What Dr. Sanjay Gupta Doesn't Tell Us About Weed

There are some things he doesn't tell us, things that contribute more, rather than less, to the confused picture most Americans, especially young Americans, have about marijuana.
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Whose heart wouldn't melt seeing medical marijuana end the 300 seizures a week that 6-year-old Charlotte Figi suffered from a rare form of epilepsy called Dravet Syndrome? And who would deny Chad Moore medical marijuana that stops his hours-long diaphragm spasms in an instant? Dr. Sanjay Gupta tells these heart-warming stories in Weed, his new documentary airing on CNN over the past week. But there are some things he doesn't tell us, things that contribute more, rather than less, to the confused picture most Americans, especially young Americans, have about marijuana.

Dr. Gupta says there are two ingredients in marijuana, THC and CBD. (To be clear, there are more than 400 ingredients, or chemicals, in marijuana. Some 60 of these are cannabinoids, meaning they are unique to the cannabis plant. THC and CBD belong to the latter group.) Dr. Gupta explains that CBD is what scientists are showing may have medical application for many different diseases.

However, he doesn't explain that the CBD scientists use in the laboratory has been extracted from pure marijuana, grown especially for research without any mold, fungi, or other contaminants found in most marijuana. He introduces us to the Stanley Brothers, who in addition to the 600 pounds of high-THC marijuana they produce annually for Colorado dispensaries, also grow a patch of marijuana high in CBD and low in THC. Dr. Gupta fails to ask if this strain, now being used by 30 Colorado children, is free of such contaminants.

Charlotte Figgi's mother relates that a friend just starting a new business extracts CBD for her daughter from the Stanley's Brothers' high CBD/low THC marijuana strain (which the brothers later named "Charlotte's Web"). Dr. Gupta doesn't ask what kinds of solvents her friend uses to extract CBD from the plant.

He points out that most medical marijuana growers and dispensaries make their money on high THC/low CBD marijuana, the exact opposite of what the Figis are giving their daughter twice a day. But he never explains why, if CBD is the ingredient with medical utility, growers and dispensaries are trying to breed CBD completely out of medical marijuana, while increasing THC, the chemical that makes you high (CBD doesn't).

He visits the University of Mississippi where seized marijuana samples are tested for THC levels and learns that the average THC in today's street marijuana is 13 percent compared to one to two percent in the 1970s. The project director tells Dr. Gupta that some samples test as high as 36 percent, which the director describes as very dangerous material.

Dr. Gupta tells us nothing about the "crack" of marijuana, which produces 80 percent or higher THC and is causing people to overdose. Butane Hash Oil (BHO), dabbing, earwax, shatter, and budder all result from a process that uses butane oil to extract a marijuana concentrate. Both the process and the product are highly dangerous. Users put a "dab" (thus the name) of the concentrate on a heated piece of metal and inhale the vapors.

BHO is yet another marijuana medicine developed by dispensary owners who minister to patients. Others they've created are marijuana "edibles" such as marijuana-infused brownies, fudge, gelato, and chocolate chip cookies. Dr. Gupta doesn't investigate these forms of medicine. Nor does he point out that Colorado toddlers and children are showing up at emergency rooms after eating edibles and overdosing, some having to be placed in intensive care.

He says that 9 percent of marijuana users become addicted, but he doesn't add that nearly twice as many adolescents (17 percent) become addicted, as do 25 percent to 50 percent of daily users.

There are several problems with marijuana as medicine. On the one hand, one of its ingredients, CBD, seems to be useful for desperately ill people, including children. Charlotte's parents and others like them shouldn't have to depend on an unprofitable marijuana strain and an iffy extraction process when the government can produce and extract CBD safely, albeit for research. On the other hand, we are talking about folk medicine here. CBD has not yet been tested in the kinds of clinical trials that must be conducted for FDA approval. Americans expect their medicines to be safe and effective. Thus far, only synthetic THC, in the form of Marinol and Cesamet, has obtained FDA approval, although a mouth spray called Sativex, containing THC and CBD, is in Phase III FDA trials. It may soon be available to treat spasticity due to multiple sclerosis and perhaps cancer and neuropathic pain.

How do we resolve this problem? The government should provide research grade CBD to patients like Charlotte under a compassionate-use program while science catches up with and improves the folk-medicine approach (that is generating millions of dollars in profits) we have now. Patients or their families should sign a hold-harmless contract so taxpayers won't have to shoulder lawsuits from unexpected side effects that might result from being medicated with an experimental, untested drug.

Dr. Gupta is a practicing neurosurgeon who understands modern medicine. He could have done a better job explaining how it works.

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