cannabisnews.com: Medical Marijuana, Myth or Miracle?





Medical Marijuana, Myth or Miracle?
Posted by CN Staff on September 16, 2002 at 21:46:33 PT
By Caitlin E. Cox
Source: Boston Weekly Dig 
Medical marijuana's history began thousands of years ago in China and India. In India, marijuana has had a solid position in Ayruvedic medicine and is still prescribed today. The world's first encyclopedia of medicines, compiled in 1 A.D. by Chinese authors, suggests marijuana for over 100 conditions such as malaria and absentmindedness. Even in the United States, pharmaceutical companies produced marijuana-based drugs until 1937, when high taxes and extensive paperwork discouraged doctors from treating patients with marijuana. 
Today's medical marijuana advocates are seeking the right to use marijuana for a relatively short list of ailments. California's Compassionate Use Act, approved by voters in 1996, supports the possession and cultivation of marijuana for the "treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief."The majority of Americans approve of legal medical marijuana use. In the past six years, citizens of Alaska, California, Colorado, the District of Columbia, Maine, Nevada, Oregon and Washington have voted in favor of this position. Supportive articles have appeared in the New England Journal of Medicine and even in Consumer Reports. Meanwhile, President Bush's drug czar, John P. Walters, targets medical marijuana in his war against recreational drugs. His Washington Post editorial warns Americans about the "cynical campaign" for medical marijuana that is based on "psuedo-science." He aims for the weak point in the argument for medical marijuana: lack of documented scientific evidence. Yet, the US government has prevented nearly all medical marijuana research for two decades. The handful who have chosen to challenge this system have faced barriers to even the most basic studies. Scientists lack adequate funding to study medical marijuana. Also, many regulations limit marijuana research. Researchers must seek permission from a long chain of agencies: the Department of Health and Human Services, the Drug Enforcement Agency and the Food and Drug Administration. The federal Controlled Substances Act of 1970 classifies marijuana as a Schedule I drug with a "high potential for abuse" and "no currently accepted medical use" in the US. The law imposes stringent rules on the registration, security, labeling and distribution of marijuana. Researchers also must navigate a maze of varying state laws that apply to marijuana regulation.Yes, No, Maybe Dr. Donald Abrams, a professor at the University of California at San Francisco, is the best-known example of a scientist whose research has been restricted by the government. Abrams' ordeal began in 1992. Partially funded by the Multidisciplinary Association for Psychedelic Studies (MAPS), his project would study the use of smoked marijuana to treat AIDS Wasting Syndrome. Some people with HIV believe that smoking marijuana has helped them decrease the amount of extreme weight loss associated with the disease, but there had never been a controlled study to measure how this treatment actually affects body composition, appetite or weight gain. After the FDA approved his study design, Abrams requested marijuana from the only legal supplier of marijuana in the United States, the National Institute on Drug Abuse (NIDA). Nine months later, the NIDA rejected his application, saying that the study's "design, scientific merit and rationale" were inherently faulty. According to the NIDA, Abrams did not have a way of ensuring that the patients had consistent dosages of marijuana. Therefore, the study could not examine whether how much marijuana the patient took affected the amount of weight gain. Also, the study did not record daily calorie intake or the types of foods eaten. NIDA did not suggest that any revisions in Abrams' design would change their stance. Abrams fired back with his response. "You and your Institute failed," Abrams wrote in a letter posted on the MAPS website. "In the words of the AIDS activist community: SHAME!" He scolded NIDA for waiting so long to reply and not allowing any discussion on the study design. He listed a variety of advisors who had assisted him with the study design to disprove the claim that the study did not have scientific merit. More importantly, he offered specific changes in the design that would satisfy NIDA's demands. He explains that their concerns are somewhat irrelevant because the study was meant to assess marijuana's impact on heart health, immune system and severity of HIV. If the pilot study did not cause any intolerable side effects, further research would address AIDS Wasting Syndrome.The exchange of proposals and letters continued. Finally, just as the government was reevaluating its position on medical marijuana research, Abrams' third proposal was approved. NIDA gave Abrams a $978,000 grant in September 1997. Abrams conducted the first legal medical marijuana research on humans in fifteen years. In his preliminary study, he found that patients who smoked marijuana for 21 days did not have any increase in HIV severity. Today, Dr. Abrams continues his research at the Center for Medicinal Cannabis Research in California. Hometown Help? Massachusetts' own quest to conduct medical marijuana research began in 1991. The State Legislature and Governor William Weld established a statute that allowed the Department of Public Health to head a "therapeutic research program," which would study how well marijuana could treat glaucoma, asthma and cancer treatment side effects. The federal government denied Massachusetts' request to begin the study. In 1996, the governor intensified state efforts to gain federal approval. He added two amendments to the law that put the commissioner of public health in charge of the program and gave legal protections to certified patients. The federal government still stalled research, implying that it would only approve a legal marijuana supply for a well-designed study but not defining any specific requirements. The following year, the Department of Public Health sent a letter to Donna Shalala, Clinton's Secretary of Health and Human Services, asking for detailed information on how to begin an approved study and receive federal marijuana. The letter clearly states the Department of Public Health's intent to research whether "marijuana improves the quality of life" for patients. "Considering the urgency of our desire to establish a compassionate, humane program," wrote David H. Mulligan, Massachusetts Commissioner of Public Health, "we seek your earliest possible response." The Massachusetts Department of Public Health tried to increase awareness by sending copies of the letter to Attorney General Janet Reno, Senator Edward M. Kennedy, Senator John F. Kerry, the Massachusetts Congressional Delegation and Barry McCaffrey, Clinton's Director of National Drug Control Policy. Despite the initial impetus of Massachusetts' demands, the therapeutic research program has mysteriously disappeared. The Department of Public Health issued a memorandum summarizing the proposed program in April 1997. By August 1997, according to the Boston Globe, the federal government still had not responded to the proposal. No written record exists after that point. The Department of Public Health declined to comment on exactly how research was blocked or why Massachusetts no longer seems to be pursuing the issue. The Government Moves So Slow – Perhaps They’re Stoned? Although Abrams and the Massachusetts Department of Public Health faced obstacles, the federal government appears to be gradually relaxing its prohibitive stance on medical marijuana research. Two major developments influenced this mood change. First, the state referenda passed in California and Arizona gave legitimacy to the medical claims made about marijuana. Second, scientists began to understand that the human body produces its own supply of cannabinoids, the class of chemical compounds such as THC that exist in marijuana. These chemicals act as keys that either open or block protein "locks" on the surfaces of our bodies' cells. These proteins send signals within the cell or to neighboring cells. The body's natural cannabinoids are believed to affect memory, pain and movement. When a person smokes marijuana, the plant's cannabinoids enter the body and act in a similar way. So far, scientists have identified 66 cannabinoids in the marijuana plant. In 1997, at around the same time that Abrams first successfully obtained government approval for his work, the NIH held a meeting to discuss possibilities for future medical marijuana research. The NIH nominated the panel of eight experts, each chosen because of their lack of strong opinions on the issue. It was, however, the first well-publicized crack in the government's solid refusal to acknowledge the potential merits of medical marijuana. The panel recommended that future clinical trials, studies involving human beings, were justifiable. At the request of the Office of National Drug Control Policy, an Institute of Medicine (IOM) study team completed a two-year report on issues related to medical marijuana in 1999. The IOM team investigated marijuana's safety, potential for addiction, effectiveness and future marketability. The report emphasizes the benefits of biotechnology, praising the pharmaceutical industry's ability to isolate chemical compounds in a plant and to create medicines rather than discover them. It states that the marijuana plant would not have "known composition or quality." While very positive about marijuana's potential to help patients, it favors the mainstream route of drug development that is expensive and difficult. The IOM team believes that the future of medical marijuana lies in the creation of synthetic cannabinoids that can be profitable enough to entice drug companies to pursue further research. Currently, the Center for Medicinal Cannabis Research (CMCR) at the University of California offers the most hope for scientists who wish to research medical marijuana in a non-hostile, stable environment. The State Legislature of California and Governor Gray Davis established the CMCR in order to "enhance understanding of the efficacy and adverse effects of marijuana as a pharmacological agent" during a three-year period. The 1997 NIH report and the 1999 IOM report will both guide the direction of research topics. The CMCR will also help investigators secure funding sources and comply with state and federal regulations. Seven studies are now in progress at the center. Medical marijuana researchers ask several questions. Scientists want to document exactly how much marijuana helps ease the symptoms of different diseases. They also wish to compare whole-plant marijuana with Marinol, the THC pill. Patients report many difficulties with the synthetic pill. Marinol takes a long time to affect the body, and patients find the pill difficult to swallow when nauseated. Many doctors, however, express concerns that burning marijuana creates chemicals that may cause cancer or weaken the immune system. Therefore, researchers are looking for ways to ingest marijuana that do not involve smoking or taking pills, such as inhalers or skin patches, but still contain the complex web of chemicals present in marijuana. In the meantime, researchers hope to establish consistent ways of smoking marijuana so that patients can ingest a standard amount of the drug. They are also seeking methods of using medical marijuana that provide relief without producing a high. Some patients, especially the elderly, do not want to deal with psychoactive effects on a daily basis. If medical marijuana follows the conventional path towards drug development, patients could be in for a long wait. The typical process takes five to ten years. For medical marijuana advocates, being able to begin experiments involving human patients is a major accomplishment, but only one in five drugs given permission to carry out human trials will ever secure final FDA approval. For now, patients and their doctors have to weigh the risk of arrest versus the ability to treat health problems. Marinol's history shows the limitations of the established path. Since appearing on the US market in 1985, Marinol has been the only legal cannabinoid medicine. Unimed, a pharmaceutical company, developed the THC pill with the financial support of the NIH. The US government partially funded the research necessary for FDA approval. Despite its adverse effects and inconvenient pill form, Marinol still has $20 million in annual sales. Individual patients pay approximately $200 a month to combat AIDS Wasting Syndrome, the most common condition treated with the drug. Many patients cannot afford the financial burden and are forced to look elsewhere for relief. Marinol's manufacturers are not concerned. According to the IOM report, "Unimed perceives only a small percentage of its market to be lost to 'competition' from marijuana itself." When the government and pharmaceutical companies join together for both research and profit, our health care suffers. If this partnership continues, medical decisions will increasingly be based on profit instead of patient need. The 1997 IOM report bluntly illustrates this connection. "The outcomes of preclinical and clinical research determine whether a drug is sufficiently safe and effective to warrant FDA approval for marketing," explains the government-funded report. "But the decisions to launch preclinical research and to proceed to clinical trials if early results are promising are dictated largely by economic factors ... For any given drug, the question is, will there be an adequate return on investment?" If money is the primary factor, medical researchers may be forced to abandon creative solutions to human suffering. The pursuit of profit creates an environment of unasked scientific questions. Patients seeking their own answers find closed paths. The question is, do Americans have access to the medicines that they need? Note: Despite Public Approval, US Government Is Slow To Allow Thorough Research Of Medical MJ.Source: Boston Weekly Dig (MA)Author: Caitlin E. CoxPublished: September 11-18, 2002Copyright: 2002 Boston Weekly DigContact: letters weeklydig.comWebsite: http://www.weeklydig.com/CMCRhttp://www.cmcr.ucsd.edu/MassCannhttp://www.masscann.org/CannabisNews Medical Marijuana Archiveshttp://cannabisnews.com/news/list/medical.shtml
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Comment #1 posted by CorvallisEric on September 17, 2002 at 02:39:20 PT
Governor Weld
The State Legislature and Governor William Weld [Republican] established a statute that allowed the Department of Public Health to head a "therapeutic research program," which would study how well marijuana could treat glaucoma, asthma and cancer treatment side effects.
This reminded me of his losing battle with Senator Jesse Helms (retiring) to become ambassador to Mexico in 1997. Lots of stuff on the internet by searching Google for Weld Helms Mexico. An example of articles at the time is a column by Robert Scheer ending with:
It's outrageous that tolerance of the medical use of marijuana could bar a man from serving as ambassador to Mexico--especially when his nemesis is a fanatical advocate for the drug that most clearly threatens the health of the world's people. Helms' position gives him veto power over the entire range of U.S. foreign policy. This is no longer a matter of one man's vile buffoonery, but represents a dangerous degradation of the nation's politics.
Jesse Helms, The Senator From Hell
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