Pubdate: Sun, 20 Mar 2011
Source: Record, The (Stockton, CA)
Copyright: 2011 The Record
Author: Dana M. Nichols
Bookmark: (California)


SAN ANDREAS - Several dozen medical marijuana patients and caregivers 
gathered on a recent week night for a two-hour seminar at Forgotten 
Knowledge Collective in Valley Springs.

After giving them an overview of the biology and science behind 
medical pot, biochemist Samantha Miller turned to one of the biggest 
questions facing the medical marijuana movement: to smoke or not to smoke.

Miller urges medical marijuana patients to cast off their butane lighters.

"When you are smoking, you are losing some of your active ingredient 
to combustion," Miller said.

And then there's the lung irritation that comes from inhaling butane 
and the jagged soot from burning plant matter at about 1,200 degrees.

Alternatives to smoking include edible forms of the drug, skin 
patches and tinctures that use alcohol or glycerine solutions to 
deliver the active compounds. One of the most popular, however, is 
the use of devices that vaporize the active ingredients in marijuana 
without burning it.

"Smoking it is not good for you, OK?" said Dr. Stacey Kerr, a Santa 
Rosa physician and a member of the Society of Cannabis Clinicians.

She advises patients to seek other methods. "The least they need to 
do is to use a vaporizer if they are going to inhale."

Vaporizers are not cheap. The devices can cost $200 or more and can 
be tricky for first-time users to operate. Also, medical marijuana 
users accustomed to smoking often initially report that vaporizing 
does not seem to yield the same benefits.

Miller acknowledged that. "The effects you are going to feel, the 
high, is going to be different than when you smoke," she said.

The active compounds in marijuana vaporize at relatively low temperatures.

A study by Dr. Donald Abrams at the University of California, San 
Francisco, concluded that vaporizing is a "safe mode of delivery" and 
that participants in the study came to prefer it.

One advantage to both smoking and vaporizing is that patients can 
gradually consume the medication, which enters the bloodstream almost 
instantly, until reaching the appropriate dose.

Eaten marijuana, in contrast, is difficult to dose accurately, 
experts say. Not only does the eaten form take effect more slowly, 
but the breakdown of marijuana compounds in the liver can actually 
transform THC into a more potent psychoactive material.

"That is many times more psychoactive than the original form," said 
Kerr. "This has made people afraid to eat it. You eat it once, (and 
get) too much, and you never want to eat it again."

Another option available so far in the United Kingdom and Canada, but 
not the United States, is a preparation called Sativex, manufactured 
by GW Pharmaceuticals. Sativex is an extract from marijuana plants 
that contains precise amounts of THC and CBD, as well as small 
amounts of many other compounds in the plant.

Sativex comes as an oral spray. If a patient pumps the spray once he 
or she will get exactly 2.7 milligrams of THC and 2.5 milligrams of 
CBD. This level of dose precision is so far almost impossible to 
achieve with smoked, vaporized or eaten marijuana.

Doctors in Britain and Canada typically prescribe Sativex for pain 
and to relieve spasticity associated with multiple sclerosis. 
Clinical trials are now underway that could lead to its approval in 
the United States.
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