Pubdate: Wed, 06 Nov 2013
Source: International New York Times (International)
Copyright: 2013 The New York Times Company
Note: Was International Herald-Tribune until Nov. 2013
Author: Jane E. Brody


U.S. Legal Classification Prevents Exploring Many Promising Elements

Marijuana has been used medically, recreationally and spiritually for 
about 5,000 years. Known botanically as cannabis, it has been called 
a "crude drug": marijuana contains more than 400 chemicals from 18 
chemical families. More than 2,000 compounds are released when it is 
smoked, and as with tobacco, there are dangers in smoking it.

Medical marijuana clinics operate in 20 states and the District of 
Columbia, and its recreational use is now legal in Colorado and 
Washington. A Gallup poll conducted last month found that 58 percent 
of Americans support the legalization of marijuana.

Yet researchers have been able to do relatively little to test its 
most promising ingredients for biological activity, safety and side 
effects. The main reason is marijuana's classification by Congress in 
1970 as an illegal Schedule I drug, defined as having a potential for 
abuse and addiction and no medical value.

American scientists seeking clarification of marijuana's medical 
usefulness have long been stymied by this draconian classification, 
usually reserved for street drugs like heroin with a high potential for abuse.

J. Michael Bostwick, a psychiatrist at the Mayo Clinic in Rochester, 
Minn., said the classification was primarily political and ignored 
more than 40 years of scientific research, which has shown that 
cellular receptors for marijuana's active ingredients are present 
throughout the body. Natural substances called cannabinoids bind to 
them to influence a wide range of body processes.

In a lengthy report entitled "Blurred Boundaries: The Therapeutics 
and Politics of Medical Marijuana," published last year in Mayo 
Clinic Proceedings, Dr. Bostwick noted that the so-called 
endocannabinoid system has an impact on the "autonomic nervous 
system, immune system, gastrointestinal tract, reproductive system, 
cardiovascular system and endocrine network."

There is evidence that several common disorders, including epilepsy, 
alcoholism and post-traumatic stress disorder, involve disruptions in 
the endocannabinoid system, suggesting that those patients might 
benefit from marijuana or its ingredients.

The strongest evidence for the health benefits of medical marijuana 
or its derivatives involves the treatment of chronic neuropathic pain 
and the spasticity caused by multiple sclerosis. Medical marijuana is 
widely recognized as effective against nausea and appetite loss 
caused by chemotherapy, though better treatments are now available.

But preliminary research and anecdotal reports have suggested that 
marijuana might be useful in treating a number of other conditions, 
including irritable bowel syndrome, Crohn's disease, glaucoma, 
migraine, cancer growth, abnormal heart rhythms, Alzheimer's disease, 
fibromyalgia, incontinence, bacterial infections, osteo-porosis, 
intense itching, Tourette's syndrome and sleep apnea.

"Medical experts emphasize the need to reclassify marijuana as a 
Schedule II drug to facilitate rigorous scientific evaluation of the 
potential therapeutic benefits of cannabinoids and to determine the 
optimal dose and delivery route for conditions in which efficacy is 
established," Diane E. Hoffmann and Ellen Weber, legal experts at the 
University of Maryland, wrote in The New England Journal of Medicine.

Marijuana's best-known ingredient, tetrahydrocannabinol, or THC, is 
responsible for the high sought by recreational users. But many 
people who try smoking marijuana to relieve a health problem are 
distressed by its psychoactive effects.

Experts believe that some people would do better with a derivative of 
marijuana that offers therapeutic action without the mind-altering 
baggage. A more precise dose, free of unwanted contaminants, would be 
safer, and its effects would be reproducible.

"We believe that physicians should clearly explain to their patients 
that medical marijuana is not approved by the Food and Drug 
Administration and that it is not a standardized or purified 
product," Herbert D. Kleber of Columbia University and Robert L. 
Dupont of Georgetown Medical School wrote last year in The American 
Journal of Psychiatry.
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