Jon Gettman is a long time contributor to HIGH TIMES. A former National Director of NORML, Jon has a Ph.D. in public policy and regional economic development and consults with attorneys, advocates, and non-profits on cannabis related research and public policy issues. On October 8, 2002, along with a coalition of organizations, he filed a new petition to have cannabis rescheduled under federal law. This column will track that petition's progress.

Oct. 23, 2003

The Anti Pot Pill

Rimonabant, a new experimental drug, neutralizes the effects of THC, the active ingredient in cannabis. Why? Because health matters, at least that's the slogan of Sanofi-synthelabo, the French pharmaceutical giant developing Rimonabant for market, specifically the health of overweight individuals who have the most to gain, or, more accurately, the most to lose from the development of this anti-pot pill. It's quite simple. Eliminate the effects of THC and you also eliminate the munchies. Eliminate the effects of the natural cannabinoids in the body and you also reduce hunger, considerably. Voila, as the French would say, a new way for people to lose weight.

The characteristic effects of cannabis occur because the active ingredient THC triggers a specific receptor in the brain, known as CB1. These receptors are naturally triggered by anandamine, a natural cannabinoid present in mammals. Agonists are drugs that trigger or activate receptors. For example the agonist CP55,940 is an experimental cannabinoid agonist that is much more potent than THC; this drug played a key role in the discovery of the cannabinoid receptor. Antagonists, on the other hand, are drugs that shut down specific receptors. SR141716 is a cannabinoid antagonist that was developed several years ago and has had a valuable role in cannabinoid research. According to Sanofi: "Now if cannabis stimulates the appetite, why shouldn't an anti-cannabis product have the opposite effect?

The results of animal tests on Rimonabant are encouraging. For example a recent 2003 study found "dose-dependently decreased food intake and body weight gain in both lean and obese animals." News about Rimonabant's potential as an anti-obesity drug has been growing in circulation during the last few years. Speaking at a meeting of the North American Association for the Study of Obesity in October 2001 Dr. H.M. Heshmati described the results of a seven day study of the drug: ""Our study found that short-term treatment with a selective CB1 receptor antagonist decreases hunger, caloric intake and body weight in overweight and obese men."

The Phase II trials resulted in a weight loss of about 10 pounds over a 16 week period. Sanofi recruited 6,180 patients for phase III trials on its effectiveness. These US and European studies of large samples are scheduled for completion this year; the company plans to file for FDA approval in late 2004 or early 2005.

The CB1 receptor is believed to play a role in both food consumption and in drug dependency/habituation. Rimonabant is also being evaluated for its ability to help individuals quit smoking; scientists believe that it also may have a role in treating alcohol dependency. When given to tobacco smokers, 30% of the study group refrained from smoking during the final week of the four week study, compared to 15% of the group taking the placebo. In this group the individuals taking Rimonabant lost on average 2.6 pounds each while those in the placebo group gained 2.4 pounds each.

These results demonstrate the great promise Rimonabant has for treating both obesity and nicotine dependency. Sanofi is right that "Health Matters"and Rimonabant offers new promising approaches to both of these wide-spread health problems.

There is, however, another potential use for Rimonabant that is not now under study but will be a tempting off-label use should it be approved for prescription use. Rimonabant is a cannabinoid antagonist; it turns off the primary cannabinoid receptor in the brain. It is the ultimate anti-pot pill. Whoever takes the drug will not be able to experience the effects of THC, and consequently Rimonabant provides a new treatment tool for marijuana dependency: heavy users who have a hard time quitting will have a new chemical aid that neutralizes the effects of cannabis. Of greater interest will be whether parents will be encouraged to give at-risk teens Rimonabant as a way to keep them from being introduced to the pleasures of cannabis use during their formative years.

Imagine the popularity of a drug that allows someone to lose weight without taking amphetamines or stimulants? Imagine a drug that helps people quit smoking tobacco without an accompanying weight gain? The therapeutic and profit potentials are enormous. And even noting the anti-pot quality of the drug these exciting developments are additional proof of the wondrous gifts provided by the cannabis plant.