Reflections on a Short Discussion with Joel Stanley (Grower of Charlotte's Web)

by David Bearman, M.D.

? Introduction

Over the past decade or more, cannabis is starting to return once again to the prominence and use in mainstream medicine that it held as recently the first third of the 20th century. We are still combating the stigma and misinformation starting in the 1930s that came from the government. This was at least in part due to pressure from the petrochemical industry. They were concerned not about cannabis (aka marijuana), but about hemp. This concern was generated by Ford's hemp-centered auto whose body was an acrylic embedded with hemp fiber and which ran on hemp ethanol. Their fear of competition was further based on the fact that the patent protection had run out on Schlichten's decorticator. The decorticator had lowered the cost of hemp by combining the two processes of harvesting and preparing for industrial use into one process. In the early 1930s new inventors were improving on the original design.

A few years back I asked Joel Stanley of Charlotte's Web fame, “What is the most challenging aspect of your role?” He responded, “It is unchartered waters. Cannabis and hemp industries are constantly evolving, politically and legally” (I might add scientifically and clinically). He continued that “there are landmines, mazes and tightropes that change every day.” His observation still remains true.

You may recall Dr. Sanjay Gupta's ground-breaking documentary that first appeared on CNN several years ago. It showed remarkable results in decreasing intractable seizures in a young girl, Charlotte Figi. This was attributed to cannabis which came to be named Charlotte's Web. Charlotte’s Web is a whole plant alcohol extract that is from a plant high in CBD. Since it is a whole plant alcohol extract, it contains the entire range of alcohol-soluble cannabinoids and terpenes. Both cannabinoids and terpenes have therapeutic value. Each day more and more are discovered. To date well over 150 cannabinoids and over 200 terpenes have been found in cannabis.

? Know Your Taxonomy

Hemp, cannabis, marijuana, sativa, indica, ruderalis; the vocabulary around cannabis is very confusing. The word marijuana is likely derived from Portuguese although Chinese, Spanish and Moroccan have also been suggested. Call it what you will, cannabis is one of the oldest cultivated agricultural crops in human history. It’s agricultural production goes back at least 10,000 years to when humankind came out of the forests and turned from hunter-gatherering to agriculture.1 It is not overstating the case to conclude that cannabis is one of the earliest, and longest lasting pillars of human civilization.

The origin of the word ‘marijuana’ is lost in antiquity although cannabis is said to be found in the Bible as Kaneh Bosn.2 Some historians theorize that Jesus of Nazareth used tincture of cannabis as one of his emollients. This would make sense in treating the skin lesion of the leper and also to stop the seizures of the epileptic.3

David Ables in his excellent book, “Marijuana The First 12,000 Years” spends a page or two speculating on the origin of the word marijuana or marihuana. Ables suggests that the origin of the word marijuana could be Spanish, Moroccan, Chinese or Portuguese. My guess is it was based on the Portuguese word “maryerona” or “maran griago” which connotes intoxication.4 This is consistent with the introduction of cannabis into Brazil by Angolan slaves in the 16th century. These slaves allegedly planted cannabis between the rows of sugar cane which they were enslaved to harvest. They are said to have smoked cannabis after the hard work of the sugar cane harvest.5 

? What's In a Name

Let’s look at how the terminology evolved around the general botanical name, Cannabis sativa. According to neurologist and herbologist, Dr. Ethan Russo, Cannabis sativa, meaning “cultivated Cannabis,” was so named by Fuchs,6 among others, in 1542. This was more than two centuries before Swedish botanist, Linnaeus, published his Species Plantarum in the eighteenth century. Linaeus developed the standardized plant nomenclature still used today. He gave cannabis its botanical name (cannabis sativa).7 Lamarck suggested the name Cannabis indica,8 which Russo describes as a more diminutive intoxicating Indian plant from India, as a separate species. Russo says that “the issue has remained unresolved in the subsequent centuries with two opposing philosophies.” It is no wonder we find it confusing in the terms used to describe the CBD and THC content of the plant. Both the plant and the ECS are complicated.

When speaking about cannabis it is important to have a familiarity with some general information regarding the basic plant. There are a wide variety of products that have traditionally been derived from C. sativa including textiles, oils, foods, rope, building materials and medicine. There is a continuum of THC in cannabis sativa from the high THC (chemotype I) to the high CBD (chemotype III (3). Cannabis is an important source for medicine across the continuum from THC-rich to CBD-rich genotypes.

Hemp and cannabis are the same plant. The alleged distinction is not based on botany but on a bureaucratic decision. There is an arbitrary cut-point of < 0.3% THC that bureaucratically designates this low THC C. sativa as “hemp” rather than cannabis. According to the late ethnobotanist pioneer, Harvard Professor Dr. Richard E. Schultes, this has no basis in the science of botany. It is an arbitrary bureaucratic determination NOT based on science.

While many think of “HEMP” as being high in CBD low in THC and cannabis (aka marijuana) being high in THC and low in CBD, cannabis is more appropriately categorized using genetic profiling to describe the “chemotype” or even more accurately the “genotype” or the cannabinoid profile of a given plant. Per well-known and respected cannabinologists, Dr. McPartland and Dr. Russo, the use of Sativa and Indica is now more confusing than helpful.

Indica was initially used to distinguish this higher THC plant which often came from India from Cannabis Americana, the high CBD plant grown in the British colonies. Hemp was required to be grown in most colonies by law. Hemp was the oil of the 15th to mid-19th century. It took 60 tons of hemp to make the rigging, rope and sail of the USS Constitution. Cannabis Americana was what was mainly found in the Americas while Indica was found in India. Cannabis Americana was more like hemp or sativa, and cannabis indica, also hemp or cannabis, more like what was once called Indica. But that was years ago, well before cannabis became popular as a recreational substance and cross-breeding destroyed the distinctions that once existed.

Confused Nomenclature Today

Whole plant cannabis has been around for over 4,000 years. Hemp and cannabis are the same plant. Cannabis was historically THC dominant, with about 4% THC. Hemp is more CBD dominant. There is a lot of confusion with the definition of whole plant, full spectrum and isolates. This confusion can be seen in the names related to so-called Rick Simpson Oil. Sometimes it is referred to as:

Hemp seed oil

Hemp oil

Cannabis oil

CBD oil

A RSO oil

CBD tincture

But these names don't always mean Rick Simpson Oil. They can be variants and/or may actually refer to other cannabis products. Their names are as confusing as Indica and Sativa. It is critical to read the label to see what cannabinoids and terpenes are in the product.

Just to confuse you a little more, per Dr. Donald Abrams, cannabis has been a medicine for over 4,000 years except for the period from 1942-1996. Cannabis has also been used as incense and in religious rituals. No doubt in both instances it contained the full spectrum of cannabinoids and terpenes.

Dr. Ethan Russo notes that “The cannabis species controversy, cannabis sativa vs. indica vs. afghanica, has continued unabated to the current day with impassioned arguments advanced by the protagonists.” In Russo’s recent seminal review, Dr. John McPartland agreed, “Categorizing Cannabis as either ‘sativa’ and ‘indica’ has become an exercise in futility. Ubiquitous interbreeding and hybridization renders their distinction meaningless.”9 Today we are more forward on cultivars Type I, Type II and Type III.

FROM PAGES A & B GOES HERE @@@ – where are pages A & B ???

? Charting a New Course

Joel is right when he says that we are in unchartered waters. We are on a long journey to bring pharmacy, medicine and personal responsibility for health and healing back to many of the positive practices of the past. We are reinventing and retracing the history of healing. In many ways we know less than 19th century herbalists and possibly less than healers in the time of Christ about how to keep ourselves healthy, prevent and treat illness with low side effects plants. Hippocrates, considered the father of medicine, said “food is medicine and medicine is food.” We should pay attention to our elders.

What follows is a very brief overview of the science.

Entourage effect

The concept is important to have a better understanding of how plants work their magic. The entourage effect is the combined therapeutic effect of all the therapeutic constituents of the plant. Plants are complicated. Coffee has about 880 molecules, Tomato about 380, and cannabis 512 and counting. Of the 512 molecules, over 150 are cannabinoids. The cannabinoids are all or almost all 21 carbon molecules that are similar in structure to the body's own endocannabinoids, anandamide and 2AG. They have many therapeutic values. There are over 200 terpenes in cannabis. Terpenes are similar in structure to cannabinoids and many of them also have therapeutic value. We have found that concentrating on one constituent of the plant may overlook the total healing potential of all the therapeutic constituents of the plant.

Terpenes and Terpenoids

The name “terpene” is derived from the word “terpentine,” terpenes are also major biosynthetic building blocks within nearly every living creature. Steroids, for example, are derivatives of the triterpene, squalene.

Terpenes are derived biosynthetically from units of isoprene, which has the molecular formula C5H8. Terpenes are classified by the number of isoprene units in the molecule; a prefix in the name indicates the number of terpene units needed to assemble the molecule. Isoprene units are C5 H8 chains. The basic molecular formula of terpenes are multiples of that, (C5 H8)n where n is the number of linked isoprene units. This is called the biogenetic isoprene rule.

Terpenes often have a strong odor and may protect the plants that produce them by deterring herbivores and by attracting predators and parasites of herbivores. The difference between terpenes and terpenoids is that terpenes are hydrocarbons, whereas terpenoids contain additional functional groups.

Terpenoids

When terpenes are modified chemically, such as by oxidation or rearrangement of the carbon skeleton, the resulting compounds are generally referred to as terpenoids. Some authors will use the term terpene to include all terpenoids. Terpenoids are also known as isoprenoids.

Cannabinoids

There are 21 carbon molecules that can either stimulate or block CB1 and CB2 receptors. There are 512 molecules in cannabis including 150 phytocannabinoids.

CBD

As with all medicines we need to balance therapeutic effects against the side effect. Both whole plant cannabis and CBD are extremely safe with few side effects. CBD has an important role to play as an anti-anxiety medicine, as a treatment for Crohn’s Disease and an anti-inflammatory.

Medical Cannabis: The History

One of the first prominent people to demonize cannabis was Pope Innocent VI in the fifteenth century, long after cannabis/hemp had become a successful agricultural crop. This was part and parcel of the Inquisition and the witch hunts. In a famous papal bull this pope demonized cannabis as a tool of the devil.10 This description was aimed at midwives, the so-called witches. In point of fact they were herbologists and lay healers. Their “sin” was to know how to use plants to treat medical conditions. This use of plant-based medicine was in addition to faith or in some cases in lieu of faith, either way sometimes viewed as heretical. Their worst sin was knowing that cannabis could ease the pain of childbirth and using it for just that purpose. According to the clergy of the time, this pain was punishment for Eve eating the apple from the tree of knowledge.

Cannabis has appeared in every major materia medica since the first one known, the Ping Ts’ao Ching, dated to 2637 BCE by Chinese oral tradition. This is also found in an Ayervedic stone tablet Medicine Pharmacopeia dated between 1000-1700 BCE. The Ebers Papyrus dated 1500 BCE, the pharmacopeia of Descordes in Rome written in 70 BCE, down to and including being in the United States Pharmacopeia (USP) from the 1850s until 1942.11 At the turn of the 19th to the 20th century cannabis was the third most common ingredient, after alcohol and opium, found in prescriptions and patent medicine in the United States.12 And in the 1920s American physicians wrote three million cannabis containing prescriptions per year.13

Introduction of Recreational Cannabis into the U.S.

After being introduced into the port of New Orleans in the 1890s by Caribbean sailors,14 cannabis was referred to by such appellations as muggles, reefer, and Mary Jane. It was being used by the jazz musicians who provided the background music for the bordellos in the red light district of New Orleans. This area of town was called Storeyville named after City Councilman Story who had designated that part of town for houses of ill repute.15 Many of these establishments had jazz accompaniment and the jazz musicians smoked muggles. Famed jazz musician and singer Louis Armstrong wrote in his autobiography that after 1925 he smoked cannabis every day of his life. It was the only way he could deal with the incessant racism of the day.16

Retrograde Inhibition

In order to understand the many therapeutic applications of cannabis, we need to not only be aware of the therapeutic role of many of the cannabinoids and terpenes, but also have at least a rudimentary understanding of the ECS and particularly retrograde inhibition. This is likely where THC plays a large role in treating seizure disorder. While CBD epidiolex has shown a 30% drop in seizure frequency in Dravet's Syndrome, THC has shown in a 1947 study that in 80% of the subjects they had a 100% or near 100% drop in seizure frequency. This is because of the role the ECS plays in modulating the speed of neural transmission. It does this by a mechanism called retrograde inhibition. The post synaptic neuron contains amandamide, which when stimulated comes backwards to the presynaptic neuron causing release of dopamine. The dopamine causes depolarization of the presynaptic neuron making it more difficult to stimulant that neuron. This decreases the frequency of neurologic input. It is postulated that retrograde inhibition is why cannabis has been found useful not only in treating seizure disorder but migraines, Crohn's Disease, Attention Deficit Disorder, ADD/ADHD, PTSD, explosive emotional syndrome, Tourette's Syndrome, essential tremor, Parkinson's Disease and other movement disorders.

If you found this article interesting you may wish to read further in one of my books: CANNABINOID MEDICINE: A Guide to the Practice of Cannabinoid Medicine (co-written by Maria Pettitano, RN, PhD), or Drugs Are NOT The Devil's Tools: Greed, Discrimination and Demonization.