Thursday, November 1, 2007

Medical Marijuana Slowly Gains Ground

Clinical Studies Begin to Replace Emotion with Evidence
By Daniel J. DeNoon
WebMD Medical News

August 29, 2003 -- A sea change in science is slowly turning the tide of the medical marijuana debate.

For hundreds of years, marijuana has been used to treat a wide variety of illnesses. But the herb has been illegal throughout the modern era of scientific medical research. Patients swear the drug works to relieve pain, prevent seizures, and counteract the nausea-inducing effects of cancer chemotherapy. But by today's standards, there's no definitive proof that this is so.

Why not? Nearly all U.S.-funded marijuana research has looked for harmful effects from using marijuana as a recreational drug. Meanwhile, there's been little money -- and huge regulatory hurdles -- for studies of marijuana's benefits. That's now changing despite the fact that marijuana remains classed as a Schedule I drug -- a dangerous compound with no medical uses.

Why now? Evidence is beginning to break down the wall of emotion preventing medical marijuana research.

Expert Panels, Breakthrough Findings

It was never clear exactly how marijuana -- which scientists call cannabis -- exerted its euphoria-inducing effects on the brain. Then, in the 1980s, a series of breakthrough studies showed that the body actually makes its own cannabis-like compounds -- cannabinoids.

Why are they there? That question led to the discovery that the body has an entire system based on cannabinoid signals. The signals seem to calm down overexcited nerve cells, says Igor Grant, MD, professor of psychiatry and director of the Center for Medicinal Cannabis Research (CMCR) at the University of California, San Diego.

"It may be the cannabinoid systems -- this is a crude example -- but I think of them as our internal shock absorbers," Grant tells WebMD. "They are circuits that prevent overexcitability, kind of dampers. If that's correct, there are going to be a number of medical applications. For example, I wouldn't be surprised if there were applications for epilepsy and other types of seizures."

Grant isn't the only scientist excited by these possibilities.

In 1997, a National Institutes of Health expert panel concluded that more needs to be known about possible marijuana benefits. In 1999, the Institute of Medicine agreed. It pointed to several areas crying out for clinical marijuana research, notes CMCR co-director Andrew Mattison, PhD.

"There are cannabinoid receptor systems in the brain areas that regulate motion -- and, in retrospect, we know that people with multiple sclerosis and difficulty with spasticity sometimes use medicinal cannabis. That is one of the Institute of Medicine indications for clinical trials," Mattison tells WebMD.

"There is a cannabinoid receptor for pain, another site that modulates appetite -- there's going to be a wealth of basic science research that will hopefully have clinical and practical applications to many different medical indications."

Early Clinical Findings Support More Research

Although funded through 2003 and only at various University of California locations by the California state legislature, the CMCR has, by default, become the national clearinghouse for marijuana research.

The CMCR works closely with state and federal regulators - including the FDA, the Drug Enforcement Administration, and the National Institute on Drug Abuse (the only legal source of marijuana in the U.S.). CMCR provides funds for clinical trials of marijuana. It's won national praise for holding its investigators to the highest scientific standards.

Even before the CMCR was up and running, one stubborn researcher managed to launch a marijuana clinical trial. Donald Abrams, MD, now chief of hematology/oncology at San Francisco General Hospital, is best known for being one of the first doctors to recognize and treat the illness that came to be known as AIDS. AIDS patients have long used marijuana to fight the terrible wasting the disease causes. It's also been said to help an extremely painful condition known as peripheral neuropathy -- a painful nerve disease that has few effective treatments.

Early Clinical Findings Support More Research continued...

Abrams wanted to get federal approval to see whether marijuana really works for this condition. But years of effort proved futile in the face of opposition by federal agencies. Finally, Abrams had a brainstorm. Marijuana affects the immune system. It was just possible that the drug was making patients worse, not better. He submitted a research proposal to look for a harmful effect of marijuana -- and finally won the approval he sought.

The results of that trial appear in the August 19 issue of Annals of Internal Medicine. And they contradict previous studies done in the test tube and with lab animals.

"Much of the published work on marijuana and the immune system is focused on animals and in vitro studies," Abrams tells WebMD. "And, well, if you flood a lot of petri dishes with THC [the active ingredient in marijuana], the immune-cell cultures are going to do poorly.

"In our clinical trial we really didn't see any detriment to the immune system from smoking cannabis. Basically we saw no perturbation of HIV viral load, no detriment to the immune system, and no significant interaction with anti-HIV drugs."

With CMCR funds, Abrams is now doing his peripheral neuropathy study. And he's well on the way to launching a study to see whether adding marijuana to other pain drugs can give relief to dying cancer patients. Overall, the CMCR now has five full-fledged clinical trials under way, which will enroll some 450 patients.

Doctors' Shifting Attitudes on Medical Marijuana

In the last week of July 2003, Medscape -- WebMD's web site for medical professionals -- asked its members what they thought about medical marijuana. It wasn't a scientific poll, although a member's vote is counted only once. Still, the results were surprising. There was a huge response. Three out of four doctors -- and nine out of 10 nurses -- said they favored decriminalization of marijuana for medical uses.

Is it a real trend? Abrams thinks so, but warns that long-held attitudes are slow to change.

"I was pretty much the Lone Ranger of medical marijuana research a few years ago. But not now," he says. "Still, researchers are wary of marijuana research. They feel their reputation may be tainted. And they may be right. For several years I've been invited to do grand rounds at a local hospital in the Bay area. Last year they disinvited me, and I hear it was because of my marijuana research. I've been disinvited from other speaking engagements, too."

"I think these attitudes will change over time -- but it will be slow-going," Mattison says. "Dr. Abrams' comment is typical. People in the medical profession may chuckle at marijuana research and think it is not a bona fide area for scientific investigation. But that will change as the science becomes more clear and more understandable and there are, at some point, some practical applications."

Doctors' Shifting Attitudes on Medical Marijuana continued...

One surprising source of support is moral encouragement from conservative politicians.

"We get a number of stories from elected officials who say, 'Look, I am not for legalization of marijuana. But my sick mother, relative, son, is using it and doing so much better, -- there must be something in it,'" Mattison says.

"A number of people have friends where medical therapies aren't working, and cannabis provided relief from spasticity, pain, nausea, or vomiting. That is turning some opinions and helping people let go of the stereotypical notion that medical marijuana is for potheads."

The CMCR has put aside enough money to complete all its currently approved clinical trials. But the California budget crisis means no more money this year -- at least. Does this mean that clinical research into medical marijuana is over? Grant doesn't think so.

"I think that even if our center runs on hard times, the ball has started rolling," he says. "Clinicians and neuroscientists have an interest in this. There is gong to be more research, and more clinical work, whether we do it or not. Eventually, I foresee NIH [National Institutes of Health] clinical trials. That's my hunch."

A Final Warning

What's changing is the attitude toward investigating possible marijuana benefits. This means more and more doctors are keeping an open mind -- not jumping to the conclusion that the drug will be all things to all people.

"I don't know what the answers will be," Grant says. "The data that are out there suggest there will be some positive applications for marijuana. If I had to bet, I'd say there will be some applications useful for patients in the future."

But, he warns, the opposite could easily be true. The one sure thing about medical research is that it doesn't always provide the answers people expect.

"The caution is that, in the movement toward making marijuana available to patients with no other treatment options, there is the assumption that it is in fact useful. We have to be careful about that," Grant says. "It may be useful for some things, but not useful for others. And if patients take things that are not useful, they may be harming themselves. I urge them to be cautious instead of jumping on the bandwagon and maybe hurting themselves."

©2005-2007 WebMD, Inc. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment.

original article link

Monday, October 22, 2007

The Cannabis Conundrum

As the founder of a British pharmaceutical company puts it, if it weren't called marijuana there would be an entire biotech business built around this plant. And that's just what's starting to happen (but not for the U.S. drug industry or the American patients these medicines might help).

From: Issue 79 | February 2004 | Page 82 | By: Bill Breen | Photographs By: Tim Bishop

One night in late September, Ethan Russo stood before a classroom packed with students on the University of Massachusetts' Amherst campus, and asked how many of them had been through the popular secondary-school program known as Drug Abuse Resistance Education, or DARE. Almost every hand in the audience went up. "Just as I thought," said Russo. "Well, we're going to hit that one head-on." He then cheerfully presented his version of what can only be described as a drug reeducation program.

Russo is a physician specializing in child neurology and one of the world's pioneering investigators into the therapeutic uses of pot. A slight, preternaturally good-humored man, Russo exhibited an outsized knowledge of his subject. Sticking strictly to the botanical name, Cannabis sativa, he noted that the plant's effects on the mind and body were first recorded by the ancient Assyrians in 2200 BC. These days, cannabis is used, mostly illegally, to relieve the nausea that accompanies chemotherapy, stimulate the appetites of AIDS sufferers, prevent blindness induced by glaucoma, suppress migraine headaches, and reduce the pain and muscle rigidity that accompanies multiple sclerosis.

Although nonprescription medications such as aspirin kill thousands of people every year, not a single death has ever been attributed to a cannabis overdose. The "therapeutic ratio" of marijuana is estimated to fall somewhere between 20,000 and 40,000--meaning it would take that many times a normal dose to kill you. If the drug is delivered as a pill or a spray (smoking just about anything is bad for you, after all), then Russo is unequivocal: "Cannabis is a safer medicine than almost all of the standard pharmaceuticals available today."

As he spoke, Russo clicked through a dazzling slide show: verdant fields of cannabis covering the foothills of Morocco's Rif Mountains; Thailand's marijuana plants on steroids, taller than a NBA center. But the most compelling slide was of a homely, quart-sized bottle labeled "Cannabis Tincture," which seemed to symbolize this country's inconsistent attitude toward medical marijuana. The United States has at times embraced the cannabis plant and its products: From the mid-19th century up until the mid-20th century, cannabis was a mainstream medicine, listed in the U.S. pharmacopoeia. The company that marketed the bottle of tincture was none other than Eli Lilly, the $11 billion behemoth that today is best known for another mood-altering drug, Prozac.

More recently, of course, the U.S. government has cast cannabis as a pariah drug. This past June, Karen Tandy, the first woman to head the Drug Enforcement Administration, declared that marijuana "has not been shown to have medical benefits."

Ethan Russo and a small group of trailblazing doctors, scientists, and businesspeople hope to prove her wrong. Russo recently signed on as a senior medical adviser to GW Pharmaceuticals, a British biotechnology company that has conducted clinical trials of cannabis-based medicines on people suffering from multiple sclerosis and chronic pain. In a memorandum to the House of Lords' committee on science and technology, GW reported that a vast major- ity of its patients have indicated "significant alleviation" of at least one symptom, including pain, spasticity, and bladder problems; in some cases, it said, the improvement "has been sufficient to transform lives."

This past May, GW inked a deal with the German pharmaceutical company Bayer Healthcare AG to market Sativex, a cannabis-laced oral spray that's used for treating severe neuropathic pain and multiple-sclerosis symptoms. Bayer, which agreed to market Sativex in the UK and Canada--and optioned rights for Europe--is betting that in the next few months, the first modern medicine made entirely of cannabis will pass muster with British regulators. GW estimates that the European market for Sativex could total $300 million to $400 million. "We're finding that cannabis medicines have enormous pharmacological capabilities and a unique capacity to attack, in a disease like MS, an entire range of symptoms," says Dr. Geoffrey Guy, GW's founder and chairman. "If it wasn't called marijuana, by now there would have been an entire biotech industry built around this plant."

GW's breakthroughs have put Guy in the vanguard of the aboveground marijuana economy, a handful of pharmaceutical entrepreneurs who are racing to build a legal market for cannabis medicines in countries that accept the drug's therapeutic potential (read: Canada, New Zealand, Australia, and most of western Europe). If Guy's bet pays off, GW just might become the Eli Lilly of medical marijuana.

"Cruel Hoax" or Solid Science?

The push to develop plant-based and synthetic cannabinoid medicines has been building since the early 1990s, when researchers identified nerve receptors in the brain that are stimulated by marijuana's active ingredient, THC, as well as the natural body chemical that binds to those receptors. The discovery of an entirely new class of brain receptors and the neurotransmitters that act on them--the endocannabinoid system--proved to be an astounding development, opening a whole new area of therapeutics. Investigators believe that the system plays a critical role in mediating pain, appetite, movement, and memory. The giants of the drug industry, including Lilly, Merck, Pfizer, and Schering-Plough, are now hard at work in the lab, attempting to cook up synthetic versions of the 61 cannabinoid compounds found in marijuana plants. These are complex molecules with 21 carbons unique to cannabis, of which THC is the best known. Big Pharma has high hopes for these synthetics for the treatment of obesity, smoking, cancer pain, migraines, and MS symptoms. But such efforts are still in the early stages of development.

Investigators believe that the system in the brain that is stimulated by marijuana also plays a critical role in mediating pain, appetite, movement, and memory.

At the more controversial end of the aboveground marijuana economy, developers are using the plant itself instead of synthetic compounds. "At least in the near future, it seems extremely unlikely that one of these companies will come up with a single synthetic agent that's as widely applicable as a cannabis-based medicine," says Russo. GW is taking whole extracts from the marijuana plant and recombining them to produce drugs that treat specific ailments. This plant-based approach has enabled the company to develop and test Sativex in five years, at a price tag of about $60 million. It's a remarkable feat, considering that Big Pharma on average shells out $800 million on a new drug and can easily devote a decade or more to animal research and first-dose-in-man testing. GW did minimal animal testing, taking Sativex rapidly to controlled, double-blind human trials. "Something like 400 million people a year take cannabis in one form or another, and yet there's never been a recorded fatality from it," says Guy.

But you won't find any commercial development of plant-based marijuana medicines being pursued in the United States. Andrea Barthwell, a deputy director in the White House Office of National Drug Control Policy and President Bush's point person on medical marijuana, says cannabis medicines aren't compatible with modern science. They do not constitute "a serious line of research," she says.

"The people who are advancing marijuana as a medicine are perpetuating a cruel hoax that exploits our compassion for the sick," Barthwell says. "They are using patients' pain and suffering in an attempt to change America's drug control policy. Marijuana is a crude plant product that most definitely is not a medicine."

It's a curious statement, given that it seems to reflect neither the views of the international scientific community nor those of the government's own regulatory agencies. For one thing, the Food and Drug Administration is reviewing 139 new-drug applications involving botanical research products, so plant-based medicines certainly aren't anathema. As for cannabis, in 1999 the Institute of Medicine, working at the behest of the White House drug czar's office, issued a lengthy report that assessed the scientific evidence concerning potential medical uses of marijuana. Its preeminent recommendation: "Research should continue into physiological effects of synthetic and plant-derived cannabinoids."

Barthwell, however, says that marijuana hasn't been standardized for pharmaceutical production. Nor is there any evidence, she says, that the plant's various compounds can be reliably produced in consistent concentrations. Clearly, she hasn't visited the world's most futuristic pot farm.

Down on the Farm

At a secret location in southeastern England, GW Pharmaceuticals has built what might well be the most high-tech pot palace on the planet. Surrounded by electrified razor wire, video cameras, and motion detectors, the greenhouse sprawls across more than an acre of land. At any one time, more than 15,000 marijuana plants are growing under its 14-foot ceiling, with its banks of lights. Inside is a sea of green, comprised of some of the world's most potent strains of pot: Hindu Kush, White Widow, Skunk, Northern Lights. Outside of the Netherlands, GW is the only commercial organization in Europe licensed to cultivate cannabis on this scale.

GW's drug-development strategy is based on the belief that various components of the plant work to treat specific illnesses, and it is breeding plant strains in which different cannabinoids predominate. In addition to its THC variety, GW is cultivating a strain that consists almost entirely of cannabidiol, or CBD, which moderates the THC high and possesses no psychoactive effect of its own. CBD may be useful in treating neuropathic pain, inflammation, and central-nervous system conditions such as epilepsy. To date, three drugs have been tested in clinical trials: GW's high-THC variety, high-CBD, and Sativex, which is a 50-50 mix of the two.

Geoffrey Guy's goal--to cultivate medical-grade pharmaceutical plants that produce a specific cannabinoid--has required him to raise the art of cannabis-breeding to a spectacular level. Guy's CBD-producing plant strain is unique. And every one of Guy's plants--whether it's a THC, CBD, or one of several other varieties--is completely uniform, with absolutely no genetic variation between each plant. In that respect, the greenhouse resembles a living factory, where the product takes exactly 14 weeks, from planting to harvest, to move down the assembly line.

"Our job is to find out, ahead of everyone else, what the cannabinoids do," says Guy. "To accomplish that, we grow into the plant the exact profile of the chemicals we want. We control our finished product by controlling the plant."

Dressed Better Than a Banker

Geoffrey Guy is a physician and a maverick entrepreneur who has previously launched two publicly traded pharmaceutical companies. On one day in his office in a high-security compound south of London, he was decked out in a double-breasted business suit, complete with a white handkerchief peeking above the breast pocket--people in the legal-cannabis business tend to dress better than bankers. Guy cracks that his favorite mind-altering drug is rugby. He claims never to have smoked anything, least of all pot: "I've brought 14 different drugs to market, and I've never taken any of those, either."

Guy might be the only man in England who has the know-how and the political connections necessary to launch a cannabis-based pharmaceutical company and shepherd its products through the British regulatory system. Nineteen years ago, he founded Ethical Holdings, a pharmaceutical company that developed morphine products, which gave him real-world experience in winning controlled-drug licenses from Britain's Home Office. In 1990, he founded Phytopharm, a company that specialized in developing medicines from Chinese herbal remedies.

Starting in the mid-1990s, patient groups in the UK--particularly the powerful Multiple Sclerosis Society--began lobbying for changes in the drug laws that would allow sick people to receive prescribed cannabis. Guy, who had been devouring the medical literature on marijuana, thought that if he could get dispensation from the government, he had the science-and-business wherewithal to develop an approved medicine from an illegal plant. His hunch paid off. In June of 1998, after months of meetings with Guy, the British government granted GW the license to cultivate and supply cannabis for research and drug development.

Still, had Guy failed to come up with an alternative to smoking cannabis, regulators never would have allowed him to proceed. For Sativex, GW has devised a delivery device that looks like a breath spritzer: Patients spray the drug onto the lining of the mouth; it takes effect within 20 to 45 minutes. The device allows patients to determine how many doses they need to relieve their symptoms. They tend to settle out at relatively modest levels--on average, 8 to 10 sprays of Sativex a day--which appear to be enough to relieve their symptoms without incurring an intoxicating effect. "These people are suffering from a terribly debilitating disease," says Guy. "They're just looking for a safe, efficacious medicine that will help them get on with their lives."

For the U.S., a Missed Market?

While the United Kingdom seems to be on the verge of approving Sativex--and countries from Canada to Australia are permitting the compassionate use of marijuana for seriously ill people--medical marijuana research remains mired in politics in the United States. California has established the Center for Medicinal Cannabis Research at the University of California at San Diego, and the National Institute on Drug Abuse has implemented a mechanism for supplying marijuana to the center's investigators. (Scientists outside of California who aspire to investigate medical marijuana face a torturous regulatory approval process.) Thus far, federal regulators have approved 14 of the center's studies. One such study is investigating the short-term effects of cannabis on spasticity in 30 MS patients. Meanwhile, GW has just completed phase III clinical trials on more than 1,000 patients--the largest program of clinical research on cannabis ever.

In September, a California physician who had just returned from a two-day conference of the International Association of Cannabis as Medicine at Germany's University of Cologne--which brought together the world's best minds in the field--bemoaned this country's stunted research environment. "It is frustrating to watch the advancements in research on cannabis and cannabinoids taking place that we here in the USA can only dream of," he wrote in a well-circulated email. "The dark ages of medicine and science imposed by the American disease, prohibitionism, is painfully apparent."

If Geoffrey Guy realizes his dream, Sativex will simply be the first of many such drugs to sweep through Europe and Canada. Meanwhile, the politics of pot insure that cannabis-based medicines will remain out of reach for U.S. patients and the U.S. pharmaceutical industry alike.

Bill Breen is a Fast Company senior writer. He did no product sampling in reporting this story.


Link to original article

Monday, October 1, 2007

Please share your experiences

I created this website because we started using marijuana (cannabis) with my father recently and it had a noticeable and positive effect. Here is a copy of the email i sent to his doctor. We have been doing this for approximately 6 weeks.

**PLEASE share your experiences. click the comment button and share your experiences***

copy of email:

My dad has clear and noticeable improvements. His affect (mood) is better. He often had the confused disoriented and scrunched up face we have all seen in our loved ones. Now his face is more relaxed and he is often smiling. His mood seems improved and he seems happier. His sense of humor is back and he is often joking around and in a positive mood. His memory has also improved - he is better with short term memory and also speaks more about specific past memories than he has in recent months. He also appears to be more engaged in conversation with others and less tuned out. I have noticed he is more attentive to the environment and noticing details he had been missing for the last 6 months. (one small example to illustrate this - my car has a crack in the windshield. my father has been in this car at least 20 times in the last year while the crack has been there. The first time we were in the car together after starting the marijuana medicine, he commented on this. He has been attentive to more and more details and appears to be processing more of his environment. By training I'm a clinical psychologist so I'm a fairly keen observer of behavior. He appears to be having a very positive response to the marijuana and we will try increasing the dosage next month to see how that affects him and if that results in other improvements in his functioning.

A week ago, I decided to create a blog to share the information with others. The blog contains information on medical marijuana, including some very interesting interviews with doctors, congress members, and patient testimonials of patients who have used medical marijuana. I have also posted all the research specific to marijuana/thc and Alzheimer's that I could find. in the future I'm hoping to post more details about my father's experiences and hoping that others will post and share their stories so we all can learn more to help our loved ones. The blog is only a few weeks old but it has already been visited by people from more than half the states in the U.S. plus at least six other countries!

Monday, September 24, 2007

Dr. Andrew Weil tells medical professional conference marijuana is medically useful


Here is an excerpt from Dr. Weil's presentation

WHY I SUPPORT MEDICAL MARIJUANA

In late May, the U.S. Department of Health and Human Services (HHS) -- after decades of obstruction—finally loosened its restrictions on medical marijuana research. Now, changes in HHS guidelines will make it easier for researchers to obtain legal (i.e., federally grown) marijuana for clinical trials. This change came in response to a report issued in March by the Institute of Medicine (IOM), a branch of the National Academy of Sciences. The report found convincing evidence that marijuana may help people with AIDS wasting syndrome, chemotherapy-induced nausea, or multiple sclerosis. The IOM panel of experts recommended further research on the use of marijuana for these conditions as well as others for which there is strong anecdotal evidence.

The IOM panel’s call for changes in federal policy on medical marijuana echoed those in recent years of an expert panel of the National Institutes of Health (NIH), the editors of the New England Journal of Medicine, the American Medical Association, and voters in seven states. Despite long years of use as a folk medicine and anecdotal evidence of its usefulness in medical conditions from epilepsy to migraine to chronic pain, until now the federal government has balked at approving, funding, or providing legal marijuana for clinical research on conditions that might benefit from the herb. I’m pleased to see some sign that more studies may finally be done on the therapeutic effects of marijuana, but I’m disappointed that the federal prohibition on the actual use of marijuana for medical purposes by patients is still in effect.

It’s unbelievable to me that it is still illegal to use marijuana medically in this country. When I published a study in Science on the physiological and psychological effects on humans in 1968 while I was still a student at Harvard Medical School, I thought that medical use of the plant would be legalized within five years. I never expected the federal government to take such a harsh stance on what is, after all, an herb for which no fatal dose has ever been established. But federal policymakers have continued to demonize marijuana, labeling it a "gateway" drug that leads to the use of harder drugs. (I was pleased to see that the IOM panel refuted that claim in their report.)

Like the IOM panel, I don’t believe the future of medical marijuana lies in smoking it. Marijuana smoke contains carcinogenic toxins, and long-term use of smoked marijuana (medical or otherwise) can raise the risk of lung disease, including lung cancer. For this reason I support research into safer delivery systems, such as inhalers (like those used by asthmatics) and low-temperature vaporizers. But for patients with certain conditions, the benefits of using medicinal marijuana to relieve symptoms may well outweigh the risks.

Over the years, many patients have told me that marijuana eased the discomforts of multiple sclerosis, cancer chemotherapy, migraine headaches, severe menstrual cramps, and fibromyalgia. These were not "potheads" avoiding conventional medicines; in most cases, they either used marijuana to moderate the side effects of conventional treatment (such as chemotherapy) or had conditions for which conventional medicines provided no relief. Because of their testimony, I’m now more likely to suggest the herb myself, especially to patients suffering from chemotherapy side effects, muscle spasticity (as seen in MS or spinal-cord injuries), or AIDS wasting syndrome. I’m frustrated that as a physician I cannot write them prescriptions or refer them to a reliable source.

A legal form of marijuana has long been available by prescription under the name Marinol, a synthetic form of THC, the main psychoactive constituent of marijuana. But patients consistently tell me this pill is inferior to smoking the natural herb—that it causes much greater intoxication, for one thing. Both the NIH and IOM panels agreed that the smoked whole plant is faster-acting than Marinol and the dosage more easily adjusted.

The Clinton Administration has taken one small step toward putting the issue of medical marijuana in the hands of health experts rather than the criminal-justice system.

But it needs to go much further. The HHS guidelines may indeed increase access to legal marijuana for research purposes—although the process will never be swift, given the need for approval by at least three federal agencies. Unfortunately, the HHS has rejected what I consider the most important recommendation made by the IOM panel—that physicians be able to prescribe marijuana to individual patients with debilitating or terminal conditions who have no other alternative for relief of pain and suffering.

I believe such compassionate use is justified. But until the federal government backs this policy, as a physician my hands are tied.

Copyright: 1999 Self Healing

Visit Dr. Weil's website

Sunday, September 23, 2007

History of "cannabis tincture" produced by U.S. pharmaceutical companies



Before marijuana/cannabis was made illegal in the United States in 1937, it was used in a wide array of medical products. The antique cannabis book documents over 600 products.

Have you heard of the Eli Lilly the well-known pharmaceutical company? They are the manufacturer of some well known medicines that you have probably heard of - Prozac, Cialis, Zyprexa, Methadone and many many more. The photo below is of a Cannabis "tincture" produced by this company in the 1900's.

The photo above is from Parke-Davis, a subsidiary of the pharmaceutical company Pfizer. Pfizer marketed the first widely available treatment for epilepsey (Dilantin), they also developed the first bacterial vaccine, and were one of the first companies contracted to manufature the Salk vaccine used to eradicate polio.

Learn more history and see more photos at the antique cannabis website.

Over of Alzheimer's research from NORML website

Alzheimer's Disease

Get the PDF Version of this Document

Alzheimer’s disease (AD) is a neurological disorder of unknown origin that is characterized by a progressive loss of memory and learned behavior. Patients with Alzheimer’s are also likely to experience depression, agitation, and appetite loss, among other symptoms. Over 4.5 million Americans are estimated to be afflicted with the disease. No approved treatments or medications are available to stop the progression of AD, and few pharmaceuticals have been FDA-approved to treat symptoms of the disease.

A review of the recent scientific literature indicates that cannabinoid therapy may provide symptomatic relief to patients afflicted with AD while also moderating the progression of the disease.

Writing in the February 2005 issue of the Journal of Neuroscience, investigators at Madrid's Complutense University and the Cajal Institute in Spain reported that the intracerebroventricular administration of the synthetic cannabinoid WIN 55,212-2 prevented cognitive impairment and decreased neurotoxicity in rats injected with amyloid-beta peptide (a protein believed to induce Alzheimer’s). Additional cannabinoids were also found to reduce the inflammation associated with Alzheimer's disease in human brain tissue in culture. "Our results indicate that … cannabinoids succeed in preventing the neurodegenerative process occurring in the disease," investigators concluded.[1]

More recently, investigators at The Scripps Research Institute in California reported that THC inhibits the enzyme responsible for the aggregation of amyloid plaque — the primary marker for Alzheimer's disease — in a manner "considerably superior" to approved Alzheimer's drugs such as donepezil and tacrine. "Our results provide a mechanism whereby the THC molecule can directly impact Alzheimer's disease pathology," researchers concluded. "THC and its analogues may provide an improved therapeutic [option] for Alzheimer's disease [by]... simultaneously treating both the symptoms and the progression of [the] disease."[2]

Previous preclinical studies have demonstrated that cannabinoids can prevent cell death by anti-oxidation.[3] Some experts believe that cannabinoids’ neuroprotective properties could also play a role in moderating AD.[4]

In addition to potentially modifying the progression of AD, clinical trials also indicate that cannabinoid therapy can reduce agitation and stimulate weight gain in patients with the disease. Most recently, investigators at Berlin Germany’s Charite Universitatmedizin, Department of Psychiatry and Psychotherapy, reported that the daily administration of 2.5 mg of synthetic THC over a two-week period reduced nocturnal motor activity and agitation in AD patients in an open-label pilot study.[5]

Clinical data presented at the 2003 annual meeting of the International Psychogeriatric Association previously reported that the oral administration of up to 10 mg of synthetic THC reduced agitation and stimulated weight gain in late-stage Alzheimer’s patients in an open-label clinical trial.[6] Improved weight gain and a decrease in negative feelings among AD patients administered cannabinoids were previously reported by investigators in the International Journal of Geriatric Psychiatry in 1997.[7] Additional study of the use of cannabinoids and Alzheimer’s would appear to be warranted.

REFERENCES

[1] Ramirez et al. 2005. Prevention of Alzheimer’s Disease pathology by cannabinoids. The Journal of Neuroscience 25: 1904-1913.

[2] Eubanks et al. 2006. A molecular link between the active component of marijuana and Alzheimer's disease pathology. Molecular Pharmaceutics (E-pub ahead of print).

[3] Hampson et al. 1998. Cannabidiol and delta-9-tetrahydrocannabinol are neuroprotective antioxidants. Proceedings of the National Academy of Sciences 95: 8268-8273.

[4] Science News. June 11, 1998. “Marijuana chemical tapped to fight strokes.

[5] Walther et al. 2006. Delta-9-tetrahydrocannabinol for nighttime agitation in severe dementia. Physcopharmacology 185: 524-528.

[6] BBC News. August 21, 2003. “Cannabis lifts Alzheimer’s appetite.

[7] Volicer et al. 1997. Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer’s disease. International Journal of Geriatric Psychiatry 12: 913-919.

source: NORML

THC reduces agitation and improves appetite in Alzheimer's patients

BBSNews - 2003-06-08 -- Science: THC reduces agitation and improves appetite in Alzheimer's patients

A pilot study suggests that THC (dronabinol) may reduce agitation and lead to weight gain in patients suffering from Alzheimer's disease. The results were presented on 15 May at the annual meeting of the American Geriatrics Society.

The study examined nine patients with a mean age of 83 years. All patients met accepted criteria for possible Alzheimer's disease and had unsatisfactory control of their agitation. The Mini Mental State Examination (MMSE), a test used to measure a person's basic cognitive skills, and an assessment of activities of daily living were used to evaluate patients at the start of the study and at one month. Patients initially received 2x2.5 mg THC daily, which was increased up to a maximum of 2x5 mg/day. In addition, all patients were treated with atypical neuroleptics and at least four medications to control behaviour.

After one month agitation was significantly reduced in six patients. Three patients experienced an average increase on the MMSE of 1.2 points (baseline: 11 points). Functional improvement was observed in three patients. Prior to the study, all patients experienced weight loss due to anorexia. After THC treatment all patients had gained weight. No adverse events, such as falls, syncope (short-term faint), seizures or exacerbation of agitation or depression were reported.

"Our trial, although preliminary, suggest dronabinol may reduce agitation and improve appetite in patients with Alzheimer's disease, when traditional therapies are not successful," said Dr. Joshua Shua-Haim, lead investigator in the study and medical director of the Meridian Institute for Aging in Central New Jersey.

In 1997 Dr. Ladislav Volicer and colleagues already conducted a study in 15 patients with Alzheimer's disease who refused food. Eleven patients completed the 12 week cross-over trial of THC and placebo (six weeks of each treatment). The THC treatment resulted in substantial weight gains. Surprisingly, THC also decreased severity of disturbed behaviour. In 1999 Unimed, the marketer of the THC preparation Marinol, estimated that about 5- 10 percent of the drug's patient population consisted of Alzheimer's patients.

(Sources: PR Newswire of 15 May 2003; NORML of 29 May 2003; Volicer L, et al. Int J Geriatr Psychiatry 1997;12:913-9; Joy JE, Watson SJ, Benson JA (eds): Marijuana and Medicine: Assessing the Science Base. Institute of Medicine, National Academy Press, Washington DC 1999)

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Friday, September 21, 2007

Former Attorney General to push for medical marijuana

By Tim Carpenter
The Capital-Journal
Published Wednesday, August 15, 2007

Former Kansas state Attorney General Robert Stephan plans to speak out Friday about what he believes is the need to legalize the medical consumption of marijuana in Kansas.

The state's chief law enforcement officer from 1979 to 1995 will participate in a news conference in the Statehouse hosted by Kansas Compassionate Care Coalition, which seeks legal protection for patients who use marijuana as part of a treatment program and for physicians who recommend the drug to patients.


Robert Stephan to appear with a coaliton on Friday.

Laura Green, director of the coalition, said in an interview Tuesday that laws relating to medicinal use of marijuana are on the books in more than 30 states. A dozen states rigidly shield patients from prosecution when consuming cannabis for medical purposes.

Consumption of marijuana is illegal under Kansas law. The first conviction is a misdemeanor, and subsequent convictions are felonies.

"There is no medical marijuana defense in Kansas," Green said.

The U.S. Food and Drug Administration issued an advisory in 2006 against marijuana consumption for medical purposes.

The document stated the drug has "a high potential for abuse, has no currently accepted medical use treatment in the United States and has a lack of accepted safety for use under medical supervision."

"Furthermore," the FDA says, "there is currently sound evidence that smoked marijuana is harmful."

Advocates of the therapeutic use of pot point to research findings indicating the drug is helpful in pain relief, control of nausea and vomiting, and appetite stimulation. It is consumed by people undergoing chemotherapy or grappling with AIDS.

Stephan, a Republican who battled cancer in the past, will offer at the news conference "his personal history of the issue," Green said.

Green said no specific legislation would be proposed at this point. The objective is to get the issue on the policy radar for the 2008 Legislature. Lawmakers convene the annual session in January.

On Wednesday, spokeswomen for Gov. Kathleen Sebelius and Attorney General Paul Morrison, both Democrats, said neither politician had endorsed medical use of marijuana.

"We stand prepared to enforce the law according to what the Legislature decides," said Morrison spokeswoman Frances Gorman.

Nicole Corcoran, who represents the governor, said Sebelius hadn't discussed the issue in terms of state policy.

Tim Carpenter can be reached at (785) 295-1158 or timothy.carpenter@cjonline.com.

source

Thursday, September 20, 2007

Cannabis lifts Alzheimer appetite

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BBC NEWS / HEALTH


Thursday, 21 August, 2003, 10:42 GMT 11:42 UK

Cannabis lifts Alzheimer appetite

Cannabis A cannabis-based drug could help people with Alzheimer's disease by giving them the "munchies", researchers say.

Patients with the condition often experience weight loss because they stop recognising when they are hungry.

The study does not suggest they should be given cannabis to smoke - instead, they tested a synthetic version of a cannabis extract.

It was found the cannabinoid led to weight and reduced agitation, another symptom of the disease.

The researchers from the Meridian Institute for Aging in New Jersey looked at a drug called dronabinol which is an artificial version of delta-9 THC, the active ingredient in cannabis.

" Dronabinol may reduce agitation and improve appetite in patients with Alzheimer's disease "
Dr Joshua Shua-Haim, Meridian Institute for Aging

The drug has already been approved in the US for the treatment of anorexia in patients with HIV/Aids and nausea associated with chemotherapy.

In the UK, a THC cannabinoid is also being tested in a trial to see if cannabis-based drugs can ease post-operative pain.

Daily life

In the latest US trial, 48 patients with an average age of 77 who had experienced problems with agitation and had been diagnosed with anorexia were studied.

All lived in a dementia unit or a care home.

Researchers assessed their cognitive skills and looked at how they coped with daily life.

They were then given daily doses of five milligrams of dronabinol per day, which was gradually increased to 10 mg a day.

They were also given anti-psychotic drugs, which reduce delusions and have a calming effect, and at least four other medications to control behaviour.

After a month, it was found all the patients had gained weight.

Two thirds experienced a significant improvement in agitation.

No adverse events such as falls, seizures or depressions were reported.

'Upsetting and stressful'

Dr Joshua Shua-Haim, medical director at the Meridian Institute for Aging, who led the study, said: "Our research suggests dronabinol may reduce agitation and improve appetite in patients with Alzheimer's disease, when traditional therapies are not successful.

"It's important to look at all the aspects of Alzheimer's disease that contribute to quality of life for patients, family members and caregivers.

"Agitation and weight loss are upsetting and stressful as the patient's needs become ever more demanding."

The research was presented to the annual conference of the International Psychogeriatric Association in Chicago.

source: BBC News

Marijuana May Prevent Alzheimer's Disease

Could THC Discovery Contribute to New Alzheimer's Medications?

Researchers at the Scripps Research Institute have found that the active ingredient in marijuana may help prevent Alzheimer's disease. Tetrahydrocannabinol or THC as it is better known, apparently inhibits the formation of amyloid plaque. In plaques, the main protein component is called beta-amyloid, which is produced from a larger protein called beta-amyloid precursor protein. Ever since the discovery of these proteins researchers have been attempting to discover their role in the disease. This study has found that THC is much more effective at breaking down the plaque than some of the FDA approved medications currently available for treating Alzheimer's disease.

Many people may have to think again about marijuana. The researchers say their findings show that there is a "previously unrecognized molecular mechanism through which THC may directly affect the progression of Alzheimer's disease".

More research will need to be done to see if a new treatment that involves the use of THC will halt or slow the progression of Alzheimer's disease.

Alzheimer's is a disease that affects about 4.5 million Americans. It is estimated that by 2050 that number of people with Alzheimer's could be as high as 16 million.

Information Source: Lisa M. Eubanks, Claude J. Rogers, Tobin J. Dickerson, Albert E. Beuscher IV, George F. Koob, and Arthur J. Olson. (2006) A Molecular Link Between the Active Component of Marijuana and Alzheimer's Disease Pathology, Journal Molecular Pharmaceutics Publication of the American Chemical Society.

Updated: October 6, 2006

reprinted from About.com

Tuesday, September 18, 2007

Overview of research on THC & Alzheimer's

the following summary is from freedomactivist.net

2006:
"We have demonstrated that THC competitively inhibits AChE and, furthermore, binds to the AChE PAS and diminishes [amyloid-beta-peptide] aggregation. In contrast to previous studies aimed at utilizing cannabinoids in Alzheimer's disease therapy, our results provide a mechanism whereby the THC molecule can directly impact Alzheimer's disease pathology. We note that while THC provides an interesting Alzheimer's disease drug lead, it is a psychoactive compound with strong affinity for endogenous cannabinoid receptors. It is noteworthy that THC is a considerably more effective inhibitor of AChE-induced [amyloid-beta-peptide] deposition than the approved drugs for Alzheimer's disease treatment, donepezil and tacrine, which reduced [amyloid-beta-peptide] aggregation by only 22% and 7%, respectively, at twice the concentration used in our studies. Therefore, AChE inhibitors such as THC and its analogues may provide an improved therapeutic for Alzheimer's disease, augmenting acetylcholine levels by preventing neurotransmitter degradation and reducing [amyloid-beta-peptide] aggregation, thereby simultaneously treating both the symptoms and progression of Alzheimer's disease." reports Lisa M Eubanks, Claude J Rogers, Albert E Beuscher IV, George F Koob, Arthur J Olson, Tobin J Dickerson, Kim D Janda from "A Molecular Link between the Active Component of Marijuana and Alzheimer's Disease Pathology", Molecular Pharmaceutics, Aug 9 2006

2005: "The active ingredient in marijuana may stall decline from Alzheimer's disease, research suggests. Scientists showed a synthetic version of the compound may reduce inflammation associated with Alzheimer's and thus help to prevent mental decline. They hope the cannanbinoid may be used to developed new drug therapies. The research, by Madrid's Complutense University and the Cajal Institute, is published in the Journal of Neuroscience. The scientists first compared the brain tissue of patients who died from Alzheimer's disease with that of healthy people who had died at a similar age. They looked closely at brain cell receptors to which cannabinoids bind, allowing their effects to be felt. They also studied structures called microglia, which activate the brain's immune response. Microglia collect near the plaque deposits associated with Alzheimer's disease and, when active, cause inflammation. The researchers found a dramatically reduced functioning of cannabinoid receptors in diseased brain tissue. This was an indication that patients had lost the capacity to experience cannabinoids' protective effects. The next step was to test the effect of cannabinoids on rats injected with the amyloid protein that forms Alzheimer's plaques. Those animals who were also given a dose of a cannabinoid performed much better in tests of their mental functioning. The researchers found that the presence of amyloid protein in the rats' brains activated immune cells. However, rats that also received the cannabinoid showed no sign of microglia activation. Using cell cultures, the researchers confirmed that cannabinoids counteracted the activation of microglia and thus reduced inflammation. ... Researcher Dr Maria de Ceballos said: 'These findings that cannabinoids work both to prevent inflammation and to protect the brain may set the stage for their use as a therapeutic approach for Alzheimer's disease.' Dr Susanne Sorensen, head of research at the Alzheimer's Society, said: 'This is important research because it provides another piece of the jigsaw puzzle on the workings of the brain. There is no cure for Alzheimer's disease, so the identification of another target for drug development is extremely welcome. The Alzheimer's Society looks forward to seeing further research being carried out on cannabinoid receptors as drug targets for Alzheimer's disease but would warn the public against taking marijuana as a way of preventing Alzheimer's. It is now generally recognised that as well as providing a 'high', long-term use of marijuana can also lead to depression in many individuals.' ... Harriet Millward, of the Alzheimer's Research Trust, said there were two main types of cannabinoid receptor, CR1 and CR2. 'It is CR1 that produces most of the effects of marijuana, including the harmful ones. If it is possible to make drugs that act only on CR2, as suggested by the authors of this study, they might mimic the positive effects of cannabinoids without the damaging ones of marijuana. However, this is a fairly new field of research and producing such selective drugs is not an easy task. There is also no evidence yet that cannabinoid-based drugs can slow the decline in human Alzheimer's patients." – "Marijuana may block Alzheimer's", BBC News, Feb 22 2005.

"Another very intriguing link between natural cannabinoids and memory was found in the brains of people who died of Alzheimer's disease. The researchers discovered that the brains of people died of Alzheimer's showed substantially less cannabinoid binding than shown by the brains of the control group. The abnormal absences of cannabinoid receptors weren't located in regions correleated with the damage done by Alzhemier's disease itself, so the researchers did not believe that the Alzheimer's disease caused the disappearance of CB1 receptors.
The difference between the Alzheimer's and control CB1 levels was the highest in the hippocampus, the same region of the brain where cannabinoids help regulate short-term memory. The Alzheimer's brains showed binding to the test cannabinoid that was reduced by 49% compared to the binding observed in the control brains.
There is not yet an explanation for this difference. Research showed that in rats, cannabinoid receptors and the ability to respond to anandamide (and THC) develop gradually from birth until adulthood, and then remain fairly constant as the animals age." claims Los Angeles Cannabis Resource Center from "Cannabinoids in the brain".

Marijuana may block Alzheimer's


The active ingredient in marijuana may stall decline from Alzheimer's disease, research suggests.

Scientists showed a synthetic version of the compound may reduce inflammation associated with Alzheimer's and thus help to prevent mental decline.

They hope the cannabinoid may be used to developed new drug therapies.

The research, by Madrid's Complutense University and the Cajal Institute, is published in the Journal of Neuroscience.


We would warn the public against taking marijuana as a way of preventing Alzheimer's
Dr Susanne Sorensen
The scientists first compared the brain tissue of patients who died from Alzheimer's disease with that of healthy people who had died at a similar age.

They looked closely at brain cell receptors to which cannabinoids bind, allowing their effects to be felt.

They also studied structures called microglia, which activate the brain's immune response.

Microglia collect near the plaque deposits associated with Alzheimer's disease and, when active, cause inflammation.

The researchers found a dramatically reduced functioning of cannabinoid receptors in diseased brain tissue.

This was an indication that patients had lost the capacity to experience cannabinoids' protective effects.

The next step was to test the effect of cannabinoids on rats injected with the amyloid protein that forms Alzheimer's plaques.

Those animals who were also given a dose of a cannabinoid performed much better in tests of their mental functioning.

The researchers found that the presence of amyloid protein in the rats' brains activated immune cells.

However, rats that also received the cannabinoid showed no sign of microglia activation.

Using cell cultures, the researchers confirmed that cannabinoids counteracted the activation of microglia and thus reduced inflammation.

Drug target

Researcher Dr Maria de Ceballos said: "These findings that cannabinoids work both to prevent inflammation and to protect the brain may set the stage for their use as a therapeutic approach for Alzheimer's disease."

Dr Susanne Sorensen, head of research at the Alzheimer's Society, said: "This is important research because it provides another piece of the jigsaw puzzle on the workings of the brain.

"There is no cure for Alzheimer's disease, so the identification of another target for drug development is extremely welcome.

"The Alzheimer's Society looks forward to seeing further research being carried out on cannabinoid receptors as drug targets for Alzheimer's disease but would warn the public against taking marijuana as a way of preventing Alzheimer's.

"It is now generally recognised that as well as providing a 'high', long-term use of marijuana can also lead to depression in many individuals."

Different receptors

Harriet Millward, of the Alzheimer's Research Trust, said there were two main types of cannabinoid receptor, CR1 and CR2.

"It is CR1 that produces most of the effects of marijuana, including the harmful ones.

"If it is possible to make drugs that act only on CR2, as suggested by the authors of this study, they might mimic the positive effects of cannabinoids without the damaging ones of marijuana.

"However, this is a fairly new field of research and producing such selective drugs is not an easy task.

"There is also no evidence yet that cannabinoid-based drugs can slow the decline in human Alzheimer's patients."

Marijuana May Slow Alzheimer's

Key Marijuana Compound Beats Current Alzheimer's Drugs In Test-Tube Study





(WebMD) THC, the key compound in marijuana, may also be the key to new drugs for Alzheimer's disease.

That's because the marijuana compound blocks the formation of brain-clogging Alzheimer's plaques better than current Alzheimer's drugs.

The finding — in test-tube studies — comes from the lab of Kim Janda, Ph.D., director of the Worm Institute of Research and Medicine at Scripps Research Institute.

"While we are certainly not advocating the use of illegal drugs, these findings offer convincing evidence that THC possesses remarkable inhibitory qualities, especially when compared to [Alzheimer's drugs] currently available to patients," Janda says in a news release.

"Although our study is far from final, it does show that there is a previously unrecognized molecular mechanism through which THC may directly affect the progression of Alzheimer's disease."

Janda's team found that THC blocks an enzyme called acetylcholinesterase, which speeds the formation of amyloid plaque in the brains of people with Alzheimer's disease.

The Alzheimer's drugs Aricept and Cognex work by blocking acetylcholinesterase. When tested at double the concentration of THC, Aricept blocked plaque formation only 22 percent as well as THC, and Cognex blocked plaque formation only 7 percent as well as THC.

"THC and its analogs may provide an improved [treatment for] both the symptoms and progression of Alzheimer's disease," the researchers conclude.

The findings appear in the Aug. 9 online edition of the journal Molecular Pharmaceutics, a publication of the American Chemical Society.

SOURCES: Eubanks, L.M. Molecular Pharmaceutics, published online Aug. 9, 2006. News release, Scripps Research Institute. News release, American Chemical Society.


By Daniel DeNoonReviewed by Louise ChangCopyright 2006, WebMD Inc. All rights reserved.