Mar­i­juana health claims lure pa­tients as sci­ence catches up

The Saratogian (Saratoga, NY) - - FRONT PAGE - By Carla K. John­son

SEAT­TLE >> Mar­i­juana has been shown to help ease pain and a few other health prob­lems, yet two-thirds of U.S. states have de­cided pot should be le­gal to treat many other con­di­tions with lit­tle sci­en­tific back­ing.

At least 1.4 mil­lion Amer­i­cans are us­ing mar­i­juana for their health, ac­cord­ing to an As­so­ci­ated Press anal­y­sis of states that track med­i­cal mar­i­juana pa­tients.

The num­ber of med­i­cal mar­i­juana card­hold­ers more than tripled in the last five years as more states jumped on the band­wagon. The anal­y­sis is based on data from 26 states and the Dis­trict of Columbia. The to­tal climbs to 2.6 mil­lion pa­tients if Cal­i­for­nia, Washington and Maine are in­cluded, the AP es­ti­mates.

States that ex­panded the use of med­i­cal pot for com­mon ail­ments such as se­vere pain, post-trau­matic stress dis­or­der and anx­i­ety saw a boost in en­roll­ment, the AP found.

The U.S. gov­ern­ment, mean­while, both con­sid­ers mar­i­juana an il­le­gal drug and a ther­a­peu­tic herb worth more study.

A look at the health claims and re­search on med­i­cal mar­i­juana:

The evidence

Be­sides chronic pain, there’s strong evidence mar­i­juana or its in­gre­di­ents can ease nau­sea and

vom­it­ing from chemo­ther­apy and help with symp­toms of mul­ti­ple sclero­sis.

Sev­eral Euro­pean coun­tries have ap­proved Sa­tivex, a mouth spray con­tain­ing THC and CBD, for mul­ti­ple sclero­sis symp­toms. Last year, U.S. reg­u­la­tors ap­proved Epid­i­olex, made from CBD, to treat two rare seizure dis­or­ders. THC causes mar­i­juana’s mind-al­ter­ing ef­fect; CBD doesn’t get peo­ple high.

Bri­tish drug­maker GW Phar­ma­ceu­ti­cals is seeking U.S. ap­proval for Sa­tivex. Other com­pa­nies are pur­su­ing Food and Drug Ad­min­is­tra­tion back­ing for prod­ucts based on mar­i­juana in­gre­di­ents.

Ari­zona-based In­sys Ther­a­peu­tics, which filed for bank­ruptcy pro­tec­tion Mon­day as it faced fall­out over its mar­ket­ing of an ad­dic­tive opi­oid painkiller, is de­vel­op­ing CBD drugs for two types of child­hood epilepsy and a rare ge­netic dis­or­der. Penn­syl­va­nia-based Zynerba Phar­ma­ceu­ti­cals is work­ing on a CBD skin patch for autism and frag­ile X syn­drome, a ge­netic con­di­tion.

Pre­scrip­tion drugs al­ready on the mar­ket use syn­thetic THC to treat weight loss, nau­sea and vom­it­ing in pa­tients with AIDS or can­cer. And re­searchers con­tinue to study whether mar­i­juana helps with PTSD, back pain and other prob­lems.

Opi­oid al­ter­na­tive?

New York, New Jersey, Penn­syl­va­nia and New Mex­ico al­low med­i­cal mar­i­juana for opi­oid ad­dic­tion de­spite lit­tle evidence it works.

But mar­i­juana may be help­ful in re­duc­ing use of opi­oid painkiller­s. The Na­tional Cen­ter for Com­ple­men­tary and In­te­gra­tive Health, bet­ter known for its re­search on herbs and yoga, has set aside $3 mil­lion for stud­ies to de­ter­mine which of mar­i­juana’s 400-plus chem­i­cals help with pain.

THC was ex­cluded how­ever.

Its mood-al­ter­ing ef­fects and po­ten­tial for ad­dic­tion and abuse make it less use­ful for pain, said Dr. David Shurtl­eff, the agency’s deputy direc­tor. And THC has been stud­ied more than the lesser-known com­pounds.

Cure for can­cer?

De­spite on­line claims, there’s only weak evidence that mar­i­juana’s in­gre­di­ents might one day be used to treat can­cer. Most stud­ies have been in animals or in the lab. Re­sults have been mixed.

In one study, nine pa­tients with an ag­gres­sive form of brain can­cer had THC in­jected into their tu­mors; any ef­fect on their sur­vival was un­clear. Another study found wor­ry­ing evidence that mar­i­juana might in­ter­fere with some can­cer drugs, mak­ing them less ef­fec­tive.

Re­search­ing an out­law medicine

The U.S. gov­ern­ment grows mar­i­juana for re­search at a farm in Mis­sis­sippi and gen­er­ally bans grant-funded stud­ies of real-world prod­ucts.

But a mo­bile lab in­side a white Dodge van al­lows Univer­sity of Colorado Boulder re­searchers to study the po­tent strains of mar­i­juana many pa­tients con­sume with­out run­ning afoul of the law.

Study par­tic­i­pants use mar­i­juana in their homes, com­ing to the van for blood draws and other tests be­fore and after us­ing, said Cin­na­mon Bid­well who has fed­eral grants to study mar­i­juana’s ef­fects on lower back pain and anx­i­ety.

With in­creased de­mand for re­search pot, the Drug En­force­ment Ad­min­is­tra­tion cre­ated an ap­pli­ca­tion process for grow­ers, but has not acted on more than two dozen ap­pli­ca­tions.

Such chal­lenges are com­mon for sci­en­tists study­ing an out­law medicine, said Dr. Igor Grant, who di­rects the old­est mar­i­juana re­search cen­ter in the U.S. at the Univer­sity of Cal­i­for­nia, San Diego.

There, sci­en­tists are study­ing mar­i­juana chem­i­cals for chil­dren with autism and adults with a brain dis­or­der that causes un­con­trol­lable shak­ing. Es­tab­lished by state law in 2000, the Cen­ter for Medic­i­nal Cannabis Re­search once re­lied solely on Cal­i­for­nia for fund­ing. The cen­ter now has sup­port from pri­vate foun­da­tions, a sign of grow­ing pub­lic ac­cep­tance of the re­search.

Track­ing pa­tients

Min­nesota med­i­cal mar­i­juana pa­tients must reg­u­larly fill out sur­veys about their symp­toms and side ef­fects. That al­lows re­searchers to study how peo­ple with can­cer re­act to mar­i­juana.

In one study, a third of can­cer pa­tients made only one pur­chase and didn’t come back dur­ing a four­month pe­riod. They may have died, or de­cided mar­i­juana was too ex­pen­sive or didn’t work. Of the rest, most re­ported im­prove­ments in vom­it­ing, pain, dis­turbed sleep, anx­i­ety and de­pres­sion with few side ef­fects.

Mar­i­juana can ease many symp­toms “all at one time,” but more study is needed, said study co-au­thor Dr. Dy­lan Zylla of the health care sys­tem HealthPart­ners. He has no fi­nan­cial ties to cannabis com­pa­nies.

Zylla is study­ing whether can­cer pa­tients can de­crease their pre­scrip­tion opi­oid use while us­ing mar­i­juana.

Mar­i­juana “does seem to help pa­tients,” he said, “but so much is un­known about the risks, side ef­fects and drug in­ter­ac­tions.”

JULIO CORTEZ — THE AS­SO­CI­ATED PRESS FILE

An em­ployee at a med­i­cal mar­i­juana dis­pen­sary in Egg Har­bor Town­ship, N.J., sorts buds into pre­scrip­tion bot­tles. At the end of 2018, about 1.4 mil­lion Amer­i­cans are ac­tively us­ing mar­i­juana to treat to treat anx­i­ety, sleep ap­nea, can­cer and other con­di­tions, ac­cord­ing to an As­so­ci­ated Press anal­y­sis.

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