Medical Marijuana's Days Are Numbered

Jacob Sullum | January 5, 2006

Yesterday GW Pharmaceuticals announced that it has received FDA approval for Phase III clinical trials of its cannabis extract spray, Sativex, which the Canadian government last year approved as a treatment for neuropathic pain in patients with multiple sclerosis. The U.S. study will test Sativex's effectiveness in treating the pain of cancer patients who do not get adequate relief from narcotics--an application that has shown promise in a European study. GW, which is based in the U.K., reports that the FDA let it skip Phase I and Phase II trials, which focus on establishing safety and appropriate dosage, because it had already conducted substantial research on Sativex in Europe.

GW's success with Sativex, which is sprayed into the mouth, once again contradicts American drug warriors' repeated denials of marijuana's therapeutic utility. At the same time, it's another step toward a future in which legal alternatives to smoked, vaporized, or ingested whole cannabis will render the medical marijuana debate moot.

Another such step is Philip Morris' medical inhaler, which is based on technology developed for its unsuccessful smokeless cigarette. The device delivers aerosol medicine to the lungs for quick absorption. If used with THC and/or other useful cannabinoids, it would have all the medical advantages of smoked marijuana (immediate action, patient control over dosage, no capsules to swallow and keep down) without the drawbacks (variable strength, combustion products). Such a product would be more expensive than homegrown or club-dispensed marijuana, but presumably it would be covered by insurance.

These developments, while a boon to patients, will pose a challenge to the drug policy reform movement, which has gotten a lot of mileage out of the federal government's cruel, know-nothing intransigence on the issue of medical marijuana. Once legal, equally effective aternatives to marijuana are readily available, reformers will be forced to switch their focus back to recreational use (which is, after all, the main form of marijuana consumption), seemingly confirming the accusation that all their talk about the drug's medical virtues was just a cover. And having emphasized the sympathetic claims of suffering patients for so long, they will be in a weak position to argue that people shouldn't need a special excuse to smoke pot.

Comments

|1.5.06 @ 11:13AM|#

Whatever the other implications may be, an effective, fast acting product with easily controllable dosage and no combustion products is something to be happy about. If it helps sick people, that is A Good Thing.

MP|1.5.06 @ 11:15AM|#

Mother Jones had a very good article on Sativex, including a discussion of the possible political ramifications.

Personally, I've always been hesitant about the Medical Marijuana issue because it carries an "illegal drugs are bad, except..." undercurrent. Because the MPP is typically unable to segregate contributions between Medical Marijuana activism and drug legalization activism (like they are pushing in NV), I only make a token contribution to their effort. I've never made the effort to find an anti-drug war non-profit that I should more fervently support. Suggestions?

|1.5.06 @ 11:28AM|#

But if they legalize medications made from marijuana, wouldn't they have to remove it from the Schedule I list? If I understand correctly, "Schedule I" means "no medical value whatsoever."

Robert Cote|1.5.06 @ 11:49AM|#

The reason marijuana is illegal is because the pharma complex and government cannot make money from it. Now that they have been forced to admit to safety and effacacy they've engineered a way to make money off of it. Next step will be to fenetically modify hemp to reduce/remove the canabanoids so that the commercial fiber value can also be exploited.

|1.5.06 @ 11:50AM|#

And having emphasized the sympathetic claims of suffering patients for so long, they will be in a weak position to argue that people shouldn't need a special excuse to smoke pot.

Which is why the argument should have been about recreational use all along. I have long thought support for "medical marijuana" was a wasted effort, and now we're about to see why.

Warren|1.5.06 @ 11:54AM|#

Once legal, equally effective alternatives to marijuana are readily available...

Of course there is no reason to think that Sativex will be either equally effective or readily available (read affordable).

Jacob is right that the drug warriors could do real damage the anti-prohibitionist movement (such as it is) by not opposing marijuana based medicine to come to market. I still find it obscene that safe and effective medicine should be available to sick people solely from the hands of big pharma, but that is a more general criticism of our medical establishment than it is of the WOD.

I was never really excited over medical marijuana for this very reason. But I did think it useful for two reasons. One, it dramatically illustrated the moral bankruptcy of the WOD. The absolute insistence that if anyone, anywhere, ever, smokes a joint, someone needs to be hauled off to jail, by flack jacketed federal agents, if necessary. Even if that someone is weak frail and dying, we can afford no sympathy (or presumably all our children will start smoking crack). The second thing I think medical MJ might do is get some sanity into the debate. I can't understand how so many people line up against legalizing. This is marijuana we're talking about, the evils people like drug czar John Walters ascribes to it are just ludicrous, and yet he is able to say them in broad daylight without being laughed out of the room. I thought that the only way that was possible was if most people refused to ever be in the same room with it. I thought that maybe if people saw that grandma was much more alert and coherent on dope than on say Oxycontin, and also that it wasn't interfering with her other drug treatments, the refer madness stigma would subside.

Rich Ard|1.5.06 @ 11:55AM|#

I thought it was an effort to get wasted.

/rimshot

B.D.|1.5.06 @ 11:55AM|#

Don't get too excited. The BBC reports today that Britain is discussing taking a step backwards on marijuana laws.

[quote]But John Henry, a clinical toxicologist at St Mary's Hospital in London, told BBC News there was a "strong link" between cannabis and schizophrenia.[/quote]

From this link:

http://news.bbc.co.uk/1/hi/uk_politics/4582818.stm

|1.5.06 @ 11:57AM|#

Jennifer, bless you, you're thinking too reasonably. Stop trying to apply consistent judgement to the window dressing that is the Schedule I issue. Instead, think as as the FDA and the government do, with your focus on marketing and propaganda.

|1.5.06 @ 12:02PM|#

Some (many?) people who advocate for medical cannabis are pretty clearly recreational users in disguise. I spoke with some medical pot advocates at a recent California gathering and I was encouraged to get a medical pot recommendation, despite my clearly stating that I was not sick.

Besides, if sativex becomes widely available, maybe recreational users could get prescriptions for it in the same way current California users get medical marijuana recommendations.

|1.5.06 @ 12:04PM|#

Imagine that. A British company is beating us to the punch with this R&D. From what I understand, it's generally understood that R&D in Europe is less onerous than R&D in the U.S., but the fact that there is one and only one source of marijuana - and garbage marijuana at that - in the U.S. surely can't be helping.

Getting this into a form that doctors and patients can control and trust is a good step for medicine in general, and a defeat for blind anti-THC zealotry. Incidentally, it may pose a stronger challenge to the problem that Jacob noted here earlier this week of discrimination by employers against patients who use legal THC-based products to relieve pain.

As for the drug reform movement, there's been plenty of mileage to squeeze out of arresting medical marijuana patients, and it will still be a good platform to point out the evils of the shitbags at the DEA for a few years to come. But the drug reform movement can't ride it forever, and making the case for legalization for personal use - like the SAFER folks did out in Denver - might as well start sooner rather than later. Nevada will certainly be interesting this year, and Vermont is one to watch as well in the coming couple of years. Slooooow but sure, I suppose.

MP - I think you can make donations straight to the Nevada initiative if you want to support a strictly-legalization for personal use push...check out regulatemarijuana.org.

Brian|1.5.06 @ 12:11PM|#

But if they legalize medications made from marijuana, wouldn't they have to remove it from the Schedule I list? If I understand correctly, "Schedule I" means "no medical value whatsoever."

Logical as that may seem, there is plenty of precident to keep things as they are. Heroin (Schedule I) is nothing more than acetylated morphine (Schedule II), and codiene (Schedule III) is nothing more than methylated morphine. Though delta-9 THC in a medicalized formulation is the same molecule as the primary active ingredient in cannibis, the argument can (and would) be made that the presence of other substances makes it a different formulation and therefore a different drug.

|1.5.06 @ 12:14PM|#

Jen - "no medical value whatsoever." should be read as "no profitable value to the pharmaceutical industry." Which can then be read as no profit value to the government if they can't tax the billions that pharma makes.

It works the same as all other things in DC. Pharma gives huge (some of the biggest) campaign donations to the pols. For this the pols insure they get the profit margins they want which the pols have have no problem with because they profit off the corp tax of those companies. This also enables the pols to make big benefit giveaways to voters who just can't seem to afford their meds for some reason and ensures those people benefiting never think about voting for anyone else.

If marijuana were legal there is no mechanism for anyone to profit from it, after all it is a plant most anyone could grow themselves. Always follow the money. Same goes with Budweiser and others who cringe to think about all their customers who now drink only because they can't legally smoke pot leaving the alcohol alone for a doobie at night. Once again no profit. Think of the insane tax rate the government has on alcohol and its not that hard to see the big picture.

I found this amusing

"The U.S. study will test Sativex's effectiveness in treating the pain of cancer patients who do not get adequate relief from narcotics."

It pretty much states outright that they really don't care that your on narcotics or not. They just want to make sure you are you on a narcotic that they provided and profit from. That old saying speed kills is only applicable to black market or self prescribed speed. The speed made by the pharma's however is just fine to be taken daily. As are the opiates, and benzos and sleeping pills they all peddle.

Ask your doctor if its right for you!

I once took a email from our CEO about the new medicare giveaways and re-worded it to mean what he actually was saying maybe I will post the original and the edited version together.

|1.5.06 @ 12:15PM|#

Unfortunately I don't believe any schedule change will make any difference on the legality of MJ. In fact, I would say that Sativex will make it even harder for MJ to become legalized. The argument will compare (not legitimately, of course) Sativex to morphine. Sativex is a powerful drug which helps people with some of the most debilitating conditions on the planet: AIDS, Cancer, MS, among many others. Morphine, too, is a powerful drug which helps people in extreme pain. Both are extracted from crude plant material. Sativex is proven a powerful drug through research, which shows why it's even more important to keep the crude plant form illegal. Just because morphine works doesn't mean opium should be legal. It will be a major setback.

It is important to note who is lobbing for Sativex
http://blogs.salon.com/0002762/stories/2005/04/20/andreaBarthwellSnakeOilSal.html


Luckily, I believe there is "moral" ground to stand on (beyond the "I think it's fine to get stoned when I want to" argument), with the prison costs and overcrowding. But the MMJ argument was a nice pedestal to stand on.

However, the moveing to schedule II might (I am unsure of this) allow true independant scientific testing of the negative effects of MJ, which would demonstrate the few real side effects of MJ use (especially when compared to booze). This could greatly help the relaxing of MJ laws.

Brian|1.5.06 @ 12:16PM|#

By the way, the "no medical value whatsoever" thing is determined entirely by the definitions set by the FDA and congress. Heroin would be an exceptionally good pain killer--especially for the terminally ill--so the fact that it is deemed to have "no medical value" shows that these definitions are not grounded in actual science.

Pete Guither|1.5.06 @ 12:19PM|#

It's been clear from the start that Drug Policy Reformers and Drug Warriors alike have been using medical marijuana.

The difference is that the Reformers knew that medical marijuana was important on its own, but was ALSO a step toward getting past the demonization. However, the Warriors knew that medical marijuana worked, but were willing to promote the suffering of patients to prevent people from seeing through the thin anti-marijuana propaganda.

Even if Sativex is accepted and the government shuts down smoked (or home vaporized, or cooked in brownies) medical marijuana in favor of the more expensive pharmaceutical version, it will still end up a victory for long-term marijuana legalization, for the simple fact that more and more people will start to wonder what the big fuss was about.

|1.5.06 @ 1:08PM|#

Heroin would be an exceptionally good pain killer--especially for the terminally ill--so the fact that it is deemed to have "no medical value" shows that these definitions are not grounded in actual science.

You don't have to even rely on conjecture. In the 80s, the DEA rescheduled Methaqualone from II to I.

Timothy|1.5.06 @ 1:40PM|#

I've never understood why Heroin is illegal, but morphine is A-Okay, frankly.

|1.5.06 @ 2:06PM|#

This won't change the medical marijuana argument. Rather, it will reinforce the hypocricy of the federal position.

|1.5.06 @ 2:13PM|#

Robert Cote wrote:

"The reason marijuana is illegal is because the pharma complex and government cannot make money from it. Now that they have been forced to admit to safety and effacacy they've engineered a way to make money off of it. Next step will be to fenetically modify hemp to reduce/remove the canabanoids so that the commercial fiber value can also be exploited."

Say what? There is an ocean of government money to be made from cannabis legalization. I think its fair to say that if the gov stopped spending money prosecuting cannabis offenses, and taxed sales of cannabis, there would be billions to be made. The government would certainly make a shitload more money from legal regulated cannabis than it ever will from sativex.

Secondly, strains of cannabis that have been bred for fiber are already so exceedingly low in cannabinoids that there is no need to genetically engineer a cannabinoid-free strain.

|1.5.06 @ 3:14PM|#

Um Patrick my friend if you think I am going to pay the government tax and buy my weed from them you must really be smoking the good shit.

Who in their right mind would pay for something you can grow damn near anywhere. People do brew their own beer and distill their own alcohol legally now. It is not easy to do well and obtain a quality product that passes taste testing so most people buy what they drink. With weed its just that a weed once you find the flavor you like the DNA will reproduce the same results over and over no brew master needed. Damn sure no government tax collecter needed. Not to mention I will be dead and cold before I start paying this government to profit off what they spent so long ruining peoples lives over.

No one I know would buy much of anything except gardening supplies and rolling papers that I know.

Let me go try to dig up this piece about a cannibis knock off drug that is claimed to be used for the exact opposite of what the gov has claimed it does to you thats bad all these years.

Hypocrisy!!!

Warren|1.5.06 @ 3:17PM|#

Patrick,
You are absolutely right. The problem is that the establishment is always invested in the status quo. Moneys resulting from the sale of pot and industrial hemp are hypothetical and not anybody's current rice bowl.

Warren|1.5.06 @ 3:25PM|#

Dar,
As one who brews his own beer and grows his own pot, I can tell you that growing quality dope is much more difficult. If pot were put in the same legal boat with booze, I predict the dope market would look a lot like the beer market does now. RJR and Phillip Morris would grab the lions share, specialty microsmokes would also be plentiful, pasty white geeks that can't get dates would grow their own.

|1.5.06 @ 4:00PM|#

Who in their right mind would pay for something you can grow damn near anywhere

Why do people still pay money for vegetables when they could just grow their own? Why is Jiffy Lube still in business when it's cheaper to change your oil yourself? Why do people buy bread when baking it yourself costs less?

|1.5.06 @ 4:59PM|#

Jen- I don't really need 1000 pounds of pot to satisfy my monkey so whether ADM and Phillip Morris start plowing every field they have with pot or not I am still growing my own. This type of mentality is what has the US turning into a service and retail economy. I personally would rather do something I can on my own versus paying someone else to do it for me. Sure you can't do everything for yourself but damn come on planting some seeds and watering it is not that hard is it. Mother nature will do all the work.

Warren- as one who brews and grows his own you must be a pasty white geek that can't get a date. For you to say growing a weed is hard makes me question what you consider easy. On further thought for you to say its hard to grow weed makes me wonder what your beer must taste like. And yes I have grown it. The shit will grow all by itself after all its a weed and was growing just fine long before we started using it. If your having problems that make you think its hard perhaps your the one trying to hard and killing them with all your love.

No doubt that people would buy the weed and pay the tax. Just not anyone I know.

|1.5.06 @ 5:09PM|#

Here is the piece about the new pot knock off drug they can't wait to sell you.

New drug acts as marijuana in the brain

MONTREAL, Dec. 13 (UPI) -- A McGill University study suggests a new anti-depressant drug works by raising levels of endocannabinoids -- similar to a substance found in marijuana.
The study suggests the new drug, called URB597, might represent a safer alternative to use of marijuana for treatment of pain and depression, and open the door to new and improved treatments for clinical depression.
In pre-clinical laboratory tests researchers found URB597 increased the production of endocannabinoids by blocking their degradation, resulting in measurable antidepressant effects.
"This is the first time it has been shown a drug that increases endocannabinoids in the brain can improve your mood," said lead investigator Dr. Gabriella Gobbi, a researcher at Montreal and McGill Universities.
The researchers, including scientists from the University of California-Irvine, were able to measure serotonin and noradrenaline activity as a result of the increased endocannabinoids.
"The results were similar to the effect we might expect from the use of commonly prescribed antidepressants, which are effective on only around 30 percent of the population," said Gobbi. "Our discovery strengthens the case for URB597 as a safer, non-addictive, non-psychotropic alternative to cannabis for the treatment of pain and depression."

So now after decades of propaganda BS financed by us for us the medical world has a drug based on cannabis that treats depression. The very same depression the government and medical community has claimed is a result of using the drug directly.

This is such exciting news!

Do you think it will also help with us regain long and short term memory and allow us to focus better on tasks. It must since now it appears weed does exactly the opposite of what government has claimed.

I think the only way to legalization is through constant bombarding of politicians about their hypocrisy and point out over and over all the lies they told as straight faced truths over the years. Remind them at every turn of the money wasted on telling lies and lives hurt. That is one of the only things a politician seems to mind being labeled as these days.

Warren|1.5.06 @ 5:57PM|#

Dar,
You missed the part where I said quallity dope. And before that gets your fingers moving, let me try and head you off a bit.

Yes you can just throw the seeds on the ground and water it like tomatoes. In fact Jennifer makes a good point, that you can grow your own tomatoes too but few people do. Indoor growing (which is what I was thinking of) is more complicated, but produces better and more reliable results. Growing outdoors yields only one crop a year, and it's subject to a variety of perils. So yes, if you have good soil and good weather, and if you take due diligence with water, pests, fertilizer, and if you avoid frost, flood, those damn kids, you can, grow good bud right next to the rhododendrons. However, most stuff grown that way is going to come out as seedy schwag weed. Growing quality herb takes knowledge (albeit no more than growing quality anything, tomatoes e.g.) and effort. Then there's the matter of harvesting, drying, and curing, which is more than enough trouble to convince most folks that over-priced over-taxed by-the-pack with a tank of gas is still the better deal.

As to some other points;
I am a pasty-faced, over weight, middle aged, white guy, with chronic flatulence. And while I am brilliant, charming and oh so witty, attractive women almost never accept my invitations. This is a deep mystery to me, I have no clue as to why this is so.

My home brew I'll stack up against anything you can find in the supermarket.

|1.6.06 @ 1:43AM|#

Having enjoyed pot virtually every day since 1968, I was almost grateful for my glaucoma diagnosis five years ago, because of the profound relief being immune from state/local prosecution brings.

I find the concept of cannabis prohibition absolutely unacceptable in a nation with thriving tobacco and alcohol industries.

NO ONE should suffer due to cannabis prohibition, LEAST of all the ill who can benefit from its theraputic effects.

Marinol should have been sufficient to repudiate the Schedule I status of the herb; Sativex simply adds more proof of its efficacy.

Robert|1.6.06 @ 1:26PM|#

Cannabis & THC per se will remain in schedule 1 while dronabinol & Sativex will be "exempt preparations" of them, respectively, in higher-numbered schedules.

And yes, of course some people will wind up using Sativex recreationally, just as some people do with oxycodone, for example.

Methaqualone's placement in schedule 1 was based on "lack of accepted medical use in the USA", which does not mean lack of medical utility! It's a circular judgement that does not rest primarily on biology but the social meaning of "accepted". The mfr. voluntarily withdrew their marketing license, which withdrawal was taken as a reflection of the use of methaqualone's being newly deemed not to be "accepted". Nobody claimed that the facts of its safety and efficacy had changed. Someone could enter the business to re-establish its medical use, and it's not clear what evidence would be taken to deem its use again "accepted", but apparently it would seem to be simply the will of a drug firm to market it. FDA would apparently require a new new drug application; an abbreviated NDA probably wouldn't work, because the eauivalency claimed would not be to a currently marketed product. Possibly however a petition to declare it "generally recognized as safe and effective" based on its history of use would be in order, but someone would have to pry open the trade secrets of its mfr. to ensure identity to the historic product.

|1.7.06 @ 9:41PM|#

Jennifer, No. just as currently Ritalin/Adderal prescribed for ADHD in kids IS METHAMPHETAMINE!

Adderall Chemical name: Amphetamine-Dextroamphetamine

Figure that one out.

:)

>>But if they legalize medications made from marijuana, wouldn't they have to remove it from the >>Schedule I list? If I understand correctly, "Schedule I" means "no medical value whatsoever."

>>Comment by: Jennifer at January 5, 2006 11:28 AM