PRESS RELEASE - 7th SEPTEMBER, 2003

Edition 7.

Cannabis News Items From Around the World

Medical Marijuana Slowly Gains Ground

http://my.webmd.com/content/Article/73/81986.htm

Clinical Studies Begin to Replace Emotion with Evidence
By Daniel DeNoon
WebMD Medical News
Reviewed By Michael Smith, MD
August 29, 2003

A sea change in science is slowly turning the tide of the medical marijuana debate.

For hundreds of years, marijuana has been used to treat a wide variety of illnesses. But the herb has been illegal throughout the modern era of scientific medical research. Patients swear the drug works to relieve pain, prevent seizures, and counteract the nausea-inducing effects of cancer
chemotherapy. But by today's standards, there's no definitive proof that this is so.

Why not? Nearly all U.S.-funded marijuana research has looked for harmful effects from using marijuana as a recreational drug. Meanwhile, there's been little money -- and huge regulatory hurdles -- for studies of marijuana's benefits. That's now changing despite the fact that marijuana
remains classed as a Schedule I drug -- a dangerous compound with no medical uses.

Why now? Evidence is beginning to break down the wall of emotion preventing medical marijuana research.

Expert Panels, Breakthrough Findings

It was never clear exactly how marijuana -- which scientists call cannabis - -- exerted its euphoria-inducing effects on the brain. Then, in the 1980s, a series of breakthrough studies showed that the body actually makes its own cannabis-like compounds -- cannabinoids.

Why are they there? That question led to the discovery that the body has an entire system based on cannabinoid signals. The signals seem to calm down overexcited nerve cells, says Igor Grant, MD, professor of psychiatry and director of the Center for Medicinal Cannabis Research (CMCR) at the University of California, San Diego.

"It may be the cannabinoid systems -- this is a crude example -- but I think of them as our internal shock absorbers," Grant tells WebMD. "They are circuits that prevent overexcitability, kind of dampers. If that's correct, there are going to be a number of medical applications. For
example, I wouldn't be surprised if there were applications for epilepsy and other types of seizures."

Grant isn't the only scientist excited by these possibilities.

In 1997, a National Institutes of Health expert panel concluded that more needs to be known about possible marijuana benefits. In 1999, the Institute of Medicine agreed. It pointed to several areas crying out for clinical marijuana research, notes CMCR co-director Andrew Mattison, PhD.

"There are cannabinoid receptor systems in the brain areas that regulate motion -- and, in retrospect, we know that people with multiple sclerosis and difficulty with spasticity sometimes use medicinal cannabis. That is one of the Institute of Medicine indications for clinical trials," Mattison tells WebMD.

"There is a cannabinoid receptor for pain, another site that modulates appetite -- there's going to be a wealth of basic science research that will hopefully have clinical and practical applications to many different medical indications."

Early Clinical Findings Support More Research

Although funded through 2003 and only at various University of California locations by the California state legislature, the CMCR has, by default, become the national clearinghouse for marijuana research.

The CMCR works closely with state and federal regulators - including the FDA, the Drug Enforcement Administration, and the National Institute on Drug Abuse (the only legal source of marijuana in the U.S.). CMCR provides funds for clinical trials of marijuana. It's won national praise for holding its investigators to the highest scientific standards.

Even before the CMCR was up and running, one stubborn researcher managed to launch a marijuana clinical trial. Donald Abrams, MD, now chief of haematology/oncology at San Francisco General Hospital, is best known for being one of the first doctors to recognize and treat the illness that came to be known as AIDS. AIDS patients have long used marijuana to fight the
terrible wasting the disease causes. It's also been said to help an extremely painful condition known as peripheral neuropathy -- a painful nerve disease that has few effective treatments.

Abrams wanted to get federal approval to see whether marijuana really works for this condition. But years of effort proved futile in the face of opposition by federal agencies. Finally, Abrams had a brainstorm. Marijuana affects the immune system. It was just possible that the drug was making
patients worse, not better. He submitted a research proposal to look for a harmful effect of marijuana -- and finally won the approval he sought.

The results of that trial appear in the August 19 issue of “Annals of Internal Medicine”. And they contradict previous studies done in the test tube and with lab animals.

"Much of the published work on marijuana and the immune system is focused on animals and in vitro studies," Abrams tells WebMD. "And, well, if you flood a lot of petri dishes with THC [the active ingredient in marijuana], the immune-cell cultures are going to do poorly.

"In our clinical trial we really didn't see any detriment to the immune system from smoking cannabis. Basically we saw no perturbation of HIV viral load, no detriment to the immune system, and no significant interaction with anti-HIV drugs."

With CMCR funds, Abrams is now doing his peripheral neuropathy study. And he's well on the way to launching a study to see whether adding marijuana to other pain drugs can give relief to dying cancer patients. Overall, the CMCR now has five full-fledged clinical trials under way, which will enrol some 450 patients.

Doctors' Shifting Attitudes on Medical Marijuana

In the last week of July 2003, Medscape -- WebMD's web site for medical professionals -- asked its members what they thought about medical marijuana. It wasn't a scientific poll, although a member's vote is counted only once. Still, the results were surprising. There was a huge response.
Three out of four doctors -- and nine out of 10 nurses -- said they favoured
decriminalization of marijuana for medical uses.

Is it a real trend? Abrams thinks so, but warns that long-held attitudes are slow to change.

"I was pretty much the Lone Ranger of medical marijuana research a few years ago. But not now," he says. "Still, researchers are wary of marijuana research. They feel their reputation may be tainted. And they may be right.

For several years I've been invited to do grand rounds at a local hospital in the Bay area. Last year they disinvited me, and I hear it was because of my marijuana research. I've been disinvited from other speaking engagements, too."

"I think these attitudes will change over time -- but it will be slow-going," Mattison says. "Dr. Abrams' comment is typical. People in the medical profession may chuckle at marijuana research and think it is not a bona fide area for scientific investigation. But that will change as the
science becomes more clear and more understandable and there are, at some point, some practical applications."

One surprising source of support is moral encouragement from conservative politicians.

"We get a number of stories from elected officials who say, 'Look, I am not for legalization of marijuana. But my sick mother, relative, son, is using it and doing so much better, -- there must be something in it,'" Mattison says.

"A number of people have friends where medical therapies aren't working, and cannabis provided relief from spasticity, pain, nausea, or vomiting. That is turning some opinions and helping people let go of the stereotypical notion that medical marijuana is for potheads."

The CMCR has put aside enough money to complete all its currently approved clinical trials. But the California budget crisis means no more money this year -- at least. Does this mean that clinical research into medical marijuana is over? Grant doesn't think so.

"I think that even if our center runs on hard times, the ball has started rolling," he says. "Clinicians and neuroscientists have an interest in this. There is gong to be more research, and more clinical work, whether we do it or not. Eventually, I foresee NIH [National Institutes of Health]
clinical trials. That's my hunch."

A Final Warning

What's changing is the attitude toward investigating possible marijuana benefits. This means more and more doctors are keeping an open mind -- not jumping to the conclusion that the drug will be all things to all people.

"I don't know what the answers will be," Grant says. "The data that are out there suggest there will be some positive applications for marijuana. If I had to bet, I'd say there will be some applications useful for patients in the future."

But, he warns, the opposite could easily be true. The one sure thing about medical research is that it doesn't always provide the answers people expect.

"The caution is that, in the movement toward making marijuana available to patients with no other treatment options, there is the assumption that it is in fact useful. We have to be careful about that," Grant says. "It may be useful for some things, but not useful for others. And if patients take things that are not useful, they may be harming themselves. I urge them to be cautious instead of jumping on the bandwagon and maybe hurting themselves."

----------------------------------------------------------------------------
SOURCES: "Annals of Internal Medicine", August 19, 2003; vol 139: pp 258-266
Vastag, B. "Journal of the American Medical Association", August 20, 2003;
vol 290: pp 877-879.
Workshop on the Medical Utility of Marijuana, National Institutes of Health, 1997. Marijuana and Medicine: Assessing the Science Base, Institute of Medicine, 1999.

Igor Grant, MD, professor of psychiatry and director, Center for Medicinal Cannabis Research, University of California, San Diego. Andrew Mattison, PhD, co-director of the Center for Medicinal Cannabis Research, University of California, San Diego.

Donald Abrams, MD, professor of clinical medicine, University of California, San Francisco, and chief of haematology/oncology, San Francisco General Hospital.
2003 WebMD Inc.

Canada: Montreal Compassion Club goes a Step Further

A sworn statement of a chronic ailment allows one to buy up to 5 grams of pot.

By MARTIN PATRIQUIN
Special to The Globe and Mail

MONTREAL -- The menu at the Montreal Compassion Club is quite unlike those of the chic cafes and bistros that populate the city's Plateau district.

For $7, you can get a gram of Mexican sativa. For $10, you can buy Afghan, Blueberry or the more potent 39-Kush. For $15, you can get a gram of "Super Moroccan" hash, which, according to the man behind the counter, is "the best in the city."

And unlike any other compassion club in the country, people don't need a doctor's note to get anything off the list. All that is required is a sworn statement that the person has a chronic ailment, and they can buy up to 5 grams of anything that helps ease the pain.

This has been the arrangement since December, 2002, said Boris St-Maurice, a local marijuana activist and director of the Compassion Club. Although the club has distributed medical marijuana to its 300 members since 1999, Mr. St-Maurice decided to relax the rules in late 2002 because most doctors were reluctant to endorse (much less prescribe) the drug.

"The college of physicians wanted nothing to do with it, the [Canadian Medical Association] wanted nothing to do with it," Mr. St-Maurice said. "Who wants to go to war with the doctors? It was a dead end."

Instead, Mr. St-Maurice asks only that prospective patients join the compassion club (membership is free) and go to a notary public and make a sworn statement that they require medicinal marijuana. The City of Montreal will notarize these statements for $5, and as a result, more patients have been passing through city offices.

"Since February, I've done many, many declarations [for people going to the Compassion Club]," said Louise Ladouceur, a city clerk in the Plateau district.

The sworn statement is taken to the club's headquarters, a small storefront just off St-Laurent Boulevard crammed with employees, volunteers and users. A file is opened, I.D. is checked and the prospective customer is told the club has the discretion to deny them marijuana.

Once accepted, the new patient orders and waits, listening to decidedly un-cheesy waiting room music -- more Black Sabbath than Yanni. Within a few minutes, they are called behind a curtain, handed a baggy full of dope by a man behind a set of scales, and are asked for payment. "Montreal Compassion Club," reads the label. "For therapeutic use only. Not for resale."

"I would defend the oath because of the quagmire surrounding doctors," Mr. St-Maurice said, estimating "maybe one person in 50" has lied to get marijuana. "These are a very small minority of cases. We are asking people for I.D. and documents. I won't hesitate to pursue legal action" against frauds.

Nor is he particularly worried about trouble from police, given the number of cases involving marijuana pending in provincial and federal court. This includes three major cases before the Supreme Court, in which decisions are expected later this year.

"It would be very unwise to proceed with anything having to do with pot before the Supreme Court rulings. They might get egg on their face," Mr. St-Maurice said.

The Montreal police haven't visited the Compassion Club, Mr. St-Maurice said. A police public-relations official could not comment yesterday.

The club gets its pot from small-time growers and people dedicated to the cause. "Anybody but the bikers," Mr. St-Maurice said. "I've terminated contracts with people because they were too close to organized crime."

The Vancouver Compassion Club, considered to be the pioneer when it comes to the distribution of medical marijuana, applauds Montreal's club.

"I have to commend them for their courage for taking the risk to help their patients," said Hillary Black, founder of the Vancouver club. "All the boundaries have to be pushed."

Claude Messier is certainly grateful. The 37-year-old writer has muscular dystonia, a rare condition characterized by constant involuntary muscle contractions, and has been smoking up to 28 grams of pot a week since 1999.

"The Compassion Club is very good. It relaxes my muscles. If I don't smoke, the pain is so hard that it stops me from working."

Australia: Not Quite So Potty

SINCE Tasmania's Country Women's Association voted unanimously to lobby for the trial use of marijuana for medical relief, Ailsa Bond's popular cheese and parsley scones have been the subject of many a joke.

"People joke that the parsley flakes could be replaced with other green flakes!" she says.

The move from the CWA to get the drug approved for medical use surprised many, but the sprightly 80-year-old responds that the organisation has always been progressive."We've been raising social issues for 60 or 70 years," she said. "We've talked about the value of water, the importance of trees, we've lobbied for childcare centres, for roads, for hospitals and libraries.

"We've got an image that all we do is have tea and scones, but we've always been outspoken.

"It's just that we haven't always been recognised for what we've done."

Even so, Mrs Bond said she was surprised to see her motion passed unanimously.She hadn't bargained on the strong support of several members who had nursed terminally ill partners and witnessed their pain.

One of the women to address the meeting was Ruth (not her real name) whosehusband died from cancer.

She later told the Sunday Tasmanian of her agony as her husband became so fragile that he broke a rib just reaching over to turn off a radio, and suffering pain so terrible it made him cry.

"To him, morphine was a poison," she said. "It made him so dreadfully ill, he couldn't keep food down. He wasted away to just 48kg.

"The doctors tried so many other pain-killers and every anti-nausea drug but nothing worked.

"It wasn't just the pain, it was the indignity."

Ruth read of overseas studies about the use of marijuana for pain relief and thought it might be just the thing as it was reported to have anti-nausea properties. But her doctor said he couldn't prescribe it.

"I read that smoking it was the most effective way. People think 'smoking - -- yuck!' but when someone is near death you're hardly going to worry about them getting lung cancer, are you?" she said.

"Of course, it might not have helped my husband -- but it may have done. What harm could there be in trying it?

"I feel very strongly about this. People don't realise the absolute horror of watching someone you love in so much pain."

Mrs Bond recalls prescribing a liquid tincture of marijuana in her early days of pharmacy in the 1940s, before concerns grew about its recreational use.

"Methadone can be controlled as a treatment for heroin addicts, so why couldn't cannabis be controlled too?" she said.

Another CWA member was disappointed to read in The Mercury this week that the State Government had responded that it had no plans to legalise medicinal use of cannabis. The woman, who is nursing a husband with war-related health problems, wants Tasmanian laws to mirror those of South Australia and the ACT where growing plants for personal use is tolerated.

"You just can't imagine the sense of hopelessness when someone is suffering like this and something that might help is beyond your reach," she said.

Potent New Canadian Pot

Date: Fri, 05 Sep 2003 21:35:35 -0700
From: "D. Paul Stanford" stanford@crrh.org
Subject: 001 SC: Ridgeland P.D. seizes new type of marijuana
Newshawk: CMAP ( http://www.mapinc.org/cmap )
Pubdate: Saturday, September 6, 2003
Source: Carolina Morning News (SC)
Contact: cmn@lowcountrynow.com
Website: http://www.lowcountrynow.com/
Webpage: http://www.lowcountrynow.com/stories/090603/LOCbcbud.shtml
Ridgeland P.D. seizes new type of marijuana
Carolina Morning News

Ridgeland police confiscated dozens of pounds of a new type of potent Canadian marijuana during a traffic stop Friday that may be worth nearly half a million dollars.

Two members of the department's new Interstate Criminal Enforcement team stopped a car at about 1 p.m. for following another vehicle too closely.

During the traffic stop, on southbound Interstate 95, they allegedly found marijuana in sealed plastic bags tucked in a suitcase in the trunk.

The amount was estimated at 60 to 100 pounds, said Investigator Chris Stevers.

The marijuana is believed to be "B.C. bud," a new type of pot out of British Columbia, Canada, that is five times more potent than normal marijuana, Stevers said.

Its estimated street value is about $5,000 per pound, he said.

The driver, a Canadian man, was arrested but additional details were not available Friday.

The Interstate Criminal Enforcement team is part of a new initiative partly funded through a federal grant, aimed at catching drug shipments on I-95.

Report of Ecstasy Drug's Great Risks Is Retracted

A leading scientific journal yesterday retracted a paper it published last year saying that one night's typical dose of the drug Ecstasy might cause permanent brain damage.

The monkeys and baboons in the study were not injected with Ecstasy but with a powerful amphetamine, said the journal, Science magazine.

The retraction was submitted by the team at Johns Hopkins University School of Medicine that did the study.

A medical school spokesman called the mistake "unfortunate" but said that Dr. George A. Ricaurte, the researcher who made it, was "still a faculty member in good standing whose research is solid and respected."

The study, released last Sept. 27, concluded that a dose of Ecstasy a partygoer would take in a single night could lead to symptoms resembling Parkinson's disease.

The study was ridiculed at the time by other scientists working with the drug, who said the primates must have been injected with huge overdoses.

Two of the 10 primates died of heat stroke, they pointed out, and another two were in such distress that they were not given all the doses.

If a typical Ecstasy dose killed 20 percent of those who took it, the critics said, no one would use it recreationally.

In an interview yesterday, Dr. Ricaurte said he realized his mistake when he could not reproduce his own results by giving the drug to monkeys orally. He then realized that two vials his laboratory bought the same day must have been mislabeled: one contained Ecstasy, the other d-methamphetamine.

Dr. Ricaurte's laboratory has received millions of dollars from the National Institute on Drug Abuse, and has produced several studies concluding that Ecstasy is dangerous. Other scientists accuse him of ignoring their studies showing that typical doses do no permanent damage.

At the time Dr. Ricaurte's study was published, it was strongly defended against those critics by Dr. Alan I. Leshner, the former head of the drug abuse institute, who had just become the chief executive officer of the American Academy for the Advancement of Science, which publishes Science.

Dr. Leshner had testified before Congress that Ecstasy was dangerous, and Dr. Ricaurte's critics accused him of rushing his results into print because a bill known as the Anti-Rave Act was before Congress. The act would punish club owners who knew that drugs like Ecstasy were being used at their dance gatherings.

Dr. Ricaurte yesterday called that accusation "ludicrous."

His laboratory made "a simple human error," he said. "We're scientists, not politicians."

Asked why the vials were not checked first, he answered: "We're not chemists. We get hundreds of chemicals here. It's not customary to check them."

THAT'S ALL FOR NOW FOLKS!