Professor Grinspoon on Cannabis

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Professor Grinspoon on Cannabis 7 Months ago

Professor Grinspoon on Marijuana, History, Chemistry, Pharmacology, Intoxicant, Medicine - OneRadioNetwork

Professor Grinspoon originally endeavored to write Marijuana Reconsidered in order to build a case against marijuana, but as his research progressed, he realized the complexities of the plant and was moved to advocate for legalization. He has testified before Congress, and as an expert witness in various legal proceedings, including the deportation hearings of John Lennon.

Lester Grinspoon is Associate Professor Emeritus of Psychiatry at Harvard Medical School and the author of several drug-related books, including Marijuana Reconsidered, Psychedelic Drugs Reconsidered, and Marijuana: The Forbidden Medicine. The first two were published during the 1970s, when it appeared cannabis was well on its way to nationwide decriminalization in the United States. The latter was published in 1993. It describes a variety of ailments for which cannabis ingestion may be indicated.

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#101

Re:Professor Grinspoon on Cannabis 6 Months, 2 Weeks ago

oldy but a goodie
www.cannabisculture.com/v2/articles/2013.html
Lester Grinspoon: defending medical marijuana
By Pete Brady - Thursday, September 13 2001

Free-thinking Harvard doctor discusses his three decade crusade for the healing properties of cannabis.

Lester Grinspoon and wife Betsy, enjoying the beach in earlier times.Lester Grinspoon and wife Betsy, enjoying the beach in earlier times.In 1994, when I was disabled, dependent on prescription painkillers, and depressed due to a severe injury and failed surgery, a friend gave me two gifts that saved my life.
One of the gifts was a potent marijuana cigarette. The other was a book, Marihuana, The Forbidden Medicine, co-written by Harvard psychiatry professor Dr. Lester Grinspoon.

I'd used marijuana as a teenager, but had stopped using it. I didn't believe marijuana could help me, and was afraid of being arrested, but after Grinspoon's book taught me that marijuana might be an ideal medicine, I smoked the joint and felt years of pain and depression slip away.

I contacted Grinspoon to thank him, and found that he was more than just a respected medical expert, treating physician, and teacher. He was also a courageous, energetic iconoclast who put his career and personal safety at risk by telling the truth about marijuana.

Grinspoon's cannabis career started in 1971, when Harvard University Press published his groundbreaking book, Marihuana Reconsidered. Medical associations, public policy experts and the media praised the tome, which featured extensive description and analysis of marijuana's history, uses, and legal status. The book is accurately described as one of the best researched, academically bulletproof, persuasively argued evaluations of marijuana written in the 20th century.
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Harvard's status quo was alarmed by Dr. Grinspoon's pot scholarship. Insiders say the doctor's chances of being promoted to "full professor" status were negatively affected by his marijuana research.

Undaunted, Grinspoon traveled the world, testifying in court and at government hearings, engaging in public debates with drug war proponents, and publishing dozens more books and essays. He joined the board of the National Organization for the Reform of Marijuana Laws (NORML), and became a movement icon, relied upon as a scholarly advocate whose Harvard credentials created automatic credibility.

Grinspoon generated controversy in 1997, when Harvard decided to honor drug czar General Barry McCaffrey with an award reserved for individuals who have produced innovative scholarly research.
"General McCaffrey was to be given an award for producing significant scholarship in the area of drug abuse," Grinspoon explained in a recent interview, "but he hadn't produced any. He knew as about as much about that subject as I knew about Sherman tanks."

Grinspoon's public opposition to McCaffrey's award was criticized by a Harvard official and by McCaffrey, who accused the doctor of perpetuating a "medical marijuana hoax." McCaffrey also refused to appear with Grinspoon when the two men were invited to debate on a major national public television program.

Although Grinspoon has scaled back his involvement with NORML and full-time Harvard teaching duties, he has not retreated from the war on the war on marijuana. The doctor runs two marijuana websites, helps patients, travels extensively lobbying for medical marijuana law reform, and is planning a new book about marijuana's ability to enhance pleasure and achievement.
Grinspoon wouldn't comment on the record about the time when the DEA tried to harass him for writing a prescription for pharmaceutical THC, or about other situations in which he suffered persecution and prejudice because of his marijuana advocacy.

Yet, the doctor's unparalleled importance in the worldwide marijuana law reform movement is illustrated by an adventure he had in 1990, when he traveled to the ultra-prohibitionist country of Malaysia, seeking to assist 35-year-old Kerry Wiley, a severely disabled computer scientist and American medical marijuana patient who was facing a death sentence for possessing ten ounces of marijuana.

In Malaysia, the death sentence is carried out via a rope around the neck.

Grinspoon knew that more than a hundred people, including eight young visitors from Hong Kong, had been hanged because of the country's drug laws.

He traveled to the country anyway. Before directly intervening in Wiley's case, he conducted a marijuana seminar for influential Malaysian physicians and lawyers. Grinspoon told his audience about Irish doctor WB O'Shaughnessy, whose 18th century cannabis discoveries were based on observations of medicinal marijuana use by Indians and Malays.

Grinspoon also performed a thorough medical exam on Wiley in the hellish prison where he had been held without bail.

Wiley had already spent a year in the cruelly overcrowded Pudu prison, sleeping on a blanket on a cement floor in a small cell with several other prisoners, bathing in dirty water. Whereas the diet of the other prisoners was rice-based, Wiley's was restricted almost exclusively to potatoes ? apparently because he was an American. He was receiving inadequate nutrition, his teeth were rotting, and he was seriously depressed.

In court, presiding judge Shaik Daud Ismaill immediately expressed irritation at Grinspoon's presence, and Wiley's prosecutor charged that Grinspoon had himself broken Malaysian law by examining the prisoner without official permission. Grinspoon sat in indignant disbelief as the prosecutor and the judge discussed whether he would join Wiley in prison.

The Harvard doctor testified anyway, unsure if he would be arrested after his testimony. He demolished the prosecutor's hostile line of questioning, gradually shaming the entire country with a vivid presentation explaining the origins of Wiley's painful injuries, his need for medical cannabis, and by implication, the inhumanity of the country's marijuana laws.

After his testimony, Grinspoon watched as court officials conferred with armed men about whether he would be arrested. The American embassy's legal counsel had to escort Grinspoon to the airport to prevent him from being arrested, never leaving Grinspoon's side until he was on the jet home with the doors closed behind him.

In early 1991, the judge decided that Wiley had been using cannabis for medical purposes. Instead of sentencing him to death, he sentenced Wiley to five years in prison and ten strokes from a hard rattan cane. The cane used in Malaysia is particularly cruel and burdens the caning recipient with motion limitation and pain for the rest of his life. Grinspoon wrote to Malaysia's Prime Minister, who was a physician, telling him that the rattan cane used in Malaysia cuts right to the periosteum of spinal column bones.

Wiley was released from prison in 1993 without serving his full sentence, and without being caned.

Grinspoon went on to work for justice and access to medicine for thousands of other patients. He spoke to Cannabis Culture from his Massachusetts home.

You told me that you used to believe that marijuana was very dangerous. How did you end up as one of the world's most respected marijuana experts?

In 1967 I had some time on my hands while waiting for colleagues to finish their contributions to a book I was writing. I decided to review the medical literature on marijuana because I had become increasingly alarmed that so many young people were using what I had understood was a very harmful drug.

Astonishingly, my literature review revealed that even though I had been trained in science and medicine, I had been misled about marijuana. I shared my findings in a paper that was published as the lead article in the December 1969 Scientific American. My article questioned whether the belief that marijuana was an exceedingly harmful drug was based on substantial scientific or medical data.

I soon received a call from Murray Chastain, Associate Director of the Harvard University Press. He suggested I write a book on marijuana. Murray called back a few weeks later. He was upset because the Board of Syndics of the Harvard University Press had rejected the book proposal. He had assumed that the approval would be pro forma; he was astonished that this board thought the book too controversial. I could have done the book for a trade publisher, but I wanted it to have the Harvard imprimatur. Fortunately, Murray and the director of the Press persuaded the Syndics to reverse their decision.

It was a much bigger project than I expected because there was more than just medical and scientific literature to review. A lot of the ideas about cannabis originated in the gaudy writings of the French Romantic literary movement, so I examined the cannabis-related writings of Gautier, Baudelaire, and other members of Le Club des Haschischins, as well as those of Bayard Taylor and Fitz Hugh Ludlow. I suspect that our first drug czar, Harry Anslinger, would have recognized some of his reefer madness ideas in these 19th century writers' wild descriptions of the cannabis experience.

What were the most interesting discoveries you made in this early research?

I learned that while marijuana was not addictive, learning about it certainly had a strong hold on me! I was fascinated by it. It became inescapably clear that while marijuana was not absolutely harmless, its harmfulness lay not so much in any inherent psychopharmacological property of the drug, but in the social and legal consequences of prohibition. I also discovered that recreational use and medical use were not the only reasons people used marijuana. All this was detailed in the book, Marihuana Reconsidered, published in 1971.

After the book came out, people questioned how you could write about marijuana without having used it.

I flirted with the idea of using marijuana, not because I believed it would inform my research, but because I thought it would be a very interesting experience. I decided against it out of fear that it would compromise my goal of producing as objective a book as I could. I believed that my best shot at objectivity and scientific legitimacy lay in abstinence.

I had another reason for postponing personal experience with cannabis. If the book was successful, I expected to be called as an expert witness before legislative committees and in courtrooms. I correctly anticipated that some of my interrogators would want to know whether I had ever used cannabis, and I wanted to be able to deny it so as to preserve the appearance of objectivity.

It began to appear that when a legislator, lawyer, judge, or media person asked me if I used cannabis, they often hoped I would answer affirmatively and that this would discredit me. I was testifying before a legislative committee when a senator asked, "Doctor, have you ever used marijuana?"

This senator with a sneering tone in his voice had already revealed his hostility. I replied, "Senator, I will be glad to answer that question if you will first tell me whether if I answer your question affirmatively, you will consider me a more or less credible witness?" The senator angrily told me I was impertinent and stormed out of the hearing room. I decided that there was nothing more to be gained by abstention. The time had come.

Grinspoon: `While marijuana was not addictive, learning about it... had a strong hold!`Grinspoon: `While marijuana was not addictive, learning about it... had a strong hold!`So you asked one of the Harvard stoner students to get you some pot?

No. The first cannabis try came when my wife Betsy and I went to a Cambridge party. We had declined offers to smoke with these people in the past, but this time we joined in, taking big puffs as the joint was passed around.

We didn't experience any effect, and I became rather worried about my book's credibility. What if cannabis had no real effect? What if it is all a placebo effect? But at the same time I knew that most people do not get high the first time they use marijuana.

Betsy and I smoked a second time, but still felt nothing. Then, on the third try, we crossed the threshold. The first sign that I was high came when I noticed I was perceiving music differently. We were listening to the Beatles' Seargent Pepper's Lonely Hearts Club Band. It was a fascinating new musical experience for me!

A year later I was having dinner with John Lennon and Yoko Ono. I was to appear the next day as an expert witness at Immigration and Naturalization Service hearings that Attorney General John Mitchell had engineered as a way of getting the couple ejected on marijuana charges after they became involved in anti-war activities.

I told John how cannabis helped me to hear his music for the first time in much the same way that Allen Ginsberg had seen Cezanne for the first time after he smoked cannabis before going to the Museum of Modern Art, to determine if marijuana could help him break through his incapacity to relate to Cezanne. It did.

John replied that I had experienced only one facet of what marijuana could do for music. He said that it also enhanced the ability for composing and making music.

So you discovered marijuana as a recreational drug, but how did you begin to focus on its medicinal uses?

In 1972, I talked to a cancer specialist about a young male leukemia patient who found that the nausea and vomiting caused by chemotherapy were unbearable. Then, the young man began smoking marijuana 20 minutes before his chemotherapy sessions, and it helped him survive.

Our son Danny had been struggling with acute lymphocytic leukemia since 1967. He had been hospitalized several times, and in 1971 he started taking chemotherapy drugs that caused severed nausea and vomiting. Standard drugs didn't allay his misery; he started to vomit shortly after chemotherapy and would continue retching for as long as eight hours. I considered the idea of his using marijuana, but it was against the law, and I was afraid it might cause problems with the hospital staff. I discussed it with Betsy, but took no further action.

A few weeks later, I arrived at the hospital to find that Betsy and Danny were already there awaiting his next chemotherapy session. When I arrived at the hospital, Betsy and Danny were in a joking, relaxed mood, and I felt they were keeping a secret from me.

It turns out that on their way to the hospital, they had stopped at the high school and Betsy asked one of Danny's friends to get her some marijuana. Danny smoked it in the hospital parking lot before entering the clinic. When I joined them, I was so relieved and happy to see how comfortable Danny was. He didn't complain about the treatment, and he was not nauseous afterwards. Betsy even stopped on the way home to buy him a submarine sandwich.

The next day I told Danny's doctor how marijuana had helped him. The doctor suggested that at the next treatment Danny smoke in the treatment room so he could observe the effects. Again, Danny became relaxed and free from nausea. He used it during the remaining year of his life. It eased his pain and gave comfort to our whole family. Danny said of the experience: "Pot turns bad things into good."

You first published Marihuana, The Forbidden Medicine, in 1993. Many people credit that book with helping to educate voters, journalists, judges and politicians. Your stature is part of the reason that medical marijuana is legal in nine states. Still, your opponents say marijuana's medical usefulness is overestimated, and that it is more harmful than you believe. How do you feel about this debate?

I am very concerned about the approach of institutions such as the Institute of Medicine, which grudgingly admitted in its 1999 report that marijuana had some medical value, but overall it views medical marijuana as a "problem." For patients, the problem is getting marijuana without going to jail. For the government, the problem is how to acknowledge marijuana's medical benefits while still maintaining prohibition.

The government's solution is what I call the "pharmaceuticalization" of cannabis. Pharmaceuticalization means that drug companies and chemists will isolate and produce natural cannabinoids, synthetic cannabinoids, and cannabinoid analogs. They want to avoid the alleged dangers of smoked marijuana by designing drugs that lack the psychoactive effects, and by making new cannabinoid medicines that do not involve inhaling smoke. In their view, it is preferable to use nasal sprays, pills, skin patches, nebulizers, and suppositories to avoid exposing the lungs to the particulate matter in marijuana smoke.

This is a hot topic in the marijuana science world. I discussed this at a conference with Geoffrey Guy, whose company GW Pharmaceuticals is attempting to use naturally derived cannabinoids in products and delivery systems that will avoid smoke and the psychoactive effects.

Dr Guy is researching the effectiveness of delivering cannabis extracts under the tongue or via nebulizers, which are inhaler devices. His nebulizer looks like it will be an expensive, complicated device. It will have some kind of computerized controls that control dosage to prevent patients or unauthorized persons from using it recreationally.

I said to Dr Guy, "You're talking about this expensive aerosol dispenser, but if I can get safe medical relief by smoking marijuana through a vaporizer what is going to compel me to buy your very expensive product?"

He didn't know what to say, but somebody interjected that insurance companies will pay for the inhaler. I said, "But 40 million Americans aren't insured, and insurance companies are upping the prescription co-payments, so regular marijuana will continue to be medically effective and cost effective."

Do you see any value in the pharmaceuticalization approach?

It's reasonable to find out what marijuana's components do, and to try to isolate them, chemically modify them, and put them in pills and inhalers. That's why the armed forces are paying for studies of a synthetic cannabinoid, HU-211, otherwise known as dexanabinol, because Raphael Mechoulam's studies found that it reduces brain damage from stroke and brain syndrome. Researchers in San Diego showed that THC, just like whole marijuana, probably accomplishes the same thing.

I was at a conference with Raphael, and I questioned whether, given the time sensitivity of this treatment, that instead of moving people to a hospital to give them dexanabinol right after a traumatic accident involving the head, why not give soldiers who remain conscious or regain consciousness khaki-wrapped joints that they could smoke right away.

It's possible that some of the new cannabinoid products will be useful and safe, but I question whether drug companies will find them all worth the enormous development costs? In most cases, new products will not be more useful or safer than natural cannabis. Synthetic tetrahydrocannabinol, known as Marinol or dronabinol, has been available for years, but patients usually find smoking marijuana is preferable to using Marinol. Unimed, the company that manufactures dronabinol, is charging a very high price for their product, despite the fact that the US government partially subsidized their development costs.

McCaffrey and his troops say medicines are not smoked. However, inhaling cannabinoids via vaporization devices is a particularly safe and effective method of delivery. Vaporizers have to be sophisticated enough to precisely maintain a temperature of between 400 and 440 degrees Fahrenheit. I have personally tested several vaporizers that work very well in this regard. People can read about some of them on my website.

Furthermore, the harms of smoked marijuana have been exaggerated. If a patient smokes a pack of joints a day, that might cause respiratory irritation. But for people who smoke a few puffs a day there is no great respiratory danger- they're probably more at risk if they breathe the air in Houston.

I don't for a second believe that pharmaceuticalization efforts will result in less medical use of whole smoked marijuana. We will probably end up with two distribution systems: there will be the system that says get a prescription, go to a pharmacy, and get a pill, but there will also be the distribution of plain marijuana, just like any other herb.

Grinspoon: `While marijuana was not addictive, learning about it... had a strong hold!`What about the assertion that marijuana's medical usefulness and safety have been exaggerated?

Many of the people who say this are not doctors or nurses who deliver direct care to patients.

Every day, doctors are faced with a dilemma that balances the harmful side effects of a medicine with its benefits. Most medicines have harmful side effects and differing degrees of effectiveness from patient to patient.

Marijuana is by far one of the safest and most versatile medicines we know of. It is surely less toxic than most of the conventional medicines it will replace when it is legally available. It has never caused an overdose death. Increasing the potency of cannabis and developing vaporizer technology so people can inhale cannabinoids instead of particulates could significantly lessen whatever respiratory problems are caused by it.

Cannabis is extremely versatile. It stimulates appetite, which is useful for cancer and AIDS patients. It prevents nausea and vomiting. It lowers intraocular pressure associated with glaucoma. It provides relief from seizures, spasms and convulsions. It reduces pain, and is a great alternative to potentially lethal and addictive opioid analgesics. It also may act as an anti-inflammatory, and as an anti-depressant.

Have you found it ironic that some medpot critics describe marijuana-induced euphoria as an "unwanted side-effect?"

Pharmaceuticalization advocates want to achieve therapeutic doses without producing psychoactive effects. I'm not sure this is very well thought out. Patients who use cannabis for severe pain or to lower intraocular pressure in glaucoma, for example, need to smoke regularly. They'll stop feeling the high when they have developed a tolerance to the psychoactive effects, but they won't develop a tolerance to pain relief, the lowering of intraocular pressure or other medical effects.

The people who smoke all day long aren't getting much of a high out of it. Most marijuana users know that the less you use the more you experience the psychoactive effect. But there's no evidence of tolerance for the medical effects.

I also question whether the psychoactive effect is always separable from the therapeutic effect, and in any event, is necessarily undesirable. Many patients suffering from serious chronic illnesses say that cannabis improves their spirits. If they note psychoactive effects at all, they generally speak of a slight mood elevation.

A government scientist told me that marijuana doesn't really make people feel better, they only think they feel better.

What is that supposed to mean? It doesn't matter whether it's the psychoactive effects of pot that make patients feel better. The doctor's bottom line is whether a drug helps patients find relief. We balance this with the risks of the medication. In the case of marijuana, since the toxicity is so limited, it's certainly worth trying.

How do you respond to people who claim that marijuana is addictive?

Addiction is difficult to define. We hear people talk about addiction to food, addiction to sex. There was a time when we thought we knew what addiction was. The withdrawal syndrome with identifiable severe symptoms was essential to that definition. You knew what it meant, and it wasn't just that you like something a lot and you miss it when it's gone, which is the case with marijuana. People love sex and it makes them feel good, and when they don't have it, it makes them unhappy, but that isn't an addiction. There are people who use a lot of cannabis and don't like being deprived of it, but they don't fall apart when they can't get it.

When I helped Ramsey Clark defend the Ethiopian Zion Coptic Church members, I had occasion to find out something about whether marijuana is addictive. They believe that God resides in each of us and that smoking ganja helps a person realize his or her godliness. I observed them for three days in Jamaica. You wouldn't believe the huge amounts they smoke. I examined them in prison after they had been deprived of ganja for about a week. There wasn't an iota of any kind of addiction withdrawal syndrome. They missed ganja, because it was part of their religion, and they felt that not having it was affecting them spiritually, but there were no withdrawal symptoms.

Grinspoon: `While marijuana was not addictive, learning about it... had a strong hold!`Do you disagree with the claim that marijuana causes memory deficits?

Marijuana's effects on memory and concentration are the opposite of what the critics allege. Marijuana gives you hyperattention so that you concentrate fully on one thing at a time. It limits your peripheral awareness so you're not investing as much of your focus on other things.

In normal consciousness, people are monitoring many aspects of their lives, both internally and externally. With cannabis you are focused in the moment; the concerns about future or past, or less interesting events, drop off while stoned. I don't think it's a question of memory so much as it is a concentration of attention.

What's behind criticisms of medical marijuana?

The government sees it as a dangerous threat to their decades of reefer madness propaganda. They worry that when Americans see cannabis easily and safely used medically by aunts, uncles, parents, grandparents, and friends, then they will not support this prohibition which involves arresting 700,000 people per year. And that is why the government wants to get cannabinoids into pill form so they can say, "No you don't have to use whole cannabis, we now have pharmaceutical company produced pills.'

Most patients who come to me for Marinol only want it because they face drug testing, and Marinol is a legal explanation for a urine test that shows the presence of cannabinoids. They find marijuana more useful than Marinol, but they are afraid of the law. The only way these pharmaceutical products will sell is if the law keeps people from using regular marijuana. On a level playing field, whole marijuana will be used more than pharmaceutical cannabinoids.

Millions of Americans have tried marijuana, and at least 10 million regularly use it, despite criminal penalties and other disincentives. Unless we are prepared to believe that all these people are driven by "Reefer Madness" cravings, we must conclude that they find something in the experience attractive and useful. And yet there is very little open exploration of these uses, with the growing exception of its medical value.

Even here, government officials want to mute the discussion out of a fear expressed by the chief of the Public Health Service when in 1992 he discontinued the only legal avenue to medicinal marijuana: "If it is perceived that the Public Health Service is going around giving marijuana to folks, there would be a perception that this stuff can't be so bad... it gives a bad signal."

Tell us about your continuing efforts to document marijuana's usefulness and share cannabis knowledge.

Most people believe that marijuana use is primarily for recreational purposes, and in recent years many thousands of people have discovered its medical utility. But there are many uses that do not fit into these two generic categories, and that's why I've described a new category called "enhancement."

People use cannabis to enhance a wide range of activities ? from dining, to music, to sex, to art. They also use marijuana to catalyze new ideas and insights. Enhancement uses overlap, to some degree, with medicinal and recreational uses, but I view it as a discrete category.

I have been gathering essays by people who use marijuana to enhance their lives. Some of your readers may wish to look at some of the essays, or even possibly to contribute to the collection, at my website (www.marijuana-uses.com). The site is attracting 32,000 hits a month, and eventually I hope to publish the best essays as an anthology.

The essay I just sent to our webmaster is called "I'm an addict." It's written by a 26-year-old man who spent a lot of time in jail because he has a violence impulse disorder. As a kid, he spent a lot of time in juvenile detention. As an adult, he's been in jails and prison. Now he's discovered that marijuana helps him control that violence. He's now married, has a young daughter, and a legitimate job. He says he's "addicted" to a lifestyle of not being violent- all he has to do is smoke marijuana every night and he isn't violent.

A New York City police officer recently wrote an essay. He said marijuana makes him a better officer, especially in drug arrest situations. There's a lot of range in these essays, including the one you wrote.

You also have a medical marijuana website that can best be described as an online doctor's office.

The medical marijuana site, www.rxmarijuana.com, gets 100,000 hits per month. It's keeping me very busy. People from all over the world write in to ask medical questions. I can only answer a fraction of them. We get hits from Yugoslavia, Ukraine, New Zealand, Australia, India, Europe, China, North and South America.

I even get questions from Sweden, which has a very bad marijuana policy, especially since it has a reputation for being so progressive. It's probably the worst of western European countries. I was there to give a speech, and was referred to on the front page of a major newspaper as "the devil from America."

You're a Harvard physician and professor who risked a lot to become publicly involved with marijuana advocacy. Isn't it difficult to combine privacy and security with advocacy?

Yes, but it's essential that more people come out of the closet about their marijuana use. Just as gays and lesbians coming out has decreased the level of homophobia, when people of substance and achievement publicly proclaim that they've used marijuana, it will help diminish the prevalence of cannabinophobia.

During an interview on a popular talk show, the host asked me whether I used marijuana. He hadn't prepped me for the question, and I was surprised by it, but I replied that I did use marijuana.

After the show I told him I was surprised he would ask about my personal life without running it by me either before the show or during a break. I asked him what he would have done if I had directed the cannabis question back to him. He was irritated and alarmed by that prospect, and said, "That's different, Lester. Everyone already knows you use marijuana."

Many famous and highly accomplished people use marijuana, but most of them are afraid to admit it. Too few people in the public eye have voluntarily acknowledged cannabis use. Except for the well-known physicist Richard Feynman, academics have been the most cautious. Feynman courageously acknowledged his ongoing use of marijuana, and I applaud his courage.

I'm not discounting the potential dangers of coming out, however. People who acknowledge cannabis use are at risk for being taken less seriously by their peers, and there could be even worse consequences.

You've been on the board of the National Organization for the Reform of Marijuana Laws (NORML) for many years. Will you continue?

I recently resigned from the NORML board, and have taken emeritus status from Harvard Medical School. My wife retired from her position as a professor of mathematics. We wanted to have more time to play together while we are still fairly fit.

I love NORML. Keith [Stroup] and Allen [St Pierre] are wonderful people, heroic people. They work very hard for the movement. When Keith was gone, Allen and Dick Cowan kept NORML together in some very desperate times. There wouldn't be a NORML if not for them. I will continue to do public appearances for NORML and help them in every way I can.

What did you think about the allegations that High Times and its parent company, the Trans-High Corporation, might owe NORML money?

I very much doubt there is any money there that NORML was gypped out of. High Times has helped NORML a lot over the years. But even if there was some missing money, to hire lawyers and do discovery and all that, it's just a waste. I can't see money going for lawsuits when we should be spending it working for our cause.

If somebody was clever enough to gyp NORML out of money, they were probably clever enough to hide it so you'd never find out. There's no point in pursuing it. You'd end up with nothing but a big bill from the lawyers and a lot of animosity.

If we had pursued it the way some wanted us to, it would have created another rupture in this movement. There have already too many internecine conflicts. The only people we want to battle are the drug warriors.

What are your predictions about marijuana's future?

I think the Bush administration will try to destroy the medical marijuana movement, but they will not succeed. The new attorney general, Ashcroft, says we need to rev up the drug war. The biggest threat to these folks is medical marijuana, because people will see this plant works and with minimal toxicity, that the drug warriors have been dishonest all these years, and there will be no way they can long maintain the fa?ade.

Patients are teaching their physicians about marijuana. How is the government going to crush that? Are they going to attack doctors as they unsuccessfully did in California? Imprison sick and dying people? It's absolutely inevitable that marijuana will become increasingly acceptable as a medicine, no matter what the government does. The momentum is unstoppable.

Marijuana prohibition is like a mass hysteria. It's like the Crusades or the witch-hunts of previous eras, when entire societies go crazy and do irrational things. Someday, we will look back on the war on marijuana and recognize it as a kind of madness, a destructive mass pathology! Grinspoon: `While marijuana was not addictive, learning about it... had a strong hold!`

? To order Dr Grinspoon's books and find out more about medicinal marijuana vist these websites: www.marijuana-uses.com and www.rcmarijuana.com