O’Shaughnessy’s • Autumn 2015 —43— Harvard, Marijuana and Me By Lester Grinspoon, MD

In 1966 through a shared involvement in scribed by Charles Mackay in his mid-19th anti-Vietnam War activities, I met the as- century book, “Extraordinary Popular De- tronomer Carl Sagan and we eventually be- lusions and the Madness of Crowds.” came close friends. He was the first person It did not occur to me to write a book on I had ever met who used marijuana. the subject. What I did write was an 80- As a sometimes arrogant young doctor page paper which was published in the In- who believed he knew something of the ternational Journal of Psychiatry in 1968. dangers of cannabis, I warned him of its Soon thereafter a shorter version appeared harmfulness and urged him to stop using in Scientific American. The latter piece it. He took another puff from his joint and attracted a huge amount of attention (my then held it toward me and said, “Lester, wife and I, listening to the 11 PM news, have a puff, it’s harmless and you will en- “heard all about it”). joy it.” Within a week or two I received telephone As I met more of his friends, and they calls from three publishers who wished to were not unsophisticated people, I dis- see me to discuss the possibility of a book. covered that most were also cannabis us- I decided then to write the book for several ers. This began to trouble me. In fact, it reasons. The subject had captured my in- compelled me to question the basis for my terest and was very much in need of a thor- firmly held belief in its harmfulness. ough review; and it was the only aspect of By 1967 I found myself in the Countway my work that my 10-year-old son Danny library searching for the medical and sci- —who had been diagnosed with acute lym- Grinspoon’s article in scientific american, entific basis for the marijuana prohibition phoblastic leukemia in 1967— expressed “Marihuana,” published in December, 1969, represented a breakthrough —a cogent chal- enacted in 1937. interest in. lenge to prohibition in a magazine widely It was not long before I had my first can- Having a choice of publishers, I decided read and respected by scientists, physicians, nabis epiphany: marijuana was, in fact, on Harvard University Press, which agreed and educated laypersons. The article led to remarkable for its lack of toxicity, and the to give me an accelerated date for publica- a book contract from Harvard University considered” in 1971. Bantam Books then harmfulness surrounding it was not to be tion if I would agree to provide the manu- Press, which brought out “Marihuana Re- brought out a mass-market paperback. found in its psychopharmacology, but rath- script to the press quickly. As promised, er in the way we as a society were dealing I had a hand-bound copy for Danny on laire and other members of the 19th century and a paperback. They also sold paperback with people who use it. March 24, 1971, the date we had agreed Parisian Le Club Des Haschischins, and the rights to Bantam Books which produced a At that time marijuana was responsible upon. Americans Bayard Taylor, Fitz Hugh Lud- large printing. for about 300,000 arrests annually. (That There was a short-lived early wrinkle: a low, Allen Ginsberg and Carl Sagan (Dr. X Interest in this book led to invitations to figure would rise to its apogee of almost few weeks after I had come to an agree- in “Marihuana Reconsidered”). appear on many different talk shows from 900,000 in 2011. It is declining and in 2014 ment with the editors at Harvard Universi- I had a growing realization that this sub- Good Morning America to the Barbara was slightly under 700,000, 89% for mere ty Press, their “Board of Syndics” rejected stance was not only remarkably non-toxic Walters Show. The latter stands out be- possession.) the book proposal as too controversial. Un- but is also capable of producing a mild cause it was the only time I was asked on Dr. Jack Ewalt was Professor of Psychia- til that moment I was unaware of the ex- altered state of consciousness which ap- air if I had ever personally used marijuana. try at the Harvard Medical School and Su- istence of this board, which must approve peared to be quite interesting -and I decid- By then I had. perintendent of the Massachusetts Mental every book published by the press. An im- ed that I would like to give it a try. I was the last of her four guests to be Health Center when I joined the hospital age of the Rembrandt painting “Syndics of However, I did not want the book to have asked. All three of them replied, “No.” The staff and the medical school faculty in the the Cloth Guild” came to mind: a group of an “n-of-one” bias (it was difficult enough first respondent was a fellow faculty mem- department of psychiatry in 1961. This serious-looking, long-haired men sitting to try to produce an objective statement on ber with whom I had smoked on a number psychiatric hospital was one of the seven around the table, exuding caution and con- this subject and I did not want to introduce of occasions. The second had trained in fiefdoms which taken together comprised servatism. It was the first instance of aca- this as a confounding variable). I also antic- my department, and during a conversation the Harvard Department of Psychiatry. demic resistance to my work in this area. ipated the possibility that the book would had shared his own personal experience. The other sub-departments were located at I could have signed on immediately with be successful and if so, I would be invited Finally, when Barbara Walters asked “And other Harvard teaching hospitals including a trade publisher that offered the prospect to be a witness at both legislative hear- how about you, Dr. Grinspoon; have you Peter Bent Brigham, Beth Israel, Massa- of selling more books. But I believed that a ings and court proceedings and I might be ever smoked marijuana?’” I replied, “Yes, chusetts General, and McLean. conservative, prestigious press would lend asked, as a legitimate credentialing ques- I have and I do smoke marijuana.” That I am not certain of the year, my best guess more credibility and influence to a book tion, “Doctor, ‘have you ever used marijua- was a jaw-dropper for Barbara Walters and is 1975, when Jack Ewalt nominated me that promised to be quite contentious. The na?’” And I wanted to be able to say “No.” probably a lot of other people. for early promotion to full professorship. director of the press was undaunted; he be- As it happened, this is exactly the way it I had postponed having my first experi- By that time I had published approximately lieved that he could persuade the Syndics turned out. ence with cannabis until 1973. From the 75 papers and articles, and two books. to reverse their decision. And so he did. “Marihuana Reconsidered” received a very beginning I was open about my use. The first was “Schizophrenia: Pharma- “Marihuana Reconsidered” was published front page review in the New York Times There was a stigma attached to marijuana cotherapy and Psychotherapy,” written by in June, 1971. Sunday Book Review under the title “The use (much more in 1973 than presently), myself, Jack Ewalt and Richard Shader During the time that I was working on the Best Dope on Pot so Far,” and it was widely but being dishonest about it would have (Williams and Wilkins Co., 1972). Techni- manuscript, I explored every aspect of the reviewed in both medical and lay publica- made me uncomfortable. cally, it was my first book but because of literature on marijuana, including the na- tions. These reviews were, with rare excep- Using marijuana proved instructive. Ini- a long delay in the receipt of one chapter ture of the “high” as recorded by such writ- tions, positive. The demand was such that tially, I believed that there were two large, by one of the junior authors, its publication ers as Theophile Gauthier, Charles Baude- the Press published a number of reprints somewhat conflated, categories of its use- date was later than that of my second book, fulness: Recreation and Medicine. In time “Marihuana Reconsidered” (Harvard Uni- I identified a third category: Enhancement. versity Press, 1971, 2nd edition 1978). Marijuana can enhance a variety of human I became fascinated by cannabis dur- capacities. I believe I have profited in all ing my initial foray into the literature for three of these domains. a number of reasons. Like almost all my I also began to think about what it would countrymen, including physicians, I had take to rescind the marijuana prohibition been brainwashed by the United States which was responsible for millions of ar- government into believing that it was a rests and unspeakable misery. It seemed to very harmful substance. The subject now me that behind every kind of prejudice or began to smack of the phenomenon de- categorical discrimination there was some stereotyping. Those who use marijuana are Lester Grinspoon, MD, is Associate Pro- commonly referred to as “potheads” which fessor Emeritus of Psychiatry at Harvard evokes a picture of young, unkempt, lazy Medical School. He practiced at the Mas- ne’er-do-wells. sachusetts Mental Health Center in Boston As I became involved in marijuana-re- for 40 years, and was the first U.S. doctor lated activities (talks, grand rounds, meet- to prescribe lithium carbonate for bipolar ings, television and radio appearances, disorder. He is a longtime active member etc.) I was identified an “activist,” which is of the NORML (National Organization for looked down on in the academic world, as the Reform of Marijuana Laws) board of if it were a result of bias rather than knowl- directors. edge and understanding. Thanks to Carol Connare, archivist at So in 1975 when Jack Ewalt announced the University of Massachusetts Amherst that he was going to put me up for early W.E.B. Dubois Library, for drawing Dr. promotion, I was pleased and grateful. I Grinspoon out on this subject. Carl Sagan and Lester Grinspoon at Sagan’s wedding in 1981. Grinspoon was best man. continued on next page —44—O’Shaughnessy’s • Autumn 2015

Grinspoon from previous page went about revising my curriculum vitae to Coyle’s arrival in Boston, each of the sub- For a moment I excitedly my generation. However, two of the lat- fit the style demanded by the Promotions departments held a meeting to introduce ter made their presence known during the Committee and happily anticipated the day him to the faculty. I was taken aback when, thought that, finally, the medical question period. A senior pediatrician ex- when the decision would be made. upon our being introduced, he said some- school was catching up with a pressed, somewhat angrily, his belief that That day came about a month or so lat- thing to the effect of: “Oh, I know your modern, data-based understand- cannabis was dangerous to young people er when Dr. Ewalt’s secretary called and name; I am acquainted with your book [not because brain development continued until asked me to come to his office. As we ex- sure if he said ‘read’] on psychedelics and I ing of cannabis as a medicine the early twenties. For that reason, he said, changed greetings there was something in didn’t like it.” I was shocked that he would and that perhaps I was being re- what I was doing was harmful to young his voice which suggested bad news. say this, let alone in front of my fellow fac- habilitated. people because I was reducing their fear “They turned you down.” ulty members. It predicted a stormy rela- of marijuana. It wasn’t exactly a question “They did?” (With constrained surprise) tionship over the following years. Since the year 2000, I have continued to but I replied that I had never advocated its “Yes.” In 1995 I announced my intention to be- write from my home office. Over the en- legal availability to people under 21. “Can you tell me why?” come emeritus in the year 2000. It was suing years I heard little from HMS other The other older person was sitting in the “They like your work in general, and they some time after that that I heard via the than perfunctory announcements of meet- second row and could barely contain her- loved the schizophrenia book, but they hat- grapevine that the Promotions Committee ings and speakers, and appeals for funds. self in attracting the attention of the chair. ed ‘Marihuana Reconsidered.’” was, after more than 20 years, reconsider- Then, in 2013 I received an invitation to She just stood up and began explaining at “They hated it? What did they hate about ing my promotion. Once again, I was very write a short piece on cannabinopathic length how harmful my position was. I lat- it?” (I was stunned.) pleased by the prospect. medicine for Harvard Medicine, a maga- er learned that she was Dr. Bertha Madras, “They said it is too controversial” It was in November, I think, that I heard zine published by the medical school. Professor of Neurobiology and a former “Too controversial! What should that from my new chief, Dr. Ming Tsuang, that For a moment I excitedly thought that, fi- Deputy Director for Demand Reduction in have to do with it? Aren’t we all in the the committee had approved the promo- nally, the medical school was catching up the White House Office of National Drug Academy? What did they think of the tion. with a modern, data-based understanding Control Policy, a Presidential appointment scholarship?” He signed it immediately and sent it over of cannabis as a medicine and that perhaps in the George W. Bush Administration. Jack then held out his hands toward me to Coyle, whose signature was required as I was being rehabilitated. The chair terminated the program on with his palms up, “Hey, don’t blame me; well. Over the next three or four months But, alas, the piece was to be published the hour but asked us if we could stay to I’m just the messenger.” Tsuang called Coyle a number of times to alongside one which would express a coun- answer questions. Two people came for- I found this news difficult to believe! In remind him that my promotion was being ter view by Dr. Kevin Hill, who heads up ward to ask Dr. Hill questions and he was addition to “controversy,” could they also held up by his failure to sign off on it. the Drug Rehabilitation Center at McLean. through in a couple of minutes. There were have been influenced by the fact that I was Finally, after the new year began, Coyle As though I were writing on evolution and several dozen enthusiastic young to mid- then considered to be an “activist” in this told Tsuang that he was going to wait for that demanded a companion piece on cre- dle-aged people in line who wished to ask area and did not hide my personal use? the new dean to arrive on July 1st as he ationism! me a question, just say hello, autograph a I found it difficult to believe that any now believed this promotion should be Shortly thereafter, I was invited to give book, or have a cell-phone picture taken of members of that committee would be countersigned by the dean. There was no a talk on marijuana as a medicine at the the two of us. aware of my activism except for radio and precedent for this requirement. “Talks at Twelve,” a program held at noon For me, this 35-minute epilogue made the television appearances. I doubt that any of Joseph Martin, MD, became the dean of to facilitate attendance by people from the experience seem very worthwhile. It gave them had seen me quoted in High Times, or Harvard Medical School on July 1, and medical school proper and all of the associ- me hope that with the passing of my gen- knew that I was on the board of NORML within about 10 days I heard via the grape- ated teaching hospitals. eration, the anti-cannabis culture, which (the National Organization for the Reform vine that he agreed with Dr. Coyle that my Again, I was disappointed to learn that I permeates Harvard Medical School and of Marijuana Law). And, while I am honest promotion should be vetoed. Dean Martin, would have only a fraction of the hour be- allopathic medicine in general, will disap- about my personal use, I am not provoca- as far as I know, knew nothing of me or my cause there was to be a “counter” presenta- pear and medical students and physicians tive. work and he apparently did not believe it tion by Kevin Hill. Each of us was allowed will have the opportunity to learn what this As I was about to leave his office, pro- was important enough to meet me or even 20 minutes so that there would be time remarkably non-toxic and versatile medi- foundly disappointed and thoroughly con- talk to me on the phone before his veto. for questions. The event took place at the cine has to offer. fused, Jack said, “They asked me to ask I left my office in 2000 with mixed feel- Armenise Ampitheater, and was billed as I continue to believe that Harvard Medi- you what you plan to work on in the fu- ings. I had very much enjoyed my work “Medical Marijuana: What are the Facts?” cal School is a great institution. But it dis- ture.” and am pleased with what I accomplished, The auditorium was overflowing, most- appointed me when it failed itself in violat- To this day I do not know whether my but my feelings toward Harvard Medi- ly with younger people and very few of ing its obligation to academic freedom. quick answer came largely from disap- cal School were mixed. I loved HMS as a pointment alloyed with anger or an instinct student, particularly because it had such a that I should avoid answering that ques- large, impressive faculty, readily available tion, or both. But I replied, even though I to students. It was with help from a faculty Profiting From ‘Treatment’ was already involved in my next project, “I mentor that I had published my first medi- In his “counter” arguments to Lester Grin- don’t know; I’m an intellectual will-o’-the- cal paper as a first-year student. spoon, addiction specialist Kevin Hill as- wisp and I can’t say.” Also during my first year, I was one of serts the NIDA line that nine percent of I wondered whether the Promotions two students awarded a scholarship which marijuana users have a medical disorder de- Committee was sending me a signal to exceeded the cost of tuition for my remain- fined by their being “dependent” on its use. “Keep your nose clean and don’t get in- ing three years. I had been borrowing mon- In fact, the Treatment Industry is dependent volved in controversial areas.” In fact, the ey for my education from a bank that had on the existence of such a medical disorder. project I was already involved in would required me to take out an insurance policy This is from Hill’s bio on the McLean’s soon be published by Harvard University on my life; what a relief that scholarship website: “Kevin P. Hill, MD, MHS, is an Press: “The Speed Culture: Amphetamine afforded me! addiction psychiatrist conducting clinical McLean’s residential rehab “cottage” Use and Abuse in America” by myself and My sense of financial indebtedness to research aimed at developing medications costs $2,250 per day and does not accept Peter Hedblom. and behavioral interventions that might help Harvard was more than resolved when in insurance. “A 30-day minimum stay is That book was not considered controver- those wanting to stop smoking marijuana 1982 I donated to the Department of Psy- recommended to help assure full benefit sail (except by pharmaceutical manufac- or cigarettes. Dr. Hill received a prestigious chiatry at the Massachusetts Mental Health from the program,” says a note on the turers) and it was largely responsible for federal K99/R00 grant award from the Na- Center my 10% royalties for editing a new McLean website forwarded by NORML’s tional Institute on Drug Abuse: his project is the Senate hearings which ultimately led publication, an annual Review of Psychia- Allen St. Pierre. to restrictions on the prescribing of am- try published by the American Psychiatric to test the efficacy of a synthetic marijuana- phetamines. I was the lead witness at those Association. like compound, nabilone, as a medication cal School, Kevin Hill’s career has been hearings, which were chaired by Sen. Gay- I had conceived the idea of an annual re- for patients with marijuana dependence. advanced by Hazelden —a leading treat- lord Nelson of Wisconsin. view, put it together, and edited it for the Dr. Hill earned a Masters in Health Science ment racket enterprise— and the Robert 1 I worked at turning my disappointment first three years. Each volume was between from the Robert Wood Johnson Clinical Wood Johnson Foundation. Immediately over being denied promotion into some- five and six hundred pages, and covered- Scholars Program at Yale and has published after Prop 215 passed in 1996, Drug War thing useful: I decided to skip as many topics such as schizophrenia, depression on numerous topics in addiction. Recently, strategists and government officials met se- faculty meetings as I could. This saved a etc. Each topic was addressed by five of he has spoken nationally and appeared on cretly in Washington, DC, to plan the con- television on the topics of marijuana policy lot of time that I could devote to research the leading experts in that area. tainment effort. A representative from the and treatment, offering a balanced, evidence- and writing, but resulted in my becoming As chairperson of the Scientific Program Robert Wood Johnson Foundation promised based stance on these issues. Dr. Hill’s book, somewhat alienated from the faculty. Committee of the APA, I chose the authors. all the funding that would be needed (See “Marijuana: The Unbiased Truth About the Fortunately, it was at about that time that I The Review of Psychiatry was quite suc- O’Shaughnessy’s Winter/Spring 2007.) World’s Most Popular Weed,” was released • Joe Martin, the Harvard dean who vetoed met James B. Bakalar, with whom I began cessful and sold thousands of copies annu- 2 by Hazelden Publishing in March 2015. Dr. Grinspoon’s promotion in 1997, had been to work. He was co-author for subsequent ally at more than $50/per. Hill also maintains a small private practice.” chancellor at UC San Francisco, where he books and years later succeeded me as Several years later I proposed a publica- Hill’s use of “balanced, evidence-based” pushed through a merger with Stanford over editor of The Harvard Mental Health Let- tion that would be called “The Harvard and “unbiased” is nothing but self-praise. faculty objections —a “public-private part- ter. Brown-bag lunches in my office with Mental Health Letter.” It was approved by His livelihood depends on marijuana caus- nership” that combined some departments “Jake” were always looked forward to. the Harvard Publications Committee and ing harm —an obvious conflict of interest from the two hospitals for reasons that sup- The “Super-Chief” within a few months James B. Bakalar and when it comes to evaluating its safety. posedly made financial sense. Martin left In 1991 Dr. Joseph Coyle was brought to I began to produce it. Against all expecta- As for spending millions of U.S. taxpay- for Harvard as the absurdity and cost of the McLean Hospital from John Hopkins to tions it was “in the black” in the first year ers’ dollars on studying synthetic THC —the merger was becoming apparent. Financial fill a newly established position of “super- and over the course of the next 15 years one psychoactive compound in Cannabis— consultants made millions from the fiasco, chief,” to whom all the chiefs of Harvard’s generated several million dollars for the as a cure for a non-existent addiction... that and California taxpayers paid out. The loss Psychiatry fiefdoms would report. Upon Harvard Medical School. seems truly crazy. in ‘99 was $86 million, and the merger was • In addition to NIDA and Harvard Medi- called off. —FG