Victor Borge, the Danish American concert pianist and comic, joked that he had a doctor cousin who discovered a cure for which there was no disease.
A new study, Cannabidiol for the treatment of cannabis use disorder: a phase 2a, double-blind, placebo-controlled, randomised, adaptive Bayesian trial, published in Lancet Psychiatry, the British medical journal may have duplicated Borge’s cousin’s success.
First, let’s discover the “disease.” I think that the most basic problem with this study is that “cannabis” is not just one substance like alcohol or cocaine. It is a plant, or a derivative of a plant with a variety of substances (Cannabinoids, terpenes, flavonoids etc,) that are not yet well understood. Consequently, when someone is said to have problems (or benefits) from “cannabis”, we literally don’t know what we are talking about.
This particular study has an interesting angle, because it suggests that someone who is having problems with “cannabis” can overcome these problems with a cannabinoid, that may or may not be in the “cannabis” they were using. This question is particularly relevant in British study, because in a contraband market like Britain’s, no one really knows what they are smoking. Also, it might well be the “Skunk” strain that is very popular in Britain and is supposedly very low in CBD.
So, perhaps they are being treated for an “addiction” to THC, when they are really suffering from a CBD deficiency. Or maybe they were getting some benefit from the THC, but were being pressured to quit because it is illegal, and then suffer from bad medical advice. After all, we know that people have been using cannabis for millennia for a variety of health problems.
Although reports on this study suggested that it is new news, a 2015 report, Cannabidiol Oil for Decreasing Addictive Use of Marijuana: A Case Report, published by The National Center for Biotechnology Information, reported much the same. “This case study illustrates the use of cannabidiol (CBD) oil to decrease the addictive use of marijuana…”
“The second most abundant component—CBD has been suggested to have the medicinal effects of decreasing anxiety, improving sleep, and other neuro-protective effects. The mechanism of action for CBD has been suggested to be antagonistic to the psychoactive properties of THC in many locations within the central nervous system. Such action raises the issue of whether it might be beneficial to use CBD in isolation to facilitate withdrawal of marijuana use.”
One cannot but wonder why, if “marijuana addiction “ is such a problem, why didn’t the addiction industry (and the DEA and NIDA) promote CBD as a treatment five years ago, when that study was reported by an agency of the US government? Perhaps because they did not want to admit that they have been suppressing evidence of the medical value of cannabis?
But what is addiction?
We joke about being addicted to whatever we particularly like, so we instinctively know that not all addictions are created equal. Barbiturate and alcohol withdrawal can be fatal. Tobacco withdrawal seems to be very hard to shake. On the other hand, we sometimes refer to compulsive behaviors as addictions, and compulsive gambling is incredibly destructive.
In 1996, two anti-prohibitionist Dutch scholars, Arjan Sas and Peter Cohen (an old friend) at the University of Amsterdam published a study, Patterns of cannabis use in Amsterdam among experienced cannabis users.
They report, “Although 45 percent of the experienced cannabis users we interviewed report having first hand knowledge of negative effects of hashish or marijuana on one or more aspects of life, this did not lead to an escalation of problems. In fact all respondents but one were able to regulate their cannabis use on their own, either by quitting or cutting down their use, or applying stricter rules to their use.”