Pubdate: Sat, 02 Jul 2005
Source: CounterPunch (US Web)
Column: Pot Shots
Copyright: 2005 CounterPunch
Author: Fred Gardner
Cited: International Cannabinoid Research Society
Cited: Center for Medicinal Cannabis Research
Cited: California Cannabis Research Medical Group
Bookmark: (Marijuana)
Bookmark: (Marijuana - Medicinal)
Bookmark: (Chronic Pain)
Bookmark: (GW Pharmaceuticals)


Marijuana smoking -"even heavy longterm use"- does not cause cancer 
of the lung, upper airwaves, or esophagus, Donald Tashkin reported at 
this year's meeting of the International Cannabinoid Research 
Society. Coming from Tashkin, this conclusion had extra significance 
for the assembled drug-company and university-based scientists (most 
of whom get funding from the U.S. National Institute on Drug Abuse). 
Over the years, Tashkin's lab at UCLA has produced irrefutable 
evidence of the damage that marijuana smoke wreaks on bronchial 
tissue. With NIDA's support, Tashkin and colleagues have identified 
the potent carcinogens in marijuana smoke, biopsied and made 
photomicrographs of pre-malignant cells, and studied the molecular 
changes occurring within them. It is Tashkin's research that the Drug 
Czar's office cites in ads linking marijuana to lung cancer. Tashkin 
himself has long believed in a causal relationship, despite a study 
in which Stephen Sidney examined the files of 64,000 Kaiser patients 
and found that marijuana users didn't develop lung cancer at a higher 
rate or die earlier than non-users. Of five smaller studies on the 
question, only two -involving a total of about 300 patients- 
concluded that marijuana smoking causes lung cancer. Tashkin decided 
to settle the question by conducting a large, prospectively designed, 
population-based, case-controlled study. "Our major hypothesis," he 
told the ICRS, "was that heavy, longterm use of marijuana will 
increase the risk of lung and upper-airwaves cancers."

The Los Angeles County Cancer Surveillance program provided Tashkin's 
team with the names of 1,209 L.A. residents aged 59 or younger with 
cancer (611 lung, 403 oral/pharyngeal, 90 laryngeal, 108 esophageal). 
Interviewers collected extensive lifetime histories of marijuana, 
tobacco, alcohol and other drug use, and data on diet, occupational 
exposures, family history of cancer, and various "socio-demographic 
factors." Exposure to marijuana was measured in joint years (joints 
per day x 365). Controls were found based on age, gender and 
neighborhood. Among them, 46% had never used marijuana, 31% had used 
less than one joint year, 12% had used 10-30 j-yrs, 2% had used 30-60 
j-yrs, and 3% had used for more than 60 j-yrs. Tashkin controlled for 
tobacco use and calculated the relative risk of marijuana use 
resulting in lung and upper airwaves cancers. All the odds ratios 
turned out to be less than one (one being equal to the control 
group's chances)! Compared with subjects who had used less than one 
joint year, the estimated odds ratios for lung cancer were .78; for 
1-10 j-yrs, .74; for 10-30 j-yrs, .85 for 30-60 j-yrs; and 0.81 for 
more than 60 j-yrs. The estimated odds ratios for oral/pharyngeal 
cancers were 0.92 for 1-10 j-yrs; 0.89 for 10-30 j-yrs; 0.81 for 
30-60 j-yrs; and 1.0 for more than 60 j-yrs. "Similar, though less 
precise results were obtained for the other cancer sites," Tashkin 
reported. "We found absolutely no suggestion of a dose response." The 
data on tobacco use, as expected, revealed "a very potent effect and 
a clear dose-response relationship -a 21-fold greater risk of 
developing lung cancer if you smoke more than two packs a day." 
Similarly high odds obtained for oral/pharyngeal cancer, laryngeal 
cancer and esophageal cancer. "So, in summary" Tashkin concluded, "we 
failed to observe a positive association of marijuana use and other 
potential confounders."

There was time for only one question, said the moderator, and San 
Francisco oncologist Donald Abrams, M.D., was already at the 
microphone: "You don't see any positive correlation, but in at least 
one category [marijuana-only smokers and lung cancer], it almost 
looked like there was a negative correlation, i.e., a protective 
effect. Could you comment on that?"

"Yes," said Tashkin. "The odds ratios are less than one almost 
consistently, and in one category that relationship was significant, 
but I think that it would be difficult to extract from these data the 
conclusion that marijuana is protective against lung cancer. But that 
is not an unreasonable hypothesis."

Abrams had results of his own to report at the ICRS meeting. He and 
his colleagues at San Francisco General Hospital had conducted a 
randomized, placebo-controlled study involving 50 patients with 
HIV-related peripheral neuropathy. Over the course of five days, 
patients recorded their pain levels in a diary after smoking either 
NIDA-supplied marijuana cigarettes or cigarettes from which the THC 
had been extracted. About 25% didn't know or guessed wrong as to 
whether they were smoking the placebos, which suggests that the 
blinding worked. Abrams requested that his results not be described 
in detail prior to publication in a peer-reviewed medical journal, 
but we can generalize: they exceeded expectations, and show marijuana 
providing pain relief comparable to Gabapentin, the most widely used 
treatment for a condition that afflicts some 30% of patients with HIV.

To a questioner who bemoaned the difficulty of "separating the high 
from the clinical benefits," Abrams replied: "I'm an oncologist as 
well as an AIDS doctor and I don't think that a drug that creates 
euphoria in patients with terminal diseases is having an adverse 
effect." His study was funded by the University of California's 
Center for Medicinal Cannabis Research.

* * *

The 15th annual meeting of the ICRS was held at the Clearwater, 
Florida, Hilton, June 24-27. Almost 300 scientists attended. R. 
Stephen Ellis, MD, of San Francisco, was the sole clinician from 
California. Los Angeles Farmacy operator Mike Ommaha and 
therapist/cultivator Pat Humphrey showed up to audit the 
proceedings... Some of the younger European scientists expressed 
consternation over the recent U.S. Supreme Court ruling and the vote 
in Congress re-enforcing the cannabis prohibition. "How can they 
dispute that it has medical effect?" an investigator working in 
Germany asked us earnestly. She had come to give a talk on "the role 
of different neuronal populations in the pharmacological actions of 
delta-9 THC." For most ICRS members, the holy grail is a legal 
synthetic drug that exerts the medicinal effects of the prohibited 
herb. To this end they study the mechanism of action by which the 
body's own cannabinoids are assembled, function, and get broken down. 
A drug that encourages production or delays dissolution, they figure, 
might achieve the desired effect without being subject to "abuse..." 
News on the scientific front included the likely identification of a 
third cannabinoid receptor expressed in tissues of the lung, brain, 
kidney, spleen and smaller branches of the mesenteric artery. 
Investigators from GlaxoSmithKline and AstraZeneca both reported 
finding the new receptor but had different versions of its 
pharmacology. It may have a role in regulating blood pressure.

Several talks and posters described the safety and efficacy of 
Sativex, G.W. Pharmaceuticals' whole-plant extract containing high 
levels of THC and CBD (cannabidiol) formulated to spray in the mouth. 
G.W. director Geoffrey Guy seemed upbeat, despite the drubbing his 
company's stock took this spring when UK regulators withheld 
permission to market Sativex pending another clinical trial. Canada 
recently granted approval for doctors to prescribe Sativex, and five 
sales reps from Bayer (to whom G.W. sold the Canadian marketing 
rights) are promoting it to neurologists. Sativex was approved for 
the treatment of neuropathic pain in multiple sclerosis, but can be 
prescribed for other purposes as doctors see fit.

A more detailed report on the ICRS meeting will appear in the 
upcoming issue of O'Shaughnessy's, a journal put out by California's 
small but growing group of pro-cannabis doctors. To get on the 
mailing list, send a contribution of any amount to the CCRMG 
(California Cannabis Research Medical Group) at p.o. box 9143, 
Berkeley, CA 94709. It's a 501c3 non-profit and your correspondent's 
main source of income.

Meanwhile, Back in San Francisco...

The California contingent was en route to the ICRS meeting when 
Marian Fry, M.D. and her husband, attorney Dale Schafer, were 
arrested on federal charges of conspiring to provide marijuana to a 
patient. On the same day, three San Francisco cannabis clubs were 
raided by the DEA and 19 people -all Asians and a few Latinos- 
charged with conspiracy to cultivate and distribute marijuana. 
Affidavits allege that they grew cannabis in rented houses in S.F., 
the East Bay and the Peninsula for sale to dispensaries and on the 
black market. Three men were charged with intent to sell ecstasy. (An 
undercover agent allegedly had purchased 1,000 tabs from a man named 
Enrique Chan. During the raids on 26 locations, a total of 50 tabs 
were found on one individual.) The two alleged ringleaders, Richard 
Wang and Vincent Wan, were charged with money laundering. Defense 
lawyers say the alleged money laundering consisted of using 
dispensary proceeds to underwrite the grow ops. At a July 1 detention 
hearing, bail for Wang was set at $2 million. Wan has not yet been 
apprehended or turned himself in.

Former district attorney Terence Hallinan is representing Sergio 
Alvarez, who hired him several months ago after police raided a house 
in the Sunset district where Alvarez was allegedly cultivating 
marijuana. "I didn't know at the time that that would become part of 
a conspiracy case," Hallinan said after the detention hearing. 
Alvarez's bail was set at $500,000; his working-class parents are 
putting up their modest Sunnyvale home as surety. Hallinan says that 
every cannabis dispensary has links to a network of growers, and that 
the decision to take down these three was an attempt to exploit 
anti-Asian sentiment. "They asked themselves, 'Who will we start with 
now that we've been given permission [by the U.S. Supreme Court's 
ruling in the Raich case]? Let's go after the Chinese!' San Francisco 
has more than a hundred-year history of anti-Chinese attitudes and 
policies." Contemporary resentments towards Asians in San Francisco 
center around their apparent economic successes. It's an impossibly 
expensive housing market, and one occasionally hears non-Asians say, 
with mixed admiration and envy, things like: "How can they arrive 
from Hong Kong in 1995 and buy a house in the Sunset in 1996?" The 
answer is: by pooling resources (conspiring) with friends and family 
to make the down payment.


I used to have the real estate knack

But all that I gaineth, I giveth back

Only to wind up with you in this cozy

Old shack in the Inner Sunset years


Obviously I did everything wrong

Except one or two that strung me along

The road to the club called Chez Nancy Wong

A shack in the Inner Sunset years


Where there's noodles at midnight

If you are in need of a treat

Where the Judah car makes an 'N'

'n careens down the street


I still believe that it's all within reach

A big enough place between here and the beach

And from each and according to each

A shack in the sunset in the sunset years


The blood orange sunset years

The cool gray sunset years 
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MAP posted-by: Richard Lake