When she was 46, a woman we鈥檒l call Hope (who asked to remain anonymous for reasons which will become obvious) was finding it impossible to fall and stay asleep at night. She was working full-time, raising a child with extreme special needs, and dealing with worrisome health issues of her own.
Since plants cross-pollinate and new varieties are being grown all the time, it鈥檚 not always obvious what grows are "hot" and what are "just hemp".
She had Lyme disease, as well as retinitis pigmentosa, a condition which resulted in the loss of vision in her left eye, and herniated disks in her back. On top of all that, Hope was leaving a job she鈥檇 had for over a decade to start a new career.
Desperate for rest, Hope tried every sleep remedy she could鈥攆rom prescription medications like Ambien to holistic remedies like valerian root. When those didn鈥檛 work she turned to meditation and hypnosis. Nothing helped.
Sleep-deprived and increasingly anxious, she was miserable.
So when a homeopath recommended she try cannabis, even though marijuana was (and still is) illegal in her state and she was herself the director of an addiction drug clinic, Hope was willing to try anything. Medical marijuana was legal where she lived, but not to treat symptoms related to Lyme or insomnia.
Hope found a secret group of users of medical marijuana on Facebook to advise her and managed to buy organically grown quality-tested cannabis illegally from an internet vendor.
It came in a taffy-like blob which she heated on the stove top with an equal amount of coconut oil. She put the tincture in a bottle, and put one drop under her tongue.
Twenty minutes later she was fast asleep.
鈥淚t was the first time I slept really well in years,鈥� she told me when we talked by phone. 鈥淚 woke up the next day, and it was like heaven 鈥� It was incredible. I started to look forward to being able to sleep.鈥�
That was five years ago. Hope has been using cannabis ever since.
When Ballot Measure 91 passed in 2014 the recreational use of cannabis became legal in Oregon. California, though it set the trend to legalize medical marijuana over two decades ago, was the last hold-out on the West Coast to legalize recreational use of pot. Legalization in California came in November 2016 when a majority of voters approved the Adult Use of Marijuana Act. California dispensaries finally started selling marijuana for recreational use on January 1, 2018, to great fanfare. According to the New York Times, some 200 enthusiastic customers lined up at an Oakland dispensary at dawn, eager to buy pot.
Despite enjoying enthusiastic support across the country, cannabis remains illegal at the federal level. The Feds classify it as a 鈥淪chedule 1鈥� narcotic, along with heroin, LSD, and ecstasy. Still, with the change in California law, recreational cannabis use is now legal up and down the West Coast, as well as in Alaska.
What that means for Southern Oregon鈥攚here I live鈥攊s that you鈥檙e apt to see dispensaries on practically every other corner in town and acres of fields being planted in rural areas. Just this week my editor reported seeing new hemp fields on North Phoenix Road, West Main Street in Medford on the way to Jacksonville, Taylor Road in Central Point, and along I-5 between Ashland and Medford.
In the midst of this cannabis craze, a robust industry has grown up around the plant鈥攊ncluding growers, harvesters, 鈥渢rimmers鈥� (who process the plants), and retailers. Then there are the graphics on Instagram and Facebook extolling its virtues and the huge billboards on I-5 advertising retail cannabis stores. To say nothing of headlines: 鈥渉ow weed helped me get in the best shape of my life鈥� and 鈥�7 incredible health benefits of marijuana.鈥�
Some of your friends and acquaintances undoubtedly believe cannabis is a miracle plant. As one small town city manager told me, 鈥淚t鈥檚 surprising how quickly it鈥檚 getting into the mainstream. I was at Easter with my wife鈥檚 family and my 85-year-old father-in-law came out with a CBD product. 鈥楩or pain,鈥� he told us. 鈥業 use it on my feet!鈥欌��
At the same time, you likely have other people in your life who believe cannabis is a leafy devil, leading to spaced-out, unfocused, unhappy people who are at best wasting their money and their time and at worst are shirking their responsibilities, sleepwalking through their lives, and committing crimes after getting stoned.
Cannabis plants contain over 100 cannabinoids that can affect different receptors, and new cannabinoids are being discovered all the time.
One criminal defense lawyer I spoke to for this article (who also wanted to remain anonymous) hates the stuff and told me cannabis use has been involved in many violent crimes his clients commit.
How do you separate the hype from the health benefits? What鈥檚 cannabis actually good for, and what is hot air? For all its uses and proponents, cannabis is a surprisingly complicated plant that鈥檚 actually not that well understood.
鈥淲hen it comes to cannabis I always talk about confirmation bias,鈥� says Matt Vogel, 44, a professional health educator and adjunct instructor at Southern Oregon University (SOU) in Ashland. 鈥淧eople really seek out the information they already believe and that they want to hear.鈥�
Vogel, who does substance use trainings with community groups, professional organizations, and high school and college students across the country, thinks there鈥檚 more bias and emotion surrounding this substance than almost any other. 鈥淪ometimes it鈥檚 really tricky to get into a rational conversation about it,鈥� Vogel admits.
So how effective is cannabis as 鈥渕edicine鈥�?
And is using it actually good for your health?
There鈥檚 no question that some people enjoy myriad health benefits from using it. But there鈥檚 also evidence that cannabis use has its downsides. Keeping in mind that every user has a different experience, that because it鈥檚 been illegal for so long cannabis has been understudied, and that new science is emerging all the time, let鈥檚 see if we can add some sense to the sinsemilla question.
Cannabis, a Primer
First, some background.
Cannabis is thought to be native to Asia. While some reports say the plant was grown and harvested 12,000 years ago, according to research published this June in the journal Science Advances, the earliest scientifically verified evidence of human consumption of cannabis was found in a 2,500-year-old cemetery in Central Asia (in what is now far western China). Analyzing the contents of wooden bowls at a burial site, an international team of scientists found this Jirzankal cannabis contained psychoactive properties.
The Vikings used cannabis for pain relief during childbirth, according to Barney Warf, Professor of Geography and Atmospheric Science at the University of Kansas, who explained to a journalist at LiveScience that both hemp and psychoactive marijuana were widely used in Ancient China and that cannabis came to North America via the southern route.
In the Americas the production of cannabis was widespread from the 1600s to the late 1800s. Colonists used the hemp plant to make rope, sails, and clothing. In America in the late 1800s and early 1900s, cannabis was also in many medicines sold at pharmacies.
While some insist there鈥檚 a categorical and hard stop difference between hemp and marijuana, taxonomically hemp and marijuana are the same plant. Since plants cross-pollinate and new varieties are being grown all the time, it鈥檚 not always obvious what grows are 鈥渉ot鈥� and what are 鈥渏ust hemp鈥� (which makes growers who need licensing for different products very nervous). Most hemp varieties have very little, if any, psychoactive components, but do contain CBD, 鈥渃annabidiol,鈥� which is considered medicinal but not psychoactive.
Vogel explains to me that when you smoke or eat cannabis, it is the resin-secreting flowers of the female plant that contain the highest concentration of the bioactive substance that makes you feel 鈥渟toned鈥� or 鈥渉igh.鈥� This substance, delta-9-tetrahydrocannabinol, is better known as THC. You probably knew that already. But what you may not know is that THC is just one of the many cannabinoids that have now been identified, and one of several known to be psychoactive.
What are cannabinoids? These are compounds that are similar to the endocannabinoids naturally produced in our bodies. The human body鈥檚 innate 鈥渆ndocannabinoid system鈥� is involved in many aspects of establishing and maintaining health.
This system, according to an international team of researchers from Vermont, Great Britain, and Italy, writing in the science journal PLoS One,
鈥溾�� modulates embryological development, neural plasticity, neuroprotection, immunity and inflammation, apoptosis and carcinogenesis, pain and emotional memory, and most importantly from the viewpoint of recent drug development: hunger, feeding, and metabolism.鈥�
Translation: Your endocannabinoid system helps you think, fight diseases, feel less pain, eat, sleep, and relax. So when you consume cannabis, the cannabinoids in the plant itself are thought to attach themselves to the innate cannabinoid receptors on cells throughout your body and to help with these processes.
As if that鈥檚 not complicated enough, cannabis plants contain over 100 cannabinoids that can affect different receptors, and new cannabinoids are being discovered all the time. So it makes sense scientifically that cannabis may offer a broad range of health benefits.
Buying Weed in Weed
At La Florista on Main Street in Weed, California (a lumber town named after its founder, Abner Weed), customers must stop at the front and show ID.
The entranceway has a comfy gray couch with white throw pillows on one side and a counter on the other, like a hotel lobby. You have to be 21 to enter.
Walk through the closed doors and inside is a 10,000 square foot retail store where you can buy cannabis products of all kinds, as well as brightly colored hippie dresses, accessories, incense, books, body oils, and more.
The owner of La Florista, Elizabeth Tabor, 53, tells me between 80 and 150 customers come into the store, which has been open for just over a year, daily.
Tabor is an energetic businesswoman with ambitious plans. Her goal is to transform Weed, an economically depressed northern California town with fewer than 3,000 inhabitants, into a tourist haven. Instead of empty store fronts, she鈥檇 like to see an old-fashioned candy store, art galleries, and upscale restaurants.
鈥淚 have celebrity A-listers who have stopped here, and they turn around and get back into their cars because there鈥檚 no other shopping downtown,鈥� she laments. 鈥淢ain Street needs to be revitalized. My goal is to bring it back.鈥�
Cannabis for Pain
Tabor, who鈥檚 been interested in alternative medicine for over a decade, is outspoken about what she thinks are the most important health benefits of cannabis. She tells me cannabis really helps with pain, and can help people wean themselves down or off highly addictive opioid pain relief, like Oxycontin and Norco.
Cannabis, Tabor insists, is a safer, less addictive, and equally effective substitute pain medication and a much better choice than opioids, though it may take a few weeks or even months to get the dosing right.
Helping addicts wean off opioids is also a benefit that Paul Thomas, MD, an addiction specialist based in Portland, Oregon, has also seen firsthand. (Thomas and I wrote a book together, The Addiction Spectrum.)
鈥淐annabis can put you in another place where you鈥檙e not focusing on the pain,鈥� explains Jamie Syken, 41, who co-owns Dirty Arm Farm in Southern Oregon with his wife Melissa. 鈥淚f you鈥檙e in a lot of pain, you can still laugh and enjoy yourself. It鈥檚 not necessarily a pain killer, but it鈥檚 more how it puts your head space.鈥�
Elizabeth Tabor tells me she鈥檚 also seen cannabis help people dealing with post-traumatic stress disorders. At the same time, she says, some of the claimed health benefits of cannabis are exaggerated.
鈥淎 lot of companies take advantage of the letters 鈥楥BD鈥� and exploit consumers,鈥� Tabor insists, mentioning a CBD face mask sold via pyramid marketing that has a minuscule amount of CBD in it. 鈥淲hat the hell good is it going to do in a face mask?鈥�
Perhaps it won鈥檛 take away wrinkles, but 2016 research published in the Journal of Pain found that cannabis lotion given to rats trans-dermally offered relief from inflammation and pain, lending credence to reports that cannabinoids help with arthritis.
Canada鈥檚 Arthritis Society estimates that two thirds of Canadians who use medical cannabis use it to manage arthritis symptoms. At the same time, a 2019 review article published in the journal Current Opinion in Rheumatology this April found that some cannabinoids have an anti-inflammatory effect while other cannabinoids may actually promote inflammation. The researchers, calling for further research, conclude: 鈥淐annabinoids might be a suitable treatment for rheumatoid arthritis, but it is important to target the right receptors in the right place.鈥�
Cannabis for Cancer and Seizures
As anyone who鈥檚 gotten the munchies from smoking pot can confirm, cannabis has long been used as an effective appetite enhancer and nausea inhibitor, helping patients who are trying to gain weight or who are undergoing chemotherapy. Research has also shown that using cannabis oil on basal cell skin cancers can inhibit tumor growth.
Another area where users and scientists seem to increasingly agree is the usefulness of cannabis in people who suffer from seizures, as well as to treat severe symptoms鈥攍ike head-banging, self-harm, and other out-of-control behaviors鈥攁ssociated with autism.
鈥淐annabis seems to be really beneficial to things that are really hard for traditional medicine to treat,鈥� Melissa Syken, 41, co-owner of Dirty Arm Farm, puts in. I interviewed the Sykens (whom I first met when they owned Growing Green Baby in Ashland) while they were driving back from their processing facility in White City, Oregon.
Melissa tells me that their customers with nerve disorders, autoimmune conditions like multiple sclerosis, and cerebral palsy have benefited from cannabis products.
But, the Sykens both insist, quality matters. A lot. Dirty Arm Farm, which has an 11,500 square foot greenhouse and harvests three times a year, tests its products for pesticides and fungicides, as well as for potency.
While most producers dry the plant first, Jamie and Melissa explain that Dirty Arm Farm uses fresh cannabis鈥攏ot dried鈥攖o make their products. The Sykens say that this practice is essential to preserving the plant鈥檚 terpenes and keeping cannabinoids from degrading.
鈥淚t鈥檚 like fresh fruit versus dry fruit,鈥� Jamie explains. 鈥淏y processing it fresh-frozen you鈥檙e giving people as much of a full spectrum effect as possible.鈥� The Sykens caution against buying CBD products that are made from an isolate instead of a full spectrum of cannabinoids. Jamie says that inferior products made from old and degraded plant material, whether cannabis or hemp, are unlikely to be medically helpful.
鈥淵ou want the cannabis with the 鈥榚ntourage effect,鈥� which means you have all the cannabinoids that that plant produced, as well as all the terpenes 鈥� and [the thousands of] unidentified chemicals in the product,鈥� Jamie says. 鈥淎ll that is gone when you make an isolate. You鈥檙e literally left with a white powder. All the medical miracles we鈥檝e been hearing about 鈥� are from medical marijuana, not isolates. Not the Diet Cannabis that they鈥檙e pushing now.鈥�
Kenneth Palfini, 67, owner of Farmers Insurance in Mount Shasta, California, has firsthand experience with medical marijuana. Palfini, who is also Mayor of Weed, tells me he鈥檚 used cannabis on and off for 50 years. In 2007 when he was fighting leukemia he used cannabis as a way to relax. After the cancer went into remission, he continued to use it recreationally.
鈥淢y use is similar to someone鈥檚 use of alcohol,鈥� Palfini, who describes himself as a lifelong conservative, explains. 鈥淚 don鈥檛 drink very much but every once in a while I鈥檒l have a beer, and every once in a while I鈥檒l have a toke.鈥�
As much as Palfini believes the legalization of cannabis is good for Weed鈥檚 economy, he also admits that between 30 and 40 percent of his constituents in Siskiyou County are not happy about having marijuana in Weed. These folks believe cannabis is a gateway drug to heroin and other bad behaviors. They鈥檙e also afraid children will have easier access and be more likely to try it.
鈥淚t鈥檚 founded in a lot of emotion,鈥� Palfini says, insisting that kids have always had access to cannabis, even before it was legalized, and recommending parents stay vigilant. 鈥淧art of parenting is being aware.鈥�
Keep Cannabis Away From Kids
But the concern that children and young teens could be harmed by exposure to cannabis is one that many people share. One parent tells me that a neighbor鈥檚 9-year-old spent two days vomiting after eating a bar of 鈥渟pecial chocolate鈥� the parents left on the coffee table. That was an accidental ingestion. But there鈥檚 a growing body of scientific research showing that the younger you are when you start using cannabis the more problematic it can be.
Matt Vogel from SOU is concerned about children getting access to high potency concentrates and using too much of an edible. It can take a long time to feel the effects of edibles, Vogel explains, and inexperienced users may inadvertently eat too much.
This happened to my friend鈥檚 elderly mother, who ate so many cannabis cookies (because she didn鈥檛 feel any effect) that she woke up in the middle of the night stoned, panicked, and having heart palpitations. 鈥淭he effects of taking too much can be psychologically devastating,鈥� Vogel adds.
But, he goes on, the biggest concern is not a bad trip. Cannabis use in young people has been correlated with schizophrenia. Vogel calls this a 鈥渃hicken and the egg question,鈥� as we don鈥檛 know if young people prone to psychosis seek out cannabis to self-medicate or if young people who would not suffer from psychosis become psychotic from cannabis use. Regardless, studies have consistently shown that the younger you are when you start using cannabis the greater the chance of suffering from schizophrenia, bipolar affective disorder, and psychotic episodes.
I ask my 20-year-old, who鈥檚 majoring in psychology in college, what she thinks about young people using cannabis. She has friends who suffer from mental health issues. They don鈥檛 have medical marijuana permits and recreational marijuana had not been legalized in New York. Though New York moved to decriminalize marijuana use just as this article was going to press, her friends had been using it illegally. Some in order to get through the stress of being at a high-pressure school. Others use it in place of anti-depressants.
鈥淭hey鈥檙e self-medicating for depression and anxiety,鈥� Hesperus says, adding that she knows at least half a dozen people, mostly in their twenties, who smoke weed more than five times a week. 鈥淚nhaling plant debris is obviously not good for your lung health,鈥� she says. But, she continues, it鈥檚 easier to be around these friends when they鈥檙e stoned because they鈥檙e more relaxed.
Jamie Syken believes one of the best health benefits to cannabis is its psychoactive effect. 鈥淲hen you鈥檙e stressed, it feels like there鈥檚 no way to escape yourself,鈥� he says. 鈥淪ometimes it鈥檚 hard to stop beating ourselves up. There鈥檚 no hang-over and it literally can allow you to relax. The absolute biggest thing with cannabis is life-quality improvement.鈥�
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The ABCs of Cannabis鈥檚 Medical Benefits
It鈥檚 hard to separate fact from fiction when it comes to the medical benefits of cannabis. What responsible growers and health care professionals seem to agree on, however, is that the more high-quality ingredients used in making tinctures and preparations, the more likely they are to have health benefits. If you try a product and it doesn鈥檛 work, the quality may be to blame. If you think cannabis might help you, consider trying different products until you find one that works.
Potential health benefits of cannabis include:
- Aiding with anxiety
- Battling symptoms associated with autism
- Curtailing vomiting and nausea
- Decreasing insomnia and restless sleep
- Easing epileptic seizures
- Exciting the appetite
- Fighting (lessening) symptoms related to cerebral palsy and Lou Gehrig鈥檚 Disease (ALS)
- Getting a handle on pain
- Helping the body fight some cancers
- Improving irritable bowel syndrome
- Increasing sexual desire
Potential Harms of Cannabis
Most daily users insist that cannabis is harmless, which it may be for them. But, like with any other medicine, whether plant-based or synthetic, side effects have been reported. The most extreme condition affecting heavy users is cannabinoid hyperemesis syndrome. This poorly understood problem results in cyclical episodes of severe nausea, abdominal pain, and vomiting. A 2018 study of frequent users at a New York City hospital found that over 30% of those who had smoked marijuana more than 20 times in the previous month suffered from cannabinoid hyperemesis syndrome. CHS, which is worsened by using more, can be treated with IV fluids for dehydration and with hot baths or showers to lessen the symptoms.
Other potential harms of cannabis include:
- Anxiety and panic attacks
- Agitation
- Coordination issues
- Depersonalization: a disorder where you feel detached or estranged from yourself
- Derealization: a disturbance where you experience the world as unreal
- Dry mouth
- Hallucinations
- Impaired reaction time, performance, and judgment
- Inability to plan
- Increased risk of other addictions
- Increased risk of schizophrenia
- Increased impulsivity
- Lack of motivation
- Poor attention
- Poor memory and decreased ability to learn new things
- Psychosis
- Red eyes
- Tachycardia (fast heart beat)
A regular contributor to the 老夫子传媒 Journal, Jennifer Margulis graduated from Cornell University, earned a Master鈥檚 degree from the University of California at Berkeley, and a PhD from Emory University. She is a science reporter and book author and her articles have been published in the New York Times, the Washington Post, and on the cover of Smithsonian Magazine. Her most recent book, The Addiction Spectrum: A Compassionate, Holistic Approach to Recovery (HarperOne), is co-authored with Paul Thomas, MD, and includes a chapter on cannabis. Some of the material in this article was adapted from that book. Learn more at www.JenniferMargulis.net.
