Program of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona 31008, Spain; Department of Biochemistry and Genetics, School of Science, University of Navarra, Pamplona 31008, Spain. AX Nguyen, AY WU, “Association between cannabis and the eyelids: a comprehensive review,” Clin Exp Ophthalmol, 48, 230 (2020). PMID: 31747112.

The latest book from Professor David Nutt is a one-stop-shop for everything you could ever need to know about cannabis. I think eye care professionals need to ask specifically about cannabis use. In some places, we might still expect patients to report this in our intake forms asking about “illicit drug” use, but not all patients will want to answer such a question. Additionally, with increased legalization, cannabis is no longer considered an illicit drug in many places and thus specifically asking about cannabis use is important. From there, asking about the regularity of use as well as the dosage, type, and form can be important (certain forms have much higher concentrations and certain forms, like edibles, have delayed effects). Chapter 4, “Doctors and the War on Drugs,” brands this MD as a heretic within his courtly profession. Nevertheless, he is respectful of and circumspect about his medical colleagues’ ignorance or skepticism regarding cannabis as a therapeutic herb. He lays blame mostly on the institutional bias of the old school medical schools whose curriculums are still teaching politically motivated falsehoods. In the United States, the falsehoods were propagandized during the losing War on Drugs waged by the Nixon administration, then were escalated into the lost War on Weed waged by the Reagan administration, and under the present Biden administration are still soldiered on by diehards and holdovers within the DEA, the FDA, and NIDA. If your own doctors plead ignorance about medical marijuana, bestow upon them copies of this book. If you must be thrifty, then make them photocopies of just Chapters 4 and 22. Overall though, the book is a good read and will make a great resource for students, patients, doctors, activists – anyone interested in cannabis and drug policy. Definitely one to add to the library if you haven’t already – and the latest in a series of books from Professor Nutt, including ‘Drugs Without The Hot Air’ that have become compulsory reading for those involved in drug policy reform circles. Peter Grinspoon is an ex-addict, marijuana enthusiast, and cannabis prescribing physician with a professional and moral obligation to know and tell the truth about cannabis’ relationship to driving, pregnancy, psychosis, autism, addiction, sleep, cancer, and much more.Never before have I read such an engaging and accessible review of the evidence.”– Ethan Nadelmann, founderand former executive director of the Drug Policy AllianceMy one gripe is that at times it does feel somewhat like an extended advertorial for Drug Science, a UK based drugs advisory body and research organisation founded by Nutt in the aftermath of his infamous dismissal from the chairmanship of the Advisory Council on the Misuse of Drugs in 2009. Grinspoon’s Harvard Health articles have reached tens of millions of readers, have been widely referenced in the national media, and have been cited in congressional testimony. His writing has been published in The Nation, the Los Angeles Times and Narrative Inquiry in Bioethics. As the world slowly but unstoppably moves away from a century of cannabis prohibition, this book acts as an indispensable guide to the past, present and future of cannabis and its uses across the globe. Ideally, skeptics can work with true believers to advocate for safe practices, many of which most of us can agree upon, such as avoiding cannabis during pregnancy and breastfeeding (except under certain very narrow circumstances), before driving, and during adolescence. There are certainly benefits that we can all agree upon, such as using cannabis to treat chronic pain and insomnia. We do better when we work together. The drug became illegal due to propaganda from the US where the world turned against the drug after a clever propaganda campaign in the US, where the end of alcohol prohibition in 1933 threatened many police jobs. The director of the agency responsible for fighting alcohol needed a new drug scare and this became cannabis. The film, Reefer Madness, which made out in a racist manner that the drug made people crazy, violent and mad. And thus, along with Harry Jacob Anslinger who was a United States government official

On the science side – the book makes complex scientific points in an accessible manner, the explanations of the entourage effect, and the way that THC and CBD form a natural complementary see-saw, counteracting the effects of one-another, were particularly interesting.National Highway Traffic Safety Administration, “Marijuana-Impaired Driving: A Report to Congress” (2017). Available at: bit.ly/3W0LLuP  This book looks at four aspects of cannabis. It tells the history of cannabis, where it came from and how it became illegal. Then it talks about how cannabis works and what it does to the brain and body. Then it looks at how cannabis, which for thousands of years with the medicine, suddenly became illegal. The last section talks about how to minimise the harms of cannabis. Dr. Grinspoon is a widely recognized expert on cannabis science and drug policy. He regularly appears as an expert on national television and radio programs, including NPR’s All Things Considered, NBC Nightly News, C-SPAN’s Washington Journal, Fox and Friends and Fox News. He is quoted frequently in the national media, in such venues as People, the New York Times, New York Magazine, the Washington Post, USA Today, the Wall Street Journal, the Chicago Tribune,and the Boston Globe.He is a TEDX speaker. Limiting or banning advertising for cannabis, at the same time as we ban it for tobacco, alcohol, and Big Pharma too. None of these ads are helpful to society Most of the literature has examined occasional users and this where our current state of knowledge exists on most vision functions, such as those mentioned above. Some studies have looked at more regular users – and the law enforcement work has typically looked at recreational, “on the street” usage. In my opinion, there isn’t enough literature examining similar vision functions or eye effects across the different types of users. These types of studies would certainly have value – it is easy to imagine that those using higher doses will experience more severe effects. How should ophthalmologists and optometrists factor cannabis use into patient assessment and care?

Use legalization as an opportunity to redress as many harms of the War on Cannabis as possible. Let nonviolent cannabis prisoners out, expunge all records for nonviolent cannabis offenses, and find a way to fund profits from the nascent industry to the families and communities that have been harmed heal their traumas and regain financial stability. To start, as Dr. Andrew Weil points out in the foreward of this book, the ways that both sides strayed from objectivity about cannabis are instructive. Some major flaws of the medical establishment were exposed. They were too often narrow-minded, disrespectful of patients’ stories and experiences, and closed off to new information that went against mainstream opinion. To an uncomfortable degree, many of the medical societies have been unduly influenced by the economic interests of Big Pharma and the political interests of NIDA and various other organs of the War on Drugs, such as the rehab industry and law enforcement. By being on the wrong side of the War on Drugs, our profession violated the dictate to “do no harm” and demonstrated a remarkable willingness to be accessories to the stigmatizing “your brain on drugs” culture war, rather than to think for ourselves, learn the nuances of the cannabis issue, and advocate on behalf of patients. An unflinching and utterly personal journey through the often-confusing cannabis landscape. Readers will delight in the historical as well as the scientific focus brought to life by Grinspoon, whose roots and professional experience provide a unique and fascinating perspective. Seeing through the Smoke has something for everyone – from the novice to the expert and everyone in between with an interest in cannabis.”– Staci Gruber, MD , Director of Marijuana Investigations for Neuroscientific Discovery (MIND) and professor of psychiatry at Harvard Medical School Seeing Through the Smoke is an unflinching examination at the grossly misunderstood drug that uses data-driven medical science and a critical historical perspective to reveal the truth behind cannabis. In this balanced and measured investigation, Cannabis specialist and Instructor in Medicine at Harvard Medical School Dr. Peter Grinspoon untangles the reality behind cannabis, revealing how we ended up with radically divergent understandings of the drug and pointing a way toward a middle ground that we can all share. Avoid using cannabis with other sedating drugs, particularly alcohol, or medications such as opioids or benzodiazepines, as the impairment can be additive.

A Cannabis Specialist Untangles the Truth about Marijuana

TREATMENT: People with a range of pain difficulties and epilepsy, cancer and other horrific conditions have been successfully treated with cannabis when other medical treatments have failed or had much worse side effects. Charlotte Figi began taking an oil made from it, and it was no longer a disappointment. Charlotte had a rare form of untreatable epilepsy, suffering from hundreds of seizures a day. After she took the oil, they stopped and this strain was renamed Charlotte’s Web. The book is full of stories of medical breakthroughs that have occurred with cannabis. Use caution if you have any history of addiction or any history or family history of mental illness, particularly psychosis or schizophrenia. Speak with your doctor (or a doctor that is able to be helpful, if your doctor isn’t) and exercise caution before starting cannabis. The use of cannabis, or any drug, can also make mental illnesses more difficult to diagnose and treat.

If you have a particularly good or bad reaction to a particular strain or chemovar, write it down. Journaling is good practice in any case—dosage, benefits, side effects, formulations, and delivery mechanism. By focusing on the most critical purported harms—driving, pregnancy, addictiveness, memory—and by focusing on the most commonly cited medical benefits—relieving chronic pain, sleep, anxiety, PTSD, autism, and cancer— Seeing Through the Smoke will help patients, parents, doctors, health experts, regulators, and politicians move beyond biased perceptions and arrive at a shared reality towards cannabis. Writing in a conversational and engaging style, Peter couples solid science with personal anecdotes, and tempers cold hard facts with his informed opinions. Bibliographic endnotes document the text, yet scholarly research rarely impedes the flow of the narrative. While credentialed as an MD, Grinspoon is no stuffy pedantic academic. As an undergrad lit major and grad student in philosophy, the medical doctor taps into his creative inner writer throughout the book. Don’t use cannabis, even medicinally, if you might have to drive. Not only is this dangerous and irresponsible; it is also extremely stressful and unpleasant, as well as unethical, as it puts others at risk. In this lively, witty, and deeply personal book, Grinspoon takes readers on a fascinating tour of everything you ever wanted to know about the benefits of cannabis—especially what it can do to ameliorate suffering and enhance human potential—while always remaining grounded in the scientific evidence. I can’t recommend it highly enough.”– Jay Wexler, professor of law specializing in marijuana law, Boston UniversityAs cannabis increasingly becomes mainstream for medicinal uses, or for whichever wellness and lifestyle enhancement people augment with cannabis – mindfulness, social connection, creativity, spirituality, enjoyment of sex, art and music — it is critical to educate cannabis users about how to use cannabis safely. Understanding that everyone’s needs and habits are different, here are some general principles: If people drive when impaired or act in a violent or antisocial way, such as they might do under the influence of alcohol, that reasonably becomes a law enforcement issue. One could argue that treatment is always more productive than punishment (which doesn’t at all help people with the disease of addiction), although intoxicated drivers do need to be taken off the roads. Otherwise, the harms of being involved with law enforcement and the court system, including the carceral system, are often worse than the harms of the drug use itself, to individuals, their families, and their communities. The very involvement of law enforcement deters people from admitting they are struggling and from seeking help. Ideally, we could make our criminal justice system more rehabilitative and less needlessly punitive, like it is in many European countries. Use with great caution as well if you have a history of coronary disease or an arrhythmia; involve your medical providers and keep the dosages very low (and avoid smoking).