MARIJUANA AS WONDER DRUG

A NEW STUDY in the journal Neurology is being hailed as unassailable
proof that marijuana is a valuable medicine.

It is a sad commentary on the state of modern medicine -- and US drug
policy -- that we still need "proof" of something that medicine has
known for 5,000 years.

The study, from the University of California at San Francisco, found
smoked marijuana to be effective at relieving the extreme pain of a
debilitating condition known as peripheral neuropathy. It was a study
of HIV patients, but a similar type of pain caused by damage to nerves
afflicts people with many other illnesses including diabetes and
multiple sclerosis.

Neuropathic pain is notoriously resistant to treatment with
conventional pain drugs.

Even powerful and addictive narcotics like morphine and OxyContin
often provide little relief. This study leaves no doubt that
marijuana can safely ease this type of pain. As all marijuana research
in the United States must be, the new study was conducted with
government-supplied marijuana of notoriously poor quality.

So it probably underestimated the potential benefit.

This is all good news, but it should not be news at all. In the 40-odd
years I have been studying the medicinal uses of marijuana, I have
learned that the recorded history of this medicine goes back to
ancient times and that in the 19th century it became a
well-established Western medicine whose versatility and safety were
unquestioned. From 1840 to 1900, American and European medical
journals published over 100 papers on the therapeutic uses of
marijuana, also known as cannabis.

Of course, our knowledge has advanced greatly over the years.

Scientists have identified over 60 unique constituents in marijuana,
called cannabinoids, and we have learned much about how they work. We
have also learned that our own bodies produce similar chemicals,
called endocannabinoids. The mountain of accumulated anecdotal
evidence that pointed the way to the present and other clinical
studies also strongly suggests there are a number of other devastating
disorders and symptoms for which marijuana has been used for
centuries; they deserve the same kind of careful, methodologically
sound research. While few such studies have so far been completed, all
have lent weight to what medicine already knew but had largely
forgotten or ignored: Marijuana is effective at relieving nausea and
vomiting, spasticity, appetite loss, certain types of pain, and other
debilitating symptoms.

And it is extraordinarily safe -- safer than most medicines prescribed
every day. If marijuana were a new discovery rather than a well-known
substance carrying cultural and political baggage, it would be hailed
as a wonder drug. The pharmaceutical industry is scrambling to isolate
cannabinoids and synthesize analogs, and to package them in
non-smokable forms.

In time, companies will almost certainly come up with products and
delivery systems that are more useful and less expensive than herbal
marijuana.

However, the analogs they have produced so far are more expensive
than herbal marijuana, and none has shown any improvement over the
plant nature gave us to take orally or to smoke. We live in an
antismoking environment. But as a method of delivering certain
medicinal compounds, smoking marijuana has some real advantages: The
effect is almost instantaneous, allowing the patient, who after all
is the best judge, to fine-tune his or her dose to get the needed
relief without intoxication. Smoked marijuana has never been
demonstrated to have serious pulmonary consequences, but in any case
the technology to inhale these cannabinoids without smoking marijuana
already exists as vaporizers that allow for smoke-free inhalation.

Hopefully the UCSF study will add to the pressure on the US government
to rethink its irrational ban on the medicinal use of marijuana -- and
its destructive attacks on patients and caregivers in states that have
chosen to allow such use. Rather than admit they have been mistaken
all these years, federal officials can cite "important new data" and
start revamping outdated and destructive policies.

The new Congress could go far in establishing its bona fides as both
reasonable and compassionate by immediately moving on this issue.
Such legislation would bring much-needed relief to millions of
Americans suffering from cancer, AIDS, multiple sclerosis, arthritis,
and other debilitating illnesses.

Lester Grinspoon, an emeritus professor of psychiatry at Harvard
Medical School, is the coauthor of "Marijuana, the Forbidden
Medicine.