1. Marcellus, Lenora MN, RN

Article Content

Women and Cannabis: Medicine, Science, and Sociology by Ethan Russo, Melanie Dreher, and Mary Lynn Mathre. New York: Hawthorn Integrated Healing Press; 2002. 187 pages, softcover, $24.95; hardcover, $39.95.


This book is an edited volume of 11 chapters written with the primary goals of providing a woman's historical perspective of cannabis use, exploring the use of cannabis to treat woman-specific conditions, and considering implications for fertility and maternal-child health. There are 3 editors of this volume, including 2 registered nurses and a neurologist. This volume was also simultaneously published in the Journal of Cannabis Therapeutics in 2002. This was the first academic scientific journal devoted to the study of clinical cannabis, endocannabinoids, and synthetic cannabinoids. Despite being well received, the journal did not develop a wide enough subscription base and subsequently ceased publication in 2004.


The 11 chapters in this book address a wide range of issues related to women and marijuana use. The first chapter, written by Ethan Russo, provides a fascinating historical grounding for the remainder of the chapters. Russo explores historical evidence of marijuana use by women as far back as the seventh century BCE. There is evidence that marijuana has been used throughout time and across cultures in a variety of ways to treat many women's health and reproductive conditions, including difficult childbirth, menstrual disorders, painful breasts, and vomiting of pregnancy. Interestingly, Russo reports that cannabis was still included in the British Pharmaceutical Codex as a treatment of dismenorrhea as recently as 1934. Folk use of cannabis continues to be reported in different cultures around the world. Although not discussed in this chapter, it is interesting to note that in North America the decline in medical use of cannabis was associated with development of propaganda in the early twentieth century that was unsupported by evidence and heavily influenced by Victorian moral standards and prohibitionist values. Marijuana was swept up in the company of cocaine and opioids in the subsequent drug panics and linked to crime, prostitution, and the general decline of American society.


Several of the chapters explore the use of marijuana for the treatment of woman-specific conditions. Bari, Battista, Cartoni, D'Arcangelo, and Maccarrone explain the role of anandamide (AME), an endocannabinoid that naturally appears in the body, in relation to human fertility. They suggest that endocannabinoids may be one component of the hormone system involved in the control of human pregnancy. Curry describes a small underground study of cannabis use as a treatment for hyperemesis gravidarum. The women in this study challenge the medical community for presenting marijuana as an unacceptable treatment alternative when the only other treatment choices that are available are invasive procedures, including intravenous nutrition, tube feeding, medications, or, ultimately, early cesarean sections. Petro reviews research studies related to the use of cannabis for women with multiple sclerosis (MS). Cannabis has been found to be effective in managing many of the common symptoms related to MS, including spasticity, pain, tremor, fatigue, and autonomic dysfunction. She concludes by stating that currently research in this field is limited to case reports or small scale studies and suggests that larger scale clinical studies are needed to provide further information about the use of cannabis for management of MS symptoms. Fried's chapter on the outcomes of marijuana use during pregnancy concludes that after confounding factors such as maternal health, nutrition, and the postnatal environment are taken into account, it is difficult to attribute any negative effects to the marijuana exposure. He does also caution that in some studies older children have demonstrated subtle changes to the cognitive processes of problem solving and attention. However, studies in this field are sparse and difficult to conduct longitudinally.


As many sources related to medical marijuana focus on treatment for general health issues such as chemotherapy-induced nausea and vomiting and AIDS wasting, it was interesting to read about applications for gender-specific health issues. Although focused on use in women, only a few of the authors address the overlying issues of society's attitudes toward drug use by women. Many of these articles describe the personal conflict that people felt when they knew that cannabis would help them with their symptoms yet forced them to participate in an illegal activity and hide their use from healthcare providers and others who would not approve of their use. This was particularly true for women who were pregnant and at risk of further judgment related to exposure of the fetus to cannabis.


Ultimately, the editors hoped that this collection of articles would stimulate practitioners to consider the potential therapeutic role of marijuana for women's medicine and "at least" promote the consideration of cannabis and cannabinoids for treatment of some clinical conditions. This book is interesting to read and presents an illuminating counterpoint to literature sources that are unwilling to reconsider the potential uses of a substance that has historically been used through the ages, particularly for women's health issues. Evidence related to marijuana use is often presented in a scientific and quantitative way; the studies in this book bring a qualitative and personal perspective to the debate on medical marijuana use. This book would be interesting reading for those practitioners interested in both the history of marijuana use and future potential medical uses of marijuana.


Lenora Marcellus, MN, RN


Instructor, School of Nursing, University of Victoria, CIHR Doctoral Research Trainee, Integrated Mentoring Program in Addictions Research Training, BC Centre of Excellence for Women's Health, Victoria, British Columbia, Canada