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A Cannabis Odyssey
Lester Grinspoon, M.D.
Every age has its
peculiar folly and if Charles Mackay, the author of the mid 19th century
classic, Extraordinary Popular Delusions and the Madness of Crowds
were alive today he would surely see “cannabinophobia” as a popular
delusion along with the “tulipmania” and “witch hunts” of earlier
ages. I believe that we are now at the cusp of this particular popular
delusion which to date has been responsible for the arrest of over twelve
million US citizens. I also believe that future historians will look at
this epoch and recognize it as another instance of the “madness of
crowds.” Everyone in this room has already arrived at this
understanding, but for some of us enlightenment came later than we would
have wished. Consistent with the goal of my Uses of Marijuana Project (www.marijuana-uses.com)
of encouraging users to write about their involvement with cannabis, I
thought I would share something of my cannabis enlightenment, a story that
now spans a third of a century.
In every life there occur seminal events that modify
the seemingly established trajectory of one's personal history. For me,
three of the four big ones were, in chronological order, the decision to
go to medical school, the extraordinary good fortune of meeting the woman
I married, and the gift of children. The fourth was my improbable
encounter with cannabis, an event that divided my life into two eras; the
before cannabis era, and the cannabis era (my son David refers to these
phases of my life as BC and AD for before cannabis and after dope). My
cannabis era began to unfold in 1967. As the senior author of a book on
schizophrenia, I found myself with what I estimated would be two to three
relatively free months before my co-authors would finish their chapters.
Because I had become concerned that so many young people were using the
terribly dangerous drug marijuana, I decided to use the time to review the
medical literature so that I could write a reasonably objective and
scientifically sound paper on the harmfulness of this substance. Young
people were ignoring the warnings of the government, but perhaps some
would seriously consider a well-documented review of the available data.
So I began my systematic review of the medical and scientific literature
bearing on the toxicity—mental and physical—of marijuana. It never
occurred to me then that there were other dimensions of this drug that
warranted exploration.
During my initial foray into this literature I
discovered, to my astonishment, that I had to seriously question what I
believed I knew about cannabis. As I began to appreciate that what I
thought I understood was largely based on myths, old and new, I realized
how little my training in science and medicine had protected me against
this misinformation. I had become not just a victim of a disinformation
campaign, but because I was a physician, one of its agents as well.
Believing that I should share my skepticism about the established
understanding of marijuana, I wrote a long paper which was published in
the now-defunct International Journal of Psychiatry; a shorter version was
published as the lead article in the December 1969 issue of Scientific
American. In these papers I questioned whether the almost ubiquitous
belief that marijuana was an exceedingly harmful drug was supported by
substantial data to be found in the scientific and medical literature.
While there was little reaction to the paper published in the psychiatric
journal, there was much interest in the Scientific American article.
Within a week of the appearance of the article, I
received a visit from the associate director of the Harvard University
Press, who suggested that I consider writing a book on marijuana. I found
the idea both attractive and daunting. The subject was worthy of a
book-length exposition, and I would have a reason to deepen my exploration
of this fascinating and harmful misunderstanding. And there was another
reason, perhaps the most compelling of all. The one aspect of my work that
interested my twelve-year old son Danny was my study of marijuana. His
illness began in July of 1967, just about the time I had decided to learn
about the dangers of marijuana. He was diagnosed with acute lymphocytic
leukemia, and his prognosis was, of course, grave. He was both excited and
pleased when I told him that I had decided to write a book on marijuana.
A few weeks later I learned that the Board of Syndics
of the Harvard University Press had rejected the book proposal as too
controversial. Until that moment I was unaware of the existence of this
board which must approve every book published by the Press. An image of
the Rembrandt painting “Syndics of the Cloth Guild” came to mind: a
group of serious-looking, longhaired men sitting around a table, exuding
caution and conservatism. I was disappointed but not surprised that they
rejected this proposal; it was the first instance of academic resistance
to my work in this area. I could have signed on immediately with a trade
publisher that offered the prospect of selling more books. But I believed
that a conservative, prestigious press would lend more credibility to a
book that promised to be quite controversial. The director of the press
was undaunted; he believed that he could persuade the Syndics to reverse
their decision. And so he did.
It turned out to be a much bigger project than I had
anticipated. I found that I had more than the medical and scientific
literature to review. Because so much of the misinformation and myths
about this drug had their origins in the gaudy writings of the French
Romantic Literary Movement, I felt compelled to examine the works of
Théophile Gautier, Charles Baudelaire, and other members of Le Club des
Haschischins, as well as those of Bayard Taylor and Fitz Hugh Ludlow. It
was fascinating to learn that much of the mythology about cannabis that
was being promulgated by the US government had its origins in these
writings. It is difficult to imagine that Harry Anslinger (our first drug
czar) was directly familiar with these 19th-century authors, but clearly
some of their hyperbolic descriptions of the cannabis experience, largely
products of effusive imagination under the influence of copious amounts of
hashish, are echoed almost a century later in the “teachings” of Harry
Anslinger.
I had come to understand that marijuana was not
addicting in the usual, rather vague understanding of that word, but I
certainly got hooked on learning about it. I was fascinated by my growing
understanding of how little I actually knew about this drug, and even more
so by the many false beliefs I had held with such conviction. It soon
dawned on me that I, like most other Americans, had been brainwashed, that
I was a part of this madness of the crowd. And the more I learned about
cannabis, the more it seemed to be capable of providing experiences which
would be worth exploring personally sometime in the future. In the
meantime, I felt like an explorer sailing an inaccurately and inadequately
mapped ocean. Where earlier cartographers had found many shoals, I found
few; where others found barren and dangerous islands, I saw lands that
looked increasingly interesting as I drew closer. The clearer the view,
the greater the temptation to land and make a direct exploration, but I
reminded myself that the point of this trip was to chart the ledges and
shoals, not to explore forbidden lands to look for riches. Long before I
decided to land, more than a year after the publication of Marihuana
Reconsidered in 1971, it had become inescapably clear that while
marijuana was not harmless, its harmfulness lay not so much in any
inherent psychopharmacological property of the drug but in the social and
legal consequences of our firmly held misbeliefs.
After the publication of Marihuana Reconsidered I
was often asked about my personal experience with cannabis. Some
questioners were skeptical when I replied that I had never used it: “What,
you wrote a book about marijuana and you never experienced it!” The
implication was that inexperience would invalidate my claim to expertise.
I would defensively respond, “I have written a book on schizophrenia and
I have never experienced that.” It was not until some years later that I
realized that there was validity to this criticism of my lack of personal
experience with cannabis. Especially in the later phases of this research
and writing, I had flirted with the idea of trying marijuana, not because
I believed at that time that it would inform my work, but because it
appeared to be such an interesting experience. I decided against it out of
fear that it would compromise my goal of producing as objective a
statement as I could. Of course the further I pursued the subject the more
I realized how difficult, if not impossible, it would be to produce a
truly neutral and objective statement. But I was not about to add to this
difficulty by personally exploring marijuana at this time even though the
temptation to do so became greater as I learned more about it.
As it turns out, it is well that I did not try it; had
I done so, as you will soon learn, I might have concluded that the “drug”
induced nothing but a placebo effect, that the whole thing was an enormous
scam or, at the very least, much ado about nothing. While it was important
to me that Marihuana Reconsidered not be an N-of-1 study (that is,
a study generalizing from the experience of one subject), I now know that
it is, in some ways, less well informed, if somewhat more objective, than
it might have been had it been written by an experienced cannabis user.
There is much about schizophrenia that I did not understand (and still do
not) when I wrote that book, but there was no way in which personal
experience could address that weakness. I had a choice where marijuana was
concerned, but I believed at the time that the best shot at objectivity
and scientific legitimacy lay in abstinence.
I had another reason for postponing personal experience
with cannabis. If the book were successful, I expected to be called as an
expert witness before legislative committees and in courtrooms. I
correctly anticipated that some of my interrogators would want to know
whether I had ever used cannabis, and I wanted to be able to deny it so as
to preserve at least the appearance of objectivity. In the beginning I did
not believe this question unfair. It seemed to me to be no different from
other questions about my credentials. But I soon learned that when it was
asked, it was almost always put by a legislator, lawyer, judge, or media
person who was hostile to the suggestion that cannabis might not be as
harmful as he firmly believed. It became increasingly clear that the
question was asked, not in the spirit of learning more about the context
of my understanding of this drug, but rather in the hope that I would
answer affirmatively and that this would discredit my testimony. More than
a year after the publication of the book I was testifying before a
legislative committee when a senator who had already revealed his
hostility asked, “Doctor, have you ever used marijuana?” Perhaps
because I was irritated by the hostility reflected in his previous
questions and his sneering tone of voice, I replied, “Senator, I will be
glad to answer that question if you will first tell me whether if I answer
your question affirmatively, you will consider me a more or less credible
witness?” The senator, visibly upset by my response, angrily told me
that I was being impertinent and left the hearing room. That was the
moment that I decided that the time had come.
Later that week Betsy and I went to a party in
Cambridge where we knew that some guests would be smoking marijuana. Ever
since a review of Marihuana Reconsidered had appeared on the front
page of the New York Times Book Review (under the banner, “The
best dope on pot so far”) people had been offering us marijuana, and we
had been politely and often a little apologetically declining it. Those
guests who knew of our previously resolute abstemiousness were surprised
when we decided to join them. We were cautious, as cannabis-naive people
should be, as we inhaled our first tokes ever. Shortly afterward my first
and only unpleasant cannabis experience began. A lit joint was passed
around a small circle and we took turns inhaling big, noisy puffs and
holding them in for a few seconds. One by one the others said they had had
enough and waved off the passing joint; they were high, or at least
claimed to be. I asked Betsy, “Do you feel anything?”
“Not a thing!”
“Neither do I.”
We were disappointed. We had been looking forward to
this initiation for several years. I had come to expect so much from the
experience, from the magical possibilities of this subtly altered state of
consciousness—and now nothing! I began to wonder; was this all there was
to it? Was my acceptance of the claims of cannabis aficionados just as
naive as my earlier belief in the propaganda disseminated by the Harry
Anslinger truth squad and its descendants? Could it be true that all I had
accomplished in over three years of intensive research was to swing the
pendulum of my gullibility from one extreme to the other? Soon my
disappointment gave way to a palpable level of anxiety. Was it possible
that I had spent all this time studying what must be for some people an
enormously persuasive placebo? Would not the author of a book, which took
as a basic premise that marijuana is a real drug, be considered
fraudulent? I tried to reassure myself. I reminded myself that I had,
after all, carefully explained to the reader that many if not most people
do not get high the first time they use marijuana. I was mindful that it
was not until his sixth attempt that a very close friend experienced a
high.
At that time I believed that the anxiety I experienced
that night was generated by a precipitous loss of confidence in my newly
arrived-at understanding of cannabis, an unshakable belief that after more
than three years of hard work, I had gotten it wrong and as a consequence
had misled a lot of people—certainly sufficient grounds for a good dose
of anxiety. It was not until much later, both chronologically and in my
experience with “stoned thinking,” that I began to question that
explanation. Usually when anxiety arises as an appropriate response to a
real threat, it evaporates once that threat is no longer present or can be
satisfactorily demonstrated never to have existed in the first place. But
the anxiety I experienced that night did not respond to my marshaling of
convincing evidence that cannabis was not a bogus drug and reassuring
myself that it is not unusual for marijuana neophytes to fail at getting
high on the first attempt. It’s as though that anxiety had a life all of
its own, unattached to any real threat, not unlike that of a general
anxiety disorder. The difference was that there was not a trace of it when
I awoke the next morning. I was puzzled by this episode, and it occurred
to me only years later while I was smoking cannabis that I might have
actually achieved a high that first night, an “anxiety high,” not the
kind I had expected. This was certainly not impossible; a small percentage
of people who use cannabis for the first time experience some degree of
anxiety. Just because they have never used it before, they don't
understand the importance of self-titration (adjusting the dose in
response to the perceived effects). In any event, titration is difficult
because they have not yet learned to recognize the subtle signs of the
intoxication. There are even a few people who always get anxious when they
use marijuana. Among the Rastafarians of Jamaica, these folks are
considered slightly deviant but are understandably excused with the
expression, “He don't have a head for ganja!”
This was not a problem with my head, for a week or so
later we smoked cannabis and again neither Betsy nor I noticed any change
in our states of consciousness that would even remotely suggest that we
were high. Thankfully, however, I was not the least bit anxious this time—only
disappointed again. Finally, on our third attempt, we were able to reach
the promised high. Our awareness of having at last crossed the threshold
arrived gradually. The first thing I noticed, within a few minutes of
smoking, was the music; it was “Sgt. Pepper's Lonely Hearts Club Band.”
This music was not unfamiliar to me, as it was a favorite of my children,
who constantly filled the house with the sound of the Beatles, the
Grateful Dead and other popular rock bands of the time. They frequently
urged me to get my “head out of classical music and try listening to
rock.” It was impossible not to listen to rock when they were growing
up, but it was possible for me, as it was for many parents of my
generation, not to hear it. On that evening I did “hear” it. It was
for me a rhythmic implosion, a fascinating new musical experience! It was
the opening of new musical vistas, which I have with the help of my sons
continued to explore to this very day.
A year later, I related this story to John Lennon and
Yoko Ono, with whom I was having dinner. (I was to appear the next day as
an expert witness at the Immigration and Naturalization Service hearings
that Attorney General John Mitchell had engineered as a way of getting
them out of the country on marijuana charges after they became involved in
anti-Vietnam War activities.) I told John of this experience and how
cannabis appeared to make it possible for me to “hear” his music for
the first time in much the same way that Allen Ginsberg reported that he
had “seen” Cézanne for the first time when he purposely smoked
cannabis before setting out for the Museum of Modern Art. John was quick
to reply that I had experienced only one facet of what marijuana could do
for music, that he thought it could be very helpful for composing and
making music as well as listening to it.
In my next recollection of that evening, Betsy and I
and another couple were standing in the kitchen in a circle, each of us in
turn taking bites out of a Napoleon. There was much hilarity as each bite
forced the viscous material between the layers to move laterally and
threaten to drip on the floor. It seemed a riotous way to share a
Napoleon. But the most memorable part of the kitchen experience was the
taste of the Napoleon. None of us had ever, “in our whole lives,”
eaten such an exquisite Napoleon! “Mary, where in the world did you find
these Napoleons?” “Oh, I've had their Napoleons before and they never
tasted like this!” It was gradually dawning on me that something unusual
was happening; could it be that we were experiencing our first cannabis
high?
We drove home very cautiously. In fact, one of the
observations I made on the way home was how comfortable I, an habitual
turnpike left-laner, was in the right-hand lane with all those cars
zipping past me. It seemed like a very long time before we arrived home.
Not that we were in a rush—the ride was very pleasant. Time passed even
more slowly between our arrival and our going to bed, but once we did, we
knew with certainty that we had finally been able to achieve a marijuana
high. And that marked the beginning of the experiential facet of my
cannabis era, a development that furthered my education about the many
uses of this remarkable drug.
I was 44 years old in 1972 when I experienced this
first marijuana high. Because I have found it both so useful and benign I
have used it ever since. I have used it as a recreational drug, as a
medicine, and as an enhancer of some capacities. Almost everyone knows
something of its usefulness as a recreational substance, growing numbers
of people are becoming familiar with its medical utility, but only
practiced cannabis users appreciate some of the other ways in which it can
be useful. It has been so useful to me that I cannot help but wonder how
much difference it would have made had I begun to use it at a younger age.
Because it has been so helpful in arriving at some important decisions and
understandings, it is tempting to think that it might have helped me to
avoid some “before cannabis era” bad decisions. In fact, now, when I
have an important problem to solve or decision to make, I invariably avail
myself of the opportunity to think about it both stoned and straight.
I cannot possibly convey the breadth of things it helps
me to appreciate, to think about, to gain new insights into. But I would
like to share several not too personal instances. For example, let me tell
you about the worst career choice I have ever made; it was my decision to
apply to the Boston Psychoanalytic Institute as a candidate for training
in psychoanalysis. I began this training, which was enormously costly in
both time and money, in 1960 and graduated seven years later. Although I
developed some skepticism about certain facets of psychoanalytic theory
during training, it was not sufficient to dull the enthusiasm with which I
began treating patients psychoanalytically in 1967 (coincidentally, the
same year I began to study cannabis). It was not until about the mid ‘70s
that my emerging skepticism about the therapeutic effectiveness of
psychoanalysis began to get uncomfortable. This discomfort was catalyzed
by cannabis. On those evenings when I smoke marijuana it provides, among
other things, an invitation to review significant ideas, events and
interactions of the day; my work with patients is invariably on that
agenda. This cannabis review-of-the-day is almost always self-critical,
often harshly so, and the parameters within which the critique occurs are
inexplicably enlarged. My psychotherapy patients, patients who sat
opposite me and who could share eye contact and free verbal exchange,
always appeared to be making better progress than my psychoanalytic
patients. I was generally satisfied with my work with the former, and
invariably at first impatient and later unhappy with the lack of progress
made by patients on the couch. There is little doubt that it was the
cumulative effect of these stoned self-critiques that finally, in 1980,
compelled me to make the decision not to accept any new psychoanalytic
patients. Nevertheless, I remained a dues paying member of the Boston
Psychoanalytic Institute because I believed that the problem was mine;
other psychoanalysts could make it work, but somehow I could not. After
much more straight and stoned thinking about this over the course of a few
years, I finally arrived at the conclusion that the problem was not mine,
that psychoanalysis as a therapeutic modality was not very useful, and at
that point I resigned from the Institute.
As I look back on it, I do not think that I did any
worse than other psychoanalysts did. Analysts are insulated from any
concern that the patient is not making progress by the shared expectation
that the process will take a long time and, even more so, by the powerful
transference which, among other things, gratifies the analyst's narcissism
and supports the patient’s (and often the analyst’s) fantasy of the
analyst's omniscience. Under these circumstances it is difficult for the
psychoanalyst to be critical of his own work. In order to do so, he has to
be equipped with a powerful “bull shit” detector. I am convinced that
cannabis helps me to fine tune this detector and that this enhanced
capacity helped facilitate my understanding that I had made an enormous
mistake when I decided to become a psychoanalyst. The decision to resign
from the Institute was very difficult, a little like deciding to get a
divorce after more than a decade of marriage. But I have no doubt that it
was the only way I could deal with this growing discomfort and rectify
what was now clearly seen as a mistake. Some of my former psychoanalyst
colleagues might believe, among other things, that I have merely traded my
involvement in what I considered a macro-delusional system for immersion
in an inverse micro version. Such a possibility notwithstanding, I am
indebted to cannabis for the help it provided me in achieving the clarity
necessary to arrive at this most difficult decision.
Cannabis can also be used as a catalyst to the
generation of new ideas. Experienced cannabis users know that under its
influence new ideas flow more readily than they do in the straight state.
They also understand that some are good and others are bad ideas; sorting
them out is best done while straight. In the absence of an agenda, the
ideas are generated randomly or as close or distant associations to
conversation, reading, or some perceptual experience. It is sometimes
worthwhile to have a stoned go at trying to solve a particular problem. An
illustration comes to mind. In 1980, during my tenure as Chairperson of
the Scientific Program Committee of the American Psychiatric Association (APA)
I “invented” and then edited the first three volumes of the Annual
Review of Psychiatry, a large book which is still published yearly by
the APA. Mindful of how much money this annual publication was earning for
the APA, the chief of our sub-department of psychiatry asked me to put my
“thinking-cap” on and come up with a way for the Harvard Department of
Psychiatry to supplement its shrinking budget. Taking his request
seriously, I smoked that night for the express purpose of trying to
generate relevant ideas. Within days, at a meeting in the Dean’s office,
it was agreed that the idea I arrived at that evening would be pursued—the
publication of a monthly mental health letter. The first edition of The
Harvard Mental Health Letter appeared in July 1984 and it soon
achieved considerable success as an esteemed mental health publication and
a steady source of income to the Harvard Medical School Department of
Psychiatry. Would the idea have come or come as easily in a straight
state? Maybe.
All through the seemingly endless heated discourse on
cannabis in this country over the last three decades, little has been said
or written about its many uses. The overwhelming preponderance of funding,
research, writing, political activity, and legislation have been centered
on the question of its harmfulness. The 65 year old debate, which has
relatively recently included discussion of its usefulness and safety as a
medicine, has never been concerned with its non-medicinal uses; it is
always limited to the question of how harmful it is and how a society
should deal with the harm it is alleged to cause. It is estimated that 76
million Americans have used cannabis and more than 10 million use it
regularly. They use it in the face of risks that range from opprobrium to
imprisonment. From the time I began my studies of marijuana, 12 million
citizens of this country have been arrested for marijuana offenses. The
number of annual marijuana arrests is increasing, and in 1999 over 700,000
people were arrested on marijuana charges, 88 percent of them for
possession. Because the government allows confiscation of property in drug
cases, many have lost valued possessions ranging from automobiles to
homes. Most have to undertake expensive legal defenses and some have
served or will serve time in prison. Unless we are prepared to believe
that all these people are driven by uncontrollable “Reefer Madness”
craving, we must conclude that they find something in the experience
attractive and useful. And yet there is very little open exploration of
these uses with the growing exception of its value as a medicine. Even
here, government officials want to mute the discussion out of a fear
expressed by the chief of the Public Health Service when in 1992 he
discontinued the only legal avenue to medicinal marijuana: “If it is
perceived that the Public Health Service is going around giving marijuana
to folks, there would be a perception that this stuff can't be so bad...
it gives a bad signal.” The government has, until very recently, refused
to acknowledge that cannabis has any value, even medicinal, but there are
millions of citizens who have discovered through their own experience that
it has a large variety of uses they consider valuable and that the health
costs are minimal.
This large population of marijuana users is a
subculture, one that has been present in this country since the 1960s.
Three decades ago it was an open, vocal, active, and articulate culture on
and off the campus. Today it is silent and largely hidden because most
users, understandably, do not want to stand up and be counted. They have
more than the law to fear. Urine testing is now a fact of life in
corporate America; a positive test result can lead, at the very least, to
a stint in a “drug treatment” program, and at most, to the loss of a
job, career destruction, even imprisonment. Users are very mindful of this
minefield, and most find ways around it. Even more pervasive, and in some
ways more pernicious, is the stigmatization attached to cannabis use.
Young people often experience little of this, at least among their
friends. But as they grow older and move into increasingly responsible and
visible positions they become much more guarded. Many believe, correctly,
that colleagues would regard them as deviant if they knew. This
stigmatization is abetted by the media, which have created and perpetrated
a stereotyped image of “potheads” as young, hirsute, slovenly dressed
ne’er-do-wells or disreputable, irresponsible, and socially marginal
hedonists who use marijuana only to hang out and party. One reason for the
fierce resistance to marijuana is the fear that it will somehow taint
middle-class society with the “pothead” culture.
There is no denying that many, especially young people,
use marijuana primarily for “partying and hanging out” in the same way
that many more use beer. And most non-users, until they become aware of
its medical value, believe that smoking to party and hang out pretty much
defines the limits of its usefulness. This stereotype is powerful, and
reactions ranging from puzzlement to outrage greet claims that this party
drug could be useful as medicine or for any other purposes. People who
make claims about its usefulness run the risk of being derided as
vestigial hippies. Under these circumstances it is not surprising that
most people who use cannabis do so behind drawn curtains, alone or with
others who share some appreciation of its value.
It is unfortunate that those who, from personal
experience, are aware of its usefulness are so reluctant to be public
about it. I believe it would be good for the country if more people in
business, academic and professional worlds were known to be marijuana
users. The government has been able to pursue its policies of persecution
and prosecution largely because of the widespread false belief that
cannabis smokers are either irresponsible and socially marginal people or
adolescents who “experiment,” learn their lesson, and abandon all use
of the drug. That lie is unfortunately perpetuated when those who know
better remain silent. It’s time to let the truth come out. Just as the
gay and lesbian out-of-the-closet movement has done so much to decrease
the level of homophobia in this country, when the many people of substance
and accomplishment who use cannabis “come out,” it will contribute
much to the diminution of cannabinophobia.
Not many well-known people are identified as users of
cannabis. A few politicians have been outed by their enemies (one went so
far as to claim that he did not inhale), and some would-be political
appointments have failed because of a history of marijuana use.
Occasionally a screen star, musician or professional athlete is arrested
for possession. Aside from Allen Ginsberg, some popular musicians, and a
few notables from the Beat and hippie movements, few people in the public
eye have voluntarily acknowledged cannabis use. Except for one well-known
scientist, the physicist Richard Feynman, academics have been most
cautious. Feynman, by courageously acknowledging his ongoing use of
marijuana, won the respect and appreciation of many and the enmity of
others. Fear of “coming out” is, of course, not without foundation. As
long as the present stereotyped understanding of marijuana use and its
effects continues to prevail, anyone who acknowledges using it will risk
being taken less seriously from then on. It is thought that potheads could
not possibly be considered mature, serious, responsible, and credible. Yet
only those who actually use cannabis can teach us how useful it is.
There was a time not so long ago when it was generally
assumed that any use of marijuana was “merely recreational.” This was
certainly true at the time I wrote Marihuana Reconsidered. The
chapter on marijuana as medicine (The Place of Cannabis and Medicine) was
concerned with past (19th and early 20th century) and potential uses;
there was no overt and little covert use of cannabis as a medicine at that
time. Now, there are many thousands of patients who use cannabis
medicinally. And as the ranks of these patients grow, so does the number
of people who observe for themselves how relatively benign this substance
is. Seventy-four percent of Americans presently believe that cannabis
should be made available as a medicine; very few people would have held
this belief in 1971. Currently it is generally thought that there are two
generic categories of marijuana use: recreational and medical. But in fact
many uses do not fit into these categories without stretching their
boundaries to the point of distortion; they fall into a third category,
one that is more diverse and for that reason difficult to label. It
includes such disparate uses as the magnification of pleasure in a host of
activities ranging from dining to sex, the increased ability to hear music
and see works of art, and the ways in which it appears to catalyze new
ideas, insights and creativity, to name a few. Furthermore, at its edges,
which are fuzzy, there is some conflation with both medicine and
recreation. Yet, the preponderance of these uses falls into this broad and
distinctive third category that I call enhancement.
This is the class of uses which is generally the least
appreciated or understood by non-cannabis users. It is also the case that
some people who use or who have used marijuana may not be aware of some if
not most of the enhancement possibilities. This may be particularly true
of young people whose predominant interest in the drug revolves around its
ability to promote sociability, jocularity and fun. All are aware of the
psychopharmacologically induced properties, such as enhancement of
appetite. This is very common and manifests itself as the “munchies,”
which may be a problem for frequent users who have marginal ability to
control their weight but a boon for people who suffer from serious
appetite loss, such as patients with AIDS. But most of these enhancement
capacities are not simple manifestations of inherent psychopharmacological
properties of the drug; some appear to require some degree of learning to
develop. A person who wants to learn to use cannabis in this multiplicity
of ways has first of all to know about these possibilities, and then to
accumulate experience in their explorations.
One category of cannabis utility that we have studied
is its usefulness as a medicine. Because there is not at this time a
systematic clinical literature on the medicinal uses of cannabis, James B.
Bakalar and I asked patients to share their experiences with cannabis as a
medicine for our book, Marihuana, the Forbidden Medicine (Yale
University Press, 1993, 1997). We supplemented these patient accounts with
our own clinical experience and what we could glean from the medical
literature. This work has occasionally been criticized as being largely
comprised of “anecdotal evidence” not supported by (so-far
non-existent) large double-blind placebo controlled studies, and therefore
not to be taken seriously. Yet, marijuana’s recently rehabilitated
reputation for and growing acceptance as a medicine derives from anecdotal
accounts. There will come a day, I hope in the not too distant future,
when cannabis is scrutinized in the same way that other new potentially
useful medicines are. Anecdotal evidence is not as persuasive as that from
double-blind placebo controlled studies, the more scientifically sound
modern medical approach to the safety and efficacy of new therapeutics. As
the results of such studies become available we may be compelled to modify
our estimate of the clinical usefulness of cannabis. At this time,
however, it is difficult to imagine that future studies will subtract much
from the clinical experience-driven perception that cannabis is a
remarkably versatile medicine with relatively little toxicity.
It is my intention to roughly follow the same format in
the Uses of Marijuana Project (www.marijuana-uses.com). While I will
attempt to illuminate the various uses of cannabis through literary
accounts and by sharing some of my own experiences, the prime source of
what I hope will be a fairly comprehensive understanding of the uses of
this versatile drug will come from contemporary users. Some will identify
themselves; others will prefer to remain anonymous for reasons that have
already been noted. Either way, I hope to present enough information about
the witness to put his or her account into a meaningful context. Unlike
medicinal use, which will eventually be fitted with scientific costume, an
understanding of those uses which fall into the category of enhancement
will probably always be based on anecdotal accounts; it is unlikely that
marijuana's capacity for the enhancement of sexual pleasure, for example,
will ever be the subject of a modern scientific (double-blind
placebo-controlled) study. However, if this ethnographic method is
successful we should be able to provide a reasonably proximate picture of
the varieties and value of cannabis use in contemporary society. And in so
doing, by telling our stories, we cannabis users can make a significant
contribution to the demise of cannabinophobia, one of our age’s most
damaging popular delusions.
In the meantime, Betsy and I are gradually being given
the opportunity to explore another dimension of the ways in which cannabis
can be valuable; we are discovering its usefulness in the task of
achieving reconciliation with the aging process, including coming to terms
with the inevitable physical and emotional aches, deficits and losses.
Cannabis also enhances our appreciation of the time we have, now that we
are both emeritus, to enjoy our children, grandchildren and friends,
literature, music and travel, and our daily walks in the New England
woods. Of still more importance, it helps us to realize the wisdom of
Robert Browning’s words, “Grow old along with me! The best is yet to
be….” |
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