Marijuana has been used medically, recreationally, and spiritually for some 5,000 years. It’s botanic name is cannabis, and it contains more than 400 chemicals from 18 chemical families. When it is smoked more than 2,000 compounds are released, and like tobacco, there are dangers in smoking it.

Medical marijuana clinics run in 20 states, as well as the the District of Columbia. In the states of Colorado and Washington recreational use is now legal. Medical marijuana will become legal in Illinois, beginning in January. Dr. Robbins believes it can help some people with pain, though he will not be prescribing it, as it won’t be indicated for migraine.

Because marijuana’s classification by Congress in 1970 as an illegal Schedule I drug, researchers have not been able to do much testing on it’s most promising ingredients for safety, side effects and biological activity.

Diane E. Hoffmann and Ellen Weber, legal experts at the University of Maryland, wrote in The New England Journal of Medicine, “Medical experts emphasize the need to reclassify marijuana as a Schedule II drug to facilitate rigorous scientific evaluation of the potential therapeutic benefits of cannabinoids and to determine the optimal dose and delivery route for conditions in which efficacy is established.”

The strongest evidence of marijuana’s health benefits involve the treatment of chronic neuropathic pain and the spasticity caused by multiple sclerosis. It’s also known to help against nausea and appetite loss caused by chemotherapy, though better treatments are now available. Preliminary research has suggested the drug may also be helpful in treating Crohn’s disease, glaucoma, migraine, Tourette’s syndrome, abnormal heart rhythms, and several other conditions.

THC, or tetrahydrocannabinol is marijuana’s best known ingredient, and is what gives recreational users the high they seek. However, some people smoking marijuana for it’s medicinal benefits don’t want the psychoactive effects. Many experts believe a derivative of marijuana can offer the therapeutic benefits without the mind-altering consequences.

Martin A. Lee, the author of “Smoke Signals” and director of Project CBD believes  cannabidiol, a compound found in marijuana can neutralize the high caused by THC, but still offer therapeutic potential.

One drug, called Sativex is currently in Phase 3 trials in the U.S. for the relief of neuropathic pain. It is a combination of CBD (cannabidiol) and THC in a ratio that lessens food cravings and drowsiness, while zeroing in on painkilling. Mr. Lee believes this is a better approach to helping patients in pain. The drug is available in Canada to treat cancer pain and neuropathic pain in multiple sclerosis. It’s sprayed under the tongue for quick entry into the bloodstream.

Dr. J. Michael Bostwick, a psychiatrist at the Mayo Clinic in Rochester, Minn., describes the potential for medical marijuana as “incredibly exciting”, but adds, “it is not being realized, because researchers can’t get the material for study.” He notes that consumers should be aware of the law in their jurisdiction, and work closely with a physician to make sure they are using the drug appropriately…….  nytimes   11/4/13



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