Doctors for Medical Marijuana: Dr. Sanjay Gupta

Dr. Sanjay Gupta recently participated in an Ask Me Anything interview on Reddit, thoroughly walking back his position on marijuana. Dr. Gupta is an assistant professor of neurosurgery at Emory University School of Medicine in Atlanta, and he served as a White House Fellow between 1997 and 1998. You can catch Gupta on the small screen on CNN, where he is a medical correspondent. In 2009, Dr. Gupta was offered position of Surgeon General. He turned the opportunity down, citing the fact that it was essentially a desk job and that he would no longer be able to perform surgery.

Much of what he has spoken openly about is available in Sanjay Gupta’s “Weed 2” documentary, available to view online for free.

 

Following is a summary of Gupta’s responses during his Reddit AMA.

Neurosurgeon for Cannabis

According to Gupta, he previously supported the government’s listing of cannabis as a Schedule 1 controlled substance because he assumed that they had done due diligence in investigating the drug’s effects on the human body. As Gupta is quick to point out, the main qualification for Schedule 1 is that the drug provides no medicinal benefit. Another requirement: “There is a lack of accepted safety for use of the drug or other substance under medical supervision.” According to Gupta, the government has been provided with plenty of evidence that neither of these statements apply to cannabis.

The doctor also cited among his reasons for recounting his 2009 statements the fact that the drug does not have a high potential for abuse. In fact, recent evidence suggests that only 9% of marijuana smokers develop dependency, and that in order for dependency to develop in the first place, people need to use the drug heavily. This hardly describes recreational users or even individuals who intend to use the plant medicinally. The final nail in the coffin for the neurosurgeon was a survey conducted among practicing physicians: 66% of the respondents stated that they would have no reservations about prescribing medical marijuana to breast cancer patients to mitigate pain.

When asked which piece of evidence for medical marijuana’s efficacy he found most profound, Gupta cited studies on the drug’s effect on epilepsy. The cannabinoids within marijuana are able to calm the tumultuous brain of epilepsy patients far better than epilepsy rescue drugs, which, if taken in too high a dose, can cause death. In the CNN documentary Weeds 2, young Vivian Wilson was shown to be effectively treated by a medical marijuana extract. Additionally, Charlotte’s Web, a sativa strain produced by Colorado growers The Stanley Brothers, was named after a young patient who was treated by it. Gupta also points out that Sativex, a popular multiple sclerosis drug derived from the cannabis plant, is not permitted in the US despite the fact that the drug has allowed some patients to walk again.

The Marijuana Stigma

The first state to illegalize marijuana was Utah in 1910. The story has it that missionaries returning from Mexico came back with a new malodorous plant. The locals quickly dubbed the plant “locoweed” because of the light-hearted attitude it instilled in their church goers. Alarmed, a campaign was initiated in the state to nix the plant. It’s worth noting that the citizens of Utah didn’t base their decision on peer reviewed studies of the plant’s effects, nor were they well equipped in that era to conduct any such studies. Other states quickly followed Utah’s lead, and before long, the plant was illegal on a federal level.

When asked whether he believes if the media is partly to blame for perpetuating the stigma surrounding the plant, Gupta said yes, although he added the caveat that the stigma itself prevents most big name users from coming forward. He also insisted, “There’s plenty of blame to go around.”

The surgeon stated that were he to draft his own bill to end the prohibition on cannabis for medical usage, the bill would include the stipulation that drugs come from whole-plant extracts whenever possible.This may be a call back to the observation that compounds removed from a natural food or plant can become harmful. For instance, there is mounting evidence that high fructose corn syrup, which is a concentrated form of fructose, may be the primary cause of the rising obesity epidemic. The reason? The fructose, a sugar, has been removed from its natural packaging, fiber.  Fiber is very filling, making it difficult to overindulge on fruits and vegetables.  Yet a person can easily down a 2-liter soda in a single day.

When asked if he believed the Southern states of the US would join the legalization bandwagon, Gupta pointed out that Florida and Georgia have already made progress to that end. Indeed, there is a growing grassroots movement for legalization nationwide, and according to numerous polls, most citizens support legalization.

Method of Ingestion

A few Reddit members asked the doctor his views on the safest way to ingest cannabis. The surgeon considered vaporization the safest method to ingest the drug, and he implied that smoking it is the least safe. Indeed, the Medical Research Institute at New Zealand has published research finding that smoking marijuana is more harmful than smoking cigarettes because cannibis smokers tend to take long drags and hold the smoke in for several seconds. Furthermore, all smoke contains carcinogens, regardless of the source.

Gupta pointed out that smoking the drug also creates byproducts that scientists have not studied in detail. Some chemicals, when heated, affect the body in ways quite different than they would if left at room temperature. On the subject of consuming the drug orally, Gupta remarked that this can result in uneven distribution of the drug in the body.

Effect on Memory

Gupta was quick to point out what several studies have borne out: teens should not smoke cannabis, and individuals below the age of 25 should use it only in moderation. The developing brain is highly sensitive to the chemicals within marijuana, and it can actually change structure in response to them. The effect can be a long-term drop in the brain’s ability to store memories. Gupta goes on to report that the drug “affects everyone in the short-term.” On the other hand, the doctor noted that the body itself produces cannabinoids. The answer may lie in moderation. A study by Rhea L. Dornbush, published in the American Journal of Psychiatry, found that high doses of marijuana can cause short-term memory loss, a reduction in reaction time and quickened heart rate.

When asked, however, if he would be okay with other healthcare professionals using the drug medicinally, the answer was a resounding yes. He went on to state, “It should be thought of as a legitimate medicine for patients that need it.” A sound argument, especially considering that most pharmaceutical drugs come with a staggering list of side effects that are well beyond the scope of those reported by medical marijuana users. The surgeon also stresses the importance of proper testing and control, and that drugs derived from the plant must be formulated and produced to exacting standards. Indeed, there is some concern among the medical community that because the plant is considered a controlled substance federally, the small labs in states like Colorado may not be able to secure the funding needed to conduct adequate testing.

Low THC and High CBD

There is much talk in the medical marijuana community of strains that are low in THC and high in medicinal chemicals such as CBD. These strains—incapable of inducing a high—have been found to effectively treat MS, epilepsy and chronic pain, at least in the short term. Jeremy R. Johnson, writing in the journal Pain and Symptom Management, states that strains that are high in THC and exceptionally low in CBD have little to no medicinal value. This jives with what Gupta had to say about the way that cannabis affects the body, stating that the human body has numerous CBD receptors along the nervous system. Gupta also said that CBD is among the most interesting of the more than 500 compounds found in cannabis, and that Americans consume 80% of the world’s pain medications—medications which have serious side effects.

US Patent 6630507

Patent 6630507, held by the US Department of Health and Human Services, explicitly states that cannabinoids have antioxidant properties and that cannabis is therefore useful in the treatment of a wide variety of maladies. The irony was not lost on the surgeon, who brought the patent up in the AMA.

When asked what the average person could do about this situation, Gupta suggested that citizens bring the issue up with their representatives. He also suggested that everyone should arm themselves with the facts: a growing body of evidence suggests that cannabis can provide numerous drugs that have little or no side effects.