Pubdate: Wed, 24 Jun 2015
Source: Denver Post (CO)
Copyright: 2015 The Denver Post Corp
Author: Ricardo Baca


However, the Drug Has Been Shown to Alleviate Pain From Chemotherapy 
and Multiple Sclerosis.

Despite medical marijuana's unquestionable worldwide momentum, it 
hasn't yet been proven scientifically to remedy most of the 
conditions governments have authorized it to treat, according to an 
influential new analysis of existing research.

While pro-legalization advocates don't disagree with the analysis' 
findings, they point out that the barriers to legitimate research on 
cannabis' medical efficacy have been so substantial in the U.S. that 
President Barack Obama's administration this week slashed some of 
those bureaucratic hurdles in a historic action - and yet marijuana 
still remains more difficult to study than cocaine or heroin.

The new compendium's findings, published in the Journal of the 
American Medical Association on Tuesday, are based on 79 trials 
involving nearly 6,500 participants. The analysis found that 
marijuana helps with some ailments, but its efficacy regarding most 
related conditions is unproven - a finding that didn't surprise the 
chief medical officer of Colorado, where medical pot was legalized in 2000.

"It's pretty consistent with our take and our observations within 
CDPHE and within the state," said Larry Wolk, executive director of 
the Colorado Department of Public Health and Environment. "We all 
recognize that we're lacking a bit in credible research, even amongst 
conditions that are deemed appropriate in different states, including 
Colorado, for medical marijuana."

The new analysis shows that medical pot has helped patients with 
severe pain, nausea and vomiting related to chemotherapy and 
spasticity from multiple sclerosis. But when it comes to the numerous 
other qualifying conditions that make up most medical marijuana 
programs, which vary tremendously from state to state and often 
include PTSD, glaucoma, arthritis and Parkinson's disease, the report 
says the evidence isn't there.

Wolk points to the $8 million of grants Colorado's Board of Health 
approved in December 2014 to study the medical efficacy of cannabis 
on childhood epilepsy, PTSD, Parkinson's, inflammatory bowel disease, 
pediatric brain tumors and spine pain.

"(The analysis) absolutely reconfirms the need for this research," Wolk said.

Sue Sisley is one of the researchers working with Colorado's money. 
She and her Arizona-based team's pot-and-PTSD study was awarded $2 
million from the state, but many of the federal-level obstacles she's 
been battling for years still exist - including the National 
Institute on Drug Abuse's monopoly on study drugs, she said.

"The research on the efficacy of marijuana has been systematically 
impeded by the federal government for two decades," Sisley said, 
noting that this week's relaxation of the research review process is 
a small step in the right direction. "That (the analysis' authors) 
are suddenly wanting to call out the lack of science, it's such 
hypocrisy it's sickening."

The analysis represents the most comprehensive review of medical 
marijuana research to date, but that's not saying much, legalization 
advocates say.

Amanda Reiman is a professor of drug and alcohol policy and substance 
abuse treatment at the University of California, and she compares the 
federal government's attitude toward marijuana research to trying to 
ride a bike with your legs tied together and your arms tied behind 
your back while blindfolded.

"Is the clinical evidence there? No," said Reiman, who is also 
manager of marijuana law and policy at the pro-reform Drug Policy 
Alliance. "But it's not for lack of trying.

"Right now we're basing policy on what people are experiencing. Even 
though there might not be randomized controlled trials on marijuana's 
efficacy with PTSD, there are thousands and thousands of (PTSD 
patients) out there who say they wouldn't be alive were it not for 
marijuana. These folks have AIDS and cancer and Crohn's and MS and 
colitis, and they deserve the chance to have a happy, healthy life - 
and we're not going to wait around for the government to allow this research."

Legalization opponent Kevin Sabet said the states' existing medical 
marijuana laws are rooted in marketing, not science.

"Anyone familiar with the literature already knew all this, but of 
course the typical American is listening to 30-second television 
commercials that say 'marijuana cures cancer' and they're not reading 
the Journal of the American Medical Association," said Sabet, who 
leads the anti-legalization group Smart Approaches to Marijuana and 
was in Washington, D.C., this week to testify at the U.S. Senate 
Caucus on International Narcotics Control hearing on Wednesday. "What 
this shows: They have shot over the mark in terms of what they're 
allowing marijuana for.

"States have gone way beyond the compassionate exception for the 
cancer patient with six months to live and allowed it for all sorts 
of conditions where there is no evidence. What we have in the states 
is the result of marijuana lobbying groups and not the result of 
scientific literature. And maybe this (analysis) will reinvigorate 
the science to be reinjected to the conversation."

Because both sides of the legalization conversation agree that more 
research is needed, where do their philosophies split? It's in the 
waiting. The federal government and Sabet's group want to wait and 
see. Legalization activists want to charge ahead with their own 
anecdotal research.

"We're are all for more research, and we applaud the Obama 
administration's move this week," said Tom Angell, chairman of 
advocacy group Marijuana Majority. "But research takes a long time, 
and many patients are suffering right now."

Wolk is somewhere in between on the waiting issue. Wolk wants science 
to lead the conversation surrounding medical pot, and he testified in 
2014 against allowing PTSD on Colorado's list of eligible conditions.

But after the state's Medical Marijuana Scientific Advisory Council 
recommended adding PTSD to the list in April, Wolk will propose the 
addition to the Board of Health in July.

"Based on research and evidence alone, medical marijuana for PTSD 
does not pass muster as far as a credible treatment along the lines 
for what we'd expect from a pharmaceutical," Wolk said. "But there 
are other reasons why adding PTSD to the list of medical marijuana 
conditions might exist."

Wolk said he's heard convincing evidence that some PTSD patients are 
already on the state's medical pot registry, hiding behind different ailments.
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MAP posted-by: Jay Bergstrom