Dr. Bob Melamede, among the country's most vocal advocates for the medicinal benefits of cannabis, pulls no punches when asked his opinion about such a prospect. "This is nonsense," he says. "It's idiotic."
Thurstone is an extremely prominent figure locally and nationally on the subject of opposition to marijuana regulation and legalization. The medical director of a Denver Health program called Substance Abuse Treatment, Education and Prevention (STEP), he was also a member of the Amendment 64 Task Force, and he remains a primary figure in Project SAM, an organization spearheaded by former Congressman Patrick Kennedy that backs a public-health approach to pot.In "Higher and Higher, the latest blog post on his personal website, Thurstone shares statistics from urinalysis tests done on STEP patients dating back to 2007; most of them were between thirteen and nineteen when they entered the program.
According to his data, THC levels in such samples have gone up from an average of 358 nanograms per milliliter of urine prior to the 2009-2010 period that marked what he calls the "big commercialization of marijuana" -- the boom period that led to hundreds of dispensaries opening in Colorado -- to 536 nanograms. He believes the reason for this rise has to do with the increasing potency of cannabis, particularly in Colorado, and widespread diversion of medical marijuana beyond the patient population, with much of it reaching teens.
Lately, Thurstone's patients have come to him with "more severe marijuana dependence and more symptoms than teens not using medical marijuana," he told us. "And it's also consistent with the whole idea that kids are using higher potency marijuana that's probably more addictive. Anecdotally, we're hearing about patients who start with cheap, low-grade marijuana before moving on to more potent marijuana, and then other ways of consuming it: waxing marijuana, dabbing marijuana and chasing a bigger and bigger high."
For that reason, Thurstone ends his essay with this line: "It is reasonable now to question how much longer it will be before we see injection use of THC -- especially as marijuana is legalized."
When asked about this prospect, he conceded that "I have not seen it clinically, and I have not seen it described except in research studies, which say it's possible to have an injectable form of marijuana. I don't know exactly how to do the preparation, to be honest, and I don't know how the high would differ. I can only hypothesize."
Immediately after our post's publication, we began hearing from readers saying that injectable THC has not been developed at this point, and may never be. One memorable note asserted that "THC is a terpene, a sap, it would be akin to injecting turpentine into your veins." The reader added, "You might as well write an article about glue huffers potentially shooting up glue."
Armed with these assertions, we reached out to Melamede, a member of the University of Colorado-Colorado Springs faculty who's previously appeared in this space and shared a spot on a High Times Cannabis Cup panel about hash with Westword medical marijuana critic William Breathes back in 2012. We wanted to find out if he agreed with Thurstone's critics -- and it turns out that for the most part, he does.
Continue for more of our interview with Dr. Bob Melamede. Melamede says intravenously delivered THC has been a goal that's thus far proven elusive.
"They've worked on more soluble versions that could be injectable, for medical reasons, but nothing has ever developed from any of that," he says.As for the assertion that THC is essentially a sap, Melamede says the truth is more complicated. "THC is actually a single molecule -- and THC alone is horrible. That's what Marinol is, and that's why no one wants to take it. It makes you very uncomfortable and it doesn't get you high in the sense that it gives people relief. It gets you stressed, which is why Marinol isn't used by anyone with an alternative -- plus, it costs something like $1,500 a month....
"But in all cases, ranging from THC to a more diluted yet more medically advantageous form, like cannabis extract, they're highly hydro-phobic. They don't like water, so you can't put it into a liquid water suspension that you could inject. These are basically oils, and oil and water don't mix -- and they certainly don't mix into any kind of form that's going to be injectable."
His conclusion: "The only injections of cannabis have occurred in this guy's mind."
Melamede also has problems with Thurstone's comments about marijuana addiction.
"I don't think in the mainstream scientific world of addiction that there's debate any more that it's addictive," Thurstone told us earlier this week. "It works on the same part of the brain as all other addictive substances, and there's an animal model of marijuana addiction now. We know that it's not just psychologically addictive but physically addictive, and studies by Dr. Alan Budney at Dartmouth have characterized a physical addiction to marijuana. Marijuana withdrawal is clinically equivalent to tobacco withdrawal -- and anecdotally, in our experience, we see adolescents coming into treatment extremely addicted to marijuana. They're dropping out of life, giving up on school and families to pursue their marijuana addiction."
To that, Melamede says, "first of all, you can't separate the physical from the psychological. Everything in our brain comes from the physical ability of how our brain works. But the studies he's referring to are very poorly controlled. If you take a population of people who are using cannabis, especially in high doses, and then cut them off from it, they have stress, poor sleeping, etc. But those are the very things people use marijuana for -- because they are stressed or not sleeping well. So you're taking away the medicine that fixes their bio-medical problems and then saying that's proof they're addicted. That's like taking someone off antibiotics they're taking for an infection and when they infection comes back saying, 'This proves they're addicted to antibiotics.'
"In reality, it's been termed to be about as addictive as caffeine. Just use a little common sense and think about how many people used marijuana prior to 25 and then stopped using until they reached their forties, fifties, sixties and seventies and were starting to get age-related illnesses. If it was so addicting, why did they all stop?"
In Melamede's opinion, the same sort of common-sense approach should be applied to concerns about marijuana users potentially injecting THC. "Some of this stuff is just so stupid," he says, "that it reflects on the competence of the people making these statements."
More from our Marijuana archive: "Marijuana users searching for bigger highs may start injecting THC, doctor fears."