New futures for cannabis-based medicines
By Gregory L. Gerdeman and Juan Sanchez-Ramos, Special to the Times
[Last modified: Nov 15, 2009 09:31 PM]
In Print: Monday, November 16, 2009
Medicinal use of cannabis is being discussed more actively than ever.
Although prior to its prohibition in 1937 cannabis was used widely in
pharmacies, there was little debate about its usefulness to treat
various symptoms such as inflammatory pain. Cannabis remedies were well
known, publicly advertised and widely prescribed.
"Marijuana," on the other hand, was virtually unknown Mexican jargon
before becoming the "assassin of youth" in propaganda films. Such
depictions led to an unceremonious vote by Congress to effectively
criminalize Cannabis sativa in all of its forms. The strongest
opposition came not from the public (which did not equate the new
"scourge" with cannabis remedies) but from the American Medical
Association, whose congressional liaison decried the legislation as
speciously motivated by "indirect hearsay evidence."
Over the next 72 years, the image of the American cannabis user morphed
from the immigrant madman and criminal deviant of the '40s, to the
counter-culture crowd of the '60s to the unmotivated slacker of the
'80s. In the '90s, a "new" image arose: the medical marijuana patient,
who is driven not to get high but to get well. It is linguistically
ironic that "medical marijuana" may usher in a new chapter in the
ancient relationship between human society and the cannabis plant.
Now the American Medical Association has turned heads by again weighing
in on cannabis policy. After extensive review of scientific and clinical
evidence regarding the harms and benefits of cannabinoids (molecules
found in cannabis) as well as recent legal precedence regarding medical
marijuana, the AMA announced that the federal Schedule I status of
marijuana (most prohibited) should be reconsidered in order to advance
clinical research with botanical cannabinoid medicines. The AMA report
furthermore expresses that "physicians who comply with their ethical
obligations to 'first do no harm' and to 'relieve pain and suffering'
should be protected in their endeavors, including advising and
counseling their patients on the use of cannabis for therapeutic
purposes."
The emphasis on research is important. There is a future for botanical
cannabis-based medicines, but patients and physicians should be
empowered to base health care decisions on real evidence rather than
hyperbolic claims of marijuana's dangers or virtues. Not surprisingly,
the AMA does not support legalizing medical marijuana through state
ballot initiatives, such as the one Floridians could vote on next year
if a petition by the group People United for Medical Marijuana gains
traction. Cannabis is a plant and modern standards for purity, packaging
and delivery of drugs play an important part in assuring reliable
predictability. Also at play is the arena of pharmaceutical development
— new drugs are being pioneered to enhance the body's THC-like
"endocannabinoid system," intended to achieve therapeutic effect with
improved specificity and minimal psychoactivity. Research is clearly
needed to ensure efficacy and safety of these new drugs.
Nonetheless, the perceived promise of such drugs highlights a need for
greater maturity in social discussion of medical use for cannabis and/or
its constituent molecules. Whatever else might be said about the
apparent sea change of public opinion about cannabis, the oft-repeated
claims by federal drug czars that medical marijuana is a "smoke screen"
or lacks even a "shred of evidence" must be laid to rest as a relic of
socially juvenile, 20th century reefer madness. Public policy should be
based on sound scientific evidence — not a roadblock to it. Cannabis
has been used safely as a folkloric remedy for thousands of years, but
in modern America inappropriate Schedule I listing of marijuana has
obstructed research to find promising therapies for debilitating human
conditions. This is a paramount reason why the scheduling should be
changed.
---
Gregory L. Gerdeman, Ph.D., is an assistant professor of biology at
Eckerd College in St. Petersburg. Juan Sanchez-Ramos, Ph.D./M.D., is the
Helen Ellis Professor of Neurology and chair for Parkinson's Disease
Research at the University of South Florida College of Medicine in
Tampa.
Sanchez-Ramos was a physician involved in the "Compassionate Use
Protocol for Marijuana" sponsored by the National Institute on Drug
Abuse and approved by the Food and Drug Administration and the Drug
Enforcement Administration. In this study, marijuana was prepared and
shipped by NIDA to patients with various medical conditions. His patient
suffered from muscle spasms and pain caused by a rare disease,
successfully treated with cannabis.
http://www.tampabay .com/opinion/ columns/new- futures-for- cannabis- based-m\
edicines-p/1052014
Tuesday, November 17, 2009
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