November 1, 2013

Experts debate effectiveness of medical marijuana

Research has yet to nail down if, and how, the drug works on specific diseases.

By Ellen Jean Hirst
Chicago Tribune

CHICAGO — Even though 20 states have passed laws legalizing medical marijuana, swayed in part by thousands of personal testimonies, current research hasn’t nailed down exactly if, and how, marijuana alleviates all the specific diseases the drug is being legalized to treat, experts say.

click image to enlarge

Mike Graham poses at his home in Manteno, Ill., with medications he used to take for degenerative disc disease. Graham began using medical marijuana about five years ago, which allowed him to stop using most of the pharmaceuticals for pain relief.

John J. Kim/Chicago Tribune/MCT

A number of proponents believe marijuana could benefit people with everything from glaucoma to cancer, and it’s been legalized in Illinois to aid patients with some 40 medical conditions. But opponents of its medicinal use believe the risks of smoking medical marijuana outweigh the benefits, while others question whether patients really improve or only feel like they improve.

Marijuana’s best-known compound is THC, but the plant actually has 105 unique cannabis compounds with potential for medicinal use, proponents say. THC has already been approved by the Food and Drug Administration in synthetic form to help patients with nausea and decreased appetite.

EVIDENCE LACKING

Some scientists believe the plant’s other compounds – called cannabinoids – could have equal promise. Although research has increased in recent years as more states legalize medical marijuana, solid evidence of how individual cannabinoids could help people with specific diseases has been significantly lacking, a review of medical literature and interviews with experts shows.

Researching the potential effects of marijuana’s various components on conditions such as multiple sclerosis, fibromyalgia or lupus could have serious implications for doctors who want to prescribe medical marijuana to patients.

If the specific benefits could be proved, experts say, doctors ultimately would be able to assign particular strains to people, depending on their condition. Further research also may help determine optimal doses and whether marijuana works better than other medicines, experts say.

While most medicines derived from nature are tested before they reach the masses, the process to evaluate marijuana has been confounded by its longtime status as an illegal drug, which it retains in the eyes of the federal government.

The only study specifically cited in Illinois’ law, signed by Gov. Pat Quinn in August and due to go into effect next year, is a 1999 Institute of Medicine report. But Dr. John Benson, a lead editor of the report, said legislators stretched the conclusion of the book-length study when it said modern medical research “has confirmed the beneficial uses of cannabis.”

While the report did say there was promise that marijuana could have medical benefits, it also suggests researchers need to continue to dig deeper into the issue. It also says marijuana should not be smoked, he said.

“Smoking marijuana is not recommended,” the report says. “The long-term harm caused by smoking marijuana makes it a poor delivery system.”

The 14-year-old article has become a primary source for both critics and supporters of medical marijuana – the Drug Enforcement Administration and advocacy groups have cited it to prove opposite points.

The legislators relied mostly on personal testimonies and compared notes with states that have also passed medical marijuana laws.

Mike Graham, of Manteno, was one person who shared his story with legislators. A little more than a decade ago, he was using 14 different pharmaceuticals. Living with an extremely painful degenerative spine disease, he has been through multiple surgeries in efforts to remedy it. But doctors feared one more could paralyze him, so he took medications for pain instead.

“I didn’t even know my name,” Graham said. “It was horrid.”

When he was in his late 30s, doctors sent him home with a hospice care nurse. After reviewing his medications, she told him he would die early if he continued taking all of them. To his surprise, she recommended pot, he said.

“I almost fell out of bed laughing,” said Graham, 51. “I come from a law enforcement family.”

(Continued on page 2)

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