Opinion: Marijuana Not Benign
Herbert D. Kleber, M.D., a professor of psychiatry and the director of the Division on Substance Abuse at Columbia University, believes rigorous FDA testing is necessary before the smoked form of marijuana is made available to patients.
Marijuana has been used since at least 2700 B.C., although it was not used in Europe until Napoleon's troops brought it back after conquering Egypt. Marijuana is a mixture of the dried leaves, stems and seeds from the cannabis sativa plant. While delta-9-tetrahydrocannabinol (THC) is the main psychoactive cannabinol and the one that causes intoxication, there are more then 400 other chemicals, 60 of which are referred to as cannabinoids. The potency of any given batch is a function of the genetic strain and the growing conditions (sunlight, moisture, temperature, etc.). Potency in the U.S. today ranges from as low as 1-3 percent (common in the 1970s) to 8-10 percent with potencies higher than 20 percent reported. Approximately 9 percent of individuals who try marijuana end up addicted to it and a withdrawal syndrome has been clearly described. The younger one starts use and the more one smokes during adolescence, the greater the likelihood of harmful effects. There are hundreds of thousands of individuals applying annually for substance abuse treatment where marijuana is the primary drug.
During intoxication, marijuana disrupts short-term memory, attention and judgment as well as impairing coordination and balance. The withdrawal syndrome is similar to nicotine withdrawal (increased anxiety, trouble sleeping, irritability, etc.) except that appetite is decreased. The withdrawal symptoms last a few days to a week or more and can be so difficult for some individuals that relapse is high even after abstinence has been reached. THC is fat soluble and can be stored in various organs for weeks after last use and can persist in the urine for up to a month. There are a number of very serious side-effects including increased likelihood of cancer, impaired immune system and increased chance of other drug problems such as addiction to opiates. Some studies disagree on these. Recently, substantial evidence has been published linking marijuana use to earlier onset of schizophrenia and other psychoses.
Comprehensive reports on possible medical uses of marijuana include the Institute of Medicine report in 1999 and the American Medical Association position paper of 2001. Proponents of "medical marijuana" suggest its use for a variety of conditions including nausea and vomiting secondary to cancer chemotherapy, AIDS wasting, neuropathic pain and movement disorders such as the spasticity associated with multiple sclerosis. Dronabinol, a synthetic form of THC in pill form is available by prescription as a schedule 3 agent and in controlled studies has been shown to be as effective as the smoked form but with a slower rate of onset, and with less hazards because it avoids the respiratory effects. A number of studies have been carried out by the Center of Medical Cannabis Research at UCSD, funded by the State of California. Approved medical researchers can be supplied with marijuana of different potencies (on a reimbursable basis). In spite of the lack of evidence for many proposed marijuana uses, some advocates urge its availability for "any condition that the individual wants to use it for." Such a stance has led in California to over 300,000 individuals receiving "medical marijuana" for numerous unproven indications or for no serious indication at all. No medication in the U.S. is currently used by the smoked route because of respiratory concerns and inconsistent dosing.
Marijuana is not a benign substance. Especially with the higher potencies available today, more serious problems are emerging. It would be a major public health mistake to make the smoked form available today before it has undergone FDA approval, especially since a THC pill is available and other approved agents are readily accessible. We should not scrap the regulatory system that has served us well for decades. While not perfect, it has prevented many drugs with dangerous effects from being marketed. Availability by referendum or legislative fiat, led in the 1980s to Laetrile, a potentially fatal agent, being approved in over 20 states for treatment of cancer. As the IOM report suggest, compassionate use in certain cases (e.g., terminal cancer) that have not responded to existing agents, including the pill form, should be possible - but under conditions where data on effectiveness and side effects can be gathered. Otherwise we are left with anecdotes but as has been pointed out frequently, the plural of anecdotes is not data.
To read Dr. Earleywine's opinion piece on medical marijuana click here.
Copyright 2010 CBS. All rights reserved. Marijuana has been used since at least 2700 B.C., although it was not used in Europe until Napoleon's troops brought it back after conquering Egypt. Marijuana is a mixture of the dried leaves, stems and seeds from the cannabis sativa plant. While delta-9-tetrahydrocannabinol (THC) is the main psychoactive cannabinol and the one that causes intoxication, there are more then 400 other chemicals, 60 of which are referred to as cannabinoids. The potency of any given batch is a function of the genetic strain and the growing conditions (sunlight, moisture, temperature, etc.). Potency in the U.S. today ranges from as low as 1-3 percent (common in the 1970s) to 8-10 percent with potencies higher than 20 percent reported. Approximately 9 percent of individuals who try marijuana end up addicted to it and a withdrawal syndrome has been clearly described. The younger one starts use and the more one smokes during adolescence, the greater the likelihood of harmful effects. There are hundreds of thousands of individuals applying annually for substance abuse treatment where marijuana is the primary drug.
During intoxication, marijuana disrupts short-term memory, attention and judgment as well as impairing coordination and balance. The withdrawal syndrome is similar to nicotine withdrawal (increased anxiety, trouble sleeping, irritability, etc.) except that appetite is decreased. The withdrawal symptoms last a few days to a week or more and can be so difficult for some individuals that relapse is high even after abstinence has been reached. THC is fat soluble and can be stored in various organs for weeks after last use and can persist in the urine for up to a month. There are a number of very serious side-effects including increased likelihood of cancer, impaired immune system and increased chance of other drug problems such as addiction to opiates. Some studies disagree on these. Recently, substantial evidence has been published linking marijuana use to earlier onset of schizophrenia and other psychoses.
Comprehensive reports on possible medical uses of marijuana include the Institute of Medicine report in 1999 and the American Medical Association position paper of 2001. Proponents of "medical marijuana" suggest its use for a variety of conditions including nausea and vomiting secondary to cancer chemotherapy, AIDS wasting, neuropathic pain and movement disorders such as the spasticity associated with multiple sclerosis. Dronabinol, a synthetic form of THC in pill form is available by prescription as a schedule 3 agent and in controlled studies has been shown to be as effective as the smoked form but with a slower rate of onset, and with less hazards because it avoids the respiratory effects. A number of studies have been carried out by the Center of Medical Cannabis Research at UCSD, funded by the State of California. Approved medical researchers can be supplied with marijuana of different potencies (on a reimbursable basis). In spite of the lack of evidence for many proposed marijuana uses, some advocates urge its availability for "any condition that the individual wants to use it for." Such a stance has led in California to over 300,000 individuals receiving "medical marijuana" for numerous unproven indications or for no serious indication at all. No medication in the U.S. is currently used by the smoked route because of respiratory concerns and inconsistent dosing.
Marijuana is not a benign substance. Especially with the higher potencies available today, more serious problems are emerging. It would be a major public health mistake to make the smoked form available today before it has undergone FDA approval, especially since a THC pill is available and other approved agents are readily accessible. We should not scrap the regulatory system that has served us well for decades. While not perfect, it has prevented many drugs with dangerous effects from being marketed. Availability by referendum or legislative fiat, led in the 1980s to Laetrile, a potentially fatal agent, being approved in over 20 states for treatment of cancer. As the IOM report suggest, compassionate use in certain cases (e.g., terminal cancer) that have not responded to existing agents, including the pill form, should be possible - but under conditions where data on effectiveness and side effects can be gathered. Otherwise we are left with anecdotes but as has been pointed out frequently, the plural of anecdotes is not data.
To read Dr. Earleywine's opinion piece on medical marijuana click here.
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Additionally, ask medical marijuana patients about marinol, it just makes them sick. THC is not the only chemical in pot, THCV is actually the one that is most responsible for euphoric feelings etc, and is also the least understand. There are other active chemicals such as CBC and CBC, a synthetic pill is no subsitute for the real stuff.
Additionally, the government terrorizes it's own population when it cuts down plants they grow, now instead of growing local you have to buy foreign and support terrorists, by extension the government is supporting terrorism by chopping the red white, blue and green plants down.
Lastly, it is cruel and unusual punishment (at least unusual) to put someone in jail for smoking marijuana when another person can, say for example, a celebrity, can openly smoke a joint on camera and have nothing happen. Also, given that roughly 5% of the american population smokes Pot, it is certainly unusual then for a pot smoker to ever be punished.
Errg, and I can't help but also so, stronger weed makes healthier people - they just smoke less of it. When you require only a 1/4 cubic meter of smoke to get the same amount of drug as you would as in a cubic meter, then that's a whole lot less carbon you're inhaling.
This guy may as well give back his MD, he has no arguments that are accurate. Inhaling vapor has no known health consequences, since nobody has proved THC to be actually bad for you (it's the burning of carbon that is bad for, burned carbon => carbon monoxide (carcinogen))... so why must we assume that to take marijuana that is must be burned and therefore proven to be harmful (again, carbon monoxide.. but that is different from cigarrettes that have other known carcignogens.. notably arcenic not to mention that hundreds of others)
Hell, a person could cook pot into food, brew into a tea, formulate it even into a lotion or lip balm.... Why not talk about the addictive properties of pot? It is addictive, a bit more addictive coffee.. Whereas cigarrettes are a bit more addictive than cocaine (also, by quantity, a person requires ten times as much cocaine for a lethal overdose than they would for nicotine [so it's not terribly hard to kill yourself by smoking with a patch on])
In fact, shame on CBS for posting this article and associating it with news or information.
And not a single mention of vaporizer technology in the article. It terrifies me that this man is licensed to practice real medicine.
Then he embarrasses his entire profession by alluding to the "schizophrenia" study. It's just sad that a medical professional would reference a debunked study that happened to make headlines when it first came out. Never mind that historical rates of cannabis use and schizophrenia are completely uncorrelated, this guy has no problem referencing a study that claimed a single joint could cause schizophrenia.
He repeats the "wait for the science" argument (never mind that we already have plenty of ignored science on the subject) while politicians just continue to block research. "You have to prove that it's safe, but we won't let you do real research."
It's like one big pathetic joke on the world.
1. "THC is fat soluble and can be stored in various organs for weeks after last use and can persist in the urine for up to a month."
Total lie. THC is not stored in the body for weeks or a month. The metabolites of THC are what persist in the body.
2. "There are a number of very serious side-effects including increased likelihood of cancer"
Another total lie. Cannabis has NOT been shown to cause cancer. In fact, THC may actually fight cancer.
3. "Approved medical researchers can be supplied with marijuana"
Hahaha. Good one. He neglects to mention that nobody gets approved. Our fabulous government has actively denied research for decades because they KNOW that such research will contradict their lies and propaganda.
4. "During intoxication, marijuana disrupts short-term memory, attention and judgment as well as impairing coordination and balance."
Gee... It's not like any legal prescription medications do that.
5. "There are hundreds of thousands of individuals applying annually for substance abuse treatment where marijuana is the primary drug."
Another total lie. He neglects to mention that these individuals are forced into treatment by the criminal justice system. Hundreds of thousands of individuals are NOT willingly seeking treatment for marijuana.