Cannabis in a Post-Truth World
Separating Fact from Fiction About Marijuana
What do you know about cannabis? No, really. How much do you really know? Is your knowledge based on research and facts? Or anecdotes and rumours amongst friends and family? Are you open to being corrected?
With the legalization of cannabis on the horizon in Canada, the question of what we know is not only of personal importance, it’s also of national public health importance.
The problem is that what you know about cannabis may not be the same as what your neighbour knows, or what law enforcement knows, or what health professionals know. This lack of consistent knowledge stems from the near century-long suppression of cannabis research in the western world; up until about 20 years ago when its medical use began being accepted. Now that the times are changing, it’s important that we start to separate myth from reality.
For one, we are now much more informed about the health effects of medical cannabis. The National Academies of Sciences, Engineering, and Medicine (NASEM) recently released a comprehensive review, covering the last 20 years of research, detailing what we currently know about cannabis, titled “The Health Effects of Cannabis and Cannabinoids.” The most glaring conclusion to the review was a desperate need for more research, but they were able to draw some well-supported conclusions on many historic points of contention.
As NASEM found, cannabis has many possible positive effects and many possible negative effects depending on the person using it, their pre-existing health conditions, how often they use cannabis, and when in their life they start using it. They found many conditions, such as cancer, irritable bowel syndrome, and epilepsy, which some believe cannabis can treat, have very little supporting evidence to that point. They stated that using cannabis does increase the risk of motor vehicle crashes; a very contentious debate in the cannabis community. And they found a moderate link between cannabis use and the development of substance dependence or abuse disorder for alcohol, tobacco and other illicit drugs, giving some credence to the long disputed “gateway drug” argument.
NASEM also found that cannabis is an effective treatment for chronic pain, spasticity associated with multiple sclerosis, and symptoms of nausea and vomiting from chemotherapy. They reported cannabis is effective at improving sleep for those with sleep apnea, fibromyalgia, chronic pain, and multiple sclerosis. And they found that acute (as opposed to chronic) use of cannabis can actually improve airway dynamics; and that cannabis use can improve one’s forced vital capacity, which is a measure of the amount of air one can exhale.
One point that the NASEM study did not touch on is the differences in cannabis strains. You need only walk into one of the hundreds of illegal dispensaries in cities across the country to observe the rhetoric around the different effects particular cannabis strains can have. They will pull a strain off the shelf to show you, and explain that this will “knock you out” or even worse, “this will help you with your serious health issue.” They will tell you the specific effects that you can expect, without knowing the cannabinoid profile of the strain and certainly without knowing anything about the individual's own bio-chemistry or other health factors; usually basing this “knowledge” off nothing more than their own personal experience or what they read online.
After having recommended dozens of strains to hundreds of patients and conducting thorough follow-ups to discuss the results, I can tell you with certainty that at this point in our understanding of cannabis, no one can tell you how any one strain may affect you. We can make estimates based on the majority of experiences, but many patients will not fit into that majority. We simply do not yet understand all of the subtle differences within different cannabis strains and how each of those may interact with all of the subtle differences in the human body.
The most popular myth on the topic of cannabis strains is the Indica-Sativa-Hybrid distinction. This distinction was originally only created to describe the differences in the look of certain cannabis plants but has since developed into notions that they have differing effects. The genetic differences between these types of cannabis is minute, and botanically speaking, they are not categorized differently. Anecdotally, most people will find Sativa strains to be more stimulating, uplifting and mood-enhancing. Many people find Indica strains are more relaxing, full-bodied, and sleep-inducing. And Hybrid strains are said to have a combination of Sativa and Indica effects. Many of our patients however have reported the complete opposite of these effects, and others have varying effects from each.
The differences in these cannabis strains is an area in desperate need of research. Most of the research does not even touch on the differences in the hundreds of strains of cannabis. In recognizing this need for research, Canadian Cannabis Clinics partnered with the University of Toronto to conduct the largest observational study of its kind on the effects and side effects of medical cannabis strains, which is now in the final year of its three-year duration. That study and hopefully many more like it will give us much needed insight into the subtle differences in cannabis strains and their effects.
So, what do you know about cannabis? Has this article changed your mind on any topics? As we enter into a new era of cannabis acceptance it’s important that we understand the risks and benefits associated with cannabis. The burden is on all of us to present a safe, intelligent, and effective approach to cannabis. We now must act as an example to the rest of the world, so that this powerful plant can finally have the attention it deserves.
Michael Murchison is a Cannabis Counsellor working out of Canadian Cannabis clinics throughout the GTA, offering free knowledge and guidance to hundreds of medical cannabis patients every day. Canvasrx.com, firstname.lastname@example.org