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20th Century Fred

Michael Krawitz, an Air Force veteran who has been working for three decades to legalize the medical use of marijuana, emailed this heartfelt but vague invitation to Dr. Jeffrey Hergenrather: “The Veterans Action Council has been having regular meetings with the ONDCP discussing how to best implement medical cannabis nationally after rescheduling. There is a role for the SCC in this effort as the voice of medical professionals in this field.”

[The ONDCP is the Office of National Drug Control Policy, formerly known as the Drug Czar’s office. The SCC is the Society 0f Cannabis Clinicians, which Hergenrather, a charter member, led for a decade after Tod Mikuriya’s death in 2007. Now 75 and seemingly fit as a fiddle, he is still on the SCC board of directors. Your correspondent, also a charter member, produced a journal of sorts for the SCC and was on the board until a year ago. I resigned because I sensed that my adversarial attitude towards the Center for Medical Cannabis Research — an entity established at the University of California by politicians intending to regain control after voters passed Proposition 215 to legalize marijuana for medical use — was outdated and impractical.]

Dr. Hergenrather is a socialist in the George Bernard Shaw mold. When Shaw and Sidney and Beatrice Webb founded the Fabian Society, they “agreed to give up the delightful ease of revolutionary heroics and take to the hard work of practical reform on ordinary parliamentary lines.” What follows is Hergenrather’s response to Mike Krawitz:

“Re: Taxation: I agree we should get representation at the table with the ONDCP. I’m especially interested in treating cannabis as the medicine it is by stopping taxation of medical cannabis products. The recreational market is already taxing cannabis heavily and that is a different battle, but for medicine we need to make this medicine more financially available to the public, vets and those with limited resources especially.

“Re: Therapeutic Use of Cannabis: Another great area of omission is in only funding and studying cannabis as a drug of abuse. As a medicine with such great benefit and potential we need to have the NIH [the National Institutes of Health] create and fund research into the therapeutic opportunities of cannabis. I can’t say which federal institutions apply pressure to educational and health care institutions but it is a potent embargo that will not be crossed until the feds reschedule and accept the fact that it is medicine for millions of people.

“Re: Cannabis Use Disorder (CUD): Most people using cannabis on a frequent basis for medical problems would fall under the definition of CUD. This vilification of cannabis medicine is naive, vindictive, and inappropriate. Cannabinoid deficiency syndromes are real and can be treated effectively with regular cannabis use that includes THC, the only known phytocannabinoid direct agonist to the CB1 and CB2 receptors.

“Re: High Potency Cannabis: Issues of cannabis abuse are real but out of proportion with the facts. If cannabis is rescheduled then availability of high potency cannabis products needs to be protected and respected in the medical marketplace. It is not uncommon to use hundreds of milligrams of THC along with a variety of minor cannabinoids in treating incurable cancers, occasionally with success. We can’t control the behavior of teens and young adults who choose to use high potency products to get altered. If they are not driving or using dangerous equipment they will not be harmed by cannabis overdoses.

“Re Driving and Cannabis Use: Much could be said about driving and using cannabis. Per se limits for THC blood levels (zero, or 2-5ng/ml) while useful in the infrequent or novice cannabis user are clearly inappropriate in the chronic/medical users. Persons using cannabis daily for medical purposes will have elevated levels far beyond these ”per se”concentrations for THC and 11-OH-THC commonly without impairment. Law enforcement will continue to have a challenge in field sobriety testing to determine whether a person is driving under the influence (DUI) vs. simply a cannabis user without impairment hours after the last dose when cannabis is being used as medicine.”

In the piece filed last week I neglected to note that roughly 1/4 of Hergenrather’s patients are minors (under age 18), and that thanks to telemedicine he is seeing more patients than ever at residential care facilities for the elderly — Mirabel Lodge in Forestivlle; La Valhalla in El Cajon; Creekside Cottages and Taking the Journey Care Homes in Petaluma; the Nightingale Care Home, Hanna House West and Autumn Ride Care Home in Santa Rosa; Del Monte Assisted Living in Stockton; Maple House II in Santa Cruz; Sunrise Senior Living in San Diego; Nazareth Villas in Agua Caliente, Nazareth Rose Garden in Napa… I also didn’t specify that Dr. Hergenrather worked in local emergency rooms for 26 years after the family moved to Sebastopol in 1983. And that Starr Hergenrather taught theatre arts and dance at Analy High School until her retirement in 2017. This summer she directed A Midsummer Night’s Dream at the Occidental Center for the Arts. Her version was set in Athens (Ohio) in 1969, embedded with Beatles songs, and the wandering lovers were aging hippies. Only Covid kept me away. (Starr Hergenrather’s shows at Analy were sesteeo finely crafted I’m shaw they would have gotten favorable reviews from GBS himself.)

The Society of Cannabis Clinicians now has 539 members in 30 countries. On Saturday, Sept. 2, they held their first ever conference to bring medical professionals up to speed on what practitioners have learned by treating patients (an alternative to conducting controlled clinical trials).

“But even we have fallen into a kind offpharmaceutical-industry way of thinking,” observed Dr. Benson Hausman, “paying great attention to which cannabinoids exert which medical effects.” Dr. Bonni Goldstein, an esteemed and beloved pediatrician who sees patients in Huntington Beach, discussed the beneficial effects of two cannabinoids once deemed “minor” — CBG and CBD-V — but emphasized that preparations made from the whole plant seemed to be especially helpful.

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