The Endocannabinoid Comes of Age

PICK UP THE BOOK Weed the People: The Future of Legal Marijuana in America if you’re looking for a male beach book. Happy pot smokers will enjoy this counterculture celebratory hug, a Rolling Stone–Fast Company–style narrative of guys talking business, with a slight macho edge of danger and big money in the wings. Journalist Bruce Barcott, a family man from Bainbridge Island, off Seattle, by turns skims, waxes eloquent, jumps elsewhere, starts again — sometimes intentionally parodying a stoner exchange. Yet he’s no dope, pun intended. He takes us on a well-researched tour of pot history and science, and of the medical marijuana movement.

As Barcott explains, we seem poised to decriminalize marijuana, but we’ve been here before: back in the 1970s, 11 states decriminalized and most others reduced their penalties. Marijuana, as we all know, has been a football in the culture wars. Right now, Team Coastal Boomer is winning, maybe because we’ve hit our 50s and 60s and have accrued sufficient clout. This time, let’s remember what went wrong and the steep price we paid for glorifying head trips.

The price: The tide turned back when parents’ groups began lobbying for stricter regulation to protect their teenagers. They were right to worry, as I’ll explain further. Reagan responded in 1986 by reinstituting mandatory sentences. The current war on drugs, including marijuana, has put millions of black people and Latinos in prison and given hundreds of thousands of teenagers rap sheets that haunt their adult lives. The American Civil Liberties Union reports that in 2010, nearly half of all drug arrests were for marijuana possession. If you haven’t already, read Michelle Alexander’s The New Jim Crow to learn how we have replaced one caste system with another. Meanwhile, it was never hard to buy pot. The Centers for Disease Control report that in 2013, 23.4 percent of 9th through 12th graders said they’d used marijuana in the last month, down a bit from 1999.

For people like me, there’s another tragedy. When I look at the list of conditions that cannabis-based pharma might help, I see every ailment that I’ve found hard to treat despite access to New York’s finest.

In 1970, without scientific review, Congress declared that marijuana had no medical value; this brought US research nearly to a halt. The only federally authorized source of cannabis is a strain grown at the University of Mississippi and accessible to researchers only if they apply to the National Institute on Drug Abuse, which has focused on demonstrating harm. This is all the stranger when you realize that we have developed and use pharmaceutical versions of heroin, meth, and cocaine. Pot, the most benign, remains relatively mysterious. That seems about to change. We’re just now beginning to see new patents for cannabis patches and controlled-dose cigarettes.

Drugs work because they mimic chemicals already in our bodies, and our “endocannabinoid” system is vast. It seems likely that the culture wars have deprived us for decades of effective painkillers, anti-anxiety drugs, appetite-modulators, bronchodilators, anti-tumor drugs, anti-allergy drugs, anti-vomiting drugs, and immunosuppressants. Instead of regulated, sophisticated pharmaceuticals, in some states people now face a silly array of hundreds of plant varieties that, like sugary breakfast cereals in supermarkets, are more alike than different. Not surprisingly, these products stress the sugar, or THC (tetrahydrocannabinol), the component that makes us high, when the plant historically contained a mix of ingredients with useful effects, particularly CBD (cannabidiol).

Shoppers can get the help they need in Cannabis Pharmacy: The Practical Guide to Medical Marijuana, a compendium that made me lust futilely for access in New York. This guide should come in handy for Californians, though. Author Michael Backes, a former special-effects advisor to Michael Crichton (Jurassic Park, Rising Sun) and a cannabis expert, clearly knows his stuff. In calm, clear, and specific prose, including plenty of history and science and quotable factoids, he’ll tell you which variety works for 29 ailments from Alzheimer’s to schizophrenia. I was impressed and relieved by his respect for “good science” in this era when Silicon Valley parents can’t be counted on to vaccinate their kids. Some tips: Less is more. Avoid habituation by taking the smallest possible dose, for the shortest period of time. If you use highly concentrated oils, you may pass out when you stand up.

If that sounds scary, and you’re worried about your kids, the evidence so far is that teen use hasn’t increased in states that allow medical marijuana. Here’s why you want to find a way to encourage your kid to go easy: About one in 11 pot smokers becomes addicted. Smoking pot weekly tends to lead to cigarette smoking, and pot smokers do move on to other drugs, though the relationship isn’t clearly causal. There’s some evidence that kids who start using pot before the age of 15 are less likely to graduate from high school. Weekly use is associated with a nearly doubled risk of anxiety or depression. Especially around puberty, some children who are vulnerable to psychosis are pushed over the edge by cannabis. About three percent of heavy users develop schizophrenia. Imagine if the celebrated mathematician John Nash had his psychotic break in his teens, instead of a decade after he earned his PhD.

Some teens clearly use pot medicinally, smoking at the beginning and end of the day to reduce anxiety, and then become dependent. After chronic pain, anxiety is the most common problem people try to alleviate with marijuana, according to a poll Backes cites. They need to proceed with caution because pot can itself induce anxiety; Backes goes into some detail about exactly how much THC and how much CBD is likely to promote calm, and he recommends low doses of Bubba Kush and purple indica. My own observation is that the current pharmaceutical remedies for anxiety — benzos and SSRIs — are inadequate. Let’s hope we soon get a good pot-based pharmaceutical.

Around 20 countries have removed criminal penalties for the personal possession of some or all drugs in the past 10 years or so. If our drug policy were run in the interest of public health instead of a larger political agenda, we wouldn’t prohibit any drug. Instead, we would create harm-reduction policies — higher legal drinking ages are the classic example — appropriate for each one, and combine them with public education. Aggressive campaigns about the dangers of smoking do seem to have brought down teen tobacco use.

My fear is that we’ll let this latest turn of events feed the libertarian impulses that, for example, make people scoff at the idea of limiting the size of sugary drinks. The word “prohibition” gets knowingly tossed around in drug discussion circles as code for “didn’t work last time, stupid.” Actually, the public has absorbed the wrong lesson about Prohibition. The temperance movement restricting access to alcohol state by state is arguably our greatest public health success. Keep in mind that it was led by women who were also fighting for the vote and on behalf of working-class women whose husbands were drinking up their paychecks. Prohibition, the final act, killed the saloons, a nexus of gambling, prostitution, crony politics, and alcohol-fueled violence; helped save those paychecks; and may have made our drinking habits more sensible for decades afterward. We did not return to pre-Prohibition levels of alcohol consumption until the early 1970s, reports historian Jack S. Blocker. Statistics on alcohol-related deaths and illness improved, and Blocker and others argue that, in the Depression era, we repealed the Eighteenth Amendment largely to revive the alcohol industry and the tax revenue it generated. You’ve heard plenty about speakeasies; many people broke the law, just as many people now cheat on their taxes, but many more did not.

In Weed the People and elsewhere, you’ll read that alcohol is a more dangerous drug than pot. The answer isn’t to throw up our hands, but impose limits on both pot and alcohol. We can decriminalize marijuana without abandoning the goal of promoting the public good. We can decriminalize marijuana and get tougher on nicotine, alcohol, and sugar. We can be smarter and actually “do good.” We’re the grown-ups now.

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Temma Ehrenfeld’s journalism has appeared in The New York Times, Newsweek, Reuters, Fortune, Yahoo.com, The Weekly Standard, Catamaran Literary Reader, and Prism International.