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About Just out. (Portland, OR) 1983-2013 | View Entire Issue (April 2, 1999)
aprii 2.1599 news U nfiltered S cience New evidence debunks marijuana myths cience once again slammed into poli tics in the public debate over the use of marijuana as medicine. The latest compendium of facts, as opposed to rhetoric, comes in the form of Marijuana and Medicine: Assessing the Science Base, a report by the prestigious nonprofit Insti tute of Medicine. The report, commissioned by U.S. drug czar Barry McCaffrey, was released by the institute at a packed Washington, D.C., news conference on March 17. “There is remarkable consensus about the science that suggests the potential of cannabi- noid drugs for medical use,” says John A. Benson Jr. (Cannabinoids are the various chemical con stituents of marijuana.) Benson is one of the principal investigators on the study. He is dean and professor emeritus at Oregon Health Sciences University School of Medicine in Portland. “There is far less convincing data about actu al medical benefits” from marijuana, he says, mainly because “appropriate studies” have not been done. He then urged that clinical trials be undertaken. The report has a strong bent against smoking marijuana, but Benson concedes there are some limited circumstances— such as terminal illness or short-term use to deal with the effects of chemotherapy— in which smoking is recom mended. According to the report, “beyond the harm ful effects from smoking, the range of problems associated with marijuana is not out of line with those of substances used in other medicines.” Stanley J. Watson Jr. is the study’s other prin cipal investigator. He is co-director and research scientist at the Mental Health Research Insti tute of the University of Michigan at Ann Arbor. “Marijuanas future as medicine does not involve smoking,” he says. “It involves exploit ing the potential in cannabinoids such as TH C , the key psychoactive ingredient in marijuana.” Natural marijuana contains about 400 com pounds, about 30 of which have been identified as active ingredients that may have some impact on the human body. The report, meanwhile, shoots down the myth that marijuana is highly addictive and a “gateway drug” to other substance abuse. It is pushing for identification of cannabinoids that by Bob Roehr are active ingredients in marijuana, and devel opment of synthetic versions of such com pounds. It also encourages the development of a mechanical inhaler that delivers the substances in the same rapid manner as smoking, while eliminating the noxious components from burn ing the plant. spectrum of physicians to offer some relief from the conflict between medicine and law,” he says. The federal government still runs a marijua na compassionate use program for eight individ uals. One patient has been on it for more than two decades. But the government closed off new entries to the program in 1992. Many people, meanwhile, are applauding the study’s findings. The Institute of Medicine is “in effect saying that most of what the government has told us about marijuana is false.... It’s not addictive, it’s not a gateway to heroin and cocaine, it has a legitimate medical use, and it’s not as dangerous "There is remarkable consensus about the science that suggests the potential of cannabinoid drugs for medical use." ■ Watson is also calling for access to marijuana through a compassionate use program similar to those for other experimental drugs. “It would offer the opportunity for a broader . — John A Benson Jr, dean and professor emeritus at OHSU School of Medicine as common drugs like Prozac and Viagra,” says Bill Zimmerman, director of Americans for Medical Rights, which has promoted state ballot initiatives to allow medical use of marijuana. “Patients already using marijuana [should] be given the benefit of the doubt and should not be arrested,” adds Chuck Thomas, director of the Marijuana Policy Project based in Washington, D.C. AIDS activist Kiyoshi Kuromiya, the lead plaintiff in a class action medical marijuana law suit now in federal court in Philadelphia, says the report “will help people get their marijuana without risking arrest for a while.” Kuromiya adds that the report “also destroys the main argument for keeping marijuana a Schedule I drug” under the Controlled Sub stances Act. Dr. Don Abrams is conducting the only clin ical trial of smoked marijuana in the United States at the University of California in San Francisco. “A Schedule I drug has no medical benefits, a Schedule II drug does,” he explains. Reclassification would have a tremendous impact on conducting research on marijuana as a medicine, making it much easier to do. As a Schedule I drug, Abrams says, there is only one legal source: the National Institute for Drug Abuse. “And that means every attempt to study marijuana needs to go through rigorous peer review,” he says. From the government’s viewpoint, McCaf frey acknowledges the study’s scientific content, but emphasizes smoking is not the route to go. He suggests the focus should be placed on find ing alternative delivery mechanisms. White House spokesman Joe Lockhart notes the positive aspects of the report, but stresses that further research is required. M edical M arijuana T rial S eeks V olunteers r. Don Abrams is at the halfway point of the only clinical trial of smoked marijuana in the United States, at the University of Cali fornia in San Francisco. More precisely, he is looking at the impact of cannabinoids delivered by smoke and by pill in people with HIV. He’s still looking for volunteers. The study began in May 1998. The count is at 31 of the 64 patients needed, and with any luck it will wrap up in January 2000. “The limiting factor is that we can only have four beds at any one time, so we have to stagger enrollment,” Abrams explains. Years of hassling with federal regulators finally allowed the research to move forward as a safety trial. It aims to explore the possible interac tions medicinal marijuana may have with protease inhibitors. The study could provide greater insight into metabolism, the immune system and hormones in the context of HIV therapy and cannabinoids. “W e’re looking for patients with stable HIV infection who are tak ing either indinavir [Crixivan] or nelfinavir [Viracept], people who have in the past smoked marijuana, but not within the last 30 days,” Abrams D says. Volunteers cannot be cigarette smokers, substance abusers or on methadone. “We have to talk with about a dozen people for every one we enroll,” he says. The 25-day trial requires that volunteers be hospitalized the entire time, with no visitors, though Internet access is provided. The pay is $40 dollars a day. Abrams says volunteers have come from New York, Los Angeles and Seattle. (The trial does not cover travel expenses.) Currently there is no waiting list, and Abrams is eager to hear from potential volunteers. “It’s a historic study,” he says. “I would hate to have the opponents say, look, they can’t even do a clinical trial when they get funded and the marijuana to do it.” For more information, contact Abrams at (415) 502-5705. ■ Reported by B o b ROEHR —. .------------------------------ v v K a m i * , w , /// ' \ > . V < / ^ ** s w i ?rw~ m Jf Physician and Surgeon, Obstetrics and Gynecology / Health First ^ 1130 N.W. 22nd Avenue, Suite 320, Portland, OR 97210 0t 229-7538 pain sppincs Serving your real estate needs for... CONDOS • V a c a tio n H o m e s H o tel P r o p e r t ie s A pa r tm en t B ldg s . C reg CRftY ( 760 ) 833-5434 92264 11