Marijuana has been used medically, recreationally and spiritually for about 5,000 years. Known botanically as cannabis, it has been called a “crude drug”: marijuana contains more than 400 chemicals from 18 chemical families. More than 2,000 compounds are released when it is smoked, and as with tobacco, there are dangers in smoking it.
Medical marijuana clinics operate in 20 states and the District of Columbia, and its recreational use is now legal in Colorado and Washington. A Gallup poll conducted last month found that 58 percent of Americans support the legalization of marijuana.
Yet researchers have been able to do relatively little to test its most promising ingredients for biological activity, safety and side effects. The main reason is marijuana’s classification by Congress in 1970 as an illegal Schedule I drug, defined as having a potential for abuse and addiction and no medical value.
American scientists seeking clarification of marijuana’s medical usefulness have long been stymied by this draconian classification, usually reserved for street drugs like heroin with a high potential for abuse.
Dr. J. Michael Bostwick, a psychiatrist at the Mayo Clinic in Rochester, Minn., said the classification was primarily political and ignored more than 40 years of scientific research, which has shown that cellular receptors for marijuana’s active ingredients are present throughout the body. Natural substances called cannabinoids bind to them to influence a wide range of body processes.
In a lengthy report entitled “Blurred Boundaries: The Therapeutics and Politics of Medical Marijuana,” published last year in Mayo Clinic Proceedings, Dr. Bostwick noted that the so-called endocannabinoid system has an impact on the “autonomic nervous system, immune system, gastrointestinal tract, reproductive system, cardiovascular system and endocrine network.”
There is evidence that several common disorders, including epilepsy, alcoholism and post-traumatic stress disorder, involve disruptions in the endocannabinoid system, suggesting that those patients might benefit from marijuana or its ingredients.
The strongest evidence for the health benefits of medical marijuana or its derivatives involves the treatment of chronic neuropathic pain and the spasticity caused by multiple sclerosis. Medical marijuana is widely recognized as effective against nausea and appetite loss caused by chemotherapy, although better treatments are now available. But preliminary research and anecdotal reports have suggested that marijuana might be useful in treating a number of other conditions, including irritable bowel syndrome, Crohn’s disease, glaucoma, migraine, cancer growth, abnormal heart rhythms, Alzheimer’s disease, fibromyalgia, incontinence, bacterial infections, osteoporosis, intense itching, Tourette’s syndrome and sleep apnea.
“Medical experts emphasize the need to reclassify marijuana as a Schedule II drug to facilitate rigorous scientific evaluation of the potential therapeutic benefits of cannabinoids and to determine the optimal dose and delivery route for conditions in which efficacy is established,” Diane E. Hoffmann and Ellen Weber, legal experts at the University of Maryland, wrote in The New England Journal of Medicine.
Marijuana’s best-known ingredient, tetrahydrocannabinol, or THC, is responsible for the high sought by recreational users. But many people who try smoking marijuana to relieve a health problem are distressed by its psychoactive effects.
Experts believe that some people would do better with a derivative of marijuana that offers therapeutic action without the mind-altering baggage. A more precise dose, free of unwanted contaminants, would be safer, and its effects would be reproducible.
“We believe that physicians should clearly explain to their patients that medical marijuana is not approved by the Food and Drug Administration and that it is not a standardized or purified product,” Dr. Herbert D. Kleber of Columbia University and Dr. Robert L. Dupont of Georgetown Medical School wrote last year in The American Journal of Psychiatry.
One vocal proponent of a more scientific approach to medical marijuana is Martin A. Lee, the author of “Smoke Signals” and director of Project CBD, an acronym for cannabidiol, a compound in marijuana with high therapeutic potential but no psychoactive properties; indeed, it can neutralize the high caused by THC.
Mr. Lee said in an interview that medical marijuana clinics “offer a hodgepodge” of products, including many strains of the plant with varying ratios of active ingredients. While all clinics are in business to make money, he said, the more serious ones try to direct consumers to products that best suit their needs.
Still, access to purified and well-tested drugs derived from marijuana would be a far better approach. One such drug, Sativex, is currently in Phase 3 trials in the United States for the relief of neuropathic pain. It is a combination of CBD and THC in a ratio that minimizes the appetite stimulation, drowsiness and anxiety induced by THC while magnifying painkilling and anti-tumor properties, Mr. Lee said.
The endocannabinoid system has two types of receptors, CB1 and CB2, that bind to different components in marijuana. CB1 receptors are concentrated in the central nervous system; when activated, they can make people feel high. And when THC stimulates CB1 receptors governing food intake, the resulting “munchies” can help people whose appetites are depressed by AIDS or cancer.
The drugs Marinol and Cesamet are THC compounds in pill form, approved by the Food and Drug Administration to treat chemotherapy-induced nausea and vomiting and AIDS-related anorexia and wasting. Their action is slowed by having to pass through the digestive system before reaching their target.
CB2 receptors are concentrated in the peripheral nervous system and immune system. Their stimulation, primarily by CBD, can relieve pain and increase the body’s anti-inflammatory activity.
Sativex, the THC-CBD combination, is available in Canada to treat cancer pain and neuropathic pain in multiple sclerosis. It is sprayed under the tongue for quick entry into the bloodstream, as happens when marijuana is smoked. CBD has just been approved for initial testing in people to treat intractable epilepsy.
Dr. Bostwick described the medical potential of marijuana as “incredibly exciting.” But, he added, “it is not being realized, because researchers can’t get the material for study.”
Lamenting the current patchwork of state laws governing medical marijuana, he said consumers should be sure to know the law in their jurisdiction and work closely with a physician to assure they are using marijuana appropriately.
A conservative Republican Utah state lawmaker is backing an unexpected group of advocates: Mormon moms fighting for medical cannabis for their children.
State Rep. Gage Froerer (R-Huntsville) has committed to help Hope 4 Children With Epilepsy, an advocacy group fighting for safe access to cannabis oil. The oil contains little to no THC, the chemical that causes the high in marijuana, but is high in cannabidiol, a compound that may fight seizures in some forms of epilepsy. Though legal in neighboring Colorado, the oil is not legal in Utah.
Froerer said he hopes to change that with his support of the group, which was founded by four Mormon moms.
“If there’s anyone who can do it, it’s conservative Mormon moms from Utah,” joked Hope 4 Children With Epilepsy cofounder Jennifer May in a phone call with The Huffington Post. May’s son, Stockton, 11, suffers from a rare form of epilepsy known as Dravet syndrome, which causes five to 30 seizures per day.
May told The Associated Press that she used to think giving a marijuana derivative to children was crazy. But after witnessing unbelievable success stories like that ofCharlotte Figi -- a 6-year-old girl who suffers from the same syndrome as May's son -- she changed her tune.
"We’re not expecting this to be any kind of miracle cure," May said. "But the results thus far with the children have been amazing with very little side effects. It’s just something that needs to be available."
May considered moving her family to Colorado to get safe access to cannabis oil for her son. “But we decided it wouldn’t do anyone else any good if we just left and didn’t fight to get this here.
“Some people think we’re crazy for not just going over there and bringing it back,” May said. “But when you think about how often our kids are in the hospital, our choice is between telling our physicians and risking getting in trouble, or not telling our physicians and risking life-threatening drug interactions with our children.”
Instead, May joined other parents of children with disabilities to rally for cannabis oil access in Utah.
May and her cofounders are careful to distance themselves from medical marijuana.
"In Utah, a medical marijuana program is not going to go over very well," May said. "Politicians here have promised to never let medical marijuana in the state and we don't want to be seen as a toe in the door." May said she hopes the state can simply categorize cannabis oil as legal instead of legalizing medical marijuana.
"It’s not making the kids high, it’s shown to be effective, but it’s labeled as medical marijuana," May said. "We want to change that."
After convincing Froerer, that goal may soon be a reality.
In a meeting with Utah's Substance Abuse Advisory Council next month, Froerer will appeal to the council to legalize cannabis oil with a THC content of less than 0.5 percent -- less than that found in hemp oil at the grocery store. He has committed to sponsoring legislation, if necessary.
“As legislators, I think we have a duty to think about what’s best for the people of our state,” Froerer told HuffPost. “If we can provide this without causing any unintended consequences, we should do so.”
There have been no clinical trials testing cannabis oil for epilepsy, according to The Salt Lake Tribune. But there have been examples of success, including Charlotte Figi, the girl with epilepsy from a conservative Colorado military family shown on the CNN documentary "Weed." Regular doses cut her seizures from 300 a week to 1, according to the documentary.
Marijuana cuts nerve pain post chemotherapy
So this is how big pharma will enter the game.......extract part of the plant (as if its new technology) and market the extraction to the sickest patients. -UA
"Our preliminary findings...indicate that cannabidiol may prevent the development of paclitaxel-induced allodynia in mice and therefore be effective at preventing dose-limiting paclitaxel-induced peripheral neuropathy in humans," according to the report by Sara Jane Ward, Ph.D., and colleagues of Temple University School of Pharmacy, Philadelphia.
Paclitaxel-commonly used in the treatment of advanced breast or ovarian cancer-can cause nerve damage (neuropathy), leading to symptoms like pain, numbness, or tingling.
Cannabidiol is a marijuana extract that has pain and inflammation-reducing effects, while avoiding the psychoactive side effects of marijuana and other "cannabinoid" compounds.
In the new study, male and female mice were treated with paclitaxel and monitored for evidence of neuropathy.
The results showed that paclitaxel induced abnormal pain responses (allodynia) mainly in female mice-less so in males. Allodynia was more likely to develop at higher doses of paclitaxel.
When female mice were treated with cannabidiol before paclitaxel, it effectively prevented the development of allodynia. Abnormal pain responses to both cold and mechanical pressure were prevented by cannabidiol.
The preventive effect was permanent, with no evidence that nerve damage developed after cannabidiol treatment was stopped, the report said.
The study has been published in the journal Anesthesia and Analgesia