Marijuana As Medicine? The Science Beyond the Controversy (2001) / Chapter Skim
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Marijuana's Medical Future
Marijuana's Medical Future
Pages 173-186
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From page 173... ...
Appropriately, the first of these recommendations supports the continuation of basic studies to learn more about how the active ingredients in marijuana affect the body. Over the past two decades research in this area has begun to demonstrate how THC and related natural and synthetic cannabinoids exert their effects on individual cells.
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From page 176... ...
But since no definitive study has shown that smoking marijuana causes cancer or chronic obstructive pulmonary disease, the IOM team called for such research in its fourth recommendation. Many studies suggest that marijuana smoke plays a role in causing respiratory disease, but no firm evidence exists to either support or refute this conclusion.
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From page 177... ...
The IOM team's final recommendation concerns short-term use of smoked marijuana by individual patients to relieve such symptoms as debilitating pain or nausea that have defied all conventional treatments. Physicians would present a scientifically and ethically based protocol for a single patient clinical trial to a regulatory board and apply for permission to prescribe marijuana to such patients on an experimental basis.
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From page 178... ...
Report Conditions recommended for treatment in clinical trials of smoked marijuana Promising targets for cannabinoid drugs Recomn on pote of marij~ cannabis Institute of Medicine2 Various, including nausea and vomiting, wasting, pain Various, including nausea and vomiting, wasting, pain House of Lords (U.K.~3 Multiple sclerosis, chronic pain Not discussed World Health Not discussed Organization4 National Institutes of Healths (U.S.) British Medical Associations American Medical Association7 Yes, esp smoking None re' Nausea and vomiting; muscle spasticity Wasting, chemotherapy-induced Nausea and vomiting, nausea and vomiting, neurological and movement disorders, glaucoma Not discussed Various, including Al DS, wasting, Not discussed chemotherapy-induced nausea and vomiting, MS, spinal cord injury, neuropathy neuropathy, possibly muscle spasticity, certain dystonias and epilepsy Muscle spasticity, neurodegenerative disorders, epilepsy Various respirator dysfunc!
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From page 179... ...
. Sing, pain Yes, especially on smoking-related harms None recommended Various, including infertility, respiratory damage, immune dysfunction, schizophrenia, and "amotivational syndrome" Whole marijuana is not a modern medicine Hazards of marijuana smoke noted Safe, reliable, rapid-onset delivery method for can nab i n oids Rapid-onset, smoke-free delivery systems (e.g., inhalation, under the tongue, and rectal suppositories)
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From page 180... ...
The British Medical Association stated that marijuana itself is "unsuitable for medical practice" but nonetheless recommended that drug regulations be modified to facilitate research on the plant material. The British House of Lords report reached a similar conclusion, adding in disagreement with the British Medical Association that British doctors should be allowed to prescribe marijuana preparations until smokeless versions become available.
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From page 181... ...
Perhaps a drug based on THC, which slows nerve impulses when it binds to one class of cannabinoid receptors, or a chemical derivative of that compound could be used to reduce pain sensations along these nerve pathways. On the strength of these findings, along with the results of experiments in animals and a few clinical studies, the IOM study team concluded that cannabinoids hold particular promise as pain relievers.
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From page 182... ...
And since highly effective antiemetic medicines already exist, there are far fewer incentives to develop cannabinoid drugs for nausea and vomiting than for other indications, such as pain. In addition to pain, nausea, and vomiting, the IOM researchers identified appetite stimulation as a promising area for further development of marijuana-based medicines (i.e., in addition to oral THC)
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From page 183... ...
to make the distinction between reducing muscle spasticity by inhibiting specific physiological processes or simply by relieving anxiety, which is known to exacerbate spastic symptoms. Even less evidence exists to indicate that cannabinoids might relieve movement disorders, the IOM report states, while noting encouraging results from relevant animal experiments.
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From page 184... ...
So far, conventional medicines have generally outperformed cannabinoid drugs in clinical trials. But not all medicines work for all people, so there may well be patients who will respond better to cannabinoids than to existing medications.
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From page 185... ...
The active compounds in marijuana may not only inspire scientists to develop a variety of useful synthetic medicines but also lead them to a greater understanding of the role of cannabinoids produced by the human body. Research has already revealed that cannabinoids influence numerous physiological processes and biochemical pathways, each of which represents a potential site of action for new highly specific drugs.
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