Posted by Jonathan Chamberlain on February 18, 2009
“John from Israel” resurrected this interesting interview:
– A Medicinal Marvel
Cannabis, or marijuana, has proven medical benefits and few, if any,
toxic side-effects. Why, then, has it been a prohibited medicine for
over fifty years?
Dr Lester Grinspoon interviewed by Jana Ray © 1996 by Jana Ray For
further information, contact: c/- B.C. Anti-Prohibition League PO
Box 8179 Victoria, British Columbia, V8W 3R8 Canada
Medicinal cannabis, also known as medical marijuana, is beginning to
receive attention worldwide. Unfortunately, scare tactics and
misinformation surrounding the international ‘war on drugs’ continue
to dominate in the political and medical arenas, leaving many
unwilling or unable to think for themselves. Despite this, more
people are discovering the ability of marijuana, or cannabis, to
relieve symptoms surrounding many medical conditions.
One of the pioneers of medicinal cannabis research is Dr Lester
Grinspoon, a professor at Harvard Medical School. In the last 30
years Dr Grinspoon has researched and written many articles along
with two books on the cannabis controversy. Marihuana
Reconsideredand Marihuana, The Forbidden Medicine introduced many to
the positive uses and benefits of one of the oldest cultivated
plants in the world.
In this interview with Dr Grinspoon, many topics are discussed
concerning the role of medicinal cannabis use in today’s society.
J. Ray: What got you interested in marijuana/cannabis?
Dr Grinspoon: In 1967, I had some unexpected time so I thought I
would look into marijuana to see what all the fuss was about. I was
convinced at the time that marijuana was a terribly dangerous drug.
I didn’t understand why young people were ignoring the government’s
warnings about its danger in using it. So, I spent the next three
years doing research and looking into it. I learned I had been
brainwashed just like so many other citizens in the United States.
While marijuana is not harmless, it is so much less harmful than
alcohol or tobacco that the only sensible way to deal with it is to
make it legally available in a controlled system. We can see this
with alcohol which is legally available to people over the age of 21
in the United States. I put all this together in a book called
Marihuana Reconsidered. It was published in 1971 by Harvard
University Press and was quite controversial at the time. It has
just been republished as a classic with a new introduction, 25 years
JR: In your research you found marijuana/cannabis to be less harmful
than tobacco or alcohol?
Dr G: I think cannabis is not harmless. There is no such thing as a
harmless drug. Cannabis is, by any criterion, less harmful than
either alcohol or tobacco. For example, tobacco costs the US about
425,000 lives every year; alcohol, perhaps 100,000 to 150,000 lives,
not to speak of all the other problems caused by alcohol use. With
cannabis there has not been a single case of a documented death due
to its use. Now, of course, death is not the only toxicity. It is
the most profound one and certainly a permanent one. If you look at
it from the point of view of other toxicities, again it comes out
much better than either alcohol or tobacco. In fact, the subject of
our latest book, Marihuana, The Forbidden Medicine, looks at
cannabis from the point of view of a medicine. When cannabis regains
the place it once had in the US Pharmacopoeia it will be among the
least toxic substances in that whole compendium.
JR: It was in the US Pharmacopoeia in the early 1900s?
Dr G: That is correct. Cannabis was a very much used drug up until
1941 when it was dropped from the US Pharmacopoeia. This was after
the passage of the first of the draconian US anti-marijuana laws in
1937, the Marihuana Tax Act. This Act made it so difficult for
physicians to prescribe cannabis that they just stopped using it.
JR: Cannabinoid receptors were recently discovered in the human
brain. Are these cannabinoid receptors related to cannabis and its
Dr G: Very definitely. Some years ago it was discovered by Dr
Solomon Snyder that there are endogenous opioids; that is to say,
substances like opium that we produce in our bodies. It followed
from that, that there would be opioid receptors in our brains. It
wasn’t long afterwards that a woman named Candace Pert discovered
this. In other words, if you consider a receptor as a kind of
keyhole and the ligand or the neurotransmitter as the key that opens
it, the key has to fit into that receptor to open it.
With cannabis it came about the other way: the receptor sites for
cannabis were discovered first. I believe this was in 1990. From
this it was implied that there had to be an endogenous cannabinoid,
a ligand that would turn this receptor site on. Indeed, a couple of
years later, a man named W. A. Devane and his group discovered this
ligand and they gave it the name “anandamide” , after the Sanskrit
word ananda, which means “bliss”. Now there are many studies of
these receptors and anandamide. It is clear that these receptors are
not just located in the brain but in various other organs in the
body as well.
I think we are going to see in the future that these receptors play
a very important part in the medicinal utility of cannabis. Right
now the clinical evidence is empirical and anecdotal but, in my
view, powerful enough to be translated into a policy which would
allow people to use cannabis legally for medicinal purposes.
JR: Do these recent discoveries contradict past research that warned
of brain damage from cannabis use?
Dr G: In my view, that kind of thing is in the realm of myth and
misinformation about cannabis. Think about it for a minute. If the
brain produces its own cannabinoid- like substances, it doesn’t make
much sense that it would produce a substance which is going to
damage the brain. Indeed, long before it was discovered that there
are endogenous cannabinoids, the empirical evidence did not
demonstrate that cannabis damaged the brain.
There are a few studies which were methodically unsound that the US
Government and, specifically, NIDA, the National Institute of Drug
Abuse, and the DEA, the Drug Enforcement Administration, focus on.
JR: Can you tell me something about the US Drug Enforcement
Administration, the DEA?
Dr G: The predecessor agency of the DEA, the Federal Bureau of
Narcotics, was organised in 1930 by a man named Anslinger. Anslinger
undertook what he called a “great educational campaign”, which
actually turned out to be a great disinformational campaign. This is
symbolised by one of the flagships of that campaign: the movie,
Reefer Madness. If you see the movie Reefer Madness today, even a
person who is not very sophisticated about marijuana will laugh at
the grossness of the exaggerations dramatised in that movie.
JR: Do you think pharmaceutical drug companies have anything to do
with the government’s prohibitive stand against medicinal cannabis
Dr G: Absolutely. The Partnership for a Drug Free America has a
budget of about a million dollars a day. A lot of that money comes
from drug companies and distilleries. You see, these companies and
distilleries have something to lose- the distilleries for obvious
reasons. The drug companies are not interested in marijuana as a
medicine because the plant cannot be patented. If you can’t patent
it, you can’t make money on it. Their only interest is a negative
one. It will eventually displace some of their pharmaceutical
Imagine a patient who requires cancer chemotherapy. Now he can take
the best of the anti-nausea drugs, which would be ondansetron. He
would pay about US$35 or $40 per 8-milligram pill and would then
take three or four of them for a treatment. Normally, he would take
it orally, but people with that kind of nausea often can’t, so he
would take it intravenously. The cost of one treatment for that
begins at US$600 because he will need a hospital bed, etc. Or he can
smoke perhaps half of a marijuana cigarette and receive relief from
Currently, marijuana on the streets is very expensive. One can pay
from US$200 to $600 an ounce. This is what I call the prohibition
tariff. When marijuana is available as a medicine, the cost would be
significantly less than other medications; it would cost about US$20
to $30 an ounce. You can’t tax it in the US because it is a
medicine. So that would translate out to maybe about 30 cents for a
So our chemotherapy patient could get, many people believe, better
relief from the marijuana cigarette for 30 cents. This, in
comparison to the ondansetron which would cost at the very least
US$160 a day and, if he had to take it intravenously, more than
US$600 per treatment.
Well, if you multiply that by all of the symptoms and syndromes we
discuss in the book, Marihuana, The Forbidden Medicine, then you can
see that the drug companies will have something to lose here.
JR: Do you see this as a big obstacle in changing drug policy here
in North America?
Dr G: Well, it is certainly playing a part. It is indirectly playing
a part in the Partnership for a Drug Free America ads. To say they
are inaccurate is an understatement.
JR: Are we also talking about DARE, the Drug Abuse Resistance
Education program we see in many schools at this time?
Dr G: Oh yes, that is a terrible program. Again, it is mis-educating
children about drugs. It has now been established in a major study
that it doesn’t do a bit of good. We’re all worried about youngsters
doing drugs, but now DARE has been demonstrated not to do any good.
JR: In your book, Marihuana, The Forbidden Medicine, there are many
references to the medicinal uses of cannabis. What are some of the
medical problems you have seen medicinal cannabis help?
Dr G: The most common cancer treatment in the last couple of decades
is with the cancer chemotherapeutic substances. A big problem with
some of these is the severe nausea and vomiting. It is the kind of
nausea that anybody who has not experienced it can only imagine. It
is very important that this nausea be defeated so patients can be
reasonably comfortable with this treatment. As I have mentioned,
there are conventional drugs available; it is just that cannabis is
often the best.
Then there is glaucoma which is a disorder of increased intraocular
pressure in the eyes. If that pressure is not brought down, glaucoma
can eventually lead to blindness. There are conventional medicines
that work pretty well; but, for some people, cannabis works better
and with fewer side-effects.
Epilepsy is a disorder which has been treated by cannabis for
centuries. About 25 per cent of people in the US who have various
forms of epilepsy don’t get good relief from the conventional
medicines. Many of them do get relief from one of the oldest anti-
epileptic medicines, cannabis.
Multiple sclerosis affects more than two million people in the US,
and one of its distressing symptoms is muscle spasm. It is very
painful. Anybody who has had a cramp while swimming will know what
muscle spasm pain is all about. Cannabis is very effective for the
muscle spasms of not only multiple sclerosis but also of paraplegia
Furthermore, cannabis helps people with MS who may have trouble
controlling their bladders. Cannabis is very helpful in reducing
this kind of loss of control. Not long ago I was in London doing a
TV debate on the topic of medicinal cannabis use. There was a woman
in the audience who said she had come down from Leeds, two-and-a-
half hours on the train, to be in the television audience. She has
MS. The part that was so distressing for her was the social
embarrassment of losing control over her bladder. Well, she said
cannabis has restored her bladder control and she could now make the
two-and-a-half- hour trip from Leeds with no trouble.
Cannabis has been used for centuries in the treatment of various
kinds of chronic pain. It was used on the battlefields of the Civil
War as an analgesic medicine until morphine displaced it. Morphine
was much quicker for the pain and a much more powerful pain-reliever
than cannabis. Cannabis cannot defeat very powerful pain. The price
of using morphine was that many people suffered from what was then
called “soldier’s disease”, which was addiction to morphine.
Cannabis is very useful in the treatment of migraine headaches. Sir
William Osler, in his last textbook on medicine, describes cannabis
as the best single medicine for the treatment of the pain of
The list is longer than that but I don’t think you want me to go on
and on about this. One of the amazing things about cannabis is its
versatility. It has many uses. It is also remarkably non-toxic and
it will be quite inexpensive when it is not a prohibited substance.
In my opinion, cannabis will be seen as a wonder drug of the 1990s,
much as penicillin was in the 1940s.
JR: In your first book on cannabis, Marihuana Reconsidered, you
mentioned that the international drug-control treaties, specifically
the United Nations Single Convention on Narcotic Drugs, were not a
serious obstacle to the legalization of cannabis. Do you still go
along with this?
Dr G: There is no question about it. There is no serious obstacle.
Treaties can be changed and I think the push to do that will come
from Europe. The interest in this is growing much more rapidly in
Europe than in the US. In fact, there is so much new information
regarding medicinal cannabis use that Yale University Press has
asked us for a second edition of Marihuana, The Forbidden Medicine.
This book has been translated into 10 languages, including Japanese.
Late in 1995 we received a letter from our German publisher
congratulating us on our seventh printing. They said our book has
begun a “robust debate on the medicinal use of marijuana in
Germany”. So, the Europeans are way ahead of us, and I think the
pressure will probably come from them to make the necessary legal
changes so cannabis can be used as a medicine without interference.
The present situation is just awful. These poor people who use it as
a medicine already have some degree of anxiety regarding their
disease. Another layer of anxiety is imposed on them by their
government; namely, they might get arrested or have their homes
confiscated because they use cannabis as a medicine.
JR: Do you think these international treaties are what keep the ‘war
on drugs’ alive?
Dr G: I think the Single Convention is not a big obstacle, frankly.
I think lots of people use that as an excuse, that we can’t do
anything because of the Single Convention. I’m not an expert on it,
but the international lawyers I’ve talked to say this is not the
problem. I think the war on drugs is a much bigger thing than our
discussion of medicinal cannabis use. The ‘war on drugs’ is a much
more complicated problem. If we stick to the narrow agenda of
medicinal cannabis use, I think putting pressure on our government
representatives and other people in powerful positions is the way.
People are learning about cannabis as a medicine. Anybody who knows
a person with AIDS who is dealing with the wasting syndrome probably
knows someone who has discovered that cannabis not only retards his
weight-loss but maybe helps him to regain weight. People who know
patients with multiple sclerosis, migraine, glaucoma who are using
cannabis, begin to see that it is a very useful medicine and they
begin to wonder what all the fuss is about. So I think people are
The other thing that is happening that I think is very hopeful is
that doctors are getting educated. You see, doctors usually get
their drug education from drug companies or from pharmaceutical
company sales people who go around to doctors’ offices, as well as
from journal articles, advertisements and promotional campaigns from
these drug companies. There are no drug companies interested in
cannabis, so doctors don’t learn much about it. In my view, doctors
have not only been mis-educated like so many other people, but they
have also been agents of that mis-education. What is happening now
is doctors are learning from patients. This is a new way for doctors
to learn about a new medicine. They learn lots of things from their
patients, but generally not about new medicines.
An example of this would be an AIDS patient who started using
cannabis for his wasting syndrome. Imagine him going into his
doctor’s office and getting on the scales. The doctor knows he’s
been losing weight all along and nothing that the doctor has given
him has helped. Suddenly, the doctor sees his patient has gained
weight since the last visit and he asks, “What’s going on?” The
patient says, “It is the cannabis I’ve been smoking: it has helped
me put on some weight.” This makes a powerful impression on a doctor
who has been struggling to help his patient gain weight. Once this
happens to a doctor, his attitude begins to change.
JR: How can the average person work for changes in the drug laws?
Dr G: Well, right now in the US, Congressman Barney Frank of
Massachusetts has introduced a bill to do just this; to make it
possible for people to use cannabis as a medicine. He needs co-
sponsorship and support for this bill. People who are interested in
this can contact Barney Frank or even their own representatives and
ask them to support HR 2618, the Bill for medical cannabis use for
those in medical need.
JR: Is this a similar bill to what Newt Gingrich and others had
introduced into Congress in the early 1980s?
Dr G: It’s the same bill. It is the McKinney bill. I had suggested
to Congressman Frank to expand the number of symptoms and syndromes
for which cannabis can be used. We know more about it than we did in
1982, but it is the same bill. Gingrich supported it then, but not
JR: In February 1994 you and James Bakalar wrote, “The War on Drugs:
A Peace Proposal”, published in The New England Journal of Medicine.
In it you talk about harm-reduction strategies in the Netherlands
and other countries. What do you think is holding back these
governments in North America from making the changes necessary for a
truce in the drug war, specifically in regards to medicinal cannabis
Dr G: Unfortunately, it is attitudes and fears that are unwarranted.
Take one harm-reduction approach; namely, clean needles. Now, we’ve
been saying for years that clean needles will reduce the spread of
AIDS among drug users. The IV drug users are the group spreading it
the most. There are people who are afraid of needle-exchange
programs because they think it will cause an increase in the use of
intravenous drugs. I would say this has been going on now for four
or five years. Now the data is overwhelming. It clearly demonstrates
that exchanging needles does cut down the spread of AIDS and it does
not cause an increase in the use of these drugs. It is so convincing
that some local municipalities have gone ahead with needle
exchanges, but the Federal government and President Clinton are all
dead set against it. We could have saved a lot of people from AIDS
by instituting this policy of clean needles early on. Even now we
are dragging our feet because of this misapprehension about giving
needles out. Ignorance and fear are not always corrected by data.
The data on needle exchange is compelling whether it’s from
Australia, New Haven or wherever. There is no question. You would
think when you have this kind of data it would be translated into
social policy, considering the cost of AIDS in human suffering. But
we’re having an awful tough time persuading the authorities that we
should go full steam ahead with needle exchange.
There is an attitude here in the US that the only way to treat
anyone using a drug not approved of is to treat them as a criminal.
Many of these people even go to jail. The costs of criminalizing
these people have been extreme. Since I started my work on marijuana
in 1967, more than 10 million Americans have been arrested on
marijuana charges in the US. In 1994, the year for which we have the
latest FBI data on this, 483,000 Americans were arrested on
marijuana charges. That is just extraordinary when you consider that
cannabis imposes less harm on the individual and on society than
either alcohol or tobacco.
JR: What kind of feedback did you receive from your June 1995
article, “Marihuana as Medicine”, in JAMA?
Dr G: Well, that article caused a lot of fuss. It was published in
the Journal of the American Medical Association (JAMA). This
organization has been steadfast in its opposition to marijuana for
50 years-since an editorial published in 1945. Although the AMA
doesn’t say so officially, I think publishing our article signals a
growing change in physicians’ attitudes towards medicinal cannabis.
There were physicians who wrote me nasty letters. More impressive
were the many physicians who shared their stories about how they
learned about cannabis from seeing how it helped a particular
patient. Several of them said we ought to have an organization, a
physicians’ organization, for the medical use of marijuana. The
article created a stir not just in this country. I think JAMA is
published in 33 languages. It was no small wonder that there was a
lot of mail from other parts of the world as well.
JR: Was the feedback mostly positive?
Dr G: Absolutely. By far, most of it was positive. There were some
nasty letters, but I have received those from the time I first
published Marihuana Reconsidered. The first letter I received was a
very nasty letter. As the years go on, though, the mail gets much
JR: What do you see for the future of medicinal cannabis use?
Dr G: It strikes me that there are a lot of parallels with the
discovery of penicillin. Penicillin was discovered by a man named
Alexander Fleming in 1928. He had gone off for summer vacation and
left a Petri dish out in his laboratory. When he came back, the
Petri dish was just covered with Staphylococcus, except for an area
surrounding what looked like a little island of mould. He looked
into it and found that the mould was giving off a substance which he
called “penicillin” . It was killing the Staphylococcus. Yet his
discovery was ignored until 1941. For over a decade his publication
was ignored, until the pressure of World War II highlighted the need
for antibacterial substances other than sulphonamides. Then a couple
of investigators did a study with just six patients and demonstrated
it was a good antibiotic.
Penicillin became very inexpensive to produce. It was clear that
penicillin was not toxic and it was very versatile as a drug. It was
used in the treatment of many different kinds of infectious
diseases. It became the wonder drug of the 1940s.
When cannabis can be produced as a medicine it will be very
inexpensive. I have already listed some of the reasons why it can be
said to be versatile, and, the government position notwithstanding,
it is remarkably non-toxic. It has exactly the same three
characteristics that made penicillin a wonder drug. These are some
of the reasons I believe that, in the late 1990s, cannabis is going
to be recognized as a wonder drug.
Grinspoon, Lester, M.D., Marihuana Reconsidered, Quick American
Archives (a division of Quick Trading Company, PO Box 429477, San
Francisco, CA 94142, USA), 1994 (ISBN 0-932551-13- 0), first
published by Harvard University Press, 1971.
Grinspoon, Lester, M.D. and James B. Bakalar, Marihuana, The
Forbidden Medicine, Yale University Press, New Haven and London,
1993 (ISBN 0-300-05435- 1 [cloth], ISBN 0-300-05994- 9 [paperback].
Grinspoon, Lester, M.D. and James B. Bakalar, “The War On Drugs: A
Peace Proposal”, New England Journal of Medicine, vol. 330, no. 5, 3
Grinspoon, Lester, M.D. and James B. Bakalar, “Marihuana as
Medicine: A Plea for Reconsideration” , Journal of the American
Medical Association (JAMA), vol. 273, no. 23.
For more information on the DARE school programs, here is a list of
articles and world wide web addresses:
Harmon, Michele Alicia, “Reducing the Risk of Drug Involvement Among
Early Adolescents: An Evaluation of Drug Abuse Resistance Education
(DARE)”, Institute of Criminal Justice and Criminology, University
of Maryland, College Park, MD 20742, USA, April 1993.
Web address: http://turnpike. net/~jnr/ dareeval. htm
“Studies Find Drug Program Not Effective”, USA Today, 11 October
1993. See web site: http://turnpike. net/~jnr/ dareart.htm.
“A Different Look at DARE”, Drug Reform Coordination Network Topics,
in-depth series. Web site address: http://drcnet. org/DARE.
About the Interviewee:
Dr Lester Grinspoon is an Associate Professor of Psychiatry at the
Harvard Medical School. He has published over 140 papers and 12
books. His major area of interest has been ‘illicit’ drugs. His
first book, Marihuana Reconsidered, was published in 1971 by Harvard
University Press and republished in 1994 as a classic. He has
written books on amphetamines, cocaine and psychedelic drugs. In
1990 he won the Alfred R. Lindesmith Award of the Drug Policy
Foundation for “Achievement in the field of drug scholarship” .
Marihuana, The Forbidden Medicine, Dr Grinspoon’s latest book,
written with James Bakalar, has been translated into 10 languages. A
second edition is now in press. [Copies of Marihuana, The Forbidden
Medicine, can be ordered from the Publicity Department, Yale
University Press, New Haven, Connecticut, USA, phone +1 (203) 432
About the Interviewer:
Jana Ray is a freelance writer and community radio personality who
works to educate the public about humane alternatives to the global
war on drugs. Harm-reduction strategies, legal medicinal cannabis
use, drug law reform and the preservation of everyone’s human rights
are fundamental principles guiding her work. Since 1992, Jana has
been an active member of the British Columbia Anti-Prohibition
League which represents various west Canadian groups. BCAPL
advocates public/government recognition of the individual’s natural,
human and legal right to determine personally his/her own religion,
lifestyle and consumption.
Extracted from Nexus Magazine, Volume 3, #5 (August-September ’96).
PO Box 30, Mapleton Qld 4560 Australia. editor@nexusmagazin e.com
Telephone: +61 (0)7 5442 9280; Fax: +61 (0)7 5442 9381 From our web
page at: http://www.nexusmag azine.com/