18 Apr 2014

Study Finds Signs of Brain Changes in Pot Smokers

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A small study of casual marijuana smokers has turned up evidence of changes in the brain, a possible sign of trouble ahead, researchers say. The young adults who volunteered for the study were not dependent on pot, nor did they show any marijuana-related problems.

“What we think we are seeing here is a very early indication of what becomes a problem later on with prolonged use,” things like lack of focus and impaired judgment, said Dr. Hans Breiter, a study author.

Longer-term studies will be needed to see if such brain changes cause any symptoms over time, said Breiter, of the Northwestern University Feinberg School of Medicine and Massachusetts General Hospital.

Previous studies have shown mixed results in looking for brain changes from marijuana use, perhaps because of differences in the techniques used, he and others noted in Wednesday’s issue of the Journal of Neurosciences.

The study is among the first to focus on possible brain effects in recreational pot smokers, said Dr. Nora Volkow, director of the National Institute on Drug Abuse. The federal agency helped pay for the work. She called the work important but preliminary.

The 20 pot users in the study, ages 18 to 25, said they smoked marijuana an average of about four days a week, for an average total of about 11 joints. Half of them smoked fewer than six joints a week. Researchers scanned their brains and compared the results to those of 20 non-users who were matched for age, sex and other traits.

The results showed differences in two brain areas associated with emotion and motivation — the amygdala and the nucleus accumbens. Users showed higher density than non-users, as well as differences in shape of those areas. Both differences were more pronounced in those who reported smoking more marijuana.

Volkow said larger studies are needed to explore whether casual to moderate marijuana use really does cause anatomical brain changes, and if so, whether that leads to any impairment.

The current work doesn’t determine whether casual to moderate marijuana use is harmful to the brain, she said.

Murat Yucel of Monash University in Australia, who has studied the brains of marijuana users but didn’t participate in the new study, said in an email that the new results suggest “the effects of marijuana can occur much earlier than previously thought.” Some of the effect may depend on a person’s age when marijuana use starts, he said.

Another brain researcher, Krista Lisdahl of the University of Wisconsin-Milwaukee, said her own work has found similar results. “I think the clear message is we see brain alterations before you develop dependence,” she said.

AP Medical Writer Lindsey Tanner in Chicago contributed to this report.

Source: Associated Press (Wire)
Author: Malcolm Ritter, Associated Press
Published: April 16, 2014
Copyright: 2014 The Associated Press

8 Apr 2014

Feds Favor Anti-Pot Research

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As the nation’s only truly legal supplier of marijuana, the U.  S.  government keeps tight control of its stash, which is grown in a 12-acre fenced garden on the campus of the University of Mississippi in Oxford.

From there, part of the crop is shipped to Research Triangle Institute in North Carolina, where it’s rolled into cigarettes, all at taxpayer expense.

Even though Congress has long banned marijuana, the operation is legitimate.  It’s run by the National Institute on Drug Abuse, part of the U.  S.  Department of Health and Human Services, which doles out the pot for federally approved research projects.

While U.  S.  officials defend their monopoly, critics say the government is hogging all the pot and giving it mainly to researchers who want to find harms linked to the drug.

U.  S.  officials say the federal government must be the sole supplier of legal marijuana in order to comply with a 1961 international drug- control treaty.  But they admit they’ve done relatively little to fund pot research projects looking for marijuana’s benefits, following their mandate to focus on abuse and addiction.

“We’ve been studying marijuana since our inception.  Of course, the large majority of that research has been on the deleterious effects, the harmful effects, on cognition, behavior and so forth,” said Steven Gust, special assistant to the director at the National Institute on Drug Abuse, which was created in 1974.

With polls showing a majority of Americans supporting legalization, pot backers say the government should take a more evenhanded approach.  The National Institute on Drug Abuse and the White House drug czar have become favorite targets to accuse of bias, with both prohibited by Congress from spending money to do anything to promote legalization.

Some critics hope the situation will change; federal officials recently approved a University of Arizona proposal that will let researchers try to determine whether smoking or vaporizing marijuana could help veterans with post-traumatic stress disorder, known as PTSD.  The researchers got the green light to provide the equivalent of two joints per day for 50 veterans.

The approval was a long time coming.

Suzanne Sisley, clinical assistant professor of internal medicine and psychiatry at the University of Arizona’s medical school, said the Health and Human Services Department waited more than three years to approve the project after it was first sanctioned by the Food and Drug Administration.  She said the extra federal review should be scrapped and that approval by the FDA should be sufficient for a study to proceed.

“Nobody could explain it – it’s indefensible,” she said in an interview.  “The only thing we can assume is that it is politics trumping science.”

After the long delay, Sisley said she’s excited to get started and hopes to launch the project late this spring or early this summer, after getting the marijuana from the National Institute on Drug Abuse.  She said pressure by veterans helped get the project approved.

For critics, the process is far too slow.  In the fight to sway public opinion, the research battles have assumed a sense of urgency, with opponents and proponents of legalization scrambling to find more evidence to advance their positions.

For opponents, it means trying to link pot use to such things as increased highway deaths, student dropouts and emergency hospital admissions.  That could help defeat a plan to legalize pot for recreational use in Alaska, set for an August vote.

For supporters, it means trying to find new ways to use pot to treat diseases.  That could get voters in more states to approve medical marijuana; 20 states and the District of Columbia already have done so, and Florida could join the list in November.

Dan Riffle, director of federal policies for the Marijuana Policy Project, a pro-legalization group, said President Barack Obama should end the National Institute on Drug Abuse’s monopoly and remove all other research barriers.  The legalization of marijuana “is inevitable” and more studies are needed, he said.

“That is exactly why federal law and policies shouldn’t tie the hands of scientists by favoring certain kinds of research over others,” Riffle said.

The national institute’s Gust said the federal government is open to the idea of looking for more medical applications for marijuana and that it’s a “red herring” to say that his agency is blocking research.

“This is an untruth that’s been put out there by certain groups, and quite frankly I wonder if it’s not having the perverse effect of actually decreasing the amount of applications and interest in research,” Gust said.

National Institute on Drug Abuse officials said they gave more than $30 million in government grants to finance 69 marijuana-related research projects in 2012, a big jump from the 22 projects that received less than $ 6 million in 2003.  While the institute would not provide exact figures, Gust said it has funded at least five to 10 projects examining possible medical applications.

The institute also provides marijuana for privately funded projects approved by the Health and Human Services Department.  Of the 18 research applicants who requested marijuana from 1999 to 2011, 15 got approval, officials said.

The University of Mississippi received nearly $847,000 in 2013 to produce and distribute the pot for the research projects, mainly Mexican, Colombian, Turkish and Indian varieties.

The university grows 6 kilograms ( a little more than 13 pounds ) of marijuana each year, or more if the demand is higher.  Nine employees are involved in the work.  Among the university’s tasks, it analyzes marijuana confiscated by drug enforcement agents and sends “bulk plant material” to North Carolina’s Research Triangle Institute, just outside of Durham at Research Triangle Park, where marijuana cigarettes are produced and packaged.

Some of the pot is sent to a handful of Americans who won the right to smoke the drug for medical reasons under a court settlement in 1976, 20 years before California became the first state to approve medical marijuana.

Source: Austin American-Statesman (TX)
Copyright: 2014 Austin American-Statesman
Contact: [email protected]
Website: http://www.statesman.com/

24 Mar 2014

Marijuana Research Hampered by Access from Gov.

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Millions of ordinary Americans are now able to walk into a marijuana dispensary and purchase bags of pot on the spot for a variety of medical ailments. But if you’re a researcher like Sue Sisley, a psychiatrist who studies post traumatic stress disorder, getting access to the drug isn’t nearly so easy.

That’s because the federal government has a virtual monopoly on growing and cultivating marijuana for scientific research, and getting access to the drug requires three separate levels of approval.

Marijuana offers hope for 6-year-old girl with rare condition: In marijuana, Lydia Schaeffer’s family members think they might have found a treatment that works. Now, they are trying to help legalize the drug.

Sisley’s fight to get samples for her study — now in its fourth month — illuminates the complex politics of marijuana in the United States.

While 20 states and the District have made medical marijuana legal — in Colorado and Washington state the drug is also legal for recreational use — it remains among the most tightly controlled substances under federal law. For scientists, that means extra steps to obtain, transport and secure the drug — delays they say can slow down their research by months or even years.

The barriers exist despite the fact that the number of people using marijuana legally for medical reasons is estimated at more than 1 million.

Stalled for decades because of the stigma associated with the drug, lack of funding and legal issues, research into marijuana’s potential for treating diseases is drawing renewed interest. Recent studies and anecdotal stories have provided hope that marijuana, or some components of the plant, may have diverse applications, such as treating cancer, HIV and Alzheimer’s disease.

But scientists say they are frustrated that the federal government has not made any efforts to speed the process of research. Over the years, the Drug Enforcement Agency has turned down several petitions to reclassify cannabis, reiterating its position that marijuana has no accepted medical use and remains a dangerous drug. The DEA has said that there is a lack of safety data and that the drug has a high potential for abuse.

Sisley’s study got the green light from the Food and Drug Administration in 2011, and for most studies, that would have been enough. But because the study is about marijuana, Sisley faced two additional hurdles.

First, she had to apply to the Department of Health and Human Services to purchase ­research-grade samples from the one farm in the United States — housed at the University of Mississippi and managed by the National Institute on Drug Abuse — that is allowed to grow marijuana under federal law. HHS initially denied her application but then approved a revised version March 14 — more than four months after it was submitted.

Now, Sisley must get permission from the DEA to possess and transport the drug.

Spokeswoman Dawn Dearden said that the agency is supportive of medical research on marijuana but needs to follow regulations under the Controlled Substances Act. “DEA has not denied DEA registration to a HHS-approved marijuana study in the last 20-plus years,” she said.

Sisley, who began her work with PTSD while at the Department of Veterans Affairs and now works at the University of Arizona College of Medicine, says she considers the HHS news a “triumph” for marijuana research. But she says the study has “a potentially long road with the DEA who is famous for delays.”

“There is a desperate need for this research, but it’s impossible to study this drug properly in an atmosphere of prohibition,” she said.

Orrin Devinsky, director of the epilepsy center at New York University’s Langone Medical Center, said many would-be marijuana researchers are driven to abandon projects after they discover how time-consuming and expensive it can be to obtain the drug.

“There is no rationale for this except for the federal government’s outdated 1930s view about marijuana,” said Devinsky, who is studying the use of an extract of the plant for the control of seizures.

A Resurgence in Research

The cannabis plant was once a staple in American pharmacies, but since the turn of the 20th century, some states began to see it as a poison and introduced restrictions. Research on its medicinal uses came to a virtual standstill.

There are now 156 active researchers who are approved by the DEA to study marijuana — a number that has remained steady in recent years — but scientists say most are government-funded and focus on the ill effects of smoking marijuana rather than on potential medicines.

That’s poised to radically change. As an increasing number of states have legalized the use of medical marijuana, a bustling industry of start-up drug companies and medical groups focused on finding marijuana-based treatments has emerged. GW Pharmaceuticals, a British company, is studying two different extracts of marijuana that have shown promise for patients with Type 2 diabetes and epilepsy. ISA Scientific, based in Utah, is researching medications for pain and diabetes made from the cannabinoids found in marijuana that could be swallowed in capsule form.

Some of these new-generation researchers are exploring ways to try to speed up their work by bypassing the federal process for obtaining the drug. In Colorado, for instance, academic researchers have asked state officials whether they would allow them to study extracts grown within the state. In Georgia, scientists are seeking legislative action to allow the state’s five medical research universities to cultivate marijuana. A bill allowing them to do so recently won the backing of a House committee.

Much of the debate surrounding marijuana research is focused on its classification by the DEA as a Schedule I drug, the most restrictive of five categories. Schedule I drugs are considered to have a high potential for abuse and no accepted medical use. Other drugs in that group include LSD, heroin and ecstasy.

The American Medical Association said in November that it does not support state medical marijuana efforts and still considers the drug dangerous. But it also called on the government to encourage more clinical research — by reconsidering its classification as a Schedule I drug. A lower-level classification would allow researchers to obtain marijuana more easily.

The fact that the Obama administration in recent months has moved to loosen restrictions on marijuana in other regards has raised hopes that it will take similar action that will help scientists. The Justice Department said last year that it would not challenge state laws legalizing marijuana, and in February, the Treasury announced new guidelines meant to make it easier for cannabis businesses to open bank accounts in states where the drug is legal.

Kevin Sabet, a former White House senior adviser for drug policy who has been dubbed the No. 1 legalization enemy by Rolling Stone magazine, said he supports efforts to break down barriers for researchers. But he proposed that this could be done more efficiently without rescheduling the drug — which remains highly controversial and would have implications for the criminal justice system.

Sabet signed a letter sent this month to senior administration officials by a coalition of people working in drug prevention and related causes. The letter suggested that the DEA could instruct field offices to process applications without delay after FDA approval and could relax storage requirements for the components of marijuana used in the context of an investigational new drug.

‘The Whole Process is Wrong’

In the brave new world of medical marijuana, family doctors, psychiatrists and other community practitioners are the gatekeepers and must determine whether a patient truly needs the drug. But in many cases, doctors are prescribing the drug for their patients against the recommendations of medical societies and with only limited research to back up what they are doing.

“The whole process is wrong,” said Andrew Weil, the American doctor and author who conducted the first double-blind clinical trials of marijuana in 1968.

“There is a great deal of evidence both clinical and anecdotal of its therapeutic effects, but the research has been set way back by government polices,” Weil added.

“We are at the point where we are really just learning about this, and for doctors that means a lot of experimentation,” said Bonnie Goldstein, a pediatrician who is medical director of the Ghost Group, which manages WeedMaps.com, a searchable directory of doctors and dispensaries.

In many states, for instance, marijuana is approved for pain and prescribed for those with arthritis. But a study published in the journal of the American College of Rheumatology this month found that the effectiveness and safety of marijuana to treat conditions such as arthritis are not supported by medical evidence.

Another condition for which medical marijuana is widely prescribed is PTSD. Yet the American Psychiatric Association discourages doctors from using it to treat psychiatric disorders. In a statement in November, the APA said, “There is no current scientific evidence that marijuana is in any way beneficial for the treatment of any psychiatric disorder.”

Sisley said she has been working with marijuana for several years to treat soldiers returning from Afghanistan and Iraq who have flashbacks, insomnia and anxiety, but she has had questions about dosages that haven’t been answered. Is one gram a day optimal? Or two? Is it better to smoke the marijuana or use a vaporizer, which heats ground marijuana leaves to produce a gas?

Sisley — who is working on the PTSD study with Rick Doblin, a psychologist and executive director of the Multidisciplinary Association for Psychedelic Studies — says she thinks the next big political fight over marijuana may come from studies such as hers. If research shows that marijuana is an effective medical treatment, it could force the federal government’s hand on reclassifying it.

Source: Washington Post (DC)
Author: Ariana Eunjung Cha
Published: March 21, 2014
Copyright: 2014 Washington Post Company
Contact: [email protected]
Website: http://www.washingtonpost.com/

29 Oct 2013

Despite Legalization, Not Much Known About Effects

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Even though 20 states, including Illinois, have passed laws legalizing medical marijuana, swayed in part by thousands of personal testimonies, current research hasn’t nailed down exactly if, and how, marijuana alleviates all the specific diseases the drug is being legalized to treat, experts say.

A number of proponents believe marijuana could benefit people with everything from glaucoma to cancer, and it’s been legalized in Illinois to aid patients with some 40 medical conditions. But opponents of its medicinal use believe the risks of smoking medical marijuana outweigh the benefits, while others question whether patients really improve or only feel like they improve.

Marijuana’s best-known compound is THC, but the plant actually has 105 unique cannabis compounds with potential for medicinal use, proponents say. THC has already been approved by the Food and Drug Administration in synthetic form to help patients with nausea and decreased appetite.

Some scientists believe the plant’s other compounds — called cannabinoids — could have equal promise. Although research has increased in recent years as more states legalize medical marijuana, solid evidence of how individual cannabinoids could help people with specific diseases has been significantly lacking, a review of medical literature and interviews with experts shows.

Researching the potential effects of marijuana’s various components on conditions such as multiple sclerosis, fibromyalgia or lupus could have serious implications for doctors who want to prescribe medical marijuana to patients.

If the specific benefits could be proved, experts say, doctors ultimately would be able to assign particular strains — with varying chemical mixes — to people, depending on their condition. Further research also may help determine optimal doses and whether marijuana works better than other medicines, experts say.

While most medicines derived from nature are tested before they reach the masses, the process to evaluate marijuana has been confounded by its longtime status as an illegal drug, which it retains in the eyes of the federal government. A complicated federal approval process and limited availability of research-grade marijuana add to the difficulty.

The only study specifically cited in Illinois’ law, signed by Gov. Pat Quinn in August and set to go into effect next year, is a 1999 Institute of Medicine report. But Dr. John Benson, a lead editor of the report, said legislators stretched the conclusion of the book-length study when it said modern medical research “has confirmed the beneficial uses of cannabis.”

While the report did say there was promise that marijuana could have medical benefits, it also suggests researchers need to continue to dig deeper into the issue. It also says marijuana should not be smoked, he said.

“Smoking marijuana is not recommended,” the report states. “The long-term harm caused by smoking marijuana makes it a poor delivery system.”

The 14-year-old article has become a primary source for both critics and supporters of medical marijuana — the Drug Enforcement Agency and advocacy groups have cited it to prove opposite points.

“I don’t think whatever the legislature is saying (in the law) is in effect untrue,” Benson, now retired, said from his California home, “but it needs to be qualified.”

Medicine by Legislation

Illinois legislators knew they had an uphill battle getting the medical marijuana bill passed last summer, Rep. Lou Lang said. Lang worked at swaying his colleagues for five years and said he compromised on the list of about 40 conditions — some of which are closely related — that will qualify people for medical marijuana once it becomes available sometime next year.

Illinois legislators, he said, did “a substantial amount of reading,” but they did not evaluate each condition on the list with any scientific methodology.

“I can’t point to specific studies that we used,” Lang said. “Much of it was done by patients telling us what worked and what didn’t. … It became crystal clear some of these things that ought to be in the bill.”

The legislators relied mostly on personal testimonies and compared notes with states that have also passed medical marijuana laws.

“When thousands of people come to me and say they’re using this drug illegally because it’s the only thing that works,” Lang said, “that’s good enough for me.”

Mike Graham, of Manteno, was one person who shared his story with legislators. A little more than a decade ago, he was using 14 different pharmaceuticals. Living with an extremely painful degenerative spine disease, he has been through multiple surgeries in efforts to remedy it. But doctors feared one more could paralyze him, so he took medications for pain instead.

“I didn’t even know my name,” Graham said. “It was horrid.”

When he was in his late 30s, doctors sent him home with a hospice care nurse. After reviewing his medications, she told him he would die early if he continued taking all of them. To his surprise, she recommended pot, he said.

“I almost fell out of bed laughing,” Graham, 51, said. “I come from a law enforcement family.”

Increasingly desperate, in 2002, he decided to give it a try. He was able to cut back on all his previous medications except a morphine pump under his skin. Now, he takes three or four puffs of marijuana in the morning and at night. Once down to 135 pounds, the more than 6-foot-tall Graham now says he’s back up to 250 after regaining his appetite.

“What it comes down to here (is) I wouldn’t be here if I hadn’t made that decision,” Graham said.

While stories like Graham’s are plentiful, doctors and researchers say the nonmedical elements of the plant could have sometimes serious adverse effects.

Dr. Eric Voth, a Topeka, Kan., internist and pain specialist and chairman of the Institute on Global Drug Policy, said relying on anecdotal evidence is dangerous because other factors could influence why patients start to feel better.

“It’s very hard to differentiate whether somebody feels better because they’re stoned or because they’re getting a true therapeutic benefit from the drug,” Voth said.

Health Risks

Smoking marijuana could increase the risk of cancer because of inhalation of tar and other carcinogens in the plant, Voth said. While proponents of its use point to the 105 unique compounds, as detailed in a soon-to-be published report by leading cannabinoid researcher Dr. Mahmoud ElSohly and his colleagues, that may be useful for medicine, there are hundreds more compounds in marijuana that some scientists believe not only have no use but may be harmful.

“You’ve still got (hundreds of other) substances in there,” Voth said. “It just (shouldn’t) be smoked. That is a crazy precedent.”

Illinois’ law allows dispensaries to sell marijuana-infused baked goods in addition to joints, but advocates say it takes longer to feel the effects of marijuana when it’s ingested instead of smoked.

Several papers in scientific journals have found that marijuana use over a long period of time can have negative cognitive effects too. Users can’t concentrate or remember as well as before, in some cases years after they have quit.

Joe Friedman, a Deerfield pharmacist, said the chemical makeup of marijuana could be tested at independent labs, and he hopes it will be in Illinois. Marijuana is designated as a Schedule I drug, defined by the DEA as “drugs with no currently accepted medical use and a high potential for abuse.”

Changing it to a Schedule II drug, which means it is considered dangerous but could have potential medicinal value, Friedman said, would help research progress in learning which type of marijuana is best for which patient.

“When a drug comes on the market, you take the active ingredients, you figure out what these drugs do,” said Friedman, who wants to open a dispensary in Illinois. “You want to be able to identify the active ingredients and the concentrations … and then down the line (after more research is done), you’ll be able to say, ‘OK this one is good for MS,’” Friedman said.

But Voth said he doubts that even identifiable benefits would be enough to outweigh the negative effects, because of other potentially harmful components that are mixed in.

“Essentially what they are, are toxic chemicals,” Voth said. “None of those things would you ever mix with medicine.”

What Some Call a Cure-All

In 1937, the U.S. criminalized marijuana, and today it’s considered a Schedule I drug, along with heroin and LSD.

The FDA approved a synthetic THC pill called Marinol in 1985, acknowledging the drug’s benefits for people with nausea and decreased appetite. In Canada and some parts of Europe, a similar drug called Sativex — containing synthetic THC and cannabidiol — has been approved in recent years, offered as an oral spray. In the late 1980s, scientists discovered a previously unknown biological system called the endocannabinoid system, which proponents for marijuana theorize could show how it works.

The National Institutes of Health reported in 2006 that the system holds “therapeutic promise in a wide range of disparate diseases.”

But experts say more research is needed before determining exactly what the system may be able to do.

Mary Lynn Mathre, a founding partner of Patients Out of Time, a marijuana advocacy group that focuses on health issues, said the leading theory regarding the system is that the human body has cannabinoid receptors — essentially key holes that cannabis compounds fit into, helping the body regulate.

“You take cannabis, which has similar chemicals that we need, and you put it in the body and they work if we’re not making the cannabinoids that we need,” explained Mathre, a longtime registered nurse. “You can liken this to a diabetic. Their pancreas isn’t making insulin, so we give them insulin. If our body can’t make this chemical, there happens to be this plant on earth that is there to supply us.”

A Call for Research

Many prominent health organizations — including the American Medical Association, the American Cancer Society and the National Multiple Sclerosis Society — support researching cannabinoids’ potential but don’t endorse the legalization of medical marijuana. The American Nurses Association and the American College of Physicians support medical marijuana’s legalization, while also calling for more research.

“Science has been doing this kind of thing for years,” Voth said. “They find a (naturally) occurring substance and then they try to dissect down to what really works, isolate it and synthesize it. That’s what pharmaceutical companies do all the time.”

While THC has a few proven medical benefits, it’s possible that other compounds that don’t have the same euphoric effect could relieve symptoms just as well or better than THC, researchers and pharmacists say.

Pritesh Kumar, a researcher who specializes in cannabinoid pharmacology and is a consultant for Chicago-based Quantum 9, a medical marijuana technology firm, has focused on CBD, a compound in marijuana some scientists believe could have significant benefits.

Research like Kumar’s, studying isolated compounds in marijuana, has picked up in recent years, but widespread research looking at how specific diseases and cannabinoids interact has not been done.

Friedman, the Deerfield pharmacist, said he’s hopeful that with medical marijuana legalization on a faster track than ever, disease-specific research in the U.S. will pick up.

“As marijuana gains popularity and (if it) moves from Schedule I to Schedule II, research will really kick in,” Friedman said. “This is a whole new industry, and this is going to get bigger and stronger as time goes on.”

Source: Chicago Tribune (IL)
Author: Ellen Jean Hirst, Tribune Reporter
Published: October 27, 2013
Copyright: 2013 Chicago Tribune Company, LLC
Website: http://www.chicagotribune.com/

1 Jun 2013

Medical Cannabis: Safe, Effective

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Where did you receive your schooling and training?

I have been a medical physician for more than 29 years since graduating from the University of Utah School Of Medicine.  I completed training in general surgery in Los Angeles and plastic surgery in Utah.  During my general surgery training I completed a one-year plastic surgery research fellowship at the University of Southern California.  I finished my board certifications in both general surgery and plastic surgery, and set up private plastic surgery practice in Las Vegas.  I practiced plastic and reconstructive surgery for six years until I underwent cervical spine surgery for herniated discs in the neck.  The surgery left me with neck pain and bodily muscle pain that prevented me from returning to the practice of surgery.

After five years, I was well enough to re-train in pain medicine at the University of Utah under a group of renowned pain-medicine physicians, who have served as current and past presidents of prominent pain academies and societies in the United States.  I hold memberships in the American Academy of Pain Medicine, the International Cannabinoid Research Society and the American Telemedicine Association.

What is your current practice?

I am a board-certified pain-medicine physician and owner of Hawaiian-Pacific Pain and Palliative Care ( medicalmarijuanaofhawaii.org ).  The focus of my practice is the care of patients with chronic pain.  In addition, I have a strong interest in hospice and end-of-life care.  This practice is done on a voluntary basis and is based in Waimanalo at the Native Hawaiian Model Agricultural Village called Pu’uhonua O Waimanalo.  Nearly all fees generated by the advocacy and clinical practice for medical cannabis therapies are used for expenses and Native Hawaiian programs.

Malama First Healthcare is a nonprofit initiative based in the village, and its goals are to improve the health care of Native Hawaiians worldwide.  I serve as their chief medical officer on a voluntary basis.

How long have you been an advocate for medical marijuana?

I have been an advocate for the use of medical cannabis since 2008, when I was first exposed to a group of chronic pain patients on the Big Island who were using cannabis as their sole pain medication, or sometimes in combination with pain pills.

Having no personal experience with marijuana use, I found it quite fascinating that so many people found benefit and relief to their chronic pain conditions using cannabis.

From there, my professional opinion evolved to the point of full political and medical advocacy.

My formal training taught me that marijuana was a gateway drug and had no medical use, which I have since learned to be completely false.  During my training, patients using cannabis often were denied opioid therapies and viewed as drug seekers and addicts.

During my training, no one explained to me how cannabis helped with pain, except one young man who suffered a severe neck injury in the Indonesia tsunami.

Our addiction psychiatrists were forcing him to quit the use of cannabis before the group would prescribe opioids.  Thankfully, this is an out-of-date notion.

These restrictions should never be forced upon any patients who suffer severe, disabling pain.  As I interviewed more people, I became more convinced of the usefulness of medical cannabis.

I thought to myself that thousands of Hawaii residents can’t be wrong.

Patients were finding significant relief from chronic pain conditions and syndromes that otherwise have poor or no effective treatments.

I then set off on an extensive endeavor to understand the medical science of cannabis, cannabinoid receptors, cannabinoid physiology and cannabinoid therapies.

At first I was shocked by the suppression of these safe and effective therapies because of irrational prejudices and political machinations.  This was followed by professional and political disdain at government, politicians, entities and corporations with ulterior motives who are willfully causing millions of people to endure greater suffering because of their direct interference in the practice of medicine and medical research, and their suppression and denial of these therapies.  Thankfully, the Hawaii State Legislature took a bold stand more than a decade ago, in the face of great political pressure, which still exists, and allowed for legal use by chronically ill and disabled people.

Chronic pain is the No.  1 medical condition in the United States, with an estimated 75 million to 100 million Americans living with it.  At least 20 million to 25 million Americans live with severe pain.  In Hawaii, it is conservatively estimated that more than 100,000 live with moderate to severe pain from all causes, including arthritic degeneration, trauma, metabolic conditions such as diabetes, and cancer or its treatment.

Where do things stand right now in the legislative arena?

This year, two bills out of many were vetted in committee and passed by both the Hawaii State Senate and House of Representatives and are expected to be signed by Gov.  Abercrombie.  The first and most important bill calls for the transfer of the medical cannabis program to the Department of Health.  Patients and physicians have requested this transfer for many years.

It is more appropriate that a program for the health and medical welfare of patients be under the auspices of a health department and not law enforcement.  The second bill attempts to improve significant shortcomings in the program itself.  Safe access is our No.  1problem and concern.

The state allows for the use of cannabis as a medicine but does not allow the access to a safe source of that medicine.

From a medical point of view this is unconscionable.  You would not make a diabetic grow and produce their own insulin or diabetes pills.

Currently, patients must obtain seeds, grow the plants, overcome the hostilities of growing by mold and bugs and then develop the yield that becomes their medicine.

The majority of patients are not in a position to even get started.

They don’t know how to grow.  They don’t feel well enough to grow.  They don’t have a place to grow.  And there’s no guarantee that these efforts will result in an adequate medication supply.

The use of cannabis is not an alternative to the use of traditional medications it is a unique medication with unique medical effects.

It is not replaceable with anything else in existence.

Immediate access can only be solved by a dispensary or retail outlet.

A state-run system would be ideal.  The other main issue is the failure to increase the qualifying diagnoses list, since cannabinoid therapy is uniquely helpful to a myriad of conditions.  A large proportion of Hawaii’s cannabis users do it for medical purposes, but the law does not respect that and allow them to be legal because they are using it for conditions not allowed by law.  Our combat soldiers are denied its legal use for PTSD after a decade of multiple deployments to war zones, and are thereby denied an effective and safe treatment for this difficult-to-treat condition.  Cannabis is superior to all other modalities in existence such as anti-depressants and anti-psychotics, which have questionable effectiveness and many adverse side effects.

How effective is medical marijuana compared with other painkillers?

At the most recent meeting of the American Academy of Pain Medicine, Dr.  M.  Moskowitz stated that “preclinical studies, surveys, case studies and randomized double-blind placebo-controlled trials with cannabis have all shown its effectiveness in chronic pain conditions .  Cannabis works to settle down the processing of wind-up ( or expanded pain processing in the brain ) and is the only drug known to do so.  It reduces inflammatory pain in the peripheral nerves, and has a unique mechanism for pain reduction unlike any other medicine.”

Studies have shown that medical cannabis is as effective as opioid therapies.  By using medical cannabis, many people are able to completely eliminate or significantly reduce their use of opioid pain pills.  This eliminates or significantly reduces the numerous adverse side effects that opioids inflict.

The major medical benefit to the withdrawal of opioids is the removal of physical dependency.  Most importantly, the mortal safety of a patient on an opioid regimen is dramatically improved with the addition of medical cannabis and a reduction in opioid dosage.

Every day, Americans are dying from the misuse and overdosing of opioid medications.  There is an epidemic of prescribed opioid pill diversions, which can lead to death or ongoing drug addiction.

The use of cannabis in chronic pain also reduces the number of other types of medications needed for coexisting sleep and mood disorders, and myofascial spasms ( within tissue surrounding the muscles ) found in nearly all chronic pain patients.

There are no other single medications in existence that can treat all of these coexisting problems in addition to treating the pain.  The removal of these other medications also removes their inherent adverse side effects and any medications needed for adverse side effects, such as drowsiness, constipation or nausea.

Anything you would like to add?

Medical cannabis is an effective and safe therapy that should not be denied to any human being.

Government policies are directly interfering with medical science and research, along with clinical care.

The prohibition of safe access is an ongoing major problem for patients in Hawaii and needs to be corrected by dynamic and outside-the-box thinking.

There are solutions to these issues.

The concerns of cannabis habituation, dependency and addiction, along with recreational or misuse in young people, are not valid reasons for the denial and suppression of these therapies for legitimate patients; otherwise, no controlled substances would be allowed in clinical practice.

I hear compelling, life-changing stories from patients almost daily.  Just today, a mother expressed her gratitude to us for helping her son, who was practically bedridden for two years, get his life back.  She cried when he tried cannabis and was able to get up and out of bed and start running around.

These are not isolated and rare occurrences.

The addition of medical cannabis as a replacement or adjuvant medication to the chronic pain patient’s medication regimen will greatly improve patient well-being and care, and provide increased patient safety.

Source: MidWeek (HI)
Column: Doctor in the House
Copyright: 2013 RFD Publications, Inc.
Contact: [email protected]
Website: http://www.midweek.com/
Author: Rasa Fournier

28 May 2013

Study To Look at Whether MMJ Really Helps Users

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A $2.2-million federally funded study soon will help answer the question: Does medicinal marijuana really help? The grant from the National Institute on Drug Abuse funds a four-year project that began this monthat the University of Michigan. Researchers will track the progress of 800 recipients of medicinal marijuana prescriptions.

Michigan, where more than 135,000 patients are now in a 4-year-old statewide registry of approved medical marijuana users, is one of 20 states in which medical marijuana is used to ease pain and symptoms from cancer, seizures, glaucoma and other conditions, according to the researchers. Michigan voters approved a measure allowing medical marijuana in 2008.

Past research on medical marijuana’s effect has mostly focused on lab studies where participants are given different levels of marijuana or a placebo, then report whether their pain is lessened.

But those studies tend to last hours or a few days, and they fall short of determining whether the marijuana has a long-term effects on their lives in more practical ways — at work, with family or in social settings, said the U-M study leader Mark Ilgen,whose past research includes substance use, abuse, suicide and post-traumatic stress disorder.

Results show that pain was reduced, he said.

Experts, however, disagree about the magnitude of the pain reduction and how it compares with other pain medications, he said.

Still, he added, any pain reduction for the sufferer is welcome.

Just as important as pain mitigation is whether that change helps the sufferer with everyday life. The longer term functioning of medical marijuana users is really unknown, he said.

“Maybe they’re functioning better because of a better (pain) control, or maybe they’re … withdrawing socially because of the marijuana use,” he said.

Part of the study will be based on participants’ reports of how they’re faring; other data will include results of drug screens for other substances or arrest records, for example, Ilgen said.

The goal is to determine who does better and who does worse with medical marijuana, and what factors make the difference, he said.

The study eventually may be used by policy makers still struggling to understand the impact of the medical marijuana laws.

Just as important, Ilgen noted, “I see this as a starting point for more research.”

Participants cannot sign up. They must be approached by research staff at their first doctor’s appointment that is part of the process to become a registered medical marijuana user in Michigan.

Source: Detroit Free Press (MI)
Author: Robin Erb, Free Press Medical Writer
Published: May 26, 2013
Copyright: 2013 Detroit Free Press
Website: http://www.freep.com/
Contact: [email protected]

2 May 2013

Some Dispensaries Not Too Thrilled By Legal Pot

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Medical marijuana groups are wary of a bill that would legalize and tax marijuana in Maine.

Estimates nationwide suggest if marijuana were legal, much of the profit gained by medical retailers and black-market criminals would disappear.

That worries Glenn Peterson, the owner of Canuvo, a Biddeford medical-marijuana dispensary.  He also serves as president of the Maine Association of Dispensary Operators, a trade group made up of five Maine dispensary owners.

Peterson said his group is concerned that the bill could “eliminate the medical marijuana industry” in Maine.

“I tend to be libertarian,” he said.  “On the other hand, I am quite protective of my dispensary.”

Paul McCarrier, a lobbyist for Medical Marijuana Caregivers of Maine, an advocacy group for state-licensed caregivers who grow marijuana for small groups of medical patients, said his group is opposing the bill.  McCarrier said it would favor dispensaries through licensing requirements, which could regulate small-time growers out of existence.

“The scope of protections for the individual to cultivate for themselves is too limited,” he said.

The head of a national group that has supported the Maine bill and similar proposals nationwide says his organization has run into opposition to legalization from medical-marijuana groups in other states.

Allen St.  Pierre, executive director of the National Organization for the Reform of Marijuana Laws, or NORML, said that “probably the most vexing thing that we’re facing right now ( in pushing for legalization ) is not the government or law enforcement agencies,” he said.  “It comes from, oddly put, anti-prohibitionists versus anti-prohibitionists.”

The Maine bill to legalize marijuana, sponsored by Rep.  Diane Russell, D-Portland, is a sweeping measure.  Chiefly, it would allow those 21 and older to possess 21/2 ounces of marijuana and six plants.

It also would license cultivators, producers of products containing marijuana, retailers and laboratories, giving preference for licensing to officials at existing dispensaries.

David Boyer, Maine political director for the Marijuana Policy Project, a nationwide group backing Russell’s bill, said the provision to give preference to existing dispensaries was partially due to a drafting error in the bill, and he and Russell are open to amending it.  Boyer has been lobbying legislators to support the bill.

Peterson said his group is lobbying for dispensaries to be granted automatic cultivation, retail and production licenses.  He said it wouldn’t oppose the bill then.

McCarrier said it isn’t clear whether caregivers are on the same plane as dispensaries in the bill.

Russell’s bill would assess a $50-per-ounce tax on cultivators, 75 percent of which Russell has said she wants to divert to the state’s General Fund.  Under her plan, the rest would go toward substance abuse programs, marijuana research and implementing the act.

Only two states, Colorado and Washington, have legalized marijuana, and they did so in 2012 referendum votes.  Marijuana possession is illegal under federal law, so even states with medical-marijuana programs are running afoul of that law.

In those states and others, legalization efforts ran into patches of opposition from medical-marijuana groups as well.

St.  Pierre suggested that’s because of economic protectionism: Simply put, when marijuana becomes legal, consumption will go up and prices will fall sharply.

McCarrier said it’s not about protecting money, but protecting “the ability for caregivers to continue to operate.”

Peterson said he sells marijuana for $360 per ounce; McCarrier said caregivers sell for between $175 and $250 per ounce.  Street prices could be higher or lower.

A paper by a group of marijuana researchers published this month in the Oregon Law Review says the American marijuana market is a $30 billion industry annually.  But modern farming techniques could supply that demand for “hundreds of millions of dollars.”

So, the paper says, most of those billions could be captured by businesses or states, but “only if competitive pressure does not drive prices down.”

Peterson said he has hundreds of thousands of dollars invested in his operation, and he’s not sure what would happen to it under legalization.

“I have no investors.  I don’t take a salary,” he said.  “But that’s what you have to do to have a program in this state.”

Medical marijuana wouldn’t be taxed at $50 an ounce, according to Russell’s proposal, and Boyer said he doesn’t want to affect the medical system “in any bad way.”

Still, “it’s kind of an evil trade-off,” Peterson said of the tax on recreational marijuana.  “You can have it legally, but it’s going to cost you.” Russell has said the price drop after legalization would more than make up for the tax.

On taxes, a fine line would have to be walked to turn the average consumer to the new, recreational market.  If the marijuana tax is too high, people will likely seek the black market or a doctor’s recommendation for patient status, say many working on tax proposals in other states.

Colorado and Washington are establishing regulations for their legal programs.  They are seeking to establish a tax system that strikes those balances.

According to The New York Times, Colorado is considering excise and sales taxes of up to 30 percent combined on recreational marijuana.  In Washington state, the Times said three levels of taxes will be levied on producers, processors and retailers.  Consumers will pay a 44 percent effective rate.

The $50-per-ounce rate has been discussed in other places.  California considered a bill that would use that rate in 2009, and lawmakers effectively killed it in 2010.

Beau Kilmer, a drug policy researcher for the RAND Corp., a nonprofit think tank, said there are a number of ways that regulators could tax marijuana, including per ounce and by the plant’s chemical makeup.

However, it’s too early to tell what would work best, so Kilmer suggests flexibility in the tax system.

“If large barriers are created to changing the taxes, it’s going to make it a heck of a lot harder to update them based on new research,” he said.

That lack of clarity makes Boyer, of the Marijuana Policy Project, wonder why some are opposing Russell’s bill so soon, before a legislative committee gets to amend it.

“I’m a little disappointed that some people are jumping the gun on this bill before it’s a final bill,” Boyer said.  “I think everyone would benefit from ending marijuana prohibition.”

McCarrier said that philosophically, he could support legalization, but “the devil’s in the details.”

Peterson also said he could support the right plan, but “I would not want to do anything that disrupted the medical side of things.  It really puts a death knell to the program.”

For St.  Pierre, the NORML director, the schism is particularly divisive for the overarching cause of his group for years — totally legal marijuana.

“For me, it is a necessary but fascinating footnote in history that some of the most active opposition is oddly coming from those who are fellow travelers of the road, shall we say — those who enjoy and use marijuana, be it for medical reasons or recreational,” he said.

Source: Morning Sentinel (Waterville, ME)
Copyright: 2013 MaineToday Media, Inc.
Website: http://www.onlinesentinel.com/
Author: Michael Shepherd

18 Apr 2013

Why It’s So Hard For Scientists To Study Medical Marijuana

posted in: Cannabis News | 0

Eighteen states (plus the District of Columbia) allow cannabis use for certain medical conditions. Despite that, scientists have a harder time doing research on the potential medical benefits of marijuana than they do on “harder” drugs like ecstasy or magic mushrooms. The public may think of pot use as no big deal, but federal laws make it difficult for researchers to obtain legal supplies. Clinical researchers can get permission from the DEA to grow or create restricted compounds like LSD, MDMA or psilocybin in the lab; not so with cannabis.

The Controlled Substances Act of 1970 placed marijuana in the most restrictive use category, Schedule I, deeming it a drug with no medicinal value and high potential for abuse. To do clinical research with marijuana, you need a DEA license, and you need to get your study approved by the FDA. When it comes to actually obtaining research-grade marijuana, though, you have to go through the National Institute on Drug Abuse, a process that has proved problematic for some researchers determined to study the potential medical benefits of pot.

“Marijuana is a linchpin in the War on Drugs,” explains Brad Burge, the director of communications for the Multidisciplinary Association of Psychedelic Research (MAPS), an organization currently embroiled in a lawsuit with the DEA over the right to establish a medical marijuana farm. “There’s a lot of investment in marijuana remaining illegal.”

Anecdotal evidence suggests that marijuana can reduce chronic pain, reduce muscle spasms in patients with multiple sclerosis and perhaps even help treat symptoms of PTSD. The small amount of clinical research out there also supports the idea that marijuana could be an effective treatment for pain. A 2007 study found that smoking cannabis reduced chronic pain in HIV-positive patients by 34 percent. Results from a Canadian study in 2010 further supported the theory that it can reduce the intensity of neuropathic pain–pain caused by damage to the nervous system–and help patients sleep.

Both the American Medical Association and the American College of Physicians have called for more research into the therapeutic uses of marijuana and for the U.S. government to reconsider its classification as a Schedule I substance.

The University of Mississippi grows and harvests cannabis for studies funded by the National Institute on Drug Abuse, yet because NIDA’s congressionally mandated mission is to research the harmful effects of controlled substances and stop drug abuse, the institute isn’t interested in helping establish marijuana as a medicine.

“If you’re going to run a trial to show this is going to have positive effects, they’re essentially not going to allow it,” Lyle Craker, a professor and horticulturist at the University of Massachusetts Amherst, says.

The federal government’s position on marijuana, according to a January 2011 document featured prominently on the DEA’s homepage, is that
The clear weight of the currently available evidence supports [Schedule I] classification, including evidence that smoked marijuana has a high potential for abuse, has no accepted medicinal value in treatment in the United States, and evidence that there is a general lack of accepted safety for its use even under medical supervision… Specifically, smoked marijuana has not withstood the rigors of science–it is not medicine, and it is not safe.

Burge tells a different story. “The United States government has gone to great lengths to prevent [medical] research on whole-plant marijuana,” he says, though research into isolated components of the plant has gone on.

“We have an FDA-approved protocol, but the only way to actually get marijuana for the study, the only federally approved source, is at University of Mississippi,” he says. “NIDA refused to sell us the marijuana for this study.”

According to NIDA, the agency can provide research-grade marijuana to projects that have received funding from the National Institutes of Health (NIH), or to a non NIH-funded project that has an approved Investigational New Drug application on file with the FDA; has proper DEA registration; and has been approved as scientifically valid by a Health and Human Services scientific review panel.

The agency describes its position on cannabis research as such:
NIDA as well as other Institutes and Centers within the National Institutes of Health (NIH) have supported and will continue to support research on both the adverse effects and therapeutic uses for marijuana provided the research applications meet accepted standards of scientific design and, on the basis of peer review, public health significance, and Institute priorities.

Because MAPS only needs supplies, not funding, the organization, with the help of Lyle Craker, has been trying to establish a private medical marijuana farm to supply cannabis for research for the past 12 years. The organization is currently suing the DEA for denying its license even after a DEA judge ruled in 2009 that such a license would serve the public interest.

Meanwhile, MAPS has applied to buy pot from the NIDA for a study on PTSD. In 2011, the scientific review panel from the Department of Health and Human Services rejected the application, citing concerns with the study’s design, though the protocol had already been approved by the FDA and has since been approved by the University of Arizona’s institutional review boards. MAPS has added a few safety procedures and plans on resubmitting the protocol to the HHS scientific review panel, but MAPS founder Rick Dobiln says he is “not hopeful since the core elements of the protocol design remain the same.”

Not everyone has had solely negative experiences with the bodies that control the flow of research-grade marijuana. The process just requires some bureaucratic legerdemain.

In 1992, Doblin approached Donald Abrams, a professor of medicine at the University of California, San Francisco and the chief of Hematology/Oncology at San Francisco General Hospital, and suggested he look into doing a clinical trial on the benefits of cannabis for HIV patients.

“Having gone to college in the ’60s myself, I thought it might be worth investigating,” Abrams says. “Little did I know how difficult that would be.” First, he attempted to study the role cannabis could play in treating patients suffering from HIV Wasting Syndrome, a condition that caused patients to lose weight and basically wither away and die without even getting an infection. But NIDA failed to approve his request for funding.

Continue reading article @ http://www.popsci.com/science/article/2013-04/why-its-so-hard-scientists-study-pot?page=1
Author: Shaunacy Ferro
Source: Popular Science

15 Apr 2013

MJ Research Funding Cut as Support for Drug Grows

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As more states embrace legalized marijuana, the drug’s growing medicinal use has highlighted a disturbing fact for doctors: scant research exists to support marijuana’s health benefits.

Smoked, eaten or brewed as a tea, marijuana has been used as a medication for centuries, including in the U.S., where Eli Lilly & Co. (LLY) sold it until 1915. The drug was declared illegal in 1937, though its long history has provided ample anecdotal evidence of the plant’s potential medicinal use. Still, modern scientific studies are lacking.

What’s more, the federal government is scaling back its research funding. U.S. spending has dropped 31 percent since 2007 when it peaked at $131 million, according to a National Institutes of Health research database. Last year, 235 projects received $91 million of public funds, according to NIH data.

That’s left the medical community in a bind: current literature on the effects of medical cannabis is contradictory at best, providing little guidance for prescribing doctors.

“What’s happening in the states is not related to science at all,” said Beau Kilmer, co-director of RAND Corp.’s drug policy research center. Kilmer is also part of a group selected to advise the state of Washington on its legalization effort. “It’s difficult to get good information,” he said.

Two states, Washington and Colorado, have fully legalized the drug, 18 states allow its use for medical reasons and 17, including New York, have legislation pending to legalize it.

1999 Report

Donald Vereen, a former adviser to the last three directors of the National Institute on Drug Abuse, says that most doctors’ and policy makers’ knowledge on the subject stems from a 1999 report from the Institute of Medicine, an independent nonprofit that serves to provide information about health science for the government. The group summed up its findings saying cannabis appeared to have benefits, though the drug’s role was unclear.

The IOM report recommended clinical trials of cannabinoid drugs for anxiety reduction, appetite stimulation, nausea reduction and pain relief. It also found that the brain develops tolerance to marijuana though the withdrawal symptoms are “mild compared to opiates and benzodiazapines.”

“We don’t know that much more than what’s in that report,” said Vereen.

Vereen, for one, says marijuana’s effects on pain without the withdrawal symptoms associated with other medications are deserving of further study to develop better pain drugs.

Medical Benefits

Subsequent research suggests marijuana may help stimulate appetite in chemotherapy and AIDS patients, help improve muscle spasms in multiple sclerosis patients, mitigate nerve pain in those with HIV-related nerve damage and reduce depression and anxiety. It’s even been suggested that an active ingredient, THC, may prevent plaques in the brain associated with Alzheimer’s, according to a 2006 study by the Scripps Research Institute.

Still, fewer than 20 randomized controlled trials, the gold standard for clinical research, involving only about 300 patients have been conducted on smoked marijuana over the last 35 years, according to the American Medical Association, the U.S.’s largest doctor group.

A few small companies are trying to tap into an emerging market for marijuana therapies, which could exceed $1 billion in California alone, according to Mickey Martin, director of T-Comp Consulting in Oakland, California, which advises people who want to set up their own cannabis businesses.

$40 Weekly

His model of about 750,000 cannabis patients found that the estimated spending from California’s patient population is $1.1 billion, including $56 million in doctors’ fees and about $1 billion in medicine. That assumes roughly two-thirds of the patient population will pay $40 a week for medication, Martin said. Cannabis Science Inc., CannaVest Corp., and Medical Marijuana Inc. (MJNA) are among a handful of companies developing drugs based on cannabis research or medical marijuana itself.

Until more laws change, it will be difficult to study an illegal substance with the goal of turning it into a medication, researchers say. And since it’s illegal to grow, marijuana isn’t subjected to the rigorous quality control most medicines are, raising concerns patients may be at risk from contaminants, said Vereen.

Marijuana advocates point out inherent obstacles to conducting research: the National Institute on Drug Abuse controls all the cannabis used in approved trials, but the agency’s mandate is to study abuse of drugs, not health benefits.

FDA Dilemma

This creates dilemmas. The Food and Drug Administration, for instance, has approved a clinical trial studying whether marijuana can relieve symptoms of post-traumatic stress disorder. The trial, however, which is in the second of three stages of clinical testing, is blocked. NIDA, which controls the legal testing supply of the drug grown at a University of Mississippi farm, has refused to supply the researchers with marijuana.

“NIDA is under a mandate from Congress to find problems with marijuana,” said Bob Melamede, CEO of Cannabis Science Inc. (CBIS), a Colorado Springs, Colorado-based company that develops medicines derived from marijuana. “If you want to run a study to show it cures cancer, they will not provide you with marijuana,” he said. “What you cannot do are the clinical studies that are necessary.”

Attempts to expand licensed facilities beyond the University of Mississippi farm, have been denied, including a petition from University of Massachusetts agronomist Lyle Craker. The Drug Enforcement Administration denied that request in 2011, reversing a 2007 recommendation from its own administrative law judge, Mary Ellen Bittner.

NIDA Projects

NIDA also administered the most projects from 2003 to 2012, overseeing $713 million split among 1,837 research efforts. The bulk of the funding in the past decade was devoted to evaluating marijuana’s risks, potential negative impacts on the brain and developing prevention and treatment strategies, according to NIDA.

“There’s been a significant amount of study, but not clinical research,” said Brad Burge, a spokesman for the Multidisciplinary Association for Psychedelic Studies, a non- profit research and advocacy group. What’s lacking, says Burge, is “research intended to move marijuana, the plant, through the path to prescription approval by the FDA.”

Contradictory Findings

For now, the research that does exist is often contradictory. A survey of 4,400 people found that those who consumed marijuana daily or at least once a week reported less depressed mood than non-users, according to a 2005 report in the journal Addictive Behaviors. A 2010, however, study in the American Journal of Drug and Alcohol Abuse of 14,000 found that anxiety and mood disorders were more common in those who smoked almost every day or daily.

Still, people continue to swear by medical marijuana. Cathy Jordan, 63, was diagnosed with amyotrophic lateral sclerosis at 36 and given 3 to 5 years to live. She smoked marijuana, a strain called Myakka Gold, on a Florida beach with friends, and from that day “the disease just stopped,” said her husband Bob, 65.

“All cannabis seems to work, and it’s slowed the progression,” he said in a telephone interview. They think marijuana may interfere with a neurotransmitter, glutamate, that can have harmful effects in the disease “but we’re just guessing here. All we know is when she doesn’t have it, she gets sick and when she does have it, she doesn’t get sick.”

On Feb. 25, they were raided for growing 23 plants for Cathy’s use. Bob was charged, though the prosecutors declined to press charges because of the medical records the couple supplied, he said. Currently, Cathy is the president of FL CAN, an advocacy group meant to generate support for changing marijuana policies.

Doctor Attitudes

Doctors’ attitudes are also shifting in favor of easing marijuana restrictions. The American Medical Association, the nation’s biggest doctor organization has called for a review of marijuana’s Schedule I status, a designation that declares it has no accepted medical use.

The American College of Physicians, the second-largest U.S. doctor organization with 133,000 members, also wants criminal penalties waived for doctors who prescribe marijuana and patients who smoke it. The drug could be useful to treat multiple sclerosis, nausea and pain, based on preliminary studies and pre-clinical lab work, the group said in a 2008 position paper calling for more research.

For the first time, a majority of Americans say they support legalization, according to a survey released April 4 by the Pew Research Center.

Restrictions Easing

As those views trickle up to law makers, there’s little doubt that the easing of marijuana restrictions on the state level will continue.

“We are in the middle of the river,” said Roger Roffman, a professor emeritus at the University of Washington’s school of social work who has studied marijuana use more than 20 years. “Change is happening so rapidly with both medical marijuana and non-medical marijuana, that it is too early to know what’s likely happening in terms of the effect.”

Source: Bloomberg.com (USA)
Author: Elizabeth Lopatto
Published: April 15, 2013
Copyright: 2013 Bloomberg L.P.
Contact: [email protected]
Website: http://www.bloomberg.com/

30 Mar 2013

Cannabinoids And Cancer

posted in: Cannabis News | 0

The Stone-Cold Truth

I got a good bit of reaction to my last piece on cannabis and cancer, so I want follow up on it before moving on to other subjects.  Obviously, many folks out there are suffering and seeking relief, but I don’t want to peddle false hope; there is already too much of that going on.  However, if you already have a death sentence hanging over your head then you pretty much have nothing to lose.

One of the major medicinal advantages of cannabis, the clinical name for marijuana, is the absence of significant and unintended side effects ( no major harms ) associated with its medicinal use 3/4which is a lot more than can be said for many pharmaceutical drugs that come with a laundry list of side effects, which sometimes include death.

That said, the website of the National Cancer institute has recently added a page titled “Cannabis and Cannabinoids” [cancer.gov/cancertopics/pdq/cam/cannabis/patient/page2].  The information on that page cites preclinical studies that indicate the following “antitumor activity” of cannabinoids ( the active substances in the marijuana plant ):

Studies in mice and rats have shown that cannabinoids may inhibit tumor growth by causing cell death, blocking cell growth, and blocking the development of blood vessels needed by tumors to grow.  Laboratory and animal studies have shown that cannabinoids may be able to kill cancer cells while protecting normal cells.

A study in mice showed that cannabinoids may protect against inflammation of the colon and may have potential in reducing the risk of colon cancer, and possibly in its treatment.

A laboratory study of delta-9-THC in hepatocellular carcinoma ( liver cancer ) cells showed that it damaged or killed the cancer cells.

A laboratory study of cannabidiol in estrogen receptor positive and estrogen receptor negative breast cancer cells showed that it caused cancer cell death while having little effect on normal breast cells.

It’s not about just a toke or two:It’s no wonder that people who have been told they are terminal are willing to try cannabis in an attempt to save themselves.  However, it is important to note that neither smoking, vaporizing nor eating cannabis-infused brownies alone can deliver an effective dose of cannabinoids to have the kind of effect patients are looking for from the plant.

That’s where something like Rick Simpson’s Hemp Oil comes in.  It’s a highly concentrated cannabinoid extract that Simpson and others claim has wondrous results, including its ability to cure many different cancers.

I can’t independently verify that claim, but when used along with conventional cancer therapy it seems to help.  After my last Higher Ground column about cannabis and cancer, a 66-year-old San Francisco woman named Michelle Aldrich contacted me.  Aldrich, and her husband Michael, have been longtime marijuana activists and received the High Times magazine lifetime achievement award in June 2011, so she’s obviously predisposed to have a favorable outlook about the herb, but her story is very compelling.

Aldrich was diagnosed with cancer in late 2011.  Further testing revealed lung cancer, three cancerous lymph nodes, a spot on her kidney and inflammation in her colon ( three polyps ) 3/4Stage 3A poorly differentiated non-small cell metastatic ad-enocarcinoma of the right lung with bulky lymph node involvement 3/4in January 2012.

Her main tumor was 30 by 31 millimeters.  The five-year survival rate for this type of cancer is about 25 percent.  Her doctors recommended that she undergo chemotherapy.  They would have added radiation except her lymph nodes were too close to her trachea for that.  The goal was to shrink the lymph nodes enough so doctors could operate and remove two lobes of her right lung.  Aldrich agreed to the course of treatment but was up front with her medical team that she was going to take what she called Milagro Oil, a variation of the Simpson extract, along with their recommended course of action.  In fact, she put together a complete holistic approach to dealing with her cancer.

“I needed to set a new course.  A course correction,” she said in a talk she gave at the sixth annual Women’s Visionary Congress in July 2012.  The talk was adapted and published in the spring 2013 edition of O’Shaughnessy’s, a journal focused on medical cannabis.”I needed to change my destiny.  I did not want to die of lung cancer.  I would do everything possible to restore my health: diet, chemo, acupuncture, and cannabis oil.  I knew I had a wonderful support group and a dream team of doctors.”

The oil she took contained 63 percent THC – she says it didn’t get her high – and she also used a CBD tincture.  Aldrich’s diet was strict: no dairy, sugar, wheat, alcohol or meat, except chicken once a month.  She said she ate a lot of fish, especially salmon.

Aldrich started chemo in early February and had the last of four courses on April 5, 2012, although she continued taking oil until mid-May.  An April 17, 2012 CT scan showed the tumor had shrunk by 50 percent.  On May 10, 2012, a PET scan showed no discernible cancer and her lymph nodes had completely shrunk.  She had surgery to remove the lymph nodes and the remains of the tumor which was “a thin rim surrounding a necrotic core.” In other words, it was dead.  Aldrich still suffered some of the bad effects of chemo such as nausea and loss of appetite, but in the end her primary doctor was amazed at the result.

“He had never seen lung cancer totally eradicated by chemo, much less in four months,” said Aldrich.  “I assume cannabis oil was the factor that made the difference.”

Cancer is not considered “cured” until it has been absent from a patient for five years, and doctors are loath to say that anyone’s cancer is cured, but testimonials such as Aldrich’s are becoming much more common.

Spread the word:Alternet, an alternative news service, picked up her story and distributed it last week; and testimonials of people’s claims of having cured several types of cancer or other ailments with some variation of Simpson oil can be easily found on the Internet.

Variations abound, with some folks adding other healing herbs that they trust to the mix, but the main ingredient is cannabis, preferably an indica strain.  They’re claiming healing or relief for Multiple Sclerosis, rheumatism, arthritis, psoriasis, eczema, diabetes, seizures, migraines and more.

“Anybody who looks at the sheer amount of these materials cannot deny that cannabis extract deserves mainstream medical attention immediately,” says Justin Kander, a board member of Phoenix Tears ( phoenixtears.ca ), the Rick Simpson organization that promotes cannabis oil.

“People don’t have time to wait for all the proper scientific channels.  We’ve been waiting years, and millions of people have died.  With pain, people don’t have a day to wait,” Kander explains.  “They don’t have 10 seconds to wait.  It’s irresponsible to hold it back.  The extract seems to work for virtually any condition.  That makes it less believable.  In theory, the reason that it works for so many things is the endocannabinoid system ( cannabinoid receptors in the human body ) maintains balance in the other systems.  All disease is some form of imbalance.  We need to investigate this further through science.”

In the meantime, a lot of people have decided not to wait.  They don’t have time.

We’ve been peddled various snake oils in the past.  So I would advise caution when treating yourself or a loved one, and it’s advisable to use cannabis oil in tandem with conventional therapies.  The bottom line is it may work, it may not work, but it won’t harm you.  And as they say on the playground – no harm, no foul.

Hash Bash: The 46th Annual Hash Bash will take place noon-1:30 p.m.  on Saturday, April 6.  Mason Tvert, who let the successful Colorado legalization drive, will headline the program along with NORML founder Keith Stroup, growing expert Ed Rosenthal and cannabis seed developer DJ Short.

Source: Metro Times (Detroit, MI)
Copyright: 2013 C.E.G.W./Times-Shamrock
Contact: [email protected]
Website: http://www.metrotimes.com
Author: Larry Gabriel