The cannabis dimension

(October 2005, revised December 2005, January 2006)

I first smoked cannabis in the early summer of 1966, when I was 17 and in my last year at school in Cambridge. These were exciting times to be a rebellious teenager. A sudden awakening of consciousness. A sense of everything happening at once. Liberation from the oppression, the grim irrationality, of Family Values. This was the year when "flower power" took off and it was in May or June 1966 - quite remarkably suddenly, I think - that the aroma of cannabis began to waft through the staircases of Cambridge colleges. A couple of months later, students were taking off in their hundreds to hitch eastwards on the hippie trail, driven by the desire for unlimited supplies of hash.

I decided straight away that cannabis had a really quite delightful effect on the mind. The world became such a pretty place, traffic lights reflected on wet tarmac the loveliest sight imaginable, my thoughts so exquisitely entertaining. What an improvement on alcohol. Try as I would I could not find a way to hold on to the "tight", "merry" stage of drinking - if I stopped drinking when it came upon me, it would rapidly pass off. But if I went on drinking, it would equally rapidly be replaced by being drunk. A state which I thoroughly disliked in myself, and also in my companions. Not that I was much keener on the company of people who got stoned out of their heads - mindlessness of any form has never appealed.

My introduction to cannabis didn't in the least fill me with a desire to smoke it all the time, any more than my first taste of alcohol had made me want to drink all the time. It remained something to be savoured as an adventure whenever the opportunity arose, but not something which I felt any wish to acquire for myself or consume in my own space.

From then until I was in my mid-20s, I carried on smoking cannabis whenever it came my way. Probably two or three times a week, as a general rule - many (but by no means all) of my friends in those days smoked cannabis. This was apart from my last year at University, when I decided that I was going to concentrate on getting a good degree and, without any difficulty at all, led an entirely drug-free life.

When I moved to Sheffield at the age of 25, I moved away from cannabis-smoking friendship networks. Apart from the very occasional indulgence I then stopped completely (and also stopped smoking cigarettes) when I was pregnant with my first child, and didn't take it up again for another 15 years. I never resumed smoking tobacco, except in joints.

By the time I was 40, I had the space in my life to do my own thing in the evenings without children around. I made the decision to smoke cannabis on a regular basis because I was thoroughly ground down with long-term low-level depression, and with chronic sleepnessless which didn't respond to the drugs the doctors gave you in those days - the valium/diazepan family. In fact the result of taking such drugs (re-tested on a number of occasions since) is to make me anxious as well as depressed, if anything slower to get off to sleep, and thoroughly bad-tempered in the morning. Cannabis, on the other hand, is guaranteed to make me relax and see the humorous side of life, even though it doesn't by any means always combat sleeplessness. I restricted myself to cannabis resin, which doesn't possess the giveaway stench of the much stronger skunk which the young things smoke these days, and which I treat with great caution because of its powerful effects.

There is now a body of research, easily located on the Internet, which suggests that the effect on the lungs of one joint could be equivalent to 5 or 6 rather than one cigarette. Given that one inhales more deeply, it's hotter etc., I can buy that possibility. If this research had been around when I resumed my cannabis consumption 15 years ago, I'm pretty sure I would have rejected the cannabis route to improving the quality of my life, and made the effort then to establish a mindfulness of breathing meditation practice. But it wasn't and I didn't. And that being the case, I have no doubts that without cannabis I would have gone to the wall, and lived the rest of my life in a state of chronic depression or worse.

I maintained a determination that I wouldn't permit myself to be addicted to cannabis. My recipe for ensuring this has been to always follow the principle of not taking cannabis away on holiday with me – the joys of being in beautiful places, of not having to go to work, are sufficient in themselves. This policy has never resulted in any withdrawal symptoms, or caused me any grief of any kind.

However, a friend of mine from my youthful cannabis-smoking days (a professor) died of lung cancer some time around 2000. Like me he was a 3 or 4 joints (or in his case pipes) most evenings cannabis smoker and hadn't smoked tobacco independently of this for around 30 years. It was because of this that I became anxious a year before diagnosis, when I started getting symptoms that something was badly wrong, that smoking cannabis could have been harmful to me.

I concluded when the mass was discovered that if it turned out I had lung cancer I would be very inclined to assume that cannabis was "villain". But at the same time, Internet sleuthing suggested that cannabis could be treated as hero rather than villain in the context of cancer. For example, cannabis was reported as having a slowing-down effect on lymphomas. See http://news.bbc.co.uk/1/hi/health/3655586.stm. In chemotherapy, its beneficial effect in terms of reducing nausea and maintaining appetite has been well-documented. For pain relief, the effectiveness of cannabis is widely-recognised. As a result of this widespread acknowledgement, British courts over the past few years have witnessed some magnificent jury acquittals of cannabis-takers suffering from painful illnesses.

If I hadn't resumed cannabis smoking 15 years ago, I am sure that I would nonetheless have taken it up again when diagnosed with a terminal cancer, whether or not it appeared that cannabis could have been the cause of the cancer. Either way (stable doors and horses), I decided when I was diagnosed with cancer that continuing to enjoy cannabis at this stage was the sensible thing to do.

Contemplation of whether there could be a link between cannabis and my cancer has remained high in my thoughts, however. A good Internet source is http://www.idmu.co.uk/cancan2003.html. This is an academic report on cannabis and cancer which summarises current research into both the potential benefits of cancer in the context of chemotherapy and palliative care, and the possible role of cannabis in causing cancers. One point made here is:

"smoking of cannabis releases a number of non-cannabinoid carcinogens into the lungs and upper respiratory tract, and a number of researchers (notably Tashkin and colleagues) have identified pre-cancerous changes in lung cells. The failure of these researchers to discover significant evidence of actual cancer cells in the lung may be attributed to these anti-cancer activities of cannabinoids including THC counteracting the effects of other carcinogens in smoked cannabis."

This set me thinking in my case - a large mass in my chest cavity but no signs of an active cancer in my lungs, and atypicalities in cell composition of the mass as far as lung cancer is concerned. Could there be the possibility of "jumping a primary" - when I'm chopped up after my demise doctors might perhaps find pre-cancerous changes in my lung cells, but not an active primary?

Mere speculation though, and I find myself with very little desire to research the issue further after the initial Internet sleuthing and reading of reports unearthed by medicalistic friends. I have subjected my lungs to various other revolting substances in my life, for instance the chemicals we used in the printing co-op. Plus asbestos, fibreglass and very large quantities of paint and stripper fumes in the course of building and renovation work on houses. Not to mention too much stress and depression in my life... Meanwhile nowhere, as far as I can establish, are there to be found any accounts of similar cancers - i.e. large tumour in chest cavity but no signs of anything going on anywhere else - and a relationship with cannabis.

When my mass was discovered, I decided to be completely upfront with the hospital doctors about the cannabis dimension to my leisure habits. I was then rather cross when I read my medical records. Close to the top was the consultant's to my mind unacceptably sloppy categorisation: "smokes lots of cannabis". Unable to string a thought together, yeah man, hardly the stereotype to prepare medical professionals for the me they would be confronted with. We ended up discussing this issue by email. She said:

The cannabis issue is all a matter of perception. As someone who has never tried cannabis and is only dimly aware of one or two friends who may have tried it once or twice your intake seemed to me to be quite a bit. Don't forget that most of our patients are not so forthcoming about some of their habits either. I'm sure compared to lots of people your cannabis intake is not excessive - as I say it's all a matter of perception.

and I replied:

Yes, it's precisely because it's all a matter of perception that loose statements like "smokes a lot" are too open to interpretation to be useful. Obviously, my cannabis intake has been excessive if it's related to the cancer, and I would want such a possibility to be flagged in cannabis-smoking circles who, as just a little bit of internet sleuthing quickly demonstrates, tend to be quite seriously in denial that its effects are anything other than benevolent.

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I worry in particular about how much cannabis it seems normal to put in a joint these days, and the youthful age at which people are consuming it. If young people start smoking cannabis before they have got their life together in any way, cannabis certainly has the capacity to demotivate consumers from putting any discipline or structure into their existences. If those structures and disciplines are already in place and, as for me, an important part of your life, there's no reason why cannabis should undermine that.

Skunk has almost entirely displaced cannabis resin as the drug of choice for young people. It becomes increasingly difficult to get hold of cannabis resin, and what can be got is often of extremely poor quality. There is more profit to be made by dealers from skunk, and more easily. Skunk supplies are home-grown indoors, using hydroponics and artificial light. The crop grows quickly and easily. It's a doddle. Consequently, it's very readily available.

Skunk is enormously, vastly much stronger (higher in THC) than the cannabis resin one is likely to encounter today, although probably not much if at all stronger than the high-quality resin available in my youth. To make a joint which has the desired effect of getting me gently stoned, I put in just a very small scattering of skunk. I'm told that it's commonplace when today's youth "build joints" to use at least ten times as much as I do. And perhaps it's significant that young people are smoking it in an entirely different cultural context from that which existed in the 60s days of love, peace and flower power. Many of the young people who are smoking skunk these days have miserable, depressing lives and live in miserable, depressing environments. As a result it's not surprising if the mood changes to which they are predisposed have more to do with hate, turbulence, and fear than with love and peace.

It's distressingly evident that a recreational goal of many of today's youth is to get "out of their heads". I have been in a good position to watch this happening, working with students as well as seeing what went on with my children and their friends in their teenage years. This applies just as much to how teenagers use drink as it does to how they use drugs. And it's not just a class thing - middle-class as well as working-class kids very often take this approach to leisure. Perhaps it's the case that boys have always been boys - be that as it may, it just isn't how it was for girls in my youth. Of course there were a small number who acted like this, but for most of us it just wasn't how we wanted to be. We might try big-time mind-altering experiences such as tripping on LSD once or twice - and, if we were lucky, as I was, greatly enjoy them - but we had no desire to lose control, to be completely out of it, on a regular basis. Being pleasantly stoned at evenings or weekends on a regular basis was another thing entirely.

Teenagers as young as 14 or 15 are smoking skunk these days, and cannabis-related psychosis is all-too-common on adolescent mental health wards. As with alcohol, it seems likely that it is capable of inflicting far greater damage on adolescents than adults. I had one or two bouts of minor paranoia from strong cannabis when I was 17, but never since. But it's only too likely that, if I was a teenager now, I would have found myself on a mental health ward.

More is said on this theme in The Guardian of 16.12.05, which carries a feature on "the new cannabis panic" - http://society.guardian.co.uk/drugsandalcohol/story/0,8150,1668786,00.html. Many advocates of cannabis who were prominent in the campaign to liberalise the law are people of my generation - now in their late fifties. It seems only to have "clicked" seriously over the past year or so that the way in which many young people use cannabis these days is an entirely different ball-game from how it was for the late 60s flower power generation. Given that skunk and cannabis resin are basically the same drug, and that the big difference is how strong today's youth roll their joints, it wouldn't seem particularly logical to distinguish between resin and skunk in legal terms. The problem is at the user end - consumers wanting to use drink and drugs in sufficient strength and quantities to get out of their heads, and wanting to do this at a very early age. (Note: I myself thought of skunk as different in kind from cannabis resin for a long time, and tolerated very poor-quality resin in preference to the dreaded skunk. It's only recently (January 2006) after discussion with a couple of old friends from when I was 17, that I began to think this was illogical. Although I would still maintain that there is something more mellow and pleasanter about a high from good grass or resin than from skunk.)

On a more trivial issue (stable doors and horses), I feel some annoyance with myself that I continue to smoke cannabis in joints rather than use the vaporiser which I have acquired. It's because of the much quicker "hit" you get from smoking it. My daughter insists that it's also because I like smoking the tobacco in the joint, but I'm not so sure. Smoking tobacco in joints has never made me want to smoke tobacco on its own, except on very rare occasions - usually in pubs when other people are smoking around me. Smoking cannabis in joints also acts as a constraint on how much I consume - if I have more than 5 or 6 in a day I have a real aversion to smoking any more.(1) Something I put down to not actually liking smoking tobacco - or perhaps smoking in general in more than a very limited quantity.

To return to cannabis in the context of palliative care for a terminal cancer. In a nutshell, for me its benefits are: 1) Brings me straight out of depressed mode - can always crack a joke when I've had some. But, unlike oral morphine, I feel in control of its effects on my mind, rather than addled by it. 2) Keeps up my appetite. I have very clearly demonstrated this to myself by experimental periods without cannabis - my appetite plummets in two days 3) Pain relief - I'm finding it mixes very satisfactorily with morphine and makes it possible for me to be comfortable on a much lower morphine dose than GP and consultant expect that I would need. In fact, my GP - who was very non-committal at first about my cannabis consumption - has commented that given how remarkably fit and cheerful I was keeping, she really didn't think I should let myself run out of cannabis.

I treat cannabis as just one in a whole range of different survival tools I make use of - meditation, all sorts of breathing techniques, very healthy veggie diet, handling pain by moving around instead of lying down, always having my piece of yew tree in my hand when I rest or sleep, firmly holding on to my Routine etc etc. I certainly don't want my comments to be picked up by the cannabis-smoking community as ammunition for arguments that cannabis is the cure for all the world's evils. Credit where credit is due, that's all.

 

Postscript, 31.10.05

Research by an academic in the Biology Dept of the University of Colorado has been published in October 2005 concluding that cannabis may inhibit cancer growth. See Bob Melamede: Harm Reduction: the Cannabis Paradox online at http://www.harmreductionjournal.com/content/2/1/17, and - same author - Cannabis and tobacco smoke are not equally carcinogenic, http://www.harmreductionjournal.com/content/2/1/21

 

Notes

1. There can be problems over quantifying the amount of cannabis one smokes. Although this doesn't apply in my case, cannabis is mostly smoked socially, sharing a joint with friends. The amount of cannabis people put in their joints varies enormously. And so too does the strength of cannabis, with skunk sometimes said to be ten times stronger than the low-grade resin which is normally all that's in circulation these days. It could be that the market value of the cannabis one smokes in a week is the best of a not very good set of possible measurement indicators - in my case, around £20. (Skunk is considerably more expensive than resin.) But then again, how much you pay per quarter-ounce or whatever depends on what quantities you buy in... Anyway, in my particular case, 1/4 ounce (6.5 grams) of skunk in 10 days is a reasonably accurate figure.

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