Cannabis Medical Articles & Studies

http://en.wikipedia.org/wiki/Medical_marijuana

Highlights of the Studies (http://medmjscience.org/Pages/science.html)

New Mexico: This study involved 250 patients.The study compared marijuana to THC capsules. The research protocol was approved by the FDA in 1978. In order to participate in the research the patient had to be referred by a physician and had to have failed on at least three other antiemetics. Patients were permitted to choose marijuana or the THC pill.

Both objective (e.g., frequency of vomiting, amount of vomiting, muscle biofeedback, blood samples and patient observation) and subjective measures were made to determine the effectiveness of the drug.

The study concluded that marijuana was not only an effective antiemetic but also far superior to the best available conventional drug, Compazine, and clearly superior to synthetic THC pill." The study found that [m]ore than [90] percent of the patients who received marijuana . . . reported significant or total relief from nausea and vomiting." The study found no major adverse side effects. Only three patients reported adverse reactions, none of these reactions involved marijuana alone. The 1984 report concluded . . . the data accumulated over all five years of the program's operation do show that marijuana smoked resulted in a higher percentage of success than does THC ingested."

California: California conducted a series of studies from 1981 through 1989. Annual reports were submitted to the FDA, state legislature and Governor. Each year approximately 90 to 100 patients received marijuana. The California research was described as a Phase III trial."

The study protocol preferred THC pills by making it much easier for patients to enter that portion of the study. Patients who received marijuana had to be over 15 years of age (the THC pill patients had to be over 5 years of age); had to be marijuana experienced, use the drug on an in-patient basis (patients could only use marijuana in the hospital and not take the medicine home) and had to be receiving rarely used and severe forms of chemotherapy. Thus, the design of the study did not favor marijuana.

Even with this built in bias against marijuana, the study consistently found marijuana to be an effective antiemetic. In 1981 the California Research Advisory Panel reported: "Over 74 percent of the cancer patients treated in the program have reported that marijuana is more effective in relieving their nausea and vomiting than any other drug they have tried." In 1982, a 78.9 percent effectiveness rate was found for smoked marijuana. By 1983 the report was conclusory in its findings stating:

The California Program also has met its research objectives. Marijuana has been shown to be effective for many cancer chemotherapy patients, safe dosage levels have been established and a dosage regimen which minimizes undesirable side effects has been devised and tested.

The California Research Advisory Panel continued to review data on marijuana until 1989 with similar results.

Michigan: The Michigan research compared marijuana to Torecan. It involved 165 patients. Upon admission to the program patients were randomized into control groups with some randomized on the conventional antiemetic Torecan and the remainder randomized to marijuana. When failure on the initial randomized drug occurred, patients could elect to crossover to the alternate therapy. This procedure allowed the Michigan Department of Health to evaluate how well patients responded to both drugs and allowed patients to register their preference.

The Michigan study reported 71.1 percent of the patients who received marijuana reported no emesis to moderate nausea. Ninety percent of the patients receiving marijuana elected to remain on marijuana. Only 8 of 83 patients randomized to marijuana chose to alter their mode of antiemetic therapy. This was almost the inverse of patients randomized to Torecan, there more than 90 percent - 22 out of 23 patients - elected to discontinue use of Torecan and switched to marijuana.

Very few serious side effects were found related to marijuana use. The most common side effect was increased appetite - reported by 32.3 percent of patients - this was a positive effect. The most common negative effects were sleepiness, reported by 21 patients and sore throat, reported by 13 patients.

Tennessee: This study involved an evaluation of 27 patients. The patients had all failed on other forms of antiemetic therapy including oral THC. The study found an overall success rate of 90.4 percent for marijuana inhalation therapy. In comparison it found a 66.7 percent success rate for THC capsules. In the under 40 age group, the study found a 100 percent success rate for marijuana inhalation therapy.

The report concludes:

We found both marijuana smoking and THC capsules to be effective anti-emetics. We found an approximate 23 percent higher success rate among those patients administered THC capsules. We found no significant differences in success rates by age group. We found that the major reason for smoking failure was smoking intolerance; while the major reason for THC capsule failure was nausea and vomiting so severe that patient could not retain the capsule.

New York: In describing the purpose of the marijuana research program the New York Department of Health stated: [t]he program is a large-scale (Phase III) cooperative clinical trial . . . ." The central question addressed is [h]ow effective is inhalation marijuana in preventing nausea and vomiting due to chemotherapy in patients . . . who have failed to respond to previous antiemetic therapy?"

By 1985, the New York program had extended marijuana therapy to 208 patients through 55 practitioners. Of that, 199 patients were evaluated. These patients had received a total of 6,044 NIDA-supplied marijuana cigarettes which were provided to patients during 514 treatment episodes.

In percentage terms the results were stunning:

* North Shore Hospital reported marijuana was effective at reducing emesis 92.9 percent of the time;
* Columbia Memorial Hospital reported efficacy of 89.7 percent;
* Upstate Medical Center, St. Joseph's Hospital and Jamestown General Hospital reported 100 percent of the patients smoking marijuana gained significant benefit.

The report concludes: "Patient evaluations have indicated that approximately ninety-three (93) percent of marijuana inhalation treatment episodes are reported to be effective' or highly effective' when compared to other antiemetics." The New York study reports no serious adverse side effects. No patient receiving marijuana required hospitalization or any other form of medical intervention. See, Evaluation of the Antiemetic Properties of Inhalation Marijuana in Cancer Patients Receiving Chemotherapy Treatment," New York Department of Health, Office of Public Health (Annual Reports).

Georgia: The Georgia program evaluated 119 patients. It compared THC to standardized smoking of marijuana and with patient-controlled smoking. To enter the program a patient had to have failed on other antiemetics. Patients were randomized to either patient-controlled smoking of marijuana, standardized smoking of marijuana or THC pills.

The report found that both THC and marijuana were effective in providing antiemetic relief for patients who were previously unresponsive to antiemetics. The rate of success was 73.1 percent. Patient controlled smoking of marijuana was successful in 72.2 percent, standardized smoking was successful in 65.4 percent and THC was effective in 76 percent of the cases. In comparing the reasons for failure between marijuana and THC the report found:

The primary reasons for failure of THC capsules were due to either adverse reaction (6 out of 18) or failure to improve nausea and vomiting (9 out of 18). The primary reason for failure of smoking marijuana were due to smoking intolerance (6 out of 14) or failure to improve the nausea and vomiting (3 out of 14).

Beaconsfield, D., Ginsburg, J., and Rainsbury, R. (1973). Therapeutic potential of marihuana. New Eng. J. Medicine 289, 1315.

Therapeutic Aspects. 1974. Marijuana and Health, Fourth Annual Report to the U.S. Congress, Nat'l Institute on Drug Abuse, 134-143.

Therapeutic Aspects. 1975. Marijuana and Health, Fifth Annual Report to the U.S. Congress, Nat'l Institute on Drug Abuse, 117-132.

Bhargave, H. (1978). Potential therapeutic application of naturally occurring and synthetic cannabinoids. Gen. Pharmac., 9, 195-213.

Ungerleider, J. (1979). Marijuana as a good medicine: Its uses against disease. Lecture delivered to UCLA Center for the Health Sciences, August 21, 1979.

Zinberg, N. (1979). On cannabis and health. J. Psychedelic Drugs, 11, 135-144.

AMA Council on Scientific Affairs. (1980). Marihuana reexamined: Pulmonary risks and therapeutic potentials. Conn. Medicine, 44, 521-523. Cohen, S. (1980). Therapeutic aspects. Nat'l Inst. Drug Abuse. Res. Mono. Ser., No. 31, 199-216.

Council on Scientific Affairs. (1981). Marijuana: Its health hazards and therapeutic potentials. JAMA, 246, 1823-1827.

DuQuesne, J. (1981). Cannabis and the Rule of Law. Lancet, Sept. 12, 1981, 581.

Rose, M. (1981). Cannabis and the rule of law. Lancet, July 18, 1981.

Therapeutic potential and medical uses of marijuana. (1982). In Marijuana and Health, Inst. of Medicine, 139-155.

Schurr, A. (1985). Marijuana: Much ado about THC. Comp. Biochem. Physiol., 80 C, 1-7.

Ungerleider, J. and Andrysiak, T. (1985). Therapeutic issues of marijuana and THC., Int'l J. Addictions, 20, 691-699.

Grinspoon, L. and Bakalar, J., (1995). Marihuana as Medicine, A Plea for Reconsideration, JAMA, 273: 1875-1876.

Medical Marijuana and Nausea, Vomiting and Appetite

Hollister, L (1970) Hunger and appetite after single doses of marihuana, alcohol and dextroamphetamine. Clin. Pharmacol. and Therapeutics, 12, 44-49.

Sallan, S.E., Zinberg, N.E., Ferei, E., III, (1975), Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. N. Eng. J.Med., 293, 795-797.

Greenberg, I., Kuehnle, J., Mendelson,J.H. and Bernstein, J.G. 1976. Effects of marihuana use on body weight and caloric intake in human. Journal of Psychopharmacology (Berlin) 49: 79-84.

Harris, L. (1976). Analgesic and antitumor potential of the cannabinoids. In Therapeutic Potential of Marijuana. (Cohen and Stillman, eds., 299-309.

Harris, L. Munson, A. and Carchman, R. (1976). Antitumor properties of

cannabinoids. In The Pharmacology of Marihuana (Braude and Szara, eds.), 749-762.

Chang, A. et al. (1979). Delta-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate. Annals of Internal Medicine, 91, 819-824.

Sallan, S.E., Cronin, C. Zelen, M., Zinberg, N.E. (1980). Antiemetics in patients receiving chemotherapy for cancer. A randomized comparison of delta-9-tetrahydrocannabinol and prochlorperazine. N. Engl. J. Med., 302: 135-8.

California State Reports, Therapeutic Cannabis Program, Annual Report to the Governor and Legislature, California Research Advisory Panel (1980-1986).

Bateman, D.C., Rawlins, M. (1982). Therapeutic potential of cannabinoids. Br. Med. J., 284, 1211-1212.

Cannabinoids for nausea, (1981). Lancet, Jan. 31, 1981, 255-256.

Frytek, S., Moertel, C.G., (1981), Management of nausea and vomiting in the cancer patient, JAMA, 245, 394-396.

Neidhart, J., Gagen, M., Wilson, H. and Young, D. (1981). Comparative trial of the antiemetic effects of THC and haloperidol. J. Clin. Pharmacol., 21, 385-425.

Michigan Department of Public Health Marijuana Therapeutic Research Project,

Trial A 1980-81," Department of Social Oncology, Evaluation Unit, Michigan Cancer Foundation (March 18, 1982).

Ungerleider, J., Andrysiak, T., Fairbanks, L., Goodnight, J., Sama, G. and Jamison, K. (1982). Cancer chemotherapy and marijuana.

Ungerleider, J., Andrysiak, T., Fairbanks, L., Goodnight, J., Sama, G. and Jamison, K. (1982). Cannabis and cancer chemotherapy: A comparison of oral delta-9-THC and prochlorperazine. Cancer, 50, 636-645.

Sensky, T., Baldwin, A., and Pettingale, K. (1983). Cannabinoids as antiemetics. Br. Med. J. , 286, 802.

Kutner, Michael H., Evaluation of the Use of Both Marijuana and THC in Cancer Patients for the Relief of Nausea and Vomiting Associated with Cancer Chemotherapy After Failure of Conventional Anti-Emetic Therapy: Efficacy and Toxicity" as prepared for the Composite State Board of Medical Examiners, Georgia Department of Health, by physicians and researchers at Emory University, Atlanta, (January 20, 1983).

Annual Report: Evaluation of Marijuana and Tetrahydrocannabinol in the Treatment of Nausea and/or Vomiting Associated with Cancer Therapy Unresponsive to Conventional Anti-Emetic Therapy: Efficacy and Toxicity," Board of Pharmacy, State of Tennessee, July 1983.

The Lynn Pierson Therapeutic Research Program," the Behavioral Health Sciences Division, Health and Environment Department, March 1983 and 1984.

Foltin, R.W., Brady, J.V. and Fischman, M.W. 1986. Behavioral analysis of marijuana effects on food intake in humans. Pharmacology, Biochemistry and Behavior. 25: 577-582.

Foltin, R.W. et al., 1988 Effects of Smoked Marijuana on Food Intake and Body Weight of Humans Living in a Residential Laboratory," Appetite 11:1-14

Vinciguerra, V., Moore, T., Brennab, E., Inhalation marijuana as an antiemetic for cancer chemotherapy, (Oct. 1988) N.Y. State J. Medicine, 525-527.

T.F. Plasse, R.W. Gorter, S.H. Krasnow, et al., 1991. Recent clinical experience with dronabinol. Pharmacology, Bichemistry and Behavior 40: 695-700.

Doblin, R., Kleiman, M., Marijuana as antiemetic medicine: A survey of oncologists' experiences and attitudes, (1991), J. Clin. Oncology, 9:7, 1314-1319.

Abrams, D. 1995, Marijuana, the AIDS Wasting Syndrome, and the U.S. Government (Response to Letter) New England Journal of Medicine, Vol. 333 (10): 670-671.

Grinspoon, L, J, and Doblin, R. 1995. Marijuana, the AIDS Wasting Syndrome, and the U.S. Government (Letter to ed.) New England Journal of Medicine, Vol. 333(10): 670-671.

Wesner, B. 1996. The Medical Marijuana Issue Among PWAs: Reports of Therapeutic Use and Attitudes Toward Legal Reform. Drug Research Unit, Social Science Research Institute, University of Hawaii at Manoa.

Medical Marijuana and Glaucoma

Hepler, R. and Frank, I., (1971). Marijuana smoking and intraocular pressure. JAMA, 217, 1932.

Hepler, R., Frank, I. and Ungerleider, J. (1972). Pupillary constriction after marijuana smoking. Am. J. Ophthalmol., 74, 1185-1190.

Shapiro, D. (1974). The ocular manifestations of the cannabinoids. Opthalmologica, 168, 366-369.

Hepler, R. and Petrus, R. (1976). Experiences with administration of marijuana to glaucoma. In The Therapeutic Potential of Marijuana. (Cohen and Stillman, eds.), 63-75.

Perez-Reyes, M., Wagner, D., Wall, M. and Davis, K. (1976). Intravenous administration of cannabinoids and intraocular pressure. In The Pharmacology of Marihuana (Braude and Szara, eds.), 829-832.

Goldberg, I., Kass, M. and Becker, B. (1978-1979). Marijuana as a treatment for glaucoma. Sightsaving Review, Winter issue, 147-154.

Crawford, W., and Merritt, J. (1979). Effects of tetrahydrocannabinol on arterial and intraocular hypertension. Int'l J. Clin. Pharmacol. and Biopharm. 17, 191-196.

Merritt, J., Crawford, W., Alexander, P., Anduze, A. and Gelbart, S. (1980). Effect of marihuana on intraocular and blood pressure in glaucoma.Ophthalmology, 87, 222-228.

Merritt, J., McKinnon, S., Armstrong, J., Hatem, G. and Reid, L. (1980). Oral delta-9-tetrahydrocannabinol in heterogenous glaucomas. Annals of Ophthalmology, 12, No. 8.

Zimmerman, T. (1980). Efficacy in glaucoma treatment-the potential of marijuana. Annals of Ophthalmology, 449-450.

Green, L., (1984) Marijuana effects on intraocular pressure, Applied, Pharmacology in the Medical Treatment of Glaucomas, (S.M. Drance, ed.), 507-526.

Merritt, J., et al. (1981). Effects of topical delta-9-tetrahydrocannabinol on intraocular pressure in dogs. Glaucoma, Jan./Feb., 13-16.

Merritt, J., Perry, D., Russell, D. and Jones, B. (1981). Topical delta-9-tetrahydrocannabinol and aqueous dynamics in glaucoma. J. Clin. Pharmacol., 21, 467S-471S.

Merritt, J., Olsen J., Armstrong, J. and McKinnon, S. (1981). Topical delta-9-tetrahydrocannabinol in hypertensive glaucomas. J. Phar. Pharmacol., 33, 40-41.

Merritt, J. (1982). Glaucoma, hypertension, and marijuana. J. Nat'l Med. Ass'n., 74, 715-716.

Merritt, J., Cook, C. and Davis, K. (1982). Orthostatic hypotension after delta-9- tetrahydrocannabinol marihuana inhalation. Ophthalmic Res., 14, 124-128.

Merritt, J. et al. (1982). Topical delta-8-tetrahydrocannabinol as a potential glaucoma agent. Glaucoma, 4 253-255.

Merritt, J. (1984). Outpatient cannabinoid therapy for heterogenous glaucomas: Guidelines for institution and maintenance of therapy. Marijuana 84: Proceedings of the Oxford Symposium on Cannabis, 681-683.

Merritt, J., Shrewsbury, R., Locklear F., Demby, K. and Wittle, G. (1986), Effects of delta-9-tetrahydrocannabinol and vehicle constituents on intraocular pressure in normotensive dogs. Research Communication in Substances of Abuse, 7, 29-35.

Medical Marijuana, Muscle Spasm and Convulsion

Carlini, E., Leite, J., Tannhauser, M. and Berardi, A. (1973). Cannabidiol and cannabis sativa extract protect mice and rats against convulsive agents. J. Pharm. Pharmac., 25, 664-665.

Karler, R., Cely, W., and Turkanis, S. (1973). The anticonvulsant activity of cannabidiol and cannabinol. Life Sciences, 13, 1527-1531.

Dunn, M. and Davis, R., (1974). The perceived effects of marijuana on spinal cord injured males, Paraplegia, 12, 175.

Turkanis, S., Cely, W., Olsen, D. and Karler, R. (1974). Anticonvulsant properties of cannabinol. Res. Comm. Chem. Path. Pharmacol., 8, 231-246.

Consroe, P., Wood, G., and Buchsbaum, H. (1975). Anticonvulsant nature of marijuana smoking. JAMA, 234, 306-307.

Karler, R. and Turkanis, S. 1976. The antiepileptic potential of the cannabinoids. In The Therapeutic Potential of Marijuana, (Cohen and Stillman, eds.), 383-396.

Feeney, D.M., Marihuana and epilepsy: paradoxical anticonvulsant and convulsant effects, Marijuana Biological Effects: Analysis, Metabolism, Cellular Responses, Reproduction and the Brain, (Nahas, GG., Paxton, M., Bruade, J.C., Hardillier, and Harvey, D.J. eds.) Pergamon Press, Oxford, England, 643-657.

Petro, D., (1980), Marihuana as a therapeutic agent for muscle spasm of spasticity, Psychosomatics, 21: 81, 85.

Cunha, J., et al. (1980). Chronic administration of cannabidiol to health volunteers and epileptic patients. Pharmacology, 21, 175-185.

Petro, D., Ellenberger, C., Jr., (1981). Treatment of human spasticity with delta-9- tetrahydrocannabinol, J. Clin. Pharmacol., 21:413S-416S.

Clifford, D.B.. 1983. Tetrahydrocannabinol for tremor in multiple sclerosis. Annals of Neurology. 13: 669-671.

Sandyk, R., Consroe, P., Stern, L., Snider, S., (1986). Effects of cannabidiol in Huntington's Disease, Neurology, 36:331.

Hanigan, W.C., Destree,R. and Truong, X.T., (Feb., 1986), The effect of delta-9- tetrahydrocannabinol on human spasticity, Clin. Pharmacol. Ther., 198. Truong, X.T.,

Hanigan, W.C., (Feb. 1986). Effect of delta-9-tetrahydrocannabinol on EMG measurements in human spasticity. Clin. Pharmacol. Ther., 232.

Cannabis, (1986) Therapeutic Claims in Multiple Sclerosis, Int'l Federation of Multiple Sclerosis Societies, 226.

Ames, F. and Cridland, S. (1986). Anticonvulsant effects of cannabidiol. S. Afr. Med. J., 69, 14.

Ungerleider, T. 1987.Delta 9 THC in treatment of spasticity associated with marijuana. Advances in Alcohol and Substance Abuse, 7: 39-51.

Meinck, H.M., Schonle, P.W., Conrad, B. 1989. Effect of Cannabinoids on Spasticity and Ataxia in multiple sclerosis. Journal of Neurology 236: 120-122.

Maurer, M., Henn, V., Dittrich A., Hoffamn, A., 1990. Delta-9-tetrahydrocannabinol shows antispastic and analgesic effects in a single case double-blind trial. European Archives of Psychiatry and Clinical Neuroscience 240: 1-4.