Originally created 06/14/05

Is marijuana for medical use a friend or a foe?

Take two tokes and call me in the morning? In many parts of country, it's no joke.

Ten states have passed laws that legalize marijuana use for medicinal purposes, and the Rhode Island Senate last week voted in favor of legalization. All that maneuvering, however, is moot because the U.S. Supreme Court ruled last week that federal authorities still can prosecute people using marijuana under the auspices of the state-overseen programs, leaving users in an unusual state of legal limbo.

What's all the fuss about? It comes down to a tongue-twisting chemical called Delta-9 tetrahydrocannabinol, or THC. Cannabis sativa, the botanical name for marijuana, contains more than 60 active compounds, and THC is the most active. Cannabinoid receptors, which are protein receptors that prompt brain cell activity, are triggered by THC. Exactly what role THC plays in overall brain chemistry is still unknown, but Ines Berger, an associate professor of anesthesiology and the director of the pain management service at MCG Health System, compared THC receptors to the ones in our body that naturally interact with opiates - cannabinoid receptors CB1 and CB2. Understanding how those receptors work is the basis behind potential remedies for myriad diseases, but much is still unknown.

"There are not a lot of controlled studies, so it's very limiting to have a discussion or be an advocate for it," Dr. Berger said.

Among the issues that she said still need to be addressed is standardized amounts. Although it's accepted, for instance, that using cannabis can help a person regain appetite, the ideal amount, type of cannabis and delivery method that should be used are not clear.

"Chronic pain management is all about neural modulation, and it's a complex system," Dr. Berger said. "It's not a black box that you put a cure into and it works for everyone. I do think research on cannabinoid receptors should be a part of it."

Deborah Lewis, a professor in MCG's Pharmacology and Toxicology department and the director of the neuroscience graduate program, compared the effects THC has on the brain to a blanket. When the cannabinoid receptors are stimulated by the body's own naturally occurring endocannabinoids, they're affected individually; THC affects numerous receptors all at once.

Researchers hope to pinpoint receptors that affect short-term memory loss, appetite and pain. In the meantime, one option that's legal throughout the country is a synthetic version of THC.

"My cousin's son had to have a bone marrow transplant because he had aplastic anemia; he was losing weight, and he was put on Marinol, which is a pill that has tetrahydrocannabinol," Dr. Lewis said. "That really helped him gain weight and helped him get over a hurdle in his recovery."

Dr. Berger said Marinol works but is expensive and not nearly strong enough for pain treatment. Although marijuana has the potential to be a gateway to other, more destructive drug use, she said there is much to be learned from the plant.

"I like to do research and study in a controlled environment," she said. "That's the mission of a medical college."

Reach Patrick Verel at (706) 823-3332 or patrick.verel@augustachronicle.com.

What is it used to combat? - Severe appetite suppression, weight loss and wasting away from HIV infection and other medical conditions.

- Chronic pain from certain types of injuries and diseases such as AIDS.

- Nausea associated with cancer and its treatments.

- Severe muscle spasticity caused by diseases such as multiple sclerosis.

Source: Center for Medicinal Cannabis Research at the University of California

Cultural referencesYou can't discuss the relevance of marijuana to American society without taking into consideration the magnitude of its influence on popular culture. From movies to music, the wacky weed has played an integral part in American entertainment. Here's a sampling:

Movies: Reefer Madness (1936), Up in Smoke (1978), Fast Times at Ridgemont High (1982), Dazed and Confused (1993), Friday (1995), Half Baked (1998), How High (2001), Harold & Kumar Go to White Castle (2004)

Music: I Wanna Get High, Insane in the Brain, Cypress Hill; Because I Got High, Afro Man; Mary Jane, Rick James; When I Get Low, I Get High, Ella Fitzgerald; Mr. Tambourine Man, Bob Dylan; Sweet Leaf, Black Sabbath; Purple Haze, Jimi Hendrix; Reefer Man, Cab Calloway

Grass Roots: A Brief History of Cannabis Sativa

2737 B.C.: Cannabis is mentioned in a Chinese medical compendium as an agent for achieving euphoria.

A.D. 1850-1942: Marijuana is listed in the United States Pharmacopeia as a treatment for labor pains, nausea and rheumatism.

1910: After the Mexican Revolution, Mexican immigrants flood into the United States and introduce American culture to recreational marijuana use.

1930: The Federal Bureau of Narcotics is formed.1937: Congress passes the Marijuana Tax Act, which effectively criminalizes the drug.

1960s: Political and social upheaval lead to relaxed attitudes about drugs; the use of marijuana becomes widespread in middle- and upper-class America.

1970: Under the Controlled Substances Act, marijuana is classified along with LSD and heroin as a Schedule 1 drug, considered to have a high abuse potential and no accepted medical use.

1974: High Times magazine is founded.

1992: Presidential candidate Bill Clinton admits to having smoking marijuana but couches his statement by saying, "I didn't inhale and I didn't try it again."

1996: California becomes the first state to legalize the medical use of marijuana for patients with AIDS, cancer and other serious, painful diseases.

2002: California residents Angel McClary Raich and Diane Monson file suit against federal officials after six of Ms. Monson's marijuana plants are seized and destroyed by the Drug Enforcement Administration.June 6, 2005: Ms. Raich and Ms. Monson's case, which was appealed to the U.S. Supreme Court, is decided in favor of the federal government.


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