“The idea that some of the molecules in marijuana may help with cancer is not crazy” (Image: Joe Chielli/Church-Street-Studios)
You’ve been on a medical marijuana odyssey of sorts. What inspired it?
It was a patient of mine. She is a retired English professor with advanced cancer and asked whether I thought marijuana might help to relieve her symptoms. At the time I told her: “as far as I know it’s an illegal drug with no benefits whatsoever.” But she kept pushing me and asking about studies, to the point where I had to admit that I really didn’t know if it would help or not. So I promised her I’d find out. I found a lot more evidence to support its use than I had ever realised existed.
You experimented on yourself. What was your most striking marijuana remedy?
I have an old back injury that haunts me from time to time. So I self-medicated with a joint I got from a friend of a friend. The results were spectacular, both in terms of pain relief and side effects: I had visual and auditory hallucinations. When I told a friend – an advocate of medical marijuana – about the experience, he told me, “Dude, you overtoked!” And that’s a lesson for those who are thinking about self-medicating with marijuana but don’t have experience using it. You can really overdo it if you aren’t careful.
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But many remedies didn’t work.
That’s right. One huge fail was a marijuana ointment I tried in Nepal. Getting any compounds through the skin is tough – it’s designed to keep stuff out. So while that ointment was supposed to relieve my knee pain after a really, really long hike, it didn’t work at all. Many people try to make ointments, teas or even salads from cannabis leaves, but you don’t extract the active ingredients – tetrahydrocannabinol and cannabidiol – that way. That shows the importance of understanding the science behind the drug.
A recent review of clinical trials of marijuana found only moderate evidence for some of its claimed benefits. What’s your take on that?
If you have cancer and you’ve tried multiple anti-nausea drugs but are still throwing up constantly for two days after chemotherapy, will you say: “Well, those marijuana trials only offer moderate evidence of nausea control, so I’ll just keep throwing up”? No, you’ll probably accept some uncertainty, and a lower level of evidence, if there’s a chance you might be able to feel human again.
What therapeutic uses is marijuana likely to be put to next?
The data for treatment of neuropathic pain – resulting from nerve damage – is quite compelling. As for the future, the idea that some of the molecules in marijuana may help with cancer is not crazy. There are laboratory studies showing that some of the drug’s compounds may reduce the cell division rate of tumours and the rate at which those tumours develop new blood vessels. Such findings suggest that these molecules may one day be an important part of a cancer treatment regimen, but it’s going to take some time for the research to get there.
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is a practising doctor and a professor at the University of Pennsylvania’s Perelman School of Medicine in Philadelphia. His new book is (Penguin)
This article appeared in print under the headline “Man on a marijuana mission”
