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lethe

medical marijuana

745 posts in this topic

Here is the "expert opinion " published by the National MS Society:

 

link to pdf from nmss

 

Just a guess, but the process of getting on the approved list in a state probably involved backing from a national advocacy group, as well as doctor testimony before a committee hearing, which would be gutsy for a doctor, given peer attitudes toward mj in general, and patient testimony.

 

-- pdbill

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I'm far from being an expert on the stuff but I believe I've read somewhere that there are different strains of marijuana that affect you in different ways. Personally I'd probably only use it to help me relax and sleep. I SO wish it was legal in my state.

 

There are well over 100 strains and as I mentioned before, commercial (street) marijuana is grown with an eye towards profits so they grow strains that grow fast and abundantly, with no real "cultivation" or recognition of genetics, which means sleep-inducing indicas - which is why many people associate the "munchies" (hunger) and a sleepy- looking expression (stoned) with red eyes to marijuana use. With medical marijuana (MM) many strains, particularly sativas, actually can have a clear-headed and stimulating effect, helping one become active physically and mentally. Unlike regular marijuana, the usual visible giveaway signs are not there. You don't look "stoned" or anything out of the ordinary.

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So the evidence seems to be really compelling regarding mmj and neuroprotection. Possibly symptom relief, for bradykinesia, maybe tremor. Even for cell rescue in the early stages.Have any of the national PD advocacy groups taken a position on mmj? Seems to me that a campaign is in order, along the lines of what the MS advocacy groups has done? As of now, PD is in the approved list only in California. However, MS is in every state with mmj laws, and it seems like the science behind mmj for PD is at least as compelling, and overlaps quite a bit with the MS justifications. MS obviously is quite different, in terms of the need for pain management and relief from muscle spasticity. To make it legal for medical use for PD at the state level, it would be helpful to have a national medical advisory panel support it. Can anyone clue us in on whether such a panel exists or is being considered?

--pdBill

 

Unfortunately as far as I've looked I haven't heard of any, only relating to AIDS and MS. I've visited many PD sites and MM just is not promoted. I suspect that may be partially because PD is more common in older people, who have never used it but formed strong opinions about it. I've run into less than a handful of PWP legally using it. But this is true for almost all ailments, MM just doesn't get the recognition it deserves. It's hard for people to get past the myths and propaganda. Up until now MM research has been severely limited by law. Nevertheless, the research and discoveries that have happened have yielded amazing results on a variety of fronts, but the medical establishment remains deliberately head-in-the sand. Both in the U.S. and here in Canada the public overwhelmingly supports the use of MM, however doctors have been a major stumbling block to progress. Many advocates realize its the doctors who really need to be educated - the majority once graduated don't keep up with medical news outside their specialty or area of focus. More influential is Big Pharma, who funds Drs and researchers and have been lobbying for exclusive access and control of MM. Here in Canada, even though crime is way down the Conservative govt is funding superjails and bringing in legislation that would mean automatic jail time for growing marijuana, as well as taking away the legal right of comfirmed patients right to grow their own safe, clean medicine.Big Pharma will control and no doubt screw it up!!

 

Also - ironically from my research, of all the diseases that might benefit from MM, PD stands out as having the most compelling scientific evidence explaining how and why, and treating the widest variety of symptoms.

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Here is the "expert opinion " published by the National MS Society:link to pdf from nmss

just a guess, but the process of getting on the approved list in a state probably involved backing from a national advocacy group, as well as doctor testimony before a committee hearing, which would be gutsy for a doctor, given peer attitudes toward mj in general, and patient testimony.

-- pdbill

 

Thanks for posting this pdbill. Fantastic to see a mainstream organization coming out so wholeheartedly with most of the real info, especially relating to the effectiveness of smoked marijuana, though for some reason they didn't mention vaporization. I want to reread that when I get a chance. Interesting contrast between inconclusive results in some studies and the high degree of anectdotal evidence from patients concerning effectiveness.

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I found a list of strains but it's huge! I'll try and regularly post parts of the list. Why so many? Many growers are constantly combining different strains and experimenting. Googling a strain name will often get you lots of info about a strain - specifics on growing it and it's effects. Below, the strain name comes first, than in brackets the seed company it's from, than the two or three strains that combine to make up the strain. X separates the strain components.

 

 

 

Strain Guide

 

A

A-K (BC Seed Co.) Afghani #1 X Hindu Kush

Acapulco Gold (Dr. Greenthumb) Landraces; Mexico, Acapulco

Afghan Delight (Soma) Afghani Skunk X Afghani Hawaiian

Afghani Orange (Capricorn) California Orange X Afghani

Afghani Special (KC Brains) Afghani X Double Afghani

Afghani Wonder (Blue Hemp) Afghani X Pakistani

Afghanica (Flying Dutchmen) Afghani #1 X Original Skunk

AK-47 (Serious) Colombian X Mexican X Thai X Afghani

All Green (Celebrity) Hindu Kush X Haze

Alp King (Valchanvre) Afghani X Skunk

Alpha 13 (Dr Chronic)

Amarelo (Brazilian Seed) Landraces; Brazilian Sativa

Amazonia (White Widow Web) White Widow X Green Thai

Ambrosia (Jordan of the Island) God Bud X Burmese

Americano (Entreprise) Skunk X Northern Light

Amethyst Bud (Soma) Lavender Bud X Afghani Hawaiian

Amnesia 99 (JLP) Soma Amnesia Haze X Cinderella 99

Amnesia Haze (Soma) Afghani Hawaiian X SouthEast Asia

AMS (Greenhouse) Swiss Sativa X Swiss Indica

Amstel Gold = Passion #1 (Dutch Passion) Amsterdam Bubblegum (THC Seeds) Afghani X Blueberry

 

Apollo 13 (Brothers Grimm) Genius X Princess 88

Apollo GF4 (Canadian Seed Co.) Apollo 11 X Genius

Apollo Mist (Reservoir) Apollo 11 G4 X 1998 Pre-Sensi Kali Mist Mother

Apollo Orange (Spice Brothers) California Orange X Apollo 11 Genius pheno

Apollo Thunder (Spice Brothers) Apollo 11 X Matanuska ThunderINAPPROPRIATE

Apollos Trip (Reservoir) Apollo 11 X Apollo 13

Apple Pie (Reeferman) Acapulco Gold X Highland Nepalese

Arjans Haze #2 (Green House) Nevilles Haze X Super Silver Haze X Laosian

Arjan's Strawberry Haze (Greenhouse) Swiss Sativa X [Northern Light #5 X Haze]

Asia Girl (Reeferman) [Thai X Nepalese] X Northern Lights #5

Astroboy (Subcool) Apollo13 X Ortega X Cinderella 99

Aurora (Chimera) Blue Domino X Northern Light

Aurora B (Flying Dutchmen) Northern Lights X Skunk #1

Aurora Indica (Nirvana) Afghani X Northern Lights

Australian Blue (Homegrown Fantaseeds) Duck X Blue Haze

Avalon (Next Generation) Afghani X Blueberry

arjan's strawberry haze (greenhouse) swiss sativa X [northern light #5 x haze]

AMS (greenhouse) swiss sativa X swiss indica

americano (entreprise seeds) skunk X northern light

amsterdam flame(paradise seeds) india x california (hollande)

atomic nothern lights(dr atomic) afghani indica(nord ouest us)x thai haze

Alp king: Afghani X Skunk

Alp Red: Alp King x Red Valais

Agent Orange: Orange Velvet X (JC x SQ) JTR

afghani Wonder arents: Afghani x Pakistani

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Here is a website that has fought the govt for access to marijuana for studies and is involved in lawsuits:

 

http://www.maps.org/research/mmj/

 

 

 

"MAPS is currently seeking regulatory approval to conduct a study of smoked and/or vaporized marijuana for symptoms of PTSD in veterans of war.

 

MAPS is currently the only organization working to demonstrate the safety and efficacy of botanical marijuana as a prescription medicine for specific medical uses to the satisfaction of the U.S. Food and Drug Administration.

 

MAPS' efforts to initiate medical marijuana research have been hindered by the National Institute on Drug Abuse (NIDA) and the Drug Enforcement Administration (DEA) since its inception in 1986. NIDA's monopoly on the supply of marijuana for research and the DEA's refusal to allow researchers to grow their own has effectively paralyzed medical marijuana research, and for over ten years MAPS has been involved in legal struggles against the DEA to end this situation.

 

See below for frequently updated information about completed, ongoing, or planned MAPS studies, as well as details of our ongoing DEA lawsuit."

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http://www.maps.org/mmj/pr5.02.03.html

 

Study Shows Vaporizer Can Drastically Reduce Toxins in Marijuana Smoke

California NORML/MAPS Press Release

May 2, 2003

 

Harmful toxins in marijuana smoke can be effectively avoided by a vaporization device, according to a new study by California NORML and MAPS (Multidisciplinary Association for Psychedelic Studies) with support from a grant from the MPP (Marijuana Policy Project).

 

The study, conducted by Chemic Labs in Canton, Mass., tested vapors from cannabis heated in an herbal vaporizer known as the Volcano® (manufactured by Storz & Bickel GmbH&Co. KG, Tuttlingen, Germany; http://www.storz-bickel.com) and compared them to smoke produced by combusted marijuana. The Volcano® is designed to heat material to temperatures of 130° to 230° C (266° to 446° F) where medically active vapors are produced, but below the threshold of combustion where smoke is formed.

 

The vapors from the Volcano® were found to consist overwhelmingly of THC, the major active component in marijuana, whereas the combusted smoke contained over 100 other chemicals, including several polynuclear aromatic hydrocarbons (PAHs), carcinogenic toxins that are common in tobacco smoke. The respiratory hazards of marijuana and tobacco smoke are due to toxic byproducts of combustion, not the active ingredients in the plant, known as cannabinoids.

 

The study suggests that medical marijuana patients can avoid the respiratory hazards of smoking by using a vaporizer. In its 1999 report on medical marijuana, the Institute of Medicine recommended against long-term use of smoked marijuana because of the health risks of smoking. However, the IOM failed to take account of vaporizers.

 

Previous studies have found that vaporizers can reduce harmful toxins in cannabis smoke. However, this is the first study to analyze the gas phase of the vapor for a wide range of toxins. A previous NORML/MAPS study conducted by Chemic Labs found that a vaporizer known as the M-1 Volatizer® (http:// www.volatizer.com) completely eliminated three specific toxins (naphthalene, benzene and toluene) in the solid phase of the vapor (D. Gieringer, "Cannabis Vaporization: A Promising Strategy for Smoke Harm Reduction," Journal of Cannabis Therapeutics Vol. 1#3-4: 153-70 (2001); http://www.canorml.org/healthfacts/vaporizerstudy1.html).

 

The new study used a gas chromatograph mass spectrometer (GCMS) to examine the gas components of the vapor. The analysis showed that the Volcano® vapor was remarkably clean, consisting 95% of THC with traces of cannabinol (CBN), another cannabinoid. The remaining 5% consisted of small amounts of three other components: one suspected cannabinoid relative, one suspected PAH, and caryophyllene, a fragrant oil in cannabis and other plants. In contrast over 111 different components appeared in the gas of the combusted smoke, including a half dozen known PAHs. Non-cannabinoids accounted for as much as 88% of the total gas content of the smoke.

 

The study used standard NIDA cannabis with 4% THC content. A quantitative analysis found that the Volcano® delivered 46% of the THC into vapor following three 45-second exposures of the sample to the heat. This compares favorably with the typical efficiency of marijuana cigarettes as observed in other studies, which depending on conditions can fall below 25% due to loss of THC in sidestream smoke. An important feature of the Volcano® is that it uses a balloon to capture the vapor, thereby avoiding leakage to the air. It is possible that higher THC efficiencies could have been reached with the Volcano® by stirring the sample around and exposing it to more heat.

 

The combusted sample achieved a relatively high THC efficiency of 78% upon complete combustion. The high efficiency seems due to the fact that the sample was completely consumed by combustion, and that smoke leakage was effectively prevented by the laboratory setup. Similar conditions do not obtain under normal circumstances when a marijuana cigarette is smoked and much of the THC is lost to the air or left in the unburned "roach."

 

Two other cannabinoids, cannabidiol (CBD) and cannabinol (CBN), were detected in the NIDA cannabis in trace amounts of 0.1%. Both the Volcano® and combustion delivered an apparent increase in CBD and CBN, but the variance of the data was too high to reach statistically significant conclusions.

 

Sponsors believe that the study results lend support for wider use of vaporizers by medical marijuana patients and researchers. At present, the only FDA-approved method for administering marijuana to human research subjects is via smoking NIDA cigarettes. NORML and MAPS are supporting efforts to have vaporizers approved by the FDA. As a first step in this effort, Dr. Donald Abrams of the University of California, San Francisco, has submitted a grant proposal to the California Center for Medical Cannabis Research in San Diego to test the Volcano® in human subjects. If the protocol is funded and the Volcano® approved by the FDA for human research, it will be the first human study using a vaporizer. If the FDA requests additional laboratory data about the Volcano@, additional funding may be necessary.

 

For more information on vaporizers, see http://www.maps.org/mmj/vaporizer.html and http://www.canorml.org/healthfacts/vaporizers.html

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Vaporizing

 

Vaporizing is simply not burning marijuana but heating it at lower levels, thereby releasing chemical compounds by vaporization.

 

Although the principle behind it is simple vaporizers run the gamut from the utilitarian Dominizer (link below) for $20 (two glass tubes), to the “Cadillac” of vaporizers, the Volcano for $900.

 

Dominizer:

 

http://www.vaporcentral.com/Dominizer.html

 

Volcano -

 

http://www.storz-bickel.com/vaporizer/volcano-vaporization-system.html?gclid=CPKNmeXb96oCFY8DQAodqWeAGA

 

I use the Herbalaire, which although a simple instrument it is widely considered to extract more (3 or 4 more bags) vapor. It sells for $300 and I highly recommend it.

 

Herbalaire:

 

http://www.herbalaire.com/scientific.htm

 

 

There are dozens of others, just google vaporizers.

 

 

Vaporizer in action (demo):

 

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Its a drug.

Hope it helps.

 

What do you mean when you say "Its a drug"?

 

A drug as in the way the FDA looks at it?

 

according to the Food, Drug, and Cosmetic Act (1) : a substance recognized in an official pharmacopoeia or formulary (2) : a substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease (3) : a substance other than food intended to affect the structure or function of the body (4) : a substance intended for use as a component of a medicine but not a device or a component, part, or accessory of a device.

 

or as defined by the DEA?

 

"an illegal substance that causes addiction, habituation, or a marked change in consciousness"

 

Personally I'd define it as an herb that I could grow in my backyard garden if it wasn't illegal. :)

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What do you mean when you say "Its a drug"?

 

A drug as in the way the FDA looks at it?

 

according to the Food, Drug, and Cosmetic Act (1) : a substance recognized in an official pharmacopoeia or formulary (2) : a substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease (3) : a substance other than food intended to affect the structure or function of the body (4) : a substance intended for use as a component of a medicine but not a device or a component, part, or accessory of a device.

 

or as defined by the DEA?

 

"an illegal substance that causes addiction, habituation, or a marked change in consciousness"

 

Personally I'd define it as an herb that I could grow in my backyard garden if it wasn't illegal. :)

 

 

 

I like this definition:

 

"A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function."(http://en.wikipedia.org/wiki/Drug) After " bodily function," I would add "and psychological perception."

 

Pot is a drug. So is coffee and crack.

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I like this definition:

 

"A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function."(http://en.wikipedia.org/wiki/Drug) After " bodily function," I would add "and psychological perception."

 

Pot is a drug. So is coffee and crack.

 

I'd not group coffee or marijuana into the same category as crack. The only thing all three things you mentioned have in common is that they all affect dopamine in one way or the other.

 

Crack cocaine is a Schedule II substance. Cocaine, in any form, is a powerfully addictive drug, and addiction seems to develop more quickly when the drug is smoked--as crack is--than snorted--as powdered cocaine typically is. In addition to the usual risks associated with cocaine use (constricted blood vessels; increased temperature, heart rate, and blood pressure; and risk of cardiac arrest and seizure), crack users may experience acute respiratory problems, including coughing, shortness of breath, and lung trauma and bleeding. Crack cocaine smoking also can cause aggressive and paranoid behavior.

 

It is interesting how crack cocaine is a substance that affects the brain chemistry of the user: causing euphoria,[7] supreme confidence,[8] loss of appetite,[7] insomnia,[7] alertness,[7] increased energy,[7] a craving for more cocaine,[8] and potential paranoia (ending after use).[7][9] Its initial effect is to release a large amount of DOPAMINE,[2] a brain chemical inducing feelings of euphoria. The high usually lasts from 5–10 minutes,[2][7] after which time dopamine levels in the brain plummet, leaving the user feeling depressed and low. A typical response among users is to have another hit of the drug; however, the levels of dopamine in the brain take a long time to replenish themselves, and each hit taken in rapid succession leads to increasingly less intense highs.

 

So it appears that a crack addict could experience some of the same feelings that us parkies feel when our dopamine isn't at the correct level. I don't understand why anyone would want to bring that on themselves??

Edited by CynthiaM

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I'd not group coffee or marijuana into the same category as crack. The only thing all three things you mentioned have in common is that they all affect dopamine in one way or the other...

 

So it appears that a crack addict could experience some of the same feelings that us parkies feel when our dopamine isn't at the correct level. I don't understand why anyone would want to bring that on themselves??

 

People take drugs to escape reality. Example: I take Mirapex to escape PD symptoms and I drink coffee to escape fatigue feelings. PD is my reality at this stage of my life. If pot is helpful to re-leave PD symptoms... should it be legal?

 

My answer is tainted by being a heavy pot smoker in the late 70's. Pot made "me" dopey. (Maybe it was all the Strohs that went down with it.) That's why we called pot... dope, back in the day.

 

Like I said, I think it is a drug. I hope it helps you.

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People take drugs to escape reality. Example: I take Mirapex to escape PD symptoms and I drink coffee to escape fatigue feelings. PD is my reality at this stage of my life. If pot is helpful to re-leave PD symptoms... should it be legal?

 

My answer is tainted by being a heavy pot smoker in the late 70's. Pot made "me" dopey. (Maybe it was all the Strohs that went down with it.) That's why we called pot... dope, back in the day.

 

Like I said, I think it is a drug. I hope it helps you.

 

Unfortunately I can't even try it because the DEA groups it together with heroine and LSD. It's illegal in my state and I try my best to not break the law. I know that from experimenting with it when I was a young adult in the early 80's that if I could use it legally right now, I'd not be suffering from only being able to sleep 2-3 hours a day. It would make me sleep like a baby and wake refreshed in the morning rather than groggy like other sleep aids make me feel. I'd bet the stuff you can legally buy at the pharmacy (if you can afford it) is more toxic to the body than a little medicinal marijuana.

 

edited to add: Mirapex made me have hallucinations, compulsive issues and when I went off of it I had to experience terrible withdrawal symptoms :(

Edited by CynthiaM

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http://tinyurl.com/6kebbsw

 

(Link includes video!)

 

Montana Dad Gives Cancer-Stricken Boy Marijuana Behind Doctor's Back

 

By SUSAN DONALDSON JAMES

May 5, 2011

 

Doctors said 2-year-old Cash Hyde would likely die after they found a stage 4 brain tumor surrounding his optic nerve just a year ago this week.

 

And he nearly did. After being subjected to seven different chemotherapy drugs, the little boy from Missoula, Montana suffered septic shock, a stroke and pulmonary hemorrhaging.

 

Cash was so sick he went 40 days without eating. His organs were threatening to shut down. His father, Mike Hyde, intervened, slipping cannabis oil into his son's feeding tube.

 

In Montana, medical marijuana is legal. Hyde had used it himself to treat his attention deficit disorder. When Cash was diagnosed in May 2010, Mike got him a marijuana card and purchased the drug from his own supplier.

 

Cash, now 3, made a miraculous recovery at Primary Children's Hospital in Salt Lake City, but his father's bold action -- taken behind doctors' backs -- has raised serious questions about a parent's role in medical treatment.

 

Hyde said he believes it was the marijuana oil that helped Cash eat again and that the drug -- illegal in most states, including Utah, can cure cancer.

 

"Not only was it helpful," Hyde, 27, told ABCNews.com. "It was a godsend."

 

Dr. Linda Granowetter, a professor of pediatrics at New York University and chief of the Division of Pediatric Hematology and Oncology, told ABCNews.com that Hyde's intervention was "fascinating" but "somewhat bothersome."

 

Granowetter said she agrees that cannabis -- the chemical form, THC can be found in the prescription drug Marinol -- is effective in treating adult nausea that accompanies chemotherapy. But there have been no clinical trials in children.

 

"Its virtue is we know exactly what you are getting and how much," she said. "I think that the fact that he didn't have the rapport and ability to be honest with the doctor is very troubling. Care is impeded when there is not complete trust."

 

Hyde, who quit his job as a car salesman when Cash was diagnosed with cancer, said he was afraid Cash's doctor might take the marijuana away.

 

"When you are told your kid has cancer, whoa," said Hyde, 27. "Then they tell me they have to do aggressive chemo and he's probably not going to make it. It's a lot to take on."

 

He had read claims by researchers online about cannabis's properties: "It's one of the best nausea and pain medications on the market," he said.

 

Because there are no pediatric oncology facilities in rural Montana, where Cash's tumor was discovered in a CT scan at the local emergency room, he was rushed to Salt Lake City, the nearest treatment center.

 

He was given the highest possible doses of chemotherapy for two months. He lost his appetite and threw up eight to 10 times a day.

 

"When he started the chemo, he was so sick," said Hyde. "For the first six weeks, he was blind. But his tumor was shrinking… It's the nastiest thing to see someone you love go through this."

 

Doctors had inserted a gastric feeding tube to administer cancer-fighting drugs and to help with his nutrition, but when August came the family experienced another medical "rollercoaster ride," according to Hyde.

 

"The G-tube burned out the inside of his stomach," said Hyde. "He didn't even have the will to eat."

 

By September, Cash had stopped eating for 40 days. "He was suffering terribly, and the doctors said it was the best they could do for him," said Hyde, who asked doctors to stop the chemotherapy drugs.

 

Instead, Hyde boiled up marijuana he had purchased in Montana with olive oil and measured 3 mm. doses that he poured into his son's G-tube twice a day.

 

Because it was illegal to use medical marijuana in Utah, Hyde never told his doctors.

 

Page 2 of 2

 

May 5, 2011

Cash Hyde Makes 'Miracle' Recovery'

 

"In two weeks he was weaned of all the nausea drugs, and he was eating again and sitting up in and laughing," according to Hyde, who said doctors called his son's recovery "a miracle."

 

NYU's Granowetter said cannabis "certainly can increase appetite and improve mood...but the idea that it can cure cancer is ludicrous."

 

She said the drug is most effective in teens who have previously used marijuana. "In young adults or children who have not had it before, it can make them paranoid."

 

"It's awfully hard to gauge if a child would have a bad reaction," according to Granowetter, who said she would welcome clinical trials on children.

 

"We know from research that 30 to 60 percent of parents with children are giving them alternative meds like vitamins, shark tooth and herbs from Chinatown," she said. "That's why we spend a lot of time asking parents what else they are giving kids and trying to be non-judgmental and work with them and guide them."

 

She said most pediatric oncologists are "open-minded" about alternative treatments.

 

Mike Hyde said he did eventually tell the Utah doctors, who were surprised by how Cash bounced back with no permanent organ damage. They say the boy has a 50 to 80 percent chance that the cancer will come back, according to Hyde, who has since started a foundation to help children with cancer.

 

"We were told I was one of the best dads," said Hyde, who lived with his wife and their other 6-year-old son in a camper in a parking lot for the nine months of treatment. "Every encounter in Salt Lake City, we were positive and never quit fighting. I was told he was going to die, but I knew he hadn't stopped the fight."

Edited by lethe

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http://www.ncbi.nlm.nih.gov/pubmed/19839934

 

US National Library of Medicine National Institutes of Health

CNS Neurol Disord Drug Targets. 2009 Dec;8(6):432-9.

Cannabinoids and Parkinson's disease.

García-Arencibia M, García C, Fernández-Ruiz J.

Source

 

Departamento de Bioquímica y Biología Molecular and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Facultad de Medicina, Universidad Complutense, 28040-Madrid, Spain.

Abstract

 

Cannabinoid-based medicines have been proposed as clinically promising therapies in Parkinson's disease (PD), given the prominent modulatory function played by the cannabinoid signaling system in the basal ganglia. Supporting this pharmacological potential, the cannabinoid signaling system experiences a biphasic pattern of changes during the progression of PD. Thus, early and presymptomatic stages, characterized by neuronal malfunctioning but little evidence of neuronal death, are associated with desensitization/downregulation of CB(1) receptors. It was proposed that these losses may be part of the pathogenesis itself, since they can aggravate different cytotoxic insults which are controlled in part by cannabinoid signals, mainly excitotoxicity but also oxidative stress and glial activation. By contrast, intermediate and, in particular, advanced stages of parkinsonism characterized by a profound nigral degeneration and occurrence of major parkinsonian symptoms (e.g. bradykinesia), are associated with upregulatory responses of CB(1) receptors, possibly CB(2) receptors too, and the endocannabinoid ligands for both receptor types. This would explain the motor inhibition typical of this disease and the potential proposed for CB(1) receptor antagonists in attenuating the bradykinesia typical of PD. In addition, certain cannabinoid agonists have been proposed to serve as neuroprotective molecules in PD, given their well-demonstrated capability to reduce excitotoxicity, calcium influx, glial activation and, in particular, oxidative injury that cooperatively contribute to the degeneration of nigral neurons. However, the potential of cannabinoid-based medicines in PD have been still scarcely studied at the clinical level despite the existence of solid and promising preclinical evidence. Considering the relevance of these preclinical data, the need for finding treatments for motor symptoms that may be alternative to classic dopaminergic replacement therapy, and the lack of efficient neuroprotective strategies in PD, we believe it is of major interest to develop further studies that allow the promising expectations generated for these molecules to progress from the present preclinical evidence towards a real clinical application

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http://tinyurl.com/yll4r46

 

National Pain Foundation

 

Alternative and Complementary

Marijuana and Pain Management

By: Bill McCarberg, M.D.

 

Millions of people in the United States suffer from chronic pain, and much of that suffering cannot be relieved adequately by existing treatments. Patients are in desperate need of new pain management approaches. Cannabinoid medicines appear very promising, although the subject often is obscured by controversy, prejudice, and confusion in part because cannabinoids have some relation to the cannabis plant – also known by the slang term marijuana.

 

What scientific reasons do doctors have to think that cannabinoids actually work? Do they provide genuine symptom improvement, or do patients become intoxicated and merely think that their symptoms are reduced?

 

Basic research conducted over the past 20 years provides us with many answers. In the early 1990s, researchers identified the cannabinoid receptor system. This system is found in some of the most primitive animal forms on earth – it is also the most widespread receptor system in the human body.

 

The cannabinoid receptor system has two types of receptors:

 

CB1 receptors are found primarily in the brain, spinal cord, and periphery.

CB2 receptors are on the immune tissues.

 

Specific molecules (called endocannabinoids) are produced by the body that interact with these CB1 and CB2 receptors, much like endorphins interact with the body's opioid receptor system. These findings initiated a new era of scientific interest and research in cannabinoids.

 

Numerous studies have now established that cannabinoids help lessen pain and affect a wide range of symptoms and bodily functions. Such research has also demonstrated that cannabinoids may work together with opioids to enhance their effectiveness and reduce tolerance.

 

This body of research has allowed cannabinoids to be informally classified into three types:

 

endocannabinoids (produced by the body)

phytocannabinoids (produced by the cannabis plant)

synthetic cannabinoids (produced in the laboratory)

 

Each type is being studied aggressively, but because endocannabinoids are quickly metabolized and probably cannot be patented, they have not yet been researched in humans.

 

What progress is being made toward developing cannabinoids as prescription pain relievers? Some cannabinoids are unstable and many are insoluble in water, which makes them difficult to research and turn into modern medicines. Patients react very differently to cannabinoids. Data from recent clinical trials are encouraging, but somewhat mixed. Looking closely at the results suggests that composition and delivery route (i.e., how a medicine is administered) are extremely important to the viability of cannabinoid medicines.

 

The Delivery Route

 

When taken orally, cannabinoids are not very well absorbed and often have unpredictable effects. Patients often become sedated or have intoxication-like symptoms when tetrahydrocannabinol (THC – the primary psychoactive cannabinoid in cannabis) is metabolized by the liver. A small number of studies with Marinol (synthetic THC in sesame oil in a gelatin capsule) and Cesamet (synthetic THC analogue) have shown some effectiveness in pain relief, but optimal doses that relieve pain often cannot be achieved because of unpleasant psychologic side effects.

 

Inhaling cannabinoids, especially THC, also may cause problems for many patients. Blood levels rise suddenly and then drop off sharply. This rapid on-off effect may produce significant intoxication, particularly in patients who are new to cannabinoids. This may pose the risk of abuse potential. Smoking cannabis produces this effect, which is the very reason that recreational users prefer the inhaled route. Patients, however, generally wish to avoid psychologic effects, and it is unclear how difficult it might be to find a dosing pattern that enables them to have pain control without side effects.

 

A new product, called Sativex, was approved by Health Canada in June 2005 for marketing as an adjunctive medicine for central neuropathic pain in multiple sclerosis. Adjunctive therapy means taking two or more medications to help control pain.

 

Sativex has a different delivery system – an oromucosal/sublingual spray absorbed by the lining of the mouth – that, according to the manufacturer, generally allows patients to gradually work up to a stable dose at which they obtain therapeutic pain relief without unwanted psychologic effects.

 

In the United States, Sativex is being studied in large randomized trials in cancer pain that has not been adequately relieved by opioids. Three early and six pivotal controlled studies in the United Kingdom demonstrated positive results treating chronic pain of various origins including neurologic pain, various symptoms of multiple sclerosis, rheumatoid arthritis, and cancer pain. Initial results show improvement in pain for more than one year despite lack of effectiveness of the opioids. Common adverse effects of Savitex have included complaints of bad taste, stinging, dry mouth, dizziness, nausea or fatigue.

 

Additional research also may uncover other ways of avoiding the problems associated with oral or inhaled delivery. Ajulemic acid, a synthetic cannabinoid, binds to both the CB1 and CB2 receptors, and has shown benefit in a small neuropathic pain trial. It may have reduced psychologic effects and is being studied for the treatment of interstitial cystitis.

 

The Interplay of Cannabinoids

 

The use of herbal cannabis – usually smoked – has received considerable media attention since California and Arizona passed "medical marijuana" initiatives in 1996. Despite numerous anecdotal reports of effectiveness, very few controlled studies have been published in the pain area. Little is known about the number of patients who actually experience some degree of benefit or side effects.

 

Furthermore, herbal cannabis is neither standardized nor monitored for quality. The cannabinoid content can vary a great deal, and cannabis sold at dispensaries may be contaminated with pesticides or mold. Dosing is uncertain, depending on the preparation or method of use. So-called "vaporizers" do not eliminate all the contaminants. Without clinical trial data and an assurance of product quality, physicians lack the information necessary to assist patients in making informed therapeutic decisions. Both the FDA and Institute of Medicine have stated that there is no future for herbal cannabis as a prescription medicine.

 

Nevertheless, there may be some truth to the idea that there is pain relief potential in phytocannabinoids (plant-based cannabinoids) and that such potential may be affected by the interaction of THC with other botanical components, particularly with other cannabinoids. Modern strains of cannabis have been bred to maximize the THC at the expense of all other cannabinoids, most of which do not have psychologic effects. Some of those cannabinoids, such as cannabidiol (CBD), have been demonstrated to have important therapeutic value, particularly on pain and inflammation.

 

Concluding Thoughts

 

The possibilities for cannabinoid medicines are very promising, and much exciting research is proceeding at a rapid pace. As new FDA-approved cannabinoid products become available, physicians and patients will have a solid scientific foundation from which to assess their appropriateness. Hopefully, robust scientific data will soon allow cannabinoids to take their place – along with opiates and other pain relievers – in the modern medical supply for treating chronic pain.

 

Bill H. McCarberg, MD, is founder of the Chronic Pain Management Program for Kaiser Permanente, San Diego, and assistant clinical professor in the Department of Family Practice at the University of California, San Diego, School of Medicine. He has served on the board of directors of the American Pain Society and currently is co-president of the Western Pain Society and a National Pain Foundation Advisor.

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October 17, 2011

Record-High 50% of Americans Favor Legalizing Marijuana Use

 

Liberals and those 18 to 29 most in favor; Americans 65 and older most opposed

by Frank Newport PRINCETON, NJ -- A record-high 50% of Americans now say the use of marijuana should be made legal, up from 46% last year. Forty-six percent say marijuana use should remain illegal.

 

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When Gallup first asked about legalizing marijuana, in 1969, 12% of Americans favored it, while 84% were opposed. Support remained in the mid-20s in Gallup measures from the late 1970s to the mid-1990s, but has crept up since, passing 30% in 2000 and 40% in 2009 before reaching the 50% level in this year's Oct. 6-9 annual Crime survey.

 

According to the National Institute on Drug Abuse, "Marijuana is the most commonly abused illicit drug in the United States." The National Survey on Drug Use and Health in 2009 found that "16.7 million Americans aged 12 or older used marijuana at least once in the month prior to being surveyed, an increase over the rates reported in all years between 2002 and 2008."

 

The advocacy group National Organization for the Reform of Marijuana Laws claims that marijuana is the third-most-popular recreational drug in America, behind only alcohol and tobacco. Some states have decriminalized marijuana's use, some have made it legal for medicinal use, and some officials, including former U.S. Surgeon General Joycelyn Elders, have called for legalizing its use.

 

A Gallup survey last year found that 70% favored making it legal for doctors to prescribe marijuana in order to reduce pain and suffering. Americans have consistently been more likely to favor the use of marijuana for medicinal purposes than to favor its legalization generally.

 

Younger Americans Most in Favor of Legalizing Marijuana

 

Support for legalizing marijuana is directly and inversely proportional to age, ranging from 62% approval among those 18 to 29 down to 31% among those 65 and older. Liberals are twice as likely as conservatives to favor legalizing marijuana. And Democrats and independents are more likely to be in favor than are Republicans.

 

More men than women support legalizing the drug. Those in the West and Midwest are more likely to favor it than those in the South.

 

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Bottom Line

 

Support for legalizing marijuana has been increasing over the past several years, rising to 50% today -- the highest on record. If this current trend on legalizing marijuana continues, pressure may build to bring the nation's laws into compliance with the people's wishes.

 

Survey Methods Results for this Gallup poll are based on telephone interviews conducted Oct. 6-9, 2011, with a random sample of 1,005 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia.

 

For results based on the total sample of national adults, one can say with 95% confidence that the maximum margin of sampling error is ±4 percentage points.

 

Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking. Each sample includes a minimum quota of 400 cell phone respondents and 600 landline respondents per 1,000 national adults, with additional minimum quotas among landline respondents by region. Landline telephone numbers are chosen at random among listed telephone numbers. Cell phone numbers are selected using random-digit-dial methods. Landline respondents are chosen at random within each household on the basis of which member had the most recent birthday.

 

Samples are weighted by gender, age, race, Hispanic ethnicity, education, region, adults in the household, and phone status (cell phone only/landline only/both, cell phone mostly, and having an unlisted landline number). Demographic weighting targets are based on the March 2010 Current Population Survey figures for the aged 18 and older non-institutionalized population living in U.S. telephone households. All reported margins of sampling error include the computed design effects for weighting and sample design.

 

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

 

View methodology, full question results, and trend data.

 

 

For more details on Gallup's polling methodology, visit www.gallup.com.

 

 

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Public release date: 6-Oct-2011

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Contact: Stephanie Berger

sb2247@columbia.edu

212-305-4372

Columbia University's Mailman School of Public Health

 

Marijuana use may double the risk of accidents for drivers

October 6, 2011 -- Over 10 million people age 12 or older are estimated to have driven under the influence of illicit drugs in the prior year, according to a 2009 National Survey on Drug Use and Health. While marijuana is the most commonly detected non-alcohol drug in drivers, its role in causing crashes has remained in question. To examine the link between marijuana use by drivers and risk of a car accident, researchers at Columbia University did a meta-analysis of nine epidemiologic studies and found that drivers who test positive for marijuana or report driving within three hours of marijuana use are more than twice as likely as other drivers to be involved in motor vehicle crashes. The researchers also found evidence that crash risk increases with the concentration of marijuana-produced compounds in the urine and the frequency of self-reported marijuana use.

 

According to the investigators 8 of 9 studies found that drivers who use marijuana are significantly more likely to be involved in crashes than drivers who do not. Only one small case-control study conducted in Thailand, where the prevalence of marijuana use is far lower than reported elsewhere, was the exception.

 

Full study findings are published online in Epidemiologic Reviews.

 

The analysis indicates that 28% of fatally injured drivers and more than 11% of the general driver population tested positive for non-alcohol drugs, with marijuana being the most commonly detected substance.

 

Guohua Li, MD, DrPh, professor of Epidemiology at Columbia University's Mailman School of Public Health, and senior author points out that although this analysis provides compelling evidence for an association between marijuana use and crash risk, one should be cautious in inferring causality from these epidemiologic data alone. However, "if the crash risk associated with marijuana is confirmed by further research, this is likely to have major implications for driving safety and public policy. It also would play a critical role in informing policy on the use of medical marijuana."

 

"Given the ongoing epidemic of drug-impaired driving and the increased permissibility and accessibility of marijuana for medical use in the U.S., it is urgent that we better understand the role of marijuana in causing car accidents."

 

###

Study co-authors from the Department of Epidemiology are Dr. Charles DiMaggio, associate professor; Joanne Brady, PhD candidate; and Keane Tzong, MPH candidate.

 

The research was supported by the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health.

 

About Columbia University's Mailman School of Public Health

 

Founded in 1922 as one of the first three public health academies in the nation, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,000 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including the International Center for AIDS Care and Treatment Programs (ICAP), the National Center for Disaster Preparedness, and the Center for Infection and Immunity. For more information, please visit http://www.mailman.columbia.edu

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Public release date: 6-Oct-2011

[ Print | E-mail | share_icon.gif Share ] [ Close Window ]

 

Contact: Stephanie Berger

sb2247@columbia.edu

212-305-4372

Columbia University's Mailman School of Public Health

 

Marijuana use may double the risk of accidents for drivers

October 6, 2011 -- Over 10 million people age 12 or older are estimated to have driven under the influence of illicit drugs in the prior year, according to a 2009 National Survey on Drug Use and Health. While marijuana is the most commonly detected non-alcohol drug in drivers, its role in causing crashes has remained in question. To examine the link between marijuana use by drivers and risk of a car accident, researchers at Columbia University did a meta-analysis of nine epidemiologic studies and found that drivers who test positive for marijuana or report driving within three hours of marijuana use are more than twice as likely as other drivers to be involved in motor vehicle crashes. The researchers also found evidence that crash risk increases with the concentration of marijuana-produced compounds in the urine and the frequency of self-reported marijuana use.

 

According to the investigators 8 of 9 studies found that drivers who use marijuana are significantly more likely to be involved in crashes than drivers who do not. Only one small case-control study conducted in Thailand, where the prevalence of marijuana use is far lower than reported elsewhere, was the exception.

 

Full study findings are published online in Epidemiologic Reviews.

 

The analysis indicates that 28% of fatally injured drivers and more than 11% of the general driver population tested positive for non-alcohol drugs, with marijuana being the most commonly detected substance.

 

Guohua Li, MD, DrPh, professor of Epidemiology at Columbia University's Mailman School of Public Health, and senior author points out that although this analysis provides compelling evidence for an association between marijuana use and crash risk, one should be cautious in inferring causality from these epidemiologic data alone. However, "if the crash risk associated with marijuana is confirmed by further research, this is likely to have major implications for driving safety and public policy. It also would play a critical role in informing policy on the use of medical marijuana."

 

"Given the ongoing epidemic of drug-impaired driving and the increased permissibility and accessibility of marijuana for medical use in the U.S., it is urgent that we better understand the role of marijuana in causing car accidents."

 

###

Study co-authors from the Department of Epidemiology are Dr. Charles DiMaggio, associate professor; Joanne Brady, PhD candidate; and Keane Tzong, MPH candidate.

 

The research was supported by the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health.

 

About Columbia University's Mailman School of Public Health

 

Founded in 1922 as one of the first three public health academies in the nation, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,000 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including the International Center for AIDS Care and Treatment Programs (ICAP), the National Center for Disaster Preparedness, and the Center for Infection and Immunity. For more information, please visit http://www.mailman.columbia.edu

 

I wonder how the risks of driving under the influence of "legal" drugs compares. This study doesn't surprise me at all when they compare marijuana to illegal drugs.

Of course the percentage rate will be higher for marijuana than other illegally obtained drugs simply because it is more widely available and easier to obtain. Probably in some parts of the country meth or crack is just about as easy to obtain. That's unfortunate :(

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