Monday, September 24, 2007

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

Here is an excerpt from Dr. Weil's presentation


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


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