Weighing in on the Medical Marijuana Issue

I have witnessed and thought long and hard on the medical marijuana issue and debate for decades. I was a too young college student, precocious and underage for a college student but more worldly wise than my “Doogie Houser” like age and circumstances would convey. I had lived in nearly half the states in the Union and over a dozen foreign countries and had many experiences than the usual late middle school aged youngster growing up in a well educated professional, college emphasizing family of my time. I had lived in countries that even in the 1960’s were paralyzed by national endemic drug use to such an extent that my father, a mining engineer had trouble finding sober, not stoned underground miners for his projects; those drugs were opiates, pot/hashish and khat. I went to college and medical school in one of the hot spots of the latter hippie years and centers of the drug revolution, Ann Arbor at the University of Michigan. I saw people all around me smoking dope, dropping acid, and experimenting with the early designer drugs, DMT etc. I was curious and observed all this just like I did the radical, anarchist white student power movements of those times, attending SDS and Weathermen meetings, hearing Tom Hayden, Rene Davis, Eric Chester, Abbie Hoffman and other lesser known student radicals of that tumultuous era give speeches at rallies and in small groups, talking about “kidnapping Kissinger,” and other idiotic things. Sitting in on some of the small group meeting-cabals, given that I came from a military family, I could look around the room, and silently count the FBI agents in disguise in attendance, chuckling and thinking to myself ‘how dumb can these people be?’ I became so interested in the student radical movements that enveloped my world in Ann Arbor, I did the scholarly thing, and did a dissertation that compared them to the radical anarchist movements in Russia before the Bolshevist Revolution of 1917 that brought Vladimir Lenin, Trotsky and the Communists to power, and have looked at radicals in those terms ever since.

During all my student, medical school and most of my adulthood as a psychiatrist who saw quite clearly the use of pot leading in its touted and to some extent, true role as the gateway drug to harder drugs. I viewed the legalization of pot as an impossibility. I saw several old friends, from my years in Ann Arbor, who were bright people, professionals, academics, and who were daily pot smokers throughout their adult years, develop memory problems and cognitive ‘slippage.” I was shocked to learn in recent years that several became frankly mildly demented in their fifties, over ten years ago now, and had to stop working in the professions.

As a psychiatrist facing substance abuse on a daily practice as any psychiatrist does, I followed the somewhat recent research on THC, i.e., pot, utilizing functional MRIs of brain functioning. I was more than a little taken aback to see this research demonstrate more and more true and disturbing central nervous system deficits, “arid holes,” as I came to call them, in full color pictures in the scientific literature. I was like most people, seeing marijuana abuse as harmful, but not by any stretch of the imagination, in the realms of heroin or alcohol.

But something has changed in the world of marijuana since my college and medical school days. Entrepreneurs growing marijuana, especially paradoxically perhaps, the better educated ones, have applied good ol’ college Mendelian genetic breeding techniques to the art of cultivating pot. The pot of today and the last 10 years at least is now at least 10 to 20 times as potent as the pot of the hippie and Vietnam War eras. So its effects have begun to be more pernicious, as medical and public health epidemiologic studies have chronicled for a number of years to the deaf ears of most. So by the time this kind of research began to surface over a decade ago, the full cry howl of excoriating counter-propaganda rose, equating the emerging warnings with the old, inane and stupid original public health education campaigns against marijuana that started in the 1950’s such as the films in the genre of “The Scourge of Marijuana,” that were laughable in the extreme. The public health stance of the “medical and substance abuse establishments” were not helped then and later by the revelations that almost all of the early decades of anti-marijuana propaganda, was funded by such non-medical organizations as J. Edgar Hoover’s FBI, and had almost no basis in legitimate medical research

However, in the last few decades, it also became clear to me that something in pot was an anxiolytic, an anti-anxiety agent that could not be ignored. Scores, if not hundreds, of patients over the last 40 years of my practice life have told me such similar accounts of its helpful effects on various forms of panic/anxiety states and low grade depression that I had to be more tolerant in my view of it. Then more beneficial effects started to make their way into our medical awareness, lexicon and the media, such as upon chronic pain, fibromyalgia, and glaucoma. I began to think to myself that if marijuana, much like tobacco, had hundreds of compounds in it in addition to its “active” ingredient of THC [tetrahydrocannabinol], that surely in the potpourri that was pot, could be found useful therapeutic agents. This analogous thinking arose in me partially from the debate over tobacco, its “down-regulation” to use a neurophysiologic term, as the anti-tobacco lawsuits, increase in pricing and the many decade long public health campaign against tobacco proceeded. Contained in the scientific community was the wish/hope and intellectual curiosity to see if in the 400 or so compounds in tobacco could be found useful agents for almost any marketable use from construction to medicine, in order to salvage and give hope to the tobacco growing farmers who were in many ways, one of the big economic losers in the Fall of Tobacco in the USA. The tobacco companies were so wealthy akin to the cellular communications and oil companies of today, that paying the some $900 billion in settlements was for them just another “cost of doing business,” and the signal to start closing their American based plants and move them to the bigger, developing markets in the Far East where they saw the billions of new smokers in China, India and the other Asian markets. And poison them too, causing the now exploding rise in all those new smoker countries, of obstructive lung disease and of course the deadly scourge of lung cancer.

Alas, not much has emerged from years of research into potential marketable uses for substnaces contained in the tobacco leaf, so the tobacco growing industry has not made any sort of comeback due to a new marketable use and demand. But I think that this likely will not be the case with  marijuana research. I firmly believe, that worthwhile medical treatment agents likely will emerge from cannabis in the decades to come. But given how hard research is, it will take decades.

Back to the current wave of legalization of “medical marijuana,” that is gradually enveloping state after state. It fascinates me that in state after state that has legalized to one degree or another, some permitted rubric under which marijuana can be legally grown and sold now, that the same politicians who inveighed against pot as if it were the scourge of scourges, are now suddenly falling all over themselves to legalize and tax it. And as usual, “it is all about the money.” How quickly the conservatives and others who railed every election cycle against such have in the last several years rushed to legalize pot realizing the decades old goal of NORML which used to be seen as almost subversive. It is not accidental nor at all coincidental that this legalization and invention of a new “revenue stream,” in the form of another “sin tax,” has gained almost Homecoming Queen popularity. The recession in this country has been long and hard and slow. And the so called recovery trumpeted on Wall Street, in the some business circles has NOT found its way to Main Street and the millions of displaced and downwardly sliding former middle class in this country, no matter which political party has been in power in Congress or the Presidency. As the ideology of not raising taxes has become one of the dreaded “Third Rails” of American politics, politicos with a sudden change of heart regarding pot, have rushed to legalize marijuana, to fill the states’ tax coffers in an easy way that has not cost them votes or their beloved re-elections. Principles sometimes die incredibly rapidly given the right (or wrong) inducements.

I can be derided as and accused of being a “reactionary,” a now “oldster,” who cannot change with the times, but I hold that we are premature in legalizing medical marijuana. When I see tv specials highlighting the “marijuana bus tours” that go to Denver or Oakland instead of to Nashville or Branson, I know that the ruse of the excusing cover of “medical” is wearing thin. And the formidable economics being reported in the last two years touting the now legal marijuana business growing into the Billions, says to me that the vultures of homegrown organized crime cannot and will not ignore this new pot of gold. Organized crime of the old forms and organizations, and I predict pessimistically, new forms, will inevitably invade the new medical marijuana sectors in the states it is “open for business.” There are already rumblings of how easy it is to obtain from less than ethical physicians, prescriptions sanctioning, or as I might sarcastically say in Archie Bunker terms, “sanctifying” purchase of marijuana for paid medical purposes.

I sincerely hope that and am optimistic that given time and appropriate continued research into the components and neural mechanisms of the complex of marijuana, we will find medical advances in many areas that are hinted at presently. I think that these can be accomplished by finding out which component is a safe anxiolytic, hopefully even safer than the current benzodiazepines, safer pain modulators that would be far safer than the opioids and more uses than we likely can possibly imagine now. But I honestly think even if this is now a growing minority view, that we have foolishly jumped the gun on the rush to legalize marijuana, look politically correct, bow to the millions who abuse it, run after its certain voluminous revenues, all the while opening the doors to social and legal problems that will certainly surface in the  years to come and bring their own costs.

About the only good thing, I cynically can think of in all this, is that maybe demand for illegally imported marijuana may diminish and put a dent in the vast wealth, power and even control of nations, that the international drug cartels now enjoy. But at what future cost we cannot see now?

 

 

In the last ten years, NORML or the national organization that has long lobbied for the legalization of marijuana, which to be honest and ‘transparent,’ During all my student, medical school and most of my adulthood, I never thought had a prayer of success,

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