Marijuana


December 03, 2009 – The latest reports out of Trenton are that by the time the current governor leaves office, New Jersey is likely to have a law authorizing medical marijuana. So on a recent trip to California I decided to check out a marijuana clinic to see what the future will be like.

I was amazed at what I witnessed when I first walked in the door of the clinic on a downtown street in Oakland. The proponents of medical marijuana argue that those who need it are often suffering from dreadful, debilitating diseases. So I felt great sympathy for the patients as I watched them walk into the back room of the clinic to get their prescriptions filled. I could only imagine the agony these poor, unfortunate souls must have been experiencing.

Amazingly, though, every single one of them exited with a spring in his step. One young patient had apparently experienced such a miraculous cure that he picked up a skateboard and went swooping away on the sidewalk after he picked up his pot. Imagine that. The guy was probably confined to a wheelchair just the other day. Now he was doing ollies and fakies halfway to Berkeley.

I was impressed. I was equally impressed by the coffee and the chocolate cake. Did I mention that the clinic is also a coffee shop? It’s called the Blue Sky, and it’s modeled after the marijuana dispensaries in Amsterdam. In fact, the locals call this part of Oakland “Oaksterdam” to highlight the resemblance.

The difference is that in Amsterdam the pot is sold to everyone. In California, you have to have a photo ID that identifies you as a patient. I got talking to some of the staff and the patients. It turns out there are a surprisingly large number of illnesses that will qualify you for that ID card. If you’re having a hard time sleeping, for example, the doctor might prescribe some “Blue Dream.” Other maladies will respond to a dose of “Green Cush” or perhaps a few hits of “Querkle.”

Another good thing about this clinic was that it didn’t have the antiseptic air of a typical health clinic. On a sunny Sunday afternoon there was a jazz band playing on the sidewalk outside. Apparently jazz musicians long ago discovered the healing properties of marijuana, and they are eager to share their knowledge with the general public.

Down the block is an educational institution called Oaksterdam University. There, students take 13-week courses in the growing of this miracle medicine. They can even buy seedlings if they care to grow some of their own at home, a practice also permitted under California law.

Somewhere in there, I began to suspect that these patients weren’t as sick as advertised. Perhaps they were just sick of not being high.

Sure enough, it turns out the ultimate goal of California’s pot proponents is to make this miracle drug available to all adults without a prescription. On the café’s counter next to the cake was a petition calling for a referendum that would make marijuana legal for all Californians over the age of 21. It would be highly taxed and both the state and the municipality would get a share.

The owners of the Blue Sky and other clinics around California already make a point of collecting tax on every transaction and handing that revenue over to the government. The idea is that the pols in cash-strapped California will become as dependent on that revenue stream as the patients are on their prescriptions.

I’ve listened to a lot of the debate over medicinal marijuana in New Jersey, and our pols insist that our medical-marijuana law would be different than California’s, with tighter controls. I doubt it. The same dynamic at work in the Golden State is at work in the Garden State. When it comes to legalization, medicinal marijuana is just the camel’s nose under the tent.

The funny thing is, there’s another Camel headed the other way. The cigarette manufacturers are finding their product becoming more tightly regulated just as the pot growers are watching their regulations loosened. Many municipalities are banning the smoking of cigarettes on streets, in parks and just about anywhere in public. Meanwhile, the pot smokers in California are already agreeing to similar restrictions as part of that referendum.

So we may wind up with a situation in which pot smokers and cigarette smokers are treated equally under the law. They’ll be able to smoke, but just in private. Only their taxes will be public.

That’s fine with me. I don’t smoke either pot or cigarettes. But if the potheads want to join the nicotine fiends in lowering my tax burden, that may be the best prescription of all. By Paul Mulshine Source.
New Jersey considers a medical marijuana law – Video:

December 3, 2009 – Marijuana is California’s largest agricultural commodity with $14 billion in sales yearly, distancing itself from the state’s second largest—milk and cream—which bring in $7.3 billion a year. But California’s coffers only receive a fraction of the marijuana sales, $200 million coming from the sale of medical marijuana. That could all change with Assemblyman Tom Ammiano’s (D-San Francisco) Marijuana Control, Regulation and Education Act (AB 390).

Since February, when the bill was introduced, it has made little headway in the Legislature. But in October, a hearing on the bill was held by the Public Safety Committee; marking the first time a legislative committee held a hearing on marijuana legalization.

AB 390 would create a system that would regulate marijuana much like alcohol is regulated. Those over the age of 21 could purchase pot from vendors with licenses to do so. The state’s Legislative Analyst and the Board of Equalization have estimated that pot sales could bring up to $1.3 billion in revenue yearly. That number is based off a proposed $50-per-oz. levy placed on marijuana purchases and sales tax.

With a projected deficit of $20 billion facing the state next fiscal year, sources of guaranteed revenue are needed. But there are those that believe that the social issues legalizing pot could have far outweigh any economic benefits.

“Why add another addictive element to our society? I don’t think we should criminalize marijuana, but I don’t think having marijuana where you can buy it like cigarettes or alcohol is something we ought to be doing as a society. I believe we are moving in the wrong direction on that,” said Steve Francis, a former San Diego mayoral candidate and founder of the site KeepComingBack.com—a site that focuses on news and research of alcohol and drug addiction.

Francis says that legalizing marijuana would ultimately cost the state money. He cited a report issued by the Marin Institute that found the economic cost of alcohol use is $38 billion annually, with the state covering $8.3 billion for health-care treatment of alcohol-caused illnesses, plus crime costs, traffic incidents and reduced worker productivity. The taxes and fees collected from alcohol sales only cover 22 percent of total government costs. He says there is every reason to believe the same would happen with marijuana.

“Whatever taxes the author of the legislation thinks we are going to collect on the taxation of marijuana will be very little compared to the social costs on California,” he said.

But the economic impact legalizing marijuana could have goes beyond taxation. Nearly a fifth of California’s 170,000 inmates are locked up because of drug-related crimes. Although most are convicted on crimes more severe than possession, legalizing marijuana would save the state $1 billion in law enforcement and corrections costs.

Orange County Superior Court Judge James Gray says the best solution is to repeal the prohibition of marijuana, allowing the substance to become regulated and less available to children.

“We couldn’t make this drug any more available if we tried,” he said in TIME. “Unfortunately, every society in the history of mankind has had some form of mind-altering, sometimes addictive substance to use, misuse, abuse or get addicted to. Get used to it. They’re here to stay. So let’s try to reduce those harms, and right now we couldn’t do worse if we tried.”

Even if California were to legalize marijuana, there are those that believe that the gray area between federal and state law would only widen. Since California’s Compassionate Use Act was passed in 1996, medicinal marijuana has become more accessible to those need it. But it has opened the gates of confusion, as federal laws still consider marijuana illegal. In fact, cannabis is described as a Schedule 1 drug by the federal Controlled Substances Act, meaning it has no medical use and cannot be prescribed by a physician. Many California municipalities have been reluctant to allow medical marijuana dispensaries, even though they were legalized 13 years ago.

There has been some indication that the federal government is starting to ease its control of marijuana. A few days after Ammiano introduced AB 390, U.S. Attorney General Eric Holder announced that states should be allowed to determine their own rules for medical marijuana and that federal raids on dispensaries would stop in California. President Obama’s nomination of Gil Kerlikowske to be the so-called drug czar and head of the Office of National Drug Control Policy indicated that a softer federal stance on marijuana is being taken. Kerlikowske is the former police chief in Seattle, where he made it clear that going after marijuana possession was not a priority for his department.

A vote by the Public Safety Committee on AB 390 is expected in January. Ammiano said the bill could take between a year and two years before it is heard or voted on in the Legislature. Until then, the debate over decriminalizing marijuana will continue amidst one of California’s worst economic times. BY Landon Bright Source.

December 3, 2009 – I attended the 1st National Clinical Conference on Medical Marijuana in Iowa in 1998. Arguably the most learned man on the subject of the effects of smoke on the lungs is named Donald Tashkin, Professor of Medicine, Division of Pulmonary & Critical Care, at UCLA. He spoke for almost an hour at the Conference, showing slides of smoke-browned lungs. He showed how marijuana smoke seems to push pollutants towards the outer lining of the lungs.

His presentation did not portray marijuana smoke as harmless, but there was no solid evidence of disease associated with the browning of the lungs’ outer lining. Donald Tashkin has conducted the most extensive research involving the largest number of long-term marijuana-only smokers, as well as multi-drug smokers–marijuana, tobacco, cocaine, and other substances, for several decades. His critique of marijuana smoke was completely non-committal. (Considering the government is his largest source of funding, there is little doubt why his lecture at the first medical cannabis conference was short and unsupportive.)

When Dr. Tashkin finished his speech, he did not wait to answer questions. He grabbed his materials and bolted for the door. I raced after him and stopped him on the steps outside the conference hall. I showed him the passages I had written about his research in The New Prescription. I stood there and watched him read everything I had written about his work. He agreed that my synopsis was correct. Then I asked him the $64,000 question. I said, “Do you know of any cases of marijuana-only smokers who had lung cancer?” He said “Yes, there is one.” Then he smiled, explaining, “He was sixteen years old.” We both smiled, knowing a teenager could not possibly have sufficient exposure to marijuana smoke to cause lung cancer–his cancer was clearly due to some other cause. By: Martin Martinez. Source.

Severe chronic pain is usually treated with opioid narcotics and various synthetic analgesics, but these drugs have many limitations.

December 3, 2009 – Opioids are addictive and tolerance develops. The most commonly used synthetic analgesics – aspirin, acetaminophen (Tylenol), and nonsteroidal antiinflammatory drugs (NSAIDs) like ibuprofen -are not addictive but they are often insufficiently powerful. Furthermore they have serious toxic side effects including gastric bleeding or ulcer and in the long run a risk of liver or kidney disease. Stomach bleeding and ulcers induced by aspirin and other NSAIDs are the most common serious adverse drug reactions reported in the United States. These drugs may be responsible for as many as 76,000 hospitalizations and more than 7,600 deaths annually. Acetaminophen is increasingly prescribed instead because it largely spares the digestive tract, but it can cause liver damage or kidney failure when used regularly for long periods. Medical researchers have estimated that patients who take one to three acetaminophen tablets a day for a year or more account for about 8% to 10% of all cases of end-stage renal disease, a condition that is fatal without dialysis or a kidney transplant.

Given the limitations of opioids and non-addictive synthetic analgesics, one might have expected pain specialists to take a second look at cannabis, but the medical literature again suggests little recent reconsideration. Cannabis may be especially useful for the kinds of chronic pain that people who survive catastrophic traumatic accidents have to live with the rest of their lives.

Martin Martinez is such a patient:
High school friends of mine made a daily springtime habit of smoking marijuana just outside the principal’s office windows, purposely blowing in billows of pungent smoke on the afternoon breeze. Being chased out of the yard by irate school officials heightened the drug’s effects as young hearts raced to join their buddies bursting with laughter. An outsider among outsiders, I was not fond of such games. Nor was I interested in the use of pot for purely social or recreational uses. Marvelous insights captivated my mind when stoned. As I grew older my use of cannabis developed beyond intuitive meditation and became the catalyst of many profound mystical experiences. Later in life I found that the moderate use of cannabis did not interfere with demanding physical tasks and skills such as building construction and home remodeling. While a large dose of marijuana would tend to make me feel less active, a smaller dose invigorated my vitality. I also rode a motorcycle in my youth. I felt that a small dose of marijuana actually increased my motor skills. By the age of 27 I had driven many thousands of miles while mildly stoned and had never caused an accident. Then one night a reckless driver swerved into my lane and crashed into me at a combined speed of 60 miles per hour. I was not expected to survive.

I suffered dozens of severe injuries in the crash, including 25 orthopedic fractures and massive skull fractures which severely crippled several cranial nerves. Two months after the crash I lay in bed a crumpled mass of pain. My IV fed me up to 10 milligrams of morphine every 7 minutes, 24 hours a day, but still I had trouble sleeping because the pain was so intense. I was told that I was not going to recover mobility and that I would spend the rest of my life connected to a medical facility. I could barely speak due to the nerve damage to my voice and throat. The constant pain in my eyes was excruciating. I was given morphine and other narcotics which incapacitated me, but did not reduce the pain in my eyes. Swallowing was a challenge which often resulted in choking and coughing fits lasting many minutes. As the weeks went by I began to suspect that the medications I was given were actually contributing to my neurological impairments by inhibiting concentration and depressing neurological responses. In addition, I was painfully aware that narcotics had a disastrous effect on my intestines.

One day I was visited by an outpatient who had AIDS. He told me a little about the medical uses of marijuana and he gave me a joint. I waited till late at night when the nurses were busy elsewhere. I smoked the joint in secret and my heart raced so much I feared that I might burst the scars of my recent surgery. But then the contraband was gone, the scent was dissipated, and outraged nurses still had not discovered me, so my heart rate slowed to a comfortable purr. I felt relaxed and at ease, but not stupefied. I could still sense the deep scars of my damaged nerves, but I was somehow mentally distanced from the pain in a way that morphine did not offer. I slept that night more soundly than I had since the crash.

I left the primary hospital as soon as I could talk my doctors into releasing me. I returned to my hometown and became an outpatient at a facility there. I continued to use narcotics and other pain medications prescribed by my doctors, but over the months and years I gradually replaced several prescription medicines with the use of cannabis. Nearly all of the drugs I had been given by doctors seemed to depress my mind and body, and the addictive quality of narcotics created numerous unpleasant psychological effects. Unlike narcotics, cannabis use imparted positive mental and physical stimulation, called euphoria, that encouraged my rapid recovery.

With the use of cannabis replacing sensory-depressive narcotics, I found myself recovering far beyond the expectations of my first 27 doctors. Five years after the crash I took some college courses and then began to work again. By the time I was well enough to maintain a full time carpentry job I was smoking hundreds of dollars worth of cannabis per month. Ten years after the crash, having spent in excess of $10,000 per year on unreliable qualities of cannabis, I was arrested for growing my own.

In my trial the prosecution proved that I was growing what they considered to be a “huge” amount of marijuana. The fact that I had possession of 88 plants was assumed to be evidence that I was a drug dealer. I proved that I had a legitimated medical necessity for the use of marijuana and that I also had a very substantial income in real estate development which precluded a profit motive. Using the harvest estimates of the Drug Enforcement Administration agent who testified against me and the consumption estimates of the physician who testified for me, the amount of cannabis seized might have lasted me up to two years and saved me up to $20,000. Eight of the jurors in my trial were sympathetic and voted to acquit me on the grounds of medical necessity. Four of the jurors agreed with the State’s contention that I had intended to sell my medicine. A mistrial was declared and I remained free.

Two months later police officers returned to my home. They held me and searched the premises without a warrant, discovering a much smaller cannabis garden than they had seized the year before. A vindictive State prosecutor arrived at my house and intentionally confiscated confidential communications to and from my attorneys. I spent a second birthday in a row deathly sick in bed after having been released from jail. Physically, emotionally, and economically bankrupt, unable to afford the enormous cost of another trial, and unable to obtain a public defender due to my ownership of severely over-mortgaged real estate, I accepted a “no jail-time” plea bargain deal which was broken the day before sentencing. The medical affidavits of Dr. Grinspoon and four additional physicians had no apparent influence on the imperious court. I was sentenced to 90 days in jail for the criminal act of cultivating cannabis for my own medical use.

I was on the brink of catastrophe, about to begin the second worst three months of my life, when a marvelous thing happened. Hundreds of people, including doctors, medical marijuana activists, other medicinal cannabis users, and other concerned citizens, started an organized telephone, fax, and letter-writing campaign which forced the State to review and reevaluate its disposition of my case. Thanks to the sincere efforts of numerous concerned persons all jail time was then commuted to 240 hours of community service and the imposition of urine analysis testing was waived. Although the criminal actions against me cost me two years of terrible hardship, at least the State eventually decided not to further endanger my health. By: Martin Martinez. Source.

December 3, 2009 – Marijuana is a complex substance containing over 60 different forms of cannabinoids, the active ingredients. Cannabinoids are now known to have the capacity for neuromodulation, via direct receptor-based mechanisms at numerous levels within the nervous system. These have therapeutic properties that may be applicable to the treatment of neurological disorders; including anti-oxidative, neuroprotective, analgesic and anti-inflammatory actions; immunomodulation, modulation of glial cells and tumor growth regulation. This article reviews the emerging research on the physiological mechanisms of endogenous and exogenous cannabinoids in the context of neurological disease.

Introduction
Over the past few decades, there has been widening interest in the viable medicinal uses of cannabis. The National Institutes of Health, the Institute of Medicine, and the Food and Drug Administration have all issued statements calling for further investigation. The discovery of an endogenous cannabinoid system with specific receptors and ligands has led the progression of our understanding of the actions of cannabis from folklore to valid science. It now appears that the cannabinoid system evolved with our species and is intricately involved in normal human physiology, specifically in the control of movement, pain, memory and appetite, among others. The detection of widespread cannabinoid receptors in the brain and peripheral tissues suggests that the cannabinoid system represents a previously unrecognized ubiquitous network in the nervous system. Dense receptor concentrations have been found in the cerebellum, basal ganglia and hippocampus, accounting for the effects on motor tome, coordination and mood state. Low concentrations are found in the brainstem, accounting the remarkably low toxicity. Lethal doses in humans has not been described.

The Chemistry of Cannabis
Marijuana is a complex plant, with several subtypes of cannabis, each containing over 400 chemicals. Approximately 60 are chemically classified as cannabinoids. The cannabinoids are 21 carbon terpenes, biosynthesized predominantly via a recently discovered deoxyxylulose phosphate pathway. The cannabinoids are lipophilic and not soluble in water. Among the most psychoactive is D9-tetrahydrocannabinol (THC), the active ingredient in dronabinol (Unimed Pharmaceuticals Inc). Other major cannabinoids include cannabidiol (CBD) and cannabinol (CBN), both of which may modify the pharmacology of THC or have distinct effects of their own. CBD is not psychoactive but has significant anticonvulsant, sedative and other pharmacological activity likely to interact with THC. In mice, pretreatment with CBD increased brain levels of THC nearly 3-fold and there is strong evidence that cannabinoids can increase the brain concentrations and pharmacological actions of other drugs.

Two endogenous lipids, anandamide (AEA) and 2-aracidonylglycerol (2-AG), have been identified as cannabinoids, although there are likely to be more. The physiological roles of these endocannabinoids have been only partially clarified but available evidence suggests they function as diffusible and short-lived intercellular messengers that modulate synaptic transmission. Recent studies have provided strong experimental evidence that endogenous cannabinoids mediate signals retrogradely from depolarized post synaptic neurons to presynaptic terminals to suppress subsequent neurotransmitter release, driving the synapse into an altered state. In hippocampal neurons, depolarization of postsynaptic neurons and the resultant elevation of calcium lead to transient suppression of inhibitory transmitter release. Depolarized hippocampal neurons rapidly release both AEA and 2-AG in a calcium-dependent manner. In the hippocampus, cannabinoid receptors are expressed mainly by GABA-mediated inhibitory interneurons. Synthetic cannabinoid agonists depress GABAA release from hippocampal slices. However, in cerebellar Purkinje cells, depolarization-induced elevation of calcium causes transient suppression of excitatory transmitter release. Thus endogenous cannabinoids released by depolarized hippocampal neurons may function to downregulate GABA release. Further, signaling by the endocannabinoid system appears to represent a mechanism enabling neurons to communicate backwards across synapses in order to modulate their inputs.

There are two known cannabinoid receptor subtypes; subtype 1 (CB1) is expressed primarily in the brain, whereas subtype 2 (CB2) is expressed primarily in the periphery. Cannabinoid receptors constitute a major family of G protein-coupled, 7-helix transmembrane nucleotides, similar to the receptors of other neurotransmitters such as dopamine, serotonin and norepinephrine. Activation of protein kinases may be responsible for some of the cellular responses elicited by the CB1 receptor.

Neuromodulation and neuroprotection
As we are developing an increased cognizance of the physiological function of endogenous and exogenous cannabinoids it is becoming evident that they may be involved in the pathology of certain diseases, particularly neurological disorders. Cannabinoids may induce proliferation, growth arrest or apoptosis in a number of cells, including neurons, lymphocytes and various transformed neural and non-neural cells. In the CNS, most of the experimental evidence indicates that cannabinoids may protect neurons from toxic insults such as glutamatergic overstimulation, ischemia and oxidative damage. The neuroprotective effect of cannabinoids may have potential clinical relevance for the treatment of neurodegenerative disorders such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Parkinson.s disease, cerebrovascular ischemia and stroke. Both endogenous and exogenous cannabinoids apear to have neuroprotective and antioxidant effects. Recent studies have demonstrated the neuroprotective effects of synthetic, non-psychotropic cannabinoids, which appear to protect neurons from chemically-induced excitotoxicity. Direct measurement of oxidative stress reveals that cannabinoids prevent cell death by antioxidation. The antioxidative property of cannabinoids is confirmed by their ability to antagonize oxidative stress and consequent cell death induced by the powerful oxidant, retinoid anhydroretinol. Cannabinoids also modulate cell survival and the growth of B-lymphocytes and fibroblasts.

The neuroprotective actions of cannabidiol and other cannabinoids have been examined in rat cortical neuron cultures exposed to toxic levels of the exitatory neurotransmitter glutamate. Glutamate toxicity was reduced by both CBD (non-psychoactive) and THC. The neuroprotection observed with CBD and THC was unaffected by a cannabinoid receptor antagonist, indicating it to be cannabinoid receptor-independent. CBD was more protective against glutamate neurotoxicity than either ascorbate (vitamin C) or a-tocopherol (vitamin E).

Cannabinoids have demonstrated efficacy as immune modulators in animal models of neurological conditions such as MS and neuritis. Current data suggests that the naturally occurring, non-psychotropic cannabinoid, CBD, may have a potential role as a therapeutic agent for neurodegenerative disorders produced by excessive cellular oxidation, such as ALS, a disease characterized by excess glutamate activity in the spinal cord.

It is not yet known how glutamatergic insults affect in vivo endocannabinoid homeostasis, including AEA, 2-AG, as well as other constituents of their lipid families, N-acylethanolamines (NAEs) and 2-monoacylglycerols (2-MAGs). Hansen et al used three in vivo neonatal rat models characterized by widespread neurodegeneration as a consequence of altered glutamatergic neurotransmission and assessed changes in endocannabinoid homeostasis. A 46-fold increase in cortical NAE concentration and a 13-fold increase in AEA was noted 24 h after intracerebral NMDA injection, while less severe insults triggered by mild concussive head trauma or NDMA receptor blockade produced a less pronounced NAE accumulation. In contrast, levels of 2-AG and other 2-MAGs were unaffected by the insults employed, rendering it likely that key enzymes in biosynthetic pathways of the two different endocannabinoid structures are not equally associated with intracellular events that cause neuronal damage in vivo. Analysis of cannabinoid CB1 receptor mRNA expression and binding capacity revealed that cortical subfields exhibited an upregulation of these parameters following mild concussive head trauma and exposure to NMDA receptor blockade. This suggests that mild-to-moderate brain activity via concomitant increase of anandamide levels, but not 2-AG, and CB1 receptor density. Panikashvili et al demonstrated that 2-AG has an important neuroprotective role. After closed head injury (CHI) in mice, the level of endogenous 2-AG was significantly elevated. After administering synthetic 2-AG to mice following CHI, a significant reduction of brain edema, better clinical recovery, reduced infarct volume and reduced hippocampal cell death compared with controls occurred. When 2-AG was administered together with additional inactive 2-acyl-glycerols that are normally present in the brain, functional recovery was significantly enhanced. The beneficial effect of 2-AG was dose-dependently attenuated by SR-141716A (Sanofi-Synthélabo), an antagonist of the CB1 receptor [30]. Ferraro et al looked at the effects of the cannabinoid receptor agonist WIN-55212-2 (Sanofi Winthrop Inc) on endogenous extracellular GABA levels in the cerebral cortex of the awake rat using microdialysis. Win-55212-2 was associated with a concentration-dependent decrease in dialysate GABA levels. Win-55212-2 induces inhibition was counteracted by the CB1 receptor antagonist SR-141716A, which by itself was without effect on cortical GABA levels. These findings suggest that cannabinoids decrease cortical GABA levels in vivo.

Sinor has shown that AEA and 2-AG increase cell viability in cerebral cortical neuron cultures subjected to 8 h of hypoxia and glucose deprivation. This effect was observed at nanomolar concentrations, was reproduced by a non-hydrolyzable analog of anandamide, and was unaltered by CB1 or CB2 receptor antagonists. In the immune system, low doses of cannabinoids may enhance cell proliferation, whereas high doses of cannabinoids usually induce growth arrests or apoptosis.

In addition, cannabinoids produce analgesia by modulating rostral ventromedial medulla neuronal activity in a manner similar to, but pharmacologically distinct from, that of morphine. Cannabinoids have been shown to produce an anti-inflammatory effect by inhibiting the production and action of tumor necrosis factor (TNF) and other acute phase cytokines. These areas are discussed in great detail in a recent paper by Rice.
Glia as the cellular targets of cannabinoids

There is now accumulating in vitro evidence that glia (astrocytes and microglia in particular) have cannabinoid signaling systems. This provides further insight into the understanding of the therapeutic effects of cannabinoid compounds. Glial cells are the non-neuronal cells of the CNS. In humans they outnumber neurons by a factor of about 10:1. Because of their smaller average size they make up about 50% of the cellular volume of the brain. Glial cells of the CNS fall into three general categories: astrocytes, oligodendrocytes and microglia. Schwann cells and the less well-recognized enteric glia are their counterparts in the peripheral nervous system. Glia are ubiquitous in the nervous system and are critical in maintaining the extracellular environment, supporting neurons, myelinating axons and immune surveillance of the brain. Glia are involved, actively or passively, in virtually all disorders or insults involving the brain. This makes them logical targets for therapeutic pharmacological interventions in the CNS. Astrocytes are the most abundant cell type of the CNS. They express CB1 receptors, and take up and degrade the endogenous cannabinoid anandamide. The expression of CB2 receptors in this population appears to be limited to gliomas and may be an indicator of tumor malignancy. Two recent studies suggest that some of the anti-inflammatory effects of cannabinoids, such as the inhibition of nitric oxide (NO) and TNF release are mediated by CB1 receptors on astrocytes.

The most recent therapeutic role for cannabinoids in the CNS evolved from the discovery that cannabinoids selectively induce apoptosis in glioma cells in vitro and that THC and other cannabinoids lead to a spectacular regression of malignant gliomas in immune-compromised rats in vivo. The mechanism underlying this is not yet clear but it appears to involve both CB1 and CB2 receptor activation. A recent study comparing the antiproliferative effects of cannabinoids on C6 glioma cells suggests the involvement of vanilloid receptors.

Microglia are the tissue macrophages of the brain. In variance from other immune tissue but in accordance with their place in the CNS microglia appear to lack CB2 receptors on protein and RNA levels. Similar to their effect on peripheral macrophages, cannabinoids inhibit the release of NO and the production of various inflammatory cytokines in microglia. Interestingly, the inhibition of NO release seems to be CB1 receptor- mediated, whereas the differential inhibition of cytokines is not mediated by either CB1 or CB2 receptors, suggesting as yet unidentified receptors or a receptor independent mechanism. Irrespective, the potential of cannabinoids on inflammatory processes such as a mouse model of MS or future experiments on brain tumors in immunocompetent animal.

Nothing is known of the effects of cannabinoids on oligodendroglia. In the light of the clinical and experimental evidence suggesting the beneficial effects of cannabinoids in MS, investigations in this direction appear promising.

Future trends

A growing number of strategies for separating the sought-after therapeutic effects of cannabinoid receptor agonists from the unwanted consequences of CB1 receptor activation are now emerging. However, further improvements in the development of selective agonists and antagonists for CB1 and CB2 receptors are needed. This would allow for the refinement of cannabinoids with good therapeutic potential and would facilitate the design of effective therapeutic drugs from the cannabinoid family. Customized delivery systems are also needed; as the cannabinoids are volatile, they will vaporize at a temperature much lower than actual combustion. Thus heated air can be drawn through marijuana and the active compounds will vaporize and can easily be inhaled. Theoretically this removes most of the wealth hazards of smoking, although this has not been well studied. Recently, pharmacologically active, aerosolized forms of THC have been developed. This form of administration is achieved via a small particle nebulizer that generates an aerosol which penetrates deeply into the lungs.

From a regulatory perspective, the scientific process should be allowed to evaluate the potential therapeutic effects of cannabis, dissociated from the societal debate over the potentially harmful effects of non-medical marijuana use. This class of compounds not only holds tremendous therapeutic potential for neurological disease but is also confirmed as having remarkably low toxicity. Source.

Benefits of Cannabis Use

December 2, 2009 – New Jersey is poised to become the next state to allow residents to use marijuana, when recommended by a doctor, for relief from serious diseases and medical conditions.

The state Senate has approved the bill and the state Assembly is expected to follow. The legislation would then head to the governor’s office for his signature.

Gov. Jon Corzine, the Democrat who lost his re-election bid last month, has indicated he would sign the bill if it reaches his desk before he leaves office in January. It would likely be one of Mr. Corzine’s last acts before relinquishing the job to Republican Chris Christie.

Mr. Christie has indicated he would be supportive of such legislation, but had concerns that one draft of a bill he read didn’t have enough restrictions, a spokeswoman said.

The bill has been endorsed by the New Jersey Academy of Family Physicians and the New Jersey State Nurses Association.

Some lawmakers oppose the legislation, saying they fear the proliferation of marijuana dispensaries, as in California, where medical marijuana is legal. “It sends a mixed message to our children if you can walk down the street and see pot shops,” said Republican Assemblywoman Mary Pat Angelini.

Federal law bars the use of marijuana. But legislatures in several states, including California, Colorado, Michigan, New Mexico, Rhode Island and Vermont, permit use of the drug for medical purposes. Attorney General Eric Holder said earlier this year that federal prosecutors wouldn’t prosecute people complying with state medical marijuana laws.

The New Jersey bill would allow people with debilitating medical conditions to grow, possess and use marijuana for personal use, provided that a physician allows it after completing a full assessment of the patient’s history and condition. The conditions that are stipulated in the Senate bill include cancer, glaucoma and human immunodeficiency viruses.

State Sen. Nicholas Scutari, a Democrat who has led the fight for the medical-marijuana bill, said that was not a final list. He said the Senate bill would have to be reconciled with whatever the Assembly might pass.

Support for the legislation stems partly from sympathy for the plight of John Ray Wilson, a New Jersey resident who suffers from multiple sclerosis, an autoimmune disease that affects the central nervous system. Mr. Wilson is scheduled to go on trial in December on felony drug charges, including operating a drug-production facility and manufacturing drugs. State police said they found 17 mature marijuana plants growing alongside his home in 2008. He has pleaded not guilty.

The Superior Court judge who will oversee the case has barred Mr. Wilson from explaining to the jury that he uses marijuana for his multiple sclerosis instead of more conventional medicines, which he said he can’t afford, since he has no medical insurance.

If convicted, Mr. Wilson faces up to 20 years in prison. “It definitely helps for pain,” Mr. Wilson said. “Stress can bring MS on. And I’m definitely under some stress.”

David Wald, a spokesman for the state attorney general, which is arguing the state’s position, said: “We’re prosecuting the law.”

At least two lawmakers, including Mr. Scutari, have asked Mr. Corzine to pardon Mr. Wilson. “I think it’s unfair,” said Mr. Scutari. “To try to incarcerate him for years and years doesn’t serve a good government function.”

The governor’s office said it wouldn’t comment on pardons involving an ongoing case.

Mr. Wilson’s case hasn’t persuaded Ms. Angelini, who voted against it in the health committee. As the executive director of Prevention First, an antidrug and antiviolence nonprofit, she said she was concerned that the bill would open the door for more liberal drug policies.

“If the drug laws are lax,” she said, “that can open it up to eventual drug legalization.”

By SUZANNE SATALINE. Source.

Wisconsin Senate and Assembly consider bill this month.

December 2, 2009 – Linda Moon felt crippled by medications prescribed for her by doctors.

“For three years, I laid in bed. I was almost comatose, and couldn’t move,” she said.

One day, the 50-year-old Fond du Lac woman threw away 25 different kinds of pills and turned to marijuana to treat chronic conditions that had left her disabled.

“I was able to get food in my system. I could get out of bed and I had a personality again,” Moon said.

She is among the supporters of a state medical marijuana bill co-sponsored by state Rep. Mark Pocan, D-Madison, and Sen. Jon Erpenbach, D-Waunakee. If the legislation passes and is signed into law, a person with a prescription from a doctor could obtain up to three ounces of marijuana from a licensed dispensary or grow up to 12 plants at home.

The Jacki Rickert Medical Marijuana Act would cover people with cancer, AIDS, Crohn’s disease, Hepatitis C, Alzheimer’s disease, post-traumatic stress disorder and other diseases that could be labeled serious medical conditions.

In October, the Obama administration announced that the federal government will not prosecute users or distributors of medicinal marijuana as long as they follow state laws. The announcement is the latest part of a trend that has seen several states, including Minnesota, take an increased interest in the issue.

Currently, 13 states have legalized marijuana for medicinal use.

Personal stories

Teresa Shepherd of Jackson chairs the community outreach committee for the new Milwaukee chapter of NORML, the National Organization for the Reform of Marijuana Laws.

A gymnast and martial artist, the 34-year-old suffers from fibromyalgia, degenerative disc disease and arthritis.

“The medications I was given made me sicker than I was,” said Shepherd, mentioning Vicodin and Lyrica. “I have been unable to work for over a year now. I didn’t think there was any hope.”

Marijuana use put her back on her feet, with no side effects.

“The people coming forward — they aren’t just trying to get high,” Shepherd said. “These are intelligent people who do not want to live on disability.”

Shepherd said she goes through about an ounce and a half each month, obtained through people she most likely would not talk to otherwise in the black market.

“I’m coming forward for every fibromyalgia patient out there. I’m tired of the suffering,” she said.

Jeffrey Smith of Brillion was paralyzed from the chest down 20 years ago and lives in constant pain.

The drugs prescribed for him — Baclofen and Gabapentin — had ill effects and their dosages were life threatening, he said.

“The Gabapentin didn’t stop the pain so much as it gave me a ‘chemical lobotomy,’ made me too spaced out to speak. On the other hand, the use of cannabis hemp as a medicinal treatment has given me a greatly improved living quality. I can once again compose music, perform it and even write for two online magazines. It has given me a life that patented medication surely took away,” he said.

Pros and cons

Dr. Steve Harvey, anesthesiologist and board-certified pain physician with Aurora Health Care in Fond du Lac and Sheboygan, sees medical marijuana as playing a significant role in treating debilitating conditions caused by cancer and chronic pain.

“I think in the case of patients with nerve pain, shingles or post-shingle pain, with pain that radiates down the leg or arms, or herniated discs, it has a direct analgesic effect,” Harvey said.

Particularly useful, he said, is marijuana’s demonstrated anti-nausea effects on cancer patients.

“There are forms of cannabis available outside of smoking it. Any arrow in the quiver that is available to us can be very useful and I think that is being demonstrated in other parts of the country. Frankly, I don’t have a problem with it,” he said.

Marijuana opponent and Fond du Lac psychiatrist Dr. Darold Treffert says the push for medical marijuana is misdirected, unnecessary and holds great risk.

“I have treated patients with AODA problems, including marijuana, for over 40 years. And marijuana is not harmless. Whatever the benefits, if any, of making medical marijuana available by prescription are far outweighed by the risks of how easily in other states it has led to ‘sham clinics’ with mass diversion to street use,” he said.

In Michigan, which recently made medical marijuana available, there are 1,000 new applications per month from patients and growers, and a “cannabis college” has been established to teach students how to grow the plants most effectively. In dispensaries, the marijuana often has rather exotic, non-medicinal-sounding names.

“I sympathize, and do have compassion, for patients experiencing long term pain or other intractable problems. But the risks of diversion and all its attendant problems far outweigh the benefits of making medical marijuana (smoked) readily available, and there are other alternatives available for such circumstances without those risks,” Treffert said. “Research is under way to synthesize THC or other cannabinols that can be delivered in standardized doses in a conventional manner. I support that research. It is simply a more sensible and less dangerous way to proceed.”

Agnesian HealthCare was unable to provide a physician that would discuss the use of medical marijuana.

More views

State Rep. John Townsend said he opposes any marijuana use, and would vote against the bill.

“Under federal law, it is an illegal substance, and there may by some problems with that. Some state statutes allow medical marijuana, but my question is whether it is really being used for medical purposes — or is it recreational? And who is regulating this use? I’ve been in contact with the local medical community, and they are not in favor of it,” he said.

Disabled veteran Steve Passehl of Wittenberg broke three vertebrae during the Gulf War and has undergone 13 surgeries.

“Marijuana helps with spasms from my paralysis and neck injury. It helps me deal with chronic pain, fights my depression, and gets me to eat,” he said.

According to a story in the Milwaukee Journal Sentinel, House and Senate Bills (AB 554 and SB 368) define how many people can be cared for and place caps on the amount of marijuana that can be available in compassion centers, as well as allowing production and distribution facilities.

Previous bills in Wisconsin relating to the topic failed despite occasional bi-partisan support.
By Sharon Roznik. Source.

Additional Facts
WHAT’S NEXT

# A hearing on the medical marijuana bill is set for Dec. 15 in front of the Senate and Assembly health committees. Written testimony can be e-mailed to Kelly.Johnson@legis.wisconsin.gov in state Sen. Jon Erpenbach’s office. The mailing address is Room 8 South, State Capitol, P.O. Box 7882, Madison, WI 53707-7882. Erpenbach’s office will make all submitted written testimony available to all members of both committees.
# The complete bill can be read at http://www.legis.state.wi.us/2009/data/AB-554.pdf.

December 2, 2009 – Stephany Bowen suffers from fibromyalgia, diabetic neuropathy and chronic pain from four back surgeries, a metal plate in the back of her neck and hypertension in her right leg.

Her daily ritual includes insulin, Vicodin and up to two bowls of marijuana, which she claims eases nausea caused by her medication and takes her mind off her pain.

She said she is unable to work and rarely leaves home. Her marijuana use is a crime under state law, but she is hopeful that one day that will change.

“I believe it does have medicinal qualities to it,” said Bowen, 46, of Penn Hills. “Since marijuana is grown naturally, it should be legal.”

Momentum supporting that position is growing. Since 1996, 13 states have legalized medical marijuana.

State Rep. Mark Cohen, D-Philadelphia, introduced House Bill 1393 in April that would legalize marijuana for medical purposes. A public hearing is scheduled tomorrow in Harrisburg before the House Health and Human Services committee.

The bill aims to ease the lives of suffering patients, take money away from the drug trade and create about $25 million a year in tax revenue from the sale of marijuana, Cohen said.

“The bill has a 1-in-4 chance of becoming law, but I think that health care groups will lean toward it,” he said.

Rep. Eddie Day Pashinski, D-Luzerne, chairman of the subcommittee on drugs and alcohol, said the decision to legalize marijuana should rest with the medical community.

“Doctors should determine whether there’s a place for the drug in the treatment of their patients,” he said.

The American Medical Association last month changed its position on medical marijuana, urging the federal government to reconsider pot’s classification as a Schedule 1 drug. The goal is to clear the way to conduct clinical research and develop marijuana-based medicines, according to the association.

The AMA’s statement was a topic of conversation recently at the first meeting of Pittsburgh NORML, the local chapter of the National Organization for the Reformation of Marijuana Laws.

A group of about 20 members, who ranged widely in age and profession, discussed methods of spreading information about medical marijuana.

“We will be organized and professional,” said Patrick Nightingale, a Downtown defense attorney and founder of Pittsburgh NORML. “We’re not a bunch of freaks getting together to get stoned.”

Nightingale, a former Allegheny County assistant district attorney, said he supports complete legalization.

“It concerns me as an attorney that I’ve had to prosecute and defend folks for conduct no different than buying a six-pack or bottle of wine,” he said.

Tomorrow’s public hearing is a small step forward for supporters of the bill, but with just six co-sponsors there’s a chance it will never reach a vote, said Rep. Randy Vulakovich, R-Shaler.

“Marijuana is still considered a gateway drug, and a lot of the people who are fighting for this bill want to use the legislation as a step-off point for legalizing all marijuana,” said Vulakovich, a former police officer.

Gov. Ed Rendell maintains his position on medical marijuana, said spokesman Gary Tuma.

“If a reasonable, well-crafted bill reached his desk,” Tuma said, “he would sign it.” By Kyle Lawson Source.

About state House Bill 1393
Although federal law prohibits the use of marijuana, Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington permit the use of marijuana for medical purposes. In Arizona, doctors are permitted to prescribe marijuana. (The Obama administration recently directed federal prosecutors to back away from pursuing cases against medical marijuana patients.)

State House Bill 1393 would legalize marijuana for use by patients with cancer, glaucoma, HIV, AIDS or any other health issues that a licensed doctor deems treatable by marijuana in a manner that is superior to treatment without marijuana.

Patients who qualify would be required to have a registry identification card and possess no more than six marijuana plants and one ounce of pot.

To read the bill, go online, select “Bill #” at the top under “Find Legislation By,” type in “H 1393″ and click “Go”

Source: State House Bill 1393

All those in favor

A Gallup poll in October found that 44 percent of Americans were in favor of making marijuana legal — not just for medicinal purposes — and 54 percent opposed it. U.S. public support for legalizing marijuana was fixed in the 25 percent range from the late 1970s to the mid-1990s, but acceptance jumped to 31 percent in 2000 and has continued to grow throughout this decade, according to Gallup.

Source: http://www.gallup.com

December 1 is World AIDS Day, an international day set aside by individuals and organizations to raise awareness about HIV/AIDS. The theme this year is “Human Rights and Access to Treatment.” Among other political and personal messages, patient advocates all over the world today will be talking to their friends, loved ones, media, and elected officials about the challenges HIV/AIDS patients face in access the health care they need. Let’s hope their voices will be heard.

The medical cannabis movement is intimately intertwined with the demand for safe access to medicine to treat the symptoms of HIV/AIDS. If it were not for the tireless crusading of men like Dennis Peron, a figurehead for medical cannabis and GLBT rights, Proposition 215 may never have been adopted. His desire to see safe and affordable access for loved ones truly changed the world.

Los Angeles medical cannabis and HIV/AIDS advocate Richard Kearns is one of many who joined Dennis in this compassionate work. Richard is a poet, prolific blogger, and outspoken advocate. He serves on the Board of Directors of one of the oldest legally organized and operated medical cannabis collectives in the Los Angeles area. He is also one of the most frequent speakers about medical cannabis before the Los Angeles City Council – something that matters as the city’s largest city struggles to adopt regulations for safe access.

Let’s not let World AIDS Day pass without honoring the commitment and sacrifices of patient advocates like Richard. More importantly, let’s take the opportunity to recognize our roots and stand in solidarity with the men, women, and trans-gendered people with HIV/AIDS who helped build the nationwide movement for safe access to medical cannabis. By Don Duncan. Source.

Thousands Learn How to Grow Legal Medical Marijuana

November 30, 2009 – Don’t expect to pull an all-nighter at Med Grow Cannabis College.
Michigan’s first training center for medical marijuana education doesn’t ask students for their homework. There are no final exams. “We’re more of a trade school,” said Nick Tennant, Med Grow’s 24-year-old founder.

As states loosen their medical marijuana laws, institutions such as Med Grow are sprouting up, looking to educate potential caregivers about how to enter the cannabis industry the legal way.

Tennant opened the doors of Med Grow’s 4,800-square-foot facility near Detroit in September, about 10 months after voters approved the state’s medical marijuana act.
Always wanting to be his own boss, Tennant had dropped out of college to manage valet and auto-detail companies. But when his businesses contracted under the smothering recession, he looked to the medical marijuana industry for his next opportunity, months before the measure was up for public vote. “We knew the law was going to get passed,” he said.

In addition to Michigan, 12 states have legalized medical marijuana use: Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington.

Tennant fashioned part of his business model after California’s Oaksterdam University, which claims to be the country’s first cannabis college, opening in 2007. Oaksterdam has three campuses in California: Oakland, Los Angeles and North Bay. Spokeswoman Salwa Ibrahim said the institution, which staffs about 50 employees, has graduated about 5,500 students. Oaksterdam welcomes the country’s new crop of cannabis colleges, she said.
“We welcome competition,” she said. “Ultimately, what we’re trying to do is change laws locally and federally.”

Hawaii activist Roger Christie says he connects the high he sustains from marijuana use as a “spiritual” ritual, a practice he believes is legal under First Amendment religion protections. He has been an advocate of marijuana use and legalization for 23 years, he said. Only recently did he add educational outreach to his Hawaii Cannabis Ministry. After reading a news story about a continental cannabis college, he decided to add monthly seminars to his ministry’s repertoire this fall.

So far, he has educated about 60 people over two weekend seminars. A $100 donation covers the cost of classes and a hemp seed lunch. “We train people to grow people to grow the best cannabis humanly possible,” Christie said. Med Grow students cover an array of topics related to the budding industry over semester-long courses or seminars. The curriculum covers proper cultivation and breeding, cooking tips and recipes, how to start a care-giving business and Cannabis History 1010. “Students should feel very confident that they’re going to succeed,” Tennant said.

Medical Marijuana Classes Flourish

Tennant’s school employs 12 people, he said. About 60 students are taking courses during this cycle. Med Grow’s five-week semester program, which offers two tracks convening on Monday or Wednesday nights, costs $475. Unlike accredited academic institutions, there is no standard of practices for cannabis colleges in Michigan. Tennant provides his graduates with a paper certificate anyway. It isn’t required, but a student could use it to establish credibility as a professional caregiver, proving he or she is “not just some Joe Shmoe off the street,” he said.

Graduates of Tennant’s college won’t be leaving their training to set up mass dispensaries. Under Michigan law, state-registered caregivers are only allowed to provide marijuana to a maximum of five patients. In California, students of cannabis colleges have a few more options, Ibrahim said. Students come from out-of-state to become lobbyists, dispensary managers as well as caregivers.

“They can do whatever they want to do,” she said. Trey Daring, 26, moved to Daly City, Calif., after graduating from Old Dominion University, in Virginia, to work as an advocate for the cannabis movement. His favorite course is advanced horticulture — it’s the most useful, he said. He’ll graduate in mid-December. Parents ‘Not Necessarily Proud’ of Cannabis College Certification

Daring’s parents are uneasy about his advocacy of the drug because marijuana is a Schedule I controlled substance under federal law, the government’s most restrictive category that also includes LSD, ecstasy and heroin, he said. “I feel like they’re understanding now but not necessarily proud,” he said. His classrooms are not that much different from ones he had in high school and college: dry-erase boards, PowerPoint presentations and knowledgeable instructors. Perhaps the part that’s most different is his classmates.

“There are a lot more people over 30 than probably outsiders would believe,” he said.
Med Grow students also run the demographic gamut. Tennant said his pupils include 18-year-old high school graduates, a 60-year-old pastor and former clients of his old auto-detailing business, some of whom find themselves struggling to keep their own businesses afloat. His instructors stress that their curriculum is for medicinal purposes only, not recreational tips, he said. “I run a very tight operation here,” he said.

The medical marijuana industry could potentially help Michigan’s battered economy, provided it is not abused, Tennant said. Ibrahim of California’s Oaksterdam University also sees cannabis as a way to contribute positively to a state’s economy. Oaksterdam’s Oakland campus recently moved into a 30,000-square-foot building and, she said, the school expects to educate about 1,000 students a month, double the capacity of the previous space. “It really is flourishing in this economy,” she said. “We’re evidence of it. We just moved into a larger facility when everything else seems to be downsizing.”
By Katie Sanders. Source

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