Medical cannabis

(Redirected from Medicinal cannabis)

A catalog page offering Cannabis sativa extract.

Medical cannabis refers to the use of the drug Cannabis as a physician recommended herbal therapy, most notably as an antiemetic. The term medical marijuana post-dates the U.S. Marijuana Tax Act of 1937, the effect of which made cannabis prescriptions illegal in the United States.

The name marijuana is Mexican or Latin American in origin. That marijuana is now well known in English as a name for cannabis is due largely to the efforts of drug prohibitionists in the United States during the 1920s and 30s. Under the name hemp the herb was then well known as a source of industrial materials and, under the name cannabis, it was also in widespread legal use as a medicine.

Due to widespread illegal use of cannabis as a recreational drug its legal or licensed use in medicine is now a controversial issue in most countries.

There are many competing claims regarding the use of cannabis in a medicinal context. Some claim that it is effective for a wide spectrum of medical problems, while others limit its efficacy to a few specific circumstances. On the other side of the debate, there are those who feel that cannabis simply has no legitimate medical uses, and others who feel that there are theoretical uses that are superseded by more effective treatments using other drugs.

Cannabis was listed in the United States Pharmacopeia from 1850 until 1942, however the United States federal government does not currently recognize any legitimate medical use. (See also DEA). Regardless, Francis L. Young, an administrative law judge with the Drug Enforcement Agency, has declared that "in its natural form, (cannabis) is one of the safest therapeutically active substances known" [1].

History

Cannabis plant

Cannabis as a medicine was common throughout most of the world in the 1800s. It was used as the primary pain reliever until the invention of aspirin^{[citation needed]}. Modern medical and scientific inquiry began with doctors like O'Shaughnessy and Moreau de Tours, who used it to treat melancholia, migraines, and as a sleeping aid, analgesic and anticonvulsant.

By the time the United States banned cannabis (the third country to do so) with the 1937 Marijuana Tax Act, the plant was no longer extremely popular. The only opponent to the bill was the representative of the American Medical Association^{[citation needed]}.

Later in the century, researchers investigating methods of detecting marijuana intoxication discovered that smoking the drug reduced intraocular pressure. High intraocular pressure causes blindness in glaucoma patients, so many believed that using the drug could prevent blindness in patients. Many Vietnam War veterans also believed that the drug prevented muscle spasms caused by battle-induced spinal injuries. Later medical use has focused primarily on its role in preventing the wasting syndromes and chronic loss of appetite associated with chemotherapy and AIDS, along with a variety of rare muscular and skeletal disorders. Less commonly, cannabis has been used in the treatment of alcoholism and addiction to other drugs such as heroin and the prevention of migraines.

In 1972 Tod H. Mikuriya, M.D. reignited the debate concerning marijuana as medicine when he published "Marijuana Medical Papers 1839-1972".

Later in the 1970s, a synthetic version of THC, the primary active ingredient in cannabis, was synthesized to make the drug Marinol. Users reported several problems with Marinol, however, that led many to abandon the pill and resume smoking the plant. Patients complained that the violent nausea associated with chemotherapy made swallowing pills difficult. The effects of smoked cannabis are felt almost immediately, and is therefore easily dosed; many patients only smoke enough to feel the medical effects — many complained that Marinol was more potent than they needed, and that the mental effects made normal daily functioning impossible. In addition, Marinol was far more expensive, costing upwards of several thousand dollars a year for the same effect as smoking a plant easily grown throughout most of the world. Many users felt Marinol was less effective, and that the mental effects were far more disastrous; some studies have indicated that other chemicals in the plant may have a synergistic effect with THC.

In addition, during the 1970s and 1980s, six US states' health departments performed studies on the use of medical marijuana. These are widely considered some of the most useful and pioneering studies on the subject.

In 2003, the American Academy of Ophthalmology released a position statement asserting that "no scientific evidence has been found that demonstrates increased benefits and/or diminished risks of marijuana use to treat glaucoma compared with the wide variety of pharmaceutical agents now available." ^[1]

Early studies on efficacy

New Mexico

Approved by the Food and Drug Administration, the study included 250 patients and compared smoked marijuana to oral THC. All participants were referred by a medical doctor and had failed to control vomiting using at least three alternative antiemetics. Patients chose smoking marijuana or taking the THC pill. Multiple objective and subjective standards were used to determing the effectiveness.

• Conclusion: Marijuana is far superior to the best available drug, Compazine, and smoked marijuana is clearly superior to oral THC. "More than ninety percent of the patients who received marijuana... reported significant or total relief from nausea and vomiting". No major side effects were reported, though three patients reported adverse reactions that did not involve marijuana alone. The report can be read here

Tennessee

27 patients had failed on other antiemetic therapies, including oral THC.

• Conclusion: 90.4% success for smoked marijuana; 66.7% for oral THC. "We found both marijuana smoking and THC capsules to be effective antiemetics. We found an approximate 23% higher success rate among those patients administered THC capsules. We found no significant differences in success rates by age group. We found that the major reason for smoking failure was smoking intolerance; while the major reason for THC capsule failure was nausea and vomiting so severe that the patient could not retain the capsule.

California

A series of studies throughout the 1980s involved 90–100 patients a year. The study was designed to make it easier for patients to enter the oral THC part of the study. Patients who wanted smoked marijuana had to be over 15 years old (oral THC patients had to be over 5) and use the drug only in the hospital and not at home. Smoked marijuana patients also had to receive rare and painful forms of chemotherapy.

• Conclusion: Despite the bias towards oral THC, the California study concluded that smoked marijuana was more effective and established a safe dosage regimen that minimized adverse side effects. The full text of the study can be seen here.

A Vapor-Bong for use with medicinal herbs prescribed by a Physician.

Georgia

119 patients that had failed using other antiemetics were randomly assigned to oral THC pills and either standardized or patient-controlled smoking of marijuana.

• Conclusion: All three categories were successful — patient controlled smokers at 72.2%; standardized smokers at 65.4%; oral THC at 76%. Failure of oral THC patients was due to adverse reaction (6 out of 18) or failure to improve (9 out of 18); failure of smoking marijuana was due to intolerance for smoking (6 out of 14) or failure to improve (3 out of 14).

Current status of medical marijuana around the world

International law

World laws on cannabis possession (small amount). Data is from multiple sources including erowid.org, norml.org, webehigh.com, and Wikipedia. This map is a work in progress, please give corrections and additions here.

Cannabis is in Schedule IV of the Single Convention on Narcotic Drugs, making it subject to special restrictions. Article 2 provides for the following, in reference to Schedule IV drugs:

A Party shall, if in its opinion the prevailing conditions in its country render it the most appropriate means of protecting the public health and welfare, prohibit the production, manufacture, export and import of, trade in, possession or use of any such drug except for amounts which may be necessary for medical and scientific research only, including clinical trials therewith to be conducted under or subject to the direct supervision and control of the Party.

This provision, while apparently providing for the limitation of cannabis to research purposes only, also seems to allow some latitude for nations to make their own judgments. The official Commentary on the Single Convention indicates that Parties are expected to make that judgment in good faith.

Albania

In spite of laws prohibiting growing and possessing cannabis, enforcement has been virtually none. There have been fewer than ten arrests in five years.

Australia

After politicians in the Australian Capital Territory voted to allow doctors to determine when cannabis was appropriate for their patients, intense lobbying by the federal government resulted in the legislation being overturned.

In May 2003 the then Premier of New South Wales (Australia's most populous state), Mr Bob Carr, promised patients a four-year trial into the medical uses of cannabis - nothing ever happened.

Belgium

Though the drug is still illegal, the Belgian government has recently initiated trials to determine the effectiveness of medical cannabis, and may soon decriminalize possession of small amounts.

Cameroon

Growing cannabis for any reason is illegal, though AIDS and cancer patients are allowed to use the drug to treat their symptoms.

Canada

In Hitzig v. Canada (2003), a court again declared Canada's Marijuana Medical Access Regulations unconstitutional "in not allowing seriously ill Canadians to use marijuana because there is no legal source of supply of the drug." In effect, this means that Canadians cannot be prosecuted for using marijuana medically because the Marijuana Medical Access Regulations gives patients the right to do so, but does not set up any legal apparatus for obtaining cannabis.

Back in July 2000, in the "Parker" (epileptic Terry Parker) decision, another judge had made a declaration of invalidity of Canada's drug laws as they relate to the "simple possession" of marijuana due to the lack of a reasonable exemption from the law for medicinal use. The Canadian government was given one year (a suspension of the declaration of invalidity) to remedy the situation, and created the Marijuana Medical Access Regulations. These regulations have been repeatedly deemed unconstitutional in a series of court decisions including "Hitzig."

In a similar case based upon these decisions, lawyer Brian McAllister argued on behalf of a 16 year old that because the Canadian government, after setting up the MMAR, never reenacted the relevant section of the Controlled Drugs and Substances Act, Canada effectively has no prosecutable laws prohibiting the "simple possession" of any amount of cannabis.

Representatives of the United States federal government have claimed that decriminalizing cannabis in Canada may disrupt border trade and relations between the two countries; many Canadians believe that this remains the primary obstacle to decriminalization in Canada.

Canada produces about 400kg of medical cannabis annually, in an abandoned mine in Flin Flon, Manitoba. On April 19, 2005, the Canadian government additionally licensed the prescription sale of a natural marijuana extract - effectively liquid marijuana - called Sativex. [2]

The federal department Health Canada now provides detailed advice (for its own citizens), including not only the medical information needed to make an informed choice, but the law enforcement aspects, and how to apply for authorization to possess marijuana for medical purposes. There is also information that may be of help to the patient's health professional. ^[2]

Germany

Purportedly, use is legal and possession of small amounts not enforced. In Germany, medical cannabis patients may grow up to 100 plants for personal consumption.

Honduras

Sick people caught with cannabis are claiming it is for medical purposes but the government and the law does not recognise this and punishments remain harsh, though enforcement for consumption is lax.

Israel

A small number of people have been granted special permission to use cannabis for medical uses by the Health Ministry.

The Israeli military uses cannabis for experimental treatment of post-traumatic stress disorder of soldiers.[3][4][5]

Jamaica

Cannabis possession remains illegal for any reason, though enforcement is scarce. A recent panel recommended legalizing possession for adults for recreation or medical use.

Japan

All THC-producing forms of cannabis have been illegal since 1948, when the occupying forces of the United States enacted the Hemp Control Law after World War II.

Luxembourg

In Luxembourg the law passed in April 2001 decriminalizes cannabis consumption, as well as its possession for personal use. The law classifies substances into two categories; A (other substances under control) and B (cannabis).

The use of cannabis is illicit but the punishment will not include prison sentences. Thus, a cannabis user may be sentenced to pay a fine (€250 – €2,500). However, prison sentences from 8 days to 6 months can still be applied, if cannabis use happens in front of minors, in schools or at the workplace. Penalties increase up to 2 years of imprisonment in case of adults using cannabis with minors, and up to 5 years in case of medical doctors or pharmacists using cannabis in specific settings (e.g. prison, school, social services). Additionally, use or possession, acquisition, and transport for personal use of illicit substance(s) other than cannabis incurs between 8 days to 6 months imprisonment and/or a fine of €250 – €2,500; Nevertheless, between 1 and 5 years imprisonment and/or a fine of €500 – €1,250,000 are foreseen in case of illicit cultivation, production, fabrication, extract, import, export, sale and offer of type A and B drugs.

Netherlands

Cannabis has been availible for recreational use in coffee shops for several years. Thus it has also been available without a prescription for medical uses. In addition, since 2003 it is a legal prescription drug known as "Mediwiet", available at the pharmacy. There it costs more than in the coffee shop: ca. €9 per gram. It is important to note that laws remain on the books classifying possession and sale as illegal, but due to a non-enforcement policy, it has been de facto legalized. See Drug policy of the Netherlands.

New Zealand

Health Minister Annette King has stated that she is not "unsympathetic to using cannabis in a medicinal form. But that's different to saying we should let everybody smoke it." Her official position is that more conclusive studies are needed, and a method of regulating dosage is necessary before she support medical access to cannabis.

Scott David Findlay, a paraplegic, was convicted of cannabis charges. The judge, Robert Spear (Dunedin District Court) offered to allow community service instead of imprisonment, but Findlay does not recognize the validity of New Zealand's cannabis laws and would not perform community service. Judge Spear claimed this was a "hollow protest" that he was nonetheless allowed to make, and sentenced him to three months imprisonment.

On the 15th of June, 2006, Green MP Metiria Turei had her Misuse of Drugs (Medicinal Cannabis) Amendment Bill drawn from the ballot, which could lead to medicinal usage.

Norway

Possession and cultivation of any THC substance is illegal and even small amounts can lead to heavy fines or jail. There is, of course, a black market, and even some semi-organized pot rings for medicinal purposes.

Portugal

Since 2001, possession of any drug for personal use has been legal, though sale and trafficking are still criminal offenses. One can still be arrested and fined for using cannabis in public, or for possession of more than 25 grams.

Spain

Research provides an important new lead compound for anticancer drugs, links to the story can be found here. The full text of the study can be seen here.

In October 2005, the autonomous government in the region of Catalonia launched a program of therapeutical use of Sativex for six hundred patients of a wide set of illnesses, from multiple sclerosis to cancer, in order to avoid nauseas or to relax tense muscles. The project involves six hospitals, forty researchers and sixty drugstores. The product is presented as an atomizer to be taken orally, and it will be delivered at drugstores inside some hospitals. The full text of the research initiative can be seen here, in Catalan, from the Universitat Autònoma de Barcelona.

South Africa

Prof. Frances Ames completed her research in 1958. The full text of the study can be seen here. Further medical research is currently being performed by the University of the Western Cape by Dr John Thomas.

Switzerland

Though all possession and cultivation remains illegal in most parts of the country, coffee shops can still be found in Bienne and Interlaken.

Thailand

cannabis is illegal in Thailand. Even so, large numbers of cannabis consumers continue to be reported, probably due to the ease of growing low potency marijuana.

United Kingdom

In 1999, a House of Lords inquiry recommended that cannabis be made available with a doctor's prescription. Though the government of the UK has not accepted the recommendations, new long-term clinical trials have been authorized. Sometimes juries have returned verdicts of "not guilty" for people charged with marijuana possession for medical use though there are many people in jail for the offence of possession, cultivation or supplying medical marijuana.

In 2003, the UK company GW Pharmaceuticals, which has been granted the exclusive licence to cultivate cannabis for medicinal trials, had hopes of obtaining regulatory approval for the manufacture and sale of a cannabis-based medicine in the United Kingdom starting in 2004. Such approval has not yet been forthcoming. In April 2005, however, its Sativex marijuana extract, which is produced in the United Kingdom, was licensed for prescription sale in Canada. Although it is not similarly licensed in the United Kingdom, it can be imported, back to the United Kingdom from Canada, for named-patient prescription use. (Named-patient prescription is a prescription process which registers the patient's name with the Home Office.)

United States

United States cannabis laws. Blue represents states with medical cannabis laws; red represents states with decriminalization laws; purple represents states with both.

Currently, seven people receive medical cannabis shipments from the U. S. Federal Government [6] as part of the Compassionate Investigational New Drug program, including Irvin Rosenfeld, a 52-year-old stockbroker who has been featured in numerous print articles and on the Penn & Teller: Bullshit! cable television series. Rosenfeld has been receiving the federal marijuana since 1983. The marijuana is grown on a farm at the University of Mississippi in Oxford and each person receives 300 joints a month.

There is a split between the U. S. federal and state governments over medical marijuana policy. On June 6, 2005, the Supreme Court, in Gonzales v. Raich, ruled in a 6-3 decision that Congress has the right to outlaw medicinal cannabis, thus subjecting all patients to federal prosecution even in states where the treatment is legalized. Currently, there are twelve states with effective medical marijuana laws on the books: Alaska, California, Colorado, Hawaii, Maine, Maryland[7], Montana, Nevada, Oregon, Rhode Island, Vermont, and Washington. It should be noted that Maryland's law does not legalize possession of medical cannabis, but rather makes it a non-incarcerable offense with a maximum penalty of a $100 fine.

The case brought into tension two themes of the Rehnquist court: the limits it has imposed on the federal government and the latitude it has afforded law enforcement officers. Those issues produced an unusual breakdown among the nine justices.

Joining Justice John Paul Stevens's majority decision were Justices Anthony M. Kennedy, David H. Souter, Ruth Bader Ginsburg and Stephen G. Breyer. Justice Antonin Scalia wrote separately to say he agreed with the result, though not the majority's reasoning. Chief Justice William H. Rehnquist and Justices Sandra Day O'Connor and Clarence Thomas dissented.

As a Schedule I drug under the federal Controlled Substances Act of 1970, marijuana is considered to have "no accepted medical use" and is illegal for any reason, with the notable exception of FDA-approved research programs. The Act allows mis-controlled substances to be reclassified by petition by any member of the public, but federal agencies whose power and budgets depend on the illegal status of marijuana have denied each such petition (another, by Jon Gettman, is pending). See cannabis rescheduling in the United States.

A successful "medical necessity" defense by patient Robert Randall led the FDA to create an "Investigational New Drug Program", which provides medical cannabis grown under a NIDA contract at the Research Institute for Pharmaceutical Science at the University of Mississippi to a small number of patients since 1978. The program was closed to new patients in 1992 when many AIDS patients applied. Six living patients continue to receive federal marijuana, including Irvin Rosenfeld [8] (for bone spurs), Elvy Musikka (for glaucoma), and George McMahon (who authored Prescription Pot, a book detailing the federal program, which contains the only existing medical study performed on the legal patients). These patients are required by the U. S. Government to smoke the marijuana through a "rolled paper tube" (they are not allowed to eat it or use pipes or vaporizers). All the patients and their doctors report significant medical benefits from their use of marijuana.

DEA and NIDA opposition prevented any scientific studies of medical marijuana for more than a decade, but in the 1990s, activists and doctors were energized by seeing marijuana help dying AIDS patients. A study of smoked marijuana at the University of California, San Francisco, under Dr. Donald Abrams was approved after five years of bureaucracy. Further research followed, particularly due to a ten million dollar research appropriation by the California legislature. The University of California coordinates this research. [9]. However, there are still significant barriers, unique among Schedule I substances, to conducting medical marijuana research in the US^[3]. Many years of work remain before sufficient research could be approved and conducted to meet the FDA's standards for approving marijuana as a new prescription medicine.

Public opinion surveys find most Americans support legalization of medical marijuana, even as they reject broader legalization of the drug. A November 2003 Gallup survey found 75% said they would favor use of marijuana under a doctor's prescription, but nearly two-thirds rejected full legalization. [10][11] While Congress has consistently rejected legislation to allow medical use of marijuana, 33 states and the District of Columbia have authorized it in some form. [12] Most require that it be "prescribed", which is problematic when federal agencies control doctors' power to prescribe. Twelve states have made laws which permit doctors to instead "recommend" marijuana, starting with California Proposition 215 (1996). The most recent such state was Rhode Island on January 3, 2006, when its state legislature overturned a gubernatorial veto of a bill legalizing medical marijuana. In 2004, Montana legalized medical marijuana by a statewide referendum. Hawaii, Maine and Maryland have legalized medical marijuana by legislative action, and the California legislature expanded patient protections in 2003. District of Columbia voters also passed several modern medical marijuana initiatives, but Congress first denied the funds to count the vote, then when that was declared unconstitutional, voted to overturn the initiative. Even in the best states, law enforcement agencies and individual officers frequently violate the law and the rights of patients, by stealing or destroying medical marijuana, and/or arresting the patients. For example, the official position of the California Narcotics Officers Association is that medical marijuana activists "misled" the public which voted to change the law [13]. Legal and social support groups such as Americans for Safe Access [14] have sprung up in defense.

Sale of medical marijuana is illegal or barely legal, even in states where patients have the right to grow or use it, due to public confusion between dispensaries and "drug dealers". However, medical marijuana dispensaries have been established in many locations, particularly in California, where they work openly with local government officials to resolve any difficulties. Many offer social services, medical consultations, and support groups as well as medicine. The first such dispensary, known as the Cannabis Buyer's Club (CBC), was opened by Dennis Peron in February, 1994. The club operated openly in San Francisco for years, even before medical marijuana was legalized. Thousands of otherwise healthy and well-behaved local gay men had died, before scientists could be persuaded to begin researching their disease. Local police and politicians did not want to be seen arresting suffering AIDS patients, or denying them any medicine that could help them. This gay community activism led directly to the "Compassionate Use Act" medical marijuana initiative, California Proposition 215 (1996), which voters approved.

Washington state Initiative 692, passed by the voters in 1998, also authorizes the medical use of marijuana. On November 2 2004, the voters of Ann Arbor, Michigan passed a similar resolution with 74% approval. In early 2005, Rhode Island's legislature was the first to legalize medical marijuana. Such an act was not sent to the voters.

In NYC, in 2001, well known local activist Kenny Toglia achieved a significant victory for medical cannabis when charges against him were dropped in the infamous "marijuana cookie case". Kenny Toglia in 2001 was involved in a historic drug policy case involving medical marijuana in NYS. He was arrested at "University of the Streets", a locally owned black community center on the corner of Tomplins Square at East 7th Street, with more than a pound of marijuana. Ultimately, all charges against him were dismissed following his complaint that the arresting officers had consumed a number of oatmeal cookies laced with marijuana which had been intended for use by patients with AIDS suffering from wasting syndrome. The events following his arrest led to the issue becoming important in the NYS gubernatorial campaign, and subsequently turned the statewide political tide in favor of the issue. reference: http://www.villagevoice.com/news/0049,friedman,20413,5.html

Despite DEA's repeated false claims that they "don't target sick and dying people" [15], federal arrests of medical marijuana users and suppliers continue. Close to thirty federal criminal cases about medical marijuana are pending. Several jurisdictions, including Oakland, California and San Mateo County, California have announced plans to distribute medical marijuana to patients. Ed Rosenthal, author of dozens of books on marijuana cultivation, grew small "starter" plants for patients on behalf of the city government of Oakland. He was convicted in federal court of manufacturing marijuana, by a jury which was never told that his marijuana was for medical patients. Shortly after the trial, eight of the fourteen jurors (and alternates) who convicted him called a press conference and denounced their verdict, arguing that the trial was not fair because the evidence that Rosenthal was growing marijuana for medical use, working on behalf of the city, and was told by DEA agents and city officials that he was immune to prosecution, was all suppressed by the judge as "irrelevant under federal law". The jury discovered the real facts, by reading newspapers, within hours after delivering their verdict. As a result of the intense public scrutiny, Rosenthal was given a sentence of only one day. He is appealing his felony conviction, and the federal government is appealing the short sentence.

The late Peter McWilliams, a vocal supporter of medical cannabis due to being terminally ill with AIDS and cancer, was investigated by the DEA and convicted for violating federal marijuana laws. Even as he vomited repeatedly during court proceedings, McWilliams was not allowed by the federal judge to explain his condition or its connection to the charges against him. His mother's house had been used to collateralize the bond on which he was allowed to remain free pending sentencing, a condition of which was that he refrain from using cannabis. Prior to his death, McWilliams stated

The federal prosecutor personally called my mother to tell her that if I was found with even a trace of medical marijuana, her house would be taken away. [16]

He choked to death on his own vomit when he was forced to switch from cannabis to Marinol.

Richard Cowan and many other critics of U. S. drug policies have described his death as murder by the federal overnment, insofar as they denied him the use of the medical cannibis which might have prevented his death.

The federal government of the United States continues to argue that smoked cannabis has no recognized medicial purpose; many officials point to the difficulty of regulating dosage (a problem for treatment as well as research). The United States has also pressured other governments (especially Canada, with which it shares a largely open border) to retain restrictions on marijuana.

Uruguay

It is illegal to possess more than 5 grams of cannabis and dealing is considered a crime. Recently the Frente Amplio Party has shown certain tendencies towards legalization and asuming a policy similar to that of the Netherlands.

Citations of modern medical reports on marijuana

• Report on and index of marijuana medical studies by Todd Mikuriya, M.D.]
• Cannabis-In-Cachexia-Study-Group; Strasser F, Luftner D, Possinger K, Ernst G, Ruhstaller T, Meissner W, Ko YD, Schnelle M, Reif M, Cerny T: Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. J Clin Oncol. 2006 Jul 20;24(21):3394-400.
  • Cannabis in cancer-related cachexia (anorexia, weight-loss, emaciation) not better than placebo. At least no toxicity.
• Janet E. Joy, Stanley J. Watson, Jr., and John A Benson, Jr., "Marijuana and Medicine: Assessing the Science Base", Division of Neuroscience and Behavioral Research, Institute of Medicine (Washington, DC: National Academy Press, 1999).
  • "The accumulated data indicate a potential therapeutic value for cannabinoid drugs, particularly for symptoms such as pain relief, control of nausea and vomiting, and appetite stimulation." and "At this point there are no convincing data to support (the concern that medical marijuana would lead to an increase in recreational use). The existing data are consistent with the idea that this would not be a problem if the medical use of marijuana were as closely regulated as other medications with abuse potential."
• Index of studies involving marijuana and multiple sclerosis
• Doblin et al., Marijuana as Antiemetic Medicine: A Survey of Oncologists' Experiences and Attitudes," Journal of Clinical Oncology, Vol. 9, No. 7, July 1991.
• Khamsi, R: Cannabis compound benefits blood vessels. Nature, 4 Apr 2005 (premium content).
  • THC has been found to combat formation of arterial blockages. A random survey of oncologists found that 44% had illegally recommended marijuana for the control of vomiting and that 48% would do so if it were legal; 54% thought it should be available by prescription.
• Vinciguerra et al., Inhalation Marijuana as an Antiemetic for Cancer Chemotherapy," The New York State Journal of Medicine, pgs., 525-527, October 1988
  • 56 Patients who had achieved no success with other antiemetics; 72% found success — the study also concluded that smoked marijuana was more effective than oral THC pills.
• Chang et al., Delta-9-Tetrahydrocannabinol as an Antiemetic in Cancer Patients Receiving High Dose Methotrexate; Annals of Internal Medicine, Volume 91, Number 6, pg. 819-824, December 1979
  • A double-blind controlled study found a 72% reduction in nausea and vomiting; the study also concluded that smoked marijuana was more effective than oral THC
• Foltin RW, Brady JV, Fischman MW: Behavioral analysis of marijuana effects on food intake in humans. Pharmacol Biochem Behav. 1986 Sep;25(3):577-82.; RW, Fischman MW, Byrne MF: Effects of smoked marijuana on food intake and body weight of humans living in a residential laboratory. Appetite. 1988 Aug;11(1):1-14.; and Greenberg I, Kuehnle J, Mendelson JH, Bernstein JG: Effects of marihuana use on body weight and caloric intake in humans. Psychopharmacology (Berl). 1976 Aug 26;49(1):79-84.
  • These three studies concluded that marijuana increases appetite.
• Sallan SE, Zinberg NE, Frei E 3rd: Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. N Engl J Med. 1975 Oct 16;293(16):795-7.
  • Study concluded that smoked marijuana was more beneficial than synthetic THC for some patients.
• Donald P. Tashkin, MD, "Effects of Smoked Marijuana on the Lung and Its Immune Defenses: Implications for Medicinal Use in HIV-Infected Patients"; Journal of Cannabis Therapeutics, Vol. 1, No. 3/4, 2001, pp. 87-102
  • "Frequent marijuana use can cause airway injury, lung inflammation and impaired pulmonary defense against infection. The major potential pulmonary consequences of habitual marijuana use of particular relevance to patients with AIDS is superimposed pulmonary infection, which could be life threatening in the seriously immonocompromised patient. In view of the immonosuppressive effect of THC, the possibility that regular marijuana use could enhance progression of HIV infection itself needs to be considered, although this possibility remains unexplored to date."
• Guy A. Cabral, PhD, "Marijuana and Cannabinoids: Effects on Infections, Immunity, and AIDS"; Journal of Cannabis Therapeutics, Vol. 1, No. 3/4, 2001, pp. 61-85
  • "However, few controlled longitudinal epidemiological and immunological studies have been undertaken to correlate the immunosuppressive effects of marijuana smoke or cannabinoids on the incidence of infections or viral disease in humans. Clearly, additional investigation to resolve the long-term immunological consequences of cannabinoid and marijuana use as they relate to resistance to infections in humans is warranted."
• Ekert H, Waters KD, Jurk IH, Mobilia J, Loughnan P: Amelioration of cancer chemotherapy-induced nausea and vomiting by delta-9-tetrahydrocannabinol. Med J Aust. 1979 Dec 15;2(12):657-9.
  • In children receiving cancer chemotherapy delta-9-tetrahydrocannabinol (THC) has an antinausea and antivomiting effect.
• Sallan SE, Cronin C, Zelen M, Zinberg NE: Antiemetics in patients receiving chemotherapy for cancer: a randomized comparison of delta-9-tetrahydrocannabinol and prochlorperazine. N Engl J Med. 1980 Jan 17;302(3):135-8.
  • THC seems to be an effective antiemetic in many patients who receive chemotherapy for cancer and for whom other antiemetics are ineffective.

Advocacy groups

The American Medical Marijuana Association (AMMA)

AMMA was founded in cyberspace on October 27, 1999 by Steve Kubby, Ed Rosenthal and Dr. Todd Mikurya. AMMA is a group of volunteers working together to implement, preserve and protect the rights of medicinal cannabis patients through political activism. Our platform is based on the idea of not bargaining away people's rights. We believe that each person will have different needs, which are best determined by the patient and physician. What works well for one patient may not work for another. AMMA recently received official recognition by the United States government as one of the top organization websites promoting medical marijuana law reform. This recommendation appears in a briefing by the White House and is available online at the official web site for the White House Drug Policy

WAMM

The Wo/Men's Alliance for Medical Marijuana WAMM at WAMM is a collective of seriously ill patients who work to educate the general public regarding the medical benefits of marijuana, and to ensure that patients, who have a recommendation from their physician, have safe access to legal, natural supplies of Marijuana for the treatment of terminal and debilitating illness.

Compassionate Coalition

The Compassionate Coalition is a grassroots, all-volunteer nonprofit organization that works to defend the rights of medical marijuana patients and care providers through education and community participation.

The Compassionate Coalition was created in April, 2004 in Sacramento, California under the leadership of founder Nathaniel Bennington Sands. Myke Folkes runs the technology department from Spokane, Washington. An off-shoot of the Sacramento chapter of Americans for Safe Access to Medical Marijuana, Compassionate Coalition was very active in Sacramento and regionally during 2005. Compassionate Coalition's most prolific period to date was that year, when the "dynamic duo" of Vice President Peter Gabriel Keyes and his wife, National Secretary Vanessa Nelson wrote and published a monthly newsletter, promoted a rally on the Capitol Steps, compiled the E-dispensary (the group's email newsletter), and did court support for numerous unlucky defendants. Shortly after Keyes and Nelson resigned their positions in April, 2006, Sands announced that he no longer wanted to be Chairman of the Board, and that he sought candidates to fill his shoes. Running unopposed, Linda Jimenez was elected as the new chairman and, commencing August 8th, 2006, now runs the national group from its new headquarters in Solano County. The group's voting Board of Directors comprises Nathan Sands in Sacramento, Mike O'Leary representing Modesto, Aaron Paradiso from Stockton, Christine Flora heading the San Jose chapter, Galen Lawton in Fairfield, Myke Folkes casts the Spokane vote, and Ms. Jimenez breaks the tie in case the board is split 3-3.

See also

• Ed Rosenthal
• Tilden's Extract
• Sativex
• Victor Robinson
• Steve Kubby
• NORML
• California Cannabis Research Medical Group

References

• Single Convention on Narcotic Drugs 1961, International Narcotics Control Board.
• Dominik Wujastyk, "Cannabis in Traditional Indian Herbal Medicine" in Ana Salema (ed.), Ayurveda at the Crossroads of Care and Cure, Lisbon, Centro de História del Além-Mar, Universidade Nova de Lisboa, 2002, pp.45--73. ISBN 972-98672-5-9. Early pre-publication draft.

Notes

External links

• Waiting to Inhale - The first documentary to examine the movement to legalize cannabis for medical use
• The Medical Cannabis Patients Resource - www.MediWana.org
• The Antique Cannabis Book | Over 600 Pre-1937 Medical Cannabis Products Documented
• Medical marijuana | Reefer madness | Economist.com
• The Wo/Men's Alliance for Medical Marijuana
• American Alliance for Medical Cannabis
• Compassionate Coalition Medical Marijuana Information and Discussions
• "A Response to the Supreme Court Decision to Outlaw Medicinal Marijuana" by David Lawson
• "NORML - National Organization for the Reform of Marijuana Laws"
• Medical Marijuana ProCon.org - Should marijuana be a medical option now?
• Iowans for Medical Marijuana - History of the current federal classification of marijuana

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