Riggs asked the Czar some tough questions, including this one specific to medical cannabis: “You’ve said before that you don’t see medical benefits to smoked marijuana and also that the jury is still out on medical marijuana. What sort of scientific consensus does the ONDCP require? How many studies have to come out arguing for medical benefits? What do you need to see?”

The Czar’s reply? “[Y]ou know there are over 100 groups doing marijuana research, and they’re getting their marijuana from the University of Mississippi. There are several things in clinical trials right now. So we’ll just have to wait for those.”

To which I reply ‘Bulls–t!’

As I write today on Alternet.org, a review of the U.S. National Institutes of Health website clinicaltrials.gov shows that there are presently only six FDA-approved trials taking place anywhere in the world involving subjects’ use of actual cannabis. Of these, two are completed, one is assessing the plant’s pharmacokinetics, and one is assessing pot’s alleged harms.

Memo to the Drug Czar: That leaves a grand total of — not “over 100″ — but rather just two ongoing clinical trials to assess the medical efficacy of cannabis. You sir, are a liar (but then again, I suppose we all knew that already).

Pot May Be Instrumental in Combating Cancer, MS and Other Diseases But the Gov’t Refuses to Fund the Necessary Research

via Alternet

[excerpt] A review of the U.S. National Institutes of Health website clinicaltrials.gov shows that NIDA’s kibosh on medical marijuana trials continues unabated. Though a search of ongoing FDA-approved clinical trials using the keyword ‘cannabinoids’ (the active components in marijuana) yields 65 worldwide hits, only six involve subjects’ use of actual cannabis. (The others involve the use of synthetic cannabinoid agonists like dronabinol or nabilone, the commercially marketed marijuana extract Sativex, or the cannabinoid receptor blocking agent Rimonabant.)

Of the six, two of the studies are already completed: ‘Opioid and Cannabinoid Pharmacokinetic Interactions‘ and ‘Vaporization as a Smokeless Cannabis Delivery System,’ both of which were spearheaded by researchers (primarily Dr. Donald Abrams) at the University of California at San Francisco.

The four remaining studies are still in the ‘recruitment’ phase. Of these, only two pertain to the potential medical use of cannabis: ‘Cannabis for Spasticity of Multiple Sclerosis,’ which is taking place at the University of California at Davis and is likely the final clinical trial associated with the soon-to-be-defunct/defunded California Center for Medicinal Cannabis Research, and ‘Cannabis for Inflammatory Bowel Disease,’ led by researchers at the Meir Medical Center in Israel.

Of the remaining studies, one focuses on the detection of cannabinoids and their metabolites on drug screens, while the other, entitled ‘Effects of Smoked Marijuana on Risk Taking and Decision Making Tasks,’ seeks to establish pot-related harms — hypothesizing that subjects “demonstrate poorer decision-making abilities and increased risk-taking behaviors” after smoking marijuana.

You can read the full text of my Alternet.org story here.

You can read the full interview with Drug Czar Kerlikowske here.

Updated and revised for 2011, this report reviews approximately 200 newly published scientific studies assessing the safety and efficacy of marijuana and its compounds in the treatment and management of nineteen clinical indications: Alzheimer’s disease, Amyotrophic Lateral Sclerosis (ALS), chronic pain, diabetes mellitus, dystonia, fibromyalgia, gastrointestinal disorders, gliomas and other cancers, hepatitis C, human immunodeficiency virus (HIV), hypertension, incontinence, methicillin-resistant Staphyloccus aureus (MRSA), multiple sclerosis, osteoporosis, pruritus, rheumatoid arthritis, sleep apnea, and Tourette’s syndrome.

Explains the report’s lead author, NORML Deputy Director Paul Armentano: “The conditions profiled in this report were chosen because patients frequently inquire about the therapeutic use of cannabis to treat these disorders. In addition, many of the indications included in this report may be moderated by cannabis therapy. In several cases, preclinical data and clinical data indicates that cannabinoids may halt the progression of these diseases in a more efficacious manner than available pharmaceuticals.”

The updated report also features a new section, authored by osteopath and medical cannabis specialist Dr. Dustin Sulak, highlighting the significance of the endocannabinoid system and its role in maintaining mental and physiological health.

“As we continue to sort through the emerging science of cannabis and cannabinoids, one thing remains clear: a functional cannabinoid system is essential for health,” writes Dr. Sulak. “From embryonic implantation on the wall of our mother’s uterus, to nursing and growth, to responding to injuries, endocannabinoids help us survive in a quickly changing and increasingly hostile environment. As I realized this, I began to wonder: can an individual enhance his/her cannabinoid system by taking supplemental cannabis? Beyond treating symptoms, beyond even curing disease, can cannabis help us prevent disease and promote health by stimulating an ancient system that is hard-wired into all of us? I now believe the answer is yes.”

Full text of the report is now available online here. Hard copies will be available for purchase shortly. Print copies of the third edition of this report will be made available at a reduced rate for those seeking bulk orders. (Please e-mail NORML for further details.)

British health regulators have approved the sale and marketing of Sativex, an oral spray consisting of natural cannabis extracts (primarily the plant cannabinoids THC and cannabidiol aka CBD) as a treatment for symptoms of multiple sclerosis. (MS)

The spray, which has been legally available to patients in Canada since 2005, went on sale in Britain on Monday. The drug will be marketed in the United Kingdom by the Bayer Corporation which estimates that Sativex will cost the country’s state-run National Health Service roughly £11, or about $16, a day for each patient.

Commenting on the drug’s regulatory approval, NORML Deputy Director Paul Armentano said: “The approval of Sativex in the UK is newsworthy though hardly surprising, as the scientific evidence in support of marijuana’s medical safety and utility has been available for decades. However, the bigger question still remains. That is: ‘How can the US government continue to promote a policy that calls for the arrest and prosecution of patients who use a substance that fourteen states and much of the rest of the western world now acknowledges as a safe and legitimate medicine?’”

In clinical trials, Sativex has been demonstrated to reduce MS-associated spasticity, pain, and incontinence. Long-term investigational trials indicate that consistent use of the cannabis-based medicine may also slow the progression of the disease.

Surveys from the UK and elsewhere indicate that MS patients often report using cannabis therapeutically, with one study reporting that some four out of ten patients with the disease find relief from marijuana.

GW Pharmaceuticals, makers of the Sativex, is expected later this year to seek separate regulatory approval for the spray in Spain, France, Germany, and Italy.

In 2006, the US Food and Drug Administration authorized recruitment for the first-ever North American clinical trial of Sativex for cancer pain treatment. A Phase III trial is anticipated to begin the US later this year.

Marijuana Law Reform in 2010 (March Update)

With New Jersey recently becoming the 14th medical marijuana state, activists in marijuana law reform have been celebrating. After all, over 82 million Americans now live in states where medical use of marijuana is legal – that’s 27% of the US population! Last election, Massachusetts became the 13th decriminalization state, which means over 107 million Americans live in a state where possession of small personal amounts of marijuana no longer merit an arrest – that’s 35% of the US population.

Population of States with Medical Marijuana Laws

Population of States that have Decriminalized Marijuana

However, after watching fourteen years of marijuana activism focused solely on those who use cannabis for medicine, I must warn activists that medical marijuana is not getting any better and the time for re-legalization of cannabis for all adults – even the healthy ones – is now.

Comparison of five core rights found in existing medical marijuana law

California legalized medical marijuana in 1996. That initiative, Prop-215, established what is clearly the most liberal medical marijuana statute to date:

• A doctor can recommend for any condition;
• You needn’t have a “bona fide” doctor/patient relationship;
• Dispensaries are allowed;
• Self cultivation is allowed;
• Patients are protected from arrest.

Comparison of plant and possession limits and qualifying conditions in medical marijuana law

If we consider these five attributes of the law the baseline, then in the past fourteen years, all thirteen medical marijuana states that have followed have failed to achieve all five. Eight states only offer three or four of those liberties and the rest offer two or only one. Most disturbingly, the right of patients to grow their own medicine (or have a caregiver do it for them), which has been a bedrock principle in medical marijuana law, was taken away from patients in the most recent medical marijuana state, New Jersey. Bills that were considered but vetoed in 2009 in Minnesota and New Hampshire, and those moving forward in New York, Pennsylvania, as well as an initiative in Arizona, all sacrifice this core right.

New Jersey - The (No Medical Marijuana) Garden State

A comparison of plant and possession limits also shows the decline from the original starting point in California, where 12 plants and 8 ounces are allowed. Oregon and Washington passed their laws next and have the highest statutory limits: 24 plants and 24 ounces in Oregon and 15 plants and 24 ounces in Washington. (To be fair, all the West Coast states started with lower limits or more vague limits that were modified by the legislature.) But since then, only one state has allowed more than 3 ounces (New Mexico with 6 ounces) and average number of plants allowed is a little less than ten.

The "Big 8" Conditions for which marijuana is recommended in the states

Another decline in medical marijuana freedom appears when we look at the conditions for which medical marijuana protection is afforded in the various states. There are eight conditions which could be considered the “standard” ones: cancer; HIV/AIDS; seizure disorders, like epilepsy; spastic disorders, like multiple sclerosis; glaucoma; chronic nausea; cachexia; and chronic pain. Most medical marijuana states recognize all eight conditions; a couple (Vermont and Rhode Island) recognize seven of eight.

Other conditions recognized in state medical marijuana laws (not a complete list)

The latest law in New Jersey, however, eliminated chronic pain, chronic nausea, and cachexia, making it the most restrictive list in the nation. The bill proposed but vetoed in New Hampshire required one to try all other remedies for chronic pain before trying medical marijuana. The vetoed Minnesota bill wouldn’t even allow cancer and HIV/AIDS patients to use medical marijuana unless they could show they were terminal (about to die). The lists in the latest proposed bills continue to become more restricted.

Until we do have legalization for all, every medical marijuana law is going to fail to adequately serve all medical users and subject them to increasing restriction and scrutiny. Additionally, medical marijuana laws make patients an attractive target for criminals because prohibition maintains huge profits for stolen medical cannabis, as well as becoming targets for overzealous anti-marijuana cops and prosecutors.

The reason the recent medical marijuana laws are losing ground is not a failure of the medical marijuana strategy, but rather due to its success. Medical marijuana has portrayed the herb as “powerful and effective medicine”. Well, what do we do with powerful and effective medicines? We keep them under lock and key. We require people to visit doctors. We strictly monitor prescription pads. We bust people who have them without proper papers.

Rather than justifying the prohibitionists’ shibboleth of medical marijuana as “the camel’s nose under the tent” for legalization, I’m arguing it’s the opposite: that continuing the medical marijuana strategy further cements the “powerful and effective medicine” frame and takes us farther away from treating cannabis as a personal choice of relaxant. We’ll get to a point where the public accepts “powerful and effective cannabis medicine” and looks upon personal use like we look at someone getting fraudulent scrips for painkillers.

If one of the West Coast states doesn’t pull off legalization soon, the pendulum is going to swing back the other way on marijuana. The economic incentives may fade if the economy recovers and then the tax & regulate argument fizzles. And if we are going to continue working on medical marijuana, the bills and initiatives need to get better, not worse. The way it’s looking now is that the Northeast and upper Midwest are going to institute chronic conditions-only, 2 oz limit, strict registry, only personal doctor, no home grow, state-run dispensary medical marijuana for $15/gram in the next six years. How then do we approach those people and say, “Hey, you know that powerful and effective medical marijuana that you only let a few hundred really sick people use after jumping though a mile of hoops? We think everybody should have it and jump through no hoops!”

Medical marijuana would never have passed in any state if it were not for the votes of non-medical users of marijuana. I do believe it is time for medical marijuana patients in the states that have programs to “repay the favor” and fight as hard for legalization as social tokers fought for medical. Only patients can best make the argument that while prohibition exists, they will always face job discrimination, loss of child custody, high black market prices, housing discrimination, and the sneers of the Bill O’Reillys who think 99% of medical marijuana patients are faking. So long as the prohibition profit exists, there will always be these CBS Undercover investigations casting a pall on all legitimate medical marijuana because of the irresponsible acts of a few.

Maybe I’m just too much of a dreamer. I imagine acres and acres of hemp fields, huge indoor hydroponic cannabis warehouses, thriving cafes and coffeehouses, some folks growing their own in a garage or closet, regular outdoor festivals and special indoor events where cannabis smoking is permitted, buying and selling all varieties of cannabis from ounces at a farmer’s market to bulk bales at CostCo… and none of that is done with “powerful and effective medicines”.

I don’t think that it is reformer’s job to pass medical marijuana in all fifty states first and then worry about legalization in one. I think states that have medical should be moving forward on legalization, states without should focus on better medical laws by calling prohibitionists’ bluff on “marijuana outta control!” in the Western states with liberal medical laws.

Researchers worldwide have performed 37 separate clinical trials assessing the therapeutic safety and efficacy of inhaled cannabis and marijuana-based medicines since 2005, according to a review published online last week in the journal Cannabinoids: The Journal of the International Association for Cannabinoid Medicines (IACM).

Investigators from Leiden University in the Netherlands and the nova-Institut in Germany conducted a systematic review of recent clinical trial data pertaining to the medical use of whole smoked marijuana and cannabinoids.

Authors identified 37 controlled studies since 2005 evaluating the therapeutic effects of cannabinoids. The trials involved a total of 2,563 subjects.

Of the 37 clinical trials that have been recently conducted, eleven assessed the drug’s impact on chronic neuropathic pain – a difficult to treat type of pain resulting from nerve damage. Other studies assessed the efficacy of cannabinoids to treat multiple sclerosis-associated spasticity (nine separate studies); HIV/AIDS (four); experimental pain (four); intestinal dysfunction (two); nausea/vomiting/appetite (two); schizophrenia (two); glaucoma (one); and ‘other indications (two).

Authors concluded, “Based on the clinical results, cannabinoids present an interesting therapeutic potential mainly as analgesics in chronic neuropathic pain, appetite stimulants in debilitating diseases (cancer and AIDS), as well as in the treatment of multiple sclerosis.”

Last Wednesday investigators from the California Center for Medicinal Cannabis Research released the results of a series of double-blind, placebo-controlled trials that determined that cannabinoids could be “a first-line treatment” for patients suffering from neuropathy.

Commenting on the review, NORML Deputy Director Paul Armentano said: “The safety and efficacy of marijuana as a medicine has now been established by the ‘gold standard’ of clinical study. Further, over 2,500 patients have used cannabinoids in controlled clinical trials over the past five years alone. This is a far greater total than the number of subjects that would likely be administered any other new drug pending United States FDA approval, and is a large enough population to once and for all establish marijuana’s objective value as a medicine.”

Author: Publius*

Most patients don’t get asked where they get their medicine. That’s because everyone knows people get their medicine from a pharmacy. But I have to get my medicine otherwise. I have to safeguard my “source” because my medicine is cannabinoid based – and that makes it almost illegal.  – But not today.  Today I can answer the source question openly because it is my local pharmacy – with drive-thru service and open to dispense medicine 24 hours a day. I drive up and push a big, yellow smiley-faced button to gain access – a soft automated voice comes over the speaker to verify that I am in the right place in order to pick up my prescription. Next, the typical professional looking person – white coat with badge – slides open the window asking my name and what I need.

“I’m picking up a prescription for Publius.”

They return with a baggie and bottle containing 30 synthetic cannabinoid capsules dosed at 5mg each – that’s right, legal cannabinoids!

What are cannabinoids? Well, here is where things get interesting. As one learns in biology, the human body has many systems – the circulatory, respiratory, digestive, and nervous systems to name a few. Each system has parts: for example, the nervous system is made up of the brain, spinal cord, and nerves. By the late 1980s, science identified a new human system – the endocannabinoid system (ECS) – also referred to as the cannabinoid system. There is a cannabinoid system present in all mammals – to include humans and 15,000 other species.  A mammal is any vertebrate animal distinguished by self-regulating body temperature, hair, and milk-producing females – as mammal means “breast” or of the breast.

The ECS has two main parts: cannabinoids, which are chemical neurotransmitters, and two receptors called “CB1″ and “CB2.” Cannabinoids activate receptors found throughout the body – in all organs, for example. In fact, all systems in our bodies are modulated by the cannabinoid system. This means that as a body system changes, it uses the ECS to do so.

Science and popular search sites like Wikipedia use three classifications of cannabinoids:

1.  Endogenous cannabinoids (also referred to as endocannabinoids), which are produced by the human body

2.  Herbal cannabinoids, the kind found in the cannabis sativa plant

3.  Synthetic cannabinoids, produced and distributed by pharmaceutical companies

The third kind is what I am picking up from the pharmacy – 30 Marinol (Dronabinol) capsules. Marinol is a prescribed cannabinoid from my doctor – and I am going to test it against the herbal cannabinoids I have been baking into my brownies for five years now.

The pharmacist hands me a white paper bag containing the Marinol prescribed for my Multiple Sclerosis (MS). Stapled to the top is a typical handout with cautionary medical information. The small amount (150mg) of the synthetic cannabinoid THC costs $370 – or more than $69,000 per ounce!

I sign my name on a distribution sheet and pay my $3 Medicare co-pay. The government, meaning our tax dollars, pays the other $367 for my medicine.  Now I am ready to go – but not before my ‘synthetic cannabinoid’ dealer informs me of possible side effects. She warns me to be on the lookout for – “dizziness, drowsiness, confusion, feeling ‘high,’ an exaggerated sense of well-being, lightheadedness, headache, red eyes, dry mouth, nausea, vomiting, stomach pain, clumsiness, or unsteadiness.”

Geez – sounds like a lot of potential adversity on my chemically sensitive body.  From personal experience, I know that the herbal cannabinoids do not cause these side effects in my body. The pharmacist did mention one noticeable side effect that I have had with eating cannabis brownies: dry mouth – which is hardly a problem when considering the overall benefits of the medicine.

When I get home I open the bag to take a look at the Marinol. The pills are a deep maroon color and perfectly round. They remind me of Boston Baked Beans – as they look exactly like those candies. One thing is for sure: synthetic cannabinoids do not look anything like herbal cannabinoids – the ones from the plant itself. The distinct medical difference of popping pills versus the variations and qualities of consuming natural cannabis cannot be understated – and surely won’t be by me. After a week of taking one pill a night before bed, as the doctor prescribed, I do not notice any positive effects from the Marinol. It makes me hungry – but that was never a problem in the first place. However, it is my first legal cannabinoid and that is what counts, right? – Not whether it works, just whether it is legal, right?

Wrong.

Here is what I know.  I have been self-medicating with herbal cannabinoids for five years to provide relief from MS, which I have had for 23 years.  During that time I went through the long list of prescribed pharmaceuticals.  The relief was minimal. The problem was (and is) the side effects, which became unbearable over time. I felt like a slave, dependent on a cycle of pharmaceutical use which abused my body and left me in the most depressed, hopeless, and flattened state.

I finally said enough of the pharma-tinkering with my body and the MS and tried baking herbal cannabinoids into brownies. In doing so, my alternative treatment made me a criminal. I began to eat a small cube of cannabis brownie three times a day. Within the first month my insomnia disappeared, my bladder issues calmed, nerve tingles of the arms, legs, and feet stilled. I was no longer breaking out in upper body tremors after being out in the world of loud noises, traffic, and the everyday racing of life.  The MS was quieter. I found I wasn’t contemplating suicide and I felt hopeful about my life again – but realized I had become a chronic criminal.

Cannabinoids are clearly medicinal to our bodies. But there is a strange distinction between which cannabinoids are effective and which ones are legal.  In the case of my MS, appetite stimulation has not been a problem – which is what the Marinol is usually prescribed for. Marinol simply did not work for me. There are other pharmaceutical cannabinoids – such as Nabilone and Sativex – available in other countries, but they remain expensive and less effective than herbal cannabinoids.  Nature created cannabis and the mammalian ECS, not you or me – and it was through the use of herbal cannabinoids that I was able to wean myself from a life of pharma-cocktails and move toward a healthier life. – Just as nature designed.

This is the first chapter of book in progress titled The Cannabis Papers being published by Illinois NORML.

More chapters are available for review here.

*Publius is Bryan Brickner, Julie Falco, Dianna Lynn Meyer, Stephen Young, William Abens, Danielle Schumacher, Derek Rea (1954-2008), David Nott, Dan Linn, Dan S. Wang, Brian Allemana, and many others.

Marijuana chemical may slow multiple sclerosis
via insciences.org

Armed with a $1.5 million National Institutes of Health grant, Temple researchers are studying more effective ways to treat multiple sclerosis. And their research utilizes synthetic cannabinoids based on chemicals derived from the marijuana plant.

… Using a compound (O-1996) synthesized by scientists at the Medical College of Virginia and the company Organix, Tuma and Ganea performed animal studies and found that the synthesized chemical affected cannabinoid receptors present primarily on immune cells.

… “This is a totally new approach to treating this disease, “says Adler, director emeritus and senior advisor for CSAR and Laura H. Carnell professor of pharmacology research. “These cannabinoids hold enormous potential, and that’s encouraging since we’re limited in options when it comes to preventing or reversing MS.”

Okay, follow along with me if you can.

The U.S. National Institutes of Health appropriates over one million dollars to fund medical research — not to investigate the therapeutic effects of natural cannabinoids (bad!), but rather to investigate the therapeutic effects of synthetic chemicals (good!) that are designed to mimic the effects of natural cannabinoids.

Equally ironically, the research is taking place at Temple University in Pennsylvania — where any use of natural cannabis (bad!) as a medicine is criminally illegal, but where research into the use  faux cannabis (good!) is embraced.

Makes sense, right? Well about as much sense as the federal government claiming that pot (bad!) has no medical utility while simultaneously patenting certain natural occurring chemicals in the plant — those that the Feds hope to one day profit from (good!) — as, you guessed it, a medicine.

Any questions?