Pubdate: Wed, 01 Jul 2015
Source: East Bay Express (CA)
Column: Legalization Nation
Copyright: 2015 East Bay Express
Author: David Downs


A series of papers in the Journal of the American Medical Association 
is starting to correct the shameful legacy of drug war politics over 
cannabis science. But a research catch-22 persists.

The nation's top medical organization released a major series of 
papers on medical cannabis last week in the Journal of the American 
Medical Association, in a move that constitutes a small step for the 
AMA, but a giant leap in cannabis medical history.

In five key papers, teams of researchers systematically reviewed 
dozens of clinical studies of marijuana, speaking in clear language 
that the "use of marijuana for chronic pain, neuropathic pain, and 
spasticity due to multiple sclerosis is supported by high-quality evidence."

The review validated what doctors and patients in California have 
risked their freedom to say for twenty years. The findings also 
directly refute critics who maintain that "marijuana is not medicine."

"They concluded cannabis is useful," said Dr. Frank Lucido, a 
Berkeley physician who specializes in cannabis. "I don't think a 
single study didn't show benefit. ... I think it was very positive."

"It is somewhat affirming to see this come out," said Clint Werner, 
best-selling author of Marijuana: Gateway to Health. "It's 
invalidating that talking point that 'it's just a Cheech and Chong show.'"

"What's driving this is a tremendous cultural shift that's preceding 
the political shift," said Martin Lee, of author Smoke Signals. The 
AMA is acknowledging "what's been known for 5,000 years."

The AMA actually opposed federal cannabis prohibition in 1937. After 
losing that round, most doctors have toed the Drug War line ever 
since. "It's great that they have finally acknowledged there's some 
medicinal value in cannabis, but the whole thing is so pathetic," Lee said.

Most major news media outlets, however, have spun the JAMA papers 
negatively, embracing the narrative that many uses for medical pot 
are still based on poor science. News reports noted that of one of 
the JAMA studies found that "there was low-quality evidence 
suggesting that cannabinoids were associated with improvements in 
nausea and vomiting due to chemotherapy, weight gain in HIV 
infection, sleep disorders, and Tourette syndrome."

News outlets also pointed to another review that found that "there is 
some evidence to support the use of marijuana for nausea and vomiting 
related to chemotherapy, specific pain syndromes, and spasticity from 
multiple sclerosis. However, for most other indications that qualify 
by state law for use of medical marijuana, such as hepatitis C, Crohn 
disease, Parkinson disease, or Tourette syndrome, the evidence 
supporting its use is of poor quality."

Cannabis experts say the problem with some of the conclusions in the 
JAMA studies, and the reporting about them, is that they fail to own 
up to the main reason why study quality has often been poor: the 
systematic blockade on pot research. For decades, the federal 
government has refused to authorize research on the medical benefits 
of cannabis. As a result, the inconclusiveness of some of the 
research is more a reflection of the federal ban than of the medical 
effectiveness of pot. "You know how incredibly hard it is to do 
research that is intended to confirm benefits of cannabis?" said 
Warner. "It's impossible. We still have a huge catch-22."

Experts also say that the decision by AMA researchers to ignore the 
research blockade shows their bias. "It's a national embarrassment. 
The federal designation that cannabis has no medical value is like 
saying the moon is made of green cheese," Lee said. "It seems the AMA 
can't say, 'No, the moon is not made of green cheese.'"

The AMA researchers also fail to acknowledge the real world benefits 
reported by patients. For example, about one in twenty California 
adults (1.4 million) have used medical cannabis for a "serious" 
condition and 92 percent of them have reported that it worked. "We 
have plenty of evidence that it helps for a lot of things," Lucido 
said. "We should always do more research. But we shouldn't stop 
people from using it in the meantime."

The AMA researchers also listed the side effects of cannabis without 
providing context. "Adverse Effects included dizziness, dry mouth, 
nausea, fatigue, somnolence, euphoria, vomiting, disorientation, and 
hallucination," one of the reports concluded.

But the AMA researchers didn't compare the adverse side effects of 
cannabis to those of competing analgesics and anti-inflammatories. 
Painkiller overdoses are America's leading epidemic. Ibuprofen, for 
example, regularly causes kidney failure. But those facts were not 
mentioned in the JAMA studies. "A full third of the Physician's Desk 
Reference is adverse effects, including death," Lucido said. 
"Cannabis has about ten adverse effects, at least two of which are 
often desired."

The AMA researchers' statements about cannabis addiction also lacked 
context. "I imagine sleeping pills probably have a much bigger 
dependency ratio," Lucido said.

Still, as half-hearted and equivocal as the JAMA papers were, they 
contributed to a rising tide of mainstream validation for cannabis 
that's washing away its prohibition.

"Culturally, the fight is over. We won," Lee said. "The pro-cannabis 
side has conquered the culture. Now politics is catching up."
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MAP posted-by: Jay Bergstrom