Editorial:

EDITORIAL
Welcome to the first edition of Cannabis Health Journal. What we are about to do with this publication would not have been possible ten years ago. Impossible because even 5 years ago the technology was not available that would enable a dedicated few to publish on this scale.

Impossible too, because politics, the law and society were not ready. The highly successful medicinal cannabis lobby has increased acceptance by the general public of the medicinal properties of cannabis, instilling confidence in more closet smokers to courageously step forward and admit a lifetime pattern of modest and responsible use.

Over the past several years the cannabis hemp movement has calmed the fears of the masses with the comforting message that hemp is not marijuana. Indeed, the differences between the strains are significant and this strategy has allowed modest gains for the hemp movement. I remember vividly a heated discussion with famous author Jack Herrar in Salmo in 1996; Jack was arguing that hemp would open the door for marijuana legalization, while I on the defensive was pressing the alternative, that marijuana must be dealt with first to avoid the proliferation of rules, regulations and people to enforce them. I was much younger then and more naïve, but alas, I was right. Western society’s fear of marijuana is rapidly diminishing and cannabis is again being embraced in all its identities: as clothing, as food, as building materials, and as medicine.

My respect and admiration goes out to the patients in California who are facing the force of the DEA and the US federal government; the Journal will follow their couragious struggle in more detail in the next edition. Also look out for more on the tomato growing myth, titled, "No Wonder We’re Confused". My apologies for not delivering on the "Question for Health Canada".Our sympathies are with HC; I am sure the last few weeks has been hell.

We will continue to submit questions to Health Canada and hope to report the responses in the coming edition.

Cannabis Health Journal is owned by the Cannabis Health Foundation, a registered non-profit society. The hard copy Journal is fully integrated with the cannabishealth.com web site. The site offers information, shopping and more in depth reporting than we have room for in print and will offer readers multiple web links to more information and other sites of interest.

The Journal will focus on the responsible marijuana user, who under Canada's new laws will soon have the right to grow a small quantity of cannabis at home for personal consumption. We will celebrate the brave pilgrims that courageously and routinely place their lives on the line for their beliefs and we will encourage the pioneers of the cannabis movement to tell their stories and share their secrets. I welcome and would like to personally thank those forward thinking individuals and businesses that have stepped forward and advertised in this first edition. The response to the Journal from the professional community and from medical users has been inspirational.

Decisions that will affect the lives of millions will be made in the next few months. The Canadian Senate report was released on September 4/02 and recommended dramatic changes in Canadian law that would extensively treat marijuana the same as alcohol. Senator Nolin, who chaired the committee, predicted that the Canadian Commons committee reviewing the same topic and due to report in November, would substantially concur with the Senate’s recommendations. Other politicians have warned of a backlash from the U.S. should we dare to legalize. Regardless of the slowdowns or bends in the trail, I have no doubt

Canada will continue down the path to more enlightened and humane drug policies.
Cannabis Health Journal will be there as the decisions are made, as the consequences unfold and as the laws change. We will be a strong and credible voice in the rapidly evolving cannabis culture.
Congratulations to all the Journal contributors, staff, volunteers and supporters; thanks for sharing the vision.

Vancouver Island Compassion Society
There were no guarantees. Of course, we were all optimistic, but as I walked into the courtroom that day, no one could be certain of the outcome. We stood up as the judge entered. As we sat down again – myself behind my able attorney John Conroy - my wife, friends and supporters in the audience, silently awaiting my fate (and the fate of the Vancouver Island Compassion Society) – the judge announced that he was going to read the entire legal decision aloud.

Judge Higinbotham began to outline the background of the long case. Since my arrest in November of 2000 I had appeared in court over 20 times:

"Philippe Lucas is President of the Vancouver Island Compassion Society, an organization that provides marijuana to its members for medical purposes. His activities in that regard resulted in a charge of possession of less than 3 kilograms of marijuana for the purpose of trafficking, contrary to section 5(2) of the Controlled Drugs and Substances Act, to which he entered a plea of guilty. Mr. Lucas has requested he be discharged absolutely, and the issue in this hearing is whether an absolute discharge is justified."

Over the 25 minutes that it took the judge to read through his decision, I had a chance to reflect on the long court battle, as well as what had gone right (and wrong) since our opening day on the 1st of October, 1999.
At the VICS, our goal has always been to help those with a legitimate medical need gain access to a safe, affordable supply of cannabis. As a secondary goal, we hope to demonstrate that this can be done in a manner that is both legally and socially acceptable. For us, this means two things: 1) complete transparency of action and accounting. 2) anticipating and addressing possible public and police concerns regarding our actions and organization.

The former has been addressed by registering as a provincial non-profit society. Non-profit status takes away one of the prosecutor’s main line of argument: that we are in this for the money. As a non-profit, ownership of the Vancouver Island Compassion Society remains in the hands of its 250 current members. All of the financial records for the organization are submitted to and reviewed by the relevant government organization. During the court case, Judge Higinbotham had the prosecution agree that there was a clear distinction between the VICS making enough money to continue its operations helping those in need, and actually profiteering from the desperation of the sick.

Our status as a non-profit also helps us gain public support; it reflects our efforts to work within the system when possible. Furthermore, non-profit status serves as a business licence, allowing us to forgo the city bureaucracy involved with obtaining a licence. Lastly, as a non-profit, we receive discounts on some essential services, such as the internet, intra-office security, banking, etc. Any and all money saved can be a real boost to a small start-up organization.
The VICS’ original location - in a residential area in Oak Bay - meant that we had to anticipate the very real concerns of the local community in our business model. Firstly, we were wise enough to look at what was already working. The British Columbia Compassion Club Society (BCCCS) had been in operation for almost three years before the VICS came along, and we learned much from their experience and success. Bureaucracy and paperwork are the most dreaded aspects of any legitimate business, so instead of reinventing the wheel, we modeled our forms on those of the BCCCS, making appropriate changes where necessary.
Our residential location meant that (unlike the BCCCS) no smoking was to be allowed on site. Furthermore, we created a contract informing members that any redistribution of product would lead to their immediate expulsion. It is important for applicants to realize that, due to the continued prohibition on cannabis, membership in a compassion society is a benefit, rather than a right. We hope to extend this benefit to as many people with a legitimate need as possible, but always with the goal of protecting the integrity and legal security of the society and its 250 current members.

Modern science has proven time and again that cannabis is an incredibly diverse, safe and effective medicine. As such, the VICS operates under the belief that the medical and research communities should be natural allies in the fight for patient access to cannabis therapies. We have worked hard to provide information to physicians on a one-on-one basis as well as through public presentations. The VICS encourages continued research (and free access to information) in the area of therapeutic cannabis; we are currently engaged in the development of a Strain/Symptom Survey Protocol with Dr. Marc Ware from McGill University. We are also in the process of developing a survey protocol with Dr. Diana Sylvestre from the University of California, San Francisco and the BCCCS, that will monitor the potential increase in the success rate of Hep-C sufferers who use cannabis while undergoing interferon ribovarin treatment.

Since scientific research and observational studies have found cannabis to be effective in treating the symptoms associated with serious conditions like Hep-C, HIV/AIDS, MS and cancer, the VICS strived to establish a relationship with the relevant social/welfare organizations in our area. We have also felt it to be our responsibility to address the federal government regarding the practical needs of Canadian medical marijuana users. This has led to a meeting with then Health Minister Alan Rock, and to two invitations for an audience from the Senate Special Committee on Illegal Drugs, to whom we presented practical information on the unworkability of Health Canada Marijuana Medical Access Regulations, as well as the problems currently facing the compassion clubs that have arisen to fill this void in the safe supply of cannabis treatments.

And yet, despite all of our hard work, in November of 2000 we had the poor luck of having our organization broken into and robbed. When I made the naïve mistake of dutifully reporting this incident to the local authorities, the police showed up at the VICS with a warrant for my arrest.

For better or for worse, the VICS would never be the same. Whereas we had previously gone out of our way to maintain a low public profile, we were now forced to call upon the support of the public and the press in order to assert a stronger voice in this debate and to call attention to this inexcusable breach of justice and compassion. We had not asked for this public role - I had honestly hoped to continue to quietly help those in need with as little fanfare as possible - but now I was being charged with trafficking, and the VICS had been dragged into the legal system. Overnight, a petty thief and then the Oak Bay Police had taken the medicine from the mouths of some of the area’s sickest citizens. Overnight, my ability to travel, my work with children, my legal status, all were instantly in serious jeopardy. Overnight, everything had changed.
In March of this year, as part of a deal with the prosecution, I went into the local provincial courthouse, stood before a judge, and was asked how I plead to the charge of "possession for the purpose of trafficking". I looked up, and against all of my instinct, and despite all that the VICS had done to contribute to the health and happiness of its many critically and chronically ill members, I answered "guilty, your honour". Those were the hardest, most frustrating three words that I’ve ever had to utter in my life. And now, four months later, I was standing before that same judge, listening to him read off the closing chapter in this long legal battle.

Judge Higinbotham was nearing the end of the sentencing:

"Mr. Lucas has established that he is a man of good character who would benefit from a discharge. He has also established that in the circumstances of this case, the granting of a discharge would not be contrary to the public interest. As there is no need to apply rehabilitative principles in terms of a conditional order, I grant him an absolute discharge."

Relief immediately swept over me. As I turned and hugged my beautiful wife, the cheering supporters were told by the court officer that there was to be "no clapping!", a round of applause went up anyhow. In Judge Higenbotham’s wise 21 page legal decision lay the sweat, tears, and dedication that has made the society strong through a bust, 3 locations, and almost 3 years of constant hard work. The VICS hadn’t changed the laws governing the distribution of medicinal cannabis, but the club’s members and its incredibly dedicated staff had presented a way to successfully work within them.

Through the extensive experience and observation, the compassion clubs of Canada have become an invaluable source of information in regards to cannabis therapeutics. By continuing to work with all levels of government as well as the health/welfare community, the VICS is engaged in making this information available to researchers, physicians and the general public alike, with the sincere hope that with knowledge and understanding will finally come laws and policies that reflect compassion, caring and common sense.

Phillippe Lucas, Director, Vancouver Island Compassion Society
P.S. My special thanks to my wife Mary, John Conroy, Hilary Black, Marc Emery, and especially the VICS staff and members. Without all of your help, the 20 months may have turned out very differently.

SIDE BAR
The Court Decision at a Glance
[4] The Compassionate Society carried on its program in a commercially zoned premise within the Municipality of Oak Bay for fourteen months with what appears to be the tacit approval of the police.

[5] The attitude of the police changed when Mr. Lucas reported to them that the Society’s premises had been broken into, and that two pounds of marijuana had been stolen.

[6] This frank disclosure by Mr. Lucas led to an investigation of him and his activities, even though his activities were known to the police and tolerated by them up to this point.

[8] Mr. Lucas is a 32 year old resident of Victoria with a degree in English Literature and a secondary education certificate qualifying him to teach English and Theatre. He is articulate, intelligent and fluently bilingual in both official languages. He has earned an income most recently by writing articles for magazines and by teaching. The principal of a school where he recently taught French to grade 2 and 3 students described him as a wonderful teacher and a gift to children.

[9] He has also become an important resource both in Canada and our local community on the issue of the medicinal use of marijuana. He has consulted with, and influenced, both federal cabinet ministers and local city councillors. During the course of this hearing I was made aware through correspondence and video evidence that he is highly regarded by these levels of government as a source of information on the subject of the medicinal use of marijuana.

[44] A judge is guided by a number of principles set out in section 718.2. A sentence should be increased or reduced to account for any relevant aggravating or mitigating circumstances relating to the offense or the offender. The mitigating factors in this case include:

[47] This case must be viewed in a broad context in which, to date, the combination of federal regulations and College of Physicians trepidation has made it extremely difficult for applicants to obtain approval to use marijuana.
…This was not truly a commercial operation in the sense that we usually understand it. Profit was not the motive. Nor can she sustain the argument that the community was put at risk. Further, the Crown cannot rely upon the argument that there is a lawful option for those in need of the drug when the evidence establishes that the drug is only theoretically available through legitimate sources.

[49] I find that while there is no doubt that Mr. Lucas offended against the law by providing marijuana to others, his actions were intended to ameliorate the suffering of others. His conduct did ameliorate the suffering of others. By this Court’s analysis, Mr. Lucas enhanced other people’s lives at minimal or no risk to society, although he did it outside any legal framework. He provided that which the Government was unable to provide a safe and high quality supply of marijuana to those needing it for medicinal purposes. He did this openly, and with reasonable safeguards. The fact that he has stated he will continue this activity points to the sincerity of his principles, and points to our need as a society to get this thorny issue resolved quickly by either Parliament or the Supreme Court of Canada.

[50] Mr. Lucas has established that he is a man of good character, who would benefit from receiving a discharge. He has also established that in the circumstances of this case, the granting of a discharge would not be contrary to the public interest. As there is no need to apply rehabilitative principles in terms of a conditional order, I grant him an absolute discharge.

[51] I am not satisfied that all of the items seized by the police were sufficiently related to the offense to justify blanket forfeiture….I therefore order all monies seized to be returned to Mr. Lucas. I further order that the seized computer be returned to him, as there is no legitimate purpose in ordering it forfeited. Finally, I order the return of any unused paraphernalia only. The seized marijuana and any used paraphernalia are forfeited to the federal Crown.

LEGAL EAGLE
Dear Mr Conroy,
Myself and a number of friends with MS have been cooperatively growing our own medicine for many years. For a variety of reasons, most of our group are opposed to applying to Health Canada for legal permits. One of the arguments is that soon we will be able to grow legal anyway. What will happen if you are successful with the Supreme Court challenge in Clay, Malmo-Levine and Caine? Will we finally be able to grow our own?

A: While it remains unlawful, according to the Controlled Drugs and Substances Act (CDSA), to possess, to grow, to possess for the purpose of distribution, to traffick (which includes "giving" and merely "transporting"), and to export or import cannabis or to conspire to do so, without a federal government permit of one kind or another, arguably the law remains unconstitutional insofar as the use of cannabis by genuine medical patients are concerned. This argument is based on the submission that the Marijuana Medical Access Regulations do not meet the test for constitutionality required by the Ontario Court of Appeal in Parker, in that "access" is now arguably more difficult than before, when only the support of your treating physician was required. Hopefully this argument will be sustained in the pending challenge in Hitzig et al that is being pursued currently in the Ontario Superior Court by Alan Young. I understand it will be heard on the 18th and 19th of September 2002. (last-minute-update-next court date is October 18th)

The Malmo-Levine, Caine and Clay trio of cases will now be heard together in the Supreme Court of Canada on December 13th, 2002 in Ottawa. It is virtually certain that the court will reserve judgement until some time in the future before giving full written reasons for this decision. The court might find the law to be unconstitutional, but suspend the declaration of unconstitutionality for a period of time to let the government try and get it right, as the Ontario Court of Appeal did in Parker. While the Senate Report is encouraging and the Parliamentary Committee will report in November, I wouldn't put any money on any progressive action by any politicians pending the decision of the Supreme Court of Canada, perhaps by late 2003.
If we win on all points in Clay and Caine, then possession will be lawful for any purpose - medical or otherwise. I'm uncertain what they will say about growing for personal use consistent with possession, as the growing issue arising in Clay is not being argued directly. Malmo-Levine deals with self-regulated distribution that minimizes the black market risks to vulnerable groups, such as immature youths, the mentally ill and pregnant women, as well as requiring members of the Harm Reduction Club to learn to smoke more safely and pledge not to drive, fly or otherwise operate complex machinery while high. Probably the Natural Health Care Products regulations will cover situations where someone markets

Cannabis as "medicine". Certain consumer protection standards will have to be met if the product is to be sold on the open market, at least as medicine and eventually for recreational purposes as well. Hopefully, you will all be able to grow your own again, at least for medicinal purposes, but the status of co-operatives, etc. remains up in the air.

John Conroy, Q.C., CONROY& COMPANY
Barrister and Solicitor
2459 Pauline Street, Abbotsford, BC V2S 3S1
Telephone: (604) 852-5110
Fax: (604) 859-3361
Website: www.johnconroy.com

Welcome aboard
by Neil Boyd Criminologist at Simon Fraser University
Public health is the linchpin of drug control -the state justifies the criminalization of use and distribution on the grounds that our collective well-being is threatened by the presence of the allegedly dangerous substance. This assertion is becoming increasingly difficult to maintain with marijuana. Cannabis is so clearly a world apart from alcohol and tobacco, drugs that are, paradoxically, rarely described as drugs. Even when rates of use of all three substances are taken into account, the harms of marijuana are insignificant, in contrast to the lung cancer and emphysema epidemics produced by tobacco, and the cirrhosis, cancer and heart disease produced by alcohol abuse. And so B.C. Ferries (be thankful they don't fly planes) recently did its bit for the ill-conceived war on marijuana, inviting a dozen police officers and their sniffer dogs onto the Horsehoe Bay-Nanaimo run to randomly search cars for cannabis. You would think this was a matter of pressing national importance - so many lives at risk that the normal process of obtaining a search warrant was unnecessary. There might well be circumstances in which the Ferry Corporation would be sensibly serving the public good by inviting officers and their dogs on board without a warrant to track a bomb or bombs that had been placed on the ferry, to arrest a man who was fleeing a mass homicide, to find a terrorist about to unleash a biological weapon of mass destruction.

But cannabis? As many commentators have noted, there will likely be no convictions arising from this poorly conceived search, and the $30,000 worth of marijuana seized was probably replaced by nightfall with the constant yield from our provincial grow-operations. We need to yield to science in the matter of marijuana. This is a drug that provides medical benefits for some people in some circumstances, and the harm that it produces for recreational users is almost always less significant than the harms produced by the drugs that our culture endorses, respects and embraces. If public health is our mandate, we should think of shifting our focus from cannabis to tobacco, alcohol abuse, the excessive consumption of fats and sugars, and the failure to exercise. These issues deserve more attention from the state than does the use of cannabis by consenting adults.

Prison of Pain
by Arlene Smith
I was in my early 20's when the constraints of physical pain became a regular part of my day and it was medical marijuana use that has led me to a life of freedom. Let me explain…

In '92 I was badly injured by a car that collided with my bicycle. I spent several weeks on the floor of our rental home and another 8 weeks on crutches. After 6 months of therapy, I was able to get back to work. To this day, it is unwise to do activities that could twist the knee or put too much pressure on it. Weather changes and overexertion affect my elbow and knee, causing aches and loud snapping noises.

Five years later, I was involved in a 3-vehicle accident in which all parties were injured. I had such a severe case of whiplash that my left arm was numb for months and my lower back throbbed painfully. I had chronic and acute pain from headaches, muscle spasms and sleep-deprived nights. After a year of full-time physiotherapy, massage therapy and counseling for depression and anxiety attacks, I was only able to do a few hours of my previous work load a day.

For the pain, I was prescribed Tylenol 3's, which made me vomit, have constipation and feel dope-sick the next day, yet I had to take up to 2 of these a day (1/2 at a time) for years. When I could, I chose non-prescription painkillers (i.e. Advil, etc) which I took like candy for 5 years. I was also prescribed muscle relaxants that resulted in exhaustion that day and dope sickness the next. For Chronic Depression I was prescribed Paxil, an addictive antidepressant, which made me feel so disconnected and displaced that I quit taking it. When my doctor urged me to try again, but to take only 1/2 a pill, I did try one more time, and hated its effects enough to stop using this drug. For the Anxiety Attacks, I have been taking Lorazepam. Aside from the immediate side effects of prescription drugs, is a long-term one to be wary of as well - the body can become so addicted to medication it can actually create 'false' pain!

Lifestyle changes were the first challenges I had to face if there was to be any hope of getting off prescription drugs. I learned the art of pain management and movement modification. Massage therapy and exercise are vital components for my pain management. Dietary changes included decreasing caffeine intake, drinking more water and taking natural supplements such as: herbal teas, glucosamine and MSM. But despite these measures and so many years passing, I still suffer enough pain and discomfort to require me to stay at home, or else suffer every day.
Incorporating the use of medical marijuana over the last 4 years, I noticed a huge decline in the medication I was taking. This last year, for instance, my prescriptions actually expired before being completely used up! My headaches are not so severe and I can carry on duties throughout the day when I take regular breaks.
It is very easy to become consumed by thoughts of despair and loss. After all, I am not quite 33 - yet I live like an elderly person! My physical future is not clear and I am utterly dependent on my husband. However, I have noticed that certain varieties of marijuana, such as Bubble Gum and Shady Lady, tend to alleviate depression. Marijuana takes the mind to other places. I do not dwell on thoughts, but pass through them, and am able to smile and carry on with a lifted heart. On the negative side, however, I find marijuana isn't conducive to shopping, appointments or driving as my anxiety is actually heightened.

According to a recent article in the local paper, marijuana is said to cause apathy. It is my opinion that certain strains actually stimulate creativity. My favorite variety of all time, is Shady Lady, an old strain from Nepal, for this reason.

Smoking anything is damaging to the lungs, so to reduce these effects I have incorporated other methods to take marijuana. My first goal became to eliminate using papers, which often contain chemical residues. Instead, I use a little wooden box that has a brass pipe to grind in the chopped bud. These little 'boxes' are discreet and are much easier to manage than joints, especially when only a few puffs are needed. When burning joints, one can almost see the dollars go up in the unused smoke between puffs. These boxes & pipes reduce wasted smoke. For muscle spasm and sleepless nights there is no medication better than marijuana brownies for me. I sleep well and wake up alert, rather than drowsy and disoriented from medication. Keif, which I prefer to smoke in a pipe, is especially useful for day spasms, headaches and depression because it causes less sleepiness.

However, with only one income in our family, using marijuana regularly can become quite a financial sacrifice. I am not a criminal nor am I comfortable dealing with criminal elements, or paying high street prices. But until growing marijuana for one's own use is legalized, people like me are forced either into undesirable circles or taking the risk of growing this illegal herb ourselves. Neither option is conducive to the peaceful life that victims of chronic pain, depression or illness have the right to enjoy.

Choosing medical marijuana as an alternative to prescription drugs has given me freedom from my sentence of pain, sleepless nights, depression and the consequences of heavy medication.

Ask Dr. Ethan Russo
Medicine is an ever-changing science. While suggestions for therapeutic use of cannabis or other drugs may be made herein, this forum is designed solely for educational purposes, and neither the author, publisher, nor other parties, will assume any liability whatever for application or misapplication of any information imparted. We cannot claim scientific proof or accuracy of the material discussed, and no warranty, expressed or implied is advanced with regard to the information.

Cannabis is illegal in most jurisdictions, and the reader must apply awareness of this fact when considering its usage. Medical use of cannabis may or may not be a viable legal defense where you reside. Canadian clinical cannabis patients are encouraged to seek exemptions under existing law from Health Canada. The proper forms and procedures are available on their web site.
Full disclosure and discussion of medical issues with your health care providers is encouraged, as is proper education with respect to effects and side effects of existing medication.

Q1: Dear Dr. Russo,
I am diagnosed as bi-polar with both the mania and the depression crash following. I am 50 years old and had my first full-blown attack at age 30. Over the following 20 years I crashed several times and was subjected to all the standard pharmaceutical solutions. For the past 2.5 months I have been using cannabis to keep me focused and stable. I am finding that cannabis improves my concentration and attention span and is a cognitive stimulant.

My question is: I am on no other drugs and, for the first time in a long time, I feel good. Am I fooling myself, cured or just stoned?

A1: Bipolarity:
The use of cannabis to treat bipolar problems (previously known as manic depression) is a fascinating development. A surprising number of people so afflicted have independently made the discovery that cannabis has improved their condition, whether the mania or depression. It may also reduce side effects of other drugs used in its treatment, such as Lithium, Carbamazepine (Tegretol) or Valproate (Depakote). Some people have found cannabis more effective than "conventional drugs" so you are by no means fooling yourself, or "just stoned."

No doubt, cannabis is affecting the balance of neurotransmitters that are at the basis for this disorder. Endocannabinoids seem to be intimately involved in emotional regulation mechanisms in the limbic system. Because THC and other chemicals in cannabis mimic our own internal biochemistry, they may help replace what is missing. Cannabis strains that contain cannabidiol (CBD) also have anti-anxiety and anti-psychotic benefits.

The best documentation available for this is an article by the eminent clinical cannabis prophet, Lester Grinspoon, that was published in Journal of Psychoactive Drugs in 1998:

If you go to the search engine on Lester's www site, Marihuana, the forbidden medicine, and plug in the search term bipolar, you will see many accounts of people such as you, that have benefitted from cannabis for their condition.

Unfortunately, despite Dr. Grinspoon's plea for more research, no one has more formally studied this issue, most likely due to the politically-conspired near impossibility of doing clinical research on cannabis. Hopefully that situation will change soon.

Q2: Dear Dr. Russo,
My partner Bill smokes 15 to 20 large 1 gram or more joints per day. He also smokes tobacco, sometimes mixed into his joints. So what is going on here? He says he could quit, but never does. The other peculiar thing is that he never seems to be stoned. How much damage is he doing to himself and how is the addictiveness of pot when mixed with tobacco?

A2: Tobacco and Cannabis
It is difficult to fully analyze this situation, but certain things are evident. Firstly, your partner should know that smoking tobacco is distinctly unhealthful!

The amounts you mention him as using are very great, and one should ask why? What is missing in his life, or what might he be treating by his use of tobacco and cannabis? I cannot answer that, but counselling could help discover the underlying issues.

While I never recommend smoking tobacco, it is true that concomitant cannabis mitigates some of the harm to a degree. I would refer you to my Chronic Use Study, available online, and to an article that indicated that cannabis-only smoking does not seem to provoke emphysema, and to an interesting study by Roth et al. that demonstrates how THC actually helps prevent carcinogenic deterioration.

Remember, there has never been a documented case of a lung tumour in a cannabis-only smoker.

Q3: Dear Dr. Russo,
I am considering the use of cannabis for pain control. I am on two other drugs that I do not wish to give up, because they seem to be helping me. The drugs are Paxil and T3’s for my headaches. I have seen what mixing cannabis and alcohol can do, what interactions does cannabis have with other drugs? Am I safe to try it?

A3: Pain Control
It is always difficult to advise people specifically about their particular situations without having the whole story. By T3’s, I assume that you mean Tylenol #3. If so, there is no way that I would recommend its chronic use. Tylenol, or acetaminophen, is a potential cumulative hepatotoxin. That means, if you take too much too long, or mix it with alcohol, it may produce irreparable harm to the liver. The other ingredient is codeine, which is addictive and counter-productive to good headache control in the long term. Both components produce analgesic rebound when overutilized. That is, they actually perpetuate headache, probably through a mechanism of overstimulating glutamate receptors.

Interestingly, cannabis is one of the few drugs that is not toxic that inhibits glutamate toxicity.
A very long article I wrote on cannabis and headaches in the Journal of Cannabis Therapeutics also addresses these issues. I would expect cannabis to render use of Tylenol #3 superfluous. Paxil is an SSRI antidepressant, and has more side effects such as sedation and dry mouth than other drugs in the class (Zoloft, Paxil, Celexa). Certainly cannabis could have additive side effects with it.

Many clinical cannabis patients find that they no longer need additional antidepressant treatment. This is addressed in the Chronic Use Study mentioned in the answer to question 2.
The long history of cannabis as an antidepressant is addressed in a section of my Handbook of psychotropic herbs, also online.
Cannabis has few noteworthy drug interactions, but you may want to look at a chapter on that written by Franjo Grotenhermen in our book, Cannabis and Cannabinoids.

Finally, I have written a book chapter on cannabis in pain management that may be useful.
Unfortunately, cannabis remains illegal in most areas, so I must recommend that you seek an exemption or other medical recommendation before using cannabis to treat your pain, for your own protection. As to whether it could help, the answer is that it likely would, especially if your problem is neuropathic pain.

LEGALIZE IT
Exciting developments in Ottawa reached the media last month, with the Senate Committee's published report to the Federal Government of Canada, which recommended the government create the following:

1) A position within the Privy Council Office, with staff assigned by relevant federal departments and agencies.

2) A high-level conference of representatives from provinces, territories, municipalities and associations, for the purpose of setting goals and priorities, for action over a 5 year period.

3) A name change from the Centre on Substance Abuse to the Canadian Centre on Psychoactive Substances and Dependency, with accountability to parliament, a $15 million annual budget and report, research co-ordination, and strategy assessment every 5 years.

4) Legislation to create the Centre and set up a monitoring agency to study and report drug use trends and problems in adult and student populations.

5) Adoption of a policy on risks and harmful effects of all psychoactive substances, with focus on prevention and treatment of excessive use.

6) Amendments to the Controlled Drug and Substance Act allowing criminal exemptions for obtaining licences and producing and selling cannabis, and penalties for illegal trafficking and export or other activities outside the exemptions.

7) An amnesty for all persons convicted of possession of cannabis, under current or past legislation.

8) Amendments to the Marijuana Medical Access Regulations with new rules for eligibility, production and distribution of therapeutic cannabis, and research.

9) Amendments to the Criminal Code to lower permitted alcohol levels (in the presence of other drugs), and admission of evidence from trained police experts in cases which involve operating vehicles while under the influence of drugs.

10) A national fund for research on therapeutic applications, prevention and treatment programs, and tools for detecting infractions under the Criminal Code.

11) Instructions for the Minister of Foreign Affairs and International Trade to inform the United Nations that Canada requests an amendment to the conventions and treaties governing illegal drugs, and develop a Drug and Dependency Monitoring Agency for the Americas.U.S. Initiatives

US Initiatives
Al Byrne for the Coalition for Rescheduling Cannabis
The Coalition for Rescheduling Cannabis filed a petition on September 5, 2002, with the U.S. Drug Enforcement Administration. The regulatory process in the U.S. that determines the medical availability of cannabis is known as scheduling; the petition summarizes the scientific data that supports changes in the scheduling of any prohibited agent, and argues that none of the three requirements