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Marijuana and Colorado, a Doctor’s Perspective

Mary Jane
As a child of the fifties and sixties growing up in Denver, I have watched this whole thing unfurl. It has many names. Marijuana; Cannabis; Reefer; Ganj; Grass; Weed; Chronic; Schwag; Pot. There should be a dictionary for the language alone.

In addition, it came in various packages. Lid; Match Box; Bag; an Ounce; a Quarter pound; a Pound (most people I knew that bought this much, were not exactly consumers).

Now the new and much stronger cannabis hybrids, “Blue Dream”; “ATF”; "Sour Diesel"; OG Kush “Grape Ape”. Yeah, the list goes on, and it is a very long list. Marijuana has taken on a life, and more importantly “a cultural phenomenon, all its own”.

SDS antiwar rally, 1966.I was in high school in the late 1960s. And there was this, "Thing", we called the “counter culture movement”, which started soon after President Kennedy was assassinated. Catalyzed by the escalating war in Southeast Asia, and nourished by our "underground" music, it moved headstrong like a juggernaut through the late-sixties and into the next decade. Its offspring? SDS (Students for a Democratic Society) along with "Hippies and Heads", and a general mindset throughout my generation, "The Baby Boomers", that it was okay to smoke marijuana. Almost every baby boomer you meet, will tell you, they have smoked it “a time or two”.

Marijuana was fun, didn’t turn people into drunken idiots, made most of us more creative, and it was cheap. Even on the black market, pot’s price as a national average of thirty dollars to forty dollars an ounce, didn’t change for twenty years. Marijuana took on a huge persona in the seventies that propelled its popularity forward. Yep! Our children, Generation X, and their children, Generation Y, "The Echo-boomers" (they had a boom too). Fifty years of general acceptance across all lines.

Hyde Park, 1969People liked it, and despite marijuana’s illicit pigeon hole, smoked it all the time. At great personal risk I might add. Realize that it was a fifteen year felony in some states to possess even one “joint” up until five years ago. That’s right. We had to wait until the "ex-hippies" who were now "yuppies", took over the country and sought progressive reform, bolstered by decades of well honed scientific research which was impossible to dispute.

As I moved through high school, college, graduate school, and medical school, it was always around, and a huge part of my generation’s quiet behind the scenes recreational culture. I met many doctors who stated' "They smoked more pot in medical school than high school and college combined". Really? Yeah! I'm afraid so. Unless you lived under rock in the sixties and seventies, why on earth would you be surprised?

That my generation found no true educated argument against its use, except for its illegal status, allowed a heralding in of decriminalization legislation. Our generation had aged, become seasoned professionals, and gained political footholds.

It was obvious, that unlike alcohol, and other potent “mood-alterers”, cannabis had no known chemical dependence associated with its ongoing use. People do not smoke it then get in their cars and drive ninety miles an hour through a red light. No, they would rather stay home, listen to music, or watch movies. Or perhaps write that book, that song, paint that picture, or study astrophysics. Go figure. You can binge all weekend on pot and go to work the following Monday feeling fine. Try that with vodka? I don’t think so.

It was inevitable that marijuana would push onward until the older generations were shoved aside, laws modified, decriminalization of pot’s possession was embraced, and a push for more research took place, eventually leading to sweeping legislation, state by state. Ex-hippie governors, justices, and legislators made sure of that. Behind the scenes the whole time, was an organization called NORML, the National Organization for the Reform of Marijuana Laws. I didn’t know anyone in college that wasn’t a member or subscriber.

To this day, many of my peers, and of course, most baby boomers agree, that cannabis is much safer than alcohol, and obviously a healthier choice for pain control and recreational use, "period".

Don’t forget that all the while this was going on, little by little, there would be breakthroughs regarding the medical uses of THC, yeah, one of the biggest words I learned in junior high, Tetra-Hydro-Cannabinol, the pharmaco-active compound found in marijuana.

DavidStarting in 1972, THC was being used for the supportive treatment of children with Acute Lymphoblastic Leukemia (ALL), an unrelenting killer not ten years earlier, now treatable with methotrexate cocktails, radiotherapy and bone marrow transplants. Treatments that were changing everything, but wreaked havoc on the gastro-intestinal tract, causing nausea and anorexia. 

They were using pot to give these kids “the munchies”, so they would eat, and it worked. It spread like wildfire into all cancer therapy regimens. By 1982, it was in every Oncologist’s doctor's bag.

Then there was an important finding that THC could lower the intraocular pressures in glaucoma patients. This research was repeated over and over again, but couldn't be squashed. This discovery was legendary. Many glaucoma patients could now get state and federal permission for medicinal use outside of a controlled setting (a hospital) despite a Federal prohibition against cannabis. The first in many allowed features of pot use, flatly ignoring the Constitution.

But the big head scratcher was this phenomenon of cannabis induced elevation of pain thresholds and its use for pain control. Yeah, I know. I was very skeptical at first. When patients would tell me in my office or at the hospital that they smoked reefer to control pain, my response was generally, “yeah, right”. 

But when scientists hit a homerun in the late eighties with “Delta 9” research firmly establishing THC as an opiate “G protein” operator, I began to eat crow. The evidence was undeniable. This is the research that introduced us to “Medical Marijuana” and its related pain clinics in the late nineties. But wait. Doesn’t the Federal government consider pot illegal?

The face of organized crime in the 1920s.Here’s the deal. The 1920s ushered in with a prohibition on alcohol. This required congress to amend the constitution, making it illegal to possess or manufacture liquor. This was doomed to failure on many levels. The biggest blow? The shift of the American economy not foreseen by Congress. The stock market crash of 1929, and America’s pockets being drained by organized crime like no other time in our history.

On the heels of this American hiccup, came the Great Depression. Because there was no booze and everybody was dirt poor, they reached for other things. A substance already well known to the jazz community, Americans started smoking reefer, because it was a pleasant functional "high", made them feel better, grew everywhere, and was cheap.

Evil Weed!So what did the federal government do? Well, the FBI, yeah, Hoover's FBI, didn't particularly care for the "jazz Community", so they acted quickly. First they amended the Constitution again, so we could all have our beer, wine, and cocktails back. Then in the mid 1930s they started a propaganda campaign called “Reefer Madness”. Yeah, we’ve all seen the movie, but what it did, was convince the “traditionalists” (The Great Generation) and their moms and dads, that "marijuana is bad". 

Without batting an eye, The United States Government enacted laws to prohibit the possession, horticulture thereof, or sale of Marijuana. A Federal Prohibition, exactly like the one on liquor.

This is a Constitutional Amendment with formidable teeth. And its shadowy effects continue to  linger. This is why specters of this black cloud, for instance, Colorado license plate profiling by State Police Departments outside of Colorado are so widespread. 

An aura set up by old “Wasp born Blue Laws” and ignorant "heads in the sand" attitudes of  what Baby Boomers called "The Establishment", has continued its "devil's grip" on society.

I know. Our parents, and their parents, just never got into “the beatnik thing”. 

"But I thought the Earth was flat". 

Uh, no, it isn't. And If you ask Baby Boomers what decade did your mom and dad love the most, they will almost all say "mom and dad wish it was still 1954". Are you kidding me?

When we had the Colorado vote in 2012, I debated heavily with friends about the Federal black cloud. Many of us, me included, thought that we stood to lose huge Federal monies if we voted to make recreational pot legal. Important tangibles that could bring the State of Colorado to its knees, like our school hot lunch programs, our highways, bridges, infrastructure, and here in Colorado, all of our National Forests and Federal Bureau of Land Management programs.

But the Yes vote came in. Things were immediately set in motion. The Free Enterprise system at its best. Marijuana stores, like liquor stores, called Budstores, and Pot bars were ready. But the big thing was making it work right and intelligently. Agricultural and Horticultural regulations; Sales and distribution regulations; Zoning for Budstores; State inspections; FDA approval of inhalants and edibles; State Licensing; Deciding on a fair tax rate; Taxing; Enforcing the tax; Collecting the tax; Where do we put the tax?; What programs do we want the taxes to feed?; monitoring Trafficking across state borders; Education of our police forces; Roadside testing for “high” drivers; Bureaucracies and Oversight bodies to run it all; Educating the public; Keeping an open dialog with the DEA. 

The task at hand was very big. This was a huge thing Colorado took on. And of course, everyone was watching. It cost us millions to set up the bureaucracy alone, but remember, we had a well established "medical marijuana" system already in place as a template. 

The end result of this hard work? Colorado made millions of dollars in just the first 3 days recreational pot became legal. On January 1, this year, when recreational pot first went retail, typical “Budstores" in Denver (“ground zero”) reported an average of 400 to 500 customers per store on opening day with an average of $40,000 dollars in sales. 

Even most “supermarket liquor stores” can’t come close to this in daily sales. In just 3 months since, state officials are predicting billions of dollars in cannabis sales and peripheral business by year’s end.  

Recreational pot is taxed at 21.12% in Denver. And the customers, most of them from out of state, keep rolling in. Colorado’s governor has said that tax revenue alone, may approach one billion dollars this fiscal year, we know we’ll make 600 million for sure. Money that will be injected immediately into school construction, education, and drug addiction programs.

U.S. Federal MarshallsThat black cloud still hovers though. Congress will inevitably have to address the issue. In the meantime, it is plausible that the DEA could march in with the Federal Marshals and shut us down with the full power of the U.S. Constitution behind them.

It’s becoming interesting now, however, as our Attorney General, Eric Holder, implied in a statement last November: that the Feds would Stand Down, and watch with great interest to see if Colorado can bring an established model with excellent and efficient enforcement policies in place, and a revenue sharing system with economic teeth the size of a Great White. It’s all about revenue.

Mr. HolderWhen this happens, one of two things will occur. Either the Obama administration will see the revenue economics glaring them in the face and move to influence congress, introducing the bill through our executive branch, or the other States, hungry for economic stimulus, will start to topple like dominoes. Congress will have no choice but to capitulate and ratify the Constitution. Yeah, maybe this cloud has a silver lining. Apparently the U.S. Department of Justice has a lot of ex-Hippies “running the show”. Thanks, Eric.

So, what really put muscle into “Medical Marijuana” and the eventual legalization gamble for recreational use by Colorado, and Washington? What’s a “Delta 9”? What does THC do? Why is it generally unable to induce chemical dependency? Why is it easier on our biological systems than alcohol or other drugs? Yeah, don’t forget, it’s a drug.

In the late 1940s, while investigating the causes of opiate addiction, it was determined that there may be specific opiate receptors in the human brain that compounds like opium, codeine, Heroin, morphine, and hydrocodone can activate. This was an interesting postulate. It infers biologically, that “if we have central nervous system receptors for opium and its cousins, it can only mean one thing, we make our own opioids in our brains". Why else would a receptor specifically shaped for opiate molecular moieties already be in the brains of humans?

Neurotransmission and opiatesThis was a bold statement, but lead to research in all directions. Receptor agonist and antagonist research models had to wait for technology to catch up. Opiate isomers were being considered for better pain control. 

There was a Heroine epidemic induced by mob prohibition money, the likes of which we will never see again, but gave birth to the science of “Addictionology", and created drug rehabilitation models that are highly effective and continue to evolve. "If we find a receptor, can we make a protein to block it?"

Then it happened. Technology quickly caught up. In the early 1960s the first hard peer reviewed papers from well built scientific models started to appear. They found G protein opiate receptors in the human brain. This pressed private enterprise as well as academic research forward on protein pharmacologic agonist and antagonist investigation protocols. And it didn't take long for the evidence to be unmasked. 

Confirmed in 1971, we now had ground breaking evidence on what we call natural or autologous pain control. Naturally occurring opioids, called Endorphins and Enkephalins binding G receptors in the central nervous system of human brains. There are several opiate receptors, but the μ receptor (mu receptor) is the true receptor for Pain control and Euphoria.

Through opiate or endorphin chemical attachment, μ receptors signal Dopamine release, which engages our pleasure centers in the limbic system and thalamus. Not only do these opioids dampen and even obliterate pain signals, these chemicals provide us with the higher emotional senses we possess as human beings. The sensations of “enthusiasm”, “elation”, “humor”, and “ecstasy”, are all chemically driven. 

Our sensations when we smile or laugh. The sensation of sexual arousal is a chemical cascade of enkephalins. They play a huge role in orgasm, and other pleasantries we humans enjoy biologically. The “runner’s high”, that “second wind”, are both examples of stress loads acting to release these chemicals in our central nervous system.

When we look at something spectacular, like the first time you see the Grand Canyon, that rush of pleasant surprise, is induced by endorphin surges binding μ receptors in your limbic reticular activating system. Wow! Yeah, we learned a lot!

Most of our opioid receptors can be found in Periaquaductal gray matter, the amygdale, cerebral cortex, hypothalamus, hippocampus, and limbic system. These structures are all tied into our emotional regulatory centers, homeostatic regulating centers and higher functioning in the cerebral cortex. A concert of mediators we experience every day.

The Human Brain So why are we talking about opiates? It’s important to understand this physiology if you want to understand how THC works to control pain, in addition to its well known “high”. In the late 1980s, the THC Δ 9 receptor (Delta-9) was discovered in the limbic system and cerebral cortex of human brains. 

Wait! There’s a receptor in our brains for marijuana? That means, you guessed it. We make natural cannabinoids in response to stress and pleasure.

This phenomenon was first observed in the seventies, when studying placebos against THC. Reproduced time and again, these research protocols were always a stumper, because when a population of candidates were told they were smoking powerful marijuana strains like "Thai Stick" or "Sensimilla", they would get rip-roaring stoned. But they were smoking THC free hemp. 

That’s right. They were making their own THC. Isn’t science awesome! The percentages of candidates experiencing being stoned was the interesting thing. Generally a positive placebo response is seen in a low percentile (typically around 3%), but almost all of these candidates would be stoned. 

By 1993 research was in full swing on this receptor. Found to be a G protein, just like the μ receptor, it was part of the human brain neurotransmission system. What came next changed everything. The THC Δ 9 receptor was found to live next to and work to augment the opiate kappa receptor and mu receptor and visa-verse. The first hard evidence that pot can control pain by working on the same railroad that opiates do.

Pain ControlFurther research conducted to nail down the “no chemical dependency” phenomenon is underway. Also being investigated is a host of physiological observations, including treatment for epilepsy, and other neurological disorders, like multiple sclerosis, and movement disorders, like Parkinsonism. 

Just this month the journal, Scientific American, reported the discovery of the cannabinoid that has anti-seizure properties.

It appears that marijuana was a source of medicinal magic bullets it took us more than fifty years of legal, political, moral, and scientific “brick wall crashing” to get on our shelves.

Okay, so here’s what it does that concerns me. Although it is well known for the “high” it produces, as well as its medicinal uses, cannabis also causes difficulty in thinking clearly in some people (with long term effects); the red eyes, everyone knows about; dry mouth too; increased appetite; tachycardia (fast heart rate); and slowed, even obtunded coordination. In addition to these effects, it causes hallucinations and delusional paranoia in many individuals. 

Psychological addiction, anxiety, and depression are also common. Even bipolar activation has been reported in peer reviewed medical literature. It is a well known migraine trigger in migraineurs. There is also research suggesting an increase in heart attack risk within the first hour of smoking marijuana. Any doctor should take pause when considering pot as therapy until these issues are further investigated and worked out.

Despite these concerns, A majority of doctors say that “medical marijuana” should be legalized nationally. Interestingly, twenty-one states already have.

The U.S. CongressWebMD Chief Medical Editor Michael W. Smith, MD. says “The medical community is clearly saying they support using marijuana as a potential treatment option for any number of medical problems. In fact, many doctors already prescribe it. 

But health professionals are still unclear as to what the long-term effects may be. The findings would indicate a strong desire to have the DEA ease restrictions on research so that additional studies can be done to conclusively show where medical marijuana can help, and where it might not”.

If we legalize marijuana nationally, it will be work. I mean a lot of work. Remember what Colorado had to put in place.

First, the prohibition has to be repealed, then the Constitution will have to be ratified. The Department of agriculture will become one of its biggest oversight bodies, in addition to the others.

We will have to construct bureaucracies to tax, enforce the tax, and collect the tax. Don’t forget licensing; regulated distribution centers; monitoring; law enforcement, and the need for indisputable roadside testing.

The Department of Justice will have to re-task its agencies, including the ATF, FBI, and the DEA. We will need counseling and addiction management programs, as well as restructuring of our Drug and DUI courts. Yes, a very huge undertaking. And what about the thousands of people in prison for pot possession? This will be a very big issue when the prohibition is repealed.

A Bumper Crop in the HeartlandKeep in mind that the positive effect on our economy would be massive, and on a scale we have never seen before. From Wall Street to the agricultural, and consumer industries, and from the textile, packaging, and accoutrement paraphernalia industries, everyone will feel the money. 

Consider what it will do to the “online” industry if pot is legal nationally. Think about it. When cannabis is legalized, who’s going to own “”? Not you and not me either. Somebody already owns it.

The DEA lists marijuana as a schedule I, illicit narcotic, the same as Heroin, Crack, and Meth. It will remain there until the Constitution is amended to repeal the prohibition. 

Pot isn’t going away. So, we must ask ourselves: If Marijuana is here to stay, is safer than our current legal recreational drug, has endless possibilities for healing, is inexpensive to grow (yeah, it’s a weed), and will stimulate the economy, wouldn’t it serve us better to run this under a free enterprise system?

Here's a thought. This would be a huge blow to the Mexican Drug Cartels, and possibly create a paradigm shift in the Mexican economy, allowing for free agricultural development, and an opportunity for Mexico to compete cooperatively as a legitimate world player in the cannabis agricultural and textile industries. 

An opportunity to lift themselves out of the third world economy into first world status. We saw this happen with Chile in the 1990s when they began to compete globally with the great wines they are producing from their Andean vineyards. They were able to pay off their debt, shrug off organized crime, and now stand with the other first world nations as one of the top economic powers in the world.

Stay healthy, and keep learning.

Dr. Counce

27 Comments to Marijuana and Colorado, a Doctor’s Perspective :

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Cynthia Tassey on Wednesday, April 16, 2014 6:05 PM
Awesome article Dr. Counce. You outdid yourself again.
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Dr. Counce on Thursday, April 17, 2014 2:37 PM
Thank you, Cynthia.

Rhonda on Wednesday, April 16, 2014 10:46 PM
Dr. Counce you are a very smart doctor, very brave, and we appreciate this article! You are a very talented writer ! Just hope all doctors have the knowledge you do about this potential medicine so they can protect and care for their patients as you would do. Keep up the good work and thanks for explaining a doctor's viewpoint!
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Dr. Counce on Thursday, April 17, 2014 2:39 PM
Thank you, Rhonda. There will be more on this subject very soon.

Timothy Trujillo on Thursday, April 17, 2014 8:38 AM
Very well written article Chuck, Always a pleasure to see what you have to say on your page.
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Dr. Counce on Thursday, April 17, 2014 2:40 PM
Thank you, Tim, for your readership. More to come.

Chris on Friday, April 18, 2014 1:42 PM
Another great article from you! Your knowledge of technical science and medicine, and ability to bring it to a level readable by anybody is amazing. Love your writing style. Waiting for the next one. Thank you.
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Dr. Counce on Friday, April 18, 2014 6:35 PM
You are very welcome, Chris. Thank you for your loyal readership. Always more coming.

Megan on Thursday, May 01, 2014 11:57 PM
You are unbelievable! I love this! You have always been a great teacher, Dr. Counce. The way you write. It's like you're talking to me at my dinner table. Thank you!
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Dr. Counce on Monday, May 05, 2014 11:11 AM
You are welcome, and thank you, Meg. We appreciate your readership. Always nice to hear from you. Let us know how things are going over there at CSU.
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Kayla Lever on Monday, May 19, 2014 2:48 PM
Thank you, Dr. Counce. I will be sharing to my friends and family. I loved this article! It brought so many facts to my attention and expanded my knowledge on the topic!
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Dr. Counce on Wednesday, May 21, 2014 8:50 AM
Thank you, Kayla. Glad you liked the article. And thank you for sharing. More coming.
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Linda on Tuesday, July 01, 2014 11:53 PM
Great post!
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Dr. Counce on Thursday, July 17, 2014 11:07 PM
Thank you, Linda!

Jessica Albrandt on Wednesday, July 23, 2014 11:27 AM
Awesome read Dr. Counce! =)
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Dr.Counce on Friday, August 22, 2014 5:50 PM
Thank you, Jessica.

Amberlea Stafford on Wednesday, July 23, 2014 11:55 AM
Awesome article!
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Dr. Counce on Friday, August 22, 2014 5:51 PM
Thank you, Princess.

Dylan Burke on Saturday, July 26, 2014 2:02 PM
Amazing article, my only worry is that with the population of which is using marijuana getting younger, (some even age 16 or younger) is the "90 mile an hour through a red light" statement. Seeing as some teens are actually learning to drive while affected by marijuana I do foresee rubbernecking, increased speeds on streets, and even texting and driving as being an issue as time goes on.
Reply to comment
Dr. Counce on Friday, August 22, 2014 5:53 PM
I agree. This is why we need a reliable roadside test. We don't have one yet.

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Dr. Counce on Tuesday, September 09, 2014 8:08 PM
Thank you very much.

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