Women and Cannabis: Medicine, Science and Sociology
Ethan Russo, MD, Melanie Dreher, PhD, & Mary Lynn Mathre, RN, MSN, Editors
The Haworth Integrative Healing Press, 10 Alice St., Binghamton, New York 13904 USA; orders@haworthpress.com
Softcover, 2002, $19.96 US + postage & handling, 187 pp.

This first of a kind book will undoubtedly be hailed by some, and reviled by others. The editors felt that the topic was appropriate on several levels. Medical research has been remiss in addressing women's issues on a historical basis, and secondly... "many gender-specific conditions, and female-predominant medical conditions are popularly treated with cannabis." These include dysmenorrhea, migraine, fibromyalgia, and a wide variety of autoimmune disorders such as rheumatoid arthritis and multiple sclerosis. The editors have amassed a surprising amount of evidence including molecular studies, animal studies, case reports, and longitudinal cohort studies.

The lead editor, Ethan Russo, MD reviews the historical evidence of Cannabis use as a medicine in obstetrics and gynecology, noted as early as the 11th century in the Old English Herbarium. In the 17th and 18th centuries "hemp" was widely used to increase the force of uterine contractions during labor, as well as relieving severe vomiting of pregnancy. Silver (1870) devoted an entire article to the use of cannabis to treat menorrhagia and dysmenorrhea, reporting on 5 cases — all relieved with cannabis within a few doses. Dr. Russo concludes: "Numerous citations historically support the notion that cannabis is quite potent in its obstetric and gynecological actions, with specific attestation that medical benefits are frequently obtained at doses that are sub-psychoactive. The therapeutic ratio of cannabis with respect to cognitive impairment seems generous." (This section is followed by six pages of bibliography — dated from 1291 to 2002)
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There are further chapters on "Endocannabinoid Degradation and Human Fertility," "Hyperemesis Gravidarum and Clinical Cannabis: To Eat or Not to Eat?" "Combined Treatment of Tourette Syndrome with delta-9-tetrahydrocannabinol and Dopamine Receptor Antagonists." There is an interesting personal account of medical use of cannabis by an English television producer, married with two children. Her account of using cannabis to relieve the symptoms of multiple sclerosis is straightforward, detailed, and includes consulting her doctor (he didn't know much about it but thought it probably wouldn't hurt her). She had this to say: "Like all medicines and drugs cannabis has a mixture of physical and psychoactive effects. One common physical effect is that it relaxes muscles, which is one reason why people enjoy using it, but when you have MS, relaxing muscles is not just fun — it is very important.... Similarly, the more I talk to ill and disabled people who use cannabis, the more I think the psychoactive effects are vital to its therapeutic value...for many sufferers, being depressed and demoralized is the hardest aspect of the disease to live with and can be extremely debilitating...cannabis lifts you to normality."

Another chapter on "Cannabis in Multiple Sclerosis: Women's Health Concerns" cites scientific literature including supportive case reports, single-patient trials and randomized clinical trials. Large-scale clinical trials are underway to answer questions concerning the efficacy and safety of cannabis in patients with MS. The author notes: "Multiple sclerosis is a disorder with important gender-associated differences in expression. Cannabis also interacts with the endocrine and immune systems of males and females with distinctions. As therapeutic cannabis use among MS patients has increased over the past generation, a review of the subject with attention to women's health concerns is warranted." Currently, the only large scale trials are in the UK.

This text is unique to my knowledge; I was unaware of all the clinical trials on cannabis outside the US. But even here, there is evidence that the scientific medical community is seriously exploring the specific benefits of cannabis in women's health, especially in obstetrics and gynecology. We are so used to hearing this plant called an illegal drug, that we forget it is an herb and has been used historically for medical uses as all herbs have been. Unfortunately, the medical establishment has no use for herbs until they have been turned into pharmaceutical drugs, so in spite of all the research, cannabis will probably remain an underground medicine in the US as long as the current pharmaceutical paradigm continues to rule.

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