Questions and Hopes Abound in Medical Marijuana Community

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In 1996, California voters passed Proposition 215 to “ensure that seriously ill Californians have the right to obtain and use marijuana for medical purposes where that medical use is deemed appropriate and has been recommended by a physician who has determined that the person’s health would benefit from the use of marijuana in the treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief,” according to the text of the law.

The proposition’s success was an indicator of a growing consensus against efforts to demonize the drug that began in the Reefer Madness era, when Harry J. Anslinger, the commissioner of the Federal Bureau of Narcotics, announced in 1937 that he could scarcely speculate “how many murders, suicides, robberies, criminal assaults, holdups, burglaries, and deeds of maniacal insanity it causes each year.” Eighty years later, with medical marijuana now legalized in 29 states, the precise nature of the drug’s health effects and the bounds of its medicinal benefits are still largely unknown.

Especially ambiguous are questions as to whether cannabis has the capacity to cure diseases or merely alleviate symptoms, and whether it possesses any preventive properties or other all-purpose health benefits for users who aren’t ill. A dearth of scientific research, owing to federal restrictions, has allowed for both unbridled optimism and offhand dismissals.

Dr. Hanya Barth – founder of Compassionate Health Solutions, a group of cannabis clinics scattered across Northern California – works out of a South-of-Market office, where she provides counseling and dispenses medical marijuana cards. Barth identified pain, insomnia, and post-traumatic stress disorder as three conditions to which the application of marijuana is especially well-suited, but she’s hesitant to delimit her practice. She treats “everything,” working with her patients to figure out cannabis regimens that serve their specific needs and agree with the particularities of their constitutions. “There’s a lot of variations,” she said, noting that treatment plans are “individualized” according to her patients’ “age, according to their condition, according to their previous use.”

Asked whether she believes marijuana has curative capacities, Barth answered, “That’s a great question, and we’re hoping that somebody will start funding research so that we can answer that definitively.” Yet in the absence of a resolution, anecdotal evidence of its salubrious potential attracts increasing numbers of users. Barth is aware of marijuana enthusiasts who “juice with it, who take the leaves from the plant and put it in the juicer along with greens and other vegetables,” as part of a diet rich in vitamins, nutrients, and antioxidants, without any clear-cut intention to treat a distinct illness. She could neither affirm nor deny the validity of such a practice. “I can tell you that many, many people find [cannabis] very helpful for many, many things,” she said.

In 2014, Eloise Theisen, a nurse practitioner in Contra Costa County, formed Green Health Consultants, a team of cannabinoid therapists whose expertise is advising senior citizens on their forays into medical marijuana. According to Theisen, the average age of her patients is 76; 85 percent of them are women; 75 percent have never previously used marijuana.

“I would say that the industry standard for a dose is 10 milligrams,” said Theisen. “In some cases, I may start a new patient at one milligram. In addition to starting with a low dose, I also educate patients about how to select quality cannabis medicine. It is essential that the products are tested for potency, pesticides, and mycotoxins.”

Theisen believes wholeheartedly in marijuana’s ability to ease the suffering of people afflicted by anxiety, depression, appetite loss, and inflammation, among other conditions, and declared that, in her career in medicine, cannabis “has been one of the most effective tools I have ever had,” but she doesn’t tout it as a miracle drug. “Animal studies have shown that cannabinoids can have curative properties. Unfortunately, the lack of human trials makes it hard to decipher which cannabinoid and dose will provide the best chance at curing a disease,” she explained, emphasizing instead marijuana’s “huge role in palliative care” and in improving “quality of life.”

Even so, Theisen isn’t bereft of larger hopes, and she alluded to the pioneering research of neurologist Ethan Russo, M.D. “Humans are born with an endocannabinoid system. The ECS is a group of neuromodulatory lipids and their receptors, responsible for regulating mood, appetite, pain-sensation, and memory. Russo theorizes that many disease states” – including cancer and diabetes – “[can] arise from a clinical endocannabinoid deficiency. Consuming cannabis can help to restore our ECS back to balance,” she summarized.

The most optimistic view of cannabis’s health effects may come in the form of the book Marijuana: Gateway to Health, published in 2011 by San Francisco marijuana advocate Clint Werner. Werner’s unabashedly partisan tract compiles a detailed history of international cannabis research – limited as it may thus far be – to make a case for marijuana’s power to fight cancer and Alzheimer’s disease.

According to Werner, the “first real evidence of anti-carcinogenic properties appeared back in 1975” with the publication in the Journal of the National Cancer Institute of “Anticancer Activity of Cannabinoids” by researchers at Virginia Commonwealth University who “described how the growth of a certain type of lung cancer was inhibited by the oral administration of three naturally-occurring cannabinoids.” Unfortunately, their “findings were inconvenient for the new ‘War on Drugs’ that President Richard Nixon had launched with great enthusiasm just five years earlier. Shortly after the study was published, Congress established the National Institute on Drug Abuse (NIDA) to serve as a gatekeeper for all research into illegal drugs and substances, and gave it a strict mandate to research only the harm posed by such compounds.”

For this reason, much of the research suggesting marijuana’s potential benefits was conceived with the intention of identifying its detriments, including the 2006 NIDA-funded lung cancer study by pulmonologist Donald Tashkin at the University of California, Los Angeles. Per Werner, Tashkin finally “had to admit that his team had ‘failed to find any positive association between marijuana use [and cancer], even heavy marijuana use. If anything, the risks were a little bit less.’” The data even seemed to show “that marijuana had a ‘protective effect,’ preventing or reducing the risk of tumors.” Six months later, a Harvard University study observed “that when mice with lung cancer were given THC their tumors were reduced by half and the spread of the disease was slowed.”

Werner posits that THC – the common name for tetrahydrocannabinol, marijuana’s primary psychoactive ingredient – “also works against other cancers by acting as a powerful anti-viral agent, inhibiting the spread of at least one type of cancer-causing virus. Scientists at the University of South Florida found that THC ‘specifically targets the viral and/or cellular mechanisms required for replication’ and prevents the replication of certain kinds of herpes viruses,” such as the gamma herpes virus, which is implicated in the development of Hodgkin’s lymphoma and nasopharyngeal carcinoma.

In Werner’s view, “cannabinoids seem to work against cancer through a number of different mechanisms, including killing mutated cells, slowing their growth, or preventing them from spreading or growing new blood vessels.” He’s equally convinced that cannabis can help fend off Alzheimer’s disease by destroying the deposits of amyloid beta (AB) that disrupt the neural pathways of Alzheimer’s victims and lead to dementia. He noted that, in 2006 doctors at La Jolla’s Scripps Research Institute announced, “Compared to currently approved drugs prescribed for the treatment of Alzheimer’s disease, THC is a considerably superior inhibitor of AB aggregation.”

For Werner, marijuana is “very good for you; like blueberries or broccoli.” He asserted that, according to a study by Dr. Xia Zhang at the University of Saskatoon, chronic marijuana use can “actually improve learning and memory” by “promoting the growth of neurons in the hippocampus.”

Werner’s husband is Dr. Donald Abrams, a renowned oncologist at the University of California, San Francisco, who has successfully battled NIDA to secure permission to examine the effects of marijuana use among HIV/AIDS patients. His 2003 study showed a slight decline in the viral load of patients who smoked pot, contradicting “previous studies suggesting that smoked marijuana suppresses the immune system,” as Abrams put it. Abrams, however, is more measured in his enthusiasm for medical marijuana, and has stated, publicly and unequivocally, that there’s no evidence that cannabis cures cancer. Werner’s account of experiments perpetrated primarily on rodents doesn’t demonstrate a human cure. Rather, it points to the imperative for more research in a seemingly promising direction, according to Abrams.

On the other hand, early last year, UCSF’s Center for Tobacco Control Research and Education produced “A Public Health Analysis of Two Proposed Marijuana Legalization Initiatives for the 2016 California Ballot.” The report supported marijuana legalization as “an appropriate response to the social inequities and large public costs of the failed War on Drugs,” but it contended that the Adult Use of Marijuana Act, which passed last November, was “written primarily to create a new business” and contains only “minimal protections for the public that are unlikely to prevent public health harms caused by the burgeoning marijuana industry.”

The paper concluded that the “goal of any marijuana regulatory framework should be to treat marijuana regulation like tobacco regulation, allowing sale and use to be legal, while simultaneously creating an environment where falling numbers of people are interested in buying and using it,” citing evidence of marijuana’s “health risks, including increased risk for cancer, heart attack, stroke, reproductive toxicity, respiratory impairment, long-lasting detrimental changes in brain function, and increased risk for addiction.”