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< INTRODUCTION >
CANNABIS: A Medical and Personal Journey
Cannabis has been tied to human history for millennia. Although the plant was first used for fiber and rope in China and on the Indian subcontinent, no one is sure when humanity first discovered the psychoactive properties of cannabis. Archaeologists can date the purposeful burning of cannabis to around 3500 BCE, and it was used in foods in India by 1000 BCE, if not earlier. The ancient Greek historian Herodotus was the first to give textual evidence that cannabis was used in some cultures as a mind-altering substance, around 2000 BCE. The word cannabis is probably derived from the Neo-Assyrian and Neo-Babylonian word qunubu, meaning to make smoke.
Psychoactive plants have a long history in human culture. Peyote, or mescaline, has been used by the Indigenous peoples of northern Mexico and the southwestern United States since the beginning of recorded history in North America. Coca leaves were chewed for their stimulatory effects for thousands of years in South America. It has even been proposed that the much-feared berserkers of Viking lore ingested hallucinogenic mushrooms to achieve what has been described as trancelike fury. Consequently, the idea that cannabis may have been part of the human narrative from the very beginning is not hard to accept.
The first documentation of the use of cannabis in Western culture started in the late 1830s in France, when physicians prescribed a number of cannabis-based products to cure a range of frightening ailments and conditions, from consumption (an early name for tuberculosis) and mental illness to plague. At around the same time, a young Irish medical researcher, William Brooke OShaughnessy, arrived in India to work as an assistant surgeon for the East India Company. Over the years, OShaughnessy conducted significant research in a number of fields, but his most important contribution was the introduction of cannabis as a therapeutic drug to Western medicine. By the latter part of the 19th century and the early 20th century, however, most countries had restricted the use and possession of cannabis and then made it illegal. Criminalizing the possession of cannabis has ultimately led to prison overcrowding in the United States and driven widespread, race-based incarceration of people for even minor infractions of this prohibition.
For centuries, cannabis has been used for spiritual purposes to induce trancelike states in Eastern cultures, as well as a means of treating illness. Ancient cultures attributed various healing properties to cannabis, such as reducing fever, managing nausea and abdominal symptoms, and even treating a stuffy nose. As the 20th century progressed into the 21st, some of those ancient applications began to reemerge. For example, people began to use cannabis to treat the symptoms of nausea and fatigue associated with chemotherapy long before there was a push to legalize cannabis for medical use. At the same time, reports began to surface about the effectiveness of cannabis as a seizure therapy. Current thinking holds that the medicinal properties of cannabis can be effective in treating a variety of medical problems.
Cannabinoid receptors, which are part of the endocannabinoid system (ECS), are scattered throughout the body and impact a wide variety of processes, including pain and stress. Cannabinoids are the active compounds found in cannabis. There are more than 400 cannabinoids, including THC, that react with a number of different receptors in the human body. Cannabinoids sit on those receptors, depending on the type of cannabinoid and the type of receptor. Two receptors are commonly identifiedCB1 and CB2but researchers have also found CB3, CB4, and CB5 receptors in isolated regions of the brain. There are other properties of the cannabis plant that we will explore in this book, including multiple strains of cannabis that have different percentages of cannabinoids and different calming or stimulating effects. Cannabis is now being widely studied and used for the treatment of many health conditions, ranging from anxiety and insomnia to pain management.
As the medical benefits of cannabis have become more established, parts of the United States and other countries around the world have begun to relax legal restrictions and now allow some usage, with proper documentation and medical supervision. Several states in the United States have also begun to allow some recreational use. However, research into cannabis is still regulated by federal law in the United States, which makes experimentation difficult. Nevertheless, much of the social stigma surrounding the use of cannabis has begun to dissipate, and renewed interest in the benefits of cannabis is blossoming.
But that was not the case 35 years ago when my personal journey with cannabis began. I grew up in a small town in northern Michigan in the 1980s. I did well in school, and I think I had a normal childhood with very loving parents, who focused on providing a great education for each of their six kids. In high school, when I wasnt frying my hair with a curling iron and using countless cans of ozone-depleting hairspray, I was experimenting with cannabis, or pot. In my senior year of high school, I unexpectedly became a mother. It was a struggle to put myself through college, and ultimately medical school, as a single mother. Over the years it became clear to me that my early use of cannabis was a method of self-medicating to control my anxieties. In 1985, in small-town northern Michigan, and everywhere else, for that matter, people simply didnt talk about anxiety or other problems like it; instead they self-medicated, typically with alcohol or, in my case, marijuana. Smoking weed made it easier to get through the day, it relieved my anxieties, and it still allowed me to function normally in school and in life.
I stopped using cannabis when I found out about my pregnancy, as well as during the years I spent in college and medical school. At the time, cannabis was frowned upon socially and forbidden professionally. I graduated from medical school with honors and then trained in internal medicine. I was board-certified and then worked in a hospital setting, as well as in my own private practice, for 20 years. During that time, I didnt forget about cannabis, but it didnt enter my mind to use itI was too busy trying to run a business, raise a family, and conform to the societal norms of the times. I wont say I didnt miss cannabis, but I did avoid it.