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Pubdate: Thu, 01 Mar 2007
Author: Lester Grinspoon
A NEW STUDY in the journal Neurology is being hailed as
unassailable proof that marijuana is a valuable medicine. It is a sad commentary
on the state of modern medicine -- and US drug policy -- that we still need
"proof" of something that medicine has known for 5,000 years.
The study, from the University of California at San Francisco, found smoked
marijuana to be effective at relieving the extreme pain of a debilitating
condition known as peripheral neuropathy. It was a study of HIV patients, but a
similar type of pain caused by damage to nerves afflicts people with many other
illnesses including diabetes and multiple sclerosis. Neuropathic pain is
notoriously resistant to treatment with conventional pain drugs. Even powerful
and addictive narcotics like morphine and OxyContin often provide little relief.
This study leaves no doubt that marijuana can safely ease this type of
pain.
As all marijuana research in the United States must be, the new study was
conducted with government-supplied marijuana of notoriously poor quality. So it
probably underestimated the potential benefit.
This is all good news, but it should not be news at all. In the 40-odd
years I have been studying the medicinal uses of marijuana, I have learned that
the recorded history of this medicine goes back to ancient times and that in the
19th century it became a well-established Western medicine whose versatility and
safety were unquestioned. From 1840 to 1900, American and European medical
journals published over 100 papers on the therapeutic uses of marijuana, also
known as cannabis.
Of course, our knowledge has advanced greatly over the years. Scientists
have identified over 60 unique constituents in marijuana, called cannabinoids,
and we have learned much about how they work. We have also learned that our own
bodies produce similar chemicals, called endocannabinoids.
The mountain of accumulated anecdotal evidence that pointed the way to the
present and other clinical studies also strongly suggests there are a number of
other devastating disorders and symptoms for which marijuana has been used for
centuries; they deserve the same kind of careful, methodologically sound
research. While few such studies have so far been completed, all have lent
weight to what medicine already knew but had largely forgotten or ignored:
Marijuana is effective at relieving nausea and vomiting, spasticity, appetite
loss, certain types of pain, and other debilitating symptoms. And it is
extraordinarily safe -- safer than most medicines prescribed every day. If
marijuana were a new discovery rather than a well-known substance carrying
cultural and political baggage, it would be hailed as a wonder drug.
The pharmaceutical industry is scrambling to isolate cannabinoids and
synthesize analogs, and to package them in non-smokable forms. In time,
companies will almost certainly come up with products and delivery systems that
are more useful and less expensive than herbal marijuana. However, the analogs
they have produced so far are more expensive than herbal marijuana, and none has
shown any improvement over the plant nature gave us to take orally or to
smoke.
We live in an antismoking environment. But as a method of delivering
certain medicinal compounds, smoking marijuana has some real advantages: The
effect is almost instantaneous, allowing the patient, who after all is the best
judge, to fine-tune his or her dose to get the needed relief without
intoxication. Smoked marijuana has never been demonstrated to have serious
pulmonary consequences, but in any case the technology to inhale these
cannabinoids without smoking marijuana already exists as vaporizers that allow
for smoke-free inhalation.
Hopefully the UCSF study will add to the pressure on the US government to
rethink its irrational ban on the medicinal use of marijuana -- and its
destructive attacks on patients and caregivers in states that have chosen to
allow such use. Rather than admit they have been mistaken all these years,
federal officials can cite "important new data" and start revamping outdated and
destructive policies. The new Congress could go far in establishing its bona
fides as both reasonable and compassionate by immediately moving on this
issue.
Such legislation would bring much-needed relief to millions of Americans
suffering from cancer, AIDS, multiple sclerosis, arthritis, and other
debilitating illnesses.
Lester Grinspoon, an emeritus professor of psychiatry
at Harvard Medical School, is the coauthor of "Marijuana, the Forbidden
Medicine."
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