It has now been 20 years since the landmark ballot initiative in the state of California that enabled patient access to cannabis for medical purposes. After litigation that was battled all the way to the 9th Circuit Court of Appeals (Conant vs. Walters), it was ruled that physicians had the right to discuss the pros and cons of cannabis, and even recommend its use to their patients. When the US Supreme Court declined to hear the case, its impact reverberated nation-wide. As is often the model with any social movement, California blazed a trail that became a model for other states and nations on this important issue. A majority of states now have legal access to cannabis for medical usage in some form. While cannabis remains an illegal, forbidden Schedule I substance under federal law, this state-by-state “experiment” is being allowed to play out, but this situation could change.
It is important to understand these developments in context. Cannabis, along with other herbal medicines, has been utilized by humans for healing purposes for millennia. It is only in the last 75 years that moral imperatives, but not science, have decreed its prohibition. Examining the issue in this light, cannabis has been the scapegoat of a historical aberration and one that may be reaching its conclusion after a long and costly “War on Drugs” both in financial respects and, more importantly, in terms of the human suffering that it has produced.
The battle is not over, however, despite the acceptance of the concept of cannabis as medicine by the overwhelming majority of the populace. Politicians are not yet fully on board with the concept and neither is the medical community, largely as the result of ignorance borne of a total lack of education on cannabis and the endocannabinoid system in medical schools. Each physician who is confronted by her first patient who asks the question, “Would cannabis help?” must decide whether to investigate the matter on her own, or merely let the question go unanswered, or be dismissed with some snarky remark that there is simply not enough information available with which to render a decision. As you will note in this book, Bonni Goldstein, MD was confronted with the same dilemma, but chose the path of educating herself so that she could best help her patients with their intractable medical problems. The results have been amazing and have produced remarkable benefits to those afflicted and their extended families. Many of us that work with such patients are constantly struck with the fact that it is only when an individual, a family member or close friend is touched by some dire medical need that finds relief in cannabis that hardened opinions against its use are softened or morphed into acceptance.
So, what is a patient or caregiver to do? Cannabis remains a subject where it is more likely than not that the patient will need to educate their doctor first. Such a task requires good tools, and I can think of few better than this book. It is affirming and refreshing to now possess a resource that presents the scientific facts on cannabis in such an accurate and accessible form. The reader will gain the knowledge necessary not only to understand cannabis and the endocannabinoid system, but also to make informed decisions on how to apply that knowledge to the treatment of myriad conditions where “conventional medicine” has all too frequently failed. We should be clear that cannabis is not miraculous. It may or may not help treat a given condition, but what is truly remarkable is how often it is of benefit, providing just enough relief so that a patient can properly cope with the challenges of their particular situation, and get on with life again as an active participant rather than a passive observer relegated to the sidelines. That is no small achievement.
I know Bonni as a gifted and compassionate healer and it pleases me greatly to know that her knowledge and experience can now be shared on a greater stage. Read, learn and enjoy!
Ethan Russo, MD