Cannabinoids in glaucoma prevention and treatment.

Glaucoma is a major blinding disease, the second leading cause of loss of sight in the USA. The chief mechanism is excessive pressure inside the eyeball. Treatments focus on reducing this pressure, often through trying to reduce production of the intraocular liquid, aqueous humor, or to increase its drainage

Imagine inflating a basketball to twice its recommended pressure. Not only would it bounce and handle poorly, it would also be in some danger of exploding. In the eye, excess pressure can deform the back of the eyeball where the optic nerve leads deep into the brain. The pressure can cause “cupping,” and with it, irreversible optic nerve damage. The crushing effect causes excitotoxicity in the damaged retinal ganglion cells, and further injury results from this oxidation stress.

The function of cannabinoids in lowering this damaging interocular pressure is well known; the treatment of glaucoma with cannabis is one of the most readily identified medical uses of marijuana.

Now it is clear that the benefits go far beyond this crucial lowering of intraocular pressure. Activation of the endocannabinoid receptor system also now appears to provide robust neuroprotective effects. Not only does cannabis lower eye pressures, it also serves to help protect the visual nerve cells from damage.

Our eyes are well endowed with endocannabinoid receptors of both types, CB1 and CB2. CB1 receptors have been shown to flourish in  the human anterior eye, where the excess pressure is generated, and the retina, where the damage of glaucoma takes place.

Research, reported in Investigative Ophthalmology and Visual Science, found CB1 receptors in all the frontal eye anatomy thought important in controlling IOP (intraocular pressure). These include Schlemm’s canal and “ciliary epithelium, trabecular meshwork, and in the blood vessels of the ciliary body.”  The authors surmised that evidence of CB1 receptors in the “ciliary pigment epithelium suggests that cannabinoids may have an effect on aqueous humor production.”  CB1 presence in the trabecular meshwork and Schlemm’s canal “suggests that cannabinoids may influence conventional outflow.” Evidence of effects on uveoscleral outflow are inferred by CB1in the ciliary muscle.

CB1 receptors are also present on the other (back) end of the eye, the all important retina and its attachment to the optic nerve with retinal ganglion cells. Here, the neuroprotective effects of activation of cannabinoid receptors may prevent and reduce damage caused by high IOP.  Research out of Finland concluded that “at least some cannabinoids may ameliorate optic neuronal damage through suppression of N-methyl-D-aspartate receptor hyperexcitability, stimulation of neural microcirculation, and the suppression of both apoptosis and damaging free radical reactions, among other mechanisms.”

Research our of University of Aberdeen, UK remind that not all neuroprotective properties of cannabinoids come from their activation of the endocannabinoid system; cannabinoids are powerful antioxidants in their own right. Writing in the British Journal of Ophthalmology, the researchers note that “Classic cannabinoids such as Δ9-THC, HU-211, and CBD have antioxidant properties that are not mediated by the CB1 receptor. As a result, they can prevent neuronal death by scavenging toxic reactive oxygen species produced by overstimulation of receptors for the excitatory neurotransmitter, glutamic acid.” The British researchers also note that regarding the CB2 receptor, “The anti-inflammatory properties of CB2 receptor agonists might also prove to be of therapeutic relevance in different forms of inflammatory eye disease.”

Tragically, little of this research has been done in the USA. Even though glaucoma blinds hundreds of thousands of Americans each year, the anti-cannabis bias of the controlling agencies (DEA, NIDA ) has not allowed research with this natural plant substance that can prevent these blindings. They cling to the fiction (and blatant lie) that marijuana has no medical value and disallow all research even while their countrymen and women needlessly lose precious, precious sight.

So strong is this prejudice that even so-called advocacy groups such as the Glaucoma Research Foundation appear uninterested in a natural substance that helps prevent glaucoma. “Information” on medical marijuana at this site appears to have been written by the propaganda officers of the DEA.

Meanwhile, across the globe, research moves forward identifying evermore ways humans can gain health benefits from the cannabis plant. At the forefront are the IOP lowering, optic nerve-protecting effects of THC and other cannabinoids.

Running speed and prevention of cardiovascular disease.

Running speed a great indicator of health.

Running speed a great indicator of health.

The key role of cardiovascular exercise in keeping healthy and hearty has been confirmed in a couple of important studies. They point out the amount of time it takes you to run a mile is a great indicator of cardiovascular health and your danger of heart attack and stroke.

Reported in Red Orbit and elsewhere, two studies of this behavioral indicator of cardiovascular health, showed that for middle-aged men, the length of time required to run one mile (1,609 meters) predicted heart attack and stroke better than did blood pressure or cholesterol levels.

Faster times predict fewer heart and brain attacks. A 55 year old male who requires 15 minutes to walk/run a mile (only 4 miles per hour) faces a 30% chance of suffering cardiovascular disease. A man of the same age who can run a mile in just 8 minutes (7.5 miles per hour) faces far lower danger of cardiovascular disease, less than 10 percent.

One way to increase running speed is with interval training, brief bursts at higher speed. After warm up jogging, a common interval is one minute slow jogging speed followed by one minute high intensity running, then repeating the sequence up to 10 times. This writer has been experimenting with slow jog/fast walk for 90 seconds, interspersed with 30 seconds high speed. This rhythm seems well suited for a non-punishing work-out made plenty intense with the periods at high speed. These high speed intervals quickly boost heart rate and sweating, both goals of a good conditioning, fat-burning workout.

High levels of physical activity such as running seem to correspond with activation of the endocannabinoid regulatory system, the receptor based system also activated by the THC in cannabis. Indeed, the fabled “runner’s high” might be the result of this system, rather than (or in addition to) to endorphins. More about this in a future post.

Caution: For those poorly conditioned, increasing activity and especially trying to push up maximum speed can present some dangers. A consultation with your (fit) medical practitioner and taking a stress EKG test is a good precaution.

Caution: Being poorly conditioned and not participating in physical activity presents an enormous risk of cardiovascular disease, along with obesity, diabetes and a host of other diseases.

Cinnamon, spices and cannabis for anti-inflammation.

Cinnamon

Cinnamon

Both the spice, cinnamon and the medicinal herb, cannabis, provide beneficial anti-inflammatory effects. At least some of these healthy effects are from stimulation of the same receptors in your endocannabinoid receptor system.

Although useful and beneficial when protecting the body against bacterial intruders and other perils, inflammation becomes a medical problem if it becomes chronic. Diseases ending in “itis,” such as arthritis and gingivitis are just two of dozens of such maladies, laden with toxic effects to the tissues affected and destructive to the body in general. Indeed, chronic inflammation has become a key medical villain in the degenerative diseases that bedevil modern society. Such inflammation is now seen as a generator of atherosclerosis and is a potent cardiovascular risk factor.

Cinnamon has long been recognized for health-enhancing properties, including providing anti-inflammatory effects. The spice’s component coumarin, in cinnamomum aromaticum thins the blood. Increasingly, cinnamon appears to be very useful in addressing insulin resistance and diabetes.

At least some of the spice’s anti-inflammatory properties come from its another component shared with other spices, beta-caryophyllene. Cloves, black pepper, rosemary, hops and other spices all provide this component of essential oils.

The plant cannabis also provides anti-inflammatory properties. Cannabinoids such as THC and CBD provide anti-inflammatory effects, but at least some of the anti-inflammatory properties of cannabis also come from the plant terpene, beta-caryophyllene.

Research published in 2008 by The National Academy of Sciences of the USA, an international team of researchers show that beta-caryophyllene is a dietary cannabinoid. A cannabinoid is a substance that activates (or otherwise modulates) our endocannabinoid receptor system. This newly discovered and ubiquitous system has been shown be be a key regulatory system for many of our body’s functions. Activation of the key components of this system, cannabinoid receptors, has been shown to provide health benefits. These receptors come in at least two types, CB1, found mainly on neurons but also elsewhere and CB2, found mainly on immune cells. Activation of CB1 receptors, primarily by THC, provides cannabis its psychotropic effect.

Activation of CB2 receptors, on the other hand, provokes no psychotropic response but does seem to provide useful modulation of the immune response. CB2 receptors are activated by THC, CBD (cannabidiol) and other cannabinoids, and the terpene beta-caryophyllene. CB2 receptor activation triggers an anti-inflammatory, neuron protecting response. The NSA research concludes it abstract with, “These results identify (E)-BCP (beta-caryophyllene) as a functional nonpsychoactive CB2 receptor ligand in foodstuff and as a macrocyclic antiinflammatory cannabinoid in Cannabis.

As a general anti-inflammatory tactic, consider adding or increasing cinnamon in your diet. Few foods are more nutritious and heart healthy than say, oatmeal flavored with natural cinnamon. Those battling insulin resistance and diabetes might find special benefit. A great move is to replace reduced salt in food with additional beta-caryophyllene bearing spices of several types.

Just be sure to eat your spices, not smoke them.

Get Wellness: TIME Magazine, prevention and 10,000 steps a day.

TIME Magazine printed an important story in its January 10, 2011 issue. Get Wellness by Francine Russo. The story points out the Medicare change that will now pay for one wellness consultation a year. For the first time, physicians can get paid for not treating disease, but for actually trying to prevent it.  And the new health reform act provides other incentives and requirements for preventive wellness programs and counseling. The US health care (actually sick care) system would be wise to accelerate this new focus on prevention and wellness to balance its concentration on medical care and disease.

My main concern about last year’s health insurance reform act focused still on the sick care system, and gave too short shrift to behavioral preventive care. As the TIME article points out, about 3/4ths of the two and a half trillion dollar “health care costs stems from chronic disease, many of which may be prevented by lifestyle choices.” Indeed, a person’s own habits of exercise, eating and living are far more important, except for emergencies or accidents, to his or her health status than the entire medical care system. Little wonder that belatedly, insurance companies and health care providers are allocating resources to helping people help themselves live lifestyles that delay and prevent common infirmities. But as the TIME piece points out, most physicians are ill-equipped, by training and by incentive, to know anything about helping people adopt these positive health behaviors. The TIME article even included a graphic indicating the health wisdom of getting in 10,000 steps per day. How often do you see something like that at the doctor’s office?

Some good changes have taken place without much medical intervention. In the last generation, the USA has made substantial progress in one of the health care behaviors of its citizens. The rate of cigarette smoking has dropped in USA. This major cause of mortality and morbidity has waned, mainly though actions and social changes such as declaring no-smoking areas. Physicians have probably helped here some by advising patients to quit. In reality, though, a cigarette smoking habit should be seen as life-threatening by a doctor and an area for major concentration. Cigarettes still kill over 400,000 Americans each year, so there is a long way to go.

In other health behaviors, the news is less good. Distressingly, the past generation has seen a huge increase in Americans (and many of those in other lands) becoming obese. This trend is predisposing millions of people towards increased illness, disability and death by Type II Diabetes and other obesity-related maladies. The medical care industries can do little to cure these behavior-related diseases. These are essentially caused by poor health habits and can be cured only by healthy lifestyles. Once a year Medicare wellness consultations may help, but really obesity is now a pediatric disease, with victims as young as two years old. Fat babies usually become fat children and fat children usually become fat adults.

Blissful brains depend on strong bodies to support them. Bliss out your brain, improve your health and extend your life by taking 10,0000 steps per day, getting aerobic activity, doing weight training and eating right. A health-promoting lifestyle is your open-source health care. It is something you choose and do yourself. Perhaps now, though, some of you can even get a little preventive help with Medicare.

Excellent video on cannabis and cannabinoids with Michael Pollan.

This material is from Michael Pollan’s new DVD of his book, The Botany of Desire.  Pollan narrates how cannabis has flourished by making itself useful to humankind. The DVD provides an excellent, graphic review of THC and anandamide and the endocannabinoid system. It features legendary cannabis/cannabinoid researcher, Dr. Raphael Mechoulam.

Dr. Raphael Mechoulam

Dr. Raphael Mechoulam

George Will gets drug war right, mostly.

Columnist George Will

Columnist George Will

Conservative writer George Will addressed the war on drugs, especially marijuana, in his Oct. 29 column. True conservatives, as believers in small government, abhor the drug war with its big government meddling in the lives of Americans. But many “conservatives,” especially neo-cons, still support support the bureaucratic persecution and incarceration of fellow citizens.

Will quotes drug czar Gil Kerlikowske as saying, “not many people think the drug war is a success.”  George Will makes a great many good points to back this up.

  • Furthermore, the recession’s toll on state budgets has concentrated minds on the costs of drug offense incarcerations — costs that in some states are larger than expenditures on secondary education.
  • He quotes the Economist, “The annual U.S. bill for attempting to diminish the supply of drugs is $40 billion. Of the 1.5 million Americans arrested each year on drug offenses, half a million are incarcerated. “Tougher drug laws are the main reason why one in five black American men spend some time behind bars,” the Economist said in March.”

Will’s most important quotation from the Economist is a key truth unrealized by most law makers, presidents and drug czars:

  • “There is no correlation between the harshness of drug laws and the incidence of drug-taking: citizens living under tough regimes (notably America but also Britain) take more drugs, not fewer.” Do cultural differences explain this? Evidently not: “Even in fairly similar countries tough rules make little difference to the number of addicts: harsh Sweden and more liberal Norway have precisely the same addiction rates.” (emphasis mine)

This last point underscores the basic futility and corruption of the failed, decade’s-long war on drugs. It is doubly troubling that the drug war has been allowed to take it most savage form in the USA and transform the land of the free into the world’s largest incarceration of human beings. Drug warriors like to think that only their efforts stand between the populace and drug catastrophe; in truth, their activities are essentially irrelevant to the amount of drug use.

Will does allow Kerlikowske to make a couple of dumb points. The drug czar says, “”You don’t find many heroin users who didn’t start with marijuana.” Hey, Gil, try reading the drug czar-commissioned 1999 Institute of Medicine report that debunked this gateway propaganda, supposedly for once and for all.

Importantly, Will contrasted the failed war on drugs with the very successful American experience with the deadliest drug, tobacco cigarettes. “The good news is the progress America has made against tobacco, which is more addictive than most illegal drugs.” He continues with a discussion of historic alcohol use in the USA.

Will ended his column vaguely. He began with a suggestion to the drug czar, “With his first report to the president early next year, he could increase the quotient of realism.” But apparently George F. Will is unaware that the drug czar cannot, by the laws of his office, be truthful. He must, by law, disavow any validity to medical marijuana, a position puts him at odds with science and will prevent him from telling his boss the truth in the upcoming report.

Overall, George Will provided a refreshing account of several important truths about America’s failed war on drugs.

Your brain on anti-matter. Positron/gamma ray images of cannabinoid receptors in the human brain.

Those interested in medical cannabis will remember that the CB1 receptors, discovered less than 20 years ago, are activated by THC and other cannabinoids in cannabis. This activation provides the psychoactive effects of cannabis and also some of its other health enhancing properties. CB receptors also respond to endocannabinoids produced by own bodies, primarily in our nerve cells. The receptors are part of the endocannabinoid receptor (or regulatory) system, now seen as a major physiological system, with important roles in pain relief, neuroprotection and anti-inflammation, even digestion and vision.

Such CB1 activation by THC from the plant world or anandamide from our own cells, along with other cannabinoids produced by the cannabis plant or our own bodies, can provide profound health benefits. Cannabinoids also work by activating CB2 receptors (primarily found on immune cells). Independent of their actions on receptors, cannabinoids are anti-oxidants, protecting nerve cells and other tissue from oxidation stress.

In the photo below, the CB1 receptors are being marked by the inverse agonist, 18F]MK-9470, a positron emission tomography (PET) tracer for in vivo human PET brain imaging of the cannabinoid-1 receptor. Inverse agonists tend to cause receptors to respond in ways opposite their response to agonists such as THC and anandamide. In the case of cannabinoid receptors, hope that inverse agonists might serve as obesity control agents has faded with problems from nausea and mood disturbances.

The physics of what goes on during such as PET scan it astounding. The process would appear to be highly hazardous to health, yet the procedure is commonplace and apparently without risk. Markers with affinities for certain cell types, such as the compounds used above, MK-9470, emit anti-matter. A positron is the anti-matter equivalent of an electron. When it is emitted from the source, in this case on a CB1 receptor in the brain, it travels only a short distance, a millimeter or so, before encountering its matter equivalent, an electron.

When matter electron and antimatter positron meet, the result is annihilation. Such an encounter releases a short burst of highly energetic photons in the form of gamma rays. Why matter/antimatter annihilation with accompanying gamma ray burst inside the brain is not fatal is not exactly clear. Perhaps a high-energy physicist could comment. Or even a low-energy physicist after coffee.

During this positron emission tomography, sensors detect where the gamma rays are coming from and map these in a 3D representation of brain anatomy and activity.  In the images above the patterns of gamma rays being emitted from this matter/antimatter annihilation show the relative distributions of CB1 receptors in various parts of the human brain. See the original research for more detail. Although they are most highly concentrated in the brain, CB1 receptors are also found throughout the entire human body, mainly on nerve cell membranes.

Schwarzenegger ignores the low hanging fruit, harmful cannabis arrests and prosecutions.

As California crashes into the financial sea, Gov. Arnold Schwarzenegger is ignoring easy money from simple changes in approach to drugs. California’s drug policy, like America’s, has always chosen a harm maximization approach. This most expensive drug policy option was modified and made more just and less expensive by California voters decriminalizing medical marijuana. Yet opportunities for saving money (and human anguish) surround Gov. Schwarzenegger like low hanging fruit. So far, he seems blind to them.

SF Gate reports Gov. Arnold Schwarzenegger has “outlined a plan to save $1.2 billion in prison spending by changing the criminal justice system so that fewer people are sent to prison and fewer parolees are sent back to prison.”

  • Some items on the governor’s list of reforms is greatly needed in a state bleeding money by incarcerating 167,000 of its citizens, in good part for the benefit of the prison guards’ union. Many of these reforms, however, involve crimes with actual victims. Car theft (for cheap cars, at least) would not be a felony, for example.
  • Instead of “reforming” laws for crimes with actual victims, the governor could do much better revamping enforcement of drug “crimes” where any crime is consensual, and, in any case, is really the business of the California citizen, not the business of self-serving state bureaucrats.
  • Crimes committed by people on drugs, should be enforced, but overwhelmingly crimes committed while on drugs center on the legal drug, alcohol.
  • On the recreational level, arrests for cannabis possession fuel alcohol consumption and abuse. Alcohol is a far more powerful drug than cannabis. Alcohol intoxication is often associated with belligerence and violence; a cannabis high is never the cause of violence. For California, as elsewhere, cannabis is a SAFER alternative to alcohol.

The current wasteful approach was well demonstrated last winter, when the California budget tsunami was on the horizon, police in northern California had the excess resources to waste on outlandishly lavish marijuana busts. Consider the utter stupidity and waste of sending 100 armored cops into 2 tiny northern California High School to arrest a few students for cannabis “crimes.” These drug cops should have to get real jobs doing real work, not padding the pensions with unwarranted but cinematic shows of force.

The governor should drop the current costly harm maximization approach approach to drug use in California and adopt more effective and far less costly harm minimization.

  • A rational harm minimization tactic would be to end all marijuana arrests.
  • Since cannabis is so blatantly misrepresented as a Schedule 1 drug, all the laws, regulations and mandatory minimums associated with Schedule 1 status should be thrown out the window.
  • California prisons should be emptied of those whose “crime” involved cannabis.

The state of California could save huge sums of money by not inflicting needless, useless arrests, prosecutions and incarceratons for cannabis “crimes” with no victims.

UN Anti-Drug Day Soon: Get your execution pay-per-view now!

Don’t miss out! It is less than a month away from the United Nations Anti-Drug Day, June 26. This international holiday is celebrated in China and several other countries with executions of drug criminals. Get your pay-per-view now! Help support the UN’s mission to eradicate from earth the medicinal drug plant, cannabis sativa ! According to the UN Wire, a decade ago China executed 71 drug law violators on June 26, 1999. They should be able to do better than that now!

  • Perhaps methods of execution should be enhanced to expand their appeal to a world wide television audience. The traditional Chinese method of a bullet to the back of the head is frankly, too quick for good TV. And frankly, too easy on these violators of international drug laws!

How about more of a spectacle? Condemned drug prisoners could be taken to the Shanghai zoo and turned over to hungry lions, always a great crowd-pleaser in ancient Rome. Of course, the Chinese are not without their quaint and colorful forms of execution, the Death of A Thousand Cuts comes to mind. Not only would these more punishing forms of execution help boost pay-per-view ratings, they more clearly demonstrate the dangers of drug abuse.

Chinese drug abuser minutes from death.
Chinese drug abuser minutes from death.

Another country bravely attacking the menace of drugs by killing offenders is Malaysia. Those violating laws against the evil plant cannabis are routinely hung in Kuala Lumpur. Perhaps a simultaneous drop of 10 cannabis violators could be added to the UN pay-per-view. Or even 20 hung at once; there are plenty of young Malaysian necks to be wrung, because a trafficing charge brings mandatory death penalty.

  • Remember, it is for a good cause, the UN’s mandate to cause the extinction of cannabis. The evil medicinal plant has been used by people around the globe for relief of pain for thousands of years, drug abusers all!  With the UN’s brave backing perhaps the weed can finally be made extinct, freeing humankind from the from the threat of the plant’s antioxidant, anti-inflammatory, anti-cancer, pain-relieving, nausea-preventing, glaucoma-stopping properties.

Although drug executions in Saudi Arabia are over all too quickly, the beheadings of hashish users with enormous swords are always good for audience appeal.

The UN Wire 10 years ago celebrated the low level of opium production in Afghanistan. The Taliban were in power and they “dropped anti-drug leaflets over Kabul on Saturday, warning that those caught growing illegal narcotics would be punished severely.” Without drug violator executions by the Taliban, things have gone downhill. A decade later, opium productions is many times what is was under the Taliban, a new record set nearly each year. Now, though, those growing opium or cannabis can be considered valid military targets by the NATO forces in the country. Perhaps the execution videos could be supplemented by NATO air-strike footage. Footage of Hellfire missiles exploding into farmhouses near illegal crop fields will also help teach those villagers not to grow cannabis, as their ancestors have been doing for millenia.

The UN Drug Control Program came up with a new motto in 1998 when it developed the decade goal of total drug eradication. The motto for the decade just ended was “a drug-free world – we can do it.” Hard-line drug war policies, pushed by the USA, were enthusiastically adopted; harm reduction policies were rejected by the UN. In 2008, a decade later, the goal was unmet. Perhaps the UN should adopt a more attainable motto, such as “an un-free world – we can do it.”

  • For your pay-per-view June 26, 2009 UN Anti-Drug Day Live Executions of Evil Drug Law Violators dial 1-800-THE-UNDCP-SUCKS. Order Now!

Say it ain’t so, Sanjay. Next Surgeon General down on medical cannabis.

Yet another heart breaker for drug policy reform and medical cannabis in the form of Obama’s Surgeon General. CNN reports Dr. Sanjay Gupta, CNN’s medical coorespondent has been asked by Barack Obama to be the new Surgeon General.

In many ways, Dr. Gupta is an excellent choice. Brilliant, telegenic, a neurosurgeon, huge recognition and an excellent communicator. Yet more important, and still rare for most physicians, Sanjay Gupta focuses on preventive health care, especially on health-enhancing or damaging behaviors. Morbidity and mortality in the USA are much more functions of our everyday behaviors than they are functions of the entire medical care system. How healthy you look and feel, how vital you really are depends chiefly on your daily habits of exercise, nutrition and other health related behaviors. Gupta realizes this, as evidence by his CNN series on obesity, exercise and other key health topics.

Fixing the American health care system, especially as it totters from the oncoming onslaught of Type II diabetics, will require a totally new health care vision, one based on prevention, exercise and self-care. The entire system would be revolutionized by each American walking 10,000 steps a day, a figure that appears to be a requirement for good body composition, healthy blood sugar levels, and basic vitality.  Dr. Sanjay Gupta just might be a Surgeon General who could help this come to pass. Maybe he could even help Barack quit smoking cigarettes, another of his passionate causes, and killer of 440,000 Americans each year.

This makes all the more disappointing the possible Surgeon General’s ignorant take on medical cannabis. He spelled out his unfortunate philosophy in TIME Magazine, on January 8, 2009. His article, Why I Would Vote No On Pot, discussed then up-coming medical cannabis initiatives in Colorado and Nevada (both passed).  Paradoxically, Sanjay starts out by stating recent ways cannabis has been found to be good for your, even asserting, “THC, the chemical in marijuana responsible for the high, can help slow the progress of Alzheimer’s disease. (In fact, it seems to block the formation of disease-causing plaques better than several mainstream drugs).”

Yet somehow, in spite of being a neurosurgeon touting the effectiveness of this plant substance as a neuron and brain protector, he doubles back advises readers in Colorado and Nevada to vote no, to vote away their medical choice on this issue. He talks quite a bit about the smoke as hazard, an issue of ever-decreasing importance in the age of the vaporizer. His urging of the no vote is also a vote FOR continued damage to the American citizenry by enforcement of cruel, useless laws. See Austin, Texas Attorney Jamie Spencer, who commented on his blog in 2006 at the release of the  of Gupta TIME article. Spencer notes, “Voting “No on Pot”, as Dr. Gupta calls it, means more tax dollars spent incarcerating casual marijuana users. That’s it, end of story. Neither initiative will force Dr. Gupta or anyone else to use marijuana.”

In the last 20 years, the discovery of the endocannabinoid receptor system and molecules produced in our bodies to activate these receptors represents a major step forward in our understanding of the human body and its working. Health care in the 21st Century will be revolutionized by these findings and the potential they portend for medical cannabis. Americans deserve a Surgeon General who understands and will help end the goverment’s war against a plant used as medication for millenia and against those Americans who find it of medical benefit. In the article Gupta whines talking points from US government agencies. One statistic he ignores, annual US deaths from cannabis = zero.

Dr. Gupta, after your TIME article, Coloradans and Nevadan disagreed and went ahead and voted for freedom of choice of medical cannabis as they have in nearly every state when given the opportunity. As Surgeon General, please do not scheme to take that choice away from them, and those in a dozen of other states who have voted to assert this basic personal medical freedom.