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October 16, 2005
Incongruiities
While it shouldn't have been assumed that Proposition 215, California's unique voter-approved experiment with "medical marijuana," would be without controversy, the original intent of that legislation is being almost completely frustrated by an amalgam of fear and hostility which literally defies description. Sadly, opposition has been so sustained and effective that prosecution of activists within the state is more virulent than ever and one community after another is considering measures that would deny business licenses to any outlet intending to distribute cannabis to qualified patients.
The hostility of various federal and local police agencies might have been anticipated for a while; but that it would be sustained for nearly ten years is both amazing- and almost certainly a consequence of the failure of either state or federal judiciaries to protect law abiding citizens from malevolent prosecution. Ditto the failure of the press to report accurately or coherently on the issues. Ditto the clueless response of either academic "drug policy analysts" or medical institutions at any level to take an intelligent interest in a problem that should have commanded their attention from the start.
Finally- and most inexplicable of all- has been the rejection of my attempts to interest self-styled supporters of medical marijuana in the results of clinical research aimed at clarifying core 'medical' issues by systematic collection of data from applicants. These are sweeping charges- some of which I've been reluctant to make publicly- my primary reason for doing so now is the simultaneous appearance of two articles in current medical literature which offer hope that the situation may be somewhat less dire than it seemed a few days ago, and may also be closer to reversal.
As noted earlier this blog is centered on a clinical study which began in late 2001. It has been carried out continuously since then with little support beyond the medical fees paid by applicants themselves. Quite apart from its political symbolism, the potential value of cannabis as a therapeutic agent was clearly a reasonable subject for research when 215 first passed in 1996, and remains even more so today. As anyone even moderately familiar with current medical literature should be aware, several studies both abroad- and more recently in the United States- have recognized that cannabinoids as potentially offering an exciting array of therapeutic benefits to an extremely broad range of clinical conditions.
In stark contrast to the glittering promise from laboratories has been the dearth of clinical research involving cannabinoids and human subjects. In only one instance I'm aware of- GW Pharmaceutical's study of Sativex, an unusual proprietary product- have any clinical studies been conducted. Given the remarkable- and virtually unchallenged- safety record of cannabis, it's clear the reason for this absence of clinical data relates directly to the status of "marijuana" as an illegal drug.
In previous blog entries, I've focused on NIDA as the federal agency most culpable for its opposition to cannabis- primarily because of its distortion of science on behalf of an obviously political message. However NIDA is merely the most vocal; all federal medical agencies have been reluctant to say anything positive about cannabinoids. And NIDA is an agency within the NIH; in that connection, it's amazing that this week's New England Journal would feature a plea from the head of the NIH for precisely the kind of "clinical-translational" research my study represents.
In another remarkable coincidence, a second prestigious journal (The Journal of Clinical Investigation) just published an exciting animal study; one which explicitly supports the idea that cannabinioids are not only anxiolytic and antidepressant, but also active in brain areas that control emotions, and- most amazing of all- seem to provoke neurogenesis, a unique and presumably helpful type of cell proliferation in those same areas. Although I question the need to study human cognition in animals with far less complex cognitive function, these observations do support my clinical observations in humans; observations I have been contending for over two years merit the interest and support of anyone interested in the truth- especially those claiming also to favor medical use of cannabis.
As a final incongruity, both journals have taken a rare step in making these unusual articles freely available for downloaded by the general public. Hopefully, that's an omen- one which will also be of some help in provoking long overdue support for a unique study.
Dr. Tom O'Connell
Posted by tjeffo at October 16, 2005 07:12 AM