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Date: 2007/03/04 Sun PM 12:59:48 CST
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Subject: Marijuana as wonder drug
Marijuana as wonder drug
http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/03/01/marijuana_as_wonder_drug By
Lester Grinspoon Lester Grinspoon, an emeritus professor of psychiatry at
Harvard Medical School, is the coauthor of "Marijuana, the Forbidden Medicine."
A NEW STUDY in the journal Neurology is being hailed as unassailable proof that
marijuana is a valuable medicine. It is a sad commentary on the state of modern
medicine -- and US drug policy -- that we still need "proof" of something that
medicine has known for 5,000 years. The study, from the University of
California at San Francisco, found smoked marijuana to be effective at
relieving the extreme pain of a debilitating condition known as peripheral
neuropathy. It was a study of HIV patients, but a similar type of pain caused
by damage to nerves afflicts people with many other illnesses including
diabetes and multiple sclerosis. Neuropathic pain is notoriously resistant to
treatment with conventional pain drugs. Even powerful and addictive narcotics
like morphine and OxyContin often provide little relief. This study leaves no
doubt that marijuana can safely ease this type of pain. As all marijuana
research in the United States must be, the new study was conducted with
government-supplied marijuana of notoriously poor quality. So it probably
underestimated the potential benefit. This is all good news, but it should not
be news at all. In the 40-odd years I have been studying the medicinal uses of
marijuana, I have learned that the recorded history of this medicine goes back
to ancient times and that in the 19th century it became a well-established
Western medicine whose versatility and safety were unquestioned. From 1840 to
1900, American and European medical journals published over 100 papers on the
therapeutic uses of marijuana, also known as cannabis. Of course, our knowledge
has advanced greatly over the years. Scientists have identified over 60 unique
constituents in marijuana, called cannabinoids, and we have learned much about
how they work. We have also learned that our own bodies produce similar
chemicals, called endocannabinoids. The mountain of accumulated anecdotal
evidence that pointed the way to the present and other clinical studies also
strongly suggests there are a number of other devastating disorders and
symptoms for which marijuana has been used for centuries; they deserve the same
kind of careful, methodologically sound research. While few such studies have
so far been completed, all have lent weight to what medicine already knew but
had largely forgotten or ignored: Marijuana is effective at relieving nausea
and vomiting, spasticity, appetite loss, certain types of pain, and other
debilitating symptoms. And it is extraordinarily safe -- safer than most
medicines prescribed every day. If marijuana were a new discovery rather than a
well-known substance carrying cultural and political baggage, it would be
hailed as a wonder drug. The pharmaceutical industry is scrambling to isolate
cannabinoids and synthesize analogs, and to package them in non-smokable forms.
In time, companies will almost certainly come up with products and delivery
systems that are more useful and less expensive than herbal marijuana. However,
the analogs they have produced so far are more expensive than herbal marijuana,
and none has shown any improvement over the plant nature gave us to take orally
or to smoke. We live in an antismoking environment. But as a method of
delivering certain medicinal compounds, smoking marijuana has some real
advantages: The effect is almost instantaneous, allowing the patient, who after
all is the best judge, to fine-tune his or her dose to get the needed relief
without intoxication. Smoked marijuana has never been demonstrated to have
serious pulmonary consequences, but in any case the technology to inhale these
cannabinoids without smoking marijuana already exists as vaporizers that allow
for smoke-free inhalation. Hopefully the UCSF study will add to the pressure on
the US government to rethink its irrational ban on the medicinal use of
marijuana -- and its destructive attacks on patients and caregivers in states
that have chosen to allow such use. Rather than admit they have been mistaken
all these years, federal officials can cite "important new data" and start
revamping outdated and destructive policies. The new Congress could go far in
establishing its bona fides as both reasonable and compassionate by immediately
moving on this issue. Such legislation would bring much-needed relief to
millions of Americans suffering from cancer, AIDS, multiple sclerosis,
arthritis, and other debilitating illnesses.
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