Permission given to reproduce this article given on Wednesday,
July 13, 2005 by Cannabis Health Journal. For subscription details see
Feature Article issue 3-5 July/Aug 2005 - Thursday June 23rd, 2005
Interview with Dr. Lester Grinspoon
Lester Grinspoon MD is an emeritus associate professor of
psychiatry at Harvard Medical School. He has been studying cannabis
since 1967 and has published two books on the subject: "Marihuana
Reconsidered" (Harvard University Press, 1971) and "Marihuana, the
Forbidden Medicine", co-authored with James B. Bakalar (Yale University
Press, 1993). He maintains two active websites: The Medical Marijuana
) and The Uses of Marijuana website (www.marijuana-uses.com
Lester is truly one of the most respected and loved marijuana
advocates in the world. His compassion and commitment to the
truth keep him, at 77, active in the reform movement and he continues
to give his time to all of us in so many ways. On behalf of all the
volunteers and supporters of Cannabis Health we would like to thank
him, from the bottom of our hearts. It has been our honor to be
able to work with him.
Cannabis Health: Could you explain what Dr. JM McPartland and Dr
Ethan Russo meant by the statement: "The combination of THC, CBD
and essential oils in cannabis based medicinal extracts may produce a
therapeutic preparation whose benefits are greater than the sum of its
Lester Grinspoon: That is a good description of herbal marijuana,
which is comprised of all of the therapeutically useful elements, some
of which probably behave synergistically, and some have yet to be
identified. If the extracts McPartland and Russo speak of contained all
of these elements, they would have the potential for being as
clinically useful as whole smoked or vaporized cannabis. However,
because they are not intended to be taken through the pulmonary system,
they are handicapped in any medical competition with herbal marihuana.
CH: GW recently stated in a press release: "Sativex is not liquid
marijuana - Sativex is a pharmaceutical product standardized in
composition formulation, and dose administered by means of an
appropriate alternative delivery system, which has been, and continues
to be, tested in properly controlled preclinical and clinical studies.
Crude herbal cannabis-often called 'marijuana'- in liquid or any other
form is none of those things".
LG: Over the 38 years during which I have been studying cannabis I
have been so impressed by both its very limited toxicity and its
versatility as a medicine that I should think that GW Pharmaceuticals
would not take umbrage with the description of Sativex as "liquid
marijuana"; I would see it as a compliment. However, I think these
folks have undertaken a bold endeavor to make use of the anecdotal data
generated by medical marijuana users to create a pharmaceutical product
which now requires them to persuade the world that manipulated orange
juice is safer, easier to deal with and healthier than whole oranges;
and, of course, it's worth the extra cost. It's an absurd proposition
but GW Pharmaceuticals has to persuade would-be medical cannabis users
that there is a significant therapeutic difference between Sativex, an
extract of marijuana, and herbal marijuana.
I believe that they will not be very successful in selling this
extract unless they succeed in making this distinction. However, if the
prohibition gets more severe, interest in Sativex is likely to increase
in the same way it has for Marinol --not because it is a better and
safer medicine than herbal marihuana, but because it is not illegal. If
the prohibition were to disappear and Sativex had to compete with
herbal marijuana on a level playing field, Sativex would probably
suffer a fate similar to that of Marinol; some people would use it,
some might even prefer it, but it would not be a major means by which
people make use of the therapeutic utilities in marijuana.
If marijuana had been allowed to be researched in the appropriate
way for such a widely used medicine, it would long since have been
"tested in properly controlled preclinical and clinical studies." It's
a little inaccurate for GW to say Sativex marks the world's first
approval of a cannabis-derived medicine. Does GW not think that
Nabilone or Marinol are cannabis-derived medicines? In the literal
sense Sativex comes from a marijuana plant as opposed to a synthetic
compound, but those drugs are cannabis-derived medicines as well.
Contemporary governments may not approve herbal marijuana as a medicine
but a significant fraction of the medical marijuana patients of the
world use it as a medicine, have done so for centuries, and will
continue to do so.
CH: What is the history of marijuana extract?
LG: By the mid-19th century, there were a number of drug companies
who were producing Cannabis indica, the generic name at the time for
extracts of marijuana. One that was commonly used was Tilden's Extract,
the brand that Fitz Hugh Ludlow decided to use. He was emulating
writers of the French Romantic literary movement, members of Le Club
des Haschischins who would take large amounts of hashish, which
together with their effusive imaginations, led to extraordinary and
often distorted accounts of cannabis experiences. In fact, in my
opinion, these descriptions led to some of the myths which, until
recently, surrounded marijuana. These exaggerated accounts even
percolated down to Harry Anslinger [architect of US prohibition],
although he almost certainly didn't read them directly.
Extracts such as Tilden's were most commonly used to treat
insomnia and pain. They could be purchased from the local
apothecary up until the Marijuana Tax Act was passed in 1937.
Bayer (the same company which is now partnering with GW Pharmaceuticals
to distribute Sativex) produced the first synthesized acetylsalicylic
acid, or Aspirin, in 1898. Physicians now could prescribe these little
white pills that would relieve mild to moderate pain. In 1900 the first
of the barbiturates was synthesized, and others came rapidly on its
heels. Now there were pills that one could prescribe for sleep.
The Marijuana Tax Act was not meant to contribute to the demise of
cannabis as a medicine, but the kinds of paperwork created by the Act
discouraged physicians from prescribing it. Consequently, with the
arrival of these new drugs which successfully treated insomnia and
pain, the two symptoms for which Cannabis indica was most commonly
prescribed, its use declined. It was removed from the pharmacopoeia in
CH: Were physicians concerned about dosing back then?
LG: Physicians of the 19th century never discovered the remarkable
boon of using cannabis with a pulmonary delivery application.
Physicians at that time couldn't control the dose with any degree of
precision because they didn't even know the potency of the Cannabis
indica they were prescribing. However, they weren't too concerned,
because if a patient did get too large a dose, there were no serious
consequences, although a patient might be uncomfortable for a while.
Physicians were more concerned about under-dosing and the fact that it
took an hour or so for this medicine to take effect.
CH: How fast is the sublingual delivery?
LG: It's not as fast as smoking but not as slow as the oral route.
You have to wait at least 20 minutes for a sublingual effect. At first
GW claimed that Sativex is totally absorbed through the mucosa under
the tongue. But the fact is, the extract tastes awful and some people
find it very uncomfortable; they can't hold it under the tongue long
enough and it drips down into the esophagus. I would suspect that most
applications of sublingual Sativex actually end up with an unknown
proportion going the sublingual route and the other part of it going
orally. There would then be two kinds of titration points, one at 20-40
minutes, the other not until 1-2 hours have passed.
To me the sublingual route is an inefficient way of taking a
medicine when it is available in a form that allows for much more
precision in titration. Furthermore, the titration precision of
the pulmonary route allows the physicians to give the patient the
responsibility for establishing his own dosage. After all, it is the
patients who can say when they have achieved relief of their symptoms.
It's not the doctors, not the pharmacists; it's the patients. We allow
patients to take their own over-the-counter medicines. Even though more
than 16,000 people die every year in the United States from idiopathic
gastric bleeding and other toxic effects caused by Nonsteroidal
Anti-Inflammatory Drugs (NSAIDS), we allow them to take ibuprofen,
aspirin and other NSAIDS over-the-counter and trust that they will use
them responsibly. It simply doesn't make any sense to forbid
patients the responsibility to use herbal marihuana and the freedom to
titrate their own dose.
CH: Can one get psychoactive effects from Sativex?
LG: This is a no-brainer; of course one can. If it contains THC
one can certainly get high and predictably there will be people whose
main interest in Sativex will be to achieve the psychoactive effect.
Furthermore, some patients will inadvertently experience the
psychoactive effects for the first time with Sativex either because the
dose can't be titrated as precisely as when it is smoked or the
therapeutic dose is too close to, or overlaps with, the psychoactivity
CH: On the MARINOL website they say their product is not similar
to drugs of abuse because the onset of action is gradual. Does this
imply that the fast acting application of marijuana makes it a drug of
LG: That gets into the difficulties of describing a drug of abuse.
Most people understand that using marijuana does not necessarily mean
abusing marijuana. Here abuse is on the part of the abuser, it is
not inherent to the drug. You can abuse anything, but the abuse does
not reside so much in the inherent psychopharmacological properties of
CH: Is the traditional way of consuming cannabis, by smoking, dangerous?
LG: One of the selling points of Sativex is that you don't have to
smoke it and run the risk of serious pulmonary damage. There is very
little evidence of this. In the 1960s when I began to write about this,
some people said, "Of course there's no pulmonary cancer; we in this
country haven't been using it very long." But look, here we are in 2005
and people in your country and mine and many other places around the
world have been smoking it for decades now. And yet we have not
seen cases of lung cancer or emphysema that are due to smoking
marijuana alone. I wouldn't be surprised if we eventually find them in
Europe where cannabis is frequently mixed with tobacco.
In the anti-smoking environment we live in, many people believe
that smoking anything is detrimental to the pulmonary system. I,
personally, believe that living in a polluted urban environment
represents more of a pulmonary risk. And those who are made
uncomfortable by smoking can now use a vaporizer and get the same
effects without smoke. There is no smoke. The cannabinoids volatilize
off in a temperature window; and when you remove the spent material
from the vaporizer you can see it hasn't been turned into ashes because
it hasn't been ignited.
CH: So pulmonary delivery is still the method of choice?
LG: Smoking allows for a very fine tuning of the dose. One of the
things that makes cannabis such an impressive
medicine is the fact that it can be taken through the lungs
either directly or through a vaporizer, which gives a patient the
capacity to titrate the dose quickly, to get just the amount
needed to get relief and no more. To me this is a great benefit, not
just from the point of delivering a medicine at the right dose, but
also because it gives the patient, the best judge of his needs, control.
CH: What is the combustion temperature of cannabis?
LG: The ignition point of cannabis is a little more than 4500F.
Good vaporizers hold the temperature between about 2840F and below the
ignition point. There are devices on the market which are called
vaporizers but which do not hold the temperature steadily in that
CH: If vaporizers or just smoking work so well, why is GW Pharmaceuticals so negative about it?
LG: The GW people, in order to successfully sell their product,
have to persuade people that there is a real danger to smoking
marijuana. This plays into the hands of the prohibitionists. The
argument goes: we are just getting on top of the tobacco problem,
cigarette consumption has gone down. Clearly tobacco consumption is
very dangerous, so why should we have another smokeable drug that will
lead to the same kind of catastrophic health consequences. The problem
with the argument is that there is very little empirical data to
support equating the consequences of smoking marijuana to those of
CH: Can the patient receive the same medical benefits from cannabis use without having the feeling of being high?
LG: From my clinical experience, I am not sure that in any
of the many different ways in which cannabis is used as a medicine,
that the therapeutic goal can always be successfully achieved
completely free of any psychoactive effect. I am also not certain that
even if it were possible, that eliminating the psychoactive effects is
a good idea. For example, people who suffer from multiple sclerosis who
use marijuana primarily to get relief from pain and muscle spasms often
say, "It makes me feel better." There are two aspects to that; one is
that they are getting symptom-relief and that makes them feel better.
But clearly there is something beyond that and I believe it to be a
function of the fact that they have some psychoactive, perhaps
It's becoming increasingly important in medicine to recognize that
people who feel better generally do better. Those who have a better
attitude about their disease or disability tend to do better. Assuming
there is some dosage difference between the point where cannabis can
relieve the symptom and the point where there is some psychoactive
effect, wouldn't it better for those who want to avoid the psychoactive
effect to be able to titrate it more finely than in the coarse way that
Sativex is said to be titrated? You can't really titrate in the usual
sense of the word with an oral preparation of marijuana whether it be
Marinol, Sativex or herbal marijuana brownies. If you suffer from
chronic pain from some kind of serious arthritic condition, such as
ankylosing spondylitis, you might want an oral preparation because its
effects last longer. But in those situations where you have
severe nausea and vomiting, or the painful cramping of Crohn's disease
or some kind of neuropathic pain and you want immediate relief, the way
to get it is by smoking. If you experience the prodrome of either a
migraine attack or a convulsive episode, you may be able to nip it in
the bud quickly by smoking.
CH: Should the patient be able to decide how much and what type of medicine works best?
LG: In many situations patients are the best judges
and certainly, once patients understand how to properly use cannabis,
it's both safe and clinically sound to let them make the judgment of
how much to use. They might get a little uncomfortable if they are
unused to or do not like the high, but they will learn and the next
time they will be more careful. It will not do anything that is harmful
CH: Is the "high" something to be concerned about?
LG: While the high may be uncomfortable for some people, it's a
very positive experience for others. Once Sativex comes on the
market some people who have never used marijuana will start using it
and they will be introduced to the cannabinoids as therapeutic
substances. Unless there is a lot of distance between the dose
necessary for the treatment of their symptoms and the psychoactive
dose, which for most symptoms I do not believe there is, many if not
most patients will get some experience of the cannabis high. Then some
may think, "Well, this must be the psychoactive effect, but it isn't so
bad; in fact, I have this slight consciousness altering effect and I
find it interesting. I feel better, I have better appetite." They may
find these effects intriguing and be emboldened to try using herbal
marijuana, even smoking it with or without a vaporizer.
There may be a lot of patients who will be introduced to cannabis
courtesy of Sativex, who will then judge for themselves which is better
for the treatment of their particular symptom. Which is quicker in
onset, which is easier to control, which is less expensive? One can
imagine that some of them will abandon Sativex, once they try it, in
favor of herbal marijuana. On the other hand there will be people who
smoke herbal marijuana now and come to believe that an oral
preparation, particularly because of the longer duration of effect,
would be easier and more useful for their particular symptom. And it is
legal! They may try Sativex and discover that, for one reason or
another, it works better for them.
That would be great as long as these two approaches were competing
on a level playing field. The most important thing that Sativex has
going for it, that herbal marijuana does not, is that it will not be
illegal to use. That may be a reason why some people for whom it does
what they seek with respect to the high will use it for other than
medicinal purposes. What troubles me most is that GW insists that
there is a world of difference between the medical value of these two
substances and the approaches to their use. I believe that if the two
substances were matched in the usual capitalist way - nose to nose, may
the best product win - I would not like to be an investor in GW
Pharmaceuticals because I think that the net effect of this product is
going to be negative both with respect to its relative usefulness as a
medicine and the task of trying to do something about this insane
Already we see that GW has hired Dr.Andrea Barthwell, (formerly
the Deputy Drug Czar for the Bush administration's Office of National
Drug Control Policy), to promote the acceptance of Sativex in the
US. She is a promoter of the widespread view that cannabis use,
that smoking marijuana must be extinguished at any cost, even at the
cost in my country of arresting about 750,000 mostly young people a
year. I expect that she and the people who hired her at GW are going to
keep making the claim that the Sativex extract is less harmful than
smoked or vaporized herbal marijuana and does not have psychoactive
effects until the empirical data to the contrary overwhelm them.
CH: So pharmaceutical companies will not want to compare their
cannabis products with herbal marijuana for fear of losing part of
their market share?
LG: Exactly. Whether herbal marijuana is more effective, or
cheaper or less uncomfortable or for whatever reasons people find this
is a better medicine, they're going to use it. The question is how much
of a legal price are they going to pay for this? Some are put in the
situation of having their jobs jeopardized if they use medical
marijuana. The reason a lot of patients use Marinol is so that when
they get hit with a urine test they can flash a copy of their
prescription. To a greater or lesser extent, the same will be true of
Sativex. Just as in an indirect way Sativex will be supportive of the
prohibition, it will also be used as a dodge to get around the legal
CH: When did you coin the phrase that, "marijuana would eventually be seen as the penicillin of the 21st century" and why?
LG: I first wrote that in "Marijuana: The Forbidden Medicine" in
1993. Alexander Fleming first discovered penicillin in 1928. He had
inadvertently left out an empty Petri dish when he had gone off on
vacation and when he returned he found that it had become overgrown
with staphylococci; and right in the middle there was a colony of mold.
The mold had excreted a substance which was toxic to staphylococcus;
that substance was later called penicillin. He published this in 1929
but nobody paid any attention to it until 1941 when two people, Howard
Florey and Ernst Chain, took it down from the shelf. They were
motivated by the fact that we were now involved in WWII and were on a
frantic search for antibiotics. They tested it in six patients, and
found how remarkably effective it was against these infections. It was
soon clear that in addition to being an amazingly effective and
versatile antibiotic, it was remarkably non-toxic and inexpensive to
produce. It soon became known as the "wonder drug" of the 1940s. One
can't help but wonder how many lives might have been saved from 1929,
when the paper was first published, until 1941; that's more than a
Now take marijuana; it is also remarkably non-toxic. In fact, when
it regains its rightful place in the US pharmacopoeia it will be seen
as one of the least toxic substances in that whole compendium. Once it
is freed of the prohibition tariff, it will be quite inexpensive.
And, like penicillin, it is an impressively versatile medicine.
So there is no question in my mind, that we have delayed a long
time and have denied many people a medical boon. In fact that's the
first thing I thought of when my son was suffering from acute
lymphocytic leukemia. When I saw how it freed him of the nausea and
vomiting of cancer chemotherapy and its terrible anticipatory anxiety,
how instead of starting to vomit immediately and having dry heaves for
over eight hours, he would now get off the gurney and say, "Mom, can we
go get a sub sandwich?". I began to wonder how many other people, how
many other youngsters who have to go through chemotherapy could be
spared this terrible nausea and vomiting? So for this family it
certainly was something like penicillin. It was a wonder drug for us.
CH: Have we lost sight of freedom of choice?
LG: Yes, we have lost sight of the importance of freedom of choice
with regard to marijuana. There is no risk with marijuana that I know
of that justifies denying its use to adults for any purpose. A
pernicious thing about the development of Sativex is that the Home
Office was apparently persuaded some years ago with an argument that
went something like this: "We all know that marijuana has
medicinal properties, but we at GW Pharmaceuticals have a way of making
it available to patients without burdening them with the two major
toxic effects -- smoking and psychoactivity."
These people are trying to hijack the medicinal properties of
cannabis toward their end of selling a product which they claim will be
safer (because it will be free of these two "serious" toxicities) than
herbal marijuana. This is consistent with the aggressive PR campaign
which is a major part of Sativex. Unless you can make the claim that
crude herbal cannabis is very different from and more toxic than
Sativex, how can you justify hiring Dr.Andrea Barthwell as spokesperson
for the promotion of this substance? She says there is no medical
utility in marijuana, that medical marijuana is a hoax. She is the
insistent author of these statements and now she is promoting Sativex.
Hiring her is consistent with this sort of schizoid approach to
cannabis: in this form it's good; in that form it's bad; in this form,
everyone who has these symptoms should try it; in the other form,
people should be punished for using it as a medicine.
CH: Do you believe that Andrea Barthwell doesn't know that these two substances are very similar in effect?
LG: That is a difficult question. It is hard to believe that with
her training as a physician, and considering her past and present
positions that she hasn't looked carefully and critically at the
literature on medicinal cannabis, including the large amount of
anecdotal data. I would have expected her to have achieved a better
understanding of this whole problem. That they hired her is as cynical
as her acceptance of the job. It's a measure of the lack of integrity
that GW Pharmaceuticals is involved in when they try to make the case;
orange juice, yes, oranges, no, they're bad.
When I talked about pharmaceuticalization in the past, as a
starting point I made it clear that there were some wonderful things
that would come out of the attempts to develop pharmaceuticals from
marijuana. I specifically mentioned, as an illustration of these
possibilities, that the development of an inverse agonist to the
"munchie" effect, the appetite stimulating property, might actually
produce something that we have failed to develop in all these years, a
non-toxic weight control substance. The other side of the
pharmaceuticalization coin was my concern that the government would see
pharmaceuticalization as a way of dealing with its problem with medical
marijuana; .i.e., how to enable its use for medicinal purposes, while
at the same time prohibiting it to people who want to use it for other
purposes. In 1985, the government mistakenly thought the problem was
solved when a small pharmaceutical company called Unimed developed the
medicine known as Marinol (dronabinol) which is synthetic THC. That is
exactly the same chemical you find in herbal marijuana and Sativex.
CH: Who supported this development?
LG: It's very expensive to develop a new drug and the cost is
borne by the drug company which develops it. However, in this
particular case the US government supported its development, but
insisted that it be encapsulated in sesame oil so it could not be
smoked. They went so far as to assign this THC (Marinol) not to
Schedule 1 alongside its identical twin, the THC which is the most
prominent cannabinoid in herbal marihuana, but to Schedule 2 so it
could now be prescribed, and a few years later to the even less
restrictive Schedule 3. But THC by any other name is THC. This is
so hypocritical. This was the government's attempt to say, "Don't keep
pushing for marijuana as a medicine; now there is a cannabis medicine;
it's called dronabinol or Marinol. Buy it at your local
pharmacy." Now this gives them a reason not to allow marijuana as
a medicine, a goal they are pursuing with the full power of the federal
government in California as they vigorously attempt to close down the
compassion clubs. Sativex will be used as another tool in this attempt
at the pharmaceuticalization of marijuana. A cynic might say it was
designed for this purpose. The US government may very well adopt it
because it gives it another preparation in this armamentarium which
allows it to say, "Look, there is now another cannabis medicine out
there. There is no need to give special license to people who want to
smoke marijuana as a medicine when they can now get what they need
through these other medicines." So the government can be expected to be
supportive of any pharmaceutical company which develops a substance
that can compete with marijuana. And self interest would suggest that
these pharmaceutical companies would be sympathetic to the US
government's goals of suppressing the use of herbal marijuana, both as
a medicine and in general.
CH: I'd like to talk a little bit about the psychological
implications of prohibition and why advocates are still stereotyped as
It's as though the modern media exchanged the stereotype of
the lascivious killer marijuana smoker of Reefer Madness for the Cheech
and Chong stereotype. You and I as well as most people who use
marijuana no more conform to that stereotype than we did to the Reefer
Madness stereotype. The way I'm trying to deal with that is through my
Uses of Marijuana website (www.marijuana-uses.com
which is a series of essays. Some of the many contributors are
well known, like Allen Ginsberg and Carl Sagan, but most of the
contributors are unknown and some use pseudonyms. I continue to
seek essays from people who use marijuana for non-medical and
non-recreational purposes and have found that it plays some significant
role in their lives.
You can't read these essays without thinking, "Hey, these are
solid citizens who are accomplishing things in their lives and who are
using it for purposes I never dreamed of." Here's an e-mail about the
web site which I received this morning: "Dear Dr. Grinspoon: There is a
real need to discuss the positive side of cannabis (does the public
know there is one?) and this seems like an excellent way to do it. I
will make a point of writing [an essay for this web site] when I have
completed my PhD this summer, much of which could not have been done
without cannabis as a creative tool and medicine. By the way, as a
young scientist, I have been inspired by and learned many lessons from
Carl Sagan's work and the ways in which he, you, and many others have
taken the risk to write about cannabis, and this knowledge is not lost
on our generation. I'm currently looking forward to doing my Post Doc
on particular cognitive processes while performing real work tasks
under the influence of cannabis, some of which I expect to be very
positive. Best regards."
I'm getting these e-mails from all over the world. It's clear the website is attracting attention.
Some decades ago a courageous psychiatrist by the name of Richard
Pillard at Boston University was the first contemporary notable gay man
to come out of the closet. That started the "out of the closet"
movement. We are a long way from defeating homophobia in this country
but we've made great strides since people have started coming out.
Pillard, Barney Frank and various others have helped people understand
that this isn't some sort of toxic mental disorder that you have to be
frightened of or scorn. Similarly I think many have come to understand
that folks like us are successful people, we do not develop extra heads
or what have you. In fact let me tell you, it's been most useful to me
in going about my life.
CH: Why is the United States government so determined to eliminate the use of herbal marijuana as a medicine?
LG: Well, I think it is because the government, for whatever
reason, is afraid that as people get more experience of marijuana
through observing people who use it as a medicine, they will be more
tempted to use it for purposes that the government disapproves of. If
you see your Aunt Nellie using it to treat the effects of chemotherapy
or a friend who uses it to treat convulsions much more successfully
than with conventional medications, you may come to change your
mind and say, "Wait a minute, what's all the fuss? This seems to
be a perfectly respectable application of herbal medicine and it
appears to be quite benign. So what if it's used for other purposes?
Nothing harmful happens; it doesn't seem to be having any kind of a
deleterious effect on these people." Let me tell you a story which
illustrates this type of change in attitude.
A colleague I worked with at the Harvard Medical School called me
one day after he had skimmed through "Marijuana: The Forbidden
Medicine". His mother-in-law had developed pancreatic cancer and was
having a lot of trouble with nausea. "That medicine you mentioned in
your book, Marinol, would that help her and would it be safe to give to
a 67 year old woman?" he asked. I told him it was quite safe and that
it probably would help her, but there was a better way to do it with
more prospect of success than taking this oral preparation. I suggested
that she find someone who would teach her how to smoke marijuana. "I
would never have my mother-in-law do that", was his reply. So I told
him what to do with respect to taking Marinol and suggested that he
give her my telephone number to use if she had any difficulty. Two
weeks later, I got a call from this 67 year old woman who told me that
the Marinol worked at first, but its effectiveness had diminished
considerably. She had raised the dose but its usefulness continued to
decline. "What should I do?" I asked if she knew anyone who could
teach her to use marijuana. She said, "Yes, I have a grandchild in
college and she's been urging me to smoke marijuana for a long time." I
said, "Okay, here's what you should do: have her show you how to roll a
joint and to smoke with you the first few times. Just take one puff and
wait two or three minutes at least, and then if you feel nothing, take
another puff and wait. Keep doing this until one of two things happen:
you start to feel uncomfortable and anxious, or you start to get
symptom relief. At that point stop."
A while later, during a meeting at the office of this associate,
he asked if I could stay for a few minutes after the meeting. His
mother-in-law was now living with them in their Boston suburban home.
"I can't tell you how thankful our family is to you," he said. He went
on to tell me how his three boys (all in their 20s and all quite
successful) would roll a joint with Granny, sit around, share a smoke
and have the best time. Her nausea was now controlled and she had
begun to eat again. "It was unbelievable." Several months later she
died. When we arrived at their annual Christmas party his wife greeted
us at the door and said in almost identical words, "I can't tell you
how indebted we feel to you!" She repeated the story of how it made all
the difference in her mother's last couple of months; free of the
nausea she perked up remarkably and had a much more fulfilling last few
months. And the family, of course, was relieved at not having to see
someone they loved suffer with such discomfort.
She also said; "When my boys were in college and I learned that
they were smoking marijuana, I came on like a banshee and really put my
foot down." In retrospect, it embarrassed her, and she went to on to
ask, "And that is what the government is afraid of?" A growing
number of people are having and will have similar experiences, and they
will see for themselves that they have been lied to for years. And
there will grow a pressure to stop arresting people who use marijuana
as a medicine, if not to reverse the prohibition altogether.
Medical marijuana is going to teach people that this substance is not
the demon that the government has been describing for years.
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