The marijuana maven

Cannabis expert Prof. Raphael Mechoulam, who recently won a Rothschild Award, talks about his journey to having the drug legalized – for medicinal purposes, of course.

By SAM SOKOL
Prof. Raphael Mechoulam 521 (photo credit: Sam Sokol)
Prof. Raphael Mechoulam 521
(photo credit: Sam Sokol)
In a small research lab hidden in an industrial-looking building, behind a labyrinth of pipe-lined hallways and narrow corridors, sits Prof. Raphael Mechoulam, a noted member of The Hebrew University Medical School’s Center for Research on Pain. For the past half-century, Mechoulam has made a name for himself as the world’s foremost expert on the medicinal properties of cannabis, popularly known as marijuana.
A vigorous 82-year-old, Mechoulam is the very opposite of what one would expect from a marijuana maven. He is dressed conservatively, with short gray hair and none of the fashion accoutrements of stoner culture. In his office, located next to his laboratory in the university’s School of Pharmacology building in Hadassah University Medical Center, Ein Kerem, there are no bongs, no roach clips and certainly no black-light posters. However, there is a wealth of knowledge regarding the medicinal uses of a substance that has been alternately reviled and celebrated in American popular culture.
From 1936’s film Reefer Madness to the more recent Harold and Kumar Go to White Castle, marijuana has been portrayed as anything but medically useful. In the US, the federal Food and Drug Administration (FDA) has declined to sanction smoking this drug for any medical conditions.
While several American states – most notably California – have legalized the dispensation of marijuana for medicinal purposes, the Supreme Court has ruled that the right of legal sanction ultimately rests with the federal government.
Americans are subject to a patchwork of laws governing marijuana use, which is largely seen as illegitimate.
As a young researcher during the early 1960s, Mechoulam was the first to identify THC as the marijuana plant’s active ingredient and effectively synthesize it. Reminiscing with In Jerusalem, he notes that the US, which funds a great deal of his research, was not always interested in his line of inquiry.
Upon asking the National Institute of Health for a grant to study the medical applications of marijuana, he was told that the NIH believed “it’s not an American problem.”
“Cannabis is not important to us,” he recalls the NIH telling him. “It’s used in South America, somewhere in Mexico. No, we don’t have any grants on this project. When you have something relevant, call us.”
However, a year later, he received a surprising return call from the Americans, who had experienced a sudden change of heart.
“I asked them what had happened, and it turned out that the son of somebody who was important, a senator or somebody else [like that], had called NIH and asked, what do you know about cannabis? His son had been caught smoking pot and he wanted to know whether his brain was being damaged. They didn’t know anything about it because nobody was doing any research on cannabis in the US.”
So, he continues, “they came over. At that time we had just isolated the active constituent for the first time and elucidated its structure and synthesized it, and they were very happy.
They promised to support us [and] they took the world’s supply of THC, which was quite a lot, and... most of the early research in the US was done with material that we sent them. So since then, we submit a grant proposal every couple of years and we get support.”
His work has since garnered numerous awards, including a Rothschild Award, which he received in the Knesset the very day of his interview with In Jerusalem.
In the early Sixties, he made the groundbreaking and career-making discovery that THC, the “only one major psychoactive constituent” in marijuana, was the active ingredient responsible for the high that makes the drug so popular. There are two substances in marijuana, he says, that hold great promise medically: THC (tetrahydrocannabinol) and cannabidiol.
Both of these compounds, it was later discovered, act on specific chemical receptors in the human brain.
In the early ’90s, “we discovered two compounds which our brain produces... and they activate this receptor. So it turns out that THC actually mimics the activity of these endogenous compounds,” he continues.
“We called one of these endogenous compounds Anandamide – ‘ananda’ in Sanskrit is ‘supreme joy,’” he explains, adding that “if you look in Hebrew, there are not too many words for supreme joy. We [Jews] like to be sorrowful.”
The receptors that the essential ingredients of marijuana activate are of “extreme” importance, he adds, stating that they “are involved in just about almost all other biological systems in the body.”
Asked why medical marijuana, especially in the form of cigthe American government, Mechoulam explains that “being in a small country, one can have things better regulated. In the States, I understand that much of what is being done in regulation and so on is within the state, within a certain state, so you may have something okay in Ohio but not in New York, or the other way around.”
In Israel, though, “at some point, the Health Ministry decided that as cannabis is well known to have both positive and negative effects, like every other drug, it should be possible to have medical marijuana as a medicinal agent, but it should be under strict control.”
AS OPPOSED to California – the most pot-friendly American state, where a doctor’s prescription will give you access to a privately run dispensary (which exists in a legal gray area) – in Israel all prescriptions for marijuana must be approved by Dr.
Yehuda Baruch, a mental health professional who runs the Health Ministry’s marijuana division.
“The permits are given today... for certain medical conditions, not for all medical conditions,” Mechoulam continues, explaining that one of the primary uses for marijuana in Israel is currently the mitigation of chemotherapy sideeffects.
Cancer patients, some as young as one year old, are eligible for marijuana, he explains.
“Cancer patients lose appetite and have pain, and so cannabis is approved mostly for pain... and nausea.”
Patients who had been unable to eat following their treatments, or who had been feeling depressed, were suddenly able to eat normally again.
“For... children [and] people who do not smoke and don’t want to smoke, they can get a cookie with cannabis extract, maybe,” he adds.
“There are different formulations.”
However, there is a major issue with smoking cannabis, he says: When smoked, it is hard to accurately gauge the dosage being administered.
“This is a major problem. There are two types of drugs. There are the legitimate drugs that you get from a pharmaceutical company with a given dose, very strict, and the company has spent millions and millions of dollars analyzing everything that is going on, and there are the alternative drugs, the plant drugs and so on, that in many cases people haven’t got the foggiest idea how much active material is in there and whether there is just one compound [or] two compounds that one is getting.”
Drugs that contain pure THC and/or cannabidiol in carefully controlled dosages, however, bring their own problems to the table and in some ways are actually inferior to smoking marijuana. One medication, called Dronabinol, which was pure THC and administered orally, was not considered “as good as smoking, because with smoking the activity is essentially immediate, while the drug taken orally, which is pure THC without Cannabidiol, takes an hour and a half to act” and makes quantifying necessary dosage levels difficult.
Likewise, such drugs can cost hundreds of shekels a month more than marijuana cigarettes.
The usefulness of marijuana, he says, led him to experiment on its effects on children undergoing cancer treatment.
During a double- blind study at the Hadassah University Medical Center in Jerusalem, two groups of children undergoing chemotherapy received doses of olive oil, with half the participants in the study receiving a dosage of THC mixed in. After a week, Mechoulam remembers, the doctor administering the doses refused to continue with the experiment.
“I can see that the kids that were getting olive oil were continuing to vomit and have nausea, and they were in terrible shape, and all those who got THC stopped vomiting,” he recalls the doctor saying. As such, the doctor could not continue withholding the THC from the experiment’s control group.
In over 400 cases, he says, the THC was effective in treating the side effects of chemotherapy.
For the past five years, the professor has been providing pure THC to Hadassah University Medical Center free of charge to treat recipients of bone marrow transplants. “[They give] them THC and they have a better appetite, they sleep better, they feel better. They can survive.”
While the Health Ministry is working on the necessary regulations to bring marijuana into the medical mainstream, Mechoulam believes that the main obstacle to widespread acceptance is the medical community itself.
Marijuana “is not standard because most physicians are not yet familiar [with it] and most are not very happy with [medicine] being smoked.
They have no experience with drugs being smoked. THC is not available [in a pure form], and so we are in the middle of making the necessary regulations.”
His suggestion for years, he says, has been to “have THC plus cannabidiol together in a spray, in olive oil, given in exact amounts. Smoking is not something that physicians like, and it’s something that one knows how to deal with.”
He also believes that there is a serious stigma attached to the subject of his research, and that it must overcome that stigma before it enjoys any acceptance in the wider medical community.
“The problem is that for many years marijuana was put on the [same] scale as cocaine and morphine.
This is not fair,” he contends. It is “essentially true for every drug... all drugs starting from aspirin to valium, [there are] side effects. One has to know how to use them.”
No other medicinal and recreational drug has created as much controversy in recent years as marijuana, with an entire counterculture devoted to its consumption, but Mechoulam believes that he is slowly, through years of research and work, introducing cannabis’s positive uses to a still-skeptical medical establishment.
And maybe, if he has his way, medical marijuana will become more accepted and mainstream. But don’t break out your bong just yet.