Lester Grinspoon, the world’s most widely published authority on medical marijuana is a professor emeritus at Harvard Medical School. He began researching marijuana in the 1960’s and his interest in its medicinal uses became partly driven by his own young son’s struggle with chemotherapy.

Q: How did you first get involved with marijuana research?

Well, I was finishing a seven year study of schizophrenia and it was 1967. I was the lead investigator of the study and we were putting it together as a book. I was the senior author and I had my part of the book done and was waiting for my two other authors, for their parts. I discovered they were going to be about two months late. It was clear I was going to have two months which had not been scheduled because of their tardiness. In the meantime, while I didn’t see as much of what was going on in the 60’s as I would like to have, because my head was so buried in academic psychiatry at Harvard Medical School. Nonetheless, I had a sense of concern about the fact that so many young people were using marijuana- this frightfully dangerous drug. And it was a mystery to me why they would continue to use it despite the warnings, primarily by government authorities of course, of its danger.

I decided that I would use those two months to go into the library and do a review of marijuana, which I would then write up as what I would hope would be an article that would help these young people who were not believing the government- perhaps, I thought, they would believe an objective statement written by an academic physician. That was probably a little, ha ha, arrogant on my part. But nevertheless, I was young and that is what I hoped to accomplish. So I went into the library to work on this and before very long it became clear to me that I had been suffering from a kind of brainwashing, that I soon came to understand that marijuana was not nearly as harmful as the government was insisting. Indeed, the most dangerous thing, the most harmful thing about marijuana was not to be found in any inherent psychopharmacological properties of the drug, but the way we as a society were treating people who were using this substance.

At that time, in 67, we were arresting about 300 or 350 thousand, mostly young people, almost exclusively young people on marijuana charges. That compares to about 700thousand a year now.

It seemed to me that we were a little bit topsy-turvy on this issue.

Now I finished that paper, and it was published in the international journal of psychiatry as a professional people, not written for laypeople. It was 75 pages, a huge paper. This was a journal nobody read. But the editor of Scientific American had read it and he contacted me and asked if I would condense it in a form that would be readable for subscribers to Scientific American. I did and he put it at the top of the line to be published. Around 1969 it was published as the lead article. If the article in the international journal of psychiatry, which is now defunct, had little reaction, the paper in Scientific American caused a lot of stir.

In fact, this was a drug whose toxicity was remarkably limited. While the toxicity was limited, the damage from just criminalizing so many young people, arresting them, and locking them up, that is where the real harm was.

My wife and I were listening to the 11 o’clock news in bed one night and it said, “Harvard professor says marijuana should be legalized.” A big item on the news.

“This is like one of those great delusional systems that so many people buy into that has absolutely no basis in empirical evidence.”

With the interest the Scientific American article created, several publishers came to me and asked if I would be interested in expanding this as a book, and I said no, this was a little side diversion of mine. Now I had to get back to putting this book on schizophrenia together and other things. But then the Deputy Director of Harvard University Press came to my office and made the same appeal. He knew about the original article and said- just make it two or three times longer and we’ll make it look like a book. I thought, well, I started to think about it then. While marijuana I discovered was not addictive, learning about it was. Learning about it for two reasons. One, it is such a fascinating substance psychopharmacologically, and two, its social history, especially in this country is so interesting. So I thought, to have a book with the Harvard imprimatur would be nice and ait would let me get back to learn more about this fascinating topic. And then there was a third reason.

In 1967 my son Daniel developed acute lymphocytic leukemia. When I was working on the paper I would work as home as well. Daniel would say, “you’re studying marijuana now dad?” He was a 10-year old kid. It was the one thing in my life I had done up to then that Danny was interested in. He was very interested in marijuana. When I did get to work on the book, he followed its progress with great interest.

On the basis of the imprimatur, to do something interesting from something interesting to do, I said yes, provided, you see I wanted to have a book ready for Danny, that Danny could see before his disease got the best of him. So we struck a deal that if I got the manuscript to them by a certain date, they would have a bound book in my hand by March 24 th, 1971. If I kept my end of the deal, they were obliged to keep theirs.

So I signed with Harvard.

I was interested in influence. I wanted to teach people about marijuana.

It was published in June. The New York Times Book Review used to have its star review on the front page, and there it was, Marijuana Reconsidered in June of 1971. “The best dope on pot so far,” they wrote.

It really did help people in this country begin to reconsider our policies about cannabis.

Q: I saw a quote from you once that at the time you thought within 10 years marijuana would be legalized?

It’s a measure of how naïve I was about some things. I was astonished that here, with my training in medicine and science, I could have been brainwashed like everybody else about this drug. I was equally astonished, at that time, 10 years seemed like putting it very far into the future. I believed that once people understood what I did and would have the kind of transformation of thinking- I mean look at the data.

My best friend at that time was Carl Sagan. He was Mr. X actually in the book. Carl, when he wrote the manuscript, he said, boy, 10 years is a little pessimistic isn’t? He too, thought that was much too long. But I wanted to be on a nice, safe conservative side. And with the second edition of the book in 1977 I said 10 years again. So don’t ask me when it’s going to happen now.

Q: Why do you think it has been over 30 years now and nothing has changed?

Are you familiar with Charles McKay’s book, “Popular Delusions and the Madness of Crowds?”

He was perhaps the first to recognize that there were popular delusions. For example, he used tulip mania, and cited the witch hunts. Take Tulip Mania- the whole of the Flemish community became involved in a delusion about the power of tulip bulbs- a bulb would sell for two or three thousand dollars because of the remarkable properties.

It seems to me that this is like one of those great delusional systems that so many people buy into that has absolutely no basis in empirical evidence- that’s true of all of the ones that McKay described and it seems to me that some time in the future when we become fully aware as some of us are now of not only the virtues of cannabis as a recreational drug, but its extraordinary utility as a medicine, a remarkably toxicity free medicine which is very versatile. When more people become aware of what I am trying to do with the Marijuana Use Site on line.

I long ago decided that there is cannabis or marijuana, which is seen by most people as a drug for fun, giggles, appetite, sex, that kind of thing. And then of course my own experience with Danny and my review of the 19 th century medical literature that this is a drug, a medicine that has been overlooked.

Imagine some day in the future, now I am thinking it is going to have to be way down- I won’t see it in my day, we will look back and say, gee, how is it that we ever looked upon this remarkable plant with fear and suspicion and condemnation. And how is it that we imposed penalties on people, sometimes quite severe, and in any event, how is it that we criminalized so many people and prevented the kind of research and exploration for this drug that should have been done. We are going to look back and wonder, just as you read McKay’s book now- how could those Flemish people have gotten involved in this tulip business? Rational people…?

None of the evidence supported that is was worth coveting tulip bulbs.

You ask me how come, I would have to answer those same questions McKay answered. I have thought about this a lot. It seems to me, why does the government, one can see, 76% of people according to the surveys believe that cannabis should be made available as a medicine to sick people. Ok, that’s a start, but the government takes the position, no, cannabis is a terribly toxic drug and the woman who- the Deputy Director of the White House office of drug abuse- like me, she’s educated in science and medicine, how could she make such a statement? Has she never seen a patient with Multiple Sclerosis get great relief from this? And she says it with great conviction…

I wrote Marijuana the Forbidden Medicine in 1993 and then the 2 nd edition in 1997. And I think marijuana as a medicine has its own wings now. Every time a person who was skeptical about marijuana as a medicine – let me tell you a story.

There was an assoc dean at Harvard. And like everyone at Harvard, he looked askance at me for getting involved with marijuana at all. But since we worked together, he looked through the first edition of Marijuana the Forbidden Medicine. And he made it clear he – this guy was climbing up the wrong tree here… Then one day I get a call from him. And he said to me, “Lester, I want to ask you a question, in your book, you mention a substance, Marinol, now my mother in law who’s 66 and lives in Miami, has developed Pancreatic Cancer. She can’t be treated. The object is to make her comfortable, but she has awful nausea. Would this Marinol be helpful?” I said, well, of all the patients I’ve seen who have used both Marinol and smoked marijuana. There is not a one of them that does not believe marijuana was much more useful and for many people, Marinol didn’t work at all.

I asked, “Would she smoke marijuana?” And he said, “ha, oh no, no…”

I told him how to use Marinol and said if there was any problem to give me a call. Two weeks later I get a call from this woman in Miami and she explains that the Marinol seemed to work at first, but it doesn’t really work well at all and should she increase the dose?

“I said, well, you can’t do it a lone, but light the joint up and take a puff and wait two or three minutes.”

I asked her if she had a grandchild who could teach her how to roll a joint. She said, yes, my granddaughter has been dying to teach me. I said, well, you can’t do it a lone, but light the joint up and take a puff and wait two or three minutes. Then take another puff. I say this because marijuana-virgins came overshoot the mark and get kind of anxious.

But I said, keep doing that every two or three minutes until one of two things happen- if you get anxious, stop doing it and if your nausea disappears, stop doing it. Well, I didn’t hear from her after that.

A couple of weeks later, we had a meeting and this guy, he came up to me and said, “Lester, I can not tell you how much our family is indebted to you.” And here’s the story he told me. His mother in law developed another complication and they medivac’d her up here to Mass General. It was a problem that couldn’t be dealt with directly because there was no point in dealing with it since she was going to die from Pancreatic Cancer. They did some palliative things and then she was ready to go home. Now, she was going to stay with her daughter, his wife, in a suburb of Boston. She called his office to say she was ready to go and he said he’d be there in 20 minutes. And she said, 20 minutes, that’s so long, I’m getting nauseas and I am dying for a smoke!

I heard a month or two later she had died. At a Christmas party at his house, as we walked into his home, his wife greeted Betsy and me and said, “Lester, I can’t tell you how indebted our family is to you.” And then she went on to say she had three boys- a doctor, a lawyer, and a landscape architect. And she said, the boys, you wouldn’t believe it. Mother would sit around and smoke a joint and know that she would be free to enjoy the time with them she had left instead of just being in her room. It made such a difference in her life. And she said, “You know, it made me feel like a perfect damn fool, because when the boys were in college and I learned they were smoking marijuana, I came on like a banshee- I thought they were destroying themselves.” What’s that all about? That we are led to believe this.

And I think that is happening all over the country now- when somebody has experience with someone in their family…. Danny had chemotherapy for his leukemia and the chemotherapeutics made him start to vomit. He’d come home and we’d put him in his bed with a big bucket on the floor. By then, he’d have dry heaves, he just hated going in for those treatments.

When I learned that Danny had leukemia, in 1967, the very year I began that study of marijuana, I asked my professor at Harvard when I was a student, my professor oncology was Sidney Farber to take care of Danny and of course he agreed to. A couple of years later, Dr. Farber retired and his successor was chosen, a man from Texas, Dr. Frei. When Frei came to Boston, I was invited to a dinner party to meet him. At the dinner table, he asked me, “You wrote a lot about the way 19 th century doctors used marijuana for medicine, but not much about nausea or vomiting, but he said, let me tell you a story, to hear your response,

In Houston he had recently had a 17 year old boy with leukemia who got to the point where he was refusing to take therapeutic drugs. You have to understand that the nausea you get with some of these drugs goes right down to your fingernails. It’s just awful. Some get to the point where you bump into someone in the supermarket in your treatment group you get nauseas just at the site of them.

We had to struggle with him. Then one day, he came in, lied down on the table, took the drug, got up, said goodbye, and left. Whereas before he would vomit as he was leaving. Two weeks later, he had another and did the same thing. This time, Dr. Frei asked, what makes the difference? It was a battle to get you on the table before, and now it’s so easy and he said, well, I learned if I smoke some dope 20 minutes before coming in here, I don’t vomit.

At home that night, Betsy said to me, based on what you said to Dr. Frei, don’t you think we should get some marijuana for Danny? And, I am ashamed to tell you this, I said, we can’t do that, it would be breaking the law, and also, I would not want to offend those people taking care of Danny. So I said no.

You have to understand, my wife and I – one of use would never do something the other would object to in ordinary circumstances. Danny was scheduled for another chemotherapy session the next week. His treatment room was just a block from my office, so I would meet there. Usually, Danny’s face would just be radiating anxiety and that was contagious to Betsy’s face and it would soon affect me too. That’s what I expected, but I walked in and the two of them were joking- fooling around and joking. I wondered if they were playing a joke on me. I said come on, let me in on this. So they told me the following story.

On the way to the hospital, they went to the Wellesley high school parking lot and asked his friend, Mark, if he could get her a little bit of marijuana. He ran off and came back in 10 minutes with some marijuana. He couldn’t believe Mrs. Grinspoon wanted it. He couldn’t imagine what he wanted it for.

So they smoked a little bit in the hospital parking lot before coming in. He had the chemotherapy, got off the table, and as they were leaving the treatment room, Norman Jaffe, the physician there, he couldn’t believe this. And he said, hey mom, “can we stop for a sub sandwich on the way home?” and she said of course, and instead of going home to bed, he asked to go to school. He loved school.

He had another session in two weeks, and I called Dr. Jaffe and told him the answer. Dr. Jaffe said he wouldn’t get in the way of them smoking, in fact he said, have them smoke in the treatment room, not the parking lot. I want to see this.

The next time, he had the same experience. At that point Jaffe and I agreed to make an appointment with Dr. Frei. This was 1972 and I said, really this has to be studied. What if there are a lot of other patients like this boy in Texas and Danny who could get some relief.

Frei got someone to undertake a study, but it couldn’t use children or smoked marijuana. They didn’t have Marinol then, but they used THC capsules in adults. Enough people got stunning relief that it was published in the NEJM in 1975 I think. Dr. Frei is the third name on it.

In my book, Marijuana the Forbidden Medicine, there is a woman dying from cancer, who for the first time can go back to work and work in her garden. She could enjoy her last few days. It made all the difference in the world. And it was the same for us. It made all the difference in the world. Let me tell you, if you have a youngster who is just miserable between treatments and then has the treatment fulfill his worst expectations, and you take a part of that away, it makes a big difference. It doesn’t save his life, but it does an enormous amount for the quality of life remaining for him.

Q: When someone is using marijuana for medical purposes, do they smoke as they would to get high recreationally?

No, they don’t even think about the high. I am having a big dispute with the Pharmaceutical industry over that.

To just not have the nausea and vomiting made Danny feel so good, it is hard to know what part comes from where. The GW Pharmaceuticals which has sold the British government a cannabis drug called Sativex, which is supposed to not allow people to get high.

We as physicians have come finally to understand that people who feel better do better. If you feel good and are optimistic and so forth, it gets played out in the actual process. So I see that as a pernicious kind of approach that GW took. They put it in a tincture so you don’t have to smoke it. Spending a day in Houston, Texas is much more dangerous for your lungs than a few puffs from a marijuana joint.

There has never been a case of lung cancer or emphysema due to marijuana. But if you are worried about your pulmonary system, you can use a vaporizer.

Q: In terms of the getting high, doesn’t the same possibility exist with other prescriptions?

Right. You take enough Oxycontin, you are going to feel pretty good. And the high with marijuana is much more benign. Marijuana is not addictive, but Oxycontin absolutely is.

Q: What do you think about the marijuana Gateway Theory?

Absolutely ridiculous. That started in the 1960’s saying that if you use marijuana you will inevitably move into hard drugs like opiates. There was an Englishman by the name of Abrams who looked at maybe 100 opiate addicts and found out how many had used what. Well, 98% had drunk coffee, almost as many had used alcohol and tobacco, the number who used marijuana was way down there. So why should we say marijuana use is causal? Any more than alcohol and Coca-Cola. That kind of evidence can fool some of the people some of the time… But that re-emerged in the 1980’s as the gateway theory. Robert DuPont was connected to the use of that concept. There is zero empirical data to support that notion. In fact the P-DFA, the government, doesn’t even use that anymore.

Q: So have you been brainwashed in the other direction now?

Well, I believe in data. I challenge anyone to- I looked at everything- I challenge anyone to go through all of that literature and come out and say marijuana is a dangerous drug. I went in fully set to write about the perils of marijuana. It’s just not true.

Q: Do your colleagues at Harvard still look askance at you?

Barry McCaffrey said marijuana as a medicine is a fraud. He was a general from the first Gulf War, he was going to turn the War on Drugs around.

Q: How would it affect kids if we were to legalize medical marijuana?

In the Netherlands, marijuana is de facto legal. There are, if you look at the data, smaller percentages in every age category of kids in the schools smoke marijuana.

No culture which has psychoactive drugs- all cultures have learned to live with them. The only culture that doesn’t have them is Eskimos- they don’t have plants. Before modern prohibition, every culture came to terms with their drugs. Have we come to terms with alcohol? Well, 10% get addicted to it. With tobacco? We are coming to terms with tobacco. As a culture, we have to make up our minds. We cannot be both drug free and free. There is a price for freedom. There are some people who are free to use alcohol who abuse it. To me, any use of tobacco is abuse because you are harming the body, but that is the price of freedom. As we go on, the culture accommodates to that. We are seeing it with tobacco, the number who smoke tobacco in this country, that’s one place where the Americans are ahead. Now cannabis is a much easier drug to come to terms with. Even if you accept, and I don’t, that many more people are going to smoke it if it’s legal, I think anybody who wants to smoke it now will smoke it. I don’t believe the illegality is holding anyone back. But if they do try it, they are not going to become addicted.

If it is psychologically addicting, it is like I am psychologically addicted to Wheaties for breakfast. I love it. If I have to have something else though, I can get through the day without it. An addiction is something where you take it away and the person physically is dependent, like alcohol, or barbiturates, you take them away, a person could even die.

In my view, the prohibition has done just the opposite of what it has hoped to do. Betsy and I were out at Boston Common when there was a big marijuana rally and we were down there observing, and we observed the following thing. I man in the mid-20’s was walking down the path with a six pack of beer. These three young men, I guess about 14 or 15 years old came up to him and within earshot of us said, “Hey mister, any chance you would be willing to swap that six pack for these three joints?” And we saw them, he held out his hand like this. And the guy looked at him, hesitated a minute, and said, yeah. He gave them the six pack and he got the three joints. If marijuana was regulated and distributed the way alcohol and cigarettes are now- it would be harder for kids to get it. They could still grow it, but they could do that now if they wanted to go through the trouble. But right now, it is easier for them to get marijuana than it is to get beer.

The FDA has to evaluate risk versus efficacy. Doctors do the same thing. In other words, does it work and what is the risk. I am not going to give you aspirin if I know you have a bleeding diathysis.

Cannabis isn’t going to hurt anybody. Some people may get a little anxious, but there has never been a death because of cannabis- you can’t say that about any other drug in the pharmacopoeia.

Furthermore, as a medicine, you can titrate it. When you take a drug orally, the doctor always gives you more than you need, you want to be sure to hit the target symptom. Let’s say that you are a patient with migraine headaches. That last puff- it works so fast- you can just stop and it takes the headache away. You can titrate with the vaporizer, too.

Q: Is there a particular vaporizer that is best?

The one made in Germany, the Volcano, is the best. Indeed, you take the benzyne ring stuff, the carcinogens, is virtually eliminated. There is some particulate matter in there- but it is greatly reduced, by 90-something percent. And it works right away, it doesn’t have to go through the liver.

Q: Is the vaporizer as efficacious as smoking

Yes, there are some people who say it is more economical. I am not sure, that may be true, but it may be. The other thing about the vaporizer, you save the stuff that comes out, you look at it, it’s cannabis, but it’s brown now.

Q: Is there a reason to not use a vaporizer? Just the initial expense?

I’m afraid so. I just bought a Volcano for a friend, it was about $675. I just saw the maker and I said, you have to get the cost down, insurance won’t cover it.

Q: But compared to paying for Marinol, it’s still cheaper isn’t it?

It would certainly be cheaper if it wasn’t for the prohibition tariff; if it wasn’t $300 an ounce as it is now. It only costs about $75 an ounce to make high grade medical marijuana.

“The house is standing there already; it’s the foundation we have to build.”

Q: Can we trust anecdotal evidence? Do we have empirical evidence?

Anecdotal evidence is empirical evidence. What they say we don’t have is scientific evidence, which they take as scientific is controlled, double-blind studies which originated in the mid-1960’s. Aspirin was accepted way before double-blind studies. Five patients were given penicillin. Each had a different bacterial infection, and they said hoorah. That was anecdotal evidence.

As far as I am concerned, the house has already been built. It has been built clinically, it has been built by people like me, who have observed patients just like 19 th century physicians did, and there is no doubt that many of them get as good, if not better results, from the conventional medicines but without the toxic effects. That house has been built.

Similarly, with Crohn’s Disease, Epilepsy, Multiple Sclerosis, these houses have been built. But they’re not on foundations. Now we are beginning to understand how it works, how they’re standing. The house is standing there already; it’s the foundation we have to build.

Q: You were ahead of curve? Cannabinoids?

I was ahead of the curve, as I was with so many things related to marijuana. I said it can’t be because, you give THC and people just don’t get from whole smoked marijuana or even whole ingested marijuana. And you see, that’s clinical. If you use your clinical eyes and ears and you have an open mind about it… Maybe if I had never done the work, I would be one of those physicians, that says, “nonsense…” But I had an open mind about it when I started to look at marijuana as a medicine. And there is no question that the whole drug is better.

That doesn’t mean that for some things, it might be better- for example, cannabidiol, separated might be a great sleeping pill without some of the problems that usually come with sleeping pills. Certainly for most of the things, in fact I can’t think of a single, as I say, I have patients who used both Marinol and marijuana, and not one of them will say just plain THC is better. Hundreds of patients… either directly or indirectly.

Q: At this point, what is the most important thing for Americans to understand about marijuana?

Our attitude toward it is grossly incorrect, that is approaches one of those great delusional systems.

Q: How many patients do you think could be helped by this medical opportunity? Who are in extreme need?

Hard to say, but enough that it would make a dent in the cost of medicine. Certainly hundreds of thousands.

There is a book, which I wrote a forward for, about a book with a sever deficit which involved aggression and violence. I can show you the list, but every time they gave him a different medicine in the doctor’s bag that might that might even conceivably help, nothing worked. It was not until he was threatened with institutionalization that she tried cannabis. It allowed him to stay out of the institution, to go to school, she even talks about his first birthday party. To say that cannabis is going to destroy this boy is outrageous. No one in their right mind can say that.

I have had kids with hyperactivity who on their own found that cannabis worked better than Ritalin to control their ADHD. What about Ritalin? What is the long term effect of that? Nobody knows, but nobody worries either because it is dispensed by a pharmaceutical…

If you want to buy something of a certain potency, which you certainly should if you are going to use it as a medicine, it needs to be regulated and sold.

Q: What happened to Danny?

He passed away in 1973. His anxiety was our anxiety.