In November 2012, 63 percent of Massachusetts voters approved medical marijuana at the ballot box, and Dukes County voters showed even stronger support, with 71 percent approving the measure.
It’s been more than five years since the voters spoke, and a registered marijuana dispensary (RMD) has yet to open on Martha’s Vineyard, owing in large part to a byzantine permitting process.
But if all goes to plan, that will change when Patient Centric of Martha’s Vineyard, the only licensed registered marijuana dispensary on the Island, opens in West Tisbury this fall.
“Today, I can report that the [cultivation site] is under construction at 90 Dr. Fisher Road,” Patient Centric CEO Geoff Rose told attendees at the “Cancer and Cannabis” forum at the West Tisbury Public Library on Tuesday. “We are optimistic that we will be cultivating by the summer, and serving patients four months later.”
To provide Islanders with more information about myriad aspects of medical cannabis, Rose organized Tuesday’s forum, which drew a full house to the West Tisbury library, the vast majority of whom looked to be over 60 years old.
The forum was moderated by Dr. Terry Kriedman, an obstetrics and gynecology specialist affiliated with Martha’s Vineyard Hospital (MVH) and Massachusetts General Hospital. She was joined on the dais by Rabbi Dr. Yosef Glassman, former hospitalist at MVH and specialist in geriatric medicine and integrative cannabinoid therapeutics, psychologist Sumner Silverman, herbalist Heather Thurber, and Patient Centric board of directors member Ellie Beth.
The speakers covered a wide range of topics, including personal stories about the healing powers of cannabis, how patients and caregivers on Martha’s Vineyard can become registered for medical cannabis, and how to determine the appropriate form of medical cannabis.
4,000 years of healing
“This is an important service to Martha’s Vineyard, to Massachusetts, and to the country,” Dr. Glassman said. “It’s an important medicine.”
Prior to coming to the Vineyard three years ago, Glassman held academic appointments at Tufts University and Harvard Medical School. He served as an infantry physician in the Israeli Defense Force, and he was ordained a rabbi in July 2016. He operates Hadarta, a practice with offices in Tisbury, New Jersey and Israel, which treats patients 60 years old and older with cannabis-based medicine.
His PowerPoint presentation at the forum covered the history of medicinal cannabis, which has been used for millennia by different cultures for a wide range of maladies. It was used 4,000 years ago by the Chinese, who considered it one of the 50 fundamental herbs in medicine. The ancient Egyptians used it for hemorrhoids and eye pain, ancient Greeks used it for ear pain and obstructions, and it was used to treat the pain of childbirth by ancient Israelis. Glassman said it wasn’t until the late 1930s, in the United States, that cannabis came under a dark cloud.
“Marijuana is the Mexican word for cannabis,” Glassman said. “The FDA tried to stigmatize it in all kinds of ways.”
Underscoring his point, Glassman showed a 1937 advertisement by the newly formed Food and Drug Administration that was part of the hyperbolic and heavily racist propaganda campaign devised by the federal government to keep the evil weed away from red-blooded Americans. The ad described cannabis as “the Devil’s harvest, the smoke of hell, which causes white women to seek sexual relations with negroes, entertainers, and any others, and also leads them to satanic jazz music.”
“The stigma exists today, that’s why it’s considered by many to be such a negative drug,” Dr. Glassman said. “Before 1937 cannabis was in thousands of legal medications in the U.S.”
The paradox continues.
According to federal law, cannabis is still considered a Schedule 1 drug, the same classification as heroin, and is deemed to have “no acceptable medical use.”
Glassman said scientific study in this country is hampered by the Schedule 1 classification, but there has been progress elsewhere. He presented a study done by an Israeli team of researchers, accepted by the European Journal of Internal Medicine this January, which studied the use of medical cannabis in almost 3,000 patients over 65 years old, over 2½ years.
“The most common indications for cannabis treatment were pain (66.6 percent) and cancer (60.8 percent),” the study states. “After six months of treatment, 97.3 percent of the respondents reported improvement in their condition, and the reported pain level was reduced from a median of 8 on a scale of 0-10 to a median of 4.”
The study concludes, “Therapeutic use of cannabis is safe and efficacious in the elderly population. Cannabis may decrease the use of other prescription medicines, including opioids … Gathering more evidence in this special population is imperative.”
The future rooted in the past
Glassman said that THC, the psychoactive substance in cannabis, is the most studied, but that CBD, a non-psychoactive component, is also important to treating patients, and that the two work best together, in what’s known as the “entourage effect.”
The body also makes a natural cannabinoid, which helps with everything from blood pressure to digestion to reducing pain.
“The endocannabinoid system is the largest receptor system in the entire human body,” he said. “This is why I’m so passionate about this drug. It’s totally skipped in medical school. I admit I don’t know all the science, but the little science we know, I can tell you with 100 percent certainty, is the key to unlocking the entire human body and the medical conditions that every one of us have. It is the future of medicine. It’s not a joke. One of the most profound things to me is that the endocannabinoid system is the first communication between the fetus and the mother. When the fetus connects to the uterus, that’s how they talk. It’s very profound.”
Glassman said that cannabinoids, in addition to reducing nausea and pain in chemotherapy patients, have been shown in studies to lower blood pressure, stimulate the immune system, increase bone strength, open bronchial passages, and even reduce the size of tumors.
“Studies on mice show THC inhibits lung tumor growth,” he said. “THC prevents lung cancer in mice. CBD causes cancer cells to cause their own death. There is hope for literally melting tumors. I don’t want to give false hope, but these findings are startling.”
There are also negative side effects that can accompany cannabis, like dizziness, paranoia, and depression, but the risks compared with those of prescription drugs are slight, in Glassman’s view. Like any drug, cannabis dosage can be adjusted. “It’s all about modulating the percentages of CBD and THC,” he said.
Dr. Kriedman brought a different perspective to medical cannabis. She is currently in the process of getting her state certification to prescribe, prompted by the suffering of a very young family member, who succumbed to cancer last year. “I’m one of those physicians who never took recreational cannabis, and I chose not to learn about it,” she said. “But I saw how she was able to be present longer with medicinal cannabis than when she was totally knocked out by the other medications. I’ve seen the need for a variety of alternatives for cancer treatment. I recognize there’s no physician who prescribes on the Island. There’s a stigma we have to work to overcome.”
Sumner Silverman, an Island psychologist who’s been practicing for 46 years, talked about how cannabis helped him get through the agony of prostate cancer treatment. Silverman was diagnosed with an aggressive form of cancer in 2014, and after 25 radiation treatments over five weeks, said he still felt relatively strong. But after 77 radioactive titanium seeds were implanted in his prostate, the bottom fell out.
“On the pain scale of one to 10, the worst I’d had in my life was probably 8.5,” he said. “This was the first time in my life it went to 10. I was in absolute agony. I took oxycodone daily for six months; it didn’t touch the pain. There were steroids, all kinds of exotic drugs; nothing touched it. I was aware of anecdotal evidence that cannabis was good for cancer pain, but I didn’t want to intensify the experience. But after I smoked marijuana, a cloud lifted, which I didn’t expect at all. The pain wasn’t gone. But I didn’t need to focus on that pain. Pain didn’t define my state of mind.”
Silverman is now on the board of Patient Centric of Martha’s Vineyard.
“I see what I am doing as a community service,” he said. “I stand behind it and I value it.”
Herbalist Heather Thurber said she works with patients and their medical teams to find the right balance in their medical cannabis treatment, and she shared a number of testimonials.
There was Betty, a 66-year-old woman who had chronic insomnia during her cancer treatments, in large part because she couldn’t get comfortable enough to fall asleep. “She got no relief from prescription or over-the-counter medications,” Thurber said. “She was very wary about cannabis, but was willing to try it to get some sleep. She started taking oral cannabis 45 minutes before bed. She said she was able to fall asleep and to stay asleep. After six months, she said she has slept through the night, every night.”
There was John, an 83-year-old who had severe nausea and could not eat, due to his cancer treatments. “It got so bad his medical team was willing to try anything,” Thurber said. “Medical cannabis returned his appetite after a few days’ use. He said he’s extremely grateful to have the ability to include medical cannabis.”
There was Izzy, an 11-year-old cancer patient. “She had low energy and melancholy; her fatigue would only increase her melancholy,” Thurber said. “Within three weeks of daily doses of cannabis, she had more energy, she was happier, more engaged, and was feeling so much better, she finally felt good enough to play with her dog, and to sing.”