What every patient should know about healing with cannabis
Here in California (pre legalization) we refer to using marijuana euphemistically with words like: medicate or heal. For instance you might say: ‘ I always keep my medicine with me; I never know when I might need to heal’ or ‘The brownies in the fridge are medicated’. It is a bit of a joke for those that use marijuana recreationally and dead serious for people who use marijuana to manage symptoms of medical conditions. The reality of marijuana as medicine is an interesting one and considering how widespread marijuana use is, worth consideration from an alternative health perspective.
The legitimacy that marijuana currently enjoys is due to the medical marijuana movement and is both heartening and discouraging to those of us who practice healing sciences. As an ayurveda practitioner\marijuana grower I met at an ayurveda conference said: ‘Marijuana is a gateway medicine to holistic, especially herbal, medicine!’. My clinical practice, consultations with patients of a medical marijuana dispensary in San Francisco, and personal experience indicate this is a ‘medicine’ that needs some management to actualize its healing potential and justify the medical nomenclature.
Ayurveda says: Everything that exists can be medicine.
Cannabis is no exception. It is considered the least problematic of the ‘intoxicant’ substances; a poison which can be used to great benefit by humans.
It is in the tradition of the great texts of ayurveda to approach complex and appealing substances first with pages of glowing praise followed by so many warnings and restrictions that only the most intrepid would not be daunted. This is the pattern I will follow in this article.
Vijaya: The Conqueror
Sanskrit synonyms for cannabis imply its potency for transformation: "soother of grief," "the sky flyer," "the poor man's heaven" , vijaya or victory in conquest, and a dozen other glowing euphemisms. Cannabis Sativa is indigenous to India; the earliest known cultivation dated 900BC.
The positive qualities of marijuana facilitate conversation, encourage social relationships, support physical awareness, highlight a deep enjoyment of life, and elevate social contact, art, and pleasure above other (perhaps less important) pursuits. These characteristics allows cannabis to be very effective where depression and isolation are primary concerns. As is testified to by the prevalence of cannabis in poorer communities all over the world cannabis proffers grace to living in adverse circumstances.
Today in India cannabis is used in spiritual practice and rituals, taken as a sacrament on specific holidays, for use on an ascetic path, as a training aid to wrestlers, and until the last century, quite broadly used medically and recreationally by various levels of society. Cannabis is found in over 80 traditional Ayurvedic formulas, several of which are available in pharmacies in India today. It is effective for pain, digestive disorders, dysentery, sexual prowess, and a dozen other medical uses known to ancient ayurveda.
The qualities inherent in the herb are responsible for its actions in the body include: heating (ushna), drying (ruksha), and astringent (kshaya--due to it’s bitter taste). It penetrates the tissues quickly (tikshna) and has the quality of lightness (laghu).
Heat increases digestive ability and relaxes the tissues to relieve pain and anxiety. But heat can also cause trouble with the blood and liver with long-term effects seen also on skin and connective tissue integrity.
Dry and astringent qualities can benefit glaucoma, swelling, and diabetes symptoms, but lead to constipation and dehydration of the skin (and other organs).
Dry, hot and penetrating qualities have a long-term negative impact on our reproductive tissue (shukra dhatu) and vitality (Ojas in ayurvedia-ese) —especially diminishing energy levels, ability to heal, and reproductive strength (yes; that means sexual depletion). Overuse can lead to dry, weak, brittle tissues that are no longer are able to do their jobs.
Holding (grahi) is a quality that helps the body hold onto nourishment and increases assimilation (useful for IBS etc). This holding quality effects sexual performance in men by delaying orgasm, but at the same time cannabis increases sexual awareness and drive. Perhaps this complex effect on sexuality is due to another quality that encourages the proper flow of liquids in the body (atisara).
The qualities of ‘drunkenness’ (madam) and distortions of sense perceptions (moham) are noted.
Cannabis is also known to enhance the actions of the herbs it is used with.
Contemporary use extends the list of things that can be treated with cannabis to things like support during chemo treatment, relief from seizures, sleep problems, and PTSD. Weekly I hear of new ways that cannabis can be applied to the ills of the modern world. I find that those who are medicating for physical problems often take a proactive approach to their medicine. They regulate when and how they medicate, and with what sorts of flower strains, concentrates or edibles.
The Bad and the Ugly
In balance-based traditions like ayurveda, benefits must be supported by proper use. The stronger a medicine the more dramatically its qualities affect the body. Cannabis is strong medicine; it is considered a poison. Cannabis can be hard to manage medically and is not for everyone. Wise use is based on moderation, processing and delivery methods, and staying alert to its effects both good and bad.
What is not mentioned in the ancient texts is that the cannabis plant is seductive compared to other herbs. Cannabis is enjoyable and compelling in ways that stop the patient from heeding negative effects. A Materia Medica of Indian herbalism published in 1941 does warn of the long- term effects of cannabis use. It is noted that it will lead to indigestion, tissue depletion, ‘melancholia and impotence. In large doses it first produces mental exaltation, intoxication, a sense of double consciousness and finally loss of memory, gloommess (sic) etc.’ (THE INDIAN MATERIA MEDICA WITH AYURVEDIC, UNANI-Tibbi, Siddha, allopathic, homeopathic, naturopathic & HOME REMEDIES. 1941. R.N. Chopra.)
Unwanted effects that I’ve seen in my practice (with chronic users) include problems arising from the blood (and other tissues) being depleted by the drying, penetrating heat and inherent instability of the herb. Symptoms you might look for include: reddish and dry skin, skin problems (either long term or temporary sensitivity to irritants), varicose veins, easy bruising, and thinness of skin. On a mental level over-sensitivity to stimulus and consequent irritability and stubbornness indicate that Rasa Dhatu is affected. Memory and focus are well known victims to long term use. Sleep and digestive problems can be well managed with cannabis; but can be exacerbated by it too. These symptoms of mis-use can be seen in the short term and are reversible with proper use and herbs, diet and lifestyle that balalces these qualities. Long term implications will vary along these lines based on the strengths and weaknesses in individual patients.
Many of these symptoms are made worse by smoking as the qualities of smoke are heating, penetrating, drying etc. Healthy edible forms of cannabis are a good choice. With classical Indian use of cannabis the herb (in many instances the whole plant and not just the high intensity flowers that we now use) is processed first in water for 24 hours, dried, then ‘decarbed’ in ghee (fried gently). The herb is then used (as with all Ayurvedic herbs) in formulas that balance the nature of marijuana have been used successfully over many generations. Even when used for recreational or spiritual purposes (rather than strictly medical) the herb is taken with other herbs or foods to make it more assimilable and less damaging to the body.
Extensive use will increase doshas or organizing principles of the body (especially Vata & Pitta). There is an easily seen effect of erosion of all tissues (dhatus) when used chronically. In combination these actions will have problematic long-term implications. All sorts of disorders can manifest when the doshas are increased and the tissues are weakened.
Beyond the effects of cannabis on the body are its effects on the mind. There are 3 characteristics of the mind in Ayurveda: tamas (delusion and lethargy), rajas (over-activity), and sattwa (calm, clear awareness). Cannabis increases tamas and rajas when not used properly and ‘clogs’ the mind. This is generally not a permanent condition and can be corrected if you follow a healthy protocol with use.
I urge strong caution to those with mental health challenges or a history of mental health problems in the family. I have seen too many tragedies in this regard. However I strongly feel that proper and moderate use can have great benefits for some mental health challenges like mild depression (esp based on isolation and social disease), ADHD and related issues. There is increasing evidence that Asperger’s symptoms can be made more manageable with correct use.
Cannabis is taken in 3 different forms in India. As the attitude towards cannabis has fluctuated greatly over time in India (largely due to Muslim and British colonizers) these definitions have morphed over the years depending on what is ‘legal’ and what is available. Bhang is generally leaves cured in a specific way and typically boiled with milk and spices. Chara is resin, akin to kif or hash. Gangha is flowers, usually taken for pleasure but also made into many different medicines. Seeds and roots are used in some formulations as well. It is good to remember that these forms of cannabis are far less potent than what is easily available in the US either on the street or in state licensed dispensaries.
How to Medicate for health:
I have cross-pollinated my Ayurvedic knowledge of cannabis with a harm-reduction philosophy and this has lead me to develop a basic guideline to healthy(er) use. This guide is helpful for those who are medicating regularly for physical complaints, to take the place of more dangerous drugs (both over the counter and illicit), or as a stress relieving measure.
How to Medicate:
Balance cannabis with other herbs and foods which have qualities and actions opposite to marijuana. Focus on cooling, moistening, stable, nourishing, mind and Ojas supporting foods and herbs. Avoid ingredients that are too heavy for you to digest. As always, eat what is freshly prepared, cooked, and enjoyed with love and pleasure.
Always choose outdoor grown and organic varieties for the best long-term medication. Indoor grown plants are usually full of chemicals and have limited medicinal use.
Modest Edibles are best. Medicinal use of cannabis in Ayurveda is always in edible form and often made into a confection. Our body most sustainably processes things that we eat and digest. Keep an eye out for organic healthy edibles or make them yourself.
Milk balances the negative qualities of cannabis quite effectively and counters the tamasic (lethargic) and rajasic (aggressive) qualities with the sweet, conscious, alert quality of a Satvic mental state.
Traditionally bhang is made by boiling leaves in milk with dates, sugar, saffron, cardamom, rose petals, and almond meal. Yum!
Ghee (clarified butter) is used in the traditional purification of cannabis. The freshly dried herb is fried lightly in ghee to bring out it’s healing properties. Ghee is the ideal oil: it increases your ability to digest and assimilate nourishment, it supports vitality and reproductive health, it keeps your tissues strong, cool (balances the burning heat of cannabis), protects the eyes and skin, and will give you an appealing glow! In my opinion no one should use cannabis and not have ghee regularly in their diet.
Satisfy cravings with grounding, nourishing, and moistening foods: Rice, oatmeal, raisins (counter dryness and constipation) and dates (supports reproductive health), fresh baked breads, cooked veggies, limited meat, and no fast food (or canned, bottled, frozen, dehydrated, microwaved, or left-over foods). The hot, dry, light quality of cannabis is balanced by the grounding, cooling and moistening effect of naturally sweet things like milk, dates, or sweet potatoes. When the munchies strike they tell us something about what our body needs; just remember to give it the healthiest version available!
Spices with cooling digestive qualities help your body get the most from what you eat and enhance the experience of eating. Try: cumin, coriander, fennel, cilantro, turmeric, anise, saffron, rose.
If you must smoke: grind your cannabis with a pinch of powdered herbs like fennel, vacha (calamus), sandalwood, jasmine, saffron, licorice, jatamousi (indian spikenard), sasparilla (American or Indian) etc. Western herbs to try are mullein, catnip, or mugwort.
Pomegranate Juice is perfect for medicating. It quenches thirst and refreshes but is also great for the digestion and removes waste liquids from the tissues. It is especially good for people who tend to get swollen or bloated or have any history of parasites. Natural grape juice is also a good choice to help you stay hydrated.
Coconut water (ideally from an actual coconut) is best for people who’s digestion is strong and perfect for athletes or those who work with their body.
Licorice or Fennel Tea is cooling, soothing, softening to the body, great for your blood and skin.