Pubdate: Sun, 21 Apr 2013
Source: Herald, The (Everett, WA)
Copyright: 2013 Bloomberg News
Contact:  http://www.heraldnet.com/
Details: http://www.mapinc.org/media/190
Page: A10

MARIJUANA RESEARCH CUT AS SUPPORT GROWS

SAN FRANCISCO - As more states embrace legalized marijuana, the 
drug's growing medicinal use has highlighted a disturbing fact for 
doctors: scant research exists to support marijuana's health benefits.

Smoked, eaten or brewed as a tea, marijuana has been used as a 
medication for centuries, including in the United States, where Eli 
Lilly sold it until 1915. The drug was declared illegal in 1937, 
though its long history has provided ample anecdotal evidence of the 
plant's potential medicinal use. Still, modern scientific studies are lacking.

What's more, the federal government is scaling back its research 
funding. U.S. spending has dropped 31 percent since 2007 when it 
peaked at $131 million, according to a National Institutes of Health 
research database. Last year, 235 projects received $91 million of 
public funds, according to NIH data.

That's left the medical community in a bind: current literature on 
the effects of medical cannabis is contradictory at best, providing 
little guidance for prescribing doctors.

"What's happening in the states is not related to science at all," 
said Donald Vereen, a former adviser to the last three directors of 
the National Institute on Drug Abuse.

"It's difficult to get good information," said Beau Kilmer, 
co-director of RAND Corp.'s drug policy research center. Kilmer is 
also part of a group selected to advise the state of Washington on 
its legalization effort.

Two states, Washington and Colorado, have fully legalized the drug, 
18 states allow its use for medical reasons and 17, including New 
York, have legislation pending to legalize it.

Vereen, the NIDA adviser, says that most doctors' and policymakers' 
knowledge on the subject stems from a 1999 report from the Institute 
of Medicine, an independent nonprofit that serves to provide 
information about health science for the government. The group summed 
up its findings saying cannabis appeared to have benefits, though the 
drug's role was unclear.

The IOM report recommended clinical trials of cannabinoid drugs for 
anxiety reduction, appetite stimulation, nausea reduction and pain 
relief. It also found that the brain develops tolerance to marijuana 
though the withdrawal symptoms are "mild compared to opiates and 
benzodiazapines."

"We don't know that much more than what's in that report," said Vereen.

Vereen, for one, says marijuana's effects on pain without the 
withdrawal symptoms associated with other medications are deserving 
of further study to develop better pain drugs.

Subsequent research suggests marijuana may help stimulate appetite in 
chemotherapy and AIDS patients, help improve muscle spasms in 
multiple sclerosis patients, mitigate nerve pain in those with 
HIV-related nerve damage and reduce depression and anxiety. It's even 
been suggested that an active ingredient, THC, may prevent plaques in 
the brain associated with Alzheimer's, according to a 2006 study by 
the Scripps Research Institute.

Still, fewer than 20 randomized controlled trials, the gold standard 
for clinical research, involving only about 300 patients have been 
conducted on smoked marijuana over the last 35 years, according to 
the American Medical Association, the U.S.'s largest doctor group.

A few small companies are trying to tap into an emerging market for 
marijuana therapies, which could exceed $1 billion in California 
alone, according to Mickey Martin, director of T-Comp Consulting in 
Oakland, Calif., which advises people who want to set up their own 
cannabis businesses.

His model of about 750,000 cannabis patients found that the estimated 
spending from California's patient population is $1.1 billion, 
including $56 million in doctors' fees and about $1 billion in 
medicine. That assumes roughly two-thirds of the patient population 
will pay $40 a week for medication, Martin said. Cannabis Science 
Inc., CannaVest Corp., and Medical Marijuana Inc. are among a handful 
of companies developing drugs based on cannabis research or medical 
marijuana itself.

Until more laws change, it will be difficult to study an illegal 
substance with the goal of turning it into a medication, researchers 
say. And since it's illegal to grow, marijuana isn't subjected to the 
rigorous quality control most medicines are, raising concerns 
patients may be at risk from contaminants, said Vereen.

Marijuana advocates point out inherent obstacles to conducting 
research: the National Institute on Drug Abuse controls all the 
cannabis used in approved trials, but the agency's mandate is to 
study abuse of drugs, not health benefits.

This creates dilemmas. The Food and Drug Administration, for 
instance, has approved a clinical trial studying whether marijuana 
can relieve symptoms of post-traumatic stress disorder. The trial, 
however, which is in the second of three stages of clinical testing, 
is blocked. NIDA, which controls the legal testing supply of the drug 
grown at a University of Mississippi farm, has refused to supply the 
researchers with marijuana.

"NIDA is under a mandate from Congress to find problems with 
marijuana," said Bob Melamede, CEO of Cannabis Science Inc., a 
Colorado Springs, Colo.-based company that develops medicines derived 
from marijuana. "If you want to run a study to show it cures cancer, 
they will not provide you with marijuana," he said. "What you cannot 
do are the clinical studies that are necessary."
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MAP posted-by: Jay Bergstrom