'Why I changed my mind on Weed' by Dr. Sanjay Gupta

I know it's long, but a great read if you care to -

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CNN Chief Medical Correspondent, 8:44 PM EDT, Thu August 8, 2013

Neurosurgeon, Dr. Sanjay Gupta says we have been "systematically misled" on marijuana.

Watch Dr. Sanjay Gupta's groundbreaking documentary "WEED" at 8 p.m. ET August 11 on CNN.

(CNN) -- Over the last year, I have been working on a new documentary called "Weed." The title "Weed" may sound cavalier, but the content is not.

I traveled around the world to interview medical leaders, experts, growers and patients. I spoke candidly to them, asking tough questions. What I found was stunning.

Long before I began this project, I had steadily reviewed the scientific literature on medical marijuana from the United States and thought it was fairly unimpressive. Reading these papers five years ago, it was hard to make a case for medicinal marijuana. I even wrote about this in a TIME magazine article, back in 2009, titled "Why I would Vote No on Pot."

Well, I am here to apologize.

I apologize because I didn't look hard enough, until now. I didn't look far enough. I didn't review papers from smaller labs in other countries doing some remarkable research, and I was too dismissive of the loud chorus of legitimate patients whose symptoms improved on cannabis.

Instead, I lumped them with the high-visibility malingerers, just looking to get high. I mistakenly believed the Drug Enforcement Agency listed marijuana as a schedule 1 substance because of sound scientific proof. Surely, they must have quality reasoning as to why marijuana is in the category of the most dangerous drugs that have "no accepted medicinal use and a high potential for abuse."

They didn't have the science to support that claim, and I now know that when it comes to marijuana neither of those things are true. It doesn't have a high potential for abuse, and there are very legitimate medical applications. In fact, sometimes marijuana is the only thing that works. Take the case of Charlotte Figi, who I met in Colorado. She started having seizures soon after birth. By age 3, she was having 300 a week, despite being on seven different medications. Medical marijuana has calmed her brain, limiting her seizures to 2 or 3 per month.

I have seen more patients like Charlotte first hand, spent time with them and come to the realization that it is irresponsible not to provide the best care we can as a medical community, care that could involve marijuana.

We have been terribly and systematically misled for nearly 70 years in the United States, and I apologize for my own role in that.


I hope this article and upcoming documentary will help set the record straight.

On August 14, 1970, the Assistant Secretary of Health, Dr. Roger O. Egeberg wrote a letter recommending the plant, marijuana, be classified as a schedule 1 substance, and it has remained that way for nearly 45 years. My research started with a careful reading of that decades old letter. What I found was unsettling. Egeberg had carefully chosen his words:

"Since there is still a considerable void in our knowledge of the plant and effects of the active drug contained in it, our recommendation is that marijuana be retained within schedule 1 at least until the completion of certain studies now underway to resolve the issue."

Not because of sound science, but because of its absence, marijuana was classified as a schedule 1 substance. Again, the year was 1970. Egeberg mentions studies that are underway, but many were never completed. As my investigation continued, however, I realized Egeberg did in fact have important research already available to him, some of it from more than 25 years earlier.

(compare) High risk of abuse

In 1944, New York Mayor Fiorello LaGuardia commissioned research to be performed by the New York Academy of Science. Among their conclusions: they found marijuana did not lead to significant addiction in the medical sense of the word. They also did not find any evidence marijuana led to morphine, heroin or cocaine addiction.

We now know that while estimates vary, marijuana leads to dependence in around 9 to 10% of its adult users. By comparison, cocaine, a schedule 2 substance "with less abuse potential than schedule 1 drugs" hooks 20% of those who use it. Around 25% of heroin users become addicted.

The worst is tobacco, where the number is closer to 30% of smokers, many of whom go on to die because of their addiction.

There is clear evidence that in some people marijuana use can lead to withdrawal symptoms, including insomnia, anxiety and nausea. Even considering this, it is hard to make a case that it has a high potential for abuse. The physical symptoms of marijuana addiction are nothing like those of the other drugs I've mentioned. I have seen the withdrawal from alcohol, and it can be life threatening.

I do want to mention a concern that I think about as a father. Young, developing brains are likely more susceptible to harm from marijuana than adult brains. Some recent studies suggest that regular use in teenage years leads to a permanent decrease in IQ. Other research hints at a possible heightened risk of developing psychosis.

Much in the same way I wouldn't let my own children drink alcohol, I wouldn't permit marijuana until they are adults. If they are adamant about trying marijuana, I will urge them to wait until they're in their mid-20s when their brains are fully developed.

Medical benefit

While investigating, I realized something else quite important. Medical marijuana is not new, and the medical community has been writing about it for a long time. There were in fact hundreds of journal articles, mostly documenting the benefits. Most of those papers, however, were written between the years 1840 and 1930. The papers described the use of medical marijuana to treat "neuralgia, convulsive disorders, emaciation," among other things.

A search through the U.S. National Library of Medicine this past year pulled up nearly 20,000 more recent papers. But the majority were research into the harm of marijuana, such as "Bad trip due to anticholinergic effect of cannabis," or "Cannabis induced pancreatitits" and "Marijuana use and risk of lung cancer."

In my quick running of the numbers, I calculated about 6% of the current U.S. marijuana studies investigate the benefits of medical marijuana. The rest are designed to investigate harm. That imbalance paints a highly distorted picture.

The challenges of marijuana research

To do studies on marijuana in the United States today, you need two important things.

First of all, you need marijuana. And marijuana is illegal. You see the problem. Scientists can get research marijuana from a special farm in Mississippi, which is astonishingly located in the middle of the Ole Miss campus, but it is challenging. When I visited this year, there was no marijuana being grown.

The second thing you need is approval, and the scientists I interviewed kept reminding me how tedious that can be. While a cancer study may first be evaluated by the National Cancer Institute, or a pain study may go through the National Institute for Neurological Disorders, there is one more approval required for marijuana: NIDA, the National Institute on Drug Abuse. It is an organization that has a core mission of studying drug abuse, as opposed to benefit.

Stuck in the middle are the legitimate patients who depend on marijuana as a medicine, oftentimes as their only good option.

Keep in mind that up until 1943, marijuana was part of the United States drug pharmacopeia. One of the conditions for which it was prescribed was neuropathic pain. It is a miserable pain that's tough to treat. My own patients have described it as "lancinating, burning and a barrage of pins and needles." While marijuana has long been documented to be effective for this awful pain, the most common medications prescribed today come from the poppy plant, including morphine, oxycodone and dilaudid.

Here is the problem. Most of these medications don't work very well for this kind of pain, and tolerance is a real problem.

Most frightening to me is that someone dies in the United States every 19 minutes from a prescription drug overdose, mostly accidental. Every 19 minutes. It is a horrifying statistic. As much as I searched, I could not find a documented case of death from marijuana overdose.

It is perhaps no surprise then that 76% of physicians recently surveyed said they would approve the use of marijuana to help ease a woman's pain from breast cancer.

When marijuana became a schedule 1 substance, there was a request to fill a "void in our knowledge." In the United States, that has been challenging because of the infrastructure surrounding the study of an illegal substance, with a drug abuse organization at the heart of the approval process. And yet, despite the hurdles, we have made considerable progress that continues today.

Looking forward, I am especially intrigued by studies like those in Spain and Israel looking at the anti-cancer effects of marijuana and its components. I'm intrigued by the neuro-protective study by Lev Meschoulam in Israel, and research in Israel and the United States on whether the drug might help alleviate symptoms of PTSD. I promise to do my part to help, genuinely and honestly, fill the remaining void in our knowledge.

Citizens in 20 states and the District of Columbia have now voted to approve marijuana for medical applications, and more states will be making that choice soon. As for Dr. Roger Egeberg, who wrote that letter in 1970, he passed away 16 years ago.

I wonder what he would think if he were alive today.

http://www.cnn.com/2013/08/08/health/gupta-changed-mind-marijuana

 

I really respect Sanjay Gupta and this article was really well written. I've never smoked pot and have never been a fan of its legalization because of its potential for misuse, but this article gives me pause....

 

I never smoked it myself, nor have the intentions to do it, but I do see the potential positive outcome from it, not just from a social standpoint, but from an economic standpoint.

See? Science is your friend.

 

Gupta's full of shit. He's admits that he smoked weed recreationally when he was younger.

I don't think that his opinion changed. It's about the changing tone of the debate about marijuana. He's now emboldened to tell the truth about marijuana on television, wheres he probably would have been ridiculed for doing so in the recent past especially on a network like CNN that has a commitment to faux neutrality on every subject.

More and more people are realizing that the "war on drugs" is a massive farce and are turning against marijuana prohibition. You can expect many more cowards like Gupta to change their tune when speaking on the subject in public in near future.

 

What about all the other legalized shit that's misused??

 

hahah . good post.

It's a lot like the gay marriage issue. All of 'em coming out of the woodwork to support gay marriage (including obama) when just a few years back they were hedging their bets and putting the finger up to the wind and saying they're against it.

I no longer smoke weed, mainly because I really don't like drug dealers at all and I'm too damn busy. But I think it's absolutely crazy to be throwing people in jail for weed.

Sorry for yet another long-assed post, but I wanna get this off my chest:

1. People abuse so many other drugs, including the legal shit that's even dangerous when used properly, like psychotropic drugs. I was surprised to find out from a coworker that you don't even need to see a psychiatrist to get a prescrip for shit like prozac. Your general practitioner can prescribe it, and they hand that shit out like candy.

2. The main dangers of weed are cops who bust you and gangsters who kill each other over the illegal drug market.

And oh yeah, the sociopaths who adulterate it with god knows what. The paranoid side of me can't escape the idea that gubmint wants to keep it illegal because while it's "underground" it can be used as a vector for whatever to poison whatever community it targets.

There have been documented cases of gangsters using tainted drugs as weapons - why not weed? And we all know gangsters work hand in hand with the gubmint in the underground.

Plus there's artificial thc now. I wonder how long it will be before dealers begin bolstering weak schwag weed with dangerous unregulated laboratory thc?

3. The most dangerous recreational drugs are perfectly legal, advertised and encouraged - alcohol and tobacco.

4. The blatant hypocrisy surrounding weed is exactly what makes kids dismiss any criticism of it and think that it's all good, with no downside. There is a downside (like everything) and people should be honest about it. They should also be honest about how weed is not as dangerous as judgmental control-freak stiffs make it out to be. If weed is illegal, why not motorcycles and football and guns for that matter?

5. They make the argument that weed nowadays is stronger stuff than it was in your parent's generation. Well, if it was legal it would come in strong, mild, extra mild, etc. Not everyone likes it so strong. If it were legal, it would be regulated and grown and marketed to taste.

6. Can you imagine any other substance that so many of our presidents have used (including Thomas Jefferson: "Some of my finest hours have been spent on my back veranda, smoking hemp and observing as far as my eye can see"), a substance that the majority of the populace thinks should be legal, a "substance" that's just a damn plant, yet the gubmint is throwing people in jail for it?

In the age of drones and cameras everywhere and NSA spying on your emails, ya gotta be careful about allowing the gubmint to get away with such capriciousness. The next capriciousness might be throwing you in jail for saying the wrong thing

Both the left and the right should be for legalization. The right wing are (as usual) hypocites, with their "get gubmint off my back" nonsense. And the left (as usual) are pussies. This is a real issue. Good people are going to jail and bad people (gangsters) are making money.

7. Can you imagine the tax revenue and tourism dollars that would flood into the U.s. if weed was legal nationwide? People from more repressive places would be clamoring for a visit, not just to see amurica but to try that fabled substance - marijuana - to boot

8. I have a sneaking suspicion that among the unspoken reasons weed is illegal is because it makes you step off the treadmill for a moment and look at life from a different perspective. The powers that be don't want that in the populace. Here are a couple of good quotes regarding that:

“Marijuana enhances our mind in a way that enables us to take a different perspective from 'high up', to see and evaluate our own lives and the lives of others in a privileged way. Maybe this euphoric and elevating feeling of the ability to step outside the box and to look at life’s patterns from this high perspective is the inspiration behind the slang term 'high' itself.”
? Sebastian Marincolo

“I am convinced that there are genuine and valid levels of perception available with cannabis (and probably with other drugs) which are, through the defects of our society and our educational system, unavailable to us without such drugs.” ? Lester Grinspoon, Marihuana Reconsidered

Those are probably among the real reasons that weed is kept illegal.

9. Here are more good quotes about weed, including good ones from William F. Buckley and my favorite stoner Carl Sagan: http://www.goodreads.com/quotes/tag/marijuana

10. Weed is actually good for learning if you use it right. It helped me have the patience and focus to learn javascript a while back, and to learn functional japanese in prep for a trip to japan. I guess the effects just depend on your personality, like any other drug.

11. Some people actually ruin their lives over addictions to weak shit like alcohol, gambling, cigarettes, food, even adrenaline and violence. Yet weed is singled out as "dangerous"?

Don't get me wrong - weed can indeed fuck you up. It can make you dramatic and affect decision making. I have a feeling that staying high contributed to dave chappelle's walking away from a $5 million contract. There was a football player (forget his name) so into weed that he did a similar thing. I think he ended up quitting weed and trying to make a comeback.

Weed can make you too sensitive and to inclined to see the world from an "idealistic" perspective, if that's the right word. And it's most definitely addictive to some people ("wake and bake" types).

But then there's nothing without a downside. That being said..

12. You bet your ass if I lived in a state that had medical marijuana I would finagle myself a prescrip. Weed is like being able to take a vacation without the plane ticket. when I retire I hope to have good health, a good woman, a good dog, a big backyard, a really good telescope for viewing the stars, and some nice indica strains...:smt033

You can leave alcohol out of that picture, btw

 

whats heroic about standing firm on a position that you believe that maybe wrong on. hell, I onced said i dont support gay marriage...simply for religous reasons. now Im for it because of constitutional reasons but against it for religous reasons. what!!!! yeah, I said it. u cant push your religion on someone else.

when it comes to the mary u have no problem with beer .....u can over4 dose on beer and die. u can over dose on prescription drugs and die.....i never heard anyone over dose and die on the mary

its couragous to say " I was wrong and lets do different"

 

good article! i read it yesterday! glad to see someone putting the medical use of herb in a positive light. i read an article about a little girl whose parents cook with herb butter and its helping her pain due to cancer.

 

Excellent post! :smt109

 

Did you even read my post? I wasn't calling him a coward for not sticking to his guns. I'm saying that he never really believed that marijuana was a harmful substance and is just saying what's socially acceptable at any given time.

He and a lot other people are cowards for waiting until public opinion shifted on marijuana legalization (and it has drastically in the past few years) before speaking out.

The government has been destroying people's lives for years with this "war on drugs" nonsense while Gupta and several other medical professionals were scared to speak up about the fact that marijuana is harmless and let people be misinformed by a bunch of propaganda.

 

There was a government study behind it during the Nixon administration and despite the analysis that marijuana isn't harmful, the Commission on Drugs dismissed it, thus never saw the light of day. Very different from scientists being able to study something that was relatively new at the time. Research like that takes years for any concrete evidence to come about to determine whether its not good for you.

The only thing I can fault scientists on is that they didn't put a government gag order on the whole thing. Then again, the trust in government was much higher at the time.

 

marijuana is a politicized substance. it has a political image. That's why so many people are against it.

I don't think it's exactly harmless, but it's a real crime that people get thrown into jail for it.

I wouldn't want my kids to smoke it either, but then I wouldn't want them to do a lot of things I've done, eg. riding motorcycles, playing football, etc.

 

Nixon reportedly had this to say about it: “Federal and state laws (should) be changed to no longer make it a crime to possess marijuana for private use.”

Weed is so politicized that if someone shoots you down, they may try to get the killer off by saying there was weed in your system. Then all the simple minds in the jury will think that you're a violent person who deserved to be shot

 

ok. that is what u stated. what are we suppose to think?

if u misstated then yeah.

 

Correct me here, but he did start the War on Drugs, right? And this was especially the scenario here with his platform being "tough" on crime.

 

maybe so. just underscores the fact that weed is a politicized substance

 

He did.

 

It's much less harmful than alcohol, which is perfectly legal.

 

That he was a coward for bowing to public sentiment instead of standing by the truth. My point was that I don't believe that he just recently came to the conclusion that cannabis is harmless substance.

 

well, ok.

its possible you are right but who knows. he may not have been sure.