An Exclusive Interview with Dr. David Casarett
As the fight for international access to medical cannabis continues to gather pace, it appears essential that the tipping point for possible scheduling restructure lies in the hands of respected medical professionals vocalizing their approval.
A couple of years ago, Dr. David Casarett may not have been the ideal candidate as a medical spokesperson for legalization. Before writing his most recent publication ‘Stoned: A Doctor’s Case for Medical Marijuana’, Casarett admits that he perceived the idea of marijuana as medicine as “a joke”.
“We all know that marijuana is a popular recreational drug. So when people say that they’re using it for medical purposes, it’s pretty easy to be skeptical. And many of my physician colleagues (still) believe that medical marijuana is just a way to get access to safe, reliable recreational pot.”
The associate professor at the University of Pennsylvania took the decision to research and publish a book on medical marijuana to satisfy his own curiosity.
“I wanted to write about whether medical marijuana works, and how it works. Many people want to read stuff like that.”
In preparation for his new literary venture, Casarett travelled around the globe, meeting medical marijuana patients, cultivators and experiencing the effects of cannabis himself. However, it wasn’t until he met one particular patient, that his opinion of marijuana as medicine completely changed.
“The patient I described in the introduction (of the book) – Caleb. He told me that marijuana helped him, but that nothing else did. He had a good-sized stash of morphine and other legal drugs in his trailer, but he wasn’t using them. So that made it pretty obvious to me that at least some people are using marijuana medically. Not to get high, or for fun, but for symptom relief they couldn’t get any other way.”
After meeting Caleb, Casarett became fascinated with the specific symptoms that marijuana has been evidently successful in treating. He focused his studies on cannabis and its effects on neuropathic pain specifically.
“Basically, neuropathic pain is pain that results from injury to a nerve. Unlike regular ‘nociceptive’ pain (from a sprained ankle or a broken wrist), neuropathic pain is caused when something damages nerves. That might be an injury, or a metabolic condition like diabetes. People get neuropathic pain after chemotherapy and sometimes with autoimmune conditions like lupus. Neuropathic pain can be hard to treat, and it doesn’t respond well to drugs like morphine. But it seems to respond to marijuana, and maybe particularly to one cannabinoid in marijuana: cannabidiol (CBD).”
After seeing the positive effects that marijuana had on neuropathic pain, Casarett decided to become a guinea pig himself, using marijuana as medicine for the first time in his life.
“I tried it for my acute, severe back pain. It worked pretty well – I was surprised, actually, by how much relief it provided, at least for a short time.”
Throughout ‘Stoned’, Casarett maintains an interactivity with his topic, often ingesting marijuana or assisting with creating products to truly ascertain its medicinal value rather than relying on conjecture.
And it is these experiences while writing his book that have dramatically altered Casarett’s perception of cannabis, especially its current scheduling which he describes as “especially confusing”.
“There are other ‘drugs’ – alcohol, and of course tobacco, that don’t have those restrictions. Tobacco and alcohol cause significant harms, yet they’re available to all adults. (There is) no question that this designation has limited research and made it very hard to get research funding.”
After publishing his book, Casarett wanted to create a place where patients like the ones featured in ‘Stoned’, could share their experiences with others. He decided to create a Kickstarter campaign in order to launch a website that could facilitate such conversation, thus marijuanaresults.org was born.
“Our goal with marijuanaresults.org was to give patients a way to share their experiences with each other. If you want to know whether medical marijuana might help your Parkinson’s or anxiety, or pain, there often aren’t good clinical trials to tell you whether you should use it for those reasons. But we thought that a website where people could learn from each other would provide answers and guidance for patients until science catches up. Also, patient stories can guide researchers, telling them which symptoms seem to respond best to marijuana, and should be the focus of clinical trials.”
When asked about the future of the medical marijuana industry, Casarett believes that detailed research and testing is the key to national scale legalization.
“One (opportunity) is delivery mechanisms: finding ways to deliver doses of cannabinoids in a safe and reliable way. That might include vaporizers, tinctures, or lots of other preparations, including (maybe) formulations that can be absorbed through the skin.”
“(When I ingested marijuana) I was surprised by the side effects: confusion, paranoia and hallucinations. Those sorts of side effects aren’t common, and most people don’t get them. But I used way too much, because I didn’t realize how potent the stuff I was given was. For me, that’s a good argument for testing of marijuana products, so naïve users can know in advance just how strong the product is”
In recent times, there has been a wealth of testimonies from patients indicating marijuana’s success on symptoms of cancer. Casarett states that he would “still put (his) trust in chemotherapy and surgery (to cure cancer), for now”, but would be very open to use it for other health issues symptomatic of the terrible disease.
“Sure (I would use cannabis based medicine). Particularly for chemotherapy-induced nausea. I’d probably try that very soon. Also for a loss of appetite. Although marijuana probably doesn’t help people with cancer gain back the weight that they lose, it does help with appetite. And of course for pain—especially neuropathic pain.”