Cannabis for Health: The Essential Guide to Using Cannabis for Total Wellness

< INTRODUCTION >

CANNABIS: A Medical and Personal Journey

Cannabis has been tied to human history for millennia. Although the plant was first used for fiber and rope in China and on the Indian subcontinent, no one is sure when humanity first discovered the psychoactive properties of cannabis. Archaeologists can date the purposeful burning of cannabis to around 3500 BCE, and it was used in foods in India by 1000 BCE, if not earlier. The ancient Greek historian Herodotus was the first to give textual evidence that cannabis was used in some cultures as a mind-altering substance, around 2000 BCE. The word cannabis is probably derived from the Neo-Assyrian and Neo-Babylonian word qunubu, meaning to make smoke.

Psychoactive plants have a long history in human culture. Peyote, or mescaline, has been used by the Indigenous peoples of northern Mexico and the southwestern United States since the beginning of recorded history in North America. Coca leaves were chewed for their stimulatory effects for thousands of years in South America. It has even been proposed that the much-feared berserkers of Viking lore ingested hallucinogenic mushrooms to achieve what has been described as trancelike fury. Consequently, the idea that cannabis may have been part of the human narrative from the very beginning is not hard to accept.

The first documentation of the use of cannabis in Western culture started in the late 1830s in France, when physicians prescribed a number of cannabis-based products to cure a range of frightening ailments and conditions, from consumption (an early name for tuberculosis) and mental illness to plague. At around the same time, a young Irish medical researcher, William Brooke O’Shaughnessy, arrived in India to work as an assistant surgeon for the East India Company. Over the years, O’Shaughnessy conducted significant research in a number of fields, but his most important contribution was the introduction of cannabis as a therapeutic drug to Western medicine. By the latter part of the 19th century and the early 20th century, however, most countries had restricted the use and possession of cannabis and then made it illegal. Criminalizing the possession of cannabis has ultimately led to prison overcrowding in the United States and driven widespread, race-based incarceration of people for even minor infractions of this prohibition.

For centuries, cannabis has been used for spiritual purposes to induce trancelike states in Eastern cultures, as well as a means of treating illness. Ancient cultures attributed various healing properties to cannabis, such as reducing fever, managing nausea and abdominal symptoms, and even treating a stuffy nose. As the 20th century progressed into the 21st, some of those ancient applications began to reemerge. For example, people began to use cannabis to treat the symptoms of nausea and fatigue associated with chemotherapy long before there was a push to legalize cannabis for medical use. At the same time, reports began to surface about the effectiveness of cannabis as a seizure therapy. Current thinking holds that the medicinal properties of cannabis can be effective in treating a variety of medical problems.

Cannabinoid receptors, which are part of the endocannabinoid system (ECS), are scattered throughout the body and impact a wide variety of processes, including pain and stress. Cannabinoids are the active compounds found in cannabis. There are more than 400 cannabinoids, including THC, that react with a number of different receptors in the human body. Cannabinoids sit on those receptors, depending on the type of cannabinoid and the type of receptor. Two receptors are commonly identified—CB1 and CB2—but researchers have also found CB3, CB4, and CB5 receptors in isolated regions of the brain. There are other properties of the cannabis plant that we will explore in this book, including multiple strains of cannabis that have different percentages of cannabinoids and different calming or stimulating effects. Cannabis is now being widely studied and used for the treatment of many health conditions, ranging from anxiety and insomnia to pain management.

As the medical benefits of cannabis have become more established, parts of the United States and other countries around the world have begun to relax legal restrictions and now allow some usage, with proper documentation and medical supervision. Several states in the United States have also begun to allow some recreational use. However, research into cannabis is still regulated by federal law in the United States, which makes experimentation difficult. Nevertheless, much of the social stigma surrounding the use of cannabis has begun to dissipate, and renewed interest in the benefits of cannabis is blossoming.

But that was not the case 35 years ago when my personal journey with cannabis began. I grew up in a small town in northern Michigan in the 1980s. I did well in school, and I think I had a normal childhood with very loving parents, who focused on providing a great education for each of their six kids. In high school, when I wasn’t frying my hair with a curling iron and using countless cans of ozone-depleting hairspray, I was experimenting with cannabis, or pot. In my senior year of high school, I unexpectedly became a mother. It was a struggle to put myself through college, and ultimately medical school, as a single mother. Over the years it became clear to me that my early use of cannabis was a method of self-medicating to control my anxieties. In 1985, in small-town northern Michigan, and everywhere else, for that matter, people simply didn’t talk about anxiety or other problems like it; instead they self-medicated, typically with alcohol or, in my case, marijuana. Smoking weed made it easier to get through the day, it relieved my anxieties, and it still allowed me to function normally in school and in life.

I stopped using cannabis when I found out about my pregnancy, as well as during the years I spent in college and medical school. At the time, cannabis was frowned upon socially and forbidden professionally. I graduated from medical school with honors and then trained in internal medicine. I was board-certified and then worked in a hospital setting, as well as in my own private practice, for 20 years. During that time, I didn’t forget about cannabis, but it didn’t enter my mind to use it—I was too busy trying to run a business, raise a family, and conform to the societal norms of the times. I won’t say I didn’t miss cannabis, but I did avoid it.

Until my brother died.

My brother Tim was a fun-loving and funny man. He spent his entire life in Michigan, working in manufacturing and eventually management. Married and with a family, he was just 52 when he found out that he had colon cancer. It was an aggressive cell type and the cancer advanced quickly, despite the best chemotherapy available. He tried everything and fought the cancer as long as he could, but eventually he was admitted to hospice. I was at his bedside constantly, at the end, trying to manage his care and make him as comfortable as possible. It was hard to control his pain and relieve his anxiety. All the tools of modern medicine were used to help alleviate Tim’s pain and every attempt was made to make him comfortable, but none of it was doing the job. I studied his situation and applied everything I knew to try to help him. I would like to say that Tim had a quiet, peaceful death, but that is not the case. I believe he was in pain and experienced skyrocketing anxiety right up to the end, despite the best that modern medicine had to offer.

At about the same time, one of my friends was in a similar situation. Although Fran was suffering from a different type of cancer than my brother’s, it also became invasive and ultimately led to her heartbreaking demise. There was a huge difference in her care while she was in hospice, however, because cannabis was available to her as a medication. It helped relieve her pain, attenuate her anxiety, and make her last weeks and months on Earth comfortable and peaceful. In short, everything that had been helpful to Fran had been missing from my brother’s experience. But I wondered why. Why did the addition of pot, which I had smoked so casually in high school, lead to an end-of-life experience for Fran that was so much better than my brother’s? I needed to get an understanding of that experience. What were the mechanics? That search led me to study the scientific literature and learn what science and medicine had to say about cannabis and its effects on the human body and mind. Maybe, just maybe, something wonderful had been right about cannabis all along, and maybe there was something in it that could potentially change the course of medicine in this century.

I began researching all the available scientific literature on cannabis. I talked to people who used it to manage different ailments, to hear what their experiences had been firsthand. What worked and what didn’t, as they experimented with different cannabis strains and dosages, routes of administration, timing, and everything else that went into their decision-making. I talked to experts, I went to conferences, I did everything I could to understand what cannabis is, how it works in the body, and how it can be beneficial for so many people around the world.

I began to produce and shoot short, entertaining, research-packed videos to help people know why and how to use cannabis. Those videos are available to everyone for free at CBDandCannabisInfo.com. I do the research so you don’t have to.

I came to the conclusion that my mission as a doctor is to educate people about cannabis, change the minds of those in power, and replace old fallacies about cannabis with new thinking based on science and medical knowledge in order to open up research in the United States and make cannabis available to everyone who needs it. This book is part of that mission. My hope is that the up-to-date information in these pages will help you and many other people around the world understand the science that underpins the beneficial uses of cannabis and also feel confident about using it in your daily life.

Wishing you empowered health,

PART 1

< Plant Magic >

IN PRAISE OF CANNABIS

Our fascination with cannabis may be as old as the human story. Shrouded in mysticism, cannabis was used in ancient Eastern cultures for spiritual and bodily well-being; it gradually made its way west to Europe and eventually to colonial America. Early users, like Benjamin Franklin, praised hemp seeds for abating venereal desires and touted the leaves as good against burns. One hundred years later, Robert E. Lee, commander of the Confederate Army during the American Civil War, dreamed of putting cannabis-based hasheesh candy into every soldier’s pocket to relieve pain, debility, and fatigue.

The first scientific record of the use of cannabis as medicine was made by physician and chemist William Brooke O’Shaughnessy during his stint with the British East India Company in the 1830s. O’Shaughnessy observed and analyzed how the local population used various parts of the cannabis plant to treat cholera, lung inflammation (or chronic pulmonary obstructive disease [COPD], as it is known today), arthritis, neuralgia, tetanus, seizures, and more. He then conducted his own clinical trials on mice to support his observations and research. O’Shaughnessy’s three major books on medicinal plants and his groundbreaking work on the healing powers of cannabis brought East and West together, showcasing ancient Ayurvedic and Persian practices, while laying the scientific groundwork for cannabis as a healer for centuries to come.

It is O’Shaughnessy’s legacy that we honor in these pages.

WHAT IS CANNABIS?

Some natural healers, in their reverence for the plant, address cannabis as her and goddess. Botanically speaking, cannabis is a plant like most others, with roots and leaves and flowers. Hemp is the umbrella family name for cannabis, and marijuana (Cannabis sativa) is the species name. The two subspecies of cannabis are hemp (Cannabis sativa sativa) and recreational marijuana (Cannabis sativa indica). For the purpose of this book, we will call every plant in this species cannabis.

Like many other plants, there are healing compounds in cannabis, such as limonene (which gives lemons their scent) and flavonoids (which make grapes red). Cannabis, however, has an additional set of plant compounds—more than 100 of them, in fact—that other plants don’t have. These plant compounds are called cannabinoids, the best known of which are cannabidiol, or CBD, and tetrahydrocannabinol, or THC. While other plant chemicals, like limonene and flavonoids, boost health in various ways—like providing vitamins C or A or protecting cells with their antioxidant power and boosting the immune system—CBD, THC, and other cannabinoids do something even more amazing.

Cannabinoids interact with a system that operates throughout the body that few of us know about. This system helps to regulate our health in countless ways, from processing memories to fighting disease. The positive impact that cannabinoids make on this system is so important that scientists have named it the endocannabinoid system, or ECS (endo means inside), because it actually produces cannabinoids inside the body to keep the system humming along. If the endocannabinoid system stumbles because of an inner upset, such as disease, or an outer upset, such as pollution invading the lungs, then a person can ingest outer cannabinoids—such as CBD and THC from the cannabis plant—to help the inner cannabinoids put the endocannabinoid system back on track.

THE ENDOCANNABINOID SYSTEM (ECS)

The endocannabinoid system (ECS) is a complex cell-signaling system involved in a wide variety of processes, including pain, memory, mood, appetite, stress, sleep, metabolism, immune function, and reproductive function. The ECS was identified in the early 1990s by researchers exploring THC, a well-known cannabinoid. Cannabinoids are compounds found in cannabis.

All cannabinoids work with the ECS in different ways—but there is one special difference between CBD and THC that can’t be denied. Although both CBD and THC can either calm or energize as they heal, THC alone has an intoxicating effect that prompts a high. CBD does not.

The endocannabinoid system is composed of receptors—mainly types called CB1 and CB2—located throughout the body. Endocannabinoids produced by the body interact with ECS receptors to keep bodily functions on course. We can thank researchers from the 1940s for identifying the cannabinoids THC and CBD, and we can thank pioneering Israeli scientist Raphael Mechoulam for his work in the 1980s and ’90s identifying the endocannabinoid system and its receptors and how cannabinoids interact with them.

Mechoulam and his team learned that cannabinoids stimulate the CB1 and CB2 receptors to help restore homeostasis and balance in the brain and every other organ in the body where there might be stress or inflammation. With additional research, they were able to show that, when inflammation strikes, the body increases the number of receptors in the inflamed area and produces its own endocannabinoids to interact with them. So, for example, if you were to take a biopsy of an inflamed bowel, you would find higher concentrations of CB receptors and a concentration of endocannabinoids where the body tried to settle down the inflammation.

MANY DIFFERENT STRAINS OF CANNABIS

STRAINIS USED TO DIFFERENTIATE BETWEEN CANNABIS SATIVA AND INDICA. IT REFERS TO THE SPECIFIC BREED OF EACH INDIVIDUAL PLANT.OVER THE YEARS, FAMILIAL STRAINS HAVE DIVIDED INTO SPECIFIC SUBSECTIONS.

The most prominent endocannabinoids are anandamide and 2-arachidonoylglycerol, or 2-AG. We call them the body’s naturally occurring CBD and THC, and you’ll hear more about how they interact with receptors to ease conditions later in this book. For example, if you draw fluid from an inflamed knee, you’ll find higher concentrations of anandamide in that fluid, showing that endocannabinoids are already working from the inside to restore balance and homeostasis. By ingesting plant, or phyto-, cannabinoids like CBD and THC, you can enhance anandamide’s efficiency.

Finally, along with observing naturally occurring endocannabinoids and phytocannabinoids, researchers are producing synthetic (i.e., not plant-derived) cannabinoids from scratch, in laboratories, by replicating cannabinoid molecules.

I have always maintained that whole plants are superior to extracts in both food and medicine; for example, to my mind, vitamin C supplements are less beneficial than eating an orange. I believe the same is true of most synthetic cannabis extracts. In some cases, synthetic concentration of a particularly valuable cannabinoid may boost the ability of the ECS to alleviate serious chronic conditions. Cancer patients or patients with uncontrolled Crohn’s disease or ulcerative colitis, for instance, may find that synthetics or distillations offer more arrows in the quiver for treatment. For most cannabis patients, however, optimal benefits to the ECS are obtained from consuming the whole plant.

Sherri Tutkus

Sherri is the founder and CEO of the Green Nurse organization and host of Green Nurse Radio Show. Sherri is a cannabis nurse, patient, and advocate who utilizes her 30 years of experience and expert nursing skills as a medical center specialist, clinical nurse liaison, and educator to bridge the gap between patients and the cannabis community. As an educator, she shares her knowledge of the endocannabinoid system and the safe utilization of cannabis with staff at dispensaries, hospitals, clinics, and patients’ homes, and she regularly does pop-up events, seminars, and expos. Sherri is an international speaker and has contributed to Clark’s Cannabis: A Handbook for Nurses, the first cannabis textbook to be published specifically for nurses. It will be available across the United States in 2021.

PART 2

< Magic into Medicine >

THE ROAD TO MEDICAL MARIJUANA

Once William Brooke O’Shaughnessy made known his groundbreaking discoveries about the healing properties of cannabis in the mid-1800s, its importance spread like wildfire in the West. By the 1850s it was a prominent entry in the U.S. Pharmacopeia of Medicines and Dietary Supplements. For the rest of the 19th century and into the 20th, cannabis was touted as an antidote for myriad upsets and chronic pains, from nausea and fatigue to arthritis and respiratory disease. As an especially effective nervine, cannabis was even used in the form of a potent hashish candy, which General Lee dispensed to calm his troops. By the turn of the 20th century, the healing power of cannabis was advertised on bottles of Cannabis Americana, in the form of various herbal materials and extracts, and were brought to the marketplace, thanks to a collaboration between pharmaceutical companies Eli Lilly and Company and Parke-Davis & Co. When cannabis was officially criminalized in the United States in the 1930s, production of medicinals stopped, and a dark age for cannabis spread around the world. But while the positive aspects of the plant were given short shrift and the negatives were amplified by the powers that be, brilliant minds were at work under the cover of science.