Alternative Medicine
Medical Marijuana

History of Medical Marijuana

From 1842—1900 cannabis, or marijuana, made up half of all medicines sold in America. More than 100 articles published in scientific journals supported its use. A 1938 study revealed that 28 pharmaceuticals contained cannabis. While drunk drivers kill, and drunk people in arguments can get out of control and kill people, we don't have a history of cannabis-related violence.

The human body (and all creatures higher than mollusks'– snails, squid, etc.) has cannabinoid receptor sites throughout our system. Wherever we have receptor sites, there is a very good reason. Cannabinoid receptors are found in every system — circulatory, endocrine, nervous system, immune, digestion, and respiratory. When cannabis binds with its natural receptor sites, a variety of positive physiological effects occur. In particular, cannabinoid receptor sites are involved in maintaining balance or homeostasis.

Prop 215

The use of medical marijuana became legal in California following the passage of Prop 215, the Compassionate Use Act of 1996. Medical marijuana is legal if the patient has had proper medical evaluation in which customary standards of medical assessment are met by a licensed physician. The doctor will determine if that individual suffers from a condition already known to benefit from marijuana. Those conditions include:

A. Most Recognized Conditions

Anxiety • Depression • Migraine • Nausea • Chronic Pain • Glaucoma • Anorexia • Muscle Spasms • HIV/AIDS • Multiple Sclerosis • Epilepsy • Cancer • Sports Injury • Post-Traumatic Stress Disorder (PTSD) • Insomnia

B. Other Conditions that the physician has determined may be useful for the individual, including but not limited to irritable bowel syndrome, asthma, bipolar disorder, adult ADD/ADHD, and chemotherapy side effects.

People can obtain marijuana in a number of ways, one of which is through dispensaries throughout the state. After Prop 215, the FDA began raiding medical marijuana dispensaries. After President Obama took office, within his first week, he told the FDA to discontinue its raids on marijuana dispensaries in states in which medical marijuana had become state law. The FDA, in defiance of the new president, continued investigating and raiding California dispensaries, in a Capital Hill power struggle. Several weeks later, President Obama spoke with the FDA again, and told them to cease and desist!

Governor Arnold Schwarzenegger is now calling for a serious look at legalizing marijuana. One of the governor's reasons is that legalization would bring California $1.3 billion sales tax annually.

In spite of Prop 215, opponents of medical marijuana have fought hard to overturn that decision. In 2005, the San Diego Board of Supervisors filed a lawsuit to reverse Prop 215. However, May 19, 2009, as this article was going to press, the U.S. Supreme Court refused to hear the case brought by the San Diego County Board of Supervisors. After the voters in California made medical marijuana legal, San Diego County became one of just several counties in the state that refused to issue medical cannabis cards. The U.S. Supreme Court decision this week dealt a final blow to this county's resistance, and now — This case is closed!

In America marijuana is a $113 billion annual business that costs taxpayers $41.8 billion a year in law enforcement. Here are some of the benefits of legalized marijuana:

a. We add a genuinely useful, low side effect, natural treatment modality.

b. We knock out that part of the drug trade and drug war that deals with marijuana. The amount of time, energy, and lost lives fought to stop the flow of marijuana is arguably a travesty. The war on drugs needs to go on, remembering that drugs like cocaine, heroin, and methamphetamine ruin lives.

c. We save $41.8 billion a year in law enforcement costs.

d. We gain billions of dollars a year on sales tax of lawfully purchased marijuana.

e. Through medical dispensaries, quality control, purity and strength of medical marijuana are maintained.

f. Funds will be freed up for controlled double-blind studies.

Reefer Madness

The decision to remove marijuana from the pharmaceutical industry and from legal use was a McCarthy-esque disinformation program, heavily fueled by the 1936 movie “Reefer Madness.” The demonizing of marijuana was not and is not supported by science. Its medical uses are extensive.

There is ongoing research into the use of medical marijuana, much of it in other countries. Data shows that marijuana decreases muscle spasms, and the pain brought on by muscle spasms. Marijuana has anti-inflammatory properties. There is growing evidence about anti-cancer properties. It lowers eye pressure, which can be a big benefit for people with glaucoma. There are a host of changes in brain neurotransmitters, some of which bring relaxation and dramatically decrease anxiety and stress, and improve sleep.

At the current time, medical marijuana is seen as alternative medicine. However, prior to 1930, numerous medications in America contained cannabis, making it “conventional medicine.” Marijuana became banned for political reasons and not for medical reasons. In the future, it is likely that medical marijuana will not only be legally available, it won't be seen as an alternative treatment anymore. My guess is that, at some point, it will once again be part of mainstream medicine. The growing body of scientific research on medical marijuana is likely to not only legitimize its use, but will also explore a wide variety of symptoms and illnesses that may benefit from its use.

The Pain Triad

I've been evaluating people for the use of medical marijuana for the last six months, and some interesting patterns are starting to crystallize for me.

Pain control is one of the main reasons people use marijuana. It's important to know that chronic pain is part of a triad of problems, along with insomnia and depression. These are a vicious circle. Pain leads to severe problems sleeping. Chronic insomnia makes pain worse. The debilitating combination of chronic pain and insomnia brings despair and depression.

Medical marijuana provides significant pain relief and dramatically improved sleep. By breaking the cycle, the depression that is commonly part of chronic pain, begins to dissipate. Most people with severe, chronic pain are prescribed narcotics like Vicodin and codeine . . . but many people cannot tolerate the side effects, which include nausea, vomiting, and mental confusion.

Mechanisms of Pain Control

There are two main ways of making scientific progress. One method involves controlled, double-blind studies. Such studies allow for evaluation of large numbers of subjects, whether humans or white rats. Because of the politics of marijuana, it has been extremely difficult for researchers to obtain the funding for double-blind studies, although such studies are being done.

The second way of understanding mechanisms of anything medical is “case reports,” or evaluation, assessment, and interpretation of individual responses to a particular form of treatment. Through the evaluation of hundreds of “Chronic Pain Case Reports,” I have come to the following conclusions.

Marijuana Pain Control — a 2-Step Process

Phase 1) Direct Analgesia (Pain Relief)

Just as a narcotic will decrease pain by a certain percentage, marijuana will decrease pain by a certain percentage. The initial phase of marijuana's action cuts pain by about 70%. There is no way to prove that number, but it is an average of hundreds of case reports.

Phase 2) Change in Pain Perception

To understand phase 2, let's quickly look at the pain experience. Let's say that you have chronic, severe pain in your right knee. When pain is severe, all you can think about is the pain. It is as if you could draw a straight line from your mind to your right knee. In essence, your mind is in your knee. Pain waxes and wanes. When it's not severe, that straight, all-consuming line disappears, and you can focus on any number of things.

Marijuana's Phase 2 Action “cuts the line” from your mind to the pain. If phase 1 decreased your pain by 70%, you still have 30% to deal with. Phase 2 involves a major shift in perception in which the pain does not tug on your mind. You are able to totally forget about the pain. It as if that straight line from your mind to your knee has been cut, and then disappeared completely. In effect, many people suffering from chronic pain have the experience that marijuana takes all of their pain away.

Really, some pain may remain, but the Mind-Pain connection has been cut. If someone asked you to refocus on the remaining 30% of the pain, you would be able to shift your awareness, think about the pain, and observe that there is some pain left (if that is true). However, it would take effort to actually focus on the pain. As soon as you would stop trying to feel the pain, your mind would again dissociate from the pain. You would not perceive or feel the pain, and could go about your business basically pain free.

When used therapeutically, marijuana does not leave people apathetic—quite the opposite. It helps free people to do what they want or need to do.

After this 2-Phase Mechanism became clear to me, I began to ask chronic pain patients about their pain experience in more detail. I ask all chronic pain patients, who I am evaluating for medical marijuana, about the percentage of pain that Phase 1 affects. Virtually all people using marijuana for pain control have an “Aha” realization when I ask about and explain this 2-Phase process.

There is quite a bit of variation regarding how much pain is relieved by phase 1 and how much by phase 2. I have evaluated two patients, whose entire pain relief was phase 2 (the perceptual shift) . . . so it is important to understand marijuana's mechanism of pain control.

Beyond Phase 1 and 2

What I have described does not explain “how” marijuana decreases pain. One way it decreases pain is by decreasing muscle spasm. Another way is by relaxing the mind and decreasing stress, which then helps reduce pain. Clearly marijuana's phase 1 action is similar to how vicodin, aspirin, or an NSAID works. That is to say, “There is a specific Phase 1 mechanism, and I could only speculate about the specific biochemistry and the neurotransmitters involved.”

Research shows that marijuana has anti-inflammatory effects. That benefit is not likely to improve pain in the short-term, but would help improve pain over weeks and months.

Marijuana and the Mind

Many people use medical marijuana for relief of anxiety, stress, and depression. A general misconception about marijuana is that it makes people unmotivated and spacey, and that it relaxes people just like a glass of wine or a strong, narcotic pain medication.

Many hard working people with high levels of responsibility get home at the end of the day and cannot turn off their mind. Many people “loop” the same events or conversations over and over again. They can't get those events out of their head. As a result, in the evening they are stressed out, can't turn off their mind, and can't sleep.

They are suffering from mental pain. For these people, marijuana takes the edge off their mental/emotional pain. Their minds slow down to a normal level. (The average person's mind churns out about 5,000 random thoughts daily). Those whose minds get stuck in loops find that marijuana stops the looping.

After their mind is slowed down, and has stopped looping, the mind loses its grip on their entire being. Their mind is still “running” but their mind stops running their life, so people can detach from their mind and focus on the present.

We are scratching the surface of medical marijuana. It is an herb with more than 200 natural compounds within it that act synergistically with each other. This article is not intended to glorify marijuana as if it has no downside. It does and that is why doctors are involved in determining if medical marijuana is indicated for a given individual.

David Gersten, M.D. practices Nutritional Medicine and Integrative Psychiatry out of his Encinitas office and can be reached at 760-633-3063. Please feel free to access 1,000 on-line pages about holistic health and nutritional therapy at


Transformational Talk:
Worried About What Others Think?

Do you worry about what others think of you? Of course everyone likes to be well regarded. Having some sense of how you're viewed is healthy. The problem comes when you imagine someone holds a negative view and you can't stop thinking about it. Your anxiety may be heightened if that someone is a family member, boss or coworker… someone whose opinion and connection matters to you.

Here's the tip. First, check what disapproving view you may be carrying about that person. What you imagine coming from him/her may be your own projected judgment bouncing back.'Look beneath any negativity for anger. This is important. Begin some sentences with “I am angry with you because…” Find a safe space to briefly stomp, shake, or holler this energy out (three minutes max.) Enjoy waves of relief when finished.

Now you'll be clear enough to see if your expectations need adjusting. Can you accept him/her as is? Perhaps you need to communicate directly –- offering feedback or making a request. Planning to do this without demanding or blaming will mitigate fear.

Finally, pull your awareness back inside. Review how you feel about you. This is the only place you have power. Be sure you're not judging or expecting too much of yourself. Ask your heart how it feels about you. Be surprised and overjoyed at the tender love available for you, from you– always.©

Penelope Young Andrade, LCSW Call: 858-481-5752 fax: 858-484-8374 email: