Tuesday, May 18, 2021

Cannabis and the Treatment of Cancer

Cannabis sativa
The other morning as I was walking past a local coffee shop, I noticed a long line-up of people outside waiting patiently for their regular dose of coffee or their shot of espresso. At moments like these, it becomes apparent that coffee is indeed a drug. I had already had my own daily fix of this dark liquid. In fact, the only time I would consider postponing my daily ritual of drinking coffee would be if I run out of coffee - which is not likely as I tend to keep stacks of whole-bean and ground coffee ready at hand in our pantry - or if I need to do bloodwork that morning, which fortunately happens only once in a blue moon.

The other observation I have made is that liquor stores in our city tend to open before the library does, hence, consciously, or unconsciously, giving an evident priority to booze over books. In fact, the addictive trio of coffee, alcohol, and cigarettes are legal drugs that are commonplace and used on a regular basis. Although the former can be imbued at any place, the other two have been restrained and restricted in their use. Only recently has marijuana joined the mix here in Canada and only after a lot of pushback and various legal battles.

Yet despite marijuana being now legal in different places around the world, there are still many stigmas, prejudices, and misconceptions attached to it. Why are people still hesitant to accept the idea and embrace the fact that marijuana is not as harmful as once believed but, on the contrary, that it has proven health benefits, including its potential of alleviating and managing pain? Why do many people hold onto unsubstantiated, unfounded, and incorrect sets of beliefs on the matter? Many consume their daily coffee and smoke cigarettes but stay away from marijuana at all costs, even though it is comparatively less addictive and despite its demonstrated medicinal properties.

These thoughts, questions, and deliberations came to the forefront especially during and after a deliberative public engagement (incidentally my second one but the first virtual kind) that I had the pleasure to partake in. As part of the process, I was asked to “think aloud” and to state my opinion about the use of cannabis for cancer treatments by being given different hypothetical scenarios and situations.

In fact, cannabis can be used in various ways as part of cancer treatments: It can reduce cancer-related pain as well as nausea after chemotherapy sessions; at the same time, it can also help with related symptoms like insomnia and depression. For many cancer patients, the medicinal use of cannabis was correlated with an overall improvement in their quality of life.

Yet the question that the research study wanted to shed light upon was what factors influenced and determined the choice of accepting and embracing cannabis as an additional complementary form of therapy towards the management of cancer-related and -induced symptoms. Put differently, who and what influences an individual’s decision-making when it comes to medicating oneself with marijuana.

I myself am currently not using marijuana in any form and manner, but I am strongly in favor of using cannabis in a medical context as part of one’s overall treatment plan. In fact, if I were given the choice between either prescription drugs and pharmaceutical products or cannabis, I would choose the latter without a doubt or hesitation. Yet many still refuse and reject this option as they remain set in their belief that cannabis is harmful.

A similar situation occurred some years ago when my mother who was suffering from glaucoma was prescribed marijuana as an alternative and effective form of treatment. Yet without giving it much or any thought for that matter, she fully and vehemently rejected that option. Nonetheless, she continues to smoke cigarettes on a daily basis, and ironically, she is perfectly fine with her smoking habit despite strong evidence of the harm that cigarettes cause and bring about. This kind of disconnect that exists between smoking physically addictive and life-threatening substances versus a medically prescribed natural herb that can treat illnesses can seem quite puzzling at first sight.

Yet the items and scenarios brought to light during the deliberative public engagement session on cannabis and cancer treatments highlighted some of the issues involved in the decision-making of whether one opts for marijuana or not as well as the potential reasons behind that choice.

On one hand, there is the subjective realm of personal belief. One assumes and thinks that it is harmful or wrong to smoke cannabis and firmly holds onto that thought despite evidence to the contrary. This may be tied with previous propaganda and exaggeration of potential adverse effects of marijuana. The onslaught of negative advertising was mainly undertaken for political and ideological reasons, and it was based on information that was generally not supported nor backed by science. Furthermore, it was promoted and propagated over various years by states, governments, and church and lobby groups.

This same idea can become robust over time and be further propagated by society itself wherein people keep sharing it, similar to the way, we, advertently or inadvertently, retweet fake news on Social Media. The belief becomes more ingrained and despite new laws, regulations, and scientific evidence, it becomes hard to shake it off or to replace it or to update one’s impressions, understanding, and knowledge on the matter.

There are also lingering concerns about what others would think of one’s actions. Since marijuana, unlike cigarette smoking, has been associated with delinquent activity for such a long time, one may become increasingly worried about how others around one’s circle may perceive or respond to the action. The social circle would include spouses and partners, family, and friends and their acceptance and approval may be important determinants in one’s choice of medicating or not medicating with cannabis.

Moreover, since marijuana smoke has such a distinct and distinctive smell, one can hardly smoke it without other people’s perception or knowledge. In fact, your neighbors would know rather immediately if you have taken on a new hobby and have started to light up a joint. Certainly, there are pills that one can consume, but those options are lesser-known and may be somewhat more difficult to obtain, while many might ignore the fact that it is indeed possible.

The other fear is that one could receive immediate and irretrievable harm. Many people state that marijuana could be a gateway drug, that one would build tolerance and then wish to try out stronger and more potent drugs. This may be the case for those already interested in exploring other drugs, but, in fact, cannabis is not physically addictive, and it may or may not be psychologically addictive. But it would be the same as believing that having a beer would turn you into an alcoholic and become a gateway for stronger drinks and hard liquor. Although this may be true in some cases, it is not the general rule or tendency.

For many, the opinion and advice of experts are factored in and taken into consideration as well. Yet physicians may also struggle with personal beliefs and convictions or they may be hesitant to fully promote a product they are not completely sure of. Although there is significant research, more cautious and traditionally-minded medical doctors may be more hesitant to favor and promote cannabis, partly due to reasons of liability, such as potential anomalies and adverse reactions as well as the fact that pharmaceutical companies (Big Pharma) are still not as closely linked and associated with the drug as is already the case with prescriptions.

Yet in such cases, it is most important to think and decide for oneself. We are often driven by what media tells us, what friends and family members expect from us, and may often choose options that are far from ideal for our health, safety, and well-being. I believe that if marijuana can provide benefits in and for a certain condition, one should at least give it a shot, regardless of what others may say and think about it.

The other point to keep in mind is that not all drugs are created equal. There is the common misconception that all drugs are equally harmful. But, in fact, they bring about different reactions and have different effects and side effects. Moreover, they vary in terms of being addictive and causing physical and/or psychological addiction. While coffee and cigarettes cause physical addiction, marijuana as a rule does not do so.  

These misperceptions are often due to and tied with the status of legality. At first glance, it may seem rather arbitrary how certain substances are legal, and others are not. The experiment of the Prohibition era, of rendering alcohol illegal, backfired and brought about more harm to society itself and because of this backlash, it was quickly abandoned. We have seen a similar trend evolving with marijuana, which was and continues to be consumed by many people.

Yet to sway opinion and make a substance illegal, it was necessary to focus, propagate, and exaggerate the potential ill effects of those drugs. Most of the time, it was a political matter and decision and not necessarily one that was based on science. In fact, it was part of a campaign of miseducation and negative education about drugs during which false non-scientific information and perceptions about drug harm were disseminated and were for the most part politically driven.

The infamous 1936 propaganda film Tell Your Children, now often referred to as “reefer madness” – a supposed temporary state of complete madness connected with the use of marijuana - highlights the moral and ideological components involved in relation to cannabis, the same way, the use of psychedelics related to certain political and ideological beliefs and was correlated with counterculture movements. As a result, more conservative-minded people would come to mistrust psychedelic drugs but would have no qualms and issues about alcohol and cigarettes.

The other interests were of economic nature. Both alcohol and cigarettes were marketed by major companies (Big Tobacco) that brought in profits, which, in turn, created and set up lobby groups that would put pressure on politicians who, in their turn, would try to direct and often purposely and purposefully mislead and misdirect public opinion. This would explain why a more toxic cancerous cocktail of drugs in cigarettes was socially tolerated and accepted, while marijuana remained taboo for so many years.

Notwithstanding, whenever the topic of drugs comes up, people have strong, preconceived, and often polarized and generalized opinions. Although a broad range of stimulants, psychoactive substances, and medication fall under the purvey of drugs, people often instinctively link and associate drugs with their legality and legal status.

Drugs that are perceived as or used to be illegal and prohibited tend to elicit and foment negative reactions, while others that are seen as commonplace and frequently used are not even considered as drugs in the first place but may at best be called and designated as a "bad habit". But we tend to ignore or disregard that not all drugs are equally harmful and that there are some that can provide potential benefits to the mind and body. In fact, there are various evidence-based health benefits of psychedelics. There is now substantial research on the topic, and it can provide mental health benefits that are under study and observation.

I was provided with relevant and insightful information by various experts on the topic of legalization of psychedelics, a debate that provided thought and discussion on both sides of the fence, those in favor and those against the legalization of psychedelic drugs. This discussion, organized by Intelligence Squared US, touched on various issues regarding and associated with drug legalization.

In fact, the benefits of the use of psychedelics could range from dealing with post-traumatic stress disorders, trauma, and anxiety to dealing with one’s stress levels to increasing one’s life satisfaction and experience. Furthermore, psychedelics can be also used for couple therapy or for deepening and strengthening personal relationships with loved ones, family, or close friends. Moreover, it could be also used in non-medicinal contexts as well, such as for personal and spiritual growth and as an impetus for stronger bonds among personal relationships with loved ones.

Although, like anything in life, drugs can be misused, and if used inappropriately or irresponsibly, they can have negative effects or lead to dangerous consequences, I think with the correct information, mindset as well as supervision and training, we ought to re-evaluate how we see and use drugs, whether it is the now-legalized cannabis or the hopefully soon-to-be-legal case of psychedelics. Nothing is set in stone and we need to evaluate and review our own feelings, emotions, and knowledge and update them according to science and research instead of merely following hearsay, gossip, rumors, or politically motivated speeches and agendas.

Tuesday, May 4, 2021

Reading the Bible with Gentle Skepticism: An Interview with Rabbi Tzemah Yoreh

Rabbi Dr. Tzemah Yoreh
Before my enlightening and delightful interview with Rabbi Dr. Tzemah Yoreh, there were at least two things I was not aware of, one, that in the first version of the Bible, Abraham went through with the deed and killed his son Isaac, and secondly, that it is possible to read and interpret the Bible with gentle skepticism.

But before we delve and explore these thought-provoking and controversial ideas of biblical proportions, let me briefly introduce the Rabbi behind those fascinating thoughts and viewpoints. This academic scholar, who playfully calls himself an “academic brat”, grew up in a text-filled environment with both of his parents curious and excited about the written word/world.

This fascination with books, knowledge, and ideas led him to obtain not only one but two (!) PhDs, one of them in biblical criticism at the Hebrew University in Jerusalem, and the other in Ancient Wisdom Literature at the University of Toronto. He is a proponent of what is known as Humanist Judaism and he is the Leader of The City Congregation, a cultural Jewish congregation based in New York City. He is indeed a multicultural wanderer and nomad being in close and continuous contact with different traditions and between three countries, Canada, Israel, and the United States.

He also loves writing and he has written various books, including Why Abraham murdered Isaac: The first Stories of the Bible revealed, which came to my attention. The title itself was intriguing, but even more so, its contents as well as its main subject of focus: the biblical famous/infamous Abraham. I have been in equal measure, fascinated by and troubled with Abraham’s so-called test of faith. I had previously written about Kierkegaard’s views on the matter, which was detailed in his seminal Fear and Trembling, but it remained one of those biblical stories that kept haunting me alongside the story of Adam and Eve. Why would God even ask Abraham to commit such an insane deed?

Yet as Dr. Yoreh explained to me, it was much worse initially, as in the original version of the Bible, Abraham indeed murdered his son Isaac; the Rabbi specifically chose the term murdered over killed to stress and highlight its atrocious aspects. This was the ultimate sacrifice asked of any person to offer his own son as a sacrificial lamb to a higher power. In a certain way, this would presage the Passion by equating Isaac with Jesus, who would also be offered as a sacrifice to his father and who refused to lift a finger to save him even though he was allegedly almighty and all-powerful.     

Yet in the case of Jesus, the Son of Man was aware of the sacrifice asked of him, and he acquiesced and accepted the consequences. But the same cannot be said of Isaac who is caught off guard and unaware that he himself was intended to be the sacrifice to God. This would make both God’s decision and Abraham’s action an unjustifiable, immoral, and criminal act of madness. As Dr. Yoreh explains, in the modern equivalent this would be a person hearing voices and murdering their child; there cannot be any justification whatsoever for such a heinous act. Neither would he even attempt to give one.

However, he could provide a potential explanation. The attempted or actual murder of Isaac was serving as a catalyst of the biblical story. In fact, Isaac was not fleshed out and his character can be considered deficient and lacking in detail. Even his age at the time of the incident remains a mystery. In the current version of the Bible, he is depicted as a child, but other sources put him anywhere between a teenager to a 37-year-old man.

To further complicate matters, it is one thing for Abraham to subdue and tie up his young son, another one to have this old man do so to his son in his mid-thirties. This only demonstrates the lack of clarity and details about the character of Isaac who lacks free will and is merely obedient for its own sake and who serves as a means towards an end, which would support Dr. Yoreh’s proposition of Isaac merely serving as a literary device.

Yet, the original murderous deed, much more shocking than the act of original sin in the garden of Eden, was hard to swallow for people, philosophers, and thinkers back then as it is now. Hence, other editorial arrangements led to the suppression of the deed and supplanted it with a divine test of faith. Editors in those times worked differently than they would today. Instead of changing, arranging, and editing the written text, they would mostly and respectfully keep the original and merely add new details, information, explanations, and commentary to the previous passage.

What about the spiritual message of the biblical story? This is where this intellectually minded humanist-inspired Rabbi significantly diverges from the mainstream religious interpretations. He is, as he himself puts it, standing on the nexus between secularity and religiosity. Although his view is not exactly atheistic - he espouses a more pantheistic vision of life – he approaches the Bible as a curious and invested reader who is interested in outstanding literature and cultural artifacts.

This is where his gentle skepticism comes into play alongside a playfulness, which is rarely seen in academia and in the world of religion. As he himself puts it, his playful tone is because of his personality and he wants to have fun with ideas but with the interest of a skeptic. This eloquent and erudite Rabbi is neither on the hard, radically skeptic end of atheism nor the sharp, dogmatically bent orthodox side, but he fills in an open gap and space in-between. I had never thought that one could combine gentleness with skepticism, but I found Dr. Yoreh’s views quite intriguing and certainly refreshing.

Yet if the Bible is merely literature, why not opt for Tolstoy and Dostoevsky instead? What would be the difference between this seminal work as opposed to great masterpieces of world literature? The main difference lies in scale and magnitude. No other work has been significant and influential for the Western world, culture, and mindset than the “book” – the Bible.  

Although he does not see it as the Word of God and does not necessarily subscribe to spiritual messages, it is nonetheless one of the most read works in the world, and you could not understand nor appreciate writers and authors like Shakespeare and Dostoevsky without the Bible. In my view, the latter would not and could not conceivably exist without the Scriptures.

But if it is not in its spiritual predominance, what else would make the Bible appealing to gentle skeptics like him? First off, it is inspiring and inspirational. Certainly, Abraham’s story and his murderous act would not be considered inspirational by any standards, but there are other passages that are inspiring, and they put one on the path of wonder and reveal and unearth the rich experiences of life and of humanity.

And there are indeed many interesting bits, ranging from murder, death, incest, betrayal to love, hope, marriage, and transformations. The Bible captures not only the richness of individual, social and cultural experiences but it traces the whole gamut of the human experience. Notwithstanding the occasional asides with details in genealogy and the explicit and detailed rituals and laws, the Bible is, in essence, a collection of intriguing, inspiring, and inspirational stories well told, and it is an amazing work of literature that has informed and ingrained culture in a profound way.

We are, in fact, re-reading these texts and stories, and it should not be about what they originally said or meant. As such, as we are looking at the broader picture, we can appreciate the Bible from a number of angles and we can engage and interact with the text on different levels, be it from a literary, ethical, philosophical, or spiritual viewpoint.

For the full-length video of the Interview with Rabbi Dr. Tzemah Yoreh on YouTube, please click here.

If you prefer to listen to the interview, here is the link to my podcast: Arash's World Podcast