Paul Armentano

THC ... and CBD ... are potent anti-oxidants, effective neuroprotectants because of their ability to reduce toxic forms of oxygen (free radicals) that are formed during cellular stress."

-Marijuana As Medicine: Assessing the Science Base, National Academy of Sciences Institute of Medicine (IOM), 1999.
Hundreds of the nation's top neurologists, clinicians and pain specialists obtained a sorely needed education on the therapeutic value of cannabis at last week's annual meeting of the American Academy of Pain Management (AAPM) in Arlington, Virginia. Highlighting the four day conference-which included one full day devoted to pot's analgesic properties-was Friday's keynote address by Geoffrey Guy, head of GW Pharmaceuticals' world-renowned medi-pot greenhouse. "This plant isn't broken; let's not take it apart," Guy told an initially cynical crowd, many of whom had likely never before heard the term marijuana unless it was in reference to Cheech and Chong. However, by the conclusion of Guy's speech, during which he announced that nearly 80 percent of all patients administered GW's sublingual cannabis extracts in clinical trials have attained significant benefits, no one was snickering. "I'd like to thank Geoffrey Guy for his informative presentation," declared one attendee. "I see we need to get over our 1960s and 70s attitudes toward marijuana."

Friday's daylong workshop, entitled "The Role of Cannabinoids in Pain Management," was the brainchild of Montana neurologist and editor of The Journal of Cannabis Therapeutics, Ethan Russo. Russo praised the AAPM for agreeing to address the pot for pain issue head on. "This body is unique for having recognized the role of medical cannabis for people with chronic pain," he said. "The reality is that there's a great deal of interest in this subject and today's [presentations are] are a manifestation of that interest." Speakers at the conference included Russo, MS specialist Denis Petro, Jon Gettman (who announced that oral arguments regarding his petition to force the federal government to reschedule marijuana will begin before the US Court of Appeals next March), patient activist and former Cannabis Cup "Goddess" Kitty Tucker, Kevin Zeese, Patients Out of Time co-founder Mary Lynn Mathre, and Institute of Medicine (IOM) researcher Janet Joy, co-author of the report: Marijuana As Medicine: Assessing the Science Base.
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Marijuana Good for the Brain [cont.]

Joy's presentation offered both good and bad news for medi-pot proponents. On the positive front, Joy announced that the National Institute on Drug Abuse (NIDA) recently approved three separate clinical trials examining the efficacy of marijuana in the treatment of MS and AIDS-related neuropathy (severe pain). All three studies, pending final approval from the Drug Enforcement Administration (DEA), will be performed at California's newly created Center for Medicinal Cannabis Research. (Though it remains to be seen whether DEA-chief and monumental medi-pot hater Asa Hutchinson will allow these or similar trials to go forward.)

However, aside from NIDA's sudden change of heart-for nearly 15 years the agency refused to allow any investigations into the therapeutic potential of whole smoked cannabis-Joy admitted that little has changed at the federal level since the release of the IOM's 1999 report. When asked what specific actions the federal government has taken to implement the IOM's recommendations, including the initiation of compassionate, single-patient (so-called "n-of-1") trials, Joy responded "essentially nothing." Regarding the possibility that pot could one day become a legal FDA-approved medication, Joy expressed little enthusiasm. "It's a botanical product," she said, "and [they] don't generally meet modern FDA standards."

Given the ignorance and recalcitrance of US drug policy, it's no wonder America lags some "five to eight years" behind other industrialized nations when it comes to unlocking pot's therapeutic potential, according to Geoffrey Guy, who described the US as "out of kilter with the entire rest of the Western world with respect to cannabinoids." Further illustrating this point, Guy said that although his company has been "welcomed with open arms by the rest of the world," -GW is set to begin numerous Phase III human studies in England and Canada this fall-they have received only a tepid reaction from US officials. "The United States has a very particular way of viewing these materials (cannabis and cannabis-based extracts), and it doesn't have to do with the materials or how they help the patients," he said.

Nevertheless, Guy's presentation made it apparent that medi-pot is alive and well internationally. Recently, England's Medicines Control Agency (MCA), the equivalent of our FDA, affirmed the safety of GW's cannabis extracts, and extended the duration for which they can provide medical pot to patients from 12 to 24 months. According to Guy, 41 of the 53 patients enrolled in GW's first three clinical trials sustained therapeutic benefits-including relief from pain, spasticity, bladder-related symptoms and tremor, as well as a 50 percent average reduction in their use of opiates-and have elected to continue their medi-pot use long-term. "These are mostly patients whose conditions were previously considered intractable," Guy said, adding that many also reported that medical pot profoundly improved their sleep, mood and overall sense of well-being.

"Somehow a million years of evolution between cannabis and humans have come up with an amazing medicine," Guy said to close Friday's workshop. For those in attendance, the day marked the beginning-but hopefully far from the end-of a long-overdue education in the use of marijuana as medicine