Many Teens Who Smoke Marijuana Use It As A Medication

A study BioMed Central’s open access journal Substance Abuse, Treatment, Prevention and Policy has suggested that around a third of teens who smoke marijuana regularly use it as a medication, rather than as a means of getting high.

The research was funded by the Canadian Institutes of Health Research and Joan Bottorff worked with a team of researchers from the University of British Columbia for conducting in-depth interviews with 63 marijuana-using adolescents. Of these, 20 claimed that they used marijuana to relieve or manage health problems.

Bottorff said, “Marijuana is perceived by some teens to be the only available alternative for those experiencing difficult health problems when legitimate medical treatments have failed or when they lack access to appropriate health care.”

The most common complaints recorded were emotional problems like anxiety, depression, stress, and sleep difficulties. The authors said, “Youth who reported they had been prescribed drugs such as Ritalin, Prozac or sleeping pills, stopped using them because they did not like how these drugs made them feel or found them ineffective. For these kids, the purpose of smoking marijuana was not specifically about getting high or stoned”.

It was emphasized by the authors that the unmet medical needs of these teens are of great importance in these gings. Marijuana provided these adolescents with immediate relief for a variety of health concerns in contrast to the unpleasant side effects of prescribed medications and long, ineffective legal therapies.

Reference:
BioMed Central

Medical Marijuana & Chronic Pain

Survey data and several recent FDA-designed chemical trials have indicated that inhaled marijuana could significantly alleviate neuropathic pain. A pair of randomized, placebo-controlled clinical trials had demonstrated that neuropathy in patients with HIV could be reduced with cannabis by more than 30 percent compared to placebo.

A 2007 University of California at San Diego double-blind, placebo-controlled trial reported that inhaled cannabis has the potential of significantly reducing capsaicin-induced pain in healthy volunteers. Both high and low doses of inhaled cannabis reduced neuropathic pain of diverse causes in subjects unresponsive to standard pain therapies, according to a 2008 University of California at Davis double-blind, randomized clinical trial. A 2010 McGill University study has revealed that smoked cannabis significantly improved measures of pain, sleep quality and anxiety in participants with refractory pain for which conventional therapies had failed.

In 2008, investigators at the University of Milan concluded: “[T]he use of a standardized extract of Cannabis sativa … evoked a total relief of thermal hyperalgesia, in an experimental model of neuropathic pain, … ameliorating the effect of single cannabinoids,” investigators concluded. … “Collectively, these findings strongly support the idea that the combination of cannabinoid and non-cannabinoid compounds, as present in [plant-derived] extracts, provide significant advantages in the relief of neuropathic pain compared with pure cannabinoids alone.”

References:
[1] New York Times. October 21, 1994. “Study says 1 in 5 Americans suffers from chronic pain.”
[2] Cone et al. 2008. Urine drug testing of chronic pain patients: licit and illicit drug patterns. Journal of Analytical Toxicology 32: 532-543.
[3] Abrams et al. 2007. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology 68: 515-521.
[4] Ellis et al. 2008. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. Neuropsychopharmacology 34: 672-80.
[5] Wallace et al. 2007. Dose-dependent effects of smoked cannabis on Capsaicin-induced pain and hyperalgesia in healthy volunteers Anesthesiology 107: 785-796.
[6] Wilsey et al. 2008. A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain. Journal of Pain 9: 506-521.
[7] Ware et al. 2010. Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. CMAJ 182: 694-701.
[8] Comelli et al. 2008. Antihyperalgesic effect of a Cannabis sativa extract in a rat model of neuropathic pain. Phytotherapy Research 22: 1017-1024.
[9] Johnson et al. 2009. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety and tolerability of THC: CBD extract in patients with intractable cancer-related pain. Journal of Symptom Management 39: 167-179.
[10] University of San Diego Health Sciences, Center for Medicinal Cannabis Research. February 11, 2010. Report to the Legislature and Governor of the State of California presenting findings pursuant to SB847 which created the CMCR and provided state funding.

Research From USC Involving Medical Marijuana

A study published in the European Journal of Immunology and conducted by Professor Prakash Nagarkatti of the University of South Carolina has explored the benefits of marijuana for medical purposes.

The study suggested that marijuana, also known as cannabis, can be extremely useful in providing significant relief to patients with multiple sclerosis, allergies, and arthritis.

Nagarkatti, the Carolina Distinguished Professor in the department of pathology, microbiology and immunology at the USC School of Medicine, also remarked that both marijuana and cancer are truly complex and placed some doubts on the usefulness of medical marijuana for treating cancer.

Nagarkatti believes that human clinical trials would be useful on finding out whether marijuana could really be of use for treating human cancer after studies on lab mice were found encouraging. He added that the medical possibilities of marijuana cannabinoids impressed him but he remarked that he is still against self-prescribing of marijuana.

Cannabinoid Receptor Agonists May Be Effective Anti-Lymphoma Agents

According to researchers at Virginia Commonwealth University in Richmond, Delta-9-tetrahydrocannibinol (THC), the major component of marijuana, and other cannabinoids induce apoptosis in murine tumors of immune origin.

Dr. Mitzi Nagarkatti explained in an interview with Reuters Health that cancers of the immune system like other cells express a cannabinoid receptor known as CB2. Compounds that bind CB2 receptors selectively induce apoptosis in these cancer cells, Nagarkatti said. Moreover, “compounds that interact with CB2 will not exhibit psychotropic effects.”

Dr. Nagarkatti and her colleagues in a series of in vitro experiments exposed murine lymphoma and mastocytoma cells to four cannabinoid receptor agonists. THC and two of the others significantly minimized cell viability and increased apoptosis. The effect of THC was confirmed by in vivo experiments. Cells collected from animals treated with the highest dose of THC showed 77.3% apoptosis ten days after mice were injected with lymphoma cells and two weeks of THC-treatment cured 25% of lymphoma-bearing mice.
“It is possible that the immunosuppressive effects of THC may have interfered with the host’s antitumor immunity, which may account for a lower percentage of cures,” the researchers commented. The research team is conducting murine dose-ranging studies. It was also demonstrated by the research group that three human leukemia and lymphoma cell lines expressed CB2 and not CB1. Three cannabinoids, including THC, induced apoptosis in these cell lines in vitro, and THC demonstrated the same effect when cultured with cells from patients diagnosed with acute lymphoblastic leukemia.

“Recently, however, we identified a human cell line that was resistant,” Dr. Nagarkatti’s team reports. “Further studies are in progress to address whether this cell line lacks physical or functional cannabinoid receptors and/or signaling molecules that trigger apoptosis.” In addition, the research team is “screening a large number of CB2 analogs to identify compounds that are highly efficacious in killing the cancer cells,” Dr. Nagarkatti said. “We are also investigating whether endogenous cannabinoids can exert antitumor activity.”

Marijuana And Multiple Sclerosis

A chronic degenerative disease of the central nervous system, multiple sclerosis (MS), causes inflammation, muscular weakness, and a loss of motor coordination. Over a period of time, patients afflicted with the disease typically become permanently disabled and the disease could be fatal in some cases. According to the US National Multiple Sclerosis Society, nearly 200 people are diagnosed every week with the disease that often strikes those 20 to 40 years of age.

Clinical and anecdotal reports of the ability of cannabinoids to minimize MS-related symptoms such as pain, spasticity, depression, fatigue, and incontinence are plentiful in the scientific literature. In 2008, investigators at the University of California at San Diego reported inhaled cannabis significantly reduced objective measures of pain intensity and spasticity in patients with MS in a placebo-controlled, randomized clinical trial. Investigators concluded that “smoked cannabis was superior to placebo in reducing spasticity and pain in patients with multiple sclerosis and provided some benefit beyond currently prescribed treatment.”

It should therefore comes as no surprise that patients with multiple sclerosis typically report engaging in cannabis therapy, with one survey indicating that almost one in two MS patients use the drug therapeutically.

Investigators at the University College of London’s Institute of Neurology, writing in the July 2003 issue of the journal Brain, reported that administration of the synthetic cannabinoid agonist WIN 55,212-2 provided “significant neuroprotection” in an animal model of multiple sclerosis. “The results of this study are important because they suggest that in addition to symptom management, … cannabis may also slow the neurodegenerative processes that ultimately lead to chronic disability in multiple sclerosis and probably other disease,” researchers concluded.

Investigators at the Netherland’s Vrije University Medical Center, Department of Neurology, also reported that oral THC could boost immune function in patients with multiple sclerosis.

References:
[1] Chong et al. 2006. Cannabis use in patients with multiple sclerosis. Multiple Sclerosis 12: 646-651.
[2] Rog et al. 2005. Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis. Neurology 65: 812-819.
[3] Wade et al. 2004. Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients. Multiple Sclerosis 10: 434-441.
[4] Brady et al. 2004. An open-label pilot study of cannabis-based extracts for bladder dysfunction in advanced multiple sclerosis. Multiple Sclerosis 10: 425-433.
[5] Vaney et al. 2004. Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled, crossover study. Multiple Sclerosis 10: 417-424.
[6] Zajicek et al. 2003. Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis: multicentre randomized placebo-controlled trial [PDF]. The Lancet 362: 1517-1526.
[7] Page et al. 2003. Cannabis use as described by people with multiple sclerosis [PDF]. Canadian Journal of Neurological Sciences 30: 201-205.
[8] Wade et al. 2003. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clinical Rehabilitation 17: 21-29.
[9] Consroe et al. 1997. The perceived effects of smoked cannabis on patients with multiple sclerosis. European Journal of Neurology 38: 44-48.
[10] Meinck et al. 1989. Effects of cannabinoids on spasticity and ataxia in multiple sclerosis. Journal of Neurology 236: 120-122.
[11] Ungerleider et al. 1987. Delta-9-THC in the treatment of spasticity associated with multiple sclerosis. Advances in Alcohol and Substance Abuse 7: 39-50.
[12] Denis Petro. 1980. Marijuana as a therapeutic agent for muscle spasm or spasticity. Psychosomatics 21: 81-85.
[13] Jody Corey-Bloom. 2010. Short-term effects of cannabis therapy on spasticity in multiple sclerosis. In: University of San Diego Health Sciences, Center for Medicinal Cannabis Research. Report to the Legislature and Governor of the State of California presenting findings pursuant to SB847 which created the CMCR and provided state funding. op. cit.
[14] Clark et al. 2004. Patterns of cannabis use among patients with multiple sclerosis. Neurology 62: 2098-2010.
[15] Reuters News Wire. August 19, 2002. “Marijuana helps MS patients alleviate pain, spasms.”
[16] Pryce et al. 2003. Cannabinoids inhibit neurodegeneration in models of multiple sclerosis. Brain 126: 2191-2202.
[17] Killestein et al. 2003. Immunomodulatory effects of orally administered cannabinoids in multiple sclerosis. Journal of Neuroimmunology 137: 140-143.
[18] Wade et al. 2006. Long-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms of multiple sclerosis. Multiple Sclerosis 12: 639-645.
[19] Rog et al. 2007. Oromucosal delta-9-tetrahydrocannabinol/cannabidiol for neuropathic pain associated with multiple sclerosis: an uncontrolled, open-label, 2-year extension trial. Clinical Therapeutics 29: 2068-2079.
[20] Canada News Wire. June 20, 2005. “Sativex: Novel cannabis derived treatment for MS pain now available in Canada by prescription.”
[21] Daily Finance. June 22, 2010. “U.K. approves pot-based drug.”

[22] GW Pharmaceuticals press release. July 28, 2010. ” Spanish Sativex approval.”

[23] http://www.gwpharm.com/Sativex6.aspx

Physiological Effects Of Marijuana

The U.S. federal government has widely claimed that the potency levels of marijuana have risen anywhere from 10 to 25 times since the 1960s though these claims lack substance.

While testifying in front of the U.S. House Subcommittee on Crime, Director of the National Institute on Drug Abuse Alan Leshner said in 1999, “There’s no question that marijuana, today, is more potent than the marijuana in the 1960s. However, if you were to look at the average marijuana potency which is about 3.5 percent, it’s been relatively stable for the last 20 years. Having said that, it’s very important that what we have now is a wider range of potencies available than we had in the 1970s, in particular.”

However, those supporting legalization of marijuana are of the view that the data is skewed as testing was only conducted on marijuana of specific geographic origins in the 1960s and 1970s and it cannot be believed to be a representative of marijuana potency overall.
It is worthwhile to note that a type of Mexican marijuana contains low levels of THC — 0.4 to 1 percent while typical THC levels range from 0.3 to 4 percent though THC levels are as high as 15 percent in some plants. The potency of marijuana is dependent on many factors, including growing climate and conditions, plant genetics, harvesting and processing. Moreover, female plant varieties of marijuana tend to have higher levels of THC than male varieties.

In order to determine the average potency levels of marijuana, researchers need to evaluate a cross section of cannabis plants that was not done in the 1960s and 1970s.