the yin and yang of medical marijuana

5
The of Medical Marijuana New scientific discoveries validate cannabis as a treatment for many diseases By Martin A. Lee I n 1964, a team of Israeli researchers led by Dr. Raphael Mechoulam isolated and synthesized tetrahydrocan- nabinol (or THC), the main psychoactive ingredient of marijuana. Although he didn't realize it at the time, Mechoulam had lit a fuse that would detonate a revolution in medical science. Just as the study of opium resulted in the discovery of endorphins, the brain's own morphine-like substance, so too, research into the complex pharmacology and meta- bolic pathways of cannabis would lead to the discovery of a unique molecular signaling system in the brain and body that is involved in the regulation of a broad range of biological functions. In 1988, scientists learned that "cannabinoid" recep- tors—specialized protein molecules embedded in ceü membranes, which respond pharmacologically to com- pounds in marijuana—are 20 times more prevalent in the human brain and central nervous system than opioid receptors. Five years later, additional cannabinoid (CB) re- ceptors were found in the gut, spleen, liver, heart, kidneys, bones, lymph and immune cells, endocrine glands, and throughout the peripheral nervous system. Mechoulam and his colleagues assumed that these receptors were not formed solely for the sake of experienc- ing the effects of a particular herb. They embarked upon a search for an endogenous substance—our "inner canna- bis," so to speak—that binds to these special receptors. In 1992, Mechoulam's team discovered a naturally occurring "endocannabinoid," similar in effect to THC, which trig- gers biochemical changes on a cellular level. After identify- ing the brain's own THC-like cousin, they decided to call it "anandamide," deriving from the Sanskrit word for bliss. Since then, scientific interest in "the endocannabinoid system"—named after the plant that led to its discovery— has flourished. In addition to anandamide, several other endocannabinoids have been identified. Advances in the burgeoning field of cannabinoid studies are paving the way for new treatment strategies for numerous physi- cal and psychological infirmities. A 2006 review ("The Endocannabinoid System as an Emerging Target of Phar- macology") by investigators at the U.S. National Institut^ of Health reported that compounds in marijuana "hold therapeutic promise in a wide range of pathological condi- tions," including neuropathic pain, arthritis, Alzheimer's, multiple sclerosis, cancer, depression, drug addiction, epi- lepsy, osteoporosis, Parkinson's, and many other diseases that are seemingly beyond the reach of conventional cures. Yet, few people outside the scientific community have heard of the endocannabinoid system. Aside from a hand- ful of cannabis clinicians in the 14 U.S. states where medi- cal marijuana is legal, most American doctors are clueless about the hard science that sheds light on why cannabis is such a versatile and enduring remedy (it's been used therapeutically at least since 2500 BC), and why it is by far the world's most popular illicit substance. Unbeknownst to the general public, scientists involved in cannabinoid studies share their findings in highly tech- nical, peer-reviewed journals and at annual conferences that attract hundreds of experts from around the world. "We are a large group that is working without really com- peting, and we are exchanging information all the time," says Mechoulam, who maintains that cannabinoids repre- sent "a medicinal treasure trove." Several hundred new scientific articles discussing can- nabinoids are published each month. Ironically, much of this cutting-edge research has been subsidized by the U.S. National Institute of Drug Abuse (NIDA), which spread its largesse in an effort to prove the harmful effects of marijuana. But rather than discrediting cannabis, NIDA inadvertently helped to facüitate a series of astonishing scientific breakthroughs. Of Knockout Mice & Men In a remarkable way, the effects of cannabis have drawn scientists to the still unfolding saga of the endocannabinoid system, which has only recently begun to reveal its profound mysteries. This ancient, internal signal system started evolv- ing more than 600 mülion years ago (long before cannabis Orgánica 1 Winter/Spring 2011 9

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A comprehensive introduction to the uses and effectiveness of medical marijuana

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Page 1: The Yin and Yang of Medical Marijuana

The

of MedicalMarijuana

New scientific discoveriesvalidate cannabis as atreatment for many diseases

By Martin A. Lee

I n 1964, a team of Israeli researchers led by Dr. RaphaelMechoulam isolated and synthesized tetrahydrocan-nabinol (or THC), the main psychoactive ingredient

of marijuana. Although he didn't realize it at the time,Mechoulam had lit a fuse that would detonate a revolutionin medical science.

Just as the study of opium resulted in the discovery ofendorphins, the brain's own morphine-like substance, sotoo, research into the complex pharmacology and meta-bolic pathways of cannabis would lead to the discoveryof a unique molecular signaling system in the brain andbody that is involved in the regulation of a broad range ofbiological functions.

In 1988, scientists learned that "cannabinoid" recep-tors—specialized protein molecules embedded in ceümembranes, which respond pharmacologically to com-pounds in marijuana—are 20 times more prevalent inthe human brain and central nervous system than opioidreceptors. Five years later, additional cannabinoid (CB) re-ceptors were found in the gut, spleen, liver, heart, kidneys,bones, lymph and immune cells, endocrine glands, andthroughout the peripheral nervous system.

Mechoulam and his colleagues assumed that thesereceptors were not formed solely for the sake of experienc-ing the effects of a particular herb. They embarked upon asearch for an endogenous substance—our "inner canna-

bis," so to speak—that binds to these special receptors. In1992, Mechoulam's team discovered a naturally occurring"endocannabinoid," similar in effect to THC, which trig-gers biochemical changes on a cellular level. After identify-ing the brain's own THC-like cousin, they decided to callit "anandamide," deriving from the Sanskrit word for bliss.

Since then, scientific interest in "the endocannabinoidsystem"—named after the plant that led to its discovery—has flourished. In addition to anandamide, several otherendocannabinoids have been identified. Advances in theburgeoning field of cannabinoid studies are paving theway for new treatment strategies for numerous physi-cal and psychological infirmities. A 2006 review ("TheEndocannabinoid System as an Emerging Target of Phar-macology") by investigators at the U.S. National Institut^of Health reported that compounds in marijuana "holdtherapeutic promise in a wide range of pathological condi-tions," including neuropathic pain, arthritis, Alzheimer's,multiple sclerosis, cancer, depression, drug addiction, epi-lepsy, osteoporosis, Parkinson's, and many other diseasesthat are seemingly beyond the reach of conventional cures.

Yet, few people outside the scientific community haveheard of the endocannabinoid system. Aside from a hand-ful of cannabis clinicians in the 14 U.S. states where medi-cal marijuana is legal, most American doctors are cluelessabout the hard science that sheds light on why cannabis

is such a versatile and enduring remedy (it's been usedtherapeutically at least since 2500 BC), and why it is by farthe world's most popular illicit substance.

Unbeknownst to the general public, scientists involvedin cannabinoid studies share their findings in highly tech-nical, peer-reviewed journals and at annual conferencesthat attract hundreds of experts from around the world."We are a large group that is working without really com-peting, and we are exchanging information all the time,"says Mechoulam, who maintains that cannabinoids repre-sent "a medicinal treasure trove."

Several hundred new scientific articles discussing can-nabinoids are published each month. Ironically, much ofthis cutting-edge research has been subsidized by the U.S.National Institute of Drug Abuse (NIDA), which spreadits largesse in an effort to prove the harmful effects ofmarijuana. But rather than discrediting cannabis, NIDAinadvertently helped to facüitate a series of astonishingscientific breakthroughs.

Of Knockout Mice & MenIn a remarkable way, the effects of cannabis have drawnscientists to the still unfolding saga of the endocannabinoidsystem, which has only recently begun to reveal its profoundmysteries. This ancient, internal signal system started evolv-ing more than 600 mülion years ago (long before cannabis

Orgánica 1 Winter/Spring 2011 9

Page 2: The Yin and Yang of Medical Marijuana

took root), when the most complex life form was sponges.Endocannabinoids, the naturally occurring messenger mol-ecules that bind to CB receptors somewhat like keys fittinginto slots, are present in fish, reptiles, amphibians, rodents,birds and mammals of every variety.

CB receptors are "turned on" by three kinds of canna-binoid keys: endogenous fatty acid cannabinoids; phyto-cannabinoids concentrated in the oüy resin on the budsand leaves of the marijuana (and no other) plant; and syn-thetic cannabinoid "agonists" concocted in academic anddrug company laboratories. Using genetically engineered"knockout" mice that lack CB receptors, researchers haveproven that cannabinoid compounds can alter disease pro-gression and attenuate experimentally induced symptoms.

Here's how it works. An "animal model" of osteoporosis,for example, is created in normal mice and in knockoutmice without CB receptors. When a cannabinoid agonist isgiven to both groups of osteoporatic mice,bone damage is mitigated in the normalmice but has no effect on rodents lack-ing CB receptors, which means that CBreceptors are instrumental in maintaininghealthy bone density. (CB receptor acti-vation, according to a German researchteam, restrains the formation of bonereabsorbing cells, known as osteodasts,by down-regulating osteoclast precursors,thus tipping the balance in favor of osteo-blasts, cells that facilitate bone formation.)Similar experiments with knockout miceindicate that CB receptors are involved inpain relief and ameliorating acute brain in-juries, arthritis, multiple sclerosis, gastriculcers, diabetes, cystic fibrosis, cerebralpalsy, amyotrophic lateral sclerosis (LouGehrig's Disease) and other neurologicaldisorders.

The actions of the endocannabinoidsystem are ubiquitous. Formed on demandin areas of need, anandamide and otherendocannabinoids impact the organismin ways that are "predominantly local andspecific," says Mechoulam. Anandamidelevels in the craniosacral fluid, for ex-ample, increase in response to strokesand other traumatic brain injuries. Withtheir unique capacity to engage in "retrograde signaling,"which inhibits immune cell migration, endogenous can-nabinoids and their botanical counterparts can normal-ize over-stimulated nerves and reduce inflammation.(Retrograde signaling is an intra-cellular communicationprocess that puts the brakes on excessive activity.)

Meanwhile, U.S. drug war oflicials continue to misleadthe public, claiming that marijuana is harmful because itweakens the immune system. It turns out that one of themain reasons why cannabis is therapeutic is precisely be-cause it temporarily impedes immune cell activity, thuseasing inflammatory and autoimmune ailments.

The human immune system, an amazing physiologicalwonder, has both an inflammatory and an anti-inflam-matory component. Picture the immune system as afurnace that switches on when a fever is required to fry avirus or a bacterial invader. When the job is done, endo-cannabinoid signaling turns down the flame and restoreshomeostasis. But if the pilot light burns too high, if theimmune system overreacts and mistakes one's own bodyfor a foreign object, then the stage is set for an autoim-mune disease or an inflammatory condition to develop.

Numerous scientific studies have determined that can-nabinoids—endo, herbal and synthetic—are neuropro-

1 0 PUBLISHED BY AUBREY ORGANICS*

tective, as well as anti-inflammatory. When consumedorally, THC packs an anti-inflammatory punch twentytimes stronger than aspirin and twice that of hydrocor-tisone. Cannabinoids literally cool the body; thus mari-juana should be assiduously avoided if a fever is neededto ñght an infection. But when it comes to autoimmunediseases and other chronic, age-related ailments that areoften resistant to conventional treatments, cannabinoidcompounds show tremendous healing potential.

The Ur-RegulatorBy now, nearly every major pharmaceutical firm has aresearch team that is intent on developing cannabinoidremedies for a wide array of infirmities, including, atlong last, a painkiller without abuse potential. (Need it besaid that no one has ever died from an overdose of can-nabinoids?) Backed by NIDA and Big Pharma, scientists

Consumed orally,THC packs an anti-

inflammatory punch20 times stronger than

aspirin and twice that ofhydrocortisone

have learned that cannabinoid receptors convey chemi-cal signals that choreograph the ebb and flow of immunecells, hormones and mood-altering neurotransmitterssuch as serotonin and dopamine. Glucose metabolism inevery cell of the human body is regulated by the endo-cannabinoid system.

Robert Melamede, professor emeritus of biology atthe University of Colorado, likens the endocannabinoidsystem to a series of thermostats that modulate thetempo and temperature of nervous, skeletal, muscular,digestive, cardiovascular and reproductive functioning;the endocrine glands, sleep cycles, appetite, immuneresponse, pain sensitivity and other crucial biologicalprocesses. "Endocannabinoids are central players in life'smultidimensional biochemical balancing act, known ashomeostasis," says Melamede. Describing the endocan-nabinoid system as "the Ur-Regulator," he explains whymarijuana is such an effective, multipurpose medicine;"It is the only plant that mimics the way our bodies try tomaintain balance.

"With the advent of antibiotics and an increased focuson public health," adds Melamede, "the leading causeof death in the United States has shifted over the lastcentury from infectious diseases such as tuberculosis, to

age-related diseases such as cardiovascular, autoimmuneand neurological disorders, and cancer. All of theseage-related diseases—and the aging process itself—arethought to have free radicals as causative agents."

Highly reactive chemicals known as free radicals areproduced when animals use oxygen to burn food forfuel. A great deal of data suggests that many problemsassociated with growing old stem from the inability ofthe aging organism to protect itself against free-radical-induced inflammation and oxidative stress, which causeneurodegenerative illnesses. "In general, free radicals canbe viewed as biochemical friction, while cannabinoidsare the biochemical oil of life," Melamede counsels. "Ap-propriate cannabis use reduces biological harm caused bybiochemical imbalances, particularly those that increasein frequency with age. Cannabis pushes the immunesystem into anti-inflammatory mode and helps slow the

progression of disease, thereby slowing down theaging process."

Some cultures revered cannabis as an "ex-tender of life." According to ancient Hindu lore,it was Shiva's gift to the world—where the nectarof immortality landed on earth, ganja sprangforth. Longevity and good health were attributedto this plant. The world's oldest pharmacopoeiafrom China, the Shen-Nung Pen-Tshao Ching,listed over 100 ailments treatable with "Ma,"medicinal hemp, which was considered an un-usually therapeutic herb because, unlike mostbotanicals, it possesses both strong yin and yangenergy (the passive feminine principle and theactive masculine force). In traditional Chinesemedicine, psychoactive hemp was prized for itshfe-enhancing and hfe-extending qualities. Tao-ist initiates embraced it as a means to achieveimmortality.

Commenting on the therapeutic upside ofmarijuana. Dr. Lester Grinspoon, professoremeritus at the Harvard School of Medicine, cutto the chase: "It's a sad commentary on the stateof modern medicine and U.S. drug policy that westul need 'proof of something that medicine hasknown for 5000 years."

Endocannabinoid DeficiencyRecent scientific research has affirmed anecdotal

accounts of medical marijuana users. University of SanFrancisco oncologist Donald Abrams, for example, con-ducted studies showing that cannabis significantly re-lieved peripheral nerve pain in AIDS patients who werenot helped by any federally certified pain medications. Inanother study published in the science journal Anesthe-siology, researchers at the University of California in SanDiego discerned that cannabis works best as a painkillerwhen moderate amounts are smoked, whereas heavypuffing may actually worsen the pain. Known in pharma-cological parlance as the "biphasic" effect, this curiousless-is-more dynamic was also noted by McGill Univer-sity scientists, who found that low doses of marijuanaincreased serotonin levels in rats, but high doses madetheir serotonin levels plummet. Similarly, low doses ofcannabis, a serotonin modulator, can relieve anxiety anddepression (hence the moniker "Green Prozac"), whiletoo much THC can wig people out.

Italian scientist Mauro Maccarrone has explored therole of cannabinoid receptors in reproductive biology. CBreceptors play an essential role in both male and femalefertility, according to Maccarrone, who describes theendocannabinoid system as the "guardian angel" or "gate-keeper" of mammalian reproduction. Endocannabinoid

Page 3: The Yin and Yang of Medical Marijuana

signaling figures decisively throughout the reproductiveprocess—from spermatogenesis to fertilization, ovu-ductal transport of the zygote, embryo implantation,fetal development, and the initiation of suckling innewborns. (High concentrations of endocannabinoidsare present in mother's milk.) CB receptors proliferatein the placenta and facilitate neurochemical "cross-talk"between the embryo and the mother. A misfiring of theendocannabinoid system, Maccarrone warns, couldresult in serious problems, including ectopic pregnancyand miscarriage. Maccarrone hopes that his researchwill lead to therapeutic applications for correcting in-fertility and improving reproductive health.

The late Israeli scientist Ester Fride observed thatgenetically engineered knockout mice missing CBreceptors resemble babies who suffer from "failure tothrive" syndrome. (Without CB receptors, mice witherand die prematurely.) This is one of many enigmaticconditions that may arise because of a dysfunctionalendocannabinoid system. Infant colic has also beenattributed to a dearth of endocannabinoids.

"Endogenous cannabinoid deficiency," explains Uni-versity of Washington neurologist Ethan Russo, couldresult from a diminished number of cannabinoid re-ceptors or the insufficient presence of anandamide andother endogenous cannabinoids. Individuals have dif-ferent congenital endocannabinoid levels and sensitiv-ities. A surplus or lack of metabolic enzymes involvedin the formation and breakdown of anandamide couldskew the endocannabinoid system. And dietary fac-tors may also contribute to endocannabinoid deficits.Essential fatty acids (abundant in hempseed, flaxseed,walnuts and fish) are biochemical building blocks ofanandamide; a diet low in omega oils can compromisethe endocannabinoid system. Whatever the causes.Dr. Russo postulates that "clinical endocannabinoiddeficiency" underlies migraines, fibromyalgia, irritablebowel disease and other degenerative illnesses whichmay respond favorably to cannabinoid remedies.

Israeli and Spanish researchers were the first to linkthe onset of Alzheimer's to the human brain's failure toproduce enough of its own marijuana-like compounds.As reported in The Journal of Neuroscience, cannabisderivatives slow the development of Alzheimer's byinhibiting the activity of microglia cells that damageneurons in the brain. In 2005, Canadian scientistsdisclosed that a synthetic cannabinoid compoundstimulated brain cell growth. Of all the so-calleddrugs of abuse, "only marijuana promotes neuro-genesis," says Dr. Xia Zhang, lead researcher for theexperiment at the University of Saskatchewan. Otherstudies found that injections of THC destroyed braintumors in rats. And laboratory experiments in severalcountries have shown that cannabinoids can kill avariety of malignant cells, including leukemia, lym-phoma, glioma, breast cancer, prostate cancer, colonand rectal cancer.

CBDrThe Non-ToxicantCannabis contains many biologically active componentsbesides THC. Another plant-derived substance that hassparked significant interest among scientists is canna-bidiol (CBD), the second most prevalent compound inmarijuana (see sidebar). CBD is a potent, non-addictivepainkiller and anti-inflammatory with an impressiverange of potential applications. In 2007, French scien-tists presented evidence that CBD can stop the progres-sion of "mad cow" disease by inhibiting the develop-ment of infectious, misshaped protein-particles, knownas prions, which cause several fatal, transmissible, neu-

rodegenerative diseases. "Our results suggest that CBDmay protect neurons against the multiple molecular andcellular factors involved in the different steps of the neu-rodegenerative process, which takes place during prioninfection," the French research team concluded. "Whencombined with its ability to target the brain and its lackof toxic side effects, CBD may represent a promisingnew anti-prion drug."

The cardioprotective qualities of CBD were confirmedby researchers in Madrid, who reported that CBD-treat-ed mice are much less prone to acute ischémie eventsthan untreated mice. And an Israeli study demonstratedthat CBD treatment dramatically reduces blood sugarlevels and the incidence of diabetes in mice. Clinicaltrials in Brazil indicate that CBD lowers anxiety amongschizophrenic patients. It was also tested successfully onchildren with therapy-resistant epilepsy.

The fact that CBD is not psychoactive—it doesn't getyou high—makes it all the more intriguing to pharma-ceutical companies, which are keen to sculpt syntheticnovelties that possess some of the therapeutic attri-butes of marijuana without altering mood or thinking(although it's not clear why mild euphoria should beconsidered a negative side effect for someone who is iU).With CBD there are no known adverse side effects; itactually softens the psychotropic impact of THC. CBDis the yin of THC's yang. Cannabidiol balances the buzzand tempers the euphoria—or in some cases, the dys-phoria—induced by THC, which in concentrated formcan make a person feel loopy and very nervous.

One of the standard arguments invoked by pot pro-hibitionists is that medical marijuana is unnecessarybecause a synthetic version of pure THC is availableby prescription under the brand name Marinol as aremedy for nausea. But Marinol, a single-moleculepill, lacks the crucial therapeutic qualities conferredby CBD. Scientists believe that CBD, which has stronganti-anxiety properties, works best in tandem withTHC, an inebriant. Together they perform a yin-yangbalancing act in keeping with the endocannabinoidsystem's role as "the Ur-Regulator," the Tao of health.

CBD interacts with THC in complex ways, aug-menting certain effects, such as THC's painkilling andanti-inflammatory capacity, while muting THC's psy-choactivity A randomized clinical trial of 177 subjectsin Great Britain showed that a combination of THCand CBD worked better than THC alone in providingrelief from cancer pain. The antioxidant propertiesof THC and CBD in combo, which mitigate damagecaused by free radicals, exceed the antioxidant potencyof vitamins C and E.

THC and CBD are the major constituents of Sativex,a non-smokable cannabis extract available by prescrip-tion in Canada, England and Spain for treating neu-ropathic pain associated with multiple sclerosis andcancer. Administered as an under-the tongue spray,Sativex is produced by GW Pharmaceuticals, a Britishfirm that has distinguished itself from other drug com-panies by developing a range of whole plant remedieswith varying ratios of THC and CBD. It's not hard toimagine plenty of off-label uses for Sativex.

The "Entourage Effect"In addition to THC and CBD, more than one hun-dred other cannabinoids are present in marijuana intiny amounts—each a slightly different molecule withunique therapeutic attributes. For example, cannabig-erol (CBG) has anti-fungal and antibiotic properties;

Yin à Yang continued on page 34

CBD:It doesn't get you high,but it's causing a buzz

M ore than one hundred "cannabinoid"compounds have been discovered thatare unique to the marijuana plant.

Tetrahydrocannabinol (THC) and cannabi-diol (CBD) have been studied most extensively.THC is predominant in plants bred for theirpsychoactive effect. CBD is the predominantcannabinoid in hemp plants bred for fiber.

CBD, a non-psychoactive component of thecannabis plant, has enormous therapeutic po-tential. Recent scientific experiments indicatethat CBD could be effective in easing symptomsof a wide range of diseases. CBD has provenneuroprotective and anti-bacterial properties,and its anti-cancer properties are currently be-ing studied at academic centers in the UnitedStates and elsewhere.

Because CBD neutralizes the psychoactiveeffect of THC, for many years cannabis breed-ers focused on creating strains that were high inTHC and low in CBD. When California legal-ized marijuana for medical use in 1996, nearlyall of the cannabis available in the Golden Statehad been bred to accentuate the swimmy-headed "stoney" feel enjoyed by pot smokers.

In an effort to ensure the safety and efficacyof their products, several medical marijuanadispensaries in California and other states havebegun testing marijuana strains for cannabi-noid profiles. Serendipitously, a few CBD-richstrains were discovered. These are now beingoffered to medical marijuana patients.

One such patient in San Francisco describedthe effects of CBD-rich cannabis as "relaxingbut not intoxicating."

The reduced psychoactivity of CBD-richcannabis makes it an appealing treatment op-tion for people seeking anti-inflammatory, an-ti-pain, anti-anxiety, anti-spasm, anti-tumoraland neuroprotective effects without distractingeuphoria or lethargy.

For more information, see:www. projectcbd. com.

Orgánica | Winter/Spring 2011 11

Page 4: The Yin and Yang of Medical Marijuana

yin 8t yangcontinued from pg. 11

CBG also relaxes the blood vessels and lowers bloodpressure. Plus, there are dozens of terpenoids (aromaticoils) and phytonutritious flavonoids in cannabis, whichimpart a distinct smell, taste and medicinal quality toeach strain of marijuana.

Scientists recently discovered that certain terpenoidstrigger changes in cell physiology and immune responseby binding directly to cannabinoid receptors. And cer-tain flavonoids activate serotonin receptors, which areinvolved in mood stabilization and uplift. Flavonoids,like cannabinoids and terpenoids, have strong antioxi-dant and anti-inflammatory properties. All of these me-dicinal components interact with each other to producea holistic "entourage effect," as Raphael Mechoulam callsit, that is far greater than the sum of the plant's parts.

Despite the pipe dreams of Big Pharma and the drugwar establishment, synthesized corporate concoctionswill never make the whole plant medically or recreation-ally obsolete. While they may prove helpful to manypeople, it is unlikely that these synthetic remedies willsupplant the use of cost-effective, organically grown,backyard bud with its pungent, antioxidant-rich mixtureof cannabinoids, terpenes and flavonoids, which act syn-ergistically to create a therapeutic impact that exceedsthe capacity of single-molecule medicines.

"The science is an avalanche coming down," says Dr.William Courtney, a cannabis clinician in Northern Cali-fornia. "And the pharmaceutical giants are salivating. Theywant to isolate all the active ingredients of marijuana andturn them into a hundred separate medicines." Endorsingthe whole plant as a preferable option, Courtney asserts:"There is a big difference between being grossly intoxi-cated and supporting an internal system without whichwe would not be alive."

Martin A. Lee is the author of Acid Dreams: TheComplete Social History of LSD, and The BeastReawakens. He is presently writing a socialhistory of marijuana. For more information,visit www.projectcbd.com.

i docontinued from pg. 21

A few weeks ago, we stood before the long mirror in thehall, me behind her, with my arms around her. "You .. . me," I said, slowly, solemnly, almost as a question. Iwas outside my standard compass of perception. "You

'* . . . and I," I said with deep feeling and astonishment.And she laughed at the sappy heft of my tone—until sherecognized I was not the man I usually am and she notthe usual woman, but that we were, and are, a remark-able accident, an extraordinary fiber of deliberation andhappenstance, blind will, beauty, expedience, hope, andkooky myth-making: all that is marriage and love, withor without the license.

On my office desk is a picture taken just after we hadexchanged I do in the living room of our house and theman from the city had presented us with a trash violation

-34 wvw/.organicanews.com

for stacking too many leaf bags in the alley. In the pic-ture, she mouths an O of smoke from an elegant browncigarette, the sleeves of my linen blazer drooping overher hands, and she gleams like the pearls she wears. I'vetried to guess what my relationship to that image will beone day. Will it become my great icon of grief? Com-mensurate with my present happiness? To some extent,it already has—in the way the very young mourn theloss of their youth. She and I are still tumorless (as faras we know), though sometimes when she waves good-bye from a car, I'm teased by a morbid inner voice-overwhich announces omnisciently, "He didn't know that wasthe last time he'd see her alive ..." Absurd, this personalspell, yet the kind of love I'm falling into seems to de-mand it. Once, driving through a summer evening in themountains, she turned to me and said, "Scatter my ashesunder a lovely tree," and she meant it. Her request mademe that much more callow. As she chats with the vendornow, I recall a day I overheard her charm a travel agenton the phone—so simply and quickly, that glibness. Herbusiness. Her life.

Most of a relationship can only be rendered like anallusion to a text no one else has read, a text unavail-able even to a willing reader. I remember the wife of anacquaintance in graduate school talking to someone at aparty, her profile backlit by a lamp. I turned and noticedthat the bridge of her nose was made faintly translucentby that light. Was she aware that her cosmetic surgeryshowed, if this is what it was? What desire did it reveal,beyond vanity? What secret history? I raked my glanceaway from it over and over, appalled and curious andarrogantly pitying. Not long afterward, she and her hus-band moved from town, and a few years later, he—oneof the most successful of our group—shot himself in thehead in front of her. We were told they had separated,so this is what he'd done. For a while, I was comfortedsomewhat by how this explanation gave us a way to seethem as part of an acceptably frustrating mystery. Then Iremembered that translucence, and I began to reconsiderthe look of the obvious.

One of Lisa's fears is that someday the two of us willfind ourselves not sharing even a glance, perhaps onlychewing waffles in some chain cafe and, by this, grimlyparodying the talk no longer between us. Yet we've al-ready had this meal—after an eight-hour descant ontrust or a night-long dispute of mutual, unacknowledgedpride. So perhaps the display of mute abstraction articu-lates a deeper bond. I suspect it less than the show of acouple, once, in a nearby booth: the woman smeared hermouth thickly with meringue and her partner licked itvoluptuously clean.

Several years ago, my brother-in-law and his wife re-turned home from a camping trip and found the Frenchdoors had blown open and, in the moonlight, fourteenblack hummingbirds roosted on their bed. They liftedeach and put them out on the porch, without waking one.Neither is sure how they did this, since taking care, theyasserted, was only the obvious part. This is a couple intheir fifteenth year of marriage, his second, her first—middle-agers and parents, lovers over the top, each timethe only time.

Their story asks: Isn't there always the sleep of fourteenhummingbirds in the marriage bed? Isn't that our dream-ing, intimate life?

Lisa and I bicker too much for some; for others, it'srepartee. For me, it's a dialogue of parts, like echoes of apoorly lateralized brain. My glum czarina, my Hollywoodassassin in Ray-Bans, who once claimed she could feelon her sex the whorls of my fingertips—there she stands

among the secrets, with an ice cream sandwich. As if shehad never known me. As if we had never met Have wemet?

I may never get another chance to see her, or us, likethis. I may never get another opportunity to turn fromthis place and steal away with some of the hummingbirds'inexplicable sleep.

So I do.

Donald Morrill's latest collection of essays is Theimpetuous Sleeper (Mid List Press). Other booksinclude The Untouched Minutes, winner of theUniversity of Nebraska Press' literary nonfictionprize, and a collection of poems, With My Back toHalf the Day (Anhinga Press).

circlingcontinued from pg. 23

"Thank you," he says with the gentlest of smiles.For a single instant, all the millions of cells inside me

come alive.

When I meet the Iranian girl again, I think I've neverseen a face so frozen, so dead, the color drained fromher lips, her eyes an emptied blackness. Her white blouseis miss-buttoned, a slight yellow stain on the sleeve. OnNovember 4,1979, the American Embassy in Tehran wasseized by Iranian students who took 63 U.S. hostages anddemanded the return of the Shah for trial in Iran. Thereign of virtue is turning into a reign of terror.

"Everyone I know is in danger," she says. "My familycan never go back."

"Do you want to?" someone asks."You always want to go back," she says softly. "Even if

you can no longer love it, it's your home, your past, theplace that gave birth to your soul."

I stare at her. Americans would never say such things.Americans seldom talk about the soul, the spirit, the rawand often conflicted longing for home. I shift away fromthe group and gaze out the window, wondering why it isso hard for me, wondering if art will be the way for meto see through to myself, to find my way back to a fam-ily who lives so fiercely inside my head. Whatever wasbirthed in Alabama got sidetracked, buried.

I'm not ready to go back.Not even for Christmas. A month later I fly from Los

Angeles to New York at Christmas break to see Nam JunePaik play music at a club in Hell's Kitchen. Anti-music,I should say. Though I've been to many galleries in NewYork, I've never been to Hell's Kitchen and going there,I consider myself bold and independent, ignoring thenameless anxiety just beneath my skin. I leave Los An-geles on December 23, 1979, staying alone in a friend'sapartment and roaming the streets of Manhattan duringthe day and early evening. On Christmas Eve, I take thesubway to the Bowery, then waUc the cold, industrialstreets, wind pushing through gaps in the buildings. Iwatch as a young man drags a Christmas tree along thedirty sidewalks, the top branches stiff with litter. It'sfreezing. I'm supposed to meet Nam June at a club wherehis band is playing, the performance starting at 11:00. It'sonly 10:00 and I'm out on the streets on Christmas Evewith nothing to do and nowhere to go. Icy wind blasts

Page 5: The Yin and Yang of Medical Marijuana

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