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    Default counter intelligence against the propoganda on weed, maybe

    http://www.jackherer.com/pregnancy.html
    If these are the effects on unborn (n they cant claim nurture only nature there just pure effects of a natural substance) is cannabis really so bad plus we have built in all natural receptors for cannabis in the brain, why? Discuss, argue, have fights, make peace.

    dekay.




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    Wow, thats an interesting read. I don't remember hearing anything about it in the news, it went down very quietly didn't it... If that had been big pharma testing one of it's own potions it would be all over by now.

    Still. I would urge some restraint, but just my 2 cents.
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    Well thats pretty crazy. Shame theres barely any information there, I guess you'd have to look at the journal..
    "Life can only be understood backwards; but it must be lived forwards" ~ Soren Kierkegaard

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    Quote Originally Posted by Pleasethinkbackwards View Post
    Well thats pretty crazy. Shame theres barely any information there, I guess you'd have to look at the journal..
    The lack of information leads me to believe that Mr. Herer is full of shit on this one.

    It should be noted that there are several limitations posed by this study and caution must be used in interpreting the results. First, the means by which the study participants were recruited may have introduced a bias in the sample. Second, the sample size is small, obviating the use statistical procedures that might be able to account for the many environmental variables that seem to influence some of the outcomes. Third, in a prospective study of this nature it is impossible to foresee and control for all the potential environmental and maternal confounders. Finally, this study has not eliminated alternative explanations. It is possible for example, that the outcomes at 1 month are related to neonatal exposure to marijuana constituents via breast milk or to prenatal influences that simply were not manifested at the 3-day examination.
    DrugLibrary link

    Also, seeing as no one really understands how cannabis works in the brain of the mother or the fetus/infants, it would be extremely irresponsible to post things like this that could encourage mothers to smoke cannabis during pregnancy. Smoking during pregnancy itself has shown to have adverse effects on fetus development because of the carbon monoxide and various carcinogens that can cross the placenta into the delicate and developing fetus.

    No one really understands exactly how cannabis works: Jack's being an ass in posting something so unexplained and unaccompanied with warning.
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    jack was just reposting something From the Schools of Nursing, Education and Public Health, the University of Massachusetts, Amherst.

    It is also known exactly how cannabis works, its the old lock n key receptor site thingy. In everyones brain is cannabinoid receptor sites n receptor sites accept molecules that fit near on exact n then a chemical message is sent out n neurons fire. Cannabinoid receptors are activated by a nuerotransmitter called anandamide n THC is the same shape as it so fits into these receptors n activates neurons in areas of the brain like the hippocampus (among others) which is responsible fer short term memory (n other stuff) n thens when u get stoned, they only thing scientists are not 100 percent on is how THC effects the levels of dopamine but its thought that receptor proteins are triggered which then send messages to dopamine terminals in ur brain.

    I had to do cannabis n cocaine in psychology fer an assignment n how they worked n what they affected.

    I agree pregnant women shouldnt smoke but the point of such studies is too say too those that just condemn it 'hey why we have cannibinoid receptors, why are there positive effects too, maybe we could utilise the good n get rid o the bad', i.e. the smoke part.



    Last edited by dekay; 10-07-08 at 09:27 PM.

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    jack was just reposting something From the Schools of Nursing, Education and Public Health, the University of Massachusetts, Amherst.


    I do not think pregnant women are going to read this post then rush off and smoke weed to help advance their child.

    If this is true (Not saying it is as there is no where near enough information) it is not surprising that the information has been kept quiet. If this was advertised as a product and these results were the selling point this stuff would be flying off the shelves.

    Much more information about the study would be needed before these results would mean anything.

    Very interesting post though.

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    I like your views there dekay, i suffer from anxiety, but still smoke weed, its pretty strange, i can smoke some weed strains & i feel hammered, but fine with it, & enjoy the buzz, then i can try something else & it will give me bad anxiety.. Do you know why this is dekay? Id be well grateful if you could tell me which strains would be good for me & what aint... some i slep and eat well on, some i dont hardly feel hungry, & feel horrible, which makes me takes vallies.. defeating the object really.. Tangerine dream, made me wrecked, but had no anxiety... can anyone tell me why this is?

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    I read something in newscientist about 2 years ago, about a study which showed that the same people who scored as having high indicators for schizophrenia in childhood, were the same kids who went on to smoke weed.
    in other words, weed is not causative.
    it is just that the same free thinkers go on to be puffers too
    it might be really good to collect lots of the positive literature in one place so that people at least know some of the scientific arguments for legalizing and other reasons.
    The fact is that a lot of the anti cannabis stuff is spun, so we should be able to easily challenge it as the tripe the politicians turn it into.
    It needs us talking it to pieces to expose it's weaknesses too.

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    I read something in newscientist about 2 years ago, about a study which showed that the same people who scored as having high indicators for schizophrenia in childhood, were the same kids who went on to smoke weed.
    in other words, weed is not causative.
    it is just that the same free thinkers go on to be puffers too
    it might be really good to collect lots of the positive literature in one place so that people at least know some of the scientific arguments for legalizing and other reasons.
    The fact is that a lot of the anti cannabis stuff is spun, so we should be able to easily challenge it as the tripe the politicians turn it into.
    It needs us talking it to pieces to expose it's weaknesses too.
    couldnt agree more!! Any figures or statistics showing a baised or negative report on anything can be achieved when you know how to manipulate factual stats...examples of this are when the government shows or publishes that weed has got stronger over the last few years they arent lying as such, they just dont show how this conclusion was reached, easy example is if the police have confiscated more hash than say herbal weed the mean average of THC is going to be far higher due to hash being a concentrated form of Cannabis but they wont publish this, which causes a generalisation of weed being stronger when if more herbal Cannabis was confiscated then the figures would show a different mean thc average, its manipulation of stats.
    Another example which I dont know if anyone else has noticed is when Cannabis is reported in the media its automatically reported as "smoking Cannabis" with no mention ever of vapourisation or even better ingestation, both of which are healthier alternatives to using Cannabis.
    The health effects of smoking anything are conlusive, lets just get that right straight away, due to the temperature of the amber, burning any plant material will cause heat-dependent chemical changes to elements and gasses (even metals) present within whatever is burning, "the high" acheived through smoking Cannabis is the result of the material ahead of the amber vapourizing the terpines/amines (same as nicotine in a cigerette) as they reach the desired temperature from the close heat source, then consequently burn up as the amber takes its place, the amber itself is causing the negative chemicals to be inhaled of which the human lungs are simply not designed for and is a result of high incandesant temperature.
    The government are not lying when they say smoking Cannabis is harmful, they stratigicly choose not to apply any other healthier way of it being used because its an arguement they cannot lose.
    manipulation of facts again!

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    Supporting Research into the
    Therapeutic Role of Marijuana
    American College of Physicians
    A Position Paper
    2008



    Supporting Research into the Therapeutic Role
    of Marijuana

    A Position Paper of the
    American College of Physicians


    This paper, written by Tia Taylor, MPH, was developed for the Health and Public Policy
    Committee of the American College of Physicians: J. Fred Ralston, MD, FACP, Chair; Molly
    Cooke, MD, FACP, Vice Chair; Andrew A. Chang, MA, Charles Cutler, MD, FACP; MA, David
    A. Fleming, MD, FACP; Brian P. Freeman, MD, FACP; Robert Gluckman, MD, FACP; Mark
    Liebow, MD, FACP; Kenneth Musana, MB, ChB; Robert McLean, MD, FACP; Mark Purtle,
    MD, FACP; P. Preston Reynolds; and Kathleen Weaver, MD, FACP. It was approved by the
    Board of Regents in January 2008.



    Executive Summary
    Marijuana has been smoked for its medicinal properties for centuries. Preclinical, clinical, and
    anecdotal reports suggest numerous potential medical uses for marijuana. Although the
    indications for some conditions (e.g., HIV wasting and chemotherapy-induced nausea and
    vomiting) have been well documented, less information is available about other potential medical
    uses. Additional research is needed to clarify marijuana’s therapeutic properties and determine
    standard and optimal doses and routes of delivery. Unfortunately, research expansion has been
    hindered by a complicated federal approval process, limited availability of research-grade
    marijuana, and the debate over legalization. Marijuana’s categorization as a Schedule I controlled
    substance raises significant concerns for researchers, physicians, and patients. As such, the
    College’s policy positions on marijuana as medicine are as follows:
    Position 1: ACP supports programs and funding for rigorous scientific evaluation of the
    potential therapeutic benefits of medical marijuana and the publication of such findings.
    Position 1a: ACP supports increased research for conditions where the efficacy of
    marijuana has been established to determine optimal dosage and route of delivery.
    Position 1b: Medical marijuana research should not only focus on determining drug
    efficacy and safety but also on determining efficacy in comparison with other
    available treatments.
    Position 2: ACP encourages the use of nonsmoked forms of THC that have proven
    therapeutic value.
    Position 3: ACP supports the current process for obtaining federal research-grade
    cannabis.
    Position 4: ACP urges review of marijuana’s status as a schedule I controlled substance
    and its reclassification into a more appropriate schedule, given the scientific evidence
    regarding marijuana’s safety and efficacy in some clinical conditions.
    Position 5: ACP strongly supports exemption from federal criminal prosecution; civil
    liability; or professional sanctioning, such as loss of licensure or credentialing, for
    physicians who prescribe or dispense medical marijuana in accordance with state law.
    Similarly, ACP strongly urges protection from criminal or civil penalties for patients who
    use medical marijuana as permitted under state laws.



    Background

    The marijuana plant, cannabis, contains more than 60 chemical compounds, known as
    cannabinoids. The main psychoactive element in marijuana is delta-9-tetrahydrocannabinol
    (THC). Cannabidiol (CBD) is the second most abundant cannabinoid, but it has no psychoactive
    effects. The concentration of THC and other cannabinoids in marijuana is highly variable,
    depending on growing condition, plant genetics, and processing after harvest (1). This variability
    in composition has hindered research on and evaluation of the drug’s medical value.
    Marijuana has been smoked for its medicinal properties for centuries. It was in the U.S.
    Pharmacopoeia until 1942 when it was removed because federal legislation made the drug illegal
    (2). The Controlled Substance Act of 1970 placed marijuana in the Schedule I category along
    with other substances deemed to have no medicinal value and high potential for abuse. Still, the
    overwhelming number of anecdotal reports on the therapeutic properties of marijuana sparks
    interest from scientists, health care providers, and patients. Over the past 20 years, researchers
    have discovered cannabinoid receptors: CB1, which mediates the central nervous system (CNS),
    and CB2, which occurs outside the CNS and is believed to have anti-inflammatory and
    immunosuppressive activity (3, 4). These scientific developments have revealed much
    information supporting expansion of research into the potential therapeutic properties of
    marijuana and its cannabinoids.
    In 1997, the White House Office of National Drug Control Policy asked the Institute of Medicine
    (IOM) to review scientific evidence and assess the risks and benefits of marijuana. The IOM
    concluded that scientific developments indicate marijuana and its cannabinoids have therapeutic
    properties that could potentially treat many illnesses and conditions. The IOM recommended that
    cannabis research should focus on the development of rapid-onset, reliable, and safe delivery
    systems (5). Since the IOM report, the body of research on cannabinoids for symptom
    management has grown slightly.
    Potential Medical Uses of Marijuana
    Appetite Stimulation/Antiemetic
    The research supporting THC as an effective appetite stimulant and antiemetic is abundant. In
    1986, the U.S. Food and Drug Administration approved Marinol® (dronabinol), an oral synthetic
    form of THC, to treat severe weight loss associated with AIDS (HIV/AIDS wasting) and nausea
    and vomiting associated with chemotherapy for patients who fail to respond to other antiemetics.
    Clinical trials have demonstrated that both oral and smoked marijuana stimulate appetite,
    increase caloric intake, and result in weight gain among patients experiencing HIV wasting (6–9).
    Studies of chemotherapy patients with nausea and vomiting found THC to be equivalent or
    superior to other antiemetics (including prochlorperazine or metoclopramide) for symptom
    reduction (10). Research has also found that administration of THC along with another
    antiemetic was more effective that either drug alone, suggesting opportunities for combined
    therapy. The IOM concluded that cannabinoids are “modest” antiemetics but may be effective for those who respond poorly to other available antiemetics. THC and other cannabinoids may offer
    relief not found in other drugs (11).
    Glaucoma
    High intraocular pressure (IOP) is a known risk factor for glaucoma. Cannabinoids have been
    shown to have neuroprotective properties and to reduce IOP, pupil restriction, and conjunctival
    hyperemia (12–14). Smoked or eaten marijuana and oral THC can reduce IOP by approximately
    25% in people with normal IOP who have visual field changes, with similar results exhibited in
    healthy adults and glaucoma patients. However, the effects of cannabinoids on IOP are shortlived,
    and high doses are required to produce any effects at all. There is concern that long-term
    use of marijuana could reduce blood flow to the optic nerve because of its systemic hypotensive
    effects and its potential for interaction with other antiglaucoma drugs (15). In addition, the
    cardiovascular and psychoactive effects of smoked marijuana contraindicate its use in glaucoma
    patients, many of whom are elderly and have comorbidities. This led to the development and
    testing of a topical THC, but its effect on IOP was insignificant. As a result, the IOM and
    American Academy of Ophthalmology concluded that no scientific evidence has demonstrated
    increased benefits or diminished risks of marijuana use to treat glaucoma compared with the
    wide variety of pharmaceutical agents currently available (16, 17).
    Neurological and Movement Disorders
    Anecdotal, survey, and clinical trial data suggest that smoked marijuana and oral THC provide
    relief of spasticity, pain, and tremor in some patients with multiple sclerosis (MS), spinal cord
    injuries, or other trauma (18, 19). A recent study of patients with HIV-associated sensory
    neuropathy (HIV–SN) found that those who smoked marijuana 3 times a day reported a decrease
    of 34% in HIV–SN, compared with 17% in the placebo group. However, the psychoactive effects
    of THC impaired posture and balance among subjects (20). CBD has some anti-inflammatory
    properties and inhibits smooth muscle contractions, thus making it a potentially powerful
    anticonvulsant that does not contain the psychoactive effects of THC. CBD has been indicated as
    a treatment for several types of seizures and epilepsy, although human research is scant.
    Preclinical trials revealed that the anticonvulsant properties of cannabinoids differ widely by dose
    and between species. CBD has been shown to induce seizures in some species and to be strongly
    anticonvulsant in others (21).
    Analgesic
    Current research on the role of various forms of marijuana as an analgesic is promising. Oral
    doses of THC resulted in pain reductions similar to that from codeine among cancer patients
    (22). A randomized, double-blind trial of patients with rheumatoid arthritis found that Sativex®,
    an oromucosal THC spray, significantly reduced pain on movement and at rest and improved
    quality of sleep (23). While studies indicate that THC has analgesic properties, there is a very
    narrow therapeutic window between doses that produce useful analgesia and those that produce
    unacceptable adverse effects. A recent study found that subjects who smoked 4% THC cigarettes
    reported reduced pain sensations after 45 minutes. On the other hand, subjects who smoked 8%THC cigarettes reported an increased sensitivity to pain after 45 minutes (24). In another study,
    smoked marijuana increased sensitivity to electric shock among normal patients. The biphasic
    action of THC, stimulation followed by sedation, increases then decreases pain. These properties
    support the need for research to identify the specific kinds of pain that may be relieved by
    marijuana and the development of a synthetic cannabinoid with few actions other than analgesia.
    Adverse Effects
    Acutely, smoked marijuana increases heart rate and may decrease blood pressure on standing;
    however, some patients find the drug’s psychoactive effects more disturbing. Undesired effects
    include impairment of short-term memory, attention, motor skills, reaction times, and the
    organization and integration of complex information (25). These effects are generally more
    severe for oral THC than for smoked marijuana (26).
    The chronic effects of smoked marijuana are of much greater concern, as its gas and tar phases
    contain many of the same compounds as tobacco smoke. Chronic use of smoked marijuana is
    associated with increased risk of cancer, lung damage, bacterial pneumonia, and poor pregnancy
    outcomes. Chronic marijuana use has also been linked to the development of tolerance to some
    effects and the appearance of withdrawal symptoms (restlessness, irritability, mild agitation,
    insomnia, sleep disturbances, nausea, cramping) with the onset of abstinence. However, these
    withdrawal symptoms are mild compared with those experienced with opiates or
    benzodiazepines (27). Moreover, THC, while quite potent in comparison with other psychoactive
    drugs, has remarkably low lethal toxicity. This led the IOM to conclude that “except for harms
    associated with smoking, adverse effects of marijuana use are within the range of effects
    tolerated for other medications (28).”
    Positions
    As with any potential therapeutic drug, there are many factors that should be considered in
    evaluating its medicinal value. These include the drug’s side effects, methods of administration,
    and availability and comparability of alternatives. However, marijuana’s categorization as a
    Schedule I controlled substance creates additional concerns for researchers, physicians, and
    patients. As such, the College adopts the following positions on medical marijuana:
    Position 1: ACP supports programs and funding for rigorous scientific evaluation of the
    potential therapeutic benefits of medical marijuana and the publication of such findings.
    Preclinical and clinical research and anecdotal reports suggest numerous potential medical uses
    for marijuana. Unfortunately, the debate surrounding marijuana’s legalization for general use has
    obscured scientific findings. Current available data suggest numerous indications for
    cannabinoids, especially antiemesis, appetite stimulation, and pain relief. For patients with AIDS
    or those undergoing chemotherapy, who suffer severe pain, nausea, and appetite loss,
    cannabinoid drugs may provide symptom relief not found in any other medication. The data
    supporting cannabinoid use for the relief of muscle spasticity and movement disorders is
    promising, but further research is needed to clarify the roles of cannabinoids in treating these conditions. For epilepsy and glaucoma, the data is much less convincing, and many of the reports
    supporting marijuana use for these conditions remain anecdotal. In addition, while the
    therapeutic effects of THC are well established, less is known about the effects and potential
    indications of other cannabinoids. Additional research is needed to clarify both the therapeutic
    properties of cannabinoids and their effects on symptom management. The IOM recommended
    the following guidelines for clinical trials of marijuana for medical use:
    • Clinical trials should involve only short-term use (less than 6 months);
    • Clinical trials should be conducted in patients for whom there is a reasonable
    expectation of efficacy;
    • Clinical trials should be approved by institutional review boards; and
    • Clinical trials should collect efficacy data (29).
    Position 1a: ACP supports increased research for conditions where the efficacy of
    marijuana has been established to determine optimal dosage and route of delivery.
    To date, much of the research into the medicinal properties of marijuana has been on oral and
    smoked forms of THC. The pharmacokinetics of oral and smoked THC differ greatly and
    therefore have varying implications. The oral, synthetic THC has low and variable bioavailability
    (30). Oral THC is slow in onset of action but produces more pronounced, and often unfavorable,
    psychoactive effects that last much longer than those experienced with smoking (31). On the
    other hand, smoked THC is quickly absorbed into the blood and effects are experienced
    immediately. Studies have found that patients prefer the immediate effect on symptoms that
    occurs after smoking marijuana (32, 33). Therefore, there may be some patient populations (e.g.,
    cancer patients who experience nausea and vomiting during chemotherapy) for whom the
    inhalation route might offer advantages over the currently available capsule formulation (34).
    Also, many cancer and HIV/AIDS patients may prefer smoking over swallowing a pill.
    However, examining the effects of smoked marijuana can be difficult because the absorption and
    efficacy of THC on symptom relief is dependent on subject familiarity with smoking and
    inhaling. Experienced smokers are more competent at self-titrating to get the desired results.
    Thus, smoking behavior is not easily quantified or replicated (35). Other problems with smoked
    marijuana include difficulty in attempting to match placebo control against smoked marijuana
    (especially for those with previous marijuana experience) and the no-smoking policy of hospitals
    and public facilities. Overall, the clinical utility of smoked marijuana is limited by its short
    duration of action and accompanying side effects. Although the long-term effects of smoked
    marijuana may not be relevant for patients with terminal illnesses or debilitating symptoms, the
    residual effects of smoked marijuana are prohibitive for long-term medical use. The IOM
    concluded that clinical trials of smoked marijuana should be the first step toward the possible
    development of nonsmoked, rapid-onset cannabinoid delivery systems (36). Additional research
    is also needed to determine optimal dosage of cannabinoid drugs for symptom management.
    Current data has shown that for some indications, particularly pain relief, there is a small margin
    between clinical benefit and unacceptable adverse events.
    Position 1b: Medical marijuana research should not only focus on determining drug
    efficacy and safety but also on determining efficacy in comparison with other available
    treatments.
    Most of the conditions for which efficacy of cannabinoid drugs has been determined already have
    well-established and effective treatments. However, little is known about how cannabinoids
    perform in comparison with these other treatments. Because of the availability of an oral form of
    THC, several studies have compared the effectiveness of both smoked THC and Marinol® to
    other antiemetic drugs (mainly prochlorperazine). Although the results from these studies varied,
    they all found that THC was as effective as prochlorperazine at controlling nausea and vomiting.
    Several studies also found that the combination of THC and other antiemetics was more effective
    than either drug alone. Research suggests that cannabinoids may have synergistic effects that may
    indicate its use as an adjunctive therapy to both antiemetics for nausea and vomiting and opioids
    for pain relief. Further research is needed to compare cannabinoids’ efficacy and safety with
    current treatments and to examine their potential role in combination therapy for some
    conditions.
    Position 2: ACP encourages the use of nonsmoked forms of THC that have proven
    therapeutic value.
    The negative effects associated with long-term smoked marijuana use necessitate consideration
    of varying modes of cannabinoid delivery. Only 2 cannabinoid drugs are currently licensed for
    sale in the U.S. (dronabinol [Marinol ®] and nabilone [Cesamet ®]), and both are only available
    in oral form. While useful for some, these drugs have serious limitations. The oral route of
    administration hampers the effectiveness of THC because of slow absorption. In addition,
    swallowing a pill may not be feasible for patients with severe nausea and vomiting, for whom
    oral THC is indicated. To overcome the limitations of oral administration, researchers have
    focused on developing other nonsmoked, rapid-onset formulations.
    Sativex®, an oromucosal spray of natural cannabis, was approved in June 2006 for prescription
    use in Canada to treat neuropathic pain in patients with MS. The manufacturer, GW
    Pharmaceuticals, received FDA approval to begin a U.S. clinical trial of Sativex for cancer
    patients in 2007.
    The development of a vapor route for THC delivery offers promise for the future of medical
    marijuana research. A recent study found that THC administered through the Volcano® vaporizer
    resulted in higher plasma THC levels than smoked marijuana at both 30 and 60 minutes after
    administration. It also found that exhaled carbon monoxide increased very little after vapor
    compared with smoking (37). Those findings, along with patient preference for the vapor
    method, indicate opportunities for future clinical trials. Vaporization of THC offers the rapid
    onset of symptom relief without the negative effects from smoking. It allows patients to selfregulate
    their dosage immediately by ceasing inhalation when or if psychoactive effects become unpleasant. Scientists are also developing a pulmonary dronabinol to be delivered with a
    pressurized metered-dosed inhaler. Preliminary studies show rapid absorption, but FDA approval
    remains distant.
    Position 3: ACP supports the current process for obtaining federal research-grade medical
    marijuana.
    Some scientists and physicians believe the procedures for obtaining marijuana for research and
    publishing research findings are particularly arduous because of the debate surrounding its
    legalization for general use (38). Marijuana’s designation as a Schedule I controlled substance
    does pose a unique challenge for researchers. The federal government is the only legal producer
    of marijuana for medical research; scientists must therefore apply for both an Investigational
    New Drug Application (IND) from the FDA and a Schedule I license from the Drug Enforcement
    Administration (DEA) to receive and dispense marijuana through a designated pharmacy. The
    marijuana is provided by the National Institute on Drug Abuse (NIDA) in the National Institutes
    of Health (NIH). Through the Drug Supply Program, NIDA arranges for marijuana to be grown
    and processed through contracts with the University of Mississippi and the Research Triangle
    Institute. The University grows, harvests, and dries marijuana, and the Institute processes it into
    cigarettes. Researchers can obtain marijuana free of charge from NIDA through an NIH-approved
    grant to investigate marijuana or through a separate protocol review.
    Because of the high biovariability in cannabis plants, obtaining research-grade cannabis is critical
    to conducting well-designed clinical trials on the safety and efficacy of marijuana and its
    cannabinoids. In addition, because of the drug’s widespread general use and high potential for
    abuse, it is imperative that the federal process is followed for obtaining research-grade marijuana
    and conducting clinical trials.
    Position 4: ACP urges review of marijuana’s status as a Schedule I controlled substance
    and its reclassification into a more appropriate schedule, given the scientific evidence
    regarding marijuana’s safety and efficacy in some clinical conditions.
    Currently, marijuana is a Schedule I controlled substance, meaning it has no medicinal value and
    high potential for abuse. An evaluation by several Department of Health and Human Services
    agencies, including the FDA and NIDA, concluded that no sound scientific studies supported
    medical use of marijuana for treatment in the United States (39). This conflicts with a review by
    the IOM, which declared that “for patients such as those with AIDS or who are undergoing
    chemotherapy and who suffer simultaneously from severe pain, scientific studies support medical
    use of marijuana for treatment in the United States.” The IOM also concluded that compared
    with other licit and illicit drugs, including alcohol, tobacco, and cocaine, “dependence among
    marijuana users is relatively rare and dependence appears to be less severe than dependence on
    other drugs.” (40) A clear discord exists between the scientific community and federal legal and
    regulatory agencies over the medicinal value of marijuana, which impedes the expansion of
    research.

    The concern that marijuana is a “gateway” drug also hinders opportunities to evaluate its
    potential therapeutic benefits. However, the IOM concluded that marijuana is a gateway drug
    only in the sense that its use normally precedes, rather than follows, initiation of other illicit
    drugs. Marijuana has not been proven to be the cause or even the most serious predictor of
    serious drug abuse. It is also important to note that the data on marijuana’s role in illicit drug use
    progression only pertains to its nonmedical use (41).
    Dronabinol, oral THC, is classified as a Schedule III substance. Recently, the DEA proposed a
    rule that would allow for classification of both synthetic and natural (derived from the cannabis
    plant) dronabinol products in Schedule III. Opiates are highly addictive yet medically effective
    substances and are classified as Schedule II substances. There is no evidence to suggest that
    medical use of opiates has increased perception that their illicit use is safe or acceptable (42).
    Given marijuana’s proven efficacy at treating certain symptoms and its relatively low toxicity,
    reclassification would reduce barriers to research and increase availability of cannabinoid drugs
    to patients who have failed to respond to other treatments.
    Position 5: ACP strongly supports exemption from federal criminal prosecution; civil
    liability; or professional sanctioning, such as loss of licensure or credentialing, for
    physicians who prescribe or dispense medical marijuana in accordance with state law.
    Similarly, ACP strongly urges protection from criminal or civil penalties for patients who
    use medical marijuana as permitted under state laws.
    Reclassification of marijuana into a more appropriate schedule would remove the legal stresses
    that can affect the physician–patient relationship. Although marijuana is a Schedule I drug, 12
    states currently have legislation permitting its use for medicinal purposes. Similar legislation is
    pending in New York and support has been shown for legislation in Minnesota and New
    Hampshire. The movement among states to permit the use of marijuana for certain conditions
    was spearheaded by California's Proposition 215, which received the support of 56% of state
    voters in 1996. This led to the establishment of a $3 million state-funded Center for Medicinal
    Cannabis Research (CMCR) at the University of California’s San Diego and San Francisco
    campuses. CMCR receives the marijuana for its research from NIDA.
    Despite these state laws and initiatives, possession of marijuana is a punishable federal offense.
    In 2005, the Supreme Court ruled that state laws confer no immunity from prosecution under
    federal law, which does not include a medical exemption to the prohibition on marijuana
    possession. This creates additional concerns for researchers, physicians, and patients. Physicians
    must be selective in their wording (when discussing the substance) so as not to appear that they
    are aiding or abetting patients in obtaining cannabis. In addition to the legalities, the lack of
    availability and standards on dose and route of delivery present medical concerns. Physicians
    cannot supervise and have very little control over their patient’s behavior. Also, the quality of the
    drug is usually undeterminable.

    Conclusion
    Evidence not only supports the use of medical marijuana in certain conditions but also suggests
    numerous indications for cannabinoids. Additional research is needed to further clarify the
    therapeutic value of cannabinoids and determine optimal routes of administration. The science on
    medical marijuana should not be obscured or hindered by the debate surrounding the legalization
    of marijuana for general use.




    Notes
    1. National Institutes of Health, Ad Hoc Expert Group. Workshop on the Medical Utility of
    Marijuana Expert Report 1997. Accessed June 7, 2007 at
    www.nih.gov/news/medmarijuana/MedicalMarijuana.htm
    2. Hollister L. Marijuana (Cannabis) as Medicine. Journal of Cannabis Therapuetics 2001;
    1(1): 5-27.
    3. Grant I, Cahn BR. Cannabis and Endocannabinoid Modulators: Therapeutic Promises and
    Challenges. Clinical Neuroscience Research 2005; 5: 185-99
    4. Robson P. Therapeutic Aspects of Cannabis and Cannabinoids. British Journal of Psychiatry
    2001; 178: 107-15.
    5. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    6. Hollister L. Marijuana (Cannabis) as Medicine. Journal of Cannabis Therapuetics 2001;
    1(1): 5-27.
    7. Woolridge E, Barton S, Samuel J, Osorio J, Dougherty A, Holdcroft A. Cannabis Use in
    HIV for Pain and Other Medical Symptoms. Journal of Pain and Symptom Management
    2005; 29 (4): 358-67
    8. Abrams D, Hilton J, Leiser R, Shade S, Elbeik T, et al. Short-Term Effects of
    Cannabinoids in Patients with HIV-Infection. Annals of Internal Medicine 2003; 139: 258-
    66.
    9. Beal J, Olson R, Lefkowitz L, Laubenstein, et al. Long-Term Efficacy and Safety of
    Dronabinol for Acquired Immunodeficiency Syndrome-Associate Anorexia. Journal of Pain
    and Symptom Management 1997; 14(1): 7-14
    10. Musty R, Rossi R. Effects of Smoked Cannabis and Oral O 9- Tetrahydrocannabinol on
    Nausea and Emesis After Cancer Chemotherapy: A Review of State Clinical Trials. Journal
    of Cannabis Therapeutics 2001; 1(1): 29-42.
    11. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    12. Grant I, Cahn BR. Cannabis and Endocannabinoid Modulators: Therapeutic Promises and
    Challenges. Clinical Neuroscience Research 2005; 5: 185-99
    13. American Medical Association. Featured Report: Medical Marijuana. Chicago, IL; June
    2001 citing Merrit JC, Crawford WJ, Alexander PC, Anduze AL, Gelbart SS. Effect of
    Marijuana on Intraocular and Blood Pressure in Glaucoma. Opthamology 1980; 87:222-28.
    12
    14. Hampson AJ, Grimald M, Axelrod J, Wink D. Cannabidiol and O 9- Tetrahydrocannabinol
    Are Neuroprotective Antioxidants. Proceedings of the National Academy of Sciences USA
    1998; 95: 8268-73.
    15. American Medical Association. Featured Report: Medical Marijuana. Chicago, IL; June
    2001.
    16. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    17. American Academy of Ophthalmology. Complementary Therapy Assessment: Marijuana
    in the Treatment of Glaucoma. Accessed on June 12, 2007 at
    www.aao.org/education/guidelines/cta/loader.cfm?url=/commonspot/security/getfile.cfm&Pa
    geID=1216.
    18. Consroe P, Musty R, Rein J, Tillery W, Pertwee R. The Perceived Effects of Smoked
    Cannabis on Patients with Multiple Sclerosis. European Neurology: 38: 44-48.
    19. American Medical Association. Featured Report: Medical Marijuana. Chicago, IL; June
    2001 citing Malec J, Harvey RF, Cayner JJ. Cannabis Effect on Spasticity In Spinal Cord
    Injury. Archives of Physical Medicine and Rehabilitation 1982: 63: 116-118.
    20. Abrams DI, Jay CA, Shade SB, Vizoso H, Reda H, Press S, et al. Cannanbis in Painful
    HIV-Associated Sensory Neuropathy: A Randomized Placebo-Controlled Trial. Neurology
    2007; 68: 515-21.
    21. Robson P. Therapeutic Aspects of Cannabis and Cannabinoids. British Journal of Psychiatry
    2001; 178: 107-15.
    22. Hollister L. Marijuana (Cannabis) as Medicine. Journal of Cannabis Therapuetics 2001;
    1(1): 5-27 citing Noyes R, Brunk DR, Avery DH, Canter A. The Analgesic Properties of
    delta-9-tetrahydrocannabinol and codeine. Clinical Pharmacology and Therapeutics 1975;
    18:84-89.
    23. Blake DR, Robson P, Ho M, Jubb RW, McCabe CS. Preliminary Assessment of the
    Efficacy, Tolerability and Safety of a Cannabis-Based Medicine (Sativex) in the Treatment of
    Pain Caused by Rheumatoid Arthritis. Rheumatology 2006; 45: 50-52.
    24. Wallace MS, et al. Dose-dependent effects of smoked cannabis on capsaicin-induced pain
    and hyperalgesia in healthy volunteers. Anesthesiology 2007; 107: epub.
    25. Grant I, Cahn BR. Cannabis and Endocannabinoid Modulators: Therapeutic Promises and
    Challenges. Clinical Neuroscience Research 2005; 5: 185-99
    26. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    27. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    28. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    29. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    30. American Medical Association. Featured Report: Medical Marijuana. Chicago, IL; June
    2001.
    31. Beal J, Olson R, Lefkowitz L, Laubenstein, et al. Long-Term Efficacy and Safety of
    Dronabinol for Acquired Immunodeficiency Syndrome-Associate Anorexia. Journal of Pain
    and Symptom Management 1997; 14(1): 7-14
    13
    32. Abrams D, Hilton J, Leiser R, Shade S, Elbeik, T et al. Short-Term Effects of
    Cannabinoids in Patients with HIV-Infection. Annals of Internal Medicine 2003; 139: 258-
    66.
    33. Musty R, Rossi R. Effects of Smoked Cannabis and Oral O 9- Tetrahydrocannabinol on
    Nausea and Emesis After Cancer Chemotherapy: A Review of State Clinical Trials. Journal
    of Cannabis Therapeutics 2001; 1(1): 29-42.
    34. National Institutes of Health, Ad Hoc Expert Group. Workshop on the Medical Utility of
    MarijuanaExpert Report 1997. Accessed June 7, 2007 at
    www.nih.gov/news/medmarijuana/MedicalMarijuana.htm
    35. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    36. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    37. Abrams DI, Vizoso HP, Shade SB, Jay C, Kelly ME, Benowitz NL. Vaporization as a
    Smokeless Cannabis Delivery System: A Pilot Study. Clinical Pharmacology & Therapeutics
    2007; advanced online publication.
    38. Sorrel, AL. Arrested Development: The Case for Studying Medical Marijuana. AMNews July
    10, 2006. Accessed April 2, 2007 at www.amaassn.
    org/amednews/2006/07/10/gvsa0710.htm
    39. U.S. Food and Drug Administration Press Release: Inter-Agency Advisory Regarding Claims
    That Smoked Marijuana Is Medicine. April 20, 2006. Accessed June 12, 2007 at
    www.fda.gov/bbs/topics/NEWS/2006/NEW01362.html
    40. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    41. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.
    42. Joy JE, Watson SJ, Benson JA. Marijuana and Medicine: Assessing the Science Base.
    National Academy of Sciences, Institute of Medicine. Washington, DC; 1999.

  14. The Following 3 Users Say Thank You to John Smith For This Useful Post:

    moomoos (07-08-11), needsmust (26-10-10), uncleskunkle (23-03-15)

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