In his latest book, Seeing Through the Smoke: A Cannabis Specialist Untangles the Truth About Marijuana, Peter Grinspoon, M.D. has written an excellent, comprehensive, and authoritative look at medical cannabis. Grinspoon is a primary care doctor at Massachusetts General Hospital and an Instructor in Medicine at Harvard Medical School. He has been a medical cannabis specialist for over twenty-five years. Dr. Grinspoon, a popular speaker, is frequently featured in the national media on issues such as cannabis, addiction, and physician health. His private practice offers comprehensive cannabis coaching, education, and certification (only in Massachusetts). Dr. Grinspoon is certified as a health and life coach to help people find their goals and follow their dreams. He offers comprehensive health and wellness coaching on various issues for which he is uniquely qualified to help.
Peter’s father, Lester Grinspoon, was a Harvard Psychiatrist who wrote Marihuana Reconsidered in 1971. It was highly controversial, and both damaged and propelled his career. The dominant narrative of the times in both the government and the psychiatric profession was that marijuana was very harmful. At that time, 12% of Americans believed in the legalization of marijuana, and now it is around 69%. While Lester Grinspoon understood the potential harm, he found Richard Nixon’s ‘War on Drugs’ and the criminalization of marijuana was profoundly harmful, especially to young people. Even though his book was on the front page of the New York Times Book Review and was a bestseller, he would receive death threats as it was so controversial.
When Peter was 8, his 16-year-old brother Danny was fighting a difficult battle with leukemia, which was becoming resistant to chemotherapy. His parents were aware of the medicinal benefits cannabis can have because of his father’s research and connections, and they decided to source this for their son. Peter writes about this experience in his book, Seeing Through the Smoke: A Cannabis Specialist Untangles the Truth About Marijuana. He recalls that without cannabis, Danny would be lying in bed throwing up. With cannabis, he could eat, hold down food, spend time outside his room, and play his guitar.
The Consequences of Criminalization
The strict criminalization of cannabis in the United States has resulted in overcrowded prisons and a staggering number of arrests for nonviolent cannabis possession. Over the past 50 years, approximately 20 million arrests have been recorded for this offense. What is particularly alarming is the disproportionate impact on black individuals, who are arrested four times more often than their white counterparts despite similar rates of cannabis use. These arrests lead to imprisonment and have far-reaching consequences, hindering education, student loans, housing, and employment opportunities. As a result, many communities, especially those targeted by these arrests, have been trapped in generational poverty. The call for cannabis legalization is not merely about avoiding legal trouble; it is about rectifying the lives ruined by these arrests and expunging minor convictions. Legalization is a matter of social justice and equality, particularly for those who have spent decades in prison or who have otherwise had their lives ruined by entanglements with law enforcement for nonviolent possession offenses.
The Need for Physician Education
In the context of cannabis legalization, doctors should be well-informed about addiction indicators, dual diagnosis, and the potential risks associated with cannabis use. While cannabis can be beneficial in treating conditions such as nausea and vomiting, especially in chemotherapy patients, heavy use can lead to dependency issues for some individuals. For instance, someone presenting in the emergency department with cannabis use and uncontrollable vomiting could be experiencing either cannabis hyperemesis or cyclic vomiting syndrome, which require different treatment approaches. Differentiating between the two conditions necessitates a three-month cessation of cannabis use to determine if it is the underlying cause. If the patient cannot stop using cannabis despite the negative consequences, this would indicate addiction.
Unfortunately, there is a lack of education for doctors regarding cannabis based on outdated myths perpetuated by psychiatrists and the U.S. government during the “war on drugs” era of the 1970s. Only around 8% of medical students studied medical marijuana, yet doctors need knowledge about cannabis to engage in informed discussions with their patients. Included is an understanding of the risks associated with cannabis use for pregnant women, young people, and individuals with psychosis.
Medical Use of Cannabis
While recreational use of cannabis is still not universally agreed upon, there are instances where medical cannabis can be a suitable treatment option. For example, individuals with chronic pain may benefit from medical cannabis. In such cases, physicians should prescribe a modest tincture, primarily CBD, with a small amount of THC. The dosage should increase gradually, starting with a few drops at night. However, one challenge is that many individuals do not disclose their cannabis use to their doctors due to fear of stigma.
Doctors must be aware of cannabis use, primarily to identify potential medication interactions. CBD, for instance, can affect the levels of other medications in the bloodstream by competing for liver enzymes responsible for their removal. Additionally, heavy cannabis users may require higher doses of anesthesia, which an anesthetist can account for if informed. Dr. Grinspoon, a prominent advocate for cannabis education, emphasizes that a lack of communication about cannabis use is more dangerous than the substance itself.
Dr. Grinspoon’s Efforts and Experiences
Dr. Grinspoon has dedicated his work to educating physicians on cannabis-related issues and dispelling myths surrounding its use. In his book, Seeing Through the Smoke, he meticulously examines the potential benefits and harms of cannabis, relying on the latest scientific evidence. In addition to writing, Dr. Grinspoon actively engages with physician groups, psychiatrists, and primary care doctors to promote understanding and knowledge about cannabis.
His personal experiences with addiction, particularly his struggle with prescription painkillers fifteen years ago, have provided him with unique insights into addiction and the challenges faced by physicians. The stress of the medical profession and easy access to medication can make doctors particularly susceptible to addiction. Dr. Grinspoon lost his license due to addiction but recovered and regained his license. He became an associate director of the Physician Health Service, a branch of the Massachusetts Medical Society, an organization supporting doctors dealing with addiction. His first book, Free Refills: A Doctor Confronts His Addiction, delves into addiction and challenges the cult-like traditional “abstinence for life” approach to addictions. He advocates for a more open-minded perspective that offers inclusion to those practicing harm reduction strategies such as the use of Suboxone, methadone, and even psychedelics like psilocybin for recovery or therapy. Dr. Grinspoon believes that welcoming individuals who use cannabis as an alternative to alcohol or opiates can reduce harm as they are no longer likely to suffer overdose or death.
Addressing Mental Health and Addiction
The United States is currently facing a crisis of loneliness and mental health issues, further exacerbating the addiction crisis. Dr. Grinspoon suggests that clinical hypnotherapy could be a valuable complement in helping individuals control their minds and address underlying factors that contribute to addictive behaviors. Techniques such as meditation and hypnotherapy tapes can assist with racing thoughts, anxiety, sleep troubles, and pain, often side effects of poor mental health and addiction.
However, access to these resources is limited, and many struggle to find the time or financial means to access therapists or medications. Dr. Grinspoon emphasizes the importance of clinicians having a better understanding of these techniques and their potential benefits. In his upcoming book, he plans to delve deeper into addiction and explore the potential role of hypnotherapy and other recovery methods.
An Awareness of Cultic Influences in Clinical Care
Clinicians and psychiatrists must recognize that destructive cult leaders can misuse hypnotherapy and meditation. Therefore, it is essential to be aware of the signs of patients who have suffered from cultic abuse. For instance, many primary doctors may not be aware that Jehovah’s Witnesses are considered a destructive cult. This lack of knowledge can hinder discussions with patients who refuse life-saving medical care, such as blood transfusions, based on religious beliefs. Doctors can save lives by having informed discussions or seeking guidance from ex-Jehovah’s Witnesses. Dr. Grinspoon recommends my book, Combating Cult Mind Control, as an outstanding resource for recognizing and understanding the signs of cultic abuse.
In conclusion, the debate surrounding cannabis legalization gets blurred by myths, opinions, and a deeply entrenched cultural war. It is crucial to approach the topic humbly and be willing to re-evaluate our perspectives. Both proponents and opponents of cannabis need to be open to the potential benefits and harms associated with its use. Dr. Grinspoon’s book, Seeing Through the Smoke, serves as a comprehensive, very readable guide that examines the scientific evidence surrounding cannabis, prioritizing scientific research and evidence to establish a middle ground where all parties can agree. This shift towards a more neutral and accepting attitude, coupled with increased education, can pave the way for a more informed and balanced approach to cannabis legalization. Ultimately, the goal should be to promote social justice, equality, harm reduction, and improved medical understanding concerning cannabis.
Free Refills: A Doctor Confronts His Addiction (Peter Grinspoon)
Marijuana Reconsidered (Lester Grinspoon, 1971)
Twitter : @Peter_Grinspoon