Dr. Peter Grinspoon, a primary care doctor at Massachusetts General Hospital, an Instructor in Medicine at Harvard Medical School, and a 25-year cannabis specialist, will be a keynote speaker at the upcoming Cannabis Science Conference Fall taking place September 21-22, 2023 in Providence, Rhode Island. Here, Dr. Grinspoon shares his background and interest in medical cannabis as well as some policies he’d like to see changed in the future.
Can you tell us a little bit about yourself and how you became interested in the cannabis industry?
Dr. Peter Grinspoon: Well, it goes back a long time and there are several reasons that sparked my interest. The first thing is that my brother Danny, in the early 1970s, was fighting an unsuccessful battle with childhood leukemia. My parents saw him suffering so much from the chemotherapy that they illegally procured him cannabis in the early 1970s, right when Richard Nixon was just embarking on his war on cannabis. It was just amazing to see my brother when he didn't use cannabis, he'd just be lying in his bed with a towel over his head barfing. But when he used cannabis, he was able to eat, hold down food, maintain his weight, strum on his Fender Stratocaster (which he loved to do), and, most importantly to us, play with his little brothers. So, I saw at a very early age how impactful medical cannabis can be and that really stuck with me for my entire medical education and my entire medical career.
The other thing I should mention is that my father, Dr. Lester Grinspoon, was a legendary psychiatrist at Harvard Medical School, and he wrote a pioneering book in 1971 called Marijuana Reconsidered, which was actually reviewed on the front page of The New York Times Book Review in glowing terms. At that time, when only 12% of Americans supported full legalization of cannabis, my dad called for the legalization of cannabis, saying, “Sure, there are some harms associated with it. Teens, pregnancy, certain people shouldn't use it. But the harms of criminalization are much worse than the harms of actually using cannabis.” So, growing up, I had all kinds of cannabis advocates and activists and proponents in my living room, sort of smoking and talking, and these were people that were actually changing the world. I started to associate cannabis not only with like healing because of my brother Danny, but with sort of an intellectual lubricant because all these super motivated people were using it in my home. So, I've been interested in it my entire medical career.
That's amazing. It sounds like you had a lot of role models in the cannabis industry from being around your father.
Dr. Grinspoon: Yes, with my dad and his colleagues I had the best role models. And, again, these weren't people that only saw the benefits of cannabis, these were people that didn't want teenagers using it, that didn't necessarily think it was safe in pregnancy or breastfeeding, that were aware that it could destabilize people who have psychotic disorders. So, these were notpro-cannabis people. They were against the drug war and for a very balanced approach to cannabis where you're allowed to talk about the harms as well as the benefits or the benefits as well as the harms. The discussion has been very, very one-sided and the research has been very one sided because of pressure from the US government just to find harms and not to discuss benefits. I actually was exposed to both sides growing up and I feel that gave me a much more nuanced view of why people use cannabis in the first place.
Can you explain the top two biggest misconceptions about cannabis that you encounter frequently?
Dr. Grinspoon: Sure. Well, number one, medical marijuana doesn't mean smoking. No doctor recommends smoking. I mean, if you're dying of cancer or you have chemotherapy and you need to take something really quickly so you don't throw up, maybe there's certain exceptions. But I had a friend huffily say to me, “How can burning smoke be medicine?” So, I was explained that you could use a tincture under your tongue, one of these old fashioned medicinal tinctures. You can take a small dose of an edible very carefully. You can actually use a skin patch, an inhaler, a suppository, or a topical. There are many different delivery methods. So, one misconception is that to use medical cannabis is to be smoking cannabis. There are many different delivery options.
Another misconception is that there's no such thing as medical marijuana and people are just trying to get high. In fact, the doses of medical marijuana are often much lower than the doses of adult use or recreational marijuana. Also, using cannabidiol (CBD) and other medicinal cannabinoids besides tetrahydrocannabinol (THC) often people get comfortable with no high effect or a minimum of the high that people associate it with. So, it doesn't mean you're stoned all the time. It just means you're getting effective symptom relief. So those are a couple of misconceptions.
What are some of the key cannabis policies you'd like to see change immediately and what would they improve?
Dr. Grinspoon: Well, first of all, I'd love to see federal legalization. That would improve the coherence of every single state legalization program. Cannabis has been criminalized for almost a century, 87 or so years. Now we're trying to re-legalize it. When we re-legalized alcohol, it was only after 13 years, everybody remembered how it worked. Now we're doing it for cannabis, but not federally and instead it’s in a state-by-state patchwork ability. I think that if we had federal legalization, the labeling, the communication, and the product quality (you could do recalls)—I think the whole enterprise would be much safer.
Another policy that we need to change is that cannabis is still stuck in Schedule 1 of the Controlled Substance Act, which means it has no medical benefits, which is patently wrong. Tell the millions of people that are using it with clear medical benefit that it has no medical benefit, let alone there are several US Food and Drug Administration (FDA) approved medications—one from CBD called Epidiolex and the other from THC called Marinol. If there are approved FDA medications from cannabis, how can they say there's no medical benefit? And then they say it has high abuse liability. Now, in reality, it has low to moderate misuse liability at worst. So, it certainly shouldn't be in the Schedule 1 in the Controlled Substance Act. The Biden Administration says they're going to reschedule it, but they honestly should de-schedule it, given that it's much safer than alcohol or tobacco—and neither of them are on the Controlled Substance Act. You can just buy them. We rely on education and adults being adults to ward off the harms of it. We don't need to put it in the Controlled Substance Act. So, I think de-scheduling cannabis would be ideal, though rescheduling is better than Schedule 1 in the Controlled Substance Act. That is another policy I'd love to see changed yesterday.
Click here to watch the full interview with Dr. Grinspoon.
Please join us at Cannabis Science Conference Fall in Providence, Rhode Island for Dr. Grinspoon’s keynote lecture on September 22, 2023. Register today for 20% off your registration with code EARLYBIRD.