 | NORML News: Book Review - Cannabis on the Brain by Paul Smith |
 Published by Dunmore Press, Palmerston North, 2002
Reviewer: Geoff Noller
NORML News Winter 2003
In Cannabis on the Brain Paul Smith critically assesses the scientific study of cannabis and cannabinoids, in the context of experimental research and social use. Addressing these areas principally as a pharmacologist, Smith manages a detailed discussion of complex scientific issues and their social correlates with a refreshing clarity and balance. After briefly describing the history of cannabis, patterns of contemporary use in Aotearoa and Australia and the nature of cannabinoids, he explores how cannabis gets into the brain, its impact on behaviour, adverse effects, evidence of dependence, therapeutic applications and, finally, social and legal issues. Despite the considerable pharmacological depth, Smith's limited technical and jargon-free discussion, his easily understood graphs and diagrams, short chapters each with concise conclusions and the wealth of references make for a straight forward and rewarding read. In a field crowded with polemic texts of dubious authority Cannabis on the Brain has much to recommend it.
There is helpful information for recreational cannabis users and those considering the herb as a means to relieve symptoms of certain medical conditions. For example, without overstating his case, Smith demonstrates that smokers face definite dangers from cannabis inhalation. It's encouraging seeing important information of this nature unaccompanied by the usual scare tactics and, instead, explanations are offered which suggest at least partial solutions to some of the health problems associated with smoking such as the danger of loosely-packed joints.
Similarly, with mental impairment, although Smith notes numerous issues being explored by a variety of experiments - some not particularly relevant to real life, with regard to driving he avoids stridency while noting how factors such as poor road conditions and an unfamiliar vehicle or road could create problems for stoned drivers.
As one might expect of a pharmacologist, Smith focuses significantly on the brain's neuropharmacology and certain mechanisms, especially cannabis receptors and the consequences of their stimulation. Thus, when he considers issues such as immunosuppression from cannabis use, analgesia (pain relief) and dependence, his arguments have clear structure. If evidence is lacking then this is noted (immunosuppressent effects) but if it's present, as Smith believes is the case for dependence, then he states this without moralising.
I found the chapter on therapeutics interesting. For a lot of cannabis enthusiasts there is almost a mythology surrounding the medical benefits attributed to cannabis. Smith tends to be relatively pessimistic about the medicinal use of cannabis although he acknowledges the success of certain synthetic cannabinoid drugs. He also notes a degree of efficacy regarding glaucoma and potential benefits for stroke suffers and possibly epileptics.
Of similar interest are the final two chapters, on society and the law, and his concluding remarks. Although seeing the health problems of recreational cannabis use and its medicinal limitations, Smith acknowledges the damage done by prohibition and looks forward to a time when cannabis' place in society is determined more by scientific evidence and rational debate than moral panic, noting "it is sensible to consider what is to be gained from decriminalisation." This balanced perspective sums up the book for me. On the negative side, a discussion of the value of devices and strategies that genuinely reduce negative health consequences for smokers (i.e. vaporisers) would have been useful as it seems the dangers of smoking are viewed as a significant barrier to the medical use cannabis. I was also a little surprised that the value of the placebo effect was given such short shrift in the therapeutic chapter. If patients report feeling better for using a particular substance then presumably this is of value. In general, the discussion on the medicinal use of cannabis, as opposed to cannabinoids, could have been enriched with clarification of the potential for different cannabinoids to 'compete' for a dominant effect through acting on different receptor populations, i.e. by ingesting cannabis, all receptors are affected, possibly cancelling out specific effects on separate brain areas and illnesses affecting them. However, this issue involves the assessment of numerous scientific papers and a significant amount of pharmacological knowledge, and is perhaps better suited to Smith's pharmacology paper (see article). For this reason a glossary would also have been useful as although Smith attempts to write for a non-expert readership, his work is necessarily based in the complex field of pharmacology. Overall, although many readers may be familiar with varying portions of what Smith discusses, to have it all in one book, presented accessibly and related to conditions in Aotearoa is excellent.
Paul Smith is a Professor of Neuropharmacology in the Department of Pharmacology and Toxicology in the School of Medical Sciences at the University of Otago Medical School, Dunedin. Originally from Australia, where he received his PhD from the University of Sydney in 1987, he has taught and conducted research at the University of Otago for the last 15 years. Cannabis on the Brain is his second book and he has published more than 160 scientific papers and book chapters. Professor Smith is currently appointed to the Health Research Council's Standing Committee on Therapeutic Trials (SCOTT) and the Scientific Advisory Committee of the New Zealand Neurological Foundation. He is also the Oceania Editor for the Journal of Vestibular Research.
Dunmore Press distributes through University bookshops and stores like Whitcoulls and Dymocks. Cannabis on the Brain is also available through Federation Press in Australia. The recommended price here is NZ $35 paperback. You can order on-line from Dunmore at: http://www.dunmore.co.nz/
Professor Smith and the Health Select Committee:
In keeping with his interest in cannabis, Professor Smith contributed a submission to the on-going Health Select Committee cannabis inquiry. He concluded by saying: "Although cannabis use is associated with significant health risks, these will remain even if cannabis use is not decriminalised. However, decriminalisation is more likely to effectively address these health risks than prohibition, by creating an environment in which accurate information can be disseminated and the use of cannabis can be monitored more effectively."
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