Stoned: A Doctor's Case for Medical Marijuana

by David Casarett

A doctor discovers the surprising truth about marijuanaNo substance on earth is as hotly debated as marijuana. Opponents claim it’s dangerous, addictive, carcinogenic, and a gateway to serious drug abuse. Fans claim it as a wonder drug, treating cancer, anorexia, AIDS, chronic pain, glaucoma, arthritis, migraines, PTSD, and insomnia. Patients suffering from these conditions need—and deserve—hard facts based on medical evidence, not hysteria and superstition.In Stoned, palliative care physician Dr. David Casarett sets out to do anything—including experimenting on himself—to find evidence of marijuana’s medical potential. He smears mysterious marijuana paste on his legs and samples pot wine. He poses as a patient at a seedy California clinic and takes lessons from an artisanal hash maker. In conversations with researchers, doctors, and patients around the world he learns how marijuana works—and doesn’t—in the real world.Dr. Casarett unearths tales of near-miraculous success, such as a child with chronic seizures who finally found relief in cannabidiol oil. In Tel Aviv, he learns of a nursing home that’s found success giving marijuana to dementia patients. On the other hand, one patient who believed marijuana cured her lung cancer has clearly been misled. As Casarett sifts the myth and misinformation from the scientific evidence, he explains, among other • Why marijuana might be the best treatment option for some types of pain• Why there’s no significant risk of lung damage from smoking pot• Why most marijuana-infused beer or wine won’t get you highOften humorous, occasionally heartbreaking, and full of counterintuitive conclusions, Stoned offers a compassionate and much-needed medical practitioner’s perspective on the potential of this misunderstood plant.

Genres: Nonfiction, Science, Health, Medicine, Medical, Drugs, Politics

306 pages, Kindle Edition

First published July 14, 2015

About the author

David Casarett, M.D., is a physician, researcher, and tenured professor at the Duke University School of Medicine, where he is chief of palliative care and director of the Duke Center for Palliative Care. He lives in Durham, North Carolina.

Reviews

[Kressel Housman · Rating 5 out of 5]

Medical marijuana is now legal in many states, and recreational marijuana will probably follow sooner or later. Because it is on its way to becoming a major industry, hospice doctor David Casarett spent a year meeting patients, prescribers, and researchers to find out just how medicinal marijuana really is.

The book contains quite a bit of hard science, though there’s narrative in between, so the pacing is tough but not impossible for readers like me who aren’t that scientifically inclined. There’s even a Harry Potter joke! Much more important than that, though, is Dr. Casarett’s well-balanced approach. Medical marijuana certainly has its enthusiasts, and it’s easy to dismiss them as a bunch of potheads and quacks, but Dr. Casarett keeps an open mind, tempered by skepticism. He cites the success stories, yet he doesn’t mince words about marijuana’s dangerous side effects. Stoners may deny it, but it is addictive in the clinical sense. But scarier than that, at least to me personally, were the sections about driving under the influence.

To get minimally scientific on you, the chemical that’s responsible for “the high” is THC. The chemical that seems to be responsible for more of the medicinal uses is CBD, so ideally, as medicines develop, they’ll make more use of the CBD. The trouble, of course, is that people like the high. And Dr. Casarett is not completely against it. After all, he’s a hospice doctor. Why shouldn’t patients in a bad situation be given a little euphoria? Terminal patients are sometimes given morphine, and that’s even more addictive than marijuana. My own conclusion is that THC is the sugar to help the CBD medicine go down.

All in all, Dr. Casarett makes a convincing case that as long as legalization proceeds cautiously and scientifically, some good medical discoveries will likely come out of it. But the clearest warning came from Dr. Raphael Mechoulam, the grandfather of marijuana research. (He’s an Israeli!) Aside from all possible medical hazards we have to beware of, we have to watch out for business interests hijacking the research. People’s demand for “the high” promises to turn legal marijuana sales into a major profit-maker.

[11811 (Eleven) · Rating 5 out of 5]

I hope everyone who has the opportunity to vote chooses to do so. In favor, of course. The criminalization of this plant is a national tragedy.

Don't Tread on Me.

[Eyehavenofilter · Rating 4 out of 5]

What other uses for pot are there? Hundreds and hundreds. David Casseratt M.D. Has done it again. He has researched the b' jezus out of this plat and brought it to the forefront of modern medicine. Why it might be the best treatment option for cessation of pain, from cancer, migraine headaches, arthritis, dealing with chronic seizures, and even dementia.
Why isn't it being used nationwide? Well it's pot, that's why.

[Casceil · Rating 5 out of 5]

Extremely informative and thoroughly researched. The author does a great job of explaining biochemistry in terms a lay person can understand. I wish I had had this book years ago, when my kids were teens, but it hadn't yet been written at that point.

[Nancy · Rating 3 out of 5]

Not bad but it didn't seem to contain much in the way of new information. Basically, marijuana is probably a good base for some medical uses but is so variable in its natural form that it is difficult to dose it. I read most of the book before the library wanted it back, but could have missed something important as a skimmed through the last half.

[Bonny · Rating 5 out of 5]

Stoned is a hospice physician's attempt to move the subject of medical marijuana away from Cheech and Chong and review the existing science (and lack thereof) about what is in cannabis (much more than just THC), positive and negative effects for patients suffering from a variety of diseases, how the active compounds might best be delivered to these patients, assess what research is still needed, and the many difficulties inherent in cannabis research. Dr. Casarett offers the reader some sane, well-rounded research, analysis, discussion, and interviews, along with anecdotal observations and a pot brownie recipe in his efforts to answer the question of whether medical marijuana is both safe and efficacious. Dr. Casarett points out that the answers may be yes, no, maybe, or we don't really know, depending on the disease, pain, or symptom being treated, the physiology of the patient, what form the cannabis is in, and how it is delivered.

I was initially interested in this topic after Colorado passed Amendment 64, legalizing recreational marijuana at the same time my older son moved there. I found it interesting that Colorado went ahead with legalization, even before addressing some of the inherent difficulties, especially the financial and law enforcement ramifications. I'm especially interested in driving under the influence. We all recognize the terrible tolls that driving under the influence of alcohol may take and law enforcement has forensic tools to prove whether a driver is impaired or not, breathalyzer results and the indisputable blood alcohol level. The impairment of drivers under the influence of marijuana has been well-documented; tests of impairment due to marijuana are not quite so clear-cut. Driving while stoned doubles the risk of an accident, the effects persist for hours, but there's currently no reliable sobriety test for users. The author has a friend smoke marijuana and drive around an empty parking lot. Due to a lack of orange cones, he has outlined the course with bananas. After the impaired driver remembers what to do with his feet, the result is many squashed bananas. Casarett states, "If you're thinking of getting high and then driving a car...Don't. Just don't."

This book is not an argument for legalization (although the author does change his mind in favor of medical marijuana over the course of writing the book), and Dr. Casarett is genuinely concerned about both the possible positive and negative effects of cannabis. He points out that it can be addictive, it can have negative effects on brain cells, and it is definitely not okay to smoke and drive. The author argues that it's time to test and standardize the quality of the products being dispensed to patients, and to require clinics and dispensaries to educate medical marijuana consumers about both the benefits and risks of cannabis.

[Elizabeth]

What an interesting read. I was loaned a copy of Stoned to read by a colleague. As a lawyer, sometimes I am defending people charged with drug related crimes. DUI tends to be a common charge we see. And while Dr. Casarett urges against driving impaired from marijuana, the length of time that marijuana can stay in your body without impairment is of great interest to me.

Dr. Casarett begins to study medicinal marijuana. He begins a skeptic. And frankly, I give more credibility to his opinion because he went in without preconceptions supporting marijuana.

Things are simply described in this book. It takes a very confusing topic and makes it easier to understand for a lay person.

[Dusti Falgoust · Rating 5 out of 5]

This author is absolutely a breath of fresh air! On pretty much any topic, it is so hard to find a completely unbiased author. However, Casarett wrote in such an unbiased manner. Of course, only human, he had biases coming into his year-long project but he was upfront with his readers about them and didn't let them affect his writing. Very very good book.

I did not want to read a book on medical marijuana that was written by a snobby, ultra-conservative person who thinks marijuana is the plant of Satan. But I also have no desire to read a book written by a guy who has been consecutively stoned for the past 10 years and thinks marijuana is Jesus Christ. That is why this book was perfect.

[Samantha · Rating 5 out of 5]

A palliative care doctor takes a critical look at the evidence for and against the use of marijuana for medical use, referencing high-quality published studies and interviewing researchers, patients and physicians. As he describes, "I subjected medical marijuana to the same scrutiny that is give to the drugs that the pharmaceutical industry tries to sell to physicians".

This book is a very well-researched, unbiased, and thorough examination of the science of cannabis. It was interesting and very well-written so that I believe anyone without a medical or scientific background would be able to understand.

[Eric De Feo · Rating 4 out of 5]

This reads like a Cannabis 101. It would be like reading about Italian food from an American who spent a summer in Tuscany. That's not a bad thing-- just different than speaking to people entrenched in the industry from day-to-day. Dr. Casarett is writing this from Philadelphia, in a state with many backwards laws around alcohol and cannabis. The book reveals how little we know about the plant, as much of the research is anecdotal and not clinical. Granted clinical studies can be just as bias and subjective. Overall, it was worth scanning for the medical factoids around endocannabinoids.

[Skip Radwany · Rating 5 out of 5]

Excellent read! The author mixes science and culture effectively and writes with an engaging and personable tone. I would recommend it for anyone interested in the legalization or medical usage debates but also for those whose interests are historical and cultural.

[Beth · Rating 4 out of 5]

THX to the Author for this Good Reads Giveaway! It was more technical than I prefer, since I suck at chemistry. But otherwise, it was really interesting.

[Alina Yasnaya · Rating 5 out of 5]

An objective account of the benefits and downsides of marijuana from a doctor of medicine. A definite must-read!

[Michelle Risa · Rating 3 out of 5]

on one hand, the information in this book is interesting and the stories he's heard from patients using medical marijuana are extraordinary. but on the other hand, and even for me, somebody who believes in the cause of medical AND recreational marijuana, the way the information was provided didn't quite do the book justice. this book reads like a fiction story about a doctor who goes on this journey to meet people and gain insight on the topic. what i was looking for was more of a nonfiction style, i guess something that's a little more straightforward and scientific. my favorite parts of the book were the parts where he writes about old experiments and studies done by scientists and researchers, or when he discusses the compounds in marijuana like THC and CBD and how those function in our brain. those were the most educational parts of the book. he also included some interviews with doctors he's met along the way which would've been great but these interviews are presented in a way where it's read like a dialogue between two characters, including facial expressions, description of tone of voice, and small analogies, which again, is precisely what i didn't like about this book.

[Jeanie · Rating 5 out of 5]

I enjoyed reading Dr. Casaett's book. It was extremely well-written and with a sense of humour. Dr. Casarett approached this important subject of medical marijuana with a very open mind - and a sense of humour. As a retired addiction counsellor, I enjoyed his approach - neither moralistic nor permissive. This is an area where we should be looking at facts - something that has been denied us in the United States due to politics and lobbying. We need to make our decisions based on science; we need to compare the good/harm of cannabis with the alternatives (or lack thereof). I feel much more comfortable with my viewpoint on the merits of "weed" since I read this book. I'd recommend it to anyone with an open mind.

[Ellen Johnson · Rating 3 out of 5]

brings up some good issues about what marijuana does and does not do and the problems of how to take it and how to know what you are taking. i was curious about the synthetic meds that he mentioned but did not elaborate on. warning, there is a lot of chemistry talk in here but you can skip over those parts if you want. Very good point on NOT does it have side effects, but are the side effects worse than the drugs we alreaddy use? Doesn't address the question of why it's okay to take pills to make us feel okay (i.e. antidepressants) but why it's not okay to take something to feel really good. Doesn't make enough comparison to alcohol.

[Katie · Rating 4 out of 5]

Follows a hospice physician's medical marijuana education. It doesn't provide anything conclusive other than his changed opinion that medical marijuana is legitimate, especially if considered an herbal remedy. ("Overall, as long as we think of marijuana as an herbal remedy, I've become a pretty strong believer.") He's a proponent of legalization, because he believes it's the most direct route to us fully understanding the pros and cons of its use through more research.

Very educational, well written and enjoyable to read (i.e. doesn't read like a text book).

[Ashlynn Elizabeth · Rating 4 out of 5]

Interesting book and the author made a point of not overselling it as a miracle cure but rather only reports on proven evidence. It did not talk a lot about autoimmune arthritis which was what I was hoping to learn more about.

[Laura B · Rating 3 out of 5]

Well worth a read, but it was halfway science-oriented and the other half was completely anecdotal. I wanted more about the scientific studies. But I guess they're in the early stages right now.
Extremely inconclusive about the medical benefits of marijuana.

[Jane]

Engaging and easy to read.

[Becky · Rating 4 out of 5]

Interesting explanation of whether it works and for what, and whether it's safe.

[Patti · Rating 4 out of 5]

Very interesting. Easy to read narrative style.

[Vladimir · Rating 4 out of 5]

well balanced combination of science of cannabis studies and cannabis folklore.

[Andrea Aleman · Rating 5 out of 5]

Excellent....learned so much

[Peter Aronson · Rating 4 out of 5]

An even-handed, careful and readable treatment of the subject by a doctor who has put a lot of time and effort into researching the subject.

[Anne Ponder · Rating 3 out of 5]

I found it kind of helpful; you should read it to see if it's helpful for you. It is defineitely not definitive as far as information goes, but I enjoyed the personal anecdotes.

[Mark]

COCC RM666.C266 C3753 2015

[Patricia Baker · Rating 3 out of 5]

Good overview of the topic. There is still a lot we don't know though so, like the author, I'm not sure how I feel about the use of this drug for many chronic conditions.

[Ronnie · Rating 5 out of 5]

I firmly believe that anyone who is involved/interested in this particular subject should read this book. It is timely. Written in an even-handed manner that covers everything. I have been to many conferences/seminars on the topic of recreational/medicinal cannabis. As a an RN I have seen many people in the throes of chronic pain/ nausea/ and the loss of control when cancer or any type of illness bedevils a person. Cannabis usage is a topic that will not go away. It is the inherent responsibility of everyone to read a book like this. There are light-hearted moments...heart-breaking moments. Patients and health-care providers along with city...state and federal leaders need to read this book. It is well-researched and daunting in scope..There are no easy answers...Please read this book. RJH

[Addie Rice · Rating 5 out of 5]

Everyone should seriously be reading this book right now. I’ve been reading a lot about medical marijuana lately, and I’ve been shocked with what I’ve read. I was thinking this book would sing it’s praises like most of the other things I’d read, but it actually provided a very thorough and balanced view of what medical marijuana may or may not do all while explaining the real risks and side-effects. It was exactly the information I was needing.