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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5515_Библиотеки_им_академика_М_И_Перельмана.pdf
percent. Following the stock market is tricky business, but astute knowledge of what is
going on in the cannabis world (like legalization events and tax increases) can help in
navigating the market. Being aware of how resources are allocated in marijuana product
development is another way to keep up with the often times blurry trends of the stock
market. We turn to these issues in the next graph.
Allocation of Research Money in Developing Cannabis as a
Medicinal
Chapter 14 discussed the complexities of the drug approval process in the US. Part of
drug approval has involved deregulating cannabis as a dangerous drug. Is marijuana
being treated in a balanced way by government regulators? One way to address this
question is to ask what the federal and state governments focus on when funding
marijuana research. It would seem logical that if governments are supporting medicinal
research and little else, one could conclude that the goal of regulation is to focus on
expanding the medical applications of cannabis. On the other hand, if the major
recipients of government funds are for research into the legal aspects of cannabis, then a
different agenda could be perceived.
Figure 17.5 shows the trends for funding of five categories of marijuana research
focus in the United States. Twenty years ago, the major focus of US research funding
was for projects examining the harmful effects of cannabis use. A good portion of the
research funding also went to studying the endocannabinoid system. Cannabinoid
(synthetics) and Cannabis (the plant) composed a mere 10 percent of the total funding
for cannabis research. As the graph shows, there have been steady increases in funding
for all five categories of cannabis research.
But the focus on cannabinoids and cannabis as therapies hasn’t gained much ground
relative to studies investigating the harmfulness of cannabis and how the
endocannabinoid system works. The amount of research money dedicated to
therapeutics is only about 20 percent of the total research budget. Even social studies of
the attitudes, economics, and regulations of cannabis are funded at a higher rate than
cannabis therapeutics. Knowing the harmfulness of cannabis and cannabinoid impacts
on humans is of course an important part of understanding cannabis’s therapeutic
potential, but it seems unfortunate that relatively little funding supports research on the
therapeutic nature of cannabis and cannabinoids. Focusing on more specific aspects of
the harms produced in a sociological context would also provide a better balance of
research investment. We turn to this topic with the next graph, which examines use of
cannabis by teens.
Figure 17.5. Graph of federal spending patterns on marijuana research from 2000 to 2020. Adapted from
O’Grady (2020).
Are Young Children Smoking a Lot of Pot?
Oddly, high school kids have been placed in the midst of marijuana culture for much of
the last century. From Ralph Wiley (“Faster, faster. Play it faster”) in the movie Reefer
Madness to Jeff Spicoli in Fast Times at Ridgemont High (“All I need are some tasty
waves, a cool buzz, and I’m fine”) to the offspring of the That ’70s Show stoners in
That ’90s Show (who are themselves stoners), film has portrayed many American
youngsters as pot smokers. And more than likely the biggest celebration of cannabis use
today, 4/20, had its beginning in a high school. While there are many origin stories for
the 4/20 celebration (for instance, the Bob Dylan factoid that 12 times 35—as in “Rainy
Day Women”—equals 420), the most plausible story suggests that a San Rafael,
California, high school was the wellspring. The kids at this high school would gather at
4:20 pm after classes to smoke marijuana. They would use “420” as a code for their
sessions. The time 4:20 morphed into the date 4/20, which became a national marijuana
day.
How prevalent is teen cannabis use in actuality? Under no current laws in the
United States can marijuana be sold to children or young teenagers. It is unreasonable to
assume, however, that they cannot get their hands on it. In places such as New York
City, where open marijuana smoking is tolerated, bus stop cannabis-smoking sessions
are common among high schoolers. In chapter 16 I mentioned the harm that can be done
to the developing teen brain if marijuana abuse is part of a teenager’s everyday life. But
to drive home the dangers, I provide a list of hazards that marijuana use poses
particularly for teenagers. This list comes from the US Substance Abuse and Mental
Health Services Administration:
Neuropsychological and neurodevelopmental decline
Poor school performance
Increased school drop-out rates
Increased risk for psychotic disorders in adulthood
Increased risk for later depression
Suicidal ideation or behavior
Figure 17.6 plots marijuana usage patterns for eighth, tenth, and twelfth graders
from 1975 to 2023. There are several interesting trends. First, although there are no data
for 1975 to 1990 for eighth and tenth grades, the usage of teens starting in the 1970s
rose to its peak around 1979 of about 50 percent of the respondents smoking marijuana
regularly. Though illegal during this period, there was a great deal of interest in
marijuana use by teens that gradually decreased to a low for twelfth graders in 1991 of
about 20 percent. Second, the years after tenth and eighth graders were placed into the
survey showed a gradual increase in usage from the eighth to tenth to twelfth grades. It
is notable that all grade categories showed a sharp increase in the 1990s, likely due to
legalization/decriminalization in some states. Third, essentially the trends for eighth,
tenth, and twelfth grades mirrored each other from 1990 to 2020; but eighth grade was
always lower than tenth grade, which was always lower than twelfth grade. Fourth,
there has been a stable pattern and maybe a slight decrease in marijuana use by teens in
the survey since 1990 until 2020–2021, where a very noticeable dip in usage appeared
at all three age levels. The dip appears to have stabilized, because the results for 2021–
2022 were all upward relative to the previous year.
Figure 17.6. Trends in marijuana use among eighth-, tenth-, and twelfth-grade US students. Data from
Monitoring the Future (https://monitoringthefuture.org/, also known as the National High School Senior
Survey). Over 32,000 students from over 300 high schools were surveyed in 2020–2021. This ongoing
study has been conducted by researchers at the University of Michigan.
This fourth trend was stunning and not evident for other drugs that the survey
considers. Even in the face of many states relaxing their marijuana laws, this
considerable dip was observed. According to Nora Volkow, the director of the National
Institute on Drug Abuse, which funded the survey, “We have never seen such dramatic
decreases in drug use among teens in just a one-year period. These data are
unprecedented and highlight one unexpected potential consequence of the COVID-19
pandemic, which caused seismic shifts in the day-to-day lives of adolescents.” Volkow
observed that, if researchers can pinpoint what made teens decrease their usage during
2020–2021 (beyond the fact of the pandemic), then perhaps we will have clues for
reducing marijuana use in teens in the future. Perhaps the pandemic induced more
parental oversight, or caused a lack of drug availability; perhaps other unforeseen
social aspects were factors. At this point we don’t know what exactly caused the dip,
but it most probably has something to do with how our lives changed during the
pandemic.
How Global Is Cannabis?
Chapter 15 reviewed the worldwide legality issues of cannabis. But what about actual
global use patterns? Figure 17.7 graphically represents the global use patterns of
cannabis. The two countries with the largest populations are not quantifiable, as data
are lacking for India and China. The pattern of use is somewhat clear for the rest of the
globe. North Americans are relatively heavy users of cannabis compared with the rest
of the world, as are Australians and New Zealanders. European use is also quite high,
with France topping the countries there at an overall use percentage of 11 percent. Some
African countries such as Nigeria and Zambia also have heavy usage. Not surprisingly,
the first country to completely legalize marijuana, Uruguay, has one of the highest usage
rates. These results seem to be solid except for one glaring problem. Oddly, Iceland
tops the chart with a whopping 18 percent usage rate. Marijuana use was at one time
legal in Iceland but was made illegal in 1969. And alcohol was prohibited in Iceland up
until about thirty years ago. Icelanders argue that the figure of 18 percent is ridiculously
high. And it might be.
The study summarized in figure 17.7 used the percentage of the entire population
that had smoked marijuana in the last year (which would be 2014 for the Iceland data).
But the 18 percent figure for Iceland resulted from asking those who used marijuana if
they had used it in the last year. This way of asking the question severely biased the
overall result. If the survey had been done correctly, the total would show only 6.6
percent of Icelanders smoking pot in the last year, pulling it down to twenty-ninth on the
pot-using list. Icelanders, although proud of their progressive attitudes, pointed out that
marijuana was illegal when the survey was taken, and this most assuredly influenced
how marijuana is used in that country. Fines for marijuana use in Iceland are somewhat
strict, and it is still not legal at the time of this writing.
Figure 17.7. Global distribution of marijuana use. Dark rectangles indicate countries with greater than 10
percent usage among the population; vertical stripes indicate between 5 and 10 percent population use;
horizontal stripes indicate 2.5 to 5 percent use; and stipples indicate less than 2.5 percent use. White
indicates no data available for that country. The stars indicate nine countries with very high marijuana use:
Iceland (18.3 percent), US (16.2 percent), Nigeria (14.3 percent), Canada (12.7 percent), France (11.1
percent), New Zealand (11 percent), Australia (10.2 percent), Zambia (9.5 percent), and Uruguay (9.3
percent). Drawing by Rob DeSalle and Patricia Wynne.
This leaves the United States as the world’s number one pot-smoking country.
According to a study by the Cannabis Price Index, New York City, Los Angeles, and
Chicago are three of the top ten cities with the highest consumption of cannabis. New
York City consumes almost twice of what the next closest city, Karachi, does per year.
The other cities in the top ten are London, Moscow, Mumbai, New Delhi, Cairo, and
Toronto. One needs to be careful in interpreting the results of this comparison, though,
because the top ten cannabis-using cities are also among the top largest cities in
population size.
Different societies take different views of marijuana’s place in their culture.
Icelanders took some offense at being identified by the study in figure 17.7 as the
number one pot-smoking country. Other nations celebrate their pot-smoking heritage,
and there is no more celebratory medium for cannabis than film, which we turn to for
our next chart.
Movies and Pot
Since the early twentieth century, cinema has become an important part of many
cultures. In 1999 a writer named Kip Kay published an annotated list of all the movies
between 1930 and 1999 that showed or referred to marijuana use. This must have been
an entertaining exercise, because he covers over sixty years and 550 films in his list.
Figure 17.8 plots the number of movies each year that included or referred to marijuana
use.
Few films referenced marijuana before the 1960s. The ones that did were often
cautionary tales against getting high. Because of its poor acting, sensationalism, and
outright bizarreness, Reefer Madness is considered the grandfather of all marijuana
movies. Released in 1936 as part of Anslinger’s Army’s arsenal to educate the public
about the evils of marijuana, it was not, however, the first movie to reference marijuana.
Two years before the release of Reefer Madness, Murder at the Vanities was released.
This film couldn’t decide whether it was a comedy, musical, detective story, mobster
movie, or drama, but it did feature B-movie actress Gertrude Michael singing “Sweet
Marijuana” with the Duke Ellington Band. The song’s refrain (“You alone can bring my
lover back to me / Even though I know it’s all a fantasy / And then put me to sleep /
Sweet Marijuana, Marijuana”) suggested a dreamy but sad relationship between
cannabis and the singer.
It is easy to imagine that the long gap between Reefer Madness and several 1950s
movies referencing marijuana was the result of the craziness about cannabis engendered
by that movie. Perhaps Reefer Madness was effective propaganda (the “young” people
in the movie either die, go crazy, or are arrested for murder), or perhaps marijuana use
wasn’t an issue during those years. People in the United States had bigger concerns,
including recovery from a crippling economic depression and the Second World War.
There are two movies that are especially interesting from the 1950s: High School
Confidential and The Gene Krupa Story. The latter film tells the story of showy jazz
drummer Krupa’s marijuana conviction (and drumstick dropping due to marijuana use).
As the movie dramatically reveals, Krupa served time but redeemed himself. The movie
is almost a paean to drug use by musicians. High School Confidential, while slightly
better acted than Reefer Madness, takes a similar stand on marijuana use by teens. I use
the word “teens” lightly, because the actors in both Reefer Madness and High School
Confidential appear to be in their late twenties to early thirties. The message of both
movies was that bad things happen when you smoke marijuana.
Figure 17.8. Percentage of movies referencing marijuana released by year (white) and number of movies
released by year (black). Films from the early and peak years are listed.
Then came the late sixties and an infusion of movies using marijuana as a plot
device. There was a large increase in films with marijuana-tinged themes throughout the
seventies, eighties, and nineties. Between 1970 and 1998 an average of about twenty
movies per year used marijuana in their storylines; the year with the highest number of
marijuana films was 1996, with forty-seven movies. Although this is a high result, if the
number is adjusted relative to the total number of films released in a year, 1980 appears
to be the most saturated year before 1999, which is the extent of Kay’s survey. Many of
these movies incorporated marijuana in a light, humorous way that mirrored the relaxed
attitudes toward marijuana of those decades.
The twenty-first century ushered in a freedom to incorporate marijuana into
storylines in ways not previously imagined. It is, however, difficult to estimate the
number of films referring to marijuana since the 1990s, because movie releases
multiplied many times from then to the present. On the other hand, a search of the
internet reveals many “top ten” lists of movies referencing marijuana that became
popular in the early twenty-first century. Figure 17.9 summarizes thirty top ten lists. I
have ranked the movies in these lists by their position in the lists and normalized their
rank by the number of lists they appear in. The numbers above the bars in the figure
refer to the number of lists in which a particular film was ranked number one. The
movies in the figure are ranked from best (on the left) to next best (to the right). A total
of 141 movies appear on the thirty top ten lists, and The Big Lebowski was ranked at
the top using the criteria established for overall ranking. Although it appears as number
one in only two lists, it is found on almost everyone’s top ten list. The movie with the
most number one rankings is Cheech and Chong’s Up in Smoke, with ten. It is not the
ultimate number one because of the strong reaction about half of the rankers had against
it. Either they loved it and ranked it number one, or hated it and left it off their lists.
Figure 17.9. Compiled internet rankings of movies, documentaries, and television series that reference
marijuana.
I consider these two films among the best of marijuana movies myself, and The Big
Lebowski certainly deserves the highest of rankings. This Coen brothers movie is a kind
of detective story, a nod to bowling, very much a comedy, and definitely an ode to
marijuana. The Dude (played by Jeff Bridges) abides throughout the movie, and there
are two trippy dream sequences that nicely detail the marijuana high. One of the
sequences, induced by a sock to the Dude’s jaw, starts off with colorful exploding
fireworks and progresses to the Dude flying through space Superman style, with a
bowling ball in his outstretched right hand. The fluidity of his flight and the ending panic
of falling from the sky and abrupt waking up are convincing depictions of what it is like
to be high. The second dream sequence is only slightly more down to earth. Bowling
again is a part of the experience, and the overall dream resembles a 1930s Busby
Berkeley movie. The image of Saddam Hussein handing the Dude his bowling shoes and
the First Edition’s hazy background song, “Just Dropped In (To See What Condition My
Condition Was In),” are perfect marijuana dream devices. This dream sequence
contrasts the euphoria of the high (sliding down a bowling alley between the legs of
dancing women) with the unceremonious comedown, depicted by three red-clad men
chasing the Dude with big scissors.
Television has also broached marijuana use in many ways. The rise of cable
television and pay networks such as Home Box Office and Showtime pushed the
envelope, with the Showtime series Weeds ranking as number one over all of the ten
lists summarized in figure 17.9. This series about a Southern California widow building
a marijuana sales empire was rated number one on half the top ten lists and was
universally regarded as a top ten series in the rankings. One network series that ranked
fairly high was That ’70s Show, with its now famous circle smoking scenes. Censorship
on network television has been stricter than for the cable and streaming channels that
prevail today, and these scenes were somewhat controversial when they first appeared
on the Fox network. Prohibited from showing marijuana smoking on-screen because of
censors, the producers decided to set a camera at the center of a table that would rotate
to view the individuals sitting at the table (but without a joint), who would then make
stoned remarks to the camera. As the joint gets passed around the table, the actual act of
smoking was avoided. That ’70s Show (airing in the late 1990s) has given rise to That
’90s Show (airing in 2023–2024), where the children of the teens in the seventies show
are now the subjects. The rotating camera device proves as effective today in the new
series produced by Netflix as it was in the late 1990s for the original series.
The TV top ten list includes cooking shows such as Bong Appetit and Cooking on
High. Julia Child was perhaps the first to produce cooking shows for television, her
French Chef series airing initially in the 1960s. Since her pioneering work, cooking
shows have become part of the culture of many countries. A nation’s cuisine is integral
to its culture, and cooking has always been a part of the culture and draw of marijuana.
It appears that marijuana has made inroads into this mainstream way of entertaining and
educating people about food.
My favorite on the top ten lists for marijuana documentaries is Super High Me,
made in 2007. It follows comedian Doug Benson, who abstains from marijuana for