Marijuana as Wonder Drug

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    The Boston Globe LESTER GRINSPOON

    Marijuana as wonder drug

    By Lester Grinspoon | March 1, 2007

    A NEW STUDY in the journal Neurology is being hailed as unassailableproof that marijuana is a valuable medicine. It is a sad commentary onthe state of modern medicine -- and US drug policy -- that we still need"proof" of something that medicine has known for 5,000 years.

    The study, from the University of California at San Francisco, foundsmoked marijuana to be effective at relieving the extreme pain of adebilitating condition known as peripheral neuropathy. It was a study ofHIV patients, but a similar type of pain caused by damage to nervesafflicts people with many other illnesses including diabetes andmultiple sclerosis. Neuropathic pain is notoriously resistant totreatment with conventional pain drugs. Even powerful and addictivenarcotics like morphine and OxyContin often provide little relief. Thisstudy leaves no doubt that marijuana can safely ease this type of pain.

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    As all marijuana research in the United States must be, the new studywas conducted with government-supplied marijuana of notoriously poorquality. So it probably underestimated the potential benefit.

    This is all good news, but it should not be news at all. In the 40-oddyears I have been studying the medicinal uses of marijuana, I havelearned that the recorded history of this medicine goes back to ancienttimes and that in the 19th century it became a well-established Westernmedicine whose versatility and safety were unquestioned. From 1840 to1900, American and European medical journals published over 100 paperson the therapeutic uses of marijuana, also known as cannabis.

    Of course, our knowledge has advanced greatly over the years. Scientistshave identified over 60 unique constituents in marijuana, calledcannabinoids, and we have learned much about how they work. We have alsolearned that our own bodies produce similar chemicals, calledendocannabinoids.

    The mountain of accumulated anecdotal evidence that pointed the way tothe present and other clinical studies also strongly suggests there area number of other devastating disorders and symptoms for which marijuanahas been used for centuries; they deserve the same kind of careful,methodologically sound research. While few such studies have so far been

    completed, all have lent weight to what medicine already knew but hadlargely forgotten or ignored: Marijuana is effective at relieving nauseaand vomiting, spasticity, appetite loss, certain types of pain, andother debilitating symptoms. And it is extraordinarily safe -- saferthan most medicines prescribed every day. If marijuana were a newdiscovery rather than a well-known substance carrying cultural andpolitical baggage, it would be hailed as a wonder drug.

    The pharmaceutical industry is scrambling to isolate cannabinoids andsynthesize analogs, and to package them in non-smokable forms. In time,companies will almost certainly come up with products and deliverysystems that are more useful and less expensive than herbal marijuana.However, the analogs they have produced so far are more expensive than

    herbal marijuana, and none has shown any improvement over the plantnature gave us to take orally or to smoke.

    We live in an antismoking environment. But as a method of deliveringcertain medicinal compounds, smoking marijuana has some real advantages:The effect is almost instantaneous, allowing the patient, who after allis the best judge, to fine-tune his or her dose to get the needed reliefwithout intoxication. Smoked marijuana has never been demonstrated tohave serious pulmonary consequences, but in any case the technology toinhale these cannabinoids without smoking marijuana already exists asvaporizers that allow for smoke-free inhalation.

    Hopefully the UCSF study will add to the pressure on the US government

    to rethink its irrational ban on the medicinal use of marijuana -- andits destructive attacks on patients and caregivers in states that havechosen to allow such use. Rather than admit they have been mistaken allthese years, federal officials can cite "important new data" and startrevamping outdated and destructive policies. The new Congress could gofar in establishing its bona fides as both reasonable and compassionateby immediately moving on this issue.

    Such legislation would bring much-needed relief to millions of Americanssuffering from cancer, AIDS, multiple sclerosis, arthritis, and other

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    debilitating illnesses.

    Lester Grinspoon, an emeritus professor of psychiatry at Harvard MedicalSchool, is the coauthor of "Marijuana, the Forbidden Medicine."

    Copyright 2007 Globe Newspaper Company.