Searching for Truth Behind the Smoke of Medical Marijuana
Researchers are looking to settle the debate over medical marijuana and prove "once and for all" whether the drug "really is good medicine," AP/CNN.com reports. While advocates tout marijuana as a "powerful and needed medicine" that eases pain, settles the stomach, improves weight and steadies spastic muscles, their support rests heavily on testimony of patients who claim that the drug "makes them feel better" -- not the "kind of dispassionate experimentation that drives medical thinking." Dr. Billy Martin, chief of pharmacology at the Medical College of Virginia, admitted, "We lack evidence that there is something unique about marijuana, other than an impressive number of anecdotal reports." For supporters of medical marijuana, the drug remains "tragically withheld" because of a "misplaced phobia" about addiction, while the medical establishment argues that backers need to offer experimental proof beyond the anecdotal "buzz" surrounding the drug. Dr. Lester Grinspoon, chair of the NORML Foundation, a group supporting the legalization of marijuana, conceded, "We're going to have to go through this business of doing these studies," but added, "they won't prove anything that clinicians who have paid attention to this don't already know." In 1996, California passed Proposition 215, an initiative allowing the use of medical marijuana, and since then Alaska, Arizona, Hawaii, Maine, Oregon and Washington adopted similar measures. Colorado and Nevada also passed ballot initiatives this year to permit the medical use of the drug.
For the first time in at least two decades, researchers plan to conduct studies on the medicinal merits of marijuana to determine if the "benefits match its mystique." The University of California-San Diego's recently established Center for Medicinal Cannabis Research will dole out $9 million over the next three years to California researchers for about six or seven marijuana studies a year, involving between 20 and 50 patients. In addition, the NIH will sponsor three studies, and California's San Mateo County will fund an additional investigation into the medical effects of marijuana. According to AP/CNN.com, the new research will target four main areas, which include:
- Relieving severe nausea and vomiting caused by cancer chemotherapy: Although marijuana "almost certainly" helps to ease nausea, the drug's effectiveness compared to other antinausea drugs remains untested;
- Stopping weight loss: Marijuana "clearly" improves appetite, but the drug has not undergone "adequate" testing in those unintentionally losing weight, such as AIDS or cancer patients;
- Treating muscle spasticity conditions, including multiple sclerosis: While patients tout the drug's effectiveness, and some animal research supports their arguments, marijuana may not prove more potent than standard medicines;
- Easing pain: Researchers hope to test the effects of marijuana on AIDS patients with peripheral neuropathy -- numbness and pain in the feet that afflicts 20% to 30% of those with the disease.
Some studies, however, will compare marijuana to THC, the most active ingredient in the drug, which has appeared on the market since the 1980s as a synthetic pill called Marinol. While THC and smoked marijuana should produce similar results, some argue that other "essential" chemicals in marijuana have important effects, and many patients prefer smoking the drug, which allows them to control the dosage "puff by puff." In one such study, Margaret Haney of Columbia University will compare marijuana with Marinol in AIDS patients experiencing unwanted weight loss. Participants will receive either marijuana, "dummy joints," Marinol or a placebo to determine "who eats the most."
However, even if researchers can prove that marijuana has "uniquely useful" medicinal properties, many critics doubt that packs of marijuana cigarettes will ever line the shelves of pharmacies, pointing to the "daunting" process of marketing marijuana as an official prescription medicine. Since companies cannot patent the drug, pharmaceutical firms will not pay "hundreds of millions" of dollars for the "encyclopedic testing" required to receive approval from federal regulators. In addition, nonsmokers often have difficulty inhaling "harsh" marijuana smoke. "It's not going to be easy to sell marijuana cigarettes as a medicine, even if it could be shown there are particular benefits," Dr. Igor Grant, head of UCSD's Center for Medicinal Cannabis Research, said, adding, "It seems that if these things are indeed useful, we would have to find a way to deliver them in a manner that is prescribable." According to some experts, marijuana's "real future" lies in the drug's ingredients -- THC and about 60 other cannabinoids -- which pharmaceutical firms can isolate, improve and patent. Several companies, including Illinois-based Unimed Pharmaceutics, the maker of Marinol, have sought "better ways to harness" the drug, such as a THC aerosol spray that would provide the "quick, easily controllable wallop" of marijuana smoking without the negative effects of smoking the drug. Unimed President Robert Dudley said that in tests the spray produced similar effects to marijuana cigarettes, reaching "peak" blood levels of THC within minutes. "It mirrors what you would expect to see with inhaled marijuana smoke," he said. Some pharmaceutical firms, however, would like to remove the "high" from medical marijuana. New York-based Atlantic Technology Ventures, for example, has tested a synthetic form of THC as a painkiller, "tweaking the molecule" to rid the drug of "psychogenic effects," CEO Joseph Rudnick said.
Researchers will use marijuana provided by the nation's only legal supplier, the federal government's National Institute on Drug Abuse. Each year or two, the federal government pays the University of Mississippi to plant an acre and a half of marijuana for experiments. Until recently, the experiments focused on marijuana's hazards, not the drug's benefits. Critics complain that the government provided marijuana only for government-backed research, with funding "almost impossibly difficult" to obtain. However, NIDA's Dr. Steven Gust argues that in the past marijuana research had a "lack of interest." He said, "The fact of the matter is, there were very, very few applications to conduct research on medical applications of marijuana." This year, the government will supply marijuana for "scientifically rigorous" studies backed by nongovernment organizations and provide the drug for experiments sponsored by Health Canada (AP/CNN.com, 11/20).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.