The Grass Is Greener...Or Not

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Mar.8, 00
Wired Magazine
The Grass Is Greener ... Or Not
( 2 Studies Have Given Ammo to Both Sides )
By Kristen Philipkoski
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Two studies have given ammunition to both sides in the ongoing medicinal marijuana controversy. One study, presented last week at an American Heart Association conference, showed that the risk of heart attack increased nearly fivefold for one hour after using marijuana.
The other study, published in Nature, claims that marijuana can help patients with muscle spasticity diseases, such as multiple sclerosis.
Pot is legalized for medicinal use in seven states, where it is used to ease the pain of cancer therapy and to mitigate the effects of AIDS wasting syndrome. Cannabinoids -- chemicals found in marijuana -- have also recently been shown to kill brain tumors in rats.
For the American Heart Association study, researchers at the Beth Israel-Deaconess Medical Center in Boston studied 3,882 between between the ages of 20 and 92 over an eight-year period. They found the first evidence that smoking marijuana can trigger heart attack. "We need to look at that more closely and to look at it better," said Kevin Zeese, president of Common Sense for Drug Policy. "The researchers didn't really understand why and how the heart attacks happened. This is one sample and a useful beginning, but we need more research into this." The study found that although the short-term risk is considerable, the danger of heart attack quickly subsides after a few hours. Valerie Corral, founder and director of the Women's Alliance for Medical Marijuana, said the results aren't all that surprising. "It has been common knowledge that marijuana does increase one's heart rate and with that consideration we at WAMM have always discouraged its use for people with heart problems," she said. "We ask that they seek medical advice before using marijuana medically." Regular marijuana users made up 3.2 percent of the total study population, and 37 subjects said they had used marijuana within 24 hours of having a heart attack. Nine patients said they smoked within one hour prior to developing their heart attack symptoms. "As far as a heart attack risk, that should trouble the baby boomers" since they are likely to have other risk factors, said Robert Maginnis, the Family Research Council's senior director for national security and foreign affairs. It's unclear, the researchers said, whether marijuana specifically triggers the heart attack or whether the carbon monoxide or other chemicals in the smoke increases the risk. Maginnis agreed that the results are not unexpected. "This just adds to a phalanx of other problems with marijuana documented in the science," Maginnis said. Besides cannabis, pot smokers inhale "more than 400 other compounds in crude marijuana and many are documented by the NIH as being carcinogenic," he said.
Maginnis was unenthusiastic regarding the other study, published in Nature, which suggested marijuana could treat diseases like multiple sclerosis. "This might show that THC cannabis has some sort of effect specifically in tremors, but we obviously have to wait until we have a double-blind study done," he said. For the Nature study, researchers of the MS Society of Great Britain and Northern Ireland looked at an autoimmune model of multiple sclerosis in mice. They found that high doses of two types of cannabinoids lessened tremor and spasticity, two early symptoms of multiple sclerosis. The researchers said that human trials should follow soon. "That's not new," Zeese said. "It's been known for a long time that marijuana can be used for therapies for all kind of muscle spasms. It goes back a century."
Maginnis said he is against the legalization of medical marijuana because it sets a bad example for children; if it's known as medicinal, kids might be more likely to try it, he said. He is not opposed, however, to developing drugs that contain cannabinoids (the THC cannabinoid has been available by prescription since 1985). "There is good science out there and we ought to rely on science, not on ideology as I firmly believe is in California and other states [where medicinal marijuana is legalized]," Maginnis said. "We need to be compassionate to sick people, but when you take into account that we have a phalanx of very good medications that our doctors can prescribe that are pure and properly dosed," he said. "There's no way to titrate [smoked marijuana] enough to get the right sort of dose." But others argue that's exactly what's superior about smoking marijuana as opposed to taking it as a pill.
"In the early '80s, there was research that compared smoked marijuana to the THC pill in about six states," Zeese said. "The conclusions showed that crude marijuana had less psychoactive effects. It was also more effective because the pill has to go through the stomach, which slows down the action." He said that smoking can also be more appropriate because patients can self-regulate how much they're taking. "With smoking, you smoke it and you get an immediate effect and within minutes the nausea goes away," he said. "You can just take one or two puffs." Both Zeese and Corral believe more research on the potential benefits of marijuana need to be done. Instead, Zeese said, studies often focus on the possible dangers. Corral, who has worked with hundreds of terminally ill patients for the past seven years, agreed. "The most confounding problem is that there is insufficient research to establish safety [unless one considers marijuana's rather innocuous use for thousands of years]. However, there exists volumes of anecdotal evidence to support marijuana's efficacy," Corral said. "Comparatively, marijuana may be among the least harmful homeopathic medicines, especially when one considers the contraindications of the myriad of allopathic drugs prescribed by doctors and used by patients throughout the world," she said. "That marijuana serves to mitigate the symptoms of such a diverse number of illnesses is remarkable." The best alternatives to smoking pot are yet to come, Maginnis said. Dr. Mahmoud ElSohly, a researcher at the University of Mississippi, has developed a cannabinoid suppository to treat nausea and vomiting associated with cancer chemotherapy, as well as AIDS-related wasting syndrome and other maladies. Maginnis said the suppository has been shown to deliver effects faster than smoking, and should be available within two year. A medicinal marijuana patch is in development at the Albany College of Pharmacy in New York, and a cannabinoid medicine that can be delivered via a vaporizer is on the horizon as well. Iain Murray, an analyst at the Statistical Assessment Service in Washington, D.C., agreed that these would be better options. "Modern medicine is all about refining medicines to the point where the beneficial effects are maximized and side-effects minimized," he said. "Simply put, it does not ask sick patients to inhale potentially toxic burning leaf smoke."
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