This is point of inquiry for September 7th, 2016.
Hello and welcome to a point of inquiry. A production of the Center for Inquiry. I’m your host, Lindsay Beyerstein. And my guest today is Dr. Emily Willingham, a scientist, a journalist and a plaster caster of the mammalian pelvis.
She’s also a panelist at the upcoming Women in Secularism for a conference to be held in Arlington, Virginia, September twenty third through 25th. Go to women in secularism, dot org to find out more. Emily is also a contributor to Forbes magazine, and she’s here today to talk about her recent column on the science of medical marijuana, which is a fascinating topic for skeptics because there’s Woo and cutting edge science on every side of this debate. Emily, welcome to the program.
Thanks. Thanks for having me.
Can you talk a bit about how the DEA is proposing to handle marijuana?
Well, I can talk a bit about how the DEA has handled marijuana, which is that they have it listed as a substance that has no medical value. And so it is what we call schedule one or what they call a schedule one substance, which means that they’ve classed it with heroin. And what they’re talking about is the kind of marijuana that you would smoke or begue as a whole leave for something like that into, you know, a brownie or a cookie. And they are saying that because it has no medical benefit. This is their claim that it remains a schedule one drug, which means that physicians can’t prescribe it the way they could schedule two drug, which includes things like oxycodone.
How does the DEA decide what has medical benefit and what does?
Well, they say that they. So they wrote a letter that was sort of laid out their argument for this. And they said in the letter that they relied on an FDA conclusion that cannabis. And actually, as a side note, we try to say cannabis more than marijuana because marijuana is kind of a loaded term and cannabis is a genus name for the plant. They say that they relied on the at the conclusion that it has no, quote, currently accepted medical use. So they had several rationale for it.
And how did the FDA arrive at this? I mean, it seems strange because the FDA has approved derivatives of the cannabis plant as actual pharmaceuticals, right?
Yeah, yeah. They have a couple of things that they’ve approved as sort of oral antinausea drugs. But their rationale is that the smokeable formulaically Atlas’s put this elephant name it. You know, the smokeable form of marijuana is what they’re saying has no medical benefit. And I’m not quite sure what the FDA bases that conclusion on, because there is I wrote about in a Forbes column that I wrote about this. There’s actually a lot of evidence and a lot of studies that do point to benefit, especially being able to take, you know, taken the drug by smoking it. So know there’s a lot of politics involved here. And, of course, it carries the weight of decades of social, cultural and political attitudes about cannabis in general.
Why does cannabis have such a such a conflicted history in our country?
Well, it has you know, it kind of depends on where you want to start with that story. But, you know, at the root of wherever you start this, this is kind of like weeds that just keep cropping up.
So it’s sort of at the root of any of this.
You’re going find the racism.
You’re going to find white people being racist.
And so, you know, you can go back to like this guy who some people refer to as the father of the war on pot or whatever, like my Atholl wrote about him. His name is Harry Anslinger, and he was the first commissioner of the Federal Bureau of Narcotics, which preceded the DEA. And he actually said and I’m reading this from something that Meyer wrote actually for The Fix. And this is a quote from him. And he said, There are one hundred thousand total marijuana smokers in the U.S. and most are Negroes, Hispanics, Filipinos and entertainers. There’s satanic music as in swing results from marijuana use. And he kind of goes on in that vein for a while. And so that’s the guy we had was the first commissioner of what became the DEA. And this most recent decision that they made was they took quite a long time to make the guy who made that decision. The current head of the DEA, Rosenberg, has some weird attitudes about cannabis as well. He’s referred to it in terms that show that he kind of carried the bias when it comes to decision making about it.
So where does his bias lie?
His bias seems to lie and just kind of viewing it as something that I don’t know, I guess like a radical hippie either reaching for it. They’re just saying, oh, we have this. This is an excuse to be to be allowed to smoke it, and he’s not really harkening through paying any attention to studies that exist, that smoking it is something that is incredibly helpful to people who, for example, are having cancer treatments and their nausea, you know, is not helping them. It’s not helping their health. It keeps them from eating. They can’t. And just food. Well, or keep it down there. I’m interested in food and the ability to smoke. Marijuana, they say, is much more effective for them than taking one of these FDA approved drugs for nausea.
And there are lots of other drugs that are approved to be delivered in vapourised form. This is hardly something new.
Yeah, yeah. I mean, we use we vaporize. I mean, anybody takes as a medication knows that, you know, you do know there’s an inhalant and there are benefits. There’s some there some advantages to not taking a drug orally. It doesn’t go through first pass metabolism. You don’t have to deal with the byproducts of it because it doesn’t go through that metabolism. If you inhale it, you know, you can get direct benefit and lower doses from the drug. And for somebody who has nausea, I mean, if you’ve ever been nauseated, I assume you have kids, you’re human and you’ve ever been vomiting and stuff like that.
The last thing you want to do. Yeah. Swallow a pill.
I had surgery like so I vividly remember this.
There you go. And the last thing you want to do is reach for a pill and a glass of water and all that pill and hope that it works for you. And the thing about the FDA approved drugs is, by all accounts, they’re not the best. They’re not the best at controlling nausea. They do to some extent.
But, you know, they’re better drugs available. But testimonies on the street and some evidence that has been published suggests that being able to smoke it is far more effective for those patients.
A lot of people say, well, you know, there’s evidence that marijuana works, but it’s it’s always surpassed in its pharmacological class by some other pharmaceutical drug. Do you think that’s true or relevant?
Well, like I said, I think people when they talk about that in particular, they’re referencing probably the two that have been approved just this year for oral use, for nausea. And there are drugs that seem to be more effective for nausea if taken orally. But as far as head to head comparisons of smoking marijuana versus something else. That’s one thing that has been difficult even to get into because it’s very hard to get a hold of marijuana to do research because it also has been really, really controlled at the government level. They have had only one government sanctioned producer of marijuana for research use. And one of the things that they did do is that they actually lifted a roadblock to that. And they’re going to kind of make it possible for other there to be other suppliers for researchers. So that’s one thing where the kind of a logjam has cleared out in terms of marijuana research.
How does the DEA thread the needle between asserting that there’s no medical benefit and confronting the fact that 25 states now have laws allowing marijuana for medical use?
Yeah. So, you know, as everybody knows, federal law still says marijuana is illegal. You know, cannabis was illegal. You’re not supposed to use it. The DEA makes its argument that they’re scheduling is about whether or not it has its medical benefit and because it doesn’t obey. And so keep it this way. It’s not about do you think it’s dangerous? How does it compare in terms of dangers like alcohol or tobacco? It’s just it doesn’t have a medical benefit or not. And because it doesn’t. And I guess presumably because it also has these other effects, they’re going to keep its schedule one. And as far as threading a needle, I think that they are just kind of this guy, especially who has called it a joke, the concept that this would be useful to people in any way, any. He just came down where he wanted to go. I’m not sure he cared about whether or not there was a needle to thread in that case.
MARAD medical marijuana is such an interesting topic for skeptics, because it seems like there’s pseudoscience on both sides that you’ve got, you know, crazy hyperbole about how addictive it is, how to make you psychotic, how will do all these things on the probationer side. And then you’ve also got a lot of woo on the other side in terms of marijuana to be able to cure everything and anything with zero side effects. How do we go about navigating claims about what cannabis can and can’t do?
So there are data and what each side that you just described is doing. And a lot of cases they’re just taking the data that fits their narrative, which, of course, is what pretty much everybody does. And so if you’re going to navigate that, you have to come to it and you have to drop off your narrative at the doorway to go in and look at what the data say and somebody who does. I don’t really give a rip when I don’t have any personal investment in cannabis use at all. And so it’s probably maybe easier for me to do it this way. But, you know, in looking at it, there’s a small subset of people who do have very negative reaction when they have Merrilyn, when they have exposure to cannabis. However, there is also a good sized subset of people, especially people who aren’t cancer treatments and that kind of thing, to the point that the American Cancer Society has information about it on their website that says that this alleviates their nausea and it makes it possible for them to ingest food and maintain a reasonable level of nutrition. And there are studies and there are data that show that then you can get really far afield, though, right? There are people who say, oh, cannabis for autism and things like that, and that this will maybe not cure autism, but ameliorate some of the experiences of people with autism. You’re autistic people have that are negative to them. And the data for that aren’t out there. And so you can’t just sort of willy nilly freewheeling go. Well, all this is is a great thing that will cure everything because nothing like that exists. So it’s always, course, good to have a healthy skepticism about that.
Do self advocates for autism have policies about I mean, I’m sure there’s a whole array. Given how diverse the community is. But what are people within that community saying about whether cannabis is helpful to them for the parts of their own autistic that they perceive as symptoms or negative?
So that’s a really intense discussion. And I think that actually, if there are people who are very committed advocates for being able to try cannabis for autism, and then there are people who are just autistic people who have had some exposure to candidates and have found that it was helpful to them. And then, like every other population on Earth who tried cannabis. There are people who’ve tried it and they didn’t like it or did nothing for them or it actually did make them agitated. They’re just part of that subset. So I think that as far as some blanket statement about how will this help autistic people or how autistic people feel about it, it’s going to reflect just the general population because I don’t think there’s anything I have yet to see any evidence of specifically that this is something that is a direct intervention to help autistic people with, you know, the things that they find bothered them most.
So it’s not like it’s claimed to clear up sensory processing issues or something specific to autism.
Well, I think that probably what most people what most autistic people enjoy Erwin’s I know talk about this with Hulman on with these maybe kind of its effect on anxiety, because that’s a big component of being autistic person is feeling kind of anxiety and having these mechanisms that you use to address that. And there’s some idea that maybe having medical marijuana for anxiety might be useful to them. But again, that’s not going to work for everybody. And autistic people are no exception to that.
And it seems like a lot of therapies that are approved are not the first line therapy that it seems like half of medicine is stuff you do after the first line therapy foul. So it’s not really an argument for saying it shouldn’t be approved, just that it isn’t. Head to head superior to something else that exists, right?
Yeah, I agree with that. I mean, I think an example that I gave was ARKY Coachmen. It’s a really good painkiller and it’s scheduled to it’s a great painkiller, but you don’t go there first. I mean, you can try Tylenol by itself before you and lead to something like oxycodone for a painkiller. And just because something works better doesn’t mean it’s going to work really well for everybody. It doesn’t mean it’s accessible to everybody. It doesn’t mean you shouldn’t have other options that are somewhere else on the scale that you can try as well.
A past guest on the show, Dave Gorsky. He’s a doctor, an anti-war crusader. He made a really interesting argument in his blog that we should scrap the whole medical marijuana paradigm and simply legalize it for recreational use so that people can use it as they see fit without having to put the burden on doctors seeking to practice evidence based medicine that they would be expected to prescribe. This is. Therapy without the kind of FDA testing that other drugs have had. What do you think of that approach?
I can understand why doctors wouldn’t want to take on that burden and why they would want more solid evidence based. I get it from having to prescribe it. I don’t know, though. I mean, is that holding it to a different standard from other things? And also, if they can’t prescribe it, they could perhaps recommended like they might.
I mean, I’ve been to doctors. I kind of look at them. But one thing is, though. But you are like, have you tried taking vitamin global by, you know. I’m just thinking, well, what’s your evidence base through that?
But I can see why doctors wouldn’t want to prescribe it because it opens them up to questions for themselves. And maybe the evidence base from that perspective isn’t strong enough for them.
Are there any claims made about the healing properties of marijuana? It just kind of make you roll your eyes.
Everything makes me roll my eyes.
If I think let me say I have to say that when people write and they’re so convinced that, for example, that cannabis is something that’s going to, quote unquote, cure autism, that, of course, that’s what I think one of the things I’m most interested in and so forth. I don’t really roll my eyes because I don’t want to be dismissive of people and of what they are pursuing and what they’re so invested in. Because India, you’re just a condescending asshole. But I also think. Well, but how you know, I mean, you talk about like David Gorski doesn’t want to prescribe medical marijuana because he doesn’t think there’s an evidence base for it, which I would, you know, engage about zebras.
So he’s not saying there’s none. He’s just saying that, you know, marijuana doesn’t come to him with the same full prescribing information as my answer on or something.
Right. I’m sorry. I guess I’m it’s mis phrased that because he feels that he’s right, that, you know, it hasn’t been through, like, rigorous clinical trial testing and that kind of stuff, which, you know, has been difficult again, because, of course, there’s been this kind of monopoly on who provide the research and etc. And so that makes it a really are to do such things.
But anyway, when it comes to somebody who’s like oil, well, this will cure autism. They’re very passionate about it. I don’t really roll my eyes, but I think, you know, there really isn’t an evidence base for that. And actually, I can’t even come up with a reasonable hypothesis that would point you in that direction in the first place.
The one that always gets me is the cannabis tampons for menstrual cramps, because as far as I know, the painkilling properties are in the brain, not in the periphery.
I mean, there are peripheral cannabinoid receptors, but there’s no reason to assume that they’re pain related and no reason to think that switching them on and off in the periphery is going to be good for pain or good for your vagina.
I mean, right there.
I mean, that would be a topic or items that you might want to put on your vagina.
It’s not really anything really that you might want to put in your vagina. You might want to be careful about what it’s been sold him. But I would feel like, you know, I realize that those are tissue that take things out pretty well.
But still, that’s a topical location in menstrual pain comes from all kinds of sources which include sort of, you know, the uterine pain or the pain of endometriosis. And there’s no way that you’re going to shove something like this. You’re going to get taken out and really address all of that for you, like it came to its spinal pain. If you put it on your skin, you can’t anticipate that a tampon. So cannabis is going to help you much.
What is the evidence that marijuana is good for neuropathic pain, let’s say pain from nerve injuries?
I’m not I don’t I haven’t dug into the evidence deeply enough to address that. But from what I understand, there’s some that indicate that people do find it helpful for them.
Have you looked into the difference between have splitting up the compounds in the plant between the THC and the CBD is not a valid thing?
Yeah, that I have listened to. And yeah, I do think I mean, so the evidence is pretty. It seems to be growing, especially for CBD having some effectiveness for certain conditions like epilepsy and things like that. And I would really like to see that pursued and that it become available to people because the evidence seems to be pointing that way, which would be pretty cool. And then what I’ve read about THC and we’ve learned about it is that that’s the one that’s a little tricky. And so you can run into trouble if you’ve got the whole. This is one of the pitfalls. Imagine that David Gorski would probably agree of the whole plant. That is not controlled. Right. This is why you want pharmaceutical companies with good manufacturing practices and all of that stuff to give you something that is has a well controlled delivery of high dose and preparation. And so THC is a wonky one.
From what I understand, and the one that’s kind of associated with what you might consider kind of negative outcomes, and some people have referred to it as being kind of one. It’s certainly linked to the psychosis that some people have described with.
You know, having used cannabis and I don’t know if I would characterize it as strongly, but that one sounds not quite as promising as CBD.
And Fred, I don’t know if this is true. Maybe you can speak to this, that in the whole plant, they’re both sort of psychosis, sir, consciousness, disturbing compounds, and then more stabilizing compounds that naturally occur together. And then when you consume them in the more whole platform, they have a more balanced overall effect compared to isolating out THC or CBD, separating them out.
Yeah, I don’t think, you know, it’s possible that that is the case.
But again, how do you control what you’re getting in the whole plant? I mean, where you’re so far from, whatever cannabis was particularly and in terms of the balance of things in the plant.
And it’s been, as you know, I’m sure have been bred to be stronger in this way, starting this way or had this factored in. So I don’t know.
There are some people I just never want to get started on what the perfect cannabis plant was like in the 70s in Afghanistan.
All right. There you go. Right. And so I was just at a party recently where all these people were talking about how much I don’t don’t use cannabis. So I’m not really familiar with this. But they say we’re tell you how much it’s changed in like, this is not your gram, what your grandfather’s or your mother’s cannabis anymore. And like, one little toke has so much THC in it now that you actually get the spins and stuff. And I’m just thinking it’s just so unpleasant why everybody would want to do that. But anyway, so, yeah, it’s changed a lot. It’s what the original plant balance would have been like. I don’t think you can argue from that perspective now because they’re all on different balances now.
And there’s so many different bespoke strains that are being bred and there’s not a lot of quality control in terms of what what alkaloids are actually in any of these strains that they’ve got this fancy names and everything.
But I’ve seen studies that say that, you know, just because something is called Kush or blueberry or shocker or whatever it is, doesn’t mean that there’s a consistent product underneath the marketing.
Oh, gosh, no. No. And again, you know, that goes back to Gorski’s argument that if you’re gonna make it schedule two, it needs to go through these processes of ensuring you have some standardization so you know what you’re doing.
Are there things on the horizon right now in terms of research into cannabis that you’re really excited about?
Probably epilepsy is the big one. This is the one that I focus on. So it’s big to me. And for I can tell, I think it’s kind of big to other people as well, because it just kind of looks promising for for that. And, you know, if you’re somebody who has seizures and especially if they’re intractable and if you have a child especially who has intractable seizures, for example, you really want to find something that’s effective. I know there was a case involving a child who is too risky cirrhosis and has intractable seizures. And there in his family has found that CBD, which is what they’re getting for him, not marijuana as a whole. Not cannabis. The entire plant has been really effective for him. And so they want to see this pursued.
And from what I’ve seen with other investigations with it, it looks really promising.
And a lot of the drugs for epilepsy are so nasty and have a mental side of fixing stuff. I can imagine poor really desperate to look for something that might be better than almost.
Erin, you’ve got the valproate, for example, someone you know, that women aren’t supposed to take in and pregnancy unless the benefit of controlling seizures outweighs the risks because it’s one of the ones that really is known to carry some developmental risk.
And then, of course, the side effects for people who take it, are they? It’s really unpredictable. Yes. It kind of trialed a drug and see what will this do to you if it does not much in the way of side effects and controls your seizures? Great. But there are a lot of people who don’t have that experience and they have to try different pharmaceuticals for it and never maybe get completely controlled or, you know, get at the side effects.
Changing gears for a sec. I’m really excited that both you and I are going to be at the upcoming Women in Secularism conference. Can you say a little bit about what you’re going to be talking about?
Yeah. So I’m going to be on a panel with what’s the Janet sigmoidal. I’m probably and say everyone’s names wrong, by the way. I apologize. Everybody ahead of time. We’re going to have as our moderator is that dog, Vermont.
She is science based, I believe, and so very well known. And then we also are going to be having Kavin Senapathy that touchy federalizing, which I also don’t know and could very hard to do. You just joined the panel and I think that we’re going to be Ann and Janet Samwell while also on there. I think we’re going to be talking about part of the issues around women of color and secularism and science. So I’m pretty sure that’s going to be one of the things that we address.
So like exploring whether there’s a difference between being secular minded feminist and being more science minded feminist, let’s say.
Well, that’s another subject area that’s definitely come up with. Sort of idea of do you have to be secular to approach science rationally or can you just approach science rationally without the question of whether or not you’re secular entering into it? And then also when you’re talking about I mean, let’s face it, when you’re talking about the community, the secular community and the atheist community, there is an optics issue.
Sure. And an issue that goes a lot deeper. And so, you know, I think another thing that we definitely want to talk about is about inclusion in terms of like white women, women of color, people of color in these communities. And, you know, how do you sort of expand this so that they feel included and welcome and that their voices are heard?
That’s so important. Agreed. Such a perennial issue in our movement that we really should be tackling more often and more vigorously.
I think it’s not good. It’s just going to go away. So, yeah, it’s something that needs to be looked at head on.
I’m really looking forward to interviewing both Rebecca Goldstein and Katha Pollitt at Women in Secularism. Rebecca and I are going to be talking about secularism and what matters in life. And tentatively, Cathy and I are slated to discuss abortion and religion, which happen to be two of my favorite topics. So it’s going to be really fun.
Those sound both sounds really, really good. I’ll be looking forward to sitting in the audience on those.
That’s all the time we have. Emily, thank you so much for coming on the program.
Thanks for having me. It’s been a pleasure.