Pubdate: Mon, 21 Apr 2008
Source: Minneapolis Star-Tribune (MN)
Copyright: 2008 Star Tribune
Contact: http://www.startribunecompany.com/143
Website: http://www.startribune.com
Details: http://www.mapinc.org/media/266
Author: Maura Lerner, Star Tribune
Bookmark: http://www.mapinc.org/mmj.htm (Marijuana - Medicinal)

IN MARIJUANA DEBATE, BOTH SIDES CAN POINT TO THE SCIENCE

Bill Would Make Minnesota the 13th State to Allow Medical Uses Within 
Strict Limits.

If marijuana were a new discovery, without cultural and political 
baggage, "it would be hailed as a wonder drug," wrote Dr. Lester 
Grinspoon last year. The Harvard psychiatrist has advocated for 
medical marijuana for decades.

Yet a gap has persisted between what many believe about medical 
marijuana's potential and what scientists could prove. Now recent 
research has applied the same rigor that would be used on any new 
pill to testing marijuana.

The results, so far, give ammunition to both sides of a debate at the 
Minnesota Legislature, where a medical marijuana bill has passed the 
Senate and a House committee. It would make Minnesota the 13th state 
to allow medical uses within strict limits.

Politics aside, what does science conclude at this point about 
medical marijuana?

No Argument

Scientists agree on one thing: the active ingredient in marijuana, 
THC, has some healing powers. In 1985, the U.S. Food and Drug 
Administration (FDA) approved the pill Marinol, a synthetic form of 
THC, to relieve nausea and vomiting from chemotherapy. A few years 
later, the pill also won FDA approval to stimulate the appetite of 
people wasting away from AIDS or cancer.

Pill vs. Plant

The debate, medically speaking, is about smoking a plant or swallowing a pill.

Government scientists agree research shows smoking marijuana gets THC 
into the bloodstream faster than a pill.

But the FDA argues that marijuana must go through the same hurdles as 
any medicine to be proven safe and effective, and that it's 
impossible to ensure the dose and potency of something that grows 
wild. The FDA has never approved any medicine to be smoked.

Also, marijuana is listed as a Schedule I controlled substance, the 
most restricted class of drugs in federal law. It's a category 
reserved for drugs with a high potential for abuse, no accepted 
medical uses and no safety data for medical use.

Promising Research

Supporters claim marijuana can help treat hundreds of conditions, 
from depression to malaria.

But the strongest scientific evidence points to a shorter list, 
according to medical groups. One of the most promising areas is pain relief.

In 1999, the Institute of Medicine (part of the National Academy of 
Sciences) conducted the most extensive review of scientific 
literature of marijuana and concluded that its chemical compounds 
"likely have a natural role in pain modulation, control of movement 
and memory."

Until recently, "medical studies, at least meeting modern standards 
. have been lacking," said Dr. Igor Grant, director of the Center 
for Medicinal Cannabis Research at the University of California, San 
Diego, which has spearheaded much of the latest research. "There has 
been quite a lot of anecdotal evidence, uncontrolled research, that 
there may be benefits."

To win over scientists, the research generally has to show that a 
drug works better than a placebo, and that neither scientists nor 
subjects knew who was getting the real thing.

Since 2007, a handful of government-approved studies at the 
University of California have found that smoking marijuana can help 
relieve neuropathic (nerve) pain from injuries or diseases such as 
AIDS and cancer. In each case, half the volunteers were given 
marijuana and the other half a fake substitute. They found a 
measurable difference.

But researchers also turned up some cautionary notes. One study, 
released in October, tested three different concentrations of 
marijuana, and found only one -- the middle dose -- provided 
"moderate pain relief." The lowest dose showed no effect and the 
highest dose actually increased pain, the study found. Another study 
found pain relief came with a worrisome downside: psychological impairment.

Still, the growing body of research has won over some major medical 
groups, such as the Leukemia and Lymphoma Society, and the American 
College of Physicians, which represents 125,000 internal medicine 
specialists. Both support lowering legal hurdles for medical marijuana.

Mixed Results

Scientists have also tested marijuana's active ingredients on other 
conditions, such as glaucoma and multiple sclerosis. Results have 
been mixed and scientists say there's no proof that it's better than 
existing drugs.

Studies suggest THC can reduce eye pressure associated with glaucoma, 
but that the effects are shortlived; and scientists worry that the 
side effects, especially on the heart, could pose an even greater 
danger to elderly patients.

With multiple sclerosis, studies have found fleeting improvement in 
spasticity, or muscle contractions, but that THC worsened patients' 
balance and control. The MS Society has called for more study.

The Downside

Like many drugs, marijuana has a long list of possible side effects. 
Some are part of the marijuana folklore: It makes people high, slows 
reaction time, impairs memory, makes people sleepy. Other effects are 
more ominous: It can cause a drop in blood pressure, fast heart beat, 
heart palpitations, anxiety, apathy, dizziness and depression.

Like tobacco, it contains toxic chemicals that can endanger pregnant 
women and cause cancer, lung damage and pneumonia.

The Future

Scientists are testing vaporizers and skin patches as alternatives to 
smoking marijuana.
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MAP posted-by: Richard Lake