Opioids,(Non)-medical Marijuana,and the Cult of the Body

Abstract

Ohio’s first medical marijuana dispensaries will open in the fall of 2018, so physicians, then, must decide whether they will participate. But is medical marijuana really medical? No, at best, it is an unproven botanical. Medicine today is progressively moving away from traditional understandings of health according to formal and final causation and toward wellness as an expanding, subjective ideal. Whereas patients are healthy if the doctor says so, patients are well if they say so. Pitched as a wellness product, cannabis presents itself as an existential palliative, part of an imminent cult of the body. Consequently, people often use cannabis to escape reality according to a new age mythos. Physicians can play their part by choosing not to certify for “medical” marijuana and seek to rediscover the body as more than mere dead matter in motion rather than insulating ourselves from the difficult questions of suffering, meaning, and purpose.

Summary:

Despite state-level legality, medical marijuana is not medical. Rather, it is often touted as part of a cult of the body to escape suffering and death.

Keywords

Cult of the body Enhancement Health Medical marijuana Palliation Suffering Wellness

The responsible prescription and use of opioids may be the most pressing public health concern today. The narrative is oft-repeated: the medico–politico–industrial complex caused hordes of Americans to become racked with a life-threatening disease consequent to significant ignorance, misleading information, and greed. We made opioids a problem, so now public health must solve this man-made crisis.

In response, physicians, policy makers, and public health experts have asked whether medical marijuana might reduce the burden of opioid misuse by providing nonopioid pain relief, particularly for chronic pain. One recent review concluded “the current literature suggests states that implement [medical cannabis] policies could reduce [prescription opioid]-associated mortality, improve pain management, and significantly reduce health care costs” (Vyas, LeBaron, and Gilson 2018, 56). While almost one-third Americans suffer from chronic pain (Committee on Advancing Pain Research, Care, and Education. 2011.) and nearly 3,500 Ohioans died from opioid overdose in 2016 (Ohio Department of Health 2017), the turn toward marijuana comes as no surprise.

The secular conversation around both opioids and cannabis normally consists of risk–benefit analyses and pharmacology. But what if opioids were totally safe? Would we palliate patients for every pain? Cannabis proponents often envision a world where cannabis can play that role, highlighting the greater context of the cannabis question: What is health? How do we respond to the reality of suffering?

One prominent marijuana policy expert has often quoted the founder of the National Organization for the Reform of Marijuana Laws (NORML) as saying: “We will use [medical marijuana] as a red herring to give marijuana a good name” (Sabet 2013). Here, I will argue that today’s medical marijuana is not medical in the full sense; rather, it contributes to rewriting the boundaries of health and disease by tapping into wellness, reinforcing medicine’s turn toward the subjective. Further, a totalizing pursuit of wellness through marijuana and other means belongs to a cult of the body concerned with existential palliation in an environment shorn from meaning and purpose.

Ohio House Bill 523

Marijuana possession, use, purchase, sale, and cultivation remain federally illegal, even as legalization—medical and recreational—grows at the state level. At the end of 2017, adults in eight states could use marijuana recreationally (National Cannabis Industry Association 2017). Further, an additional twenty-one states have legalized medical marijuana, with Ohio opening its first dispensaries in the fall of 2018. The Ohio law will be most important to review, given it has been passed most recently, and physicians practicing there will soon need to decide whether to participate in medical marijuana, as doctors in other states have needed to choose.

Anecdotally, at a recent medical ethics conference in Ohio, the presentation generating the most heated debate was delivered by state policy representatives explaining the implementation of the law, while touting Ohio’s regulation as the tightest in the nation, meaning Ohio will claim the most effective prevention of nonmedical uses of any state. Since the use and sale of cannabis remains federally illegal, state policy makers must develop their own strategies to regulate medical marijuana apart from federal entities such as the Food and Drug Administration (FDA). The following is an overview, albeit brief, of the Ohio legislation.

Patients will be able to obtain medical marijuana in the form of vapors, oils, tinctures, plant material, edibles, and patches with physician approval to treat a variety of conditions. Smoking, however, will not be permitted in an attempt to keep marijuana strictly medicinal. Acceptable conditions include AIDS, Amyotrophic Lateral Sclerosis (ALS), Alzheimer’s disease, cancer, chronic traumatic encephalopathy, Crohn’s disease, epilepsy or another seizure disorder, fibromyalgia, glaucoma, hepatitis C, inflammatory bowel disease, multiple sclerosis, pain that is either chronic and severe or intractable, Parkinson’s disease, positive status for HIV, post-traumatic stress disorder, sickle cell anemia, spinal cord disease or injury, Tourette’s syndrome, traumatic brain injury, and ulcerative colitis (Ohio Medical Marijuana Control Panel 2017).

With doctor certification, patients can obtain up to a ninety-day supply of marijuana at a dispensary licensed by the state board of pharmacy. Home growth is not permitted. Physicians wishing to certify patients for marijuana must first obtain a certificate from the state medical board, and they will not be able to professionally possess marijuana. Physicians and health systems, though do not need to participate in medicinal marijuana, and system participation may be rather slim considering the possibility of federal intervention, even if legalized at the state level. Local municipalities, as well, can opt to keep dispensaries outside their borders.

Is Medical Marijuana Medical?

The word certification, however, is used very intentionally in the Ohio law, in lieu of prescription. Why? Physicians, nurse practitioners, and physician assistants can only legally prescribe FDA-regulated medications; however, medical marijuana cannot be FDA-regulated as long as it remains federally illegal. For similar reasons, medical marijuana will be sold at dispensaries, rather than pharmacies, which are not required to have a pharmacist on site (Ohio Administrative Code 2017). Marijuana could, conceivably, be approved by the FDA in the future as a legitimate treatment with specific indications but that could only occur after removing the federal ban and conducting appropriate clinical trials. Empirical studies to date show that marijuana and its derivatives show promise for treating chronic pain and spasticity, although with an increased risk of adverse events, but evidence for other indications written into the Ohio law is weak or nonexistent (Whiting et al. 2015; Deshpande et al. 2015). Consequently, the Ohio State Medical Association (OSMA 2016) released the following statement during legislation debates:

The OSMA supports exploring and potentially determining the most-appropriate application of marijuana in treating certain medical conditions. The OSMA also supports the use of those drugs prescribed for medicinal purposes that have previously been clinically researched and approved by the Food and Drug Administration (FDA). Because HB 523 bypasses this level of necessary clinical research, the OSMA cannot support HB 523.

National professional organizations, including the American Medical Association and American Academy of Family Practice, have taken similar positions as OSMA in opposition to state-level medical marijuana. Lacking evidence for the current crude botanicals to be sold at dispensaries, medical marijuana, then, is weak science at best.

Valuable therapeutics backed by empirical evidence will likely come from studies of particular cannabinoids, rather than crude plant or leaf products currently available, which have a spectrum of chemical compositions with poorly defined clinical effects to date. Marijuana-derived drugs, rather than crude products, have shown promise to date. For example, Sativex is an oral mucosa spray containing delta-9-tetrahydrocannabinol (THC) and cannabidiol in a 1:1 ratio currently accessible in Europe for treating multiple sclerosis–related spasticity, presenting an example of a marijuana-derived product undergoing acceptable pharmacologic study (Sativex 2017). Additionally, synthetic cannabinoids, unlike botanical cannabis found in dispensaries, have been used pharmaceutically for years to treat nausea.

Several studies have cast doubt on whether patients, in truth, use medical marijuana as a medicine or recreationally. Up to 96 percent of patients seeking medical certification have used it recreationally (Ilgen et al. 2013). O’Connell and Bou-Mater (2007) found that 85 percent had used other illegal substances at some point. Further, medical users without a history of recreational use often discontinue due to psychoactive drug effects (Kalant 2008). A Canadian study found that 80 percent of HIV patients using medical marijuana also used it for recreational purposes (Furler et al. 2004).

Physician recommendations in medical marijuana states have been impressively easy to attain. For example, a Californian can receive a twelve-month certification online through “Getnugg” and others just by selecting a cannabis-approved condition, such as pain, and a small doctor fee. It should also be noted that medical cannabis users dictate their dosage rather than the recommending physician.

Taken together, Ohio patients, often experienced recreational marijuana users, will be able to obtain a physician certification to obtain FDA-unregulated marijuana at a dispensary without a pharmacist on site. According to current legislation and clinical evidence, is medical marijuana, indeed, medical? No, at least not in the same way as morphine or penicillin, even if used under the guise of clinical indications and government regulation. Marijuana could be classified like other nonpharmaceutical herbal remedies. However, at present, it does not meet professional standards for legitimacy but rather seems to be an intoxicant disguised as a therapeutic. So, if dispensary marijuana is not medical, what is it? An answer to this question will have to wait for later.

New Paradigms of Health

Cannabis proponents, who “will use [medical marijuana] as a red herring to give marijuana a good name” (quoted above, Sabet 2013), see medical legalization as a stepping-stone toward full legalization, despite widespread disapproval from professional organizations. As a result, “states formulate medical marijuana statutes based not on scientific evidence but on political ideology and gamesmanship” (Bostwick 2012, 172-173). Proponents of a more mainstream drug culture often go a step further by tapping into growing subjective understandings of health.

Abandoning Formal and Final Causes

Modern ethics has become a confused pursuit founded on emotivism as MacIntyre (1981) has brilliantly described in After Virtue, and it began with the loss of a telos. The reason for living according to objective ethical norms and rationally considering one’s life has classically been to move from potency to act, from present reality to the end inscribed within human nature, which is the perfection (Latin: consummationem) of nature. Ethics was pursued, classically, as the bridge toward man’s natural and, ultimately, supernatural end: eternal happiness found in the inner life of God. The ethical life would be lived according to his revelation and right reason.

Secular medicine does not consider this framework. In fact, Jeffrey Bishop (2011) has shown the triumph of efficiency over formal and final causes, exhibited by the corpse becoming the epistemological heart of medical education and research. Rather than considering man’s nature and final end, medicine focuses on manipulating matter and outcomes, devoid of inherent meaning and purpose. There is no telos, just a terminus in dead matter.

Medical ethics atrophies into mere risk/benefit calculi and settling decisional capacity when efficiency alone remains. There is no recourse to objective reference points or an attempt at defining the good. So, according to the typical efficiency logic of secular bioethics, unlimited risk-free drugs—opioids and cannabis in particular—may not be bad at all. Rather than assessing a substance according to a thorough anthropology and its intrinsic goodness for man, like that done by Sullivan and Austriaco (2016) in the Thomist tradition, the consequences of drug dependence are typically judged poorly according to the immanent ideals of liberal capitalism—liberty, long life, and wealth, for example. Medicine practiced for these ideals, rather than the classical pursuit of virtue and the good, results in a different understanding of the medical profession and embodiment.

In this context, terms often taken for granted, such as health, therapy, and enhancement, have become less clear, as the Journal of Medicine and Philosophy has even devoted an entire recent special edition to philosophically defining the boundaries of health and disease (August 2017).

The classical paradigm understood bodily health as the perfection of the body’s nature. The body was whole when its nature was perfected, and things which perfect nature, then, are good, while those which do not are evil. In a general Christian ethos, this could easily be understood through the good action of the Creator who can only rightfully make a good creation as a mirror of his preeminent goodness. While obedient to laws of biology, the created bodily nature helped reveal fundamental truth leading the whole body–soul composite person to perfection and wholeness. Disease and disorder, then, were understood as corruptions of the natural order, which medicine sought to alleviate and restore.

Sullivan and Austriaco (2016), for example, discussed the ethics of recreational marijuana use by examining recent empirical literature in a Thomistic framework. They concluded that recreational marijuana cannot ever be justified because, in addition to the intrinsic harms it has upon the body, it cannot be used temperately like alcohol. Recreational use of marijuana necessarily means intoxication (getting high), therefore the user necessarily intends to impede the rational faculty.

While therapeutics, classically, treated disease to restore health, enhancements elevated nature above its norm. Maintaining these distinctions today, however, is not simple, as seen through oral contraception. If considered a therapy, women’s fertility would be a disease suffered just by being a woman. Few physicians would make such a claim. But if it is an enhancement, childbearing would be intrinsically flawed, and why should health insurance pay for something not treating or preventing disease? Regardless, most insurers cover the pill, and we are left puzzling over therapy, enhancement, and an imaginary normative body. In a secular pluralistic society where every moral outlook is seen as essentially emotive (see MacIntyre 1981), who could justify the authority to impose the normative body, whereby therapies properly treat disease to reorient the body toward the good, and enhancements elevate the body beyond its natural state? No, the secular normative body does not exist, despite the Enlightenment project’s hopes to construct ethical systems apart from Christian tradition.¹

Embracing Autonomy

Principlism has been the premier method for ethical decision-making in today’s medicine at least since 1978, with the publication of Beauchamp and Childress’s first Principles of Bioethics. Their four prima facie principles, well-known in medical education as the main or only vision for medical ethics, gained popularity in a social environment filled with change, not to mention the popularization of recreational marijuana, and in many ways became a summative response to abuses by physicians and researchers. In scenarios where these mid-level principles conflict, though, autonomy usually trumps the others because it “counters the historical dominance of benign authoritarianism or paternalism in the traditional ethics of medicine…[and] protects patients against submergence of their moral values and beliefs” (Pelligrino 2008, 189).

Historically, however, patient autonomy did not play such a prominent role in the doctor–patient relationship. It was rather part of a fuller vision of the patient’s good, teleologically understood—physician beneficence and patient autonomy were more like two harmonious virtues striving for the same end.

Physicians in various circumstances through history, though, mistreated patients by inflating their authority in a paternalist sense—the patient’s voice was often eschewed in favor of the professional’s. The four principles, then, sought to correct paternalism and shift decisional authority back toward the patient by emphasizing autonomy as the prime principal. While principlism was correcting past paternalism, moral consensus was quickly waning. Thus, the doctor and patient shared less moral vision than ever before, and autonomy could morally and legally defend patients “against physician paternalism and against those who would impose their values,” as Pelligrino (2008) summarized (p. 206).

Pelligrino (2008) also pointed out that beneficence is sometimes equated with paternalism in medicine, solidifying the autonomy–beneficence dichotomy and reinforcing autonomy as the chief principle in an environment of moral pluralism (p. 207). Today, the ethical decision in medicine often means whatever the patient chooses.

What does this have to do with marijuana? Above all, autonomy-driven visions for the doctor–patient relationship preclude the possibility of a shared understanding of health and disease. The patient meets the physician, then, as consumer and contractor, cornering medicine to operate strictly according to patient choice rather than the patient’s objective good.²

Prior to the rise of patient autonomy as the chief principle of medicine, patients were deemed sick or healthy by the doctor. Moving toward the patient’s will as the main determinant of the doctor–patient relationship, patients, to the contrary, are well if they say so.

Health and Wellness: Definitions

Health has traditionally meant wholeness proper to the organism, taking into consideration personal characteristics (Kass 1981). Wholeness means quite different things, for example, for a prepubescent boy—who should be growing in height—and a postmenopausal woman—who should not be growing in height. In both cases, the person’s health is evaluated against a formal norm. For Aristotle, health “is a condition which allows us while keeping free from disease to have use of our bodies” (Rhetoric 1361b). As a positive attribute, although easiest conceived by its absence, it is an instrumental good for attaining higher goods. We can see that Aristotle’s understanding of health as “keeping us free to have use of our bodies” maintains an objective, almost palpable realism to health.

Wellness, though, has only recently become a common term. The word was originally coined as the opposite of illness in the seventeenth century and then reemerged in recent decades. Take, for illustration, the preamble to the 1948 World Health Organization’s (WHO) constitution, which defined health as a “state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (Zimmer 2010). The WHO continues to use this definition today, yet many authors have commented on the vague and expansive nature of well-being, including Engelhardt (1975):

This concept of well-being suggests the notion of a satisfactory lifestyle, including successful adaptation to one’s environment. Yet, even here the norms are obscure. What is a good adaptation? Is a good adaptation possible in a complex industrial society for those with I.Q.’s of less than 80? Are such persons ill? Further, if health is a state of complete physical, mental and social well-being, can anyone ever be healthy? Does health become a regulative ideal, one to which one strives, but which one can never fully achieve? On the other hand, if no one is truly healthy, is everyone ill?

The satisfactory lifestyle choices connoted in well-being, tastes in music, food, and leisure, are subjective, emotivist ones, bearing personal preference as their main rationale, versus an objective norm or good. Embracing a bio–psycho–social model, paired with more effective clinical tools, seems to broaden the space for the medical profession, “from unwanted childlessness to unwanted pregnancy, from marital difficulties to learning difficulties, from genetic counselling to drug addiction, from laziness to crime” (Kass 1981).

In other words, health seems to be shifting from objective formal norms to subjective wellness of the bio–psycho–social being. This begins to explain the resurgent emphasis on the mind–body connection, chiropractory, natural foods, yoga, and physical fitness—a quick Internet search shows that wellness gathers each of these under its umbrella—and underlines their growing niche in medicine today.

I will be using health to mean the classical, objective norm inscribed within the nature of the person, and wellness to mean a modern, subjective ideal arising from each individual’s will. In summary, then, health is shifting to wellness, and a robust, content-full telos to a subjective secular ideal.

Weed for Wellness

Certain marijuana proponents have begun promoting cannabis as a wellness product, while rejecting the medical and recreational categories. It is no surprise, then, that medical legalization and recreational legalization have been tied in state approvals, given the ambiguity of its medical and recreational uses, also described by Bostwick (2012).

In The Cannabis Manifesto: A New Paradigm for Wellness, DeAngelo (2015) takes the fact that people have used marijuana for a myriad of purposes—medicine, worship, recreation, and so on—without clear boundaries between them as a starting point for arguing to remove the medical and recreational categories from marijuana use. He claims that most people turn to cannabis for wellness enhancement of all kinds rather than to get high. Pain relief, altered sensory perception, anxiolysis, and transcendental experiences all qualify for his wellness enhancement. In sum, DeAngelo argues that marijuana is used for wellness, rather than strictly medical therapy, and borders between medical and recreational purposes should be removed.

Pillar 4 of his cannabis manifesto enucleates the argument: “Choose cannabis for wellness, not intoxication” (DeAngelo 2015, XXIII). Why? As both medicine and recreation, marijuana serves a common purpose: wellness of the bio–psycho–social man. And who could argue against wellness? Against experiencing life more intensely without needless cares? Intoxication, on the other hand, leads down the same path as opioid dependence, leaving substance users without jobs, families, and futures.

Now that “gay marriage is legal, and varying tastes in fashion and music and even sexuality are accepted as personal choices…cannabis prohibition is increasingly being seen as a lingering relic of an old America that doesn’t really exist anymore” (DeAngelo 2015, 170–71). Our progressive society can then move forward under science and choice, freed from the unenlightened past. The old morality and health paradigm used to blindly dictate the common life and social structure, imposing values without consent from autonomous subjects; now, though, we are free to choose as we wish and not be judged for it, free from outside parties making a claim on us. In a positivist sense, we make our own morality and define wellness for ourselves.

French economist Hervé Juvin (2010), in discussing the changing understandings of the body due to capitalism in The Coming of the Body, argues that once we overthrow every determinant—objective morality, health, and religion—every aspect of life must come under the domain of decision. Determinants set aside, we are responsible for self-determining, for constructing our own morality, and ascribing meaning to reality. Thus, we see that health, inscribed into nature and elaborated by tradition, was proper to premodernity, a determinant imposed by the old, “unenlightened” order. Wellness, on the other hand, is proper to the new age. Its content and meaning arises from the will through the satisfaction of subjective desires including cannabis wellness enhancement. In short, we are healthy if the doctor says so, but we are well if we say so.

The Cult of the Body

Journalist and marijuana proponent Michael Pollan shares with DeAngelo his desire to remove prohibitions against marijuana to institute a more open culture. Pollan, though, does so by attempting to write a nonfiction coevolutionary narrative between humans and plants, featuring cannabis. In short, cannabis needed human feet to disperse the plant, while humans needed THC from cannabis to fulfill a fundamental desire for intoxication (Pollan 2002). Together, life can be more harmonious for both.

Unlike other proponents, Pollan does not emphasize marijuana as a biomedicine. He rather goes for something deeper that “this is a brain-zone drug for coping with the human condition” (Pollan 2002, 14). Having fallen from grace in the garden, it is the ideal solution, even a sort of immanent savior, to cope with a world failing to quench human aspirations for redemption and consummation.

Cannabis proponents such as DeAngelo, Pollan, and NORML, quoted earlier, envision quasi-utopian societies with free marijuana use. Cannabis is certainly not the wonder-drug proponents make it out to be; yet, their visions apprehend common problems in the modern world. Typically, moderners expect every bio–psycho–social ailment to be swiftly palliated and eradicated—ailments from anxiety to insomnia and chronic pain to low libido—underlining the growing authority of subjectivity, described by Juvin (2010):

The advent of the body is fabricating a new reality, one that serves the body, comforts it, and reaches out to it; and the world that is coming will be illegible, unworkable, to anyone outside the kingdom of the body, of its satisfaction, its desire, its well-being. A new regime of truth is under construction. The good, the true, and the beautiful are being recomposed; a new reality is in labor. (p. 41)

An Immanent Religion

This vision for the good life can be called a veritable cult of the body, at once the well-satisfied body living life to the full and a religion professing the imminent satiety of the desires. The “people of the body” simultaneously love and hate the body. They love its sensual potential to provide substrate for subjectivity; they love its material simplicity to enhance sense-experience and palliate suffering through marijuana and other wellness products. On the other hand, they despise suffering and corruption, which endlessly drag man back to earth from his illusions. They, too, despise the body’s necessity and finitude, that no one has escaped death, time, and space.

The cult of the body is not mere permissiveness but rather a cult of wellness becoming a way of life by projecting an ethos of satisfaction to forget death and despair. Since man cannot yet transform himself beyond the necessity of the body, he enhances what he loves about it and silences what he despises, not so different from the risk/benefit calculus oft-performed in secular medical ethics today. Similar in methodology, the people of the body calculate quality of life as a measure of being enchanted with the body, as opposed to loathing it. Since the Enlightened people overthrew religion as something received and submitted to, the cult of the body can take its place.

Like every ethos, though, it makes claims on people for “the real criminals are those who deny patients the treatment they need” (DeAngelo 2015, XXIII), involving both the people of the body and those who stand in its way. It acts as a determinant much like the old church–state partnership. Although the people of the body try to free themselves from determinants toward absolute liberty, they merely swap the burden from received-religion to self-religion.

The cult of the body asserts itself as universal value-free fact, covering over and enveloping diverse worldviews with wellness, autonomy, and quality of life rhetoric. In sum, the cannabinoid cult of the body imports a value-laden system aimed at existential palliation.

From Disease to Despair

As far as wellness goes, can anyone ever really achieve this physical, mental, and social ideal? (Engelhardt 1975) For, when health becomes wellness, everyone becomes a patient in need of life-enriching cannabis amid other wellness products. The body must be satisfied and enhanced, goes the refrain, implying the natural state constitutes a lesser one than artificially generated well-being, framing man’s existential nature as meaninglessness and despair.

The best the people of the body can do is endlessly strive after an imminent paradise, which is ultimately a drug-induced illusion. The subject, so to speak, is responsible for climbing out of the meaningless pit of necessity, corruption, and insignificance. Cannabis, as a wellness product enveloping medicine and recreation, presents itself, then, as an existential palliative—an assessment Pollan (2002) shares (p. 8).

Here, we must distinguish between existential palliation and compassionate pain relief. Drugs used to numb the mind or nontherapeutically alter consciousness hail pleasure and pain as the determinants of life, make many addicts out of users, and put the user into an illusionary paradise apart from God, man’s true meaning and purpose. Pollan praises such a paradise in The Botany of Desire, where cannabis lets a person forget all concerns and cope with life outside the garden of Eden without hope for redemption.

Compassionate pain alleviation, on the other hand, restores man to pursue higher goods and become more human, so to speak, rather than intrinsically creating false paradises. It is palliation in service to the truth that man is rational and has the capacity for God.

Smoked marijuana intrinsically classifies as an intoxicating, existential therapeutic as others have argued (Sullivan and Austriaco 2016; Sabet 2013; Kalant 2008), and dispensary, “medical” marijuana predictably leads there. To be clear, patients using particular dispensary products cannot be globally judged on whether they are seeking existential palliation or whether nonsmoked dispensary products inherently intoxicate users. However, as referenced earlier, studies suggest dispensary marijuana users do not clearly separate medical from recreational usage (Furler et al. 2004), and there is no reason to believe that dispensary products, even if used for pain relief or spasticity, won’t also get patients high, especially products with high THC content.

Lastly, all wellness products, including marijuana, have the tendency to elevate bio–psycho–social perfection as an all-consuming pursuit, in contrast to the virtue of temperance. This is the most subtle and pervasive force in the cult of the body. Even if patients seek legitimate pain relief through dispensary products, which I think could be considered a botanical, the movement toward “medical” marijuana, as a whole, participates in the more general institution of a mainstream drug culture operationalized by the medical apparatus. “Medical” marijuana can be used as a red herring to give cannabis a good name.

Toward Cyclic Religious History

With the overthrow of a reference point beyond the horizon of the subjective, the body alone remains with its infinite desires. The counterculture of the 1970s, enriched with marijuana smoke and environmentalism, has clearly been connected to neo-paganism. Although marijuana proponents obviously desire full legalization, I propose that they desire the infinite more than a particular plant with biochemical effects that may prove useful for the human condition. They nearly make themselves pagan prophets calling on priest-doctors to minister to the cult of the body, with a new age mythos.

Psychologist Philip Rieff (2006) noted decades ago: this is the age of the therapeutic, the self-help guide and life coach leading others to cope with the void of meaning and purpose in a post–Christian world. Pollan (2002, 19) elaborates the neo-paganism shared by many marijuana proponents and observes that “plants with the power to revise our thoughts and perceptions, to provoke metaphor and wonder, challenge our engrained Judeo-Christian belief that our conscious waking selves somehow stand apart from nature.” Now is the time to revisit the pre-Christian pagans, vilified by cannabis, for “just what happens to this flattering [Judeo-Christian] self-portrait, if we discover that transcendence itself owes to molecules that flow through our brains, and at the same time, through the plants in the garden?” (p. 19)

One Nation under Wellness?

Opioids could never live up to being the fifth vital sign, although Americans consume 99 percent of the world’s hydrocodone (International Narcotics Control Board 2016). As the wellness cult of the body has settled in, it was almost fate that we would be facing an opioid crisis. More effective regulation would have curtailed the problem, but would it have changed the driving force? Not if the problem is existential before it is biochemical. The cannabinoid cult of the body provides existential palliation to forget the sting of death and create an illusory paradise, even if under the guise of medical indications. The Catechism of the Catholic Church (CCC) judges the cult of the body clearly:

If morality requires respect for the life of the body, it does not make it an absolute value. It rejects a neo-pagan notion that tends to promote the cult of the body, to sacrifice everything for its sake, to idolize physical perfection and success at sports. (CCC 2289)

Implications

Where does this leave us practically? Here is a summary:

Ohio’s medical marijuana is not medical, so it should not be thought of as a new treatment for sick patients.

Dispensary marijuana can be considered a botanical remedy, but is questionable, at best. Physicians should not certify patients to access it but should determine whether one’s chronic pain is sufficiently treated.

More studies should be done to investigate cannabis-derived pharmaceuticals, especially for chronic pain and spasticity.

The doctor–patient relationship’s movement toward consumer-driven care encourages subjective understandings of the body such as wellness. Patients should be reminded that bodily health is not the ultimate good.

Cannabis proponents wish to spread a culture of neo-paganism, a hedonist cult of the body, rooted in existential problems.

Footnotes

Acknowledgments

Special thanks to J. Bradley Pierron, Carol Rieth, and anonymous Linacre Quarterly reviewers for their thoughtful comments and critiques of this essay.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Notes

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