WHEN SCIENCE GOES TO POT

Poring Over the Tens of Thousands of Scientific Papers on Pot

Welcome to the world of science. I didn't do well in high school
science and have pretty much avoided addressing scientific subjects
formally until now. That's because I've been delving into the science
of marijuana to try to figure out some of the hows and whys of
medical marijuana's workings. There are some 20,000 published
scientific papers analyzing marijuana and its parts. So don't let
anybody tell you there is too little known about marijuana to make a
call regarding its usefulness.

Most of those papers are beyond my understanding, and making sense of
those I could understand came with the help of a medical dictionary.
But at least I'm trying. Most public policy and attitudes about the
plant have been formed without the help of science. In fact, when
President Richard Nixon ramped up the drug war in the early 1970s, it
was in direct contradiction of the information and recommendations of
his own marijuana task force.

There are probably lots of things we believe wthout a scientific
basis, but maybe we're at a point where more clearheaded inquiry is
possible. So here we go. First of all, delta-9-tetrahydrocannibinol,
or THC as we commonly call it, is not the only active substance in
marijuana. We know about it mostly because it's what gets you high.
However it is not the only component that has medicinal value.

In my last column on medical marijuana, I posed questions about what
in marijuana gives you the munchies, what relieves spasm and what
causes memory loss -- not to mention numerous other effects such as
pain reduction and nausea relief. I can't give you definitive answers
to all of that, but here is an explanation of how our bodies interact
with marijuana.

The first thing we need to get a grip on is the cannabinoid system in
the human body. OK, that word sounds like cannabis (the scientific
name for marijuana), but that is only because the system was
discovered during the 1990s during research on how marijuana affects
the brain. Apparently, most multicellular organisms have a
cannabinoid system and cannabinoid receptors that process the
endocannabinoids (naturally occurring cannabinoids) that they
produce. The system plays a role in regulating things like body
temperature, blood pressure, hunger, etc.

Or as is formally stated by Neil Goodman, Ph.D., in "An Overview of
the Endogenous Cannabinoid System," research suggests "that the
endocannabinoids and their receptors constitute a widespread
modulatory system that fine-tunes bodily responses to a number of stimuli."

"It's a regulatory system for things like appetite, circulation, pain
response and immune response," says Paul Armentano, deputy director
of the National Organization for the Reform of Marijuana Laws and
expert witness on marijuana science. "Cannabinoids seem to regulate
or maintain all of these different functions. ... When mice are bred
not to have these receptors, a couple of very shocking studies show
they die almost immediately. They suffer from failure to thrive and
have no appetite at birth. If you force them to stay alive, they die
of old age long before they become old. If this system doesn't work
right, people don't survive."

A functioning cannabinoid system is essential for good health.
Cannabinoids are found around injuries stabilizing nerve cells and
promoting anti-inflammatory responses. There are cannabinoids in
mothers' milk that give babies the munchies so that they learn how to eat.

Well, now, what are the cannabinoids and how do they affect specific
maladies? The best-known is the aforementioned
delta-9-tetrahydrocannibinol, aka THC. It is the main psychoactive
ingredient in marijuana and produces the euphoria recreational users
seek. It's also what gives you munchies. THC is very similar to the
endocannabinoid (naturally occurring) that the body produces to tell
you it's time to eat. Therefore when marijuana is eaten, THC binds to
the cannabinoid receptors and, in addition to the euphoria, you feel
like eating. There are further indications that it specifically
stimulates taste buds related to sweets in the mouth.

Of up to 100 cannabinoids, a handful are known to show promise as
therapeutic agents. The second most widely known cannabinoids is
cannabidiol, or CBD, the most exciting cannabinoid for medical
science. There are indications it's helpful for inflammation, nerve
pain in disorders such as multiple sclerosis and Crohn's disease;
it's an antispasmodic, anticancer, antidiabetic and neuroprotective substance.

"What makes marijuana so interesting is that we can explain why we
get the results that we get," says Armentano. "We have this strain
that is high in CBD. We know this person has Crohn's disease. We know
that CBD interacts with receptors in the gastrointestinal tract and
it reduces inflammation."

Most other known cannabinoids have a variety of healing properties
that support those of THC and CBD. In fact, natural marijuana as a
whole seems to work better than any of its isolated components.
Cannabinoids as a group have a synergistic effect that produces
better outcomes and fewer side effects. And those effects are both
palliative (relieving symptoms) and curative (modifying the disease itself).

For instance, laboratory testing has indicated CBD slows down the
proliferation of certain cancers, lowers the incidence of diabetes,
and slows the development of multiple sclerosis. Also, some
traditional drugs seem to work better when used in tandem with
marijuana's cannabinoids and, over time, some patients have less need
to take their traditional drugs.

Pharmaceutical companies have taken note of this and, mostly outside
the United States, many drugs using marijuana are in the pipeline. In
the United States, it is almost impossible for a pharmaceutical
company to even experiment with drugs using any naturally occurring
part of marijuana because it's listed as a Schedule 1 drug. There are
synthetic cannabinoids such as dronabinol (marinol) and WIN 55,212-2
available in the United States. However, a British company, GW
Pharmaceuticals, has developed an oral spray, Sativex, which employs
natural parts of marijuana and treats MS. It is available in several
other countries, including Canada.

In the past, most marijuana breeding has been to increase the THC
level. Now people are thinking about breeding the plant for higher
CBD or other cannabinoid levels. Also, we're learning about
cannabinoids in other plants, such as echinacea, that hold some
promise for future pharmacological developments. More is not
necessarily better. Some indications show that there is an optimum
level of cannabinoids to affect diseases -- too little or too much
renders it ineffective. The good thing is that no one has ever died
from a marijuana overdose. The same thing cannot be said of many other drugs.

However, one thing prevalent in anecdotal accounts of medical
marijuana use is not playing out under scientific analysis. Patients
have reported getting different euphoric effects from cannabis sativa
and cannabis indica strains. Science finds no appreciable difference
in the cannabinoids in those plants.

I read several papers regarding medical marijuana for this column.
Two notable reviews are "Non-psychotropic plant cannabinoids: new
therapeutic opportunities from an ancient herb" (tinyurl.com/46h6o25)
and "The Endocannabinoid System as an Emerging Target of
Pharmacotherapy" (tinyurl.com/4w5ew72). Norml.org also has good
information. If you're curious, these are places to start.