Jun 01, 2005 02:32 AM #113
Cannabis use in HIV for pain and other medical symptoms.
Woolridge E, Barton S, Samuel J, Osorio J, Dougherty A, Holdcroft A.
Magill Department of Anesthesia, Imperial College London, United Kingdom.
Despite the major benefits of antiretroviral therapy on survival during HIV infection, there is an increasing need to manage symptoms and side effects during long-term drug therapy. Cannabis has been reported anecdotally as being beneficial for a number of common symptoms and complications in HIV infections, for example, poor appetite and neuropathy. This study aimed to investigate symptom management with cannabis. Following Ethics Committee approval, HIV-positive individuals attending a large clinic were recruited into an anonymous cross-sectional questionnaire study. Up to one-third (27%, 143/523) reported using cannabis for treating symptoms. Patients reported improved appetite (97%), muscle pain (94%), nausea (93%), anxiety (93%), nerve pain (90%), depression (86%), and paresthesia (85%). Many cannabis users (47%) reported associated memory deterioration. Symptom control using cannabis is widespread in HIV outpatients. A large number of patients reported that cannabis improved symptom control.
Jun 01, 2005 02:39 AM #114
Recommendations from five recent key reports pertaining to the medical use of marijuana are listed below by subject. Recommendations made on issues outside the scope of this report, such as drug law and scheduling decisions, are not included here. The following reports were reviewed:
Health Council of the Netherlands, Standing Committee on Medicine. 1996. Marihuana as Medicine. Rijswikj, the Netherlands: Health Council of the Netherlands.
Report of the Council on Scientific Affairs. 1997. Report to the American Medical Association House of Delegates. Subject: Medical Marijuana. Chicago: AMA.
British Medical Association. 1997. Therapeutic Uses of Cannabis. United Kingdom: Harwood Academic Publishers.
National Institutes of Health. 1997. Workshop on the Medical Utility of Marijuana. Bethesda, MD: National Institutes of Health.
World Health Organization. 1997. Cannabis: A Health Perspective and Research Agenda. Geneva: WHO.
In November 1998, the British House of Lords Science and Technology Committee published Medical Use of Cannabis, in which the committee reported its conviction that "cannabis almost certainly does have genuine medical applications." The House of Lords report was released too late in the preparation of the present Institute of Medicine report to permit careful analysis and is not summarized here. It is available on the Internet at: www.parliament.uk.
Health Council of the Netherlands
In order to assess the efficacy of marijuana and cannabinoids, the committee studied literature published during the past 25 years. Based on those findings, the committee concluded that there was insufficient evidence to justify the medical use of marijuana.
AMA House of Delegates
Adequate and well-controlled studies of smoked marijuana should be conducted in patients who have serious conditions for which preclinical, anecdotal, or controlled evidence suggests possible efficacy, including AIDS wasting syndrome, severe acute or delayed emesis induced by chemotherapy, multiple sclerosis, spinal cord injury, dystonia, and neuropathic pain.
British Medical Association
Research on the clinical indications for medical prescription of cannabinoids should be undertaken. For all indications listed below (anti-emetics, pain, epilepsy, glaucoma, asthma, immunological effects, multiple sclerosis, spinal cord injury, and other spastic disorders) further research is required to establish suitable methods of administration, optimal dosage regimens, and routes of administration. A central registry should be kept of patients prescribed cannabinoids so that the effects can be followed up over the long term.
National Institutes of Health
For at least some potential indications, marijuana looks promising enough to recommend that new controlled studies be done. The indications in which varying levels of interest were expressed are the following: appetite stimulation and wasting, chemotherapy-induced nausea and vomiting, neurological and movement disorders, analgesia, [and] glaucoma. Until studies are done using scientifically acceptable clinical trial design and subjected to appropriate statistical analysis, the question concerning the therapeutic utility of marijuana will likely remain largely unanswered. To the extent that the NIH can facilitate the development of a scientifically rigorous and relevant database, the NIH should do so.
World Health Organization
Therapeutic uses of cannabinoids warrant further basic pharmacological and experimental investigation and clinical research into their effectiveness. More research is needed on the basic neuropharmacology of THC and other cannabinoids so that better therapeutic agents can be found.
Jun 01, 2005 07:14 AM #115
those are very good facts
Jun 01, 2005 08:55 AM #116
State Health Department Studies
In addition to the published research there have been a series of six studies conducted by state health departments under research protocols approved by the U.S. Food and Drug Administration.The focus of these studies, conducted by six state health agencies was the use of marijuana as an anti-emetic for cancer patients. The studies, conducted in California, Georgia, New Mexico, New York, Michigan and Tennessee, compared marijuana to antiemetics available by prescription, including the synthetic THC pill, Marinol. Marijuana was found to be an effective and safe antiemetic in each of the studies and more effective than other drugs for many patients.
Highlights of the Studies
New Mexico: This study involved 250 patients.The study compared marijuana to THC capsules. The research protocol was approved by the FDA in 1978. In order to participate in the research the patient had to be referred by a physician and had to have failed on at least three other antiemetics. Patients were permitted to choose marijuana or the THC pill.
Both objective (e.g., frequency of vomiting, amount of vomiting, muscle biofeedback, blood samples and patient observation) and subjective measures were made to determine the effectiveness of the drug.
The study concluded that marijuana was not only an effective antiemetic but also far superior to the best available conventional drug, Compazine, and clearly superior to synthetic THC pill." The study found that [m]ore than  percent of the patients who received marijuana . . . reported significant or total relief from nausea and vomiting." The study found no major adverse side effects. Only three patients reported adverse reactions, none of these reactions involved marijuana alone. The 1984 report concluded . . . the data accumulated over all five years of the program's operation do show that marijuana smoked resulted in a higher percentage of success than does THC ingested."
California: California conducted a series of studies from 1981 through 1989. Annual reports were submitted to the FDA, state legislature and Governor. Each year approximately 90 to 100 patients received marijuana. The California research was described as a Phase III trial."
The study protocol preferred THC pills by making it much easier for patients to enter that portion of the study. Patients who received marijuana had to be over 15 years of age (the THC pill patients had to be over 5 years of age); had to be marijuana experienced, use the drug on an in-patient basis (patients could only use marijuana in the hospital and not take the medicine home) and had to be receiving rarely used and severe forms of chemotherapy. Thus, the design of the study did not favor marijuana.
Even with this built in bias against marijuana, the study consistently found marijuana to be an effective antiemetic. In 1981 the California Research Advisory Panel reported: "Over 74 percent of the cancer patients treated in the program have reported that marijuana is more effective in relieving their nausea and vomiting than any other drug they have tried." In 1982, a 78.9 percent effectiveness rate was found for smoked marijuana. By 1983 the report was conclusory in its findings stating:
The California Program also has met its research objectives. Marijuana has been shown to be effective for many cancer chemotherapy patients, safe dosage levels have been established and a dosage regimen which minimizes undesirable side effects has been devised and tested.
The California Research Advisory Panel continued to review data on marijuana until 1989 with similar results.
Michigan: The Michigan research compared marijuana to Torecan. It involved 165 patients. Upon admission to the program patients were randomized into control groups with some randomized on the conventional antiemetic Torecan and the remainder randomized to marijuana. When failure on the initial randomized drug occurred, patients could elect to crossover to the alternate therapy. This procedure allowed the Michigan Department of Health to evaluate how well patients responded to both drugs and allowed patients to register their preference.
The Michigan study reported 71.1 percent of the patients who received marijuana reported no emesis to moderate nausea. Ninety percent of the patients receiving marijuana elected to remain on marijuana. Only 8 of 83 patients randomized to marijuana chose to alter their mode of antiemetic therapy. This was almost the inverse of patients randomized to Torecan, there more than 90 percent - 22 out of 23 patients - elected to discontinue use of Torecan and switched to marijuana.
Very few serious side effects were found related to marijuana use. The most common side effect was increased appetite - reported by 32.3 percent of patients - this was a positive effect. The most common negative effects were sleepiness, reported by 21 patients and sore throat, reported by 13 patients.
Tennessee: This study involved an evaluation of 27 patients. The patients had all failed on other forms of antiemetic therapy including oral THC. The study found an overall success rate of 90.4 percent for marijuana inhalation therapy. In comparison it found a 66.7 percent success rate for THC capsules. In the under 40 age group, the study found a 100 percent success rate for marijuana inhalation therapy.
The report concludes:
We found both marijuana smoking and THC capsules to be effective anti-emetics. We found an approximate 23 percent higher success rate among those patients administered THC capsules. We found no significant differences in success rates by age group. We found that the major reason for smoking failure was smoking intolerance; while the major reason for THC capsule failure was nausea and vomiting so severe that patient could not retain the capsule.
New York: In describing the purpose of the marijuana research program the New York Department of Health stated: [t]he program is a large-scale (Phase III) cooperative clinical trial . . . ." The central question addressed is [h]ow effective is inhalation marijuana in preventing nausea and vomiting due to chemotherapy in patients . . . who have failed to respond to previous antiemetic therapy?"
By 1985, the New York program had extended marijuana therapy to 208 patients through 55 practitioners. Of that, 199 patients were evaluated. These patients had received a total of 6,044 NIDA-supplied marijuana cigarettes which were provided to patients during 514 treatment episodes.
In percentage terms the results were stunning:
North Shore Hospital reported marijuana was effective at reducing emesis 92.9 percent of the time;
Columbia Memorial Hospital reported efficacy of 89.7 percent;
Upstate Medical Center, St. Joseph's Hospital and Jamestown General Hospital reported 100 percent of the patients smoking marijuana gained significant benefit.
The report concludes: "Patient evaluations have indicated that approximately ninety-three (93) percent of marijuana inhalation treatment episodes are reported to be effective' or highly effective' when compared to other antiemetics." The New York study reports no serious adverse side effects. No patient receiving marijuana required hospitalization or any other form of medical intervention. See, Evaluation of the Antiemetic Properties of Inhalation Marijuana in Cancer Patients Receiving Chemotherapy Treatment," New York Department of Health, Office of Public Health (Annual Reports).
Georgia: The Georgia program evaluated 119 patients. It compared THC to standardized smoking of marijuana and with patient-controlled smoking. To enter the program a patient had to have failed on other antiemetics. Patients were randomized to either patient-controlled smoking of marijuana, standardized smoking of marijuana or THC pills.
The report found that both THC and marijuana were effective in providing antiemetic relief for patients who were previously unresponsive to antiemetics. The rate of success was 73.1 percent. Patient controlled smoking of marijuana was successful in 72.2 percent, standardized smoking was successful in 65.4 percent and THC was effective in 76 percent of the cases. In comparing the reasons for failure between marijuana and THC the report found:
The primary reasons for failure of THC capsules were due to either adverse reaction (6 out of 18) or failure to improve nausea and vomiting (9 out of 18). The primary reason for failure of smoking marijuana were due to smoking intolerance (6 out of 14) or failure to improve the nausea and vomiting (3 out of 14).
Jun 01, 2005 08:57 AM #117
The above article was summerized. If you are so inclined to further educate yourself about the positive medical uses of cannabis then a full transcript of said article can be sent. Just send me a PM.
Jun 01, 2005 08:59 AM #118
STUDY TARGETS STALEMATE OVER MEDICINAL USE OF MARIJUANA
San Jose Mercury News (CA), Sunday, July 19, 1998
by Lisa M. Krieger
Three times a day, a neatly machine-rolled marijuana joint is delivered from a locked cabinet at San Francisco General Hospital to Patient No. 9. He closes the door to his small white room, stuffs a towel under the door and lights a match. A nurse watches through a window.
Following strict research protocol, he inhales for five seconds, holds for 10, then releases. He waits 45 seconds. The exercise is repeated 10 times.
Patient No. 9, a 34-year-old former Navy man with HIV, is a volunteer in a new $1 million, two year research experiment that hopes to help resolve a long-running and emotional debate in federal drug policy: Does marijuana, the country's most widely used illegal drug, have medicinal value?
The study -- the first and only government-sanctioned marijuana-therapy research project in the United States -- pays volunteers $1,000 to undergo more than three weeks of isolation and rigorous medical testing. They smoke pot, ingest a tablet form of the drug or take a placebo.
``It is a really intense study,'' said Patient No. 9, who has experience in pot smoking and much patience -- both necessary criteria for the study. ``I knew that coming in.''
The patient, a muscular 34-year-old man with tattoos and a gold chain, relaxes by reading Stephen King and watching ``Jurassic Park'' and Disney videos including ``The Little Mermaid,'' ``The Lion King'' and ``Hercules.'' His earnings from the study will help finance an autumn trip to Disney's Animal Kingdom in Florida.
Critical to the research are the blood tests that measure immune function, hormones, the AIDS virus and marijuana's active ingredient, delta-9-tetrahydrocannabinol (THC). There are also tests of Patient No. 9's body composition to see if marijuana has any effect on weight gain or appetite. A large plastic bubble is pulled over his head for 30 minutes each morning to monitor his carbon dioxide levels.
The results of the experiment ultimately could influence the debate over the medicinal use of marijuana, which won public support in the 1996 approval of California's Proposition 215. The courts have since been shooting down the law.
The study's lead investigator insists that the experiment is motivated by medicine, not politics.
``It was the need to find answers so that patients could be best advised concerning marijuana,'' said Dr. Donald Abrams, a professor of medicine at the University of California-San Francisco, a renowned Stanford-educated AIDS expert.
Pot used through ages, But scientific documentation lacking
Marijuana has been used as a recreational, ceremonial and therapeutic substance throughout history. But neither risks nor benefits have been scientifically documented.
``The policy cart has tended to pull the scientific horse with respect to marijuana,'' said Dr. David Smith, founder and medical director of the Haight Ashbury Free Clinics Inc.
Marijuana once was more readily available through the federal government.
In 1978, it was distributed to a limited number of patients under an Investigational New Drug procedure. But when requests burgeoned in 1991, the program was suspended, though seven patients continue to receive pot under this program.
Since then, the federal government has denied there is any legitimate use for marijuana. The agency formally classifies it as a Schedule I ``controlled substance,'' the same as heroin and LSD. That means it has no recognized medicinal purpose and may not be prescribed.
A band of dissident doctors and pro-marijuana activists have sought to reverse the government's stance, contending the illicit weed already is being used by tens of thousands of patients suffering from muscle diseases, glaucoma and the side effects of cancer chemotherapy.
The AIDS epidemic brought new urgency to the issue, as many people turned to marijuana as a medicinal treatment for HIV-associated anorexia and weight loss. An estimated 11,000 Bay Area residents with HIV obtained marijuana for medicinal use from local marijuana buyers clubs before most were shut in a post-Proposition 215 crackdown.
Without solid research, doctors have been unable to advise their patients on the effect of the drug on appetite, lung and immune function. Nor did they understand the interaction, if any, between marijuana and anti-viral protease inhibitors. Because both drugs are metabolized by the same liver enzyme system, there is reason to fear that pot smoking can concentrate the AIDS drugs, causing toxicity -or alternatively, reduce levels of AIDS drugs, rendering them useless.
Sympathy for sick people who could benefit from marijuana led to the passage of Proposition 215. It allowed seriously ill patients and their primary caregivers, with the oral or written recommendation of a doctor, to possess and cultivate marijuana for patients' personal use.
The government's response to Proposition 215 was swift and dramatic. It warned that physicians who recommended medicinal marijuana would be punished under federal law, including criminal prosecution.
The government cautioned that marijuana had as many as 400 components, some of them cancer causing. And it said that modern medicines, such as the THC-based drug Marinol, are superior to marijuana.
Technically, marijuana -- like any other Schedule I drug -- is available for research. But every proposal had failed to pass muster with the federal government.
Five years ago, Abrams first tried to win permission to scientifically study the drug. He found a supplier of pot in the Netherlands, but the Drug Enforcement Administration (DEA) refused to let it be imported. Nor would the DEA donate pot confiscated in arrests. The National Institutes of Drug Abuse would give him government-grown pot only if the National Institutes of Health approved the study. But his proposal was turned down by NIH, which criticized its design and expressed concerns about the risks of smoking.
Abrams went back to the drawing board, redesigned the study -- and finally, last October, got the federal approval and funding to proceed.
Moderate potency - Only legal pot farm in United States
As pot goes, the 1,400 joints used in the study are nothing special: Only moderately potent, they're a little too dry, although free of seeds and stems.
Since the cigarettes arrive freeze-dried, San Francisco General Hospital nurses say they have to humidify them in a special chamber.
As a connection, Uncle Sam grows his own. It takes place on a seven-acre marijuana farm on the outskirts of the campus of the University of Mississippi, originally created to provide pot through the 1978 program. Located in the northeast corner of a state known for its long growing season, the Research Institute of Pharmaceutical Sciences is the only legal
marijuana plantation in the United States.
Long-awaited results could help break the emotional stalemate over medicinal marijuana, said Abrams. If the drug is found to be dangerous, doctors will know to warn their patients. But if it works, the push will increase for the drug to be approved for medicinal use.
``It is clear that the real hard work is just about to begin,'' said Abrams. ``We are delighted with the way the study is going so far. Answers to important questions will be answered by the trial. We are really pleased that after a long time, the study is launched and going smoothly.''
``Five years of persistence has clearly paid off,'' said Abrams. ``Despite roadblocks, the scientific questions prevailed.''
Saying thanks - Patient No. 9 wants to aid science
Not long ago, Patient No. 9 -- the anonymity is a condition for media access -- was so sick with AIDS he signed ``do-not-resuscitate papers'' in preparation for death. His weight dropped from 240 to 163 pounds. He was fighting Pneumocystis pneumonia, Kaposi's sarcoma and internal parasites.
Experimental treatments turned his life around. The pneumonia and parasites were cured; his KS receded. AIDS virus levels, once sky-high, became ``undetectable'' in tests. He wants to give something back to science, as a way of saying thanks, he said.
In preparation of the pot study, he paid his bills and rent in advance. He got ahead on his work; mail is being handled by his roommate.
Not wanting to become the focus of attention, he's not telling many people about his role in the experiment. ``I told them I'm on vacation, visiting my mother.''
He doesn't mind the confinement: The 12-by-17-foot hospital room is neat and clean, with a pink blanket and a picturesque view of the terra-cotta shingles of the hospital roof below. A fan pulls the thick sweet smoke out into the cool San Francisco air.
He selects his meals from a special menu, rather than the usual hospital fare. A refrigerator in his room is stocked with cereal, fresh fruit, yogurt, crackers, soda, juice, three kinds of ice cream and five types of cookies.
Although not allowed visitors, he can talk on the phone and take an occasional stroll with a nurse chaperon.
The restrictions don't bother him. ``I volunteered because I am a strong believer in research,'' he said. ``It has to be done well, because the feds will scrutinize this up and down, every facet of it."
Jun 01, 2005 09:04 AM #119
NEW & ONGOING STUDIES
* National Institutes of Health (NIH)
On February 19-20, 1997, the National Institutes of Health held a workshop on "The Medical Utility of Marijuana," a forum for scientists and policy-makers. Discussions focused on the results of previous studies of medical marijuana, and the ways in which NIH could help design and facilitate new research to answer key questions in this area. On August 8, 1997, NIH released a 45-page report with its expert panel's conclusions. The report urged "more and better studies" of marijuana's medical value, and suggested streamlining the process by which researchers may obtain marijuana from the federal government for such studies. Since then, NIH has evaluated and funded one medical marijuana study - one which had been presented for the first time five years before.
* National Academy of Sciences/Institute of Medicine
On January 7, 1997, drug czar Barry McCaffrey announced that his office would fund a $1-million survey of research on marijuana's medical value. The study was commissioned through the National Academy of Science's Institute of Medicine (IOM), as a contract with the Office of National Drug Control Policy (ONDCP). Critics argued that the new study appeared too much like a research review when new, controlled studies were actually needed. Once a panel was appointed, the group held several public hearings around the country, and IOM panelists met with marijuana-using patients and doctors who were sympathetic to the issue, among others. The IOM report is now expected at the end of 1998 or in early 1999.
* University of California, San Francisco study of marijuana and AIDS
The first government-approved medical marijuana research project in nearly a decade is now under way at the University of California, San Francisco (UCSF). Dr. Donald Abrams, a renowned AIDS expert, had begun trying to obtain approval for this kind of study in 1992. However, Abrams met with repeated rejections by key federal agencies, making his team unable to obtain marijuana for the study. After passage of California's new medical marijuana law, Dr. Abrams obtained the needed approvals, and received federally produced research marijuana in the summer of 1998. Dr. Abrams' team is investigating the safety of marijuana smoking by AIDS patients, and will examine the effects of the drug on weight gain and other factors.
You really think we would pour MILLIONS of dollars into bullshit research so a bunch of hippies can get stoned legally ? Think again. This medication is for the people who actually need it. If you choose to use recreationally that is (or should be) your own business and not the governments. I certainly won't judge you.
Jun 01, 2005 09:21 AM #120
I LOVE SMOKING weed its good to relax for someone like me who has panic attacks all the time i think it helps me calm down in some ways and i know when to stop.
We love the wood chucks
Last edited by [email protected]; Jun 01, 2005 at 09:25 AM.
Reason: Because i forgot to say sumthing