Opinion: Marijuana Not Benign

Dr. Herbert Kleber Outlines Potential Risks Associated With Medical Marijuana

(CBS)  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.

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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.

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To read Dr. Earleywine's opinion piece on medical marijuana click here.

[danperson83]

Crap article. "Marijuana is a mixture of the dried leaves, stems and seeds from the cannabis sativa plant," is FALSE statement, the guy can't properly even explain what marijuana is. Marijuana is primarily the FLOWERS of either a cannabis sativa or a cannabis indica plant (hemp is from a cannabis ruderalis). Often marijuana is mixed in with leaves stems and seeds as it is very difficult to seperate them. Though the leaves will still contain some of the active drug ingredients, the stems contain trace amounts and the seeds none (except the seed casings are rich active drug compounds).

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.

[sporter777]

It's obvious Dr. Kleber has no real knowledge concerning cannabis, so he and his opinions are totally worthless - adding NO value to our society - he's just shooting his mouth off about things he knows NOTHING about. Hell, even drinking WATER kills more people every year than using marijuana does. BTW, marijuana smokers are not interested in leaves, stems, or seeds, as Kleber defines marijuana as being. It's all in the BUDS from female plants. Kleber needs to find another line of work ... and he NEEDS TO GET OUT MORE!!! What a total idiot. Being a total idiot is much more dangerous to the American people than any amount of weed will ever be! Maybe we should lock HIM up ... and free all non-violent prisoners who are being held illegally based on substance abuse 'laws'! Now that's an idea with real MERIT!

[squareandrare]

Oh, and I love the argument about Marinol being safer because it's taken orally, and it takes longer to set in. Am I the only one that sees a problem with prescribing an oral pill to someone whose medical issue is uncontrollable nausea? If they need a pill to be able to not throw up, what the hell makes you think they'll be able to keep the pill down?

And not a single mention of vaporizer technology in the article. It terrifies me that this man is licensed to practice real medicine.

[squareandrare]

They had to dig all the way down to a psychiatrist to make the "con" argument? That alone should tell you something. Not a biologist, not a neurologist, we're given a psychiatrist.

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.

[TheGreatCornholio]

What the heck? Who is this guy? Is he even a real doctor? How can a doctor post a bunch of lies like this and still keep his medical license?

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.

[layups]

Basically the Dr is saying he is fine with it if the FDA spends MILLIONS of OUR TAX DOLLARS to research weed for two years and come to a decision. Sounds like beautiful bureaucracy to me

[dkb218]

Until alcohol is reclassified as a drug and given the same status a Heroin or cocaine then this Opinion means nothing.

[dkb218]

As the saying goes, Opinions are like A**holes. Everybody has one.

[Nabreen1]

I am discusted at this report. A lot of mis information about the use of Medical Marijuana. Obviously this Dr. has never really studied all the positive effects of this natural healing plant. Don't buy it people, read more about medical marijuana before you decide.

[mason2012]

The effect legalized marijuana would have on the cultivation of industrial hemp which is now prohibited must be considered . If marijuana were legal hemp would also be legal. The prospect of legal hemp would bring far more income to farmers than marijuana as the products for hemp have far reaching social consequences. Hemp can be used as fuel, food, paper and fiber. In some parts of the nation hemp can be harvested three times a year. Hemp would replace many items that petroleum now produce. Such as nylon and plastics. The plastic would be of high quality and biodegradable. Marijuana and hemp are the same plant and should always be considered together when weighting the merits or demerits of legalization. The legalization of this plant would benefit all americans. One of those benefits being a lessening of our dependence on foreign oil. Another would be the environment as this plants products would be sustainable and benevolent to our exosphere. It would put farmers to work bring new economy and tax income. The effect of legalization would be felt on the industrial products of the plant and the benefits would far outweigh any problems associated with the drug.

[BuckNDunn]

I can't believe CBS News would publish this rubish. There is so much misinformation in the first two paragraphs that I couldn;t continue. This piece is garbage.

[bartlettpaul]

He first uses the standard scare tactic: State a ridiculously refutable debate point, then position yourself on the other side for a quick victory. An example would be the congressman who stood up and said "Marijuana is not harmless the way some people claim!" The problem is, no educated person says it's harmless; it's a faulty ruse to appear to be the winner.
Now on to medical issues. I guess he did not read the study from Madrid that THC administration decreases recurrent glioblastoma multiforme (GBM) tumor growth in humans, according to the findings of the first-ever clinical trial assessing cannabinoids' anti-tumor action. Investigators also reported that THC demonstrated significant anti-proliferative activity on human GBM cells in culture. Separate preclinical studies indicate that cannabinoids and endocannabinoids can stave off tumor progression and trigger cell death in other cancer cell lines, including breast carcinoma, prostate carcinoma, colectoral carcinoma, skin carcinoma, and pancreatic adenocarcinoma.
Short story: Doctors have found that Marijuana fights cancer.

[undrgrndgirl]

guess it's ok to publish drug war propaganda and mis-intormation when you put it under "opinion"...most of what is said here is down right INCORRECT...

[Wolfman97]

Let's suppose that Dr. Kleber is right in everything he says. He isn't, and he is off by a mile in several respects, but let's just allow for the sake of argument, that everything he says is 100 percent correct.

Marijuana is harmful he says. Therefore, if sick people use it then they should be punished.

That is, sick people who do nothing more than try to relieve their own suffering should be thrown in jail and their property should be seized.

Isn't that an absolutely insane idea -- no matter what you think of marijuana?

Suppose these people were growing their own tobacco and rolling their own cigars because they thought that tobacco cigars made them feel better. We know, of course, that tobacco is not a medicine and, in fact, is quite harmful to the health. Would any sane, rational person suggest that the best approach to that problem is to put them in jail and seize their property?

There is a lesson here. It is stupid and insane to punish sick people who have done nothing more than to try to relieve their own suffering -- even if you disagree with their choice of medicine.

Furthermore, any doctor who suggests that his patients are better off in jail, with their property seized, so they won't smoke marijuana should have the good sense to shut up and leave them alone.

[tincup356]

TOTAL BS this article goes against many studies on marijuana,,,,,,you can bet the author of this story,,,,has never tried marijuana in their life and ONLY goes on what propaganda that has been preached over the years ,,,ALL LIES.

[Gumshrud]

What's more benign, cannabis or fried bacon?

[dgilmanjm]

Is it dangerous? Loaded question. I've seen vitamin A send people to hospital. So like almost all substances that we ingest, there is at least potential danger, however, a lot of what he has stated has not observed by me.

Where I live in Jamaica,the stuff is all too readily available. It's actually growing in several of the yards in my neighborhood. I currently live 1,000 feet above seal level, and the soil and climate seems very good for the plant.

Haven't seen any addicts yet. Seems to act as a kind of tranquilizer (puts the user in a very relaxed mood). We have a lot of accidents caused my alcohol, but I know of none involving marijuana use, even though I have seen many drive while smoking some of the most potent stuff grown around me.

None of the very avid users have ever become violent around me except those who already display a violent temperament. The only one who has ever even posed a threat to me had actually not been smoking at the time, and calmed down after a smoke.

I would just love the doctor or any other researcher to do a study on this effect of the drug(s) in marijuana.

Also, marijuana is very cheap., some of the medical benefits have been scientifically established, so why not do more research and allow the beneficial extracts to be used as prescription drugs?

[starlon]

"It is true that marijuana causes people to act as though they are crazy. "

I've yet to see a stoner acting "crazy" or "schizophrenic." That is simply FUD used by the prohibitionists. A schizophrenic also has adverse reactions to alcohol. I don't see anyone claiming that alcohol increases the chance of developing schizophrenia.

Sick people will self-medicate. That should never be against the law. If the person experiences adverse side-effects, and continues to use the substance, that person is being irresponsible, not "crazy."

[starlon]

Vaporization is healthier than smoking, and still provides the same reactive medicinal properties. Marinol is a proactive medicine. Reactive medicines are suitable for nausea, loss of appetite, and depression just to name a few.

Also, a medicine that can knock two or more birds out with one stone, and do so at such a low cost to the patient, is preferable to practically all modern medicines. You're simply protecting Big Pharma. The fact that synthetic THC is schedule III only proves your mislead opinion, and which side you're taking in this battle against Big Pharma. You should be on the side of the patients, and I find your attempts to thwart their recovery reprehensible.

[rsteeb]

To keep Cannabis illegal while tobacco and alcohol are dispensed freely is murderously stupid.

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Richard Steeb
San Jose, California