The implications of using medical marijuana as an alternative to prescription drugs are certainly not a new discussion topic. “We’ve been using cannabis for 5,000 years,” Harvard Medical School instructor and medical cannabis specialist Dr. Peter Grinspoon pointed out in an interview with the Harvard Independent. “If you look at the big picture in human history, it hasn’t been an alternative treatment. It just recently was criminalized in the 1930s.”
Grinspoon attributes such stigmatization to the treatment, at least partially to the war on drugs. Grinspoon, a physician who overcame prescription drug addiction and has now made a career endorsing the use of medical marijuana, brings a nuanced perspective to discussions of how concerns of addiction should be considered when utilizing cannabis in a medical context.
Aside from his medical qualifications, Grinspoon’s personal experiences aid his ability to compare pharmaceutical treatments to often-stigmatized natural drugs. “There’s no substitute for lived experience,” Grinspoon said. Having recovered from prescription drug addiction, Grinspoon now leverages his past struggles with addiction to help others and evaluate treatment options.
We often assume that the individuals addicted to prescription drugs are exclusively patients. However, physicians have proven to be equally vulnerable to the dangers of pharmaceuticals—studies have found that around 10-15% of all healthcare workers develop an addiction during their respective careers.
Grinspoon explained that being a physician is immensely emotionally taxing, contributing to high rates of burnout among professionals. The standards and expectations that are associated with being a doctor only exacerbate the frustrations of addiction. “Nobody really expects doctors to be sick or to have problems, so there’s a lot of guilt, shame, and secrecy involved with being an addicted physician,” Grinspoon said.
Following his recovery from prescription addiction, Grinspoon is committed to combating prescription drug addiction and dependence. After pursuing substance-related activism, including public harm reduction, five years into his recovery, Grinspoon was invited to become an Associate Director for the Massachusetts Physician Health Service. “I had the pleasure of helping hundreds of other doctors with their addictions,” he said.
Beyond this work, Grinspoon contributes to organizations such as Doctors for Drug Policy Reform and has published books on navigating addiction as a physician. “I really enjoy using my lived experience to help treat other people, whether they’re doctors or people from the street who are addicted,” Grinspoon added. When asked if his past fuels his advocacy for harm reduction practice in medicine, Grinspoon responded, “Absolutely.”
“I mean, it’s all about harm reduction,” Grinspoon said. “Cannabis can have a lot of side effects.”
Even as a medical cannabis specialist, Grinspoon openly acknowledges the inherent risks of marijuana. “It can be addictive. It can destabilize people with psychosis. It’s not safe in pregnancy. You don’t want teenagers to use it. It might affect your heart,” he said. Despite this, Grinspoon maintains that cannabis is much less addictive and less harmful than mainstream treatments such as opioids.
Despite emerging research on the side effects of marijuana use, Grinspoon does not find arguments against medical marijuana persuasive enough to disregard it as a viable treatment. Grinspoon believes that “even the most reefer madness-infected doctor who thinks that cannabis is satanic lettuce wouldn’t argue that it’s not more dangerous than OxyContin. OxyContin is much more dangerous.” OxyContin, a prescription painkiller, has been noted by the Mayo Clinic to become potentially addictive with long-form use and should be taken only under provider supervision and according to prescription guidelines to effectively relieve pain. But Grinspoon added that the “pharmaceutical industry promoting OxyContin so that everybody uses it—gets addicted to it,” may worsen the issue.
With this controversy in mind, Grinspoon believes that education is the key to reducing harm and negative public perception of medicinal marijuana among physicians—something that he thinks the current pharmaceutical industry is failing to deliver. “They haven’t been taught anything helpful about cannabis,” he said. “If you look at polls, most doctors want to talk to their patients about medical marijuana, but don’t know enough to have a meaningful, helpful discussion.”
Grinspoon has his own method to safely prescribe the substance.“I generally start people on a tincture, like an old-fashioned medicinal tincture under the tongue, or I start them on an edible like a gummy or a piece of chocolate, or ideally, a pill that looks like cannabis, that isn’t some kind of tasty cannabis treat that some kids gonna eat or some pet,” he said. By using a tincture or edible for consumption, one mitigates the harmful effects of smoke on the heart and lungs. In terms of dosage, Grinspoon advises a low and slow approach, easing the way into cannabis consumption to prevent possible dangerous side effects or anxiety from the treatment.
Grinspoon’s earlier struggles with addiction have offered him the ability to craft a unique understanding of how to approach harm reduction and cannabis usage. The complex relationship between his medical degree and struggles with addiction compels him to challenge how society perceives the use of cannabis, particularly in a medical context.
“The first priority is educating doctors about cannabis,” he said. “I think education is critical, but I think we also need to get everybody on the same page about cannabis.” Moving forward, Grinspoon emphasizes that the implementation of this treatment method depends on how it is evaluated on a factual basis rather than biased social perceptions that often discredit it.
Megan Legault ’28 (mlegault@college.harvard.edu) thinks that there is a strong POTential future for medicinal marijuana.