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Should a terminally-ill woman be prosecuted under federal law for using marijuana to alleviate pain from an inoperable brain tumor? The decision handed down by an appellate court in March 2007 was yes. While the court sympathized with Angel Raich, a 41-year-old San Francisco woman who had been using the drug on her doctor's recommendation, they found that she lacked the legal grounds to be exempt from the law.
The use of medical marijuana is currently legal in 12 states, including California. But federal laws, which can override those of the states, still classify cannabis as a highly addictive substance with no medicinal value, thereby rendering the use, sale, and cultivation of the drug illegal.
The legal impasse reflects the ongoing debate within the medical community about the efficacy of therapeutic marijuana. Gregory T. Carter, M.D., clinical professor of rehabilitation medicine at the University of Washington School of Medicine in Seattle, says that while marijuana is not a panacea, it exerts its therapeutic effects with remarkably low toxicity compared to other commonly prescribed medications used for similar purposes.
Marijuana contains more than 60 “cannabinoid” compounds that are similar to the cannabinoids naturally produced by the human body. These compounds help regulate many bodily functions, including pain perception. Although medical studies of marijuana has been limited by legal hurdles and by the dearth of researchers willing to withstand them, there is some evidence in its favor:
▸ One of the first randomized trials of smoked marijuana showed that it significantly relieved the symptoms of peripheral neuropathy associated with HIV.
▸ Marijuana has been shown to help alleviate nausea, appetite loss, depression, and pain in patients suffering from cancer, HIV, and amyotrophic lateral sclerosis.
▸ Smoking marijuana can reduce intraocular pressure, a common cause of blindness in glaucoma patients.
▸ Anecdotal reports suggest that cannabis use may improve not only tics but also behavioral problems in people with Tourette's syndrome.
Still, many health professionals advise caution in prescribing cannabis. The drug carries a high potential for abuse, and some studies have linked its use with lung cancer and respiratory dysfunction. Recent research also suggests that heavy and sustained marijuana use in teenagers leads to increased risk of developing psychosis and schizophrenia.
In a legalization controversy polarized as much by myth as politics, some researchers worry that the science is getting lost. Donald Abrams, M.D., director of clinical programs at the Osher Center for Integrative Medicine and head of the recent HIV neuropathy study, hopes that his work will help to tip the scales in favor of more research. “People are always saying there's no evidence. I'm saying Here it is.”