From foodconsumer.org
Marijuana a natural pain killer -study
By Ben Wasserman - foodconsumer.org
Feb 13, 2007 - 11:49:33 AM
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Smoking marijuana effectively relieves nerve pain in HIV
patients including aching, painful numbness, and burning, according to a study
published in the February 13, 2007 issue of Neurology. The finding is expected
to cause a stir again in the ever-lasting debate over the medical value of
marijuana.
The study of patients with sensory neuropathy led by Donald
Abrams, MD, with
San Francisco General
Hospital in
San Francisco,
California
and colleagues showed daily nerve pain was reduced by 34 percent in patients
who smoked marijuana three joints a day compared to 17 percent in the placebo
group.
Sensory neuropathy affects about one third of HIV patients,
causing neuropathic pain that is usually perceived as a steady burning and/or
"pins and needles" and/or "electric shock" sensations.
The nerve pain is commonly treated with prescription
painkillers, but the results are not always satisfying.
Many patients with HIV or cancer reported
that smoking marijuana is more effective than the conventional treatment.
However, there has little scientific evidence to support
such a claim on the effect of smoking marijuana because researchers have little
access to marijuana, which is banned in the
U.S. and many other countries and
any research can be illegal.
The current study, supported by the University of California
Center for Medicinal Cannabis Research involved 50 people with HIV-associated
sensory neuropathy, who had an average daily pain score of 30 or higher on a
100-point scale.
In the study, the participants were randomly assigned to
smoke either marijuana or a placebo three times a day for five days.
The placebo cigarettes are otherwise identical
to marijuana except that a supposedly active ingredient known as
elta-9-tetrahydrocannabinol (THC) was extracted.
Those who smoked marijuana were more likely than those who
smoked the placebo to experience at least 30 percent reduction in pain, 52
percent versus 24 percent, according to the study.
The first marijuana seemed particularly effective in
relieving the never pain in the HIV patients. It reduced chronic pain by up to
72 percent compared with 15 percent only for placebo.
Dr. Abrams and colleagues reported that adverse events such
as sedation, dizziness, and confusion were more common among the cannabis smokers.
But they also said these side effects in both
groups were insignificant and they "do not present any serious safety
concerns."
“Smoking marijuana was well tolerated and effectively
relieved chronic nerve pain from HIV-associated sensory neuropathy,” said Dr.
Abrams. “Our findings show the amount of relief from smoking marijuana is
comparable to relief provided by oral drugs currently used for chronic nerve
pain.”
Better yet, results of the study showed marijuana worked to
relieve chronic nerve pain for a wider host of patients than did the
anticonvulsant drugs such as lamotrigine and gabapentin, which are prescribed
to HIV patients to help ease pain.
According to Abrams, some patients don’t respond well to
these drugs. Because of this, there's there’s heightened interest in evaluating
marijuana as a treatment for chronic nerve pain.
The researchers concluded that "Smoked cannabis was
well tolerated and effectively relieved chronic neuropathic pain from
HIV-associated sensory neuropathy. The findings are comparable to oral drugs
used for chronic neuropathic pain."
According to the researchers, two placebo-controlled studies
were published to show that smoking marijuana can also ease nerve pain
associated with multiple sclerosis.
While patients suffering severe pain may be happy about the
findings, the federal drug-control agency does not seem enthusiastic about
it.
David Murray with the Office of
National Drug Control Policy was cited by news media as saying that people who
smoke marijuana are subject to bacterial infections. He also said that the
study is small and is not convincing enough to consider marijuana as a medical
treatment.
But other experts think otherwise.
Igor Grant, director of the University of
California Center for Medicinal Cannabis Research was cited by Washington Post
as saying the study was probably the best
U.S. test of marijuana's medical
potential in decades and the results "highly believable."
Dr. Mark Wallace, professor of clinical anesthesiology and
program director of the Center for Pain Medicine at the
University
of
California,
San Diego, was cited by healthyday.com as applauding
the study and saying it was well done.
"There are very few studies of this kind looking at
inhaled cannabis and pain, and they are difficult to conduct," he said.
"The authors should be commended."
Marijuana use for any purpose is flatly banned by the
federal government while some states including
California,
Alaska,
Colorado,
Hawaii,
Maine,
Montana,
Nevada,
Oregon,
Vermont
and
Washington
were reported early to allow patients with severe pain to grow a small number
of the plant for personal use.
Angel Raich of
Oakland with a
brain tumor and Diane Monson of Oroville with degenerative spine disease filed
a lawsuit to Supreme Court against the Department of Justice after federal agents
seized and confiscated marijuana plants they grew in 2002, which were allowed
by the
California
law.
Raich and Monson followed their
physicians' prescription to use marijuana to ease their pain.
The U.S. Supreme Court voted 6-to-3 affirming that medical
use of marijuana is a federal crime. The says that the federal government has
the power to seize and confiscate any marijuana plant intended for medical use
and federal agents can send the violators to jail.
Justice John Paul Stevens who voted along with other
justices against the plaintiffs said: "The case is made difficult by
respondents' strong arguments that they will suffer irreparable harm because,
despite a congressional finding to the contrary, marijuana does have valid
therapeutic purposes.
"The question before us, however, is not whether it is
wise to enforce the statute in these circumstances; rather, it is whether
Congress' power to regulate interstate markets for medicinal substances
encompasses the portions of those markets that are supplied with drugs produced
and consumed locally."
In the dissenting statement, Justice Sandra Day O'Connor
said that the state should have the right to make its own laws. "The
states' core police powers have always included authority to define criminal
law and to protect the health, safety, and welfare of their citizens,"
said O'Connor.
Justice O'Connor also said that the court was wrong in,
"making it a federal crime to grow small amounts of marijuana in one's own
home for one's own medicinal use."
The results of the current study have again ignited hopes in
people who support marijuana for medical use.
"It's time for
Washington
to stop playing politics with patients' lives and advance this important
scientific discovery," healthday.com quoted Steph Sherer, executive
director of Americans for Safe Access, as saying in the statement. "The
study is a wake-up call for Congress to hold hearings to investigate
therapeutic use and encourage research."
Cannabis in painful HIV-associated sensory neuropathy
A randomized placebo-controlled trial
D. I. Abrams, MD, C. A. Jay, MD, S. B. Shade, MPH, H.
Vizoso, RN, H. Reda, BA, S. Press, BS, M. E. Kelly, MPH, M. C. Rowbotham, MD
and K. L. Petersen, MD
NEUROLOGY 2007;68:515-521