Pubdate: Wed, 06 Jul 2005
Source: Anderson Valley Advertiser (CA)
Column: Cannabinotes
Copyright: 2005 Anderson Valley Advertiser
Author: Fred Gardner
Bookmark: (Cannabis - California)
Bookmark: (Cannabis - Medicinal)
Cited: Gonzales v. Raich ( )


Protective Effect "Not Unreasonable"

Marijuana smoking -"even heavy longterm use"- does not cause cancer of the 
lung, upper airways, 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, 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-airways 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 years that number smoked). 
Controls were found based on age, gender and neighborhood. Among them, 46% 
had never used marijuana, 31% had used for less than one joint year, 12% 
had used for 1-10 j-yrs, 5% had used 10-30 j-yrs, 2% had used for 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 airways cancers. A relative risk 
ratio of .72 means that for every 100 non-users who get lung cancer, only 
72 people who smoke get lung cancer. All the odds ratios in Tashkin's study 
turned out to be less than one!  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 [according to the abstract book and .66 according to notes from 
the talk] .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, it almost 
looked like there was a negative correlation, i.e., a protective effect. 
Could you comment on that?" [Abrams was referring to Tashkin's lung-cancer 
data for marijuana-only smokers, 1-10 j-yrs.]

"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.

After Abrams's presentation, a questioner bemoaned the difficulty of 
"separating the high from the clinical benefits." Abrams responded: "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. Medical student 
Sunil Aggarwal, 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 California...

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, 
June 22, 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 more than 1,000 marijuana plants. 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. The alleged leader, Vince 
Ming Wan, is one of several defendants who have not yet been apprehended or 
turned themselves in.

Three men -Enrique Chan, Richard Wong, and Thy Quang Nguyen-were also 
charged with intent to sell ecstasy. (An undercover agent allegedly had 
purchased 1,000 tabs from Chan. During the raids on 26 locations, a total 
of 50 tabs were found on one individual.) Wong and Phat Van Vuong were also 
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 Wong was set at $2 million.

Former district attorney Terence Hallinan is representing Sergio Alvarez, 
who hired him months ago after police raided a Hunters Point warehouse 
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, 
from 'String 'em up by their pigtails' to restricting them to the ghetto of 

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.

The Inner Sunset

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 streeeeet

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: Jay Bergstrom