The first time Dr. Ethan Russo talked with a patient about medical cannabis, the canna-landscape was a very different place than today.
The year was 1980. The Reagan Era would soon begin a backlash to the excesses of the 1970s that would evolve into a wide-spread war on cannabis and Americans who enjoyed it. A physician advocating for cannabis faced no small amount of personal, professional and even legal peril.
Yet when Russo, then a young neurologist working at a Veterans Administration clinic, met a patient whose muscle deterioration had slowed since self-medicating with cannabis, he could not ignore it. In fact, it sparked a revolution in his thinking about medicine and natural treatments.
“It occurred to me that I was giving increasingly toxic drugs to my patients with less and less return, whether it be treating epilepsy or migraines,” he said.
Russo would go on to become one of the foremost advocates of the medical benefits of cannabis, writing several books and pioneering numerous pharmaceutical cannabis medicines. He had to battle the federal government and the mainstream medical establishment along the way.
But with medical cannabis now legal in two dozen states and more countries each year, it sure looks like he won. Or at least he’s no longer a voice out of left field, but a founding member of a global movement.
Like many who came of age in the ‘60s and ‘70s, he was already acquainted with cannabis.
“Unlike some people, I inhaled frequently, deeply and with forethought, but that was a long time ago,” he told us in a recent phone interview.
After completing his residency at the Seattle VA hospital, he opened a practice in Missoula, Montana, a liberal bastion in cowboy country. If a patient asked—or if he thought it could help their condition—he freely espoused the benefits of cannabis. Multiple sclerosis, muscle tightness, mood problems, depression; cannabis seemed to have benefits for these and more. A patient with ALS, a degenerative condition, taking only cannabis lived for a decade with no deterioration.
“We didn’t cure anyone, however, the people that did use it tended to be better clinically and certainly had a better adjustment to their illness,” he said. And he was open about it, telling the state’s medical board that he was advising, but not prescribing, patients on cannabis. Soon other doctors were sending patients to him.
Russo also began to wonder about what other plants out there could benefit human health. So in 1995, he took a sabbatical to live with an indigenous tribe in the jungles of Peru, studying the many plants and herbs used medicinally. The experience further shaped his curiosity of herbal benefits and helped inspire his first book, Handbook of Psychotropic Herbs.
But one herb in particular was still his main focus.
Battling the Feds
There was a twisted irony to anyone wanting to legally study cannabis in the 1990s.
In 1997, the Food and Drug Administration denied his research request to study its effect on migraines. The FDA denied it again the next year. The study was approved in 1999, but cannabis for scientific research was required to come from the National Institute on Drug Abuse. That agency refused to provide it.
Russo said, “I realized I was never going to be able to do the kind of cannabis therapeutic research I wanted in this country.”
So in 2003, he quit his practice and began working for British company GW Pharmaceuticals. He didn’t have to move to Europe, but spent quite a bit of time there. He helped develop groundbreaking products like a liquid extract spray for MS patients, currently approved in 27 countries, but not the U.S.
He remains frustrated by federal roadblocks to cannabis research, even as people in places like Washington and Colorado can simply walk into a store and buy the plant for recreational purposes.
“Essentially what the government has set up is a situation in which American companies who might have a great deal of experience in this area cannot compete with companies from abroad,” he said. “What they’re doing is inhibiting commerce and proper research that could lead to better advancements and not only improved therapeutic applications but better safety as well.”
Last year, he became medical director of startup company PHYTECS, where he is conducting research on the human endocannabinoid system, a network of receptors in the brain and nervous system that he believes holds the key for many more breakthroughs in cannabis medicine.
Russo envisions a time when patients will be able to go into a pharmacy to get their cannabis medicine instead of a tie-dye-draped dispensary. And of a time when mainstream doctors will be comfortable prescribing it.
“Doctors get little or no training about cannabis in medical school and almost none about the endocannabinoid system. The system predates cannabis. It’s been present in us and animals for millions and millions of years, before there even was cannabis,” he said. “Why isn’t this important system that regulates how our bodies operate being taught in medical school?”
Still, he has reason to be optimistic.
“I do think when a cannabis-based medicine like (anti-seizure medicine) Epidiolex is approved in the US, physicians will take notice. If it’s been through the FDA process, they’re much more likely to accept it, be interested in it and be comfortable prescribing it so patients can get a script, go to a pharmacy and it will be like any other medicine at that point. The comfort level will increase and the intellectual curiosity will kick in and we’ll begin to make progress.”