Does marijuana research justify use as medicine?

An L. A. Times article reported on Nov. 11, 2009: The American Medical Assn. changes its policy to promote clinical research and development of cannabis-based medicines and alternative delivery methods.” It goes on to state: “In changing its policy, the group said its goal was to clear the way to conduct clinical research, develop cannabis-based medicines and devise alternative ways to deliver the drug.”

A NewsLanc reader has noted a quotation by AMA board member Dr. Edward Langston that appeared in the article:“Despite more than 30 years of clinical research, only a small number of randomized, controlled trials have been conducted on smoked cannabis, insufficient to satisfy the current standards for a prescription drug product.”

NewsLanc brought the quote to the attention of Dr. Lester Grinspoon, a Professor of Psychiatry at Harvard, the author of “Marijuana, the Forbidden Medicine,” whose work has been published in the Journal of the American Medical Association. Grinspoon approved the following observations:

“As Dr. Langston suggests, double-blind studies on marijuana would quickly resolve this controversy but the U.S. Government has done everything possible to prevent such research. The legislation establishing the National Institute on Drug Abuse, for example, specifically prohibits the agency from examining any possible positive effects of the drug. Congress felt at the time that even suggesting that marijuana might not be pure evil would send the wrong message to our children.

“A mountain of anecdotal evidence about the efficacy of this herbal medicine already exists. If scientific studies had been permitted we would be much more advanced in possible mitigation of serious conditions like Crohn’s disease, Multiple Sclerosis, migraine headaches, and extreme nausea and vomiting.

“Dr. Langston says there is no future for the herb itself, only for its isolated components, but this position has been discredited by the experience of actual patients. Some of the isolated cannabinoid compounds he speaks of are already available. With the rise of public demand for medical access to the plant in the early 1990s, the federal government tried to thwart this movement by supporting the development of Marinol, a synthetic version of the cannabinoid THC.

“While Marinol is better than nothing, I have never seen a patient who says Marinol is as effective as the whole plant. The same is true for the other synthetic pharmaceutical cannabinoids. None measure up to the gold standard of the plant itself. People use these drugs not because they are more effective but because they are legal. The pharmaceutical industry is frantically searching for synthetic compounds because the plant itself cannot be patented. It that were possible, machine-rolled cigarettes would no doubt already be available from the major drug companies.

“Dr. Langston’s concern about the safety of marijuana is without scientific foundation. Marijuana is remarkably non-toxic. There are one to two thousand fatalities a year in the U.S. from aspirin and more than 7000 from NSAIDs like ibuprophen. There has not been a single overdose death from marijuana anywhere in the world.

“Cannabis was a perfectly legal drug until 1937 and in my view when it reclaims its rightful place in the U.S. pharmacopeia it will be among the safest medications in that compendium. I believe it should be treated as an over-the-counter medication and the patient should be allowed to determine his or her own dosage.”