Federal drug czar Gil Kerlikowske is a little bit perturbed at millions of Californians' intention to tax and regulate personal possession of cannabis through Prop 19 Nov. 2. The Czar has called for a press conference with celebrity addiction specialist Dr. Drew Wednesday to denounce the 5,000-year-old herbal remedy's effect on mind and body.
But the government has a seventy-year history of being dishonest about cannabis. Pot's medical benefits and drawbacks is also the subject of a new book by Dr. Julie Holland, former head of the psychiatric ER at Bellevue Hospital in New York. Dr. Holland is a psychiatrist specializing in drugs and the brain, a clinical assistant professor of psychiatry at NYU School of Medicine, and author of Ecstasy: The Complete Guide. She spent three years researching The Pot Book, a hefty 551-page-primer on the risks and rewards of the plant, written in conjunction with 52 doctors, academics, writers, and thinkers including Michael Pollan, Neal Pollack, and Douglas Rushkoff. Holland heads off another round of Reefer Madness in Los Angeles tomorrow in the Q&A below, edited for length.
Legalization Nation: In our last post, you talked about how the federal government actually gives sick people pot, has its own pot doctor and farm, yet says this plant is a dangerous drug with no medical benefit and high potential for abuse.
Dr. Holland: Cannabis is not just something that gets people high. It actually really does have a lot of medical value. When I started this book three years ago, I knew about its effect on nausea, appetite, chronic pain, and chronic wasting and that it really can be the difference between life and death. There aren't many medications that reliably induce appetite, and even fewer that reliably decrease nausea.
But I didn't really know what a great muscle relaxer it is, how helpful it is for MS. I didn't realize that it was a good anti-inflammatory medicine and I didn't know it was an antioxidant — a free radical scavenger. Some cannabinoids kill cancer cells while sparing healthy cells. They stop a tumor's blood supply from forming. I learned all these things and I thought, 'Oh my god, people need to know this.' I had these 'a-ha' moments over and over again. Everywhere I looked, I just kept learning, 'This is good for you,' and it's, like, 'Oh my god, why can't people have access to this?'
'Oh, because it makes you laugh. Because it makes you silly and giddy. That's why.' As a psychiatrist, I have to tell you, this is insanity. It's absolutely crazy that the only reason why people can't have access to this medicine, food and fuel is because it makes you laugh. That's just wrong.
Legalization Nation: So which is actually more dangerous to Americans: cigarettes, marijuana, alcohol, or malnutrition?
Dr. Holland: There's no comparison. The big killers are bad diet and cigarettes. Cigarettes kill half its users. ... I quit a long time ago. It's hard to quit. I've seen my patients deal with it, too.
This is something I sort of lecture on a lot is how bad for you cigarettes and alcohol are. And there's no comparison. Especially if you use a vaporizer. Then you're really talking about minimal harm. Cannabis is not toxic to brain cells, it's not toxic to liver cells, it's not particularly toxic to your body. Smoking irritates the lungs. If your lungs are bad you need to be a harm reductionist and use a vaporizer or find some way of ingesting it.
Also, certain strains have a really high ratio of THC to CBD. The problem is really potent, high-THC strains can make you very self-conscious and paranoid. If you've got a history of psychosis, you can get yourself into trouble. So if your lungs or brain is in questionable shape, this is probably not the drug for you.
Legalization Nation: There's this cliché in pot culture that no one ever died from a pot overdose.
Dr. Holland: It's absolutely true. You really cannot overdose. There's no toxic dosage. You can't say that about that many other drugs, and the other thing is there's not many interactions. It plays nicely with other drugs. If you're taking pain medications or muscle relaxers you can use cannabis as a medicine on top of that without worrying about drug interactions, and you can't say that about a lot of other medications.
Legalization Nation: Tell me about addictiveness of marijuana versus other drugs.
Dr. Holland: In terms of other drugs it's definitely lower on the list, but it's not zero. It's definitely lower than alcohol and cigarettes and it's obviously lower that heroin and cocaine, but it's not zero. The people who try the drug once and go onto to be addicted is 32 percent for nicotine, 23 percent for heroin, 18 percent for cocaine, 15 percent for alcohol, and then cannabis is 9 percent, so it's the lowest number of those five.
Legalization Nation: Tell me about quitting compared to other drugs. Is it hard?
Dr. Holland: A lot of people don't realize if you're a chronic drinker, and you abruptly stop drinking alcohol there is a 30 percent chance you will die, so alcohol addiction is potentially fatal. [Read about alcohol's uniquely toxic other effects on the body here.] Now I don't care how heavy a smoker you are, if you abruptly stop, you may be a little psychologically uncomfortable, but there's no physical withdrawal symptoms. There's certainly isn't anything dangerous about withdrawals. You may be grouchy, but it's hard to even prove.
The people up at Columbia have done all these crazy studies to try to show that there's a withdrawal syndrome and the best that they come up with is that people get a little testy when you take a remote from them. It's hardly measurable.
Legalization Nation: What is the “endocannabinoid” system and why is it such a hot topic right now?
Dr. Holland: We all have pot inside our brains and inside our bodies and it's not a fully understood system. We've got receptors in our brains for the endogenous cannabinoid, which is called anandamide.
Everyone has anandamide inside their body and their brains. One thing it does is it helps people forget. You don't want to remember every single thing that happens to you every single minute you're walking down the street. You'd have to remember each of every one of the thirty strangers' faces you saw. There needs to be a mechanism for getting rid of data and anandamide seems to help with that.
It also helps to modulate the immune system, so actually cannabis is very good for treating auto-immune diseases. The thing about using it with MS is it does not just seem to slow down the progression of MS but arrest it.
There's also this component of cannabis called cannabidiol, CBD, which seems to be particularly important with anti-inflammatory and auto-immune modulation and with cancer, because it has anti-cancer properties.
So it's a really interesting compound. I promise you in the next few years we're going to end up seeing new drugs on the market regardless of what happens to medical marijuana. I think you're starting to see the pharmaceutical industry roll out medicines based on CBD. It's got anti-anxiety properties, and it's got anti-psychotic properties.
Because they can standardize it and have it just be one particular chemical that does one particular thing — that's the way that big pharma works — you'll start to see these drugs come out.
But the thing about plants: there's like 400 chemicals in pot. It's complicated, and they modulate each other. The CBD modulates the THC, that's why these strains that are bred for high-THC/low-CBD levels and getting people into trouble. The CBD helps to modulate and ameliorate THC's effects.
[Editorial note: new research indicates high-CBD cannabis can guard against potential memory loss associated with THC as well. You can read our prior post with Dr. Holland here, and look for upcoming posts on the frontiers of cannabis psychiatry, and exactly where cannabis came from. Proceeds from the sale of The Pot Book go to independent research through MAPS.]