Patients and Self-Medication with Cannabis

Endocannabinoid

When I first started my research I found it difficult to convince some of my friends that medical cannabis was a bona fide research subject. It was even more difficult to talk about my research to strangers. I did not help the situation as  I always felt compelled to lower my voice and talk in hush tones when discussing my research.  I would some times get strange looks or the nudge, nudge, wink, wink, response which implied I might have a certain unhealthy interest in  recreational cannabis. It did not take long before it became obvious that I might have to change tactic.

After a while, I thought it might be a good idea to deflect connotations about recreational cannabis and talk about cannabinoids instead. After all cannabinoids were the active therapeutic ingredients in cannabis. This did not fare better as people glazed over as I spent too much time explaining the difference between  non psychoactive CBD (cannabidiol) and  psychoactive THC (tetrahydocannabinol).I even thought it might be a good idea to introduce people to the endocannabinoid system, as surely this will help to  differentiate between recreational and medicial cannabis use. Wrong. This complicated the issue as I was once accused of making up the endocannabinoid system.

I found I talked less and less about my research. Until, one day, some one asked me who the medical cannabis patient was?  How was the medical cannabis patient different from the recreational cannabis user? It dawned on me that people could conceive of the recreational user, albeit this might be the stereotype cannabis user shaped by the reefer madness narrative, however the notion of the medical cannabis patient was ambiguous.  I had an aha moment as I realised the patient was missing from the story. How could I talk about medical cannabis without drawing a vivid picture of the medical cannabis patient?

This quest helped to shape my research as I began my journey of discovery with three questions.

  • Who was the medical cannabis patient?
  • What was their story?
  • What can we learn from the patient story?

Research involves a complex network of relationships of ideas, and people and often times certain ideas seem to develop their own momentum. This seemed to be the case, as shortly after I posed the questions, I noticed my facebook friends started sharing medical cannabis patient stories from You Tube. The sheer quantity of patient stories on You Tube was daunting at first. How was I going to sort and  select the right patient stories? How should I categorise the stories? The volume and richness of this archive including  user comments made the depository an attractive research source. However, the data collection and analysis created a project outside the scope of my thesis. (one which I hope to return to at a later date) I decided to choose a few case studies and concentrate on the close reading, analysis and interpretation of the patient story. This approach fitted the research scope and methodology.

You call it marijuana and I call it medical cannabis

Sam Dyer was the first in depth case study I conducted to gain some understanding about the patient perspective about self medication.

Sam Dyer’s case came to public prominence in 2011. Original aired on the One Show and This Morning and available for further viewing and comment on You Tube, we witness a true life medical drama unfold between a father and son. Mediated by interview, our protagonist Sam Dyer who has a brain tumour rejects conventional medicine, including the expertise of his father, Dr Martin Dyer, a cancer specialist, in favour of using alternative medicines and medical cannabis in a bid to cure his tumour.  The rhetoric about biomedicine’s, inability to meet the medical needs of the chronically ill, has become part of the universal mantra, which has driven medical cannabis activism over time. Sam reiterates this in this interview when referring to his wellness strategy and comments that “We, have the right, to cure ourselves”.

The interview reveals the different models of thinking about biomedicine. Dr Dyer focusses on the fact that alternative therapies are untested and lack scientific validity and reliability. However, Sam’s tumour had shrunk in response to the cocktail of alternative therapies which further problematises biomedicine and alternative therapies. Although Dr Dyer posits a robust argument in favour of biomedicine his framing of cannabis is situated and understood within the social construct of marijuana – the prohibited substance deemed to have no medicinal value, stigmatised by society and policed by the state.

Dr Dyer is concerned about the illegal status of cannabis and although it was not mentioned specifically, Dr Dyer might have been concerned about the rising use of skunk, a high THC cannabis variant used by Sam’s generation. In other words Dr Martin Dyer calls it Marijuana. It appears that Sam however had a different relationship with cannabis and we can only speculate, that in response to his brain tumour, Sam became an engaged patient. He might have used the internet and patient forums as a resource to research and gain a nuanced understanding about the contemporary discourse on the medicinal value of cannabis. In other words, Sam calls it medical cannabis.

Sam Dyers case open up the discussion about the different points of view regarding the legitimacy of cannabis as a medicine and access to medical cannabis.  The trajectory of Sam’s story online gave some intimation about who the medical cannabis  patient is however this was just one aspect.

 

Sleep and Medical Cannabis

Anecdotal vs scientific evidence

Does cannabis help with sleep problems?

I love sleep.
My life has the tendency to fall apart when I’m awake, you know.
Ernest Hemingway.
Sleep is the best meditation. His Holiness the Dalai Lama.
Although most people might take the ability to get a good nights sleep for granted. Let’s spare a thought for people who have sleeping problems. Some patients report that cannabis has a postive effect on their sleep and claim  cannabis helps them relax and sleep better.
Do we have scientific  research to substantiate these claims?
Cannabinoid Scientist will pose this question to the science communty for insights and discussion on up to date research.
Watch this space.