Winners don’t use drugsWilliam S. Sessions, Director, FBI
Ever noticed how a bad hangover feels like your body is dying? The truth is, it sort of is. What you did the night before was knowingly load your body full of a poison.
Anyone that has ever taken that “one drink too many” knows all too well the symptoms of what amounts to mild poisoning.
The weak heartbeat, tiredness, muscle fatigue, dehydration, headache, bad breath.
We even know what long-term alcoholism looks like either thanks to the media or our own personal experience (the UK’s National Health Service reported 9 % of adult males as having alcohol dependence back in 2009[ref]NHS (2011) – link/report[/ref]).
The reality is alcohol, as a drug, has a high cost to society. Alcohol is highly addictive, with major detrimental health connotations in both the short and long-term, ranging from minor injuries to multi-organ failure.
But, because alcohol is a drug that we have been using for millennia, because we have a very successful alcohol industry framing the discussion, society accepts alcohol.
After all, we are not drug addicts, but needing a drink…
A rational discussion?
Papers in the Lancet from leading professors in the field, have called time[ref]Lancet (2007) – journal[/ref] and time[ref]Lancet (2010) – journal[/ref] again for us to rethink drug classification, where drug laws are set arbitrarily rather than any cost or risk analysis.
[ref]The Economist (2010) – link[/ref]
Professor David Nutt, the lead author and one-time UK government’s chief drug advisor, was in fact sacked from his advisory position for stating as such. Explaining Prof. Nutt’s dismissal in a letter the Home secretary wrote in The Guardian[ref]The Guardian (2009) – link[/ref]
Professor Nutt is indeed a reputable scientist whose views on drugs policy are well known. However, his role as my principal adviser was to (unsurprisingly) present advice. It is the job of the government to decide policy… he [Prof. Nutt] cannot be both a government adviser and a campaigner against government policy. Alan Johnson MP, Home secretary
Responding in The Times, Prof. Nutt said[ref]The Times (2009) – link (paywall)[/ref]
I gave a lecture on the assessment of drug harms and how these relate to the legislation controlling drugs. According to Alan Johnson, the Home Secretary, some contents of this lecture meant I had crossed the line from science to policy and so he sacked me. I do not know which comments were beyond the line or, indeed, where the line was Prof. Nutt
The history of marijuana
Clearly a rational discussion cannot be had, even on a topic as commonplace as alcohol. How then do we have an informed and rational discussion on an emotive topic like marijuana?
A good place to start is looking at the history of marijuana.
The ancient world
Archaeologists record the first use of cannabis to an ancient village in Taiwan dating back over 10,000 years from the Stone Age[ref]Ernest L. Abel (1980) – book[/ref] where tools were found for loosening the cannabis fibers from the plant stem. The Chinese book, Book of Rites (second century BC) even states that out of respect for the dead, mourners at a funeral should wear hemp.
During the long course of Ancient Chinese history, hemp found its way into almost every aspect of Chinese life. Hemp is even accredited with the invention of modern paper. Previously, everyday writings were carved into bamboo or wood, whilst decorative writings would be written upon hugely expensive silk paper.
The first account of outlawing cannabis comes far later in 1378With time, hemp became a symbol of power over evil in China.
Healers would burn cannabis stalks, carved with snake-like figures to banish demons from the bodies of the sick. As far back as 2727 BC, crushed cannabis leaves were pressed into wounds to aid with the pain of suffering.
The first account of outlawing cannabis comes far later in 1378. The Ottoman Emir, Soudoun Scheikhouni banned the use of hashish in the Muslim world. The Emir worried that claims of being able to communicate directly with God would threatened the religious establishment that had him in power.[ref]Martin A. Lee (2013) – book[/ref]
That was 600 years ago.
The modern era
Today’s attitudes towards cannabis lay in the US, and in racism.
The US has a long history in outlawing drugs as a way to suppress minorities.
Opium was banned in San Francisco in 1875, coinciding with a migration of Chinese immigrants.
Cocaine – the drug hailed by Sigmund Freud as the “non-addictive” cure-all – was the main drug of the African-American community in the US. Cocaine was quickly outlawed in response to media fear-mongering about lurid stories in which drug-fueled black men were attacking Southern, white women.
Alcohol prohibition (1920-1933) was largely seen as a way to instill old-fashioned Protestant values on the socially undesirable, working class Catholics, whom were typically associated with alcohol.
In the Mexican revolution (1910-1920), an estimated 1 million Mexican refugees entered into the US, bringing with them recreational marijuana.
The media was once again instrumental in creating fear against this latest immigrant influx. This was further fueled by William Randolph Hearst, who wanted to keep hemp out of his lumber and paper interests[ref]Biography (2015) – link[/ref]. A series of studies linking marijuana usage to violent crime and other undesirable behaviour appeared, ultimately criminalised marijuana in the US in 1937.
As with so many other drug policies, once a law is passed it is difficult, if not impossible, to revert. Furthermore, most countries around the world simply find it easier to tow the same line as the US to provide a unified front to war on drugs .regardless of their own cultural stance.
Then came a chemist
Even into the middle of the 20th century, science did not understand the first thing about marijuana.
What it was. How it worked.
All a mystery.
Due to the illegality and tainted image of cannabis, few scientists were going to risk besmirching their reputation.
Then in 1963, at the Weizmann Institute of Science, outside Tel Aviv (my old workplace), a young organic chemist called Raphael Mechoulam decided to do something.
It seemed odd to this young man that morphine had been extracted from opium in 1805. Cocaine from coca leaves in 1855. Yet, here was marijuana. Still a mystery.
Mechoulam reflects in this month’s National Geographic cover story[ref]National Geographic (2015) – link[/ref]
It was just a plant…It was a mess, a mélange of unidentified compounds.Dr. Raphael Mechoulam
With a short phone call to the Israeli police, he quickly sourced 5 kilos of Lebanese hashish and set to work.
His team isolated several compounds, which were purified and injected separately into rhesus monkies.
He noted that only one compound “sedated” the normally aggressive rhesus monkey.
Further testing found what the world now knows as the principal active ingredient of the cannabis plant.
Mechoulam, along with a colleague, had discovered tetrahydrocannabinol (THC).
He and his team also elucidated the chemical structure of cannabidiol (CBD), another key ingredient in marijuana, one that has many potential medical uses but no psychoactive effect on humans.
Israel, as a result, has one of the world’s most advanced medical marijuana programs. Some 20,000 patients have a license to use cannabis to treat glaucoma, Crohn’s, inflammation, Tourette’s and even asthma.
Despite several promising results in several trials, Mechoulam himself warns against legalising marijuana, insisting that it is “not an innocuous substance”.
In the still-developing brains of the younger population, prolonged, high THC levels can change the way the brain develops, and in some can provoke serious anxiety attacks. There is also emerging evidence that cannabis in a small minority may trigger a genetic predisposition to schizophrenia.
Mechoulam goes on to say
Right now, people don’t know what they’re getting. For it to work in the medical world, it has to be quantitative. If you can’t count it, it’s not science.Dr. Raphael Mechoulam
His lifetime of work also discovered many other endocannabinoids, as well as their receptors in the brain.
Scientists have come to realise that endocannabinoids interact with a specific neurological path, apparently playing an important role in such basic functions as memory, balance, movement, immune health, and neuroprotection as well as “probably account[ing] for what jogging enthusiasts call runner’s high.”
Pharmaceutical companies are currently manufacturing many cannabis-based medicines, but historically they have sought to isolate individual compounds in order to minimise the complexity involved. However, most marijuana researchers believe that there is something to the cocktailing of multiple compounds, found in the cannabis plant that make it so effective.
He concludes, with perhaps one of my favourite quotes of all time
We have just scratched the surface and I greatly regret that I don’t have another lifetime to devote to this field.Dr. Raphael Mechoulam
Fact from fiction
We have reached a problematic point in time. All of us have heard of some anecdotal, pseudo-science story where cannabis has played a palliative role in treatment to a disease.
There is little question that marijuana can help stave off nausea, improve appetite, reduce pain and aid sleep.
A simple Google search will return millions of results testament to it.
One could even believe some miracle cure had been found.
The problem lies in that all of these stories are, anecdotal at best, and downright fraudulent at worst.
However, strides in genuine clinical trials are being made. In Israel, cancer is being shown to have its growth slowed with palliative medicine marijuana[ref]HAARETZ (2015) – link (paywall)[/ref]. In Spain, cannabinoids are showing dramatic reduction in the size and aggression of brain tumours[ref]Nature Reviews Cancer (2003) – article[/ref].
Meanwhile back in the US
Undoubtedly, a huge amount of global research clout comes from the US.
Earlier this year, for the first time in 40 years the US Public Health Service (PHS) approved protocols required for a study to treat treatment-resistant combat veterans with post-traumatic stress disorder (PTSD).[ref]Alternet (2015) – link[/ref] However, the DEA still needs to sign off on the experiment before trials can begin.
Within a month of that press release, a prominent researcher, Dr. Sue Sisely, recipient of the Leo B. Hart Humanitarian award, generous donor to the University of Arizona, with 76 veterans ready to participate in cannabis study, had all three of her university contracts stripped overnight.[ref]Alternet (2015) – link[/ref]
Speaking with The LA Times, Dr Sisely says[ref]The LA Times (2014) – link (paywall)[/ref]
This is a clear political retaliation for the advocacy and education I have been providing the public and lawmakers, I pulled all my evaluations and this is not about my job performance.Dr. Suzanne Sisely
The future of marijuana research
So what happens in the future?
Cannabis research is not going anywhere.
Whilst any anecdotal evidence exists, it will create hope.
With hope, comes more stories. More stories yields more attention, and at some point, the mounting attention will need to be addressed.
Just this week, Australian millionaire, Barry Lambert donated $33.7 million to the University of Sydney for cannabis research.[ref]Australian Financial Review (2015) – link[/ref] The largest donation in Australian history.
The experience of our granddaughter, who suffers from debilitating epilepsy, has opened our eyes to the extraordinary possibility of cannabinoids treating not only her condition but a range of chronic illnesses that often don’t respond to conventional treatmentsBarry Lambert
Scientific research is ongoing into the medical potential of cannabis in Australia, Israel, the Netherlands and Spain.
But the truth remains, so much is unknown about the actions of the compounds within cannabis.
With so much uncertainty, can anything be determined as safe?
Will governments continue their hard stance on drugs, despite almost all evidence to the contrary saying that Richard Nixon’s War on Drugs and minimum sentences do not work?
The answer is a very personal one.
It is my belief that the answer lies in your opinion of government and the self.
Everything in this world has an associated risk. If it is your belief that choice is the individual’s to make, then cannabis legalisation makes sense. If it is your belief that some choices should be removed from the individual for the greater good of society, then should we not be first addressing the alcohol and tobacco industries?