Medicinal Marijuana

Medicinal Marijuana on Trial
By DAN HURLEY

Published: March 29, 2005



Medical marijuana is now legal in 11 states, and bills to legalize it are pending in at least 7 more. The drug is also at the heart of a case being considered by the United States Supreme Court.

Yet there remains much confusion over whether marijuana in fact has any significant medical effect.

"People subjectively report benefits," said Dr. Joseph I. Sirven, an epilepsy specialist and associate professor of neurology at the Mayo Clinic College of Medicine in Scottsdale, Ariz. "There's a whole Internet literature suggesting what a wonderful thing it is. But the reality is, we don't know."

In an editorial last year in the journal Neurology, Dr. Sirven pointed out that the best studies of marijuana's effects on humans have so far shown little objective evidence of benefit in patients with epilepsy or multiple sclerosis. And a growing body of research indicates that, at least in teenagers, heavy marijuana use over a period of years significantly increases the risk of developing psychosis and schizophrenia.

In the Supreme Court case, two California residents, Angel McClary Raich and Diane Monson, brought a suit against federal officials in October 2002 to defend their use of marijuana after six of Ms. Monson's marijuana plants were seized and destroyed by the Drug Enforcement Administration.

The federal government, which considers marijuana illegal under the Controlled Substances Act, asked the Supreme Court to overturn a Court of Appeals ruling that supported the two women. Oral arguments were heard just after Thanksgiving, and a ruling could come any day.

Ms. Raich's physician, Dr. Frank Henry Lucido of Berkeley, Calif., asserted in an affidavit that Ms. Raich risked death if she was denied the marijuana to treat nausea, anorexia, severe chronic pain and other disorders brought on by a variety of illnesses, including post-traumatic stress disorder, asthma and an inoperable brain tumor. On a Web site created on her behalf, www.angeljustice.org, Ms. Raich says she joined the lawsuit "in order to save my life."

While little scientific evidence supports such a lifesaving role for marijuana, many studies have found modest benefits in patients' subjective measures of pain, sleep, nausea, appetite, tremors and muscle spasms.

"There's nothing better for nerve pain than marijuana," said Phillip Alden, 41, a writer in Redwood City, Calif.

Twice a month, he spends about $200 to buy a half ounce of high-potency marijuana from one of San Francisco's medical marijuana buyers' clubs.

He smokes it three or more times a day to treat pain from a back injury, and to improve his appetite and reduce nausea associated with AIDS and the antiviral drugs he takes for it. It has even checked the progression of his peripheral neuropathy, he said.

Two recent surveys, also published in Neurology, have documented widespread use of marijuana among Canadian patients and a widespread belief in its benefits.

The first survey, of 220 patients with multiple sclerosis, found that 36 percent had used marijuana to treat their symptoms, and that 14 percent were using it at the time of the survey.

The second survey, of 136 patients attending the University of Alberta Epilepsy Clinic, found that 21 percent had used marijuana in the previous year. Just over two-thirds of the active users said it decreased the severity of their seizures and slightly more than half reported a decreased frequency of seizures.

But the lead author of the epilepsy study said it proved only that some patients believed in marijuana, not that it or its active ingredients, called cannabinoids, actually worked.

"There's not been a randomized, controlled trial demonstrating that marijuana or any cannabinoid is any more effective in controlled seizures than a placebo," said Dr. Donald W. Gross, director of the University of Alberta's adult epilepsy program.

Although doctors may now prescribe marijuana in Canada for certain disorders, including epilepsy, Dr. Gross said he had never done so. "It's terribly complicated from a physician's standpoint, and somewhat frustrating," he said. "We have a product that has been legitimized without any evidence of efficacy."

A large body of research in test tubes and animals supports the view that cannabinoids have anticonvulsive properties. But while a 2003 study of 657 patients with M.S. published in the journal Lancet found significant improvements in subjective reports of muscle spasms and pain, it found no improvement by objective measures after 15 weeks.

 

I'd love to see marijuana legalized but since the Thumpers think it would send the entire nation to hell, I would be happy if they legalized it for cancer and AIDS victims. It sho do pep up your appetite I hear!

 

legal or not...im still