Pubdate: Sun, 03 Apr 2005
Source: Contra Costa Times (CA)
Copyright: 2005 Knight Ridder
Contact:  http://www.contracostatimes.com/
Details: http://www.mapinc.org/media/96
Author: Dan Hurley
Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal)
Bookmark: http://www.mapinc.org/people/Angel+Raich (Angel Raich)

MEDICINAL BENEFITS OF MARIJUANA STILL HAZY

Medical marijuana is now legal in 11 states, and bills to legalize it
are pending in at least seven more.

The drug is also at the heart of a case being considered by the U.S.
Supreme Court.

Yet there remains much confusion over whether marijuana in fact has
any significant medical effect.

"People subjectively report benefits," said Dr. Joseph Sirven, an
epilepsy specialist and associate professor of neurology at the Mayo
Clinic College of Medicine in Scottsdale, Ariz.

"There's a whole Internet literature suggesting what a wonderful thing
it is. But the reality is, we don't know."

In an editorial last year in the journal Neurology, Sirven said the
best studies of marijuana's effects on humans so far have shown little
objective evidence of benefit in patients with epilepsy or multiple
sclerosis.

And a growing body of research indicates that, at least in teenagers,
heavy marijuana use over a period of years significantly increases the
risk of developing psychosis and schizophrenia.

In the Supreme Court case, two California residents, Angel McClary
Raich and Diane Monson, brought a suit against federal officials in
October 2002 to defend their use of marijuana after six of Monson's
marijuana plants were seized and destroyed by the Drug Enforcement
Administration.

The federal government, which considers marijuana illegal under the
Controlled Substances Act, asked the Supreme Court to overturn a Court
of Appeals ruling that supported the two women.

Oral arguments were heard just after Thanksgiving and a ruling could
come any day.

Raich's physician, Dr. Frank Henry Lucido of Berkeley, asserted in an
affidavit that Raich risked death if she was denied the marijuana to
treat nausea, anorexia, severe chronic pain and other disorders
brought on by a variety of illnesses, including post-traumatic stress
disorder, asthma and an inoperable brain tumor.

On a Web site created on her behalf, http://www.angeljustice.org, Raich says
she joined the lawsuit "in order to save my life."

Although little scientific evidence supports such a lifesaving role
for marijuana, many studies have found modest benefits in patients'
subjective measures of pain, sleep, nausea, appetite, tremors and
muscle spasms.

"There's nothing better for nerve pain than marijuana," said Phillip
Alden, 41, a writer in Redwood City.

Twice a month, he spends about $200 to buy a half-ounce of
high-potency marijuana from one of San Francisco's medical marijuana
buyers' clubs.

He smokes it three or more times a day to treat pain from a back
injury and to improve his appetite and reduce nausea associated with
AIDS and the antiviral drugs he takes for it.

It has even checked the progression of his peripheral neuropathy, he
said.

Two recent surveys published in Neurology have documented widespread
use of marijuana among Canadian patients and a widespread belief in
its benefits.

The first survey, of 220 patients with multiple sclerosis, found that
36 percent had used marijuana to treat their symptoms and that 14
percent were using it at the time of the survey.

The second, of 136 patients attending the University of Alberta
Epilepsy Clinic, found that 21 percent had used marijuana in the
previous year.

Just more than two-thirds of the active users said it decreased the
severity of their seizures and slightly more than half reported a
decreased frequency of seizures.

But the lead author of the epilepsy study said it proved only that
some patients believed in marijuana, not that it or its active
ingredients, called cannabinoids, actually worked.

"There's not been a randomized, controlled trial demonstrating that
marijuana or any cannabinoid is any more effective in controlled
seizures than a placebo," said Dr. Donald Gross, director of the
University of Alberta's adult epilepsy program.

Although doctors may now prescribe marijuana in Canada for certain
disorders, including epilepsy, Gross said he had never done so.

"It's terribly complicated from a physician's standpoint, and somewhat
frustrating," he said. "We have a product that has been legitimized
without any evidence of efficacy."

A large body of research in test tubes and animals supports the view
that cannabinoids have anticonvulsive properties.

But while a 2003 study of 657 patients with MS published in the
journal Lancet found significant improvements in subjective reports of
muscle spasms and pain, it found no improvement by objective measures
after 15 weeks.

A follow-up report on the same group of patients did show modest
benefit after 12 months, but the researchers said the results should
be interpreted cautiously because the study had been intended to test
only short-term benefits.

Dr. David Baker, a professor at the Institute of Neurology in London,
has found beneficial effects of cannabinoids in mice who have an
artificially induced type of multiple sclerosis.

But, he said, "Showing clinical benefit in humans has been an elusive
beast."

"At best, there is a narrow therapeutic effect before the side effects
become unacceptable for many people," he said.

"What is clear is that there have been no dramatic improvements
overall."

Research in the United States has been greatly hampered by legal
restrictions.

In 1997, Dr. Donald Abrams, an oncologist and assistant director of
the Positive Health Program at UC San Francisco, became the first
doctor authorized by the National Institute of Drug Abuse to receive
marijuana to conduct research to determine if it provided medical benefits.

Now more than a dozen California researchers are studying it under the
auspices of the University of California's Center for Medicinal
Cannabis Research.

"Cannabis has a 5,000-year history of medical use," Abrams
said.

He said he had completed three studies in patients with HIV that
showed no negative effects on their immune systems or on the
functioning of the protease inhibitor drugs they were taking.

He is now trying to show that marijuana has a beneficial effect on
immune functioning, he said.
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MAP posted-by: Larry Seguin