Pubdate: Mon, 20 Nov 2000
Source: Honolulu Star-Bulletin (HI)
Copyright: 2000 Honolulu Star-Bulletin
Contact:  P.O. Box 3080, Honolulu, Hawaii 96802
Fax: (808) 523-8509
Feedback: http://starbulletin.com/forms/letterform.html
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Author: Daniel Q. Haney, Associated Press
Note: This is an edited version of the original wire service story at:
http://www.mapinc.org/drugnews/v00/n1723/a02.html
Cited: Center for Medicinal Cannabis Research:
http://www.cmcr.ucsd.edu/home.htm
Related: Institute of Medicine report:
http://books.nap.edu/html/marimed/
National Institutes of Health report:
http://www.nih.gov/news/medmarijuana/MedicalMarijuana.htm
Bookmarks: Cannabis - Medicinal
http://www.mapinc.org/mmj.htm
Cannabis - Medicinal - Canada
http://www.mapinc.org/mmjcn.htm

RESEARCHERS INTEND TO FIND OUT WHETHER POT IS GOOD MEDICINE

California Researchers Will Receive $9 Million During The Next Three Years 
To Conduct Marijuana Studies

SAN DIEGO -- Maybe the smoke is about to clear in the debate over medical 
marijuana.

Few ideas, it seems, are so firmly held by the public and so doubted by the 
medical profession as the healing powers of pot. But at last, researchers 
are tiptoeing into this field, hoping to prove once and for all whether 
marijuana really is good medicine.

To believers, marijuana's benefits are beyond discussion: Pot eases pain, 
settles the stomach, builds weight and steadies spastic muscles. It 
relieves PMS, glaucoma, itching, insomnia, arthritis, depression, 
childbirth, attention deficit disorder and ringing in the ears.

Marijuana is a powerful and needed medicine, they say, tragically withheld 
by misplaced phobia about drug addiction.

However, the drive to legalize medical marijuana is based almost entirely 
on the testimonials of sick people who swear it makes them feel better. 
Those stories are not the kind of dispassionate experimentation that drives 
medical thinking.

"We lack evidence that there is something unique about marijuana, other 
than an impressive number of anecdotal reports," says Dr. Billy Martin, 
chief of pharmacology at the Medical College of Virginia.

Pot has many effects on the body, including some that are probably 
worthwhile. But does it substantially relieve human suffering? And if so, 
is it any better than medicines already in drugstores?

For the first time in at least two decades, marijuana the medicine is being 
put to the test. Scientists say they will try to hold marijuana to the same 
standards as any other drug, to settle whether its benefits match its mystique.

Given marijuana's recreational uses and abuses, people in this field are 
eager to come across as serious scientists experimenting with a serious 
medicine. (Even marijuana's usual reason to be -- the high -- is dismissed 
as a mere side effect, and probably an unwanted one at that.)

One way to buff up a pharmaceutical's raffish image is to call it something 
else. When the University of California-San Diego started the first 
institute to study the medical uses of marijuana this year, they named it 
the Center for Medicinal Cannabis Research, using the botanical term for pot.

"We talked about it a lot," says Dr. Igor Grant, the psychiatrist who heads 
the new center. "Marijuana is such a polarizing name. We don't want this 
institute to be caught in the cross-fire between proponents and 
antagonists. Ultimately, if cannabis drugs become medicine, they will 
almost certainly be known by that name, not marijuana.

The center will give out $9 million over the next three years to California 
researchers -- enough to underwrite six or seven marijuana studies a year, 
with each involving between 20 and 50 patients.

At least four other studies of the medical effects of marijuana are 
planned, three sponsored by the National Institutes of Health, one by 
California's San Mateo County.

The movement began in earnest in 1996, when California passed a referendum 
intended to make it legal. Alaska, Arizona, Hawaii, Maine, Oregon and 
Washington adopted similar laws, and Colorado and Nevada joined them in the 
November election.

"I was just so surprised at these policy decisions being made with so 
little scientific information," says Margaret Haney of Columbia University. 
"I'm not against the use of medical marijuana. There's just no data about 
its efficacy."

Four Primary Promising Uses

Most of the new research will probably focus on four main uses of marijuana 
that seem to hold the greatest promise:

Relieving severe nausea and vomiting caused by cancer chemotherapy. This is 
probably marijuana's best-known medical use. While it helps ease nausea, 
there is no research showing how it stacks up against anti-nausea drugs 
developed the past 15 years.

Stopping weight loss. Marijuana clearly improves appetite. However, the 
drug has not been adequately tested in people who are unintentionally 
losing weight, such as those with AIDS or cancer.

Treating muscle spasticity, including multiple sclerosis. Many patients say 
it helps, and some animal research backs up the idea.

Easing pain. Researchers want to test it on AIDS patients with peripheral 
neuropathy, numbness and pain in the feet that afflicts 20-30 percent of 
AIDS patients. Animal studies suggest marijuana may be a mild to moderate 
painkiller, and many with AIDS already use it.

One of the first questions to answer is whether objectively testing 
marijuana as a medicine is even practical. At the San Mateo County Health 
Center, Dr. Dennis Israelski will tackle this by enrolling 60 AIDS patients 
who already use marijuana for painful neuropathy.

They will be randomly assigned to smoke marijuana -- or forgo it -- for six 
weeks. Will people go along with this if it means giving up something they 
already believe helps them? If not, larger studies of marijuana may be hard 
to accomplish.

Other studies will compare marijuana to THC -- 
delta-9-tetrahydro-cannabinol -- the most active ingredient in pot. THC has 
been available since the 1980s in a synthetic pill form called Marinol.

Theoretically, THC and smoked marijuana should do pretty much the same 
things, although some argue that the other chemicals in pot are essential 
for its effects. But many prefer smoking marijuana because the dose is 
easier to control.

Marinol takes a couple of hours to kick in. By then it is impossible to 
fine-tune the level in the bloodstream, which sometimes is too high, 
producing an unpleasantly intense and uncontrollable high.

When smoked, marijuana's chemicals reach the bloodstream in seconds and hit 
the brain soon thereafter. Users can regulate the effect.

In one of the new studies, Haney will compare marijuana with Marinol in 
AIDS patients experiencing unwanted weight loss. Volunteers will not be 
told whether they are getting genuine marijuana or dummy joints, Marinol or 
sugar pills. Then she will see who eats the most.

But even if Haney and others show marijuana to be uniquely useful, many 
doubt that packs of marijuana cigarettes will ever become standard items at 
the pharmacy.

Probably Not By Prescription

The job of making marijuana an official prescription medicine would be 
daunting. Because the stuff cannot be patented, no drug company will pay 
hundreds of millions for the encyclopedic testing necessary to convince 
regulators.

And then there is that drug delivery system. Nonsmokers often have trouble 
inhaling marijuana smoke, which they find harsh. And it is, after all, a 
form of smoking, one of the ultimate health taboos.

"It's not going to be easy to sell marijuana cigarettes as a medicine, even 
if it could be shown there are particular benefits," says Grant. "It seems 
that if these things are indeed useful, we would have to find a way to 
deliver them in a manner that is prescribable."

That may mean marijuana's real future is its ingredients, THC and the other 
60 or so unique compounds called cannabinoids. These are chemicals that 
pharmaceutical firms can isolate, improve and call their own, refashioned 
to avoid pot's unwanted effects and delivered without smoke.

"Marijuana does too many things to be a really good drug by itself," says 
John Huffman of Clemson University, a chemist who works with cannabinoids 
full time.

Some of the things it does are obvious to the 70 million or so Americans 
who admit trying marijuana: the sense of well-being, a ravenous appetite, 
messed-up perception of time and distance, talkativeness and the rest. 
Marijuana also appears to disrupt short-term memory and suppress immune 
defenses.

Among the companies searching for better ways to harness marijuana are 
Unimed Pharmaceutics of Deerfield, Ill., which makes Marinol. The company 
is working on a THC aerosol spray, intended to offer the quick, easily 
controllable wallop of marijuana smoking.

Unimed President Robert E. Dudley says that in testing, the spray seems to 
work pretty much like smoked pot, reaching peak blood levels of THC within 
minutes. "It mirrors what you would expect to see with inhaled marijuana 
smoke," he says, including the high.

The high is one thing some designers would like to get rid of.

Atlantic Technology Ventures of New York is testing a synthetic form of THC 
as a painkiller. CEO Joseph Rudnick says, "We kept most of the benefits of 
THC but got rid of the psychogenic effects."

All the research done on genuine marijuana will use pot supplied by the 
nation's only legal supplier, the federal government's National Institute 
on Drug Abuse. Every year or two, it pays the University of Mississippi to 
plant an acre and a half of marijuana for experiments. 
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MAP posted-by: Richard Lake