Is Medical Marijuana Gaining Society's Approval?

Posted: Monday, July 5, 2010 | Posted by Chico Brisbane |

From The Denver Post:


The newest research leaves little doubt that marijuana — or at least its chemical components — has promise in alleviating symptoms of some ailments, while also making clear that the drug is not without its drawbacks, some potentially serious.

What is less certain is whether Colorado's medical-marijuana system of dispensaries and caregivers — where commitment to scientific rigor and compassionate patient care is largely voluntary — can maximize that treatment potential for the benefit of patients.

Some dispensaries keep detailed patient records and embrace scientific testing in the hopes of providing patients with what works best. But medical-marijuana users report other dispensaries seem interested in just slinging snazzy weed, regardless of a patient's needs or ailments. (One ad on Craigslist: "Licensed caregiver looking to trade for Widespread Panic tickets.")



The mainstream medical community, meanwhile, questions whether any system that uses a raw plant as medicine can be optimally effective. Instead, conventional drug researchers see promise mostly in harvesting marijuana's ingredients for more traditional medicines and avoiding consumption methods like smoking that can hurt patients' health.

"If there is any future for marijuana as a medicine," a panel of experts wrote in a landmark 1999 report for the National Academy of Science's Institute of Medicine, "it lies in its isolated components."

Most marijuana advocates enthusiastically embrace a future in which pot is as much an accepted medicine as penicillin. But that future might not come without significant changes to the way medical marijuana is handled. New medicines require new tests and government approvals. Those lead to new regulations and new oversight. There is a focus on standardization, sterility, precision, discipline.

If there were ever a world where marijuana was available behind the counter at the corner pharmacy, the do-it-yourself independence of Colorado's — and many other states' — medical-marijuana system might not have a place. The bud could become obsolete, and dispensaries — both medically inclined and not — could go extinct with it. Indeed, not every marijuana supporter is watching the development of cannabis-based pharmaceuticals enthusiastically.

"When they get through the FDA with their cannabis-based drugs, no legislature in the country will allow doctors and patients access to whole, smoked marijuana," said Allen St. Pierre, the executive director of the National Organization for the Reform of Marijuana Laws, or NORML.




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What was missing, though, was an understanding of how marijuana provided its touted medical benefits — or, for that matter, even a basic understanding of how marijuana gets people stoned.
"We knew marijuana has effects," said Bob Melamede, a biology professor at the University of Colorado at Colorado Springs and a prominent marijuana activist. "So the question was, 'How does it have them?' "

Answers arrived starting in the late 1980s with the discovery in the body of something called the endocannabinoid system. The system acts much like a traffic-control network, with receptors spread out across the brain, the organs, the immune system and various other areas to regulate functions as diverse as appetite, mood and pain. Using chemicals produced in the body called cannabinoids as traffic cops, the body turns on or off those receptors and controls the different functions.

Sending certain cannabinoids to one receptor and flipping it on, for instance, stimulates appetite. Tripping another dampens the body's inflammatory response.
Marijuana also contains cannabinoids that can fit into the endocannabinoid system's receptors — purely "pot luck," Melamede cracks. Ingesting marijuana unleashes into the bloodstream swarms of new cannabinoid molecules that quickly begin linking into the system and flipping switches. This explains both the medical and recreational effects of the drug — which in many cases are one and the same.

By jiggering with the receptors that control appetite, for instance, marijuana creates the much-joked-about munchies. But it is that same effect that spurs the appetites and calms the stomachs of cancer and AIDS patients. In the same way marijuana impairs the motor skills of some users, it can also calm the painful muscle spasticity of multiple sclerosis patients.

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