Pubdate: Thu, 12 Jan 2017
Source: San Francisco Chronicle (CA)
Copyright: 2017 Hearst Communications Inc.
Author: David Downs


Marijuana and its derivatives can be effective medicines for treating
pain, nausea, vomiting, muscle spasms and other conditions, but cannabis
is not harmless, and more research is needed, the nation's top scientists
concluded in a landmark review of research released Thursday.

The nonprofit National Academies of Sciences, Engineering and Medicine
issued their report, "The Health Effects of Cannabis and Cannabinoids,"
summarizing the current state of evidence for the efficacy of medical
marijuana and recommending new studies.

The 395-page report will stand as the most official medical review of the
botanical drug, which an estimated 8 percent of Americans used in the last

Broken down marijuana plants sit in bags before being trimmed at Tim
Blake's farm Laytonville California, Friday, November 13, 2015.

Brandy Turnbull displays a jar of medicinal marijuana buds at the Buddha's
Pantry booth during the Hempcon Cannabis Festival at the Cow Palace in
Daly City, Calif. on Saturday, April 16, 2016.

Chief among the peer-reviewed findings, the scientists criticized
cannabis' placement atop the U.S. government's list of dangerous,
medically useless drugs.

Even though marijuana has no lethal overdose level, the federal government
ranks marijuana as "Schedule 1" - above prescription opioids like Vicodin
and OxyContin that were linked to more than 180,000 deaths from 1999 to

Cannabis' Schedule 1 designation is a regulatory barrier that "impedes the
advancement of ... research," the study found. "It is often difficult for
researchers to gain access to the quantity, quality, and type of cannabis
product necessary to address specific research questions on the health
effects of cannabis use."

The report is likely to increase pressure on lawmakers to reschedule
marijuana. The drug, the study found, does have medical uses.

"Conclusive or substantial evidence" confirms cannabis can treat chronic
pain, nausea, vomiting, and multiple sclerosis spasticity. There is
moderate evidence cannabis can improve sleep, and limited evidence pot or
its derivatives can help manage post-traumatic stress disorder and

"Our government should de-schedule marijuana," said Berkeley-based
physician Dr. Frank Lucido, who specializes in medicinal cannabis.

The National Academies commissioned and released the study, which updates
their highly cited 1999 medical review, in reaction to the rapid expansion
of medical and adult-use pot laws in America.

Twenty-eight states and Washington D.C. have legalized cannabis for
medical conditions. Eight states and Washington D.C. have legalized
recreational use. More than 22 million Americans are thought to have used
pot in the last month.

"The growing acceptance, accessibility, and use of cannabis raise
important public health concerns and there is a clear need to establish
what is known and what needs to be known about the health effects of
cannabis use," the report stated.

The review began in March 2016 and involved 16 experts, including UCSF
oncologist Dr. Donald Abrams. The study was paid for by federal, state,
philanthropic and nongovernmental organizations. The committee considered
more than 10,700 abstracts and arrived at nearly 100 different research

"This is a pivotal time in world of cannabis policy and research. Shifting
public sentiment, conflicting and impeded scientific research, and
legislative battles have fueled the debate about what, if any, harms or
benefits can be attributed to the use of cannabis or its derivatives," the
study said.

The report undermines many critics of legalization. Unlike with legal
tobacco or alcohol, studies show cannabis does not cause lung, head or
neck cancer, the report found.

But the report also diminishes some claims of medical marijuana advocates,
finding, for instance, that there is not sufficient evidence cannabis or
its compounds can treat cancer, epilepsy, or schizophrenia.

The study found "limited evidence" of a link between current, frequent or
chronic cannabis smoking and a highly curable type of testicular cancer.

Cannabis can also be hard on the circulatory system and there is "limited
evidence" of a link between pot smoking and heart attack, or stroke.

Cannabis is a mixed bag, in many respects. Pot smokers have less risk of
diabetes, but increased risk of pre-diabetes.

Long-term cannabis smoking can cause more frequent bronchitis, but can
improve airways and lung volume, the report said. Pot does not appear to
cause asthma or airway obstruction disease. There's no evidence using pot
increases mortality or occupational accidents.

Maternal cannabis smoking could be linked to lower birth weight, the
review finds, but there is little evidence it causes pregnancy
complications or later negative outcomes in offspring.

The scientists found some evidence of a link between pot use and certain
mental health conditions like depression, but also moderate evidence that
there's no link between cannabis use and the worsening of negative
symptoms of schizophrenia.

The study also buttresses calls for age restrictions on legal cannabis
use. Scientists are pretty sure smoking weed when you're young is a risk
factor for developing "problem cannabis use."

Pot also might be a gateway drug to tobacco use, limited evidence shows.
There's moderate evidence of a link between pot use and developing
problems with other substances, but it's not clear if marijuana use is the
cause or merely correlated.

The study highlights the need to change federal law with regard to
cannabis' Schedule 1 designation and its illegality, said Amanda Reiman,
the marijuana law and policy manager for the pro-legalization Drug Policy

"The calls for science end up getting swallowed up by the politicization
of pot," she said. "This tidal wave of scientific support hits this huge
political wall - like that ice wall in 'Game of Thrones.'"

Arizona physician Dr. Sue Sisley, who has tried for years to get federal
approval to study cannabis' impact on post-traumatic stress disorder, said
"it's unsurprising" the National Academies failed to find evidence
cannabis can treat cancer or epilepsy.

"The federal government has systematically impeded efficacy studies," she

Dr. Lucido said the review appears generally accurate, but was clearly
limited by federal research barriers. "I certainly have enough patients
with Tourette's who benefit from (marijuana)," he said. "For anxiety, it
definitely helps some people, but for others it's not so useful.

"For epilepsy, it's a slam dunk," he said. "That definitely helps. I've
seen over 100 kids with seizure or autism, and a lot of them are doing
much better with cannabis than multiple harmful medications in the past.
It doesn't work for everybody, but it's been miraculous for some of the

He said he has seen "a number of people who can stay off addictive drugs
and alcohol by using cannabis - but it's not for everybody."

The review refutes critics' claim that there's not enough research to
support pot decriminalization or legalization, said Paul Armentano, deputy
director of the National Organization for the Reform of Marijuana Laws.

When cannabis was made Schedule 1 in 1970, there were fewer than 400
scientific papers, he said. Today, he counts 24,000 related citations, far
more than for opioids like hydrocodone or the stimulant Adderall or the
over-the-counter pain reliever ibuprofen - all of which are given to

"Over and over again we're told, 'We don't know enough, there's not
adequate science, we don't have the data.' The focus ought to be on the
data we do have and do know," Armentano said.

"The hope is that it encourages pundits and policy-makers to focus on the
science and move forward with public policies that comport with the
available evidence," he said. "That has not happened in the past but we're
hopeful that the publication of this report may encourage lawmakers to act
different in the future."
- ---
MAP posted-by: