Sulak has recommended various forms of marijuana to his patients and has seen striking results. Patients with chronic pain needed fewer prescription pain meds. Patients with multiple sclerosis had less painful muscle spasms. Patients with severe irritable bowel syndrome began to eat again.
“These responses are the most impressive to me,” says Sulak, who practices at Maine Integrative Healthcare in Manchester. Maine is one of 20 states, along with the District of Columbia, where medical marijuana is legal. “With irritable bowel syndrome, we’ll see patients who were at death’s door turn around dramatically.”
Sulak’s experience is powerful and adds to the large body of personal stories -- dating from 5,000 years ago -- about the therapeutic value of marijuana.
But the scientific evidence behind the drug’s benefits remains elusive, even as 10 more states consider legalizing medical uses in 2014. The problem: In 1970, the federal government classified marijuana as an illegal, highly addictive drug with no medical value, making research harder to do.
A Marijuana Discovery
Here’s what is known: About 20 years ago, scientists discovered a system in the brain that responds to 60 chemicals in marijuana, also known as cannabis. It’s called the endocannabinoid system. This system plays a role in many of the body’s functions, such as in the heart, along with the digestive, endocrine, immune, nervous, and reproductive systems. The discovery sparked interest in finding specific chemicals made from marijuana that could be targeted for specific conditions.
Since that time, scientific projects around medical marijuana worldwide have sped up dramatically. Many of the studies that have been done show that chemicals in marijuana can help treat some conditions. They have helped manage pain and reduced muscle spasms in MS patients. They’ve worked as an appetite stimulant, and as an alternative drug for brain disorders such as schizophrenia and Tourette’s syndrome.
Few of these studies, though, followed a controlled clinical trial. This is considered the best type of trial because it compares a drug to another drug, or to a placebo (a "fake" treatment).
Also, most of the studies had fewer than 200 patients. So doubt continues about marijuana’s value and who it really can help, says J. Michael Bostwick, MD. He's a psychiatrist at the Mayo Clinic and author of a review of medical marijuana research.
Based on medical science, it seems possible that marijuana-based treatments could be developed for some conditions; but federal restrictions make it hard for the research to advance, Bostwick says.
That’s because scientists in the U.S. have to get approval from the Drug Enforcement Agency (DEA) and the FDA to do research on medical marijuana.
A series of studies allowed by the DEA came to a conclusion similar to Bostwick's. The 13 studies were done by The Center for Medicinal Cannabis Research at the University of California in San Diego between 2000 and 2010.
The conclusion: “Cannabinoids may be useful medicine for certain indications” and deserve further research, wrote Igor Grant, professor and executive vice chairman of the Department of Psychiatry at the university. The studies also showed that inhaling marijuana through a vaporizer or a spray was a better way to deliver it than by smoking.
Among the unanswered questions about medical marijuana is the risk to users. About 10% of people who smoke marijuana become addicted. It’s not known what that means if it is being used for medical reasons, Bostwick says. He adds that some patients find the effects of marijuana “intolerable.”
Marijuana-Based Drugs
Despite the obstacles, three FDA-approved drugs are made from marijuana. They include:
Marinol and Cesamet: Both drugs are used to treat nausea and lack of appetite related to chemotherapy and in AIDS patients. They are man-made versions of THC, the primary chemical in marijuana that gives users a “high.” Both were approved in the 1980s.
Epidiolex: This drug to treat children’s epilepsy received FDA approval in 2013. Its use is highly restricted.
Another drug, Sativex, is in clinical trials in the U.S. for pain with breast cancer. It is a combination of chemicals from the marijuana herb and is sprayed into the mouth. Sativex is approved in more than 20 countries to treat muscle spasms from MS and cancer pain.
Research on Marijuana
No single organization tracks all research studies of medical marijuana and marijuana-based drugs and herbs. The following review is a summary of controlled studies since 1990. It is based on reporting; research provided by NORML, the marijuana legalization advocacy group; and data found in PubMed, the National Institutes of Health’s RePORTER, and a database maintained by the International Association for Cannabinoid Medicines, a medical marijuana research organization based in Cologne, Germany.
Story Source: The above story is based on materials provided by MEDSCAPE Note: Materials may be edited for content and length
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