Cannabis is a vastly underutilized therapeutic option that has been wrongly vilified by U.S. regulatory agencies. In this interview, Dr. Margaret Gedde, a Stanford-trained pathologist and award-winning researcher, discusses the therapeutic value of this plant.
While initially focused on the conventional medical model, Gedde eventually transitioned over to holistic, drug-free health care in 2004. At present, she runs an alternative medical practice in Colorado, the home of medical marijuana, as it was one of the first states to widely legalize and apply it.
Gedde specializes in the use of cannabis, especially for the use of pain, thereby allowing her patients to get off dangerous drugs like opiates, which have created a public health emergency of massive proportions.
Drug Enforcement Administration Just Took a Huge Step Backward
We've come a long way in the U.S. when it comes to re-normalizing the use of medicinal marijuana. Unfortunately, the Drug Enforcement Administration (DEA) is still trying to suppress it as best they can.
In December, 2016, the agency announced cannabidiol (CBD) is being reclassified as a Schedule 1 controlled substance, putting it on par with LSD and heroin.
This despite the fact that CBD has no psychoactive component, meaning it cannot render you "high." This is truly tragic when you consider the many medical uses for CBD. As noted by Gedde:
Indeed, the decision is so beyond irrational, the only justification I can see is that the DEA is influenced or controlled by the pharmaceutical industry. Making CBD — a non-psychoactive, non-toxic component with medicinal value — a schedule 1 drug benefits no one except the drug companies that have to compete against it.
There's absolutely no justification in a rational, science-based system for this decision. Ironically, synthetic tetrahydrocannabinols (THC) drugs, such as Dronabinol and Marinol, are listed as Schedule 3 drugs.
Rendering CBD Illegal May Create More Medical Refugees
The DEA's decision on CBD means that patients who live in states where medical marijuana is not permitted may again have to contemplate physically relocating to a state where CBD is legally available, such as Colorado, since it can no longer be shipped across state lines.
While not commonly discussed, there are in fact many such "medical refugees" in the U.S. Prior to the reclassification, CBD was freely available in all U.S. states, and could be easily obtained via mail order.
Cannabis Has Been a Boon to Colorado
Medical cannabis is very heavily taxed, and Colorado has seen enormous amounts of revenue flowing into the state with the legalization of marijuana. A big portion of that money is also given back as rebates to the residents of Colorado. So, from the state's financial perspective, it's been enormously effective and beneficial.
Colorado also allows the adult recreational use of marijuana. Interestingly, Gedde believes the impact of legalizing recreational marijuana has also been quite positive. For starters, if it's legal for adults to use marijuana, then it's easier for a person to seek medical cannabis.
Why Has Marijuana Been Vilified?
Smoking marijuana was once viewed as an act of political dissidence against the Vietnam War and looking back at the history of what President Nixon was doing at the time, one can rightfully conclude that one of the reasons marijuana was so heavily targeted was to get rid of the hippies.
Marijuana became the fulcrum in the social battle of the day, and the U.S. government sought a means to take certain types of individuals out of society, and what better way than to arrest them and put them in jail? As noted by Gedde:
On Entering the Medical Marijuana System
Gedde was trained in the idea that molecular biology will provide us with all the answers we need. By understanding the details of how cells work, we'll be able to design a cure for every disease. However, once she found herself actually working inside the pharmaceutical industry, seeing how decisions were made, she came to realize the flaws of the system.
The fact of the matter is, drug companies have the legal mandate to turn a handsome profit. This in and of itself can create situations where profits are placed ahead of actual medical benefits. Moreover, when a company selects a product to develop, that product is not necessarily what is most needed. It's the thing that will make the most money.
She opened her medical practice in 2004, but it wasn't until 2009 that she began realizing the usefulness of cannabis. Initially, she learned from patients who were using it. They would tell her about how it helped heal their various ailments. Eventually she began researching it on her own, discovering the human endocannabinoid system in the process — a biological system not touched upon in medical school.
In 2010, she made the decision to focus on medical cannabis full-time — a decision she ascribes to careful deliberation of what actually helps patients the most.
The Endocannabinoid System
The human endocannabinoid system — endo meaning "within" — strongly suggests the human organism is actually designed to make good use of the cannabis plant. In other words, the marijuana plant triggers something that's been inside us since the dawn of mankind. The endocannabinoid system exists in other mammals as well, suggesting it is a truly an ancient biological system.
The cannabis plant makes cannabinoids, also known as phytocannabinoids or plant cannabinoids. This encompasses both CBD and THC, the latter of which is the psychoactive ingredient. In all, there are about 60 different cannabinoids in the cannabis plant, and medicinally, several of them are used. You also make cannabinoids inside your own body. So far, two major ones have been identified and studied since the early '90s.
The endocannabinoid system was first described in a science article in "The Journal of Science" in 1992. The primary role of the endocannabinoid system — which releases human cannabinoids that interact with receptors found in virtually all tissues in the body — is to bring balance (homeostasis) to tissues and biological systems.
Essentially, the endocannabinoid system plays a key regulatory role in the human body. For example, there are endocannabinoid receptors in the nervous system, where cannabinoids are made locally on demand. What this means is that, in your nervous system, you have sending nerve cells and receiving nerve cells, and the endocannabinoid system works with those cells to maintain balance.
For example, if the receiving nerve cell becomes too excited, you end up with a seizure. Seizures are due to uncontrolled electrical activity in the neurons. It's an overstimulated state. The endocannabinoid receptor detects this overstimulation and, on demand, makes human cannabinoids to dial down the sending impulses, thereby balancing the system.
Cannabinoids Benefit Your Entire Body
By bringing tissues back into balance, cannabinoids can reduce pain, nerve stimulation causing seizures, and muscle spasm. They also help you relax and improve sleep.
Cannabis Has Self-Limiting Effects
There is no fatal toxicity associated with cannabis. As noted by Gedde, the effects of THC and CBD are both dose-dependent. They have a bell-shaped response curve, which means there's a sweet spot where you get the benefit without any adverse effects. For THC, small, appropriate doses are relaxing and settle the stomach.
Too high a dose of THC will trigger anxiety. It can also cause nausea, confusion and/or disorientation. In severe cases, you might not know where or who you are. Temporary psychosis can also occur on high doses of THC. However, these effects are temporary and will resolve once the drug wears off.
Such side effects are actually helpful in that they cause cannabis use to become self-limiting. People don't want to feel terrible, so excessive doses are automatically discouraged by creating adverse reactions. Opiates, on the other hand, has no such feedback mechanism. People who take too high a dose simply die in a very relaxed state.
Adverse Effects and Precautions
There is research in the medical literature suggesting that young people who already have a tendency to schizophrenia seem to receive a schizophrenia diagnosis sooner if they've been using marijuana. However, it's still not clear whether THC is actually causing or triggering the schizophrenia. That said, people with a family history of schizophrenia would be wise to use caution, and to work closely with an experienced doctor should they decide to try medical marijuana.
Benefits of Cannabis and Specific Cannabinoids
As mentioned, CBD has no psychoactive activity, and has a long list of medicinal uses. It's an excellent muscle relaxer, easing spasms and pain. For this use, it can be applied topically, although edible versions tend to provide the deepest and most long-lasting relaxation and pain relief.
THC is famous for settling nausea associated with chemotherapy. According to Gedde, there's really nothing a doctor can prescribe that's as effective as THC for nausea. It also helps improve digestive function. For this reason, THC is particularly valuable for digestive disorders such as colitis and inflammatory bowel disease (IBD).
Cannabis has been shown to help glaucoma by reducing the intraocular pressure. It also helps normalize blood pressure, although that's not a valid medical indication for medical cannabis use in Colorado. As noted by Gedde:
Seizures are a classic indication of use, but you need to be very careful with the dosing when treating seizures. Gedde has found that CBD tends to be more difficult to use for seizures than THC, as too much CBD will exacerbate the seizures. HIV and cancer are other indications for use, as cannabis helps with sleep, nausea, pain and immune support, and has anti-tumor activity.
Different Marijuana Strains Have Different Effects
In addition to cannabinoids, there's a whole other set of compounds in cannabis called terpenes — the same compounds found in essential oils. Terpenes are what give each marijuana strain its unique color and smell. Some strains smell like lemon. Other strains are purple and smell like lavender. In fact, the same terpene found in lavender, linalool, which gives lavender its calming, relaxing potential, is also found in many marijuana strains.
There's a whole range of marijuana strains known for their calming, sleep-inducing, relaxing properties, collectively known as "indicas." Indicas strains will not induce anxiety. They're relaxing and stress-reducing. The sativas are more stimulating and energizing, and resemble caffeine in this regard.
While helpful for anxiety and depression, sativas could produce paranoia and put you on edge, especially those with post-traumatic stress disorder (PTSD). When addressing the psychological spectrum, strain selection is very important.
CBD and THC Work Very Well Together, Ameliorating Side Effects
Gedde stresses the point that CBD and THC work very well in combination, and while medical cannabis has been primarily THC-based, the availability of CBD has been a real boon, as CBD helps temper the psychoactivity of the THC.
In closing, another point of note is that when the plant is unheated, meaning raw, it actually does not have THC in it. That's another one of its remarkable properties. The plant actually makes THC acid (THCA) and CBDA. So when you eat it raw, you get the THCA, not THC, which relieves pain and spasms. THCA is a synergizing agent, but it doesn't have the psychoactivity associated with THC.
This means you can consume marijuana raw and get health benefits without the psychoactivity. A number of doctors have become proponents of using raw cannabinoid as a dietary supplement. The key is to not heat the plant. If it were legal to use recreationally where I live I would grow it and regularly throw it in my smoothies.
Personally, I believe there are many still undiscovered benefits of taking cannabis therapeutically. There are no real downsides; no major adverse effects. Even the psychoactive side effects are only related to the heating of the plant, and even then they're temporary and largely self-limiting. The same cannot be said for opioids, which have overtaken cigarettes in popularity and kill tens of thousands of users each year, even when taken as prescribed.
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