Cannabis as a medicine,
as a "drug",
Affidavit by Bryan A. Krumm (1999)
The Hemp Control Law
Affidavit of Dr. Lester Grinspoon
HER MAJESTY THE QUEEN
AFFIDAVIT OF DR. LESTER GRINSPOON
I, LESTER GRINSPOON M.D., of the City of Boston in the State of Massachusetts, MAKE OATH AND SAY AS FOLLOWS:
- I am currently an Associate Professor of Psychiatry at the Harvard Medical School in Boston and have been a professor at Harvard since 1973. I have written approximately 29 articles on various aspects of the use of cannabis, and I have been studying the social and medical aspects of cannabis use since 1967. In addition, I have authored two books on cannabis; namely, Marihuana Reconsidered (1971, Harvard University Press. 1st ed.; 1977, 2nd ed.; classic ed. 1994) and Marihuana.. The Forbidden Medicine (1993, Yale University Press). My book, Marihuana: The Forbidden Medicine has been translated into eight languages. In 1990, I was awarded the Alfred Lindesmith Award for Achievement in the Field of Scholarship. Attached hereto as Exhibit "A" is a true copy of my I. Attached hereto as Exhibit "B" and Exhibit "C" are copies of the two books noted in this paragraph.
- In addition to my publications on the use of cannabis, I have had occasion to testify before the National Marihuana Commission (1972), the House Select Commission on Narcotics (1977, 1978, 1979), the Controlled Substances Advisory Committee and the Drug Abuse Research Advisory Committee (1978). Additionally, in 1975, I testified before the Alaska Supreme Court in Ravin v. State 537 P.2d 494 (1975). In that case, the Alaska Supreme Court concluded that possession of marihuana by adults for personal use is constitutionally protected. In making its decision, the Court took into consideration the information provided in my book, Marihuana Reconsidered.
- It is believed that Cannabis sativa has been cultivated for over 10,000 years. There is definitive proof that it was cultivated in China by 4,000 B.C. and in Turkestan by 3,000 B.C. It has long been used as a medicine in India, China, the Middle-East, South-East Asia, South-East Africa and South America. The first evidence of medicinal use is in a document entitled Herbal (an ancient equivalent of the US. Pharmacopoeia) that was published during the reign of the Chinese Emperor Chen Nung five thousand years ago. Herbal recommended cannabis sativa for malaria, constipation, rheumatic pains, absent-mindedness and female disorders. Another Chinese Herbal recommended a mixture of hemp, resin and wine as an analgesic during surgery. In India, cannabis was recommended to quicken the mind, lower fevers, induce sleep, cure dysentery, stimulate appetite, improve digestion, relieve headaches and cure venereal disease. In Africa, it was used for dysentery, malaria and other fevers. Cannabis was also considered to be a remedy by Galen and other physicians of the classical and Hellenistic eras. It was also highly valued in medieval Europe.
- Definitively labeled Cannabis Sativa by Linnaeus in 1753, the plant is in most parts of the world better known by its popular name, Indian Hemp. This plant, and its fibre, were widely used in Europe for industrial purposes. The pharmacological properties of the plant were largely unknown in Western medicine until various physicians started to recommend its use for medicinal purposes in the 19th century. These physicians had taken note of its medicinal use in other parts of the world. Eventually, it appeared as a reliable therapeutic in the US. Pharmacopoeia and the National Formulary and, until 1937, tincture of cannabis could be prescribed by physicians as a remedy for a variety of ailments. It was ultimately removed from the US. Pharmacopoeia in 1941.
- It was during this century that cannabis lost its appeal as a medicinal product. This was largely a result of the development of apparently suitable alternatives, such as the hypodermic needle, water-soluble analgesics and synthetic hypnotics. In addition, after the passage of the Marihuana Tax Act in 1937, it became increasingly difficult for physicians to prescribe cannabis.
- Through the 19th century and the early part of the 20th century, cannabis was primarily used for medicinal purposes. In the 19th century, cannabis was the subject of experimentation among the literary giants of France and England, including Baudelaire, Gautier, Balzac and Hugo. In the 1840s, these writers founded Le Club de Hachichins in which these writers would ingest hashish brought from Egypt and then record their observations on how this substance affected their literary muse. In America, its recreational use was limited to a small group of jazz musicians and itinerant Mexican workers crossing the border from Mexico into Texas. By the 1930's, national newspapers carried horror-filled stories of the "Marihuana Menace" - this caused a great deal of consternation because the substance was being used almost exclusively by minority groups (i.e. Mexican immigrants and African-American jazz musicians). As a result, cannabis became the subject of criminal sanction in most states through the 1920's and 1930's.
- When cannabis became the subject of criminal sanction in the 1920's and 1930's, there were little or no clinical studies indicating that cannabis was harmful to the body or mind. I have reviewed and analyzed the various studies conducted in the intervening years, and, in my opinion, there is no sound scientific evidence that chronic use of cannabis does any serious damage to the body or the mind. Among the psychoactive drugs available, cannabis seems to be the least dangerous. The only well-documented adverse effects common to the prolonged use of marihuana are related to residual substances in the smoke and not to the drug itself. The question remains whether some pathology has been ignored either because it is too subtle to be detected, even with modern laboratory techniques, or because it is too rare to be uncovered without full-scale epidemiological analysis. In my opinion, the search for damaging effects of marihuana has been more of a fishing expedition and less of an attempt to scientifically validate a causal connection with an observed clinical abnormality. A summary of my review of the existing clinical studies on medical harm is found in Chapter 14 of my book, Marihuana Reconsidered.
- With respect to the claim that marihuana is addictive, there is no longer any doubt that marihuana is not a drug of addiction. Studies have indicated that the use of cannabis does not give rise to biological or physiological dependence and that the discontinuance of the drug does not result in withdrawal symptoms. The World Health Organization's Expert Committee of Drugs Liable to Produce Addiction, has revised its views on addiction and has re-written its definition in terms of "drug dependence". According to the W.H.O., the characteristics of an addictive substance are : 1) an overpowering desire or need (compulsion) to continue taking the drug and to obtain it by any means; 2) a tendency to increase the dose; and 3) a psychological, and sometime a physical, dependence on the effects of the drug. Cannabis does not exhibit any of these characteristics; however, the claim has been made that cannabis, although not physically addictive, can result in a psychological dependency. In my view, the concept of psychological dependence is so vague and ill defined that it is as applicable to the consumption of a psychoactive substance as it is to a person's strong attachment to a car, a pair of trousers or a spouse. A summary of my review of the existing clinical studies on addiction is found in Chapter 9 of my book, Marihuana Reconsidered.
- In regards to the claim that marihuana is a "stepping stone" or "gateway" drug leading to the use of more dangerous psychoactive substances, there is absolutely no evidence that any property of marihuana produces a particular susceptibility to heroin addiction or that marihuana users tend to graduate to heroin abuse. There is simply no valid evidence of anything inherent in cannabis, or in cannabis use, which would make the marihuana user more likely to become a heroin or other opiate user. Marihuana is, so far as has been determined, only a precursor of further marihuana use. A summary of my review of the existing clinical studies on the "gateway" theory is found in Chapter 9 of my book, Marihuana Reconsidered.
- With respect to the claim that marihuana use is criminogenic, the contention that marihuana use causes crime has now been thoroughly discredited, presumably beyond hope of revival. There is no convincing evidence that the pharmacological properties of marihuana incite or enhance human aggression. In fact, the pharmacological properties of marihuana tend to manifest itself in passive behaviour, introspection, tendency to hilarity and sensory enhancement. The notion that marihuana leads to aggressive and violent behaviour was largely a product of misinformation disseminated by law enforcement agencies given responsibility to enforce the prohibition in the 1930's and 1940's. A summary of my review of the existing clinical studies on the relationship between marihuana use and crime is found in Chapters 11 and 14 of my book, Marihuana Reconsidered.
- With respect to the claim that marihuana can induce psychoses, there is no convincing evidence that marihuana use is causally related to the development of mental disorder. In the few studies in which marihuana use appeared to result in psychotic behaviour, it is apparent that many of these individuals who demonstrated psychotic behaviour were suffering from a pre-existing mental disorder. It seems clear that among populations of illicit drug users there will be found more psychopathology than among nonusers. However, the critical questions are (1) whether the drug use comes before the psychopathology and, if it does, whether it is causally related to the development of the psychopathology (either as a precipitating factor or a synergistic one), and (2) whether the drug use is completely independent of the psychopathology or, at the most, an expression of it. In fact, there is evidence that marihuana use is not psychologically destructive, but rather restitutive; that is, individuals have consumed marihuana as a mechanism for dealing with conflict, anxiety and depression. A summary of the existing clinical studies on the relationship between marihuana use and psychoses is found in Chapter 10 of my book, Marihuana Reconsidered.
- There has never been a death directly attributable to the consumption of marihuana. After five thousand years of cannabis use by hundreds of millions of people throughout the world, there is no credible evidence that this drug has caused a single death. The lethality of drugs is ordinarily measured by a value called the "LD50", the dose that will cause 50 percent of animals or human beings taking it to die. The LD50 for cannabis in human beings is not known, because there are no data from which it can be derived.
- It appears that for the most part of this century the medical dangers of marihuana have been vastly overstated, while the medical value of this substance has been grossly understated and ignored. There is now a growing body of evidence indicating that consumption of marihuana is a medically valuable treatment:
- as an anti-emetic to control nausea and vomiting associated with cancer chemotherapy;
- as an anti-emetic to control nausea and vomiting associated with the use of drugs employed to control the spread of the AIDS virus (marihuana allows AIDS patients to take these drugs without the fear that these nausea-inducing drugs will be regurgitated prior to being absorbed by the body. It also retards or reverses the weight reduction syndrome of AIDS);
- to control seizures in patients suffering from epilepsy;
- to reduce intra-ocular pressure (i.e. pressure within the eyes) associated with glaucoma;
- which alleviates muscle spasms associated with multiple sclerosis; and
- which alleviates pain and muscle spasms for paraplegics and quadriplegics;
In addition, there is some evidence that marihuana may be medically useful as a bronchodilator in the treatment of asthma, as a hypnotic to combat insomnia, and as a antibacterial agent resistant to conventional antibiotics in the treatment of staphylococcus. There is also evidence that marihuana has tumour-reducing properties and that patients with idiopathic dystonia (a disorder characterized by spasms and abnormal muscle contractions) have improved their condition when smoking marihuana. A summary of the existing clinical studies and anecdotal evidence relating to the therapeutic value of marihuana can be found in my book, Marihuana: The Forbidden Medicine.
- Although there is a growing body of evidence indicating that marihuana has multi-faceted use , as medicine, it is difficult to make definitive statements as a result of the fact that there is paucity of funding for research on the medicinal value of cannabis. The government is not likely to fund many studies as this may be perceived as inconsistent with the policy of prohibition. Pharmaceutical companies are not likely to fund these studies because marihuana, as an organic plant substance, cannot be the subject of a pharmaceutical patent. This lack of funding is most regrettable because marihuana as an effective treatment agent would not trigger the same deleterious side-effects associated with the use of conventional, synthetic drugs that patients would otherwise be forced to rely upon.
- Despite the lack of funded medical research, in 1988
administrative law judge Francis J. Young
reviewed the existing evidence and concluded that approval by a "significant minority" of physicians was enough to meet the standard of "currently accepted medical use in treatment in the United States" required by the Controlled Substances Act for a Schedule II drug. He added that marihuana, in its natural form, is one of the safest therapeutically active substances known to man. One must reasonably conclude that there is accepted safety for use of marihuana under medical supervision. To conclude otherwise, on the record would be unreasonable, arbitrary, and capricious." Young went on to recommend "that the Administrator [of the DEA] conclude that the marihuana plant considered as a whole has currently accepted medical use in treatment in the United States, that there is no lack of accepted safety for use of it under medical supervision and that it may lawfully be transferred from Schedule I [ a drug with no medical use] to Schedule II [ a drug with recognized medical use]." The DEA, however, disregarded the opinion of its own administrative law judge and refused to re-schedule cannabis. In 1991, the District of Columbia Court of Appeals ordered the DEA to re-examine its standards for reclassifying a drug as having medicinal value. The DEA issued a final rejection of all pleas for reclassification in March of 1992.
- Since 1985, oncologists in the U.S. have been legally permitted to administer synthetic THC (the active ingredient in marihuana) orally in capsule form. The trade name is "Marinol". However, it is apparent that inhaled cannabis maybe preferable for a number of reasons. Oral THC is absorbed erratically and slowly into the bloodstream. Furthermore, a patient who is severely nauseated and constantly vomiting may find it almost impossible to keep the capsule digested until it activates. In addition, the effectiveness of THC is dependent on how much is absorbed into the blood stream; investigators have shown that smoked THC is absorbed more effectively. Most patients also prefer smoking marihuana to taking THC orally, as the latter makes them anxious and uncomfortable. One reason that the oral ingestion of THC makes patients anxious and uncomfortable is the difficulty of titrating the dose of oral THC to control the amount that reaches the blood and brain. In 1990, a survey of over 2,000 members of the American Society of Clinical Oncology found that only 43% were satisfied that the available legal anti-emetic drugs (including oral THC) provided adequate relief to all or most of their patients. On average, they considered smoked marihuana more effective than oral synthetic THC and roughly as safe.
- While there can be no question that the use of psychoactive drugs may be harmful to the social fabric, the harm resulting from the use of marihuana is of a far lower order of magnitude than the harm caused by abuse of narcotics, alcohol, and other drugs. Marihuana itself is not criminogenic: it does not lead to sexual debauchery, it is not addictive, there is no evidence that it leads to the use of narcotics. It does not, under ordinary circumstances, leads to psychoses, and there is no convincing evidence that it causes personality deterioration. Even with respect to automobile driving, evidence exists that marijuana is less detrimental to this skill than alcohol. Marihuana use, even over a considerable period of time, does not lead to malnutrition or to any known organic illness. There is no evidence that mortality rates are any higher among users of marijuana than nonusers. In fact, relative to other psychoactive drugs, it is remarkably safe.
SWORN BEFORE ME
at the City of Boston
in the Commonwealth of Massachusetts, USA
this 26th day
of March, 1997
DR. LESTER GRINSPOON
Thanks to Richard Lake of the Media Awareness Project for scanning the affidavits.
Hemp in religion,
for fibre, food and fuel,