One curious byproduct of our
increasingly technological culture is the way we keep searching
for natural solutions to otherwise-baffling problems.
It's a drive that's been a big
part of the stuff we're made of since the beginnings of time:
an innate desire to find keys in the natural world to unlock
mysteries of both body and mind.
It's the impulse that discovered
penicillin in a lab dish and which created vaccines for polio
and smallpox out of the diseases themselves. And that same restless
imagination is now being tested in the fight against AIDS.
Today, that spark is heating
up the debate over one of nature's oldest medicines: marijuana.
And it's why pot is being taken seriously again in serious medical
Most of the current interest
stems from successes AIDS patients have reported in reducing
appetite loss, but pot's value has also been noted against neuromuscular
disorders and the side effects of cancer chemotherapy.
The recent endorsement, by voters
in 12 states and the District of Columbia, of initiatives authorizing
medical use of marijuana only increased the interest.
And the opposition of the federal
bureaucracy to the measures only intensified the controversy.
That's why we've put together
Because even though the debate
over pot's legal status may be far from over, the drug seems
to have real value in treating problems that have baffled science
for centuries. And that offers real hope to people in places
where hope has been in awfully limited supply.
..Why the sudden interest in marijuana
Actually, it's anything but sudden
-- or new.
Marijuana has been a main ingredient
in natural remedies for thousands of years.
Marijuana products were used
in China and India as early as 3000 B.C. to treat a variety of
ills -- from easing the pain of childbirth to relieving asthma
and epilepsy, even improving appetite and disposition.
In fact, at one time or another,
marijuana has been used to treat just about every disease in
the books, from sciatica to insomnia.
In the United States, as many
as 30 marijuana-based medicines were distributed as recently
as 1937, when the Marijuana Tax Act closed the door on further
medical use of the drug.
But the door didn't stay shut.
And, as pot use expanded, researchers began to re-examine the
drug's possible therapeutic uses. In fact, much of their interest
was sparked by smokers themselves, who reported that the drug
helped relieve a variety of problems.
..What kinds of problems?
At first, interest focused on
common ills: headaches, menstrual cramps, and the like. Recently,
pot's been tried against more serious conditions, including glaucoma,
the "wasting syndrome" associated with AIDS, and such
"movement disorders" as multiple sclerosis and Tourette's
It's in these areas that marijuana
has been thought to have the greatest therapeutic potential.
Its potential was deemed great
enough and public support strong enough that, by 1997, then-national
drug czar Barry McCaffrey commissioned the National Academy of
Sciences to conduct a comprehensive two-year study of pot's value
as a therapeutic drug.
The Academy's report, Marijuana
and Medicine: Assessing the Science Base, probably disappointed
both sides in the debate, by concluding that marijuana and its
active ingredients (known as cannabinoids) show promise
against a range of conditions, but not always to the extent that
some advocates hoped.
According to the panel, marijuana
is most effective in treating pain and wasting syndrome, and
in relieving the nausea and vomiting caused by cancer therapies:
"For patients such as those
with AIDS or who are undergoing chemotherapy, and who suffer
simultaneously from severe pain, nausea, and appetite loss, cannabinoid
drugs might offer broad-spectrum relief not found in any other
The panel agreed that pot seemed
less effective against movement disorders, epilepsy, and glaucoma.
..How does marijuana produce therapeutic
That's hard to say. Marijuana
is a complex drug made up of at least 400 compounds -- 60 of
which occur nowhere else in nature. That's why establishing which
ingredient produces which effect is still an often-uncertain
Another reason is that most of
marijuana's therapeutic effects -- including its ability to improve
appetite, and to reduce nausea, vomiting, and muscle spasms --
are mediated and modified by its interaction with the central
That means that one or more of
the cannabinoids could produce a CNS effect (say, a temporary
alteration at the binding site of a single neurotransmitter)
which in turn may produce the desired therapeutic effect.
Oddly, pot's main mood-changing
agent -- delta-9 tetrahydrocannabinol, or THC -- may be behind
many of the drug's therapeutic actions.
Recognizing THC's effectiveness
in relieving nausea brought on by cancer chemotherapy, the U.S.
Food and Drug Administration in 1985 approved a synthetic version
of the drug called dronabinol.
It's distributed under the trade
..Does that mean pot cures cancer?
Not at all. THC and other cannabinoids
don't do a thing to block or prevent tumor growth.
What THC does do is relieve the
severe nausea and vomiting caused by anti-cancer agents.
Still, it doesn't work for everybody.
In its report, the NAS panel cited a New York study of cancer
patients who had been unresponsive to other anti-nausea drugs.
While 34 percent of the group
rated marijuana as moderately or highly effective, nearly one
in four couldn't tolerate smoking it -- either due to its psychoactive
effects or their own inexperience with smoking.
Still, the panel found that inhaled
THC has real advantages over oral forms of the drug, especially
onset of action -- how quickly effects are produced.
Because of these factors, and
because absorbing a drug via inhalation holds obvious advantages
for patients who can't even keep food down, much less tablets
and capsules, the panel recommended new research into alternative
methods of "delivering" marijuana to the lungs, including
the use of vaporizers.
..Have any problems been linked to medical
Some. Perhaps the biggest worry
concerns potential effects on the body's immune system. Although
any impairment seems slight and temporary in healthy users, any
loss of immune system function could have serious consequences
for severely-ill patients.
Other potential problems center
on damage to the lungs and respiratory system caused by smoking
marijuana, particularly since pot smoke contains almost as many
tars and cancer-causing chemicals as tobacco.
One problem with both marijuana
and Marinol involves THC's psychoactive effects, which some users
find unpleasant. In studies by Roxane Labs, Marinol's manufacturer,
24 percent of subjects receiving that drug reported effects ranging
from drowsiness and dizziness to anxiety and "muddled thinking."
Some medical-pot proponents charge
that the psychoactive effects produced by Marinol are more pronounced
than those triggered by marijuana itself. They argue that the
real reason drug companies oppose pot is that they can't patent
-- and don't stand to make any money off of -- a medicine that
literally grows on trees.
Other problems involve the drug's
side effects, particularly speeded-up heart rate. Both effects
are usually harmless in healthy individuals, but could pose problems
in the elderly and the very ill.
One big question remains: Is
prescription pot on the horizon? And the only answer, for the
moment, at least, is yes and no.
It is, if proponents have anything
to say about it, and expand their victories in recent electoral
initiatives to other states. It isn't, if Washington drug warriors
Only the future -- and the courts
-- will tell how that conflict will play out.
Since marijuana contains so many
different components, most research to date has been
aimed at developing modified cannabinoids -- drugs that produce
therapeutic benefits without altering the brain or other systems.
Medical marijuana advocates remain
skeptical, and continue to argue that therapeutic effects may
result from the interaction of cannabinoids in marijuana itself,
an interaction that may never be replicated synthetically.
Future therapies could well evolve
along parallel paths. The "official" path will likely
rely on synthetic compounds, while the "unofficial"
path will continue as it has for centuries, with ordinary people
treating themselves for everything from migraines to wasting
We'll have to wait and see if
cannabinoids fit into the medical wonderworld we're told awaits
us in the future, but it's probably safe to say that, for some
people at least, marijuana will still be around as a medicine,
It seems that it always has been.
It may always be.
..Sidebar | Politics
If you (or someone you care about)
might benefit from med ical marijuana, can you get it, legally?
Because even though laws to permit
medical use have been enacted in at least 12 states, and 35 state
legislatures have passed resolutions endorsing compassionate
use, marijuana is still a Schedule I controlled substance under
That means it's officially recognized
as having no "accepted medical use." And despite the
support of professional groups and publications (including The
New England Journal o f Medicine), that's not likely to change
any time soon.
So what can you do? One option
is to move to a state that allows compassionate use. At least
in those places, you'll have state law on your side, even if
you don't necessarily have access to medical marijuana.
If that's impractical, you can
do what millions of users have been doing for years: buy pot
on the street. And while we don't recommend that for a couple
of reasons (including the risk of arrest or side effects from
contaminants), it's the fastest way (and only) way currently
for a sick person to get a supply.
If you have the patience you
can try for a legal prescription, by filing a "Compassionate
Investigational New Drug" application with the FDA. Then
write a member of Congress or two. It's a long shot, but for
now, it's the only shot you've got.
For more information, contact
Americans for Safe Access via their web site at www.safeaccessnow.org.