BC, Emperor Shen-Nung described the medical benefits of hemp, called “ma,” which were later recorded in the Shen Nung Ben Ts’ao (The Divine Farmer’s Classic of Materia Medica), the world’s oldest pharmacopeia. Ma was recommended for rheumatism, constipation, malaria, absentmindedness, and “female problems,” and was used in childbirth for retained placentas and postpartum bleeding. Not surprisingly, ma had its ups and downs; if used in excess, “ma-fen” (the fruit of hemp) could “produce visions of devils [and on the plus side] over a long term, it makes one communicate with spirits and lightens one’s body . . . ,” Its long-term use was also said to make people fat, strong, and “never senile.”

What we now refer to as cannabis spread from China to other parts of the world through trading, migration, and military conquests. It arrived in India around 2000 BC, and by 1000 BC, it was considered to be a sacred plant used in religious rituals. “Bhang,” as it was called in India, was said to cause happiness, joy, feelings of freedom, and relief from anxiety. It was also used medically as a painkiller, diuretic, anticonvulsive, anti-phlegmatic, appetite stimulant, and aphrodisiac, among other remedies.

Ancient Middle Eastern and Western Countries

Since the time of the pharaohs (ca. 3100 BC), cannabis was used in Egypt for a variety of conditions. The first written evidence, which was found in the Ramesseum Papyrus (ca. 1700 BC), described it as a treatment for eye diseases, while the Ebers Papyrus (ca. 1550 BC) mentioned that it was used to induce childbirth contractions, treat infected fingers and toes, reduce fevers, and heal urinary and rectal problems. It was administered in a variety of ways: inhaled, taken orally, applied topically, and inserted rectally and vaginally, all delivery methods still used today. (See Chapter 3.)

In Israel, archaeologists recently found residues of cannabis that contained THC in an ancient eighth-century BC temple. This is claimed as the first evidence that ancient Israelis used the drug for religious rituals. In the sixth century BC, cannabis, which was called “kaneh bosem,” was mentioned in the Torah as part of the ritual offerings that Moses gave to God. Almost one thousand years later, in AD 350, kaneh bosem (aka kaneh bosm) was referred to in the Talmud as an intoxicating incense that was burned during religious services.

After taking root in India and Egypt, cannabis spread to Rome, Greece, and other parts of the ancient world. Around 450 BC, the ancient Greek historian Herodotus described in his book, The Histories, how the Scythians of Central Asia would inhale smoke from hempseeds during funerals and “howl in joy.” But no mention was made of its medicinal use. Several centuries later, however, the Roman naturalist and historian Pliny the Elder (AD 23-79) wrote about its risks and benefits in his thirty-eight-volume book, Natural History (the world’s first encyclopedia):

Hempseed, it is said, renders men impotent: the juice of this seed will extract worms from the ears, or any insect which may have entered them. A decoction of the root in water, relaxes contractions of the joints, and cures gout and similar maladies.

About a century later, the Roman physician Galen wrote that cannabis juice helped relieve earaches, and hempseed cakes could cause hilarity, relaxation, and euphoria. But he also warned that hempseeds were difficult to digest and could hurt both the stomach and head. In the twelfth century AD, Maimonides-the Jewish philosopher and physician to the Egyptian royal court-mentioned that hemp seeds and oil were used medicinally, but he didn’t provide any details. This may be because by the twelfth century, cannabis had been banned in Jewish and Muslim societies.

The Middle Ages in Europe

In medieval times in Western Europe, hemp was extensively used to make textiles and other products, but not necessarily for medical purposes. It was, however, a popular folk medicine in Eastern Europe, where it was used to treat toothaches, aid in childbirth, reduce fevers, relieve joint pain, and even prevent convulsions.

An eleventh-century German, Hildegard von Bingen-a nun, herbalist, mystic, composer, and writer-was one of the first Europeans to write about hemp’s medical benefits. A true Renaissance woman before the Renaissance, she was also the first woman to write a medical book, Physica (translated as The Book of Medicinal Simples). She wrote that hemp could help the stomach, wipe out mucus, and relieve pain-especially head pain. As she rather cryptically observed: Whoever has an empty brain and head pains may eat it and the head pains will be reduced. Though he who is healthy and full of brains shall not be harmed by it. He who has an empty brain shall be caused pain by indulging in hemp.

The medical benefits of hemp became more widely known and accepted in the seventeenth century, when prominent herbalists, botanists, and scholars started writing about its use as a cure for a long list of conditions. In England, in 1640, the royal botanist, John Parkinson, described how cannabis seeds were used to treat intestinal and gallbladder diseases, and how concentrated hemp roots could reduce inflammation and swelling, as well as relieve pain from burns, tumors, gout, and other joint problems. The famous seventeenth-century herbalist and physician-scientist Nicholas Culpeper wrote in his book, Complete Herbal, “The seed of hemp consumes wind, and by too much use . . . dries up the natural seed of procreation . . . ,” which may or may not have been considered a benefit.

Cannabis wasn’t just believed to be useful for physical disorders; the Oxford scholar Robert Burton suggested in his popular book, The Anatomy of Melancholy (1691), that cannabis might be helpful for treating depression. About 150 years later, Jacques-Joseph Moreau, a French psychiatrist who is considered the father of modern psychopharmacology, was also interested in the psychoactive effects of cannabis. In the 1840s, he experimented with hashish on himself and his students. Moreau later used it to treat his psychiatric patients and found that it not only helped calm them down, but it also improved their sleep, increased their appetites, and relieved their headaches.

While hashish was all the rage for recreational use, cannabis wasn’t very popular for medicinal purposes in Europe at the time. Its big breakthrough came as a result of the careful observations and experimentations of William O’Shaughnessy, a British physician and an army surgeon in India in the 1830s. He was impressed by how the Indians successfully used cannabis as a cure for a number of conditions, which he meticulously documented. He then conducted research studies, first on animals and then on patients-the very first cannabis clinical trials in history. O’Shaughnessy found the drug to be both safe and effective: the gold-standard outcome for clinical trials. He reported that hemp extracts and tinctures resulted in the “alleviation of pain in most-remarkable increase of appetite in all-unequivocal aphrodisia, and great mental cheerfulness,” in all his subjects. And because the drug didn’t produce “headache or sickness of stomach,” he concluded that “no hesitation could be felt as to the perfect safety of giving the resin of hemp.”

When O’Shaughnessy returned to England, he brought a large supply of cannabis with him, and produced and distributed a tincture of hemp, called “Squire’s Extract,” to other physicians throughout Great Britain. This helped pave the way for the acceptance of cannabis into mainstream medical practice. Based on O’Shaughnessy’s research and writing, hemp extracts became widely used during the Victorian era for convulsions, muscle spasms, rheumatism, insomnia, and menstrual cramps, and to induce childbirth contractions. Except for use during childbirth, O’Shaughnessy was way ahead of his time!

It has long been rumored that Queen Victoria used pot for her period pain. And there may be some truth to it; Queen Victoria’s personal physician, Sir John Russell Reynolds, was a great champion of cannabis and wrote extensively about its benefits. Two of these benefits-controlling convulsions and relieving nausea and vomiting-are among the most important proven benefits of cannabis today. Also important was Reynolds’s recommendation that doctors start their patients on very small doses of cannabis and gradually increase the dose until their patients find relief. As you’ll see throughout this book, his good advice is extremely relevant today.

Cannabis Hits the New World


Hemp first arrived in the American Colonies around 1611, when Jamestown settlers brought the plant from England to Virginia to grow for cloth and other necessary products they needed for survival.

England also needed large amounts of hemp, not only for textiles, but for ropes and sails for its military ships. To meet these growing demands, in 1754, King George II offered the American colonists large bounties for sending bales of raw hemp to London. This annoyed Ben Franklin, who complained that there wasn’t even enough hemp for the colonists’ consumption. Penalties were imposed on farmers who didn’t produce the product, and as a result, hemp cultivation increased dramatically in the colonies to meet the need domestically and abroad and was thus woven into the fabric of our nation. Perhaps if Virginians had discovered some of the other benefits of hemp, they would have come around to approving medical marijuana sooner!

But the medicinal use of hemp didn’t really take off on either side of the Atlantic until O’Shaughnessy’s publications promoting cannabis as a cure gained traction in the mid-1840s. In 1850, cannabis and its cures were listed for the first time in the United States Pharmacopeia, where it remained until 1942. By the end of the nineteenth century, more than one hundred medical journal articles were published in England and the United States touting the many benefits of cannabis, including for indigestion, poor appetites, migraine headaches, menstrual pain, muscle spasms, insomnia, eczema, gastrointestinal problems, gonorrhea, and even “childbirth psychosis.” The 1896 Merck index promoted six cannabis preparations, which were recommended for such conditions as hysteria, tremors, insomnia, gout, depression, and insanity. Anyone could sell it or buy it from apothecaries, general stores, mail-order catalogs, and traveling salesmen. In addition to Merck, other pharmaceutical companies-including Squibb, Eli Lilly, and Parke-Davis-manufactured and sold various forms of cannabis.

Cannabis was also considered safer and superior to opiates because it had fewer side effects and wasn’t physically addictive. At the turn of the twentieth century, there were a million Americans addicted to morphine or other opioids. Some journal articles even promoted cannabis as a treatment for opiate addiction! Talk about history repeating itself: an increasing number of medical journals articles today are providing evidence that cannabis appears to be reducing the use of opioids-and may even help treat opiate addiction. (See Chapter 4.)

So how exactly did marijuana go from being considered an effective, safe cure for many conditions to being maligned as a dangerous drug that leads to madness and even heroin addiction?

The Fall and Rise of Cannabis


Cannabis elixirs were commonly found in many American households in the late nineteenth to early twentieth centuries, but they soon started to lose popularity. As rival remedies like tranquilizers and painkillers such as morphine, cocaine, aspirin, barbiturates, and hypnotics came on the market, these potent but potentially dangerous drugs won out because they were produced and heavily promoted by the burgeoning pharmaceutical industry. The big game changer came in 1844: the invention of the hypodermic needle followed by the wide availability of injectable morphine. Morphine use shot up in popularity, especially among wounded Civil War soldiers and veterans and other chronic pain sufferers.

It was the Mexican Revolution of 1910, though, that had the biggest hand in the demise of medical cannabis. After the revolution, many Mexicans workers fled to Louisiana, Texas, and other southern and border states, where they were hired and exploited as cheap labor. Some brought marihuana (Spanish for Mary Jane) with them, which they smoked for relaxation and relief from their hard labor.

Marijuana then spread to poor immigrant and minority communities at a time when poverty, unemployment, and crime increased. Mexican immigrants, especially, became scapegoats; they were not only blamed for taking jobs away from whites, but for bringing drugs and crime to the United States. Sound familiar?

But it wasn’t just the Mexicans who took the heat. In 1911, “Hindoo” immigrants in California became the target of discrimination and were blamed for crime and the spread of marijuana among the white population. In 1913, California became the first state to pass a marijuana prohibition law. Then in 1914, a federal antidrug law called the Harrison Act was passed. However, while it restricted the sale and use of opiates and cocaine, it only imposed a tax on the distribution, sale, or possession of marijuana for nonmedical uses.

With the passage of the anti-alcohol Volstead Act in 1919, prohibition became the law of the land. But it didn’t stop people from finding other ways to procure their favorite beverage. Some made their own “moonshine” or “bathtub gin,” while others got bootlegged booze at speakeasies or through private connections. Some who couldn’t afford to buy it, weren’t into DIY brew, or were afraid of getting arrested or poisoned by adulterated alcohol found another alternative. Smoking “weed” or “reefers” became a cheaper, easier, and safer option. “Tea pads” soon became the rage in large cities-especially in Black and other minority neighborhoods-where “hepsters,” jazz musicians, artists, radicals, and freethinkers could hang out, get high, and listen to the newly popular reefer music.

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Additional information

Dimensions	0.8000 × 5.9400 × 8.9800 in
Imprint	Avery
ISBN-13	09780593190241
ISBN-10	0593190246
Author	Andrew Weil, M.D., Joan Liebmann-Smith, PhD, Mikhail Kogan, M.D.
Audience	General / adult
BISAC	HEA011000, MED004000
Subjects	wellness books, herbal medicine, health books, chinese medicine, medical books, health and fitness, homeopathy, herbal remedies book, herb book, medical books for doctors, medicinal herbs, cannabis books, MED004000, stoner gifts, stoner books, cbd book, medical book, medical marijuana book, marijuana book, marijuana books, cbd, wellness, self help, science, health, medical, Herbs, medicine, HEA011000, herbal, mental health, science books, herb, Herbalism, health and wellness, cannabis, marijuana, alternative medicine, medical marijuana, weed