New cacophony erupts over cannabinoid
New cacophony erupts over cannabinoid
Does marijuana have a role in medical treatment?
The debate over medical marijuana flared up again with the publication of a long-awaited report from the Institute of Medicine (IOM) in Washington, DC. The report, titled Marijuana and Medicine: Assessing the Science Base, was commissioned by the White House Office of National Drug Control Policy.
The report backs claims from physicians and patients alike that for years have gone unheard — that marijuana does have a therapeutic value for several indications, including:
• pain relief;
• control of nausea and vomiting;
• appetite stimulation.
Patients with terminal illnesses or debilitating symptoms have lobbied for legalization of the drug citing effective pain relief. The report notes that for patients with severe AIDS or cancer symptoms, such as nausea, wasting, and lack of appetite, the drug has benefits that outweigh the risks.
Some states ahead of the game
Despite the controversy over the risks or benefits, several states passed legislation in 1998 allowing for the use of medical marijuana, but under regulated conditions. States that passed measures in 1998 were: Alaska, Arizona, Colorado, Nevada, Oregon, and Washington. California was the first state to pass a measure legalizing the use of medical marijuana in 1996, but federal authorities have successfully prevented the law from being implemented. (See news brief on the most recent state to legalize marijuana, p. 46.)
The recent passage of bills in several states has increased pressure on the U.S. Food and Drug Administration in Rockville, MD, to remove marijuana from the schedule one’ list of most dangerous narcotics.
The report did mention existing concerns over the use of marijuana, namely the method of administration and its potential addictive qualities. While the report notes that the practice of smoking the drug is medically dangerous and could cause respiratory disease, it states that "smoked marijuana should not generally be recommended for long-term medical use." The report later states, however, that "the long-term risks are not of great concern."
Despite opponents who argue that the drug would become addictive, the investigators found that marijuana was not particularly addictive and did not act as a gateway’ drug to the use of harder drugs, such as heroin.
President Clinton’s anti-drug czar,’ Barry McCaffrey, ordered the report in 1997. McCaffrey is an outspoken opponent of relaxing anti-marijuana laws. The Office of National Drug Control Policy called for more research, but added, "We will carefully study the recommendations and conclusions contained in this report" in a statement.
Sidestepping the politics
Researchers reinforced throughout the report — in an effort to sidestep the political issue — that the brief was to assess the effectiveness of cannabinoid’ drugs such as THC. THC is marijuana’s main active element. Researchers instead call for the development of standardized forms of the drug that could be taken using an inhaler. Development of an inhaler could take several years, researchers noted.
"Marijuana has potential as medicine, but it is undermined by the fact that patients must inhale harmful smoke," says Stanley Watson Jr. of the Mental Health Research Institute at the University of Michigan in Ann Arbor, one of the study’s investigators.
So far, the only FDA-approved synthetic cannabinoid is Marinol, manufactured by Roxane Laboratories in Columbus, OH. Proponents of the synthetic drugs argue, however, that the raw plant is more effective.
Supporters of medical marijuana claim victory from the results of the IOM report. Bill Zimmerman, director of the Los Angeles-based Americans for Medical Rights, the sponsor of the 1998 states’ marijuana initiatives, says the findings will radically alter the public image of what has long been a demon drug’ in the United States.
"They are in effect saying that most of what the government has told us about marijuana is false . . . it’s not addictive, it’s not a gateway to heroin and cocaine, it has legitimate medical use, and it’s not as dangerous as common drugs like Prozac and Viagra," says Zimmerman. "This is about as positive as you can get."
[Editor’s note: The complete volume of Marijuana and Medicine: Assessing the Science Base is available for sale from the National Academy Press, 2101 Constitution Ave., N.W., Lock Box 285, Washington, DC 20055. Telephone: (800) 624-6242 or (202) 334-3313. World Wide Web bookstore: www.nap.edu.]
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