Nursing Book Club

The Cannabis Manifesto: A New Paradigm for Wellness by Steve Deangelo

Making the case, not always persuasively, for the wellness benefits of marijuana

With California legalizing the retail sale of recreational marijuana as of Jan. 1, 2018, I decided it was high time for me to learn more about the medical use of cannabis, which has been legal in California since late 1996. I must admit that I don’t know much about medical marijuana, so I picked up The Cannabis Manifesto at my local bookstore.

The presence of the word “wellness” in the subtitle of this book (published more than a year before Prop. 64 legalized adult recreational use of marijuana in California) was unexpected, but vaguely reassuring, suggesting images of good health.

According to the book jacket, author Steve DeAngelo is director of Harborside Health Center in Oakland, which describes itself as the world’s largest medical marijuana dispensary. He is also the star of the Discovery Channel’s “Weed Wars.” Since DeAngelo is an outspoken advocate for the therapeutic use of marijuana, it seemed like he might have something valuable to say. After reading his book, I was left with mixed feelings.

Therapeutic Benefits

The author explains that cannabis has been used medicinally by the Chinese for something like 5,000 years, with Chinese texts describing it as one of the 50 “fundamental herbs,” useful in the treatment of 120 different conditions. (A 2015 Medscape article cites pharmaceutical references to cannabis in other cultures dating back to about 2,000 B.C.)

The therapeutic benefits of cannabis lie in chemical compounds called cannabinoids. There are about 85 different cannabinoids, which have a range of effects depending on their strength and combination. They affect the receptors that control how our bodies metabolize neurotransmitters known as endocannabinoids, which help to regulate different neural and metabolic functions.

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Probably the best-known cannabinoid is THC (delta-9-tetrahydrocannabinol), which is known for its psychoactive effects and is the main source of the marijuana high. THC is also an appetite stimulant and antiemetic. Another class of cannabinoid with therapeutic potential is cannabidiols (CBD), which have powerful antiinflammatory, antispasmodic and neuroprotective effects.

War on Drugs

None of this is scientifically disputed, and it’s all useful information. The remaining chapters of DeAngelo’s manifesto, however, take a detour into the author’s personal history with the legal system and his views on the drug wars. I came away with a better understanding of the difference between state and federal marijuana laws and why there is such a dearth of research on the medical uses of this drug.

However, I have my doubts about the author’s position on the ramifications of legalizing marijuana use. DeAngelo seems to believe that if prohibitions were removed, all adults would use cannabis sensibly and there would be wellness for all. (On his website, he says he believes cannabis “should be used to further personal wellness and not be used as an intoxicant.”)

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I tend to think that alcohol is a more probable model for legal marijuana, including marketing and advertising, taxes, health problems and the subsequent possibility of addiction. The California Highway Patrol has similar fears; over New Year’s weekend, electronic highway signs across the state warned, “Drive High, Get a DUI.” I also feel DeAngelo is stretching to sell me on the idea when he talks about the hundreds of jobs legal marijuana will create. Is that part of the wellness model?

I’ve heard lots of anecdotal stories about the positive use of medical marijuana to improve cancer patients’ appetites and stop weight loss. (The FDA has approved several drugs using synthetic THC for those purposes.)  So, I can’t deny there is a medicinal place for cannabis. I’m just not sure that The Cannabis Manifesto gave me the unbiased, evidence-based facts that I need to have an informed opinion on the subject.

EDITOR’S NOTE: While California and 34 other U.S. states have legalized at least some use of marijuana, federal law still considers cannabis a Schedule I drug (“no currently accepted medical use and a high potential for abuse”) and prohibits its sale or distribution. Back in 2013, the Justice Department instructed U.S. attorneys to avoid pursuing federal charges for marijuana-related activities that local law permits (except in certain specific circumstances.)

However, on Jan. 4, 2018, Attorney General Jeff Sessions rescinded that guidance, leaving the decision to prosecute or not prosecute up to individual U.S. attorneys. Lt. Gov. Gavin Newsom has condemned the federal policy change and vows that California will “pursue all legal, legislative and political options to protect its reforms and its rights as a state.”

The Cannabis Manifesto: A New Paradigm for Wellness, by Steve DeAngelo (North Atlantic Books, 2015)

Christine Contillo, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.

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