epilepsy

A compound derived from marijuana decreases seizure frequency in children with Dravet syndrome, and there's nothing "miraculous" about it

oracknows — Fri, 26 May 2017 01:01:41 +0000

A compound derived from marijuana decreases seizure frequency in children with Dravet syndrome, and there's nothing "miraculous" about it

When I first started to take an interest in medical marijuana, I was struck by how much it reminded me of herbalism. Although herbalism is scientifically the most plausible of modalities commonly associated with "complementary and alternative medicine" (CAM), the use of herbal medicines still involve a number of problems, the biggest of which is what I like to call either the delivery problem or the bioavailability problem. In brief, herbs, when they work, are adulterated drugs. The active ingredient is often a relatively small, embedded in thousands of other constituents that make up herbs, and it’s very difficult to control lot-to-lot consistency with respect to content or active ingredients given how location, weather, soil conditions, rainfall, and many other factors can affect how the plants from which the medicines are extracted grow and therefore their chemical composition. To demonstrate the concept, I frequently point out that it’s much safer and more predictable to administer digoxin to a patient who needs its activity on the heart than it would be for the patient to chew on some foxglove leaves, given that the therapeutic window (the difference between the doses needed to produce therapeutic effects and the lowest dose that will cause significant toxicity) is narrow.

I have nothing against recreational marijuana use and have come around to the view that it should be legalized, taxed, and regulated, just like alcohol and tobacco. Unfortunately, medical marijuana has been co-opted as a "foot in the door" to try to legalize marijuana. The problem with this approach is that it necessitated massively overblown claims for marijuana's health benefits, up to and including claims that it is a great treatment for autism and that it can cure cancer. It isn't and can't. Nor does it stop exaggerated miraculous claims. Basically, the bottom line in terms of scientific evidence for medical marijuana is that it mostly doesn't do what it's claimed to be able to do.

None of this is to say that it might not have some value in some conditions. One condition for cannabinoids isolated from marijuana have shown some promise is in seizure disorders. That's why I learned with interest of a study published in the New England Journal of Medicine (NEJM). This study is a randomized, placebo-controlled clinical trial of a candidate drug isolated from marijuana on severe drug-resistant seizures in children that made the national news Wednesday night. To be honest, the study's gotten less press coverage than I thought it would, but it is an interesting study nonetheless. Medical marijuana proponents frequently misrepresent the skeptic position as being unalterably opposed to the idea that marijuana might have value as a medication. I can't speak for anyone else, but what I've always objected to are the exaggerated, evidence-free claims so many advocates make, and the veritable cult that has sprung up around it. I actually like evidence, which is why this study caught my attention. (Indeed, I would have written about it yesterday, except that the night before I fell asleep on the couch before I got one paragraph in.)

So let's look at the study by Dr. Orrin Devinsky, a neurologist at New York University Langone Medical Center, and colleagues, Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. The first thing I can't help but note is that this is not really medical marijuana, but rather an oral solution of cannabidiol (CBD), Investigational Medicinal Product GWP42003-P, manufactured by GW Pharmaceuticals under the trade name Epidiolex®. GWP42003-P is formulated from extracts prepared from Cannabis sativa L. plants that contain consistent levels of CBD as the principal phytocannabinoid. Extracts from these plants are processed to yield pure (>95%) CBD that contains less than 0.5% (w/w) THC. This pure CBD is subsequently dissolved in excipients with added sweetener and flavoring. So basically, it's a drug isolated from a plant, as many drugs are isolated from plants (and sometimes chemically modified).

Another thing that's important to note is that this trial was to test whether CBD was useful against drug-resistant seizures due to a specific genetic disorder, Dravet syndrome, also known as severe myoclonic epilepsy in infancy (SMEI). Dravet syndrome is due to a mutation in the voltage-gated sodium channel α1 subunit gene SCN1A, which encodes the pore-forming subunit of the NaV1.1 voltage-gated sodium. channel. There are currently more than 700 known SCN1A mutations, and 90% of them occur in DS patients. Two-thirds of these mutations give rise to truncations in the protein while the remaining third are missense mutations that are predicted to severely impair channel function. In patients with Dravet syndrome, the severity of the epilepsy can vary, but myoclonic seizures are the defining feature of Dravet syndrome, and can be massive, contributing to a mortality rate as high as 20% by age 20. The syndrome is also associated with developmental delay. The most devastating aspect of Dravet syndrome is that the epilepsy associated with it is among the most drug resistant forms, and most anti-epilepsy drugs provide inadequate relief.

This trial was pretty straightforward. Basically, it was a multi-institution phase II study carried out in the US and Europe with the following protocol, summarized by this flow sheet (click to embiggen)

The baseline characteristics of the two groups were well matched, ranging in age from 2 to 18, and patients had previously tried a median of 4 antiepileptic drugs, with a range from 0 to 26(!). Subjects were randomized to receive either placebo or CBD, and the primary end point measured was frequency of convulsive seizures. The CBD solution contained 100 mg/ml, and the placebo solution was identical except for the absence of CBD. Before the intervention began, there was a four week baseline period in which investigators trained caregivers to record daily seizure information. Then CBD or placebo was added to the subjects' regular anti-seizure regimen. This is actually a very important point that most reporting of the trial I've seen misses. This trial does not show that CBD has anti-seizure activity as a single agent, only that, when added to other regimens of anti-seizure medications, CBD can further decrease seizure frequency. We don't know from this trial whether CBD alone would be a useful treatment for Dravet syndrome seizures.

But back to the trial design. The dose was escalated up to 20 mg/kg per day with the use of a 14-day dosing regimen of twice daily administration. At the end of the treatment period, the cannabidiol and placebo solutions were tapered (10% each day) over a period of 10 days. After trial completion, all patients could enter a long-term open-label study. Each day, patients or caregivers recorded the number and type of seizures (tonic, clonic, tonic–clonic, or atonic) for the primary end point. Laboratory assessments were carried out at baseline and after 2, 4, 8, and 14 weeks of the trial regimen, as well as at the end of the taper period for those patients who did not enter the open-label extension study or who withdrew early and tapered the trial agent.

The results were encouraging. In the CBD group, the median frequency of seizures decreased from 12.4 to 5.9 per month, compared with a decrease from 14.9 to 14.1 in the placebo group. The percentage of patients with at least a 50% reduction on convulsive seizure frequency was 43% with CBD and 27% with placebo. The percentage of patients who became seizure-free was 5% in the CBD group, and 0% in the placebo group, but neither of these results achieved statistical significance (p=0.08 for both). I must admit that the way NBC reported Devinsky saying, ""Quite remarkably, 5 percent of the children in the active treatment group with CBD were completely seizure free during the 14 weeks of the trial but neglecting to point out that the result didn't achieve statistical significance. I understand that there were some children who had dramatic remissions, but this observation does have to be put into context.

There were some adverse events due to the CBD, including diarrhea, vomiting, fatigue, fever, somnolence, and abnormal liver-function tests. There were more withdrawals from the trial in the cannabidiol group. Indeed, nine out of the 61 subjects in the CBD group withdrew from the study, compared to only three from the placebo group. Overall, serious adverse events were more common in the cannabidiol group than in the placebo group (16% vs. 5%)

One interesting aspect of this trial is that the mechanism of CBD against seizures in patients with Dravet syndrome is not known. The clinical manifestations of Dravet syndrome are due to a single gene, SCN1A. In an accompanying editorial, Dr. Samuel Berkovic notes:

A major aim in the field of the Dravet syndrome and other genetic encephalopathies is to develop precision therapies — treatments directed at the specific genetic defect. Because the Dravet syndrome has a single-gene basis, it is an attractive target for precision medicine. However, cannabidiol is not a precision treatment for the syndrome, because there is no established link of the cannabinoid receptors with the inhibitory interneuron pathology of the Dravet syndrome, and the response across the cohort of the current study was not uniform.

He also notes:

Devinsky et al. found a significantly greater reduction in seizure frequency among patients who received cannabidiol than among those who received placebo, and the seizure-free rate was 5% with the active drug as compared with 0% with placebo. Thus, anecdote has been confirmed by data, and one might ask whether a controlled trial was really necessary. The answer is absolutely yes. Perhaps counterintuitively, the rate of response to placebo in clinical trials is higher among children than among adults. Moreover, parents who go to enormous efforts to get cannabis for their children report a higher response rate than those who can easily obtain it. Cannabidiol is not without side effects. The dropout rate in the active-treatment group was appreciable, and common side effects included vomiting, loss of appetite, and diarrhea. With additional experience, perhaps these effects can be modified with dose adjustment and other strategies.

I would quibble again here. If you look at Table 3, you'll see that the difference between placebo and control didn't achieve statistical significance for reaching 100%, 75%, and 50% decreases in seizure frequency. Now, I'm not so dogmatic that I won't accept that this difference is probably real, failure to achieve a p-value less than 0.05 notwihstanding, but if you're going to use frequentist statistics and define statistically significant as 0.05, then you should at least be consistent. That quibble aside, I do agree with Dr. Berkovic that absolutely a clinical trial was indicated. I would also add a further quibble that "anecdote has been confirmed by data" is overstating it a bit, given the tiny percentage of patients who were seizure free. However, some patients do apparently have fairly dramatic responses.

Another interesting aspect is that, counterintuitively, seizure frequency did decrease in the placebo group by 13.3%, compared to the CBD group, where seizure frequency decreased by 38.9%. This should be a lesson as to why placebo controls are necessary, even for seemingly objective measures. Of course, given that these were either self-reported or caregiver-reported measures, they are not completely objective; so it is not surprising that there was a slight decrease in seizure frequency, even in the placebo control group.

Finally, I can't help but note that medical marijuana advocates, the ones who will be flogging this study as vindication that marijuana is a miracle drug (even though what this study shows is much more modest) tend also to be very much anti-pharma and pro-alternative medicine. That's why I want to draw attention to this part of the methods section:

The funding source, GW Pharmaceuticals, was responsible for the trial design (with input from investigators and other experts), trial management, site monitoring, trial pharmacovigilance, data analysis, and statistical analysis. GW Pharmaceuticals prepared and provided the active treatment and placebo. Trial procedures were reviewed at multisite investigator meetings. Services were used for clinical laboratory testing; bioanalytical laboratory testing; design of the case-report form; data management; trial-agent distribution, returns, and destruction; the interactive voice-response system; diagnosis of the Dravet syndrome and seizure classification; and translation of documents. The authors vouch for the accuracy and completeness of the reported data and analyses and for the adherence of the trial to the protocol (available with the full text of this article at NEJM.org). The authors affirm that they approved the final draft of the manuscript.

This is, of course, a not uncommon practice for a drug company doing a clinical trial upon which it wants to base an application for FDA approval for its drug, and that's exactly what GW Pharmaceuticals is doing. Nothing wrong with that. It's what a drug company needs to do, and GW Pharmaceuticals is a drug company. It's a good idea to be a little more skeptical about the results of this study than most medical marijuana advocates I've seen gloating over it as total vindication are doing. This is a positive study, but not as strongly positive as it's being spun, and there are issues with CBD and adverse events. As Dr. Berkovic puts it:

This trial represents the beginning of solid evidence for the use of cannabinoids in epilepsy. It requires replication. Future trials may answer further questions about the applicability of cannabinoids to the many other syndromes of childhood epilepsy and to treatment in adults. After an era dominated by anecdote and obfuscated by medicolegal issues and emotionally infused debate, more scientific studies are under way. Much more research is needed to understand the basic science, benefits, and risks of cannabinoids in epilepsy.

Correct. This is a study that demonstrates that one chemical that can be isolated from marijuana has promise as a treatment for the epilepsy assocaited with Dravet syndrome. The mechanism by which it appears to work is not clear, as the relationship between cannabinoid receptor and SCN1A is not clear. It's thus not clear whether this result is generalizable to other forms of seizure disorders, but it's worth investigating. In other words, CBD is just like any other drug. It appears to have reasonable activity against the epilepsy due to Dravet syndrome, but it also has significant side effects, just like a lot of other antiepileptic drugs. It's no miracle, but it could be a step forward, particularly if its study leads to a greater understanding of the role of cannabinoid receptors in seizure disorders.

oracknows Thu, 05/25/2017 - 21:01

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Clinical trials

complementary and alternative medicine

medicine

Pseudoscience

Skepticism/Critical Thinking

complementary and alternative medicine

medicine

Ask The Experts: Epilepsy medication used to treat Alzheimer's

dr. dolittle — Wed, 19 Nov 2014 12:43:28 +0000

Ask The Experts: Epilepsy medication used to treat Alzheimer's

I recently received the following question from a reader based on a prior blog entry on how a medication used to treat epilepsy also helps reverse memory loss with Alzheimer's disease. You can see the original blog here

Question:

"I find it a little confusing as to how it is possible that this medication can improve brain and memory function but at the same time cause cognitive impairment? Is that not contradictory that the meds are suppose o help the brain but the side effects are related to the brain? Did the research account the facts that humans do not share all the same proteins as mice. For example the apoE4 gene in humans is not found in mice. It is this gene that is responsible for the degeneration in Alzheimer’s patients. Was this gene taken into account when conducting the experiment?"

To answer this question, I contacted study author Dr. Lennart Mucke, MD, Director of the Gladstone Institute of Neurological Disease and Professor of Neurology at University of California, San Francisco.

Here is his response:

Dr. Lennart Mucke, Director of the Gladstone Institute of Neurological Disease (Photo credit: Chris Goodfellow)

"Most drugs have a “therapeutic window” within which they help and outside of which they can impair the organ or system they target. Think of heart medicines, drugs for high blood pressure, and insulin. In some people, the therapeutic window can be shifted or narrower, compared to others, based on genetic factors. In most people, though, levetiracetam is well tolerated, particularly at the low doses we found to be efficacious in mouse models of Alzheimer’s disease. Notably, similar blood levels of the drugs also had positive effects on brain function in people with amnestic mild cognitive impairment in a clinical trial carried out by Dr. Michela Gallagher and her coworkers at Johns Hopkins (Bakker et al. Neuron (2012)). As far as apoE4 is concerned, the mice we studied did not have it. Although apoE4 increases the risk for developing Alzheimer’s disease, the disease clearly occurs also in human non-carriers, i.e., in the absence of this risk gene.

Best wishes,

Lennart Mucke"

For more information about the causes of Alzheimer's disease, check out this YouTube video featuring Dr. Mucke:

Original article:

Sanchez PE, Zhua L, Verreta L, Vossela KA, Orra AG, Cirritoc JR, Devidzea N, Ho K, Yua G-Q, Palopa JJ, and Mucke L. Levetiracetam suppresses neuronal network dysfunction and reverses synaptic and cognitive deficits in an Alzheimer’s disease model. Proceedings of the National Academy of Sciences. Epub ahead of print. doi: 10.1073/pnas.1121081109

dr. dolittle Wed, 11/19/2014 - 07:43

Tags

University of California

Thanks for facilitating this interesting discussion, Dr. D!

Sir,
my child is 8 years old. his eeg diagnous Epilepsy.my child after every one or two hour fitiks four of five minuts after fitics some deep sleep. my child is not talking.please advice me about my child. I am Worried about my child. i am witing for your positive response.

Medical marijuana and the new herbalism, part 1

oracknows — Thu, 10 Jul 2014 08:00:43 +0000

Medical marijuana and the new herbalism, part 1

Three months ago, I wrote about how the Cleveland Clinic had recently opened a clinic that dispensed herbal medicine according to traditional Chinese medicine (TCM) practice. As regular readers might expect, I was not particularly impressed or approving of this particular bit of infiltration of quackademic medicine into a major, generally well-respected academic medical center, particularly given some of the amazingly pseudoscientific treatments espoused by the naturopath who was running the clinic. I also pointed out that, although herbalism is the most plausible (or perhaps I should say the least implausible) of modalities commonly associated with "complementary and alternative medicine" (CAM) or “integrative medicine”, it still exhibits a number of problems, the biggest of which is what I like to call either the delivery problem or the bioavailability problem. In brief, herbs, when they work, are adulterated drugs. The active ingredient is usually a minor constituent, embedded in thousands of other constituents that make up herbs, and it's almost impossible to control lot-to-lot consistency with respect to content or active ingredients given how location, weather, soil conditions, rainfall, and many other factors can affect how the plants from which the medicines are extracted grow and therefore their chemical composition. To demonstrate the concept, I pointed out that it's much safer and more predictable to administer digoxin to a patient who needs its activity on the heart than it would be for the patient to chew on some foxglove leaves, given that the therapeutic window (the difference between the doses needed to produce therapeutic effects and the lowest dose that will cause significant toxicity) is narrow.

Which brings me to medical marijuana, a.k.a. medical cannabis.

Before I continue, let me just state my position on marijuana, which is different than it was, say, 20 years ago. Today, I believe there’s no reason why marijuana shouldn’t be legalized and treated by states the same way as tobacco products and alcoholic beverages are; they should be heavily regulated and taxed. Among physicians, this appears to be a common view, at least if you can believe a poll I saw a while back (for which I can’t find the link, alas). It’s also, these days, more and more of a mainstream view. In any case, medical marijuana has been a topic I’ve been meaning to write about for a while, now, but my “Dug the Dog” tendencies have kept popping up over ~~squirrels~~ topics like the Food Babe, ketogenic diets for cancer, and a variety of other topics.

Medical marijuana arrived in my state in 2008, when the voters approved a measure permitting it. After some time for the state to draft regulations, the law was implemented, and I had the strange (to me at the time) experience of receiving notices about state regulations, requirements, and documentation should I wish to prescribe medical marijuana. Indeed, more than twenty states, plus the District of Columbia, have legalized medical marijuana. They've done so on the basis of a political movement among patients that make pot sound like a miracle drug that can help when no other intervention can. And it's more than that. Medical cannabis has been touted as a near-panacea for everything from pain to chemotherapy-induced nausea to HIV- and cancer-induced cachexia to even curing cancer itself. Yes, there's a lot of hype out there, and there are a lot of claims that sometimes go viral on various social media, even though the evidence to support the claims is often, to put it mildly, less than rigorous.

Indeed, the acceptance of medical marijuana appears to be far more driven by politics than it is by science, as was pointed out in a recent New York Times article about the impending legalization of medical cannabis in New York State:

New York moved last week to join 22 states in legalizing medical marijuana for patients with a diverse array of debilitating ailments, encompassing epilepsy and cancer, Crohn’s disease and Parkinson’s. Yet there is no rigorous scientific evidence that marijuana effectively treats the symptoms of many of the illnesses for which states have authorized its use.

Instead, experts say, lawmakers and the authors of public referendums have acted largely on the basis of animal studies and heart-wrenching anecdotes. The results have sometimes confounded doctors and researchers.

I note that this article was written over a week before the Governor signed New York’s medical marijuana bill into law, thus legalizing it in New York. The article then goes on to give several examples, such as Alzheimer’s disease, lupus, Sjogren’s syndrome, Tourette’s syndrome, Arnold-Chiari malformation and nail-patella syndrome, and in particular rheumatoid arthritis:

Yet there are no published trials of smoked marijuana in rheumatoid arthritis patients, said Dr. Mary-Ann Fitzcharles, a rheumatologist at McGill University who reviewed the evidence of the drug’s efficacy in treating rheumatic diseases. “When we look at herbal cannabis, we have zero evidence for efficacy,” she said. “Unfortunately this is being driven by regulatory authorities, not by sound clinical judgment.”

As is the case with so much herbalism—and, make no mistake, medical marijuana is the new, popular herbalism of the moment—claims have far outstripped the evidence. Also, as pointed out in the NYT article, even advocates of medical marijuana admit that “the state laws legalizing it did not result from careful reviews of the medical literature.”

That’s the understatement of the year! Reading advocate websites for medical marijuana, I ask myself if there’s any disease or condition the holy weed isn’t good for? Truly, we are talking belief over science!

Unfortunately, even famous doctors like Sanjay Gupta are getting in on the act with a report, "Cannabis Madness," full of a lot of anecdotes and rhetoric about “policy against patients.” Again, I believe that marijuana should be legalized, regulated, and taxed, just like alcohol and tobacco. If marijuana is going to be approved for use as medicine rather than for recreational use, however, the standards of evidence it must meet should be no different than any other drug, and for the vast majority of indications for which it's touted medical cannabis doesn't even come close to meeting that standard.

The evidence

There are definitely chemicals with potential medicinal use in the marijuana. No one, even the most die-hard drug warrior, denies that. These compounds are called cannabinoids, which is a term that describes a family of complex molecules that bind to cannabinoid receptors, which are proteins on the surface of cells. There are two types of cannabinoid receptors, type 1 (CB1) and type 2 (CB2). These receptors are seven transmembrane G-protein coupled receptors (so named for the seven protein domains that span the membrane), a class of receptor I’m pretty familiar with, because one of the receptors I study is of the same class, which looks like this:

"Cb1 cb2 structure" by Esculapio at it.wikipedia - Own work (Original caption: “Immagine creata da --Esculapio”). Licensed under CC BY-SA 3.0 via Wikimedia Commons.

The details of how this happens aren’t essential for this particular post, but when these receptors are stimulated by the binding of cannabinoid molecules, including endocannabinoids (produced by mammals), plant cannabinoids (such as (−)-trans-Δ⁹-tetrahydrocannabinol, more commonly referred to by its abbreviation THC) produced by (for example) the cannabis plant, and synthetic cannabinoids (such as HU-210), downstream chemical signaling pathways are initiated from the receptor to the inside of the cell, thus producing the effects on the cell and organism. There is mounting evidence that there are more than two types of cannabinoid receptors. In any case, CB1 receptors are found widely in the central nervous system, where they modulate a variety of responses, and are also found in other parts of the body, for instance, the pituitary gland, thyroid gland, lungs, and kidney, as well as fat cells, muscle cells, liver cells, and in the digestive tract. CB2 receptors, on the other hand, are expressed primarily in the immune system, the gastrointestinal tract, and, to a much lesser extent than CB1 receptors, in the brain and have been implicated in modulation of immune responses. In particular, stimulating CB2 receptors cannabinoids could be potentially useful as anti-inflammatory drugs. Over the last couple of decades, endocannabinoids and cannabinoid receptors have been implicated a large variety of functions, including memory, pain, energy metabolism, and more. It is thus plausible that manipulation of cannabinoid signaling could have therapeutic effects in a variety of areas.

Unfortunately, one of the problems with medical marijuana, as noted in the NYT article is that enthusiasm for weed as a cure-all has far outstripped existing medical evidence. This disconnect between the existing evidence base ranges from thin to nonexistent, depending on the condition. One of the most frequent claims I see is that cannabis can be used to treat cancer. I’m not going to address that claim specifically in this post, except very briefly, because I think it’s a large enough topic to warrant its own post. Suffice to say that interesting preclinical studies have been exaggerated beyond all evidence, but nonetheless certain cannabinoids could have potential in the treatment of certain cancers. I might also review the evidence base for cannabinoids and autism, given how I’ve been seeing discussions of its use starting to pop up lately on the usual sites. In other words, stay tuned for parts two and three spread out over the next several weeks, whenever no squirrels distract Dug the Dog.

In all fairness, in this country, at least, studying the medicinal properties of marijuana and its constituents is not easy, given that it is currently an illegal drug, as was discussed in the NYT article. It’s not for lack of interest, but mainly because the law (and therefore the Drug Enforcement Agency) classifies it as a schedule 1 drug with “no currently accepted medical use.” Scientists who want to do research on marijuana and its constituents—particularly clinical trials—must register with the DEA and submit an investigational new drug (IND) application to the Food and Drug Administration for human trials. Moreover, the National Institute on Drug Abuse is the only supplier of legal, research-grade marijuana. On the other hand, while doing research on marijuana is difficult in this country, researchers in other countries that have long had much more lax laws and regulations should have an easier time of it.

Another issue is how to do a proper placebo control. Given that many of the conditions for which medical marijuana is touted are conditions with a large subjective symptomatic component, such as pain, nausea, fatigue, or lack of appetite, clinical studies of medical marijuana are going to require really good placebo controls. Given that at least one of the active components causes a high, it’s arguably even more difficult than in the case of, for instance, acupuncture, to design studies with adequate controls. That’s why most of the more rigorous studies have used specific purified cannabinoids. For example, in this study, a titanium pipe loaded with doses of THC varying potencies is used rather than plant, while this study of cannabis for neuropathic pain used high-dose cannabis, low-dose cannabis, and placebo cigarettes.

Be that as it may, let’s look at the evidence base for conditions for which medical marijuana might provide a benefit. Remember, again: I’m leaving out cancer and autism for another day. Leaving these aside, here are the potential medical uses for marijuana for which evidence exists that ranges from reasonably good to suggestive.

Chronic pain. It’s been known for a long time that cannabinoids modulate pain responses; so it’s plausible that either smoked marijuana or cannabinoids isolated from marijuana (or synthetic cannabinoids) could be useful for chronic pain. Fortunately, this is one of the more widely-studied uses for medical cannabis. For example, a recent review of uses of cannabinoids for the treatment of non-cancer pain concluded that there was evidence that cannabinoids are safe and modestly effective in neuropathic pain, citing preliminary evidence of efficacy in fibromyalgia and rheumatoid arthritis. As is the case with most reviews, more study was recommended. This particular review included smoked cannabis, oromucosal extracts of cannabis based medicine, nabilone (a synthetic cannabinoid), dronabinol (a synthetic delta-9-THC), and a novel THC analogue. Most studies have only been short term, and adverse events have tended not to be serious. The current general recommendation is that cannaboids should probably not be used as first line agents “for conditions for which there are more supported and better-tolerated agents,” and adverse effects are not well studied.

Appetite stimulation. I’ve never smoked marijuana, but those who have, have told me about the “munchies,” something that anyone who’s ever seen a comedy in which characters smoke post has likely seen used as fodder for jokes. Given its ability to stimulate appetite, it is therefore plausible that medical cannabis might be useful for appetite stimulation in patients with cachexia due to cancer or HIV/AIDS. (Cachexia is the “wasting” that can occur in advanced cases of malignancy and AIDS, among other diseases.) Unfortunately, a recent Cochrane review noted variable outcomes and concluded that the “efficacy and safety of cannabis and cannabinoids in this setting is lacking” and noting no good evidence of long-term effects on AIDS-related mortality and morbidity. Regarding cancer cachexia, Peter Lipson noted several years ago a study that failed to find any benefit from cannabis extract for cancer-related cachexia, speculating that maybe the mechanisms that cause appetite suppression in cancer are different than the mechanisms by which cannabinoids modulate appetite.

Currently, there are few controlled trials cited at the NCI website, which, taken together, find that oral THC has variable effects on appetite stimulation and weight loss in patients with advanced malignancies and human immunodeficiency virus (HIV) infection. A PubMed review by yours truly also found the evidence rather sparse. For instance, this randomized trial testing cannabis extract (CE), THC, and placebo (PL) reported that “no differences in patients' appetite or quality of life were found either between CE, THC, and PL or between CE and THC at the dosages investigated." Another randomized trial comparing megestrol acetate (Megase) and dronabinol found that “megestrol acetate provided superior anorexia palliation among advanced cancer patients compared with dronabinol alone” and that “combination therapy did not appear to confer additional benefit.” A more recent small randomized trial tested THC versus placebo and found that “THC may be useful in the palliation of chemosensory alterations and to improve food enjoyment for cancer patients.” To be honest, I was shocked at how sparse the literature is covering this particular indication. Indeed, as the NCI notes, there are no randomized controlled trials of smoked cannabis for this indication in cancer patients.

Nausea/antiemetic. Despite many advances in anti-emetics (anti-nausea and vomiting) agents, cancer-induced nausea and vomiting (CINV) is still among the most troubling symptoms cancer patients face. There are two FDA-approved cannabis products for this indication, dronabinol and the synthetic cannabinoid nabilone. The NCI cites several clinical trials and meta-analyses finding that these two drugs are efficacious against CINV, and the National Comprehensive Cancer Network guidelines recommend these drugs as treatment for breakthrough nausea and vomiting due to chemotherapy. One systematic review from 2001 found that cannabinoids were slightly more effective antiemetics than prochlorperazine, metoclopramide, chlorpromazine, thiethylperazine, haloperidol, domperidone, or alizapride, but were not more effective in patients already using large doses of antiemetic drugs. A more recent systematic review and meta-analysis found that cannabinoids were superior to conventional drugs but that “adverse effects were more intense and occurred more often among patients who used cannabinoids.” In children with cancer undergoing chemotherapy, a Cochrane systematic review concluded that “cannabinoids are probably effective but produce frequent side effects” and that the review “suggests that 5-HT(3) [seratonin] antagonists with dexamethasone added are effective in patients who are to receive highly emetogenic chemotherapy although the risk-benefit profile of additional steroid remains uncertain.”

Inflammatory bowel disease (IBD). Last fall, the first clinical trial of cannabis in IBD was reported by a group of Israeli researchers. It was a small trial (21 patients), in which subjects were assigned randomly to groups given cannabis, twice daily, in the form of cigarettes containing 115 mg of Δ9-tetrahydrocannabinol (THC) or placebo containing cannabis flowers from which the THC had been extracted. A clinical response was achieved in 10 of 11 patients receiving cannabis with THC and 4 of 10 in the placebo group. Overall, this was a small study, but intriguing. No difference in complete remissions between the groups was observed, but that could easily be because of the small numbers. As with many conditions, all one can conclude is that more research is needed.

There is, of course, a laundry list of other conditions. Cannabinoids have been shown to lower intraocular pressure, making them potentially useful for treating glaucoma, although using cannabis to treat glaucoma is impractical in the vast majority of patients (see below), and there exist better treatments. After that, other conditions for which medical cannabis is frequently recommended include schizophrenia, for which a Cochrane Review concludes that there is no good evidence for or against the use of cannabis for schizophrenia. For epilepsy, data from double-blind randomized controlled clinical trials is lacking, although clinical trials are finally being done.

Overall, the evidence base supporting medical cannabis use, from my interpretation, ranges from nonexistent (most indications) to suggestive (e.g., anti-inflammatory), to fairly good in one case (ant-emetic). However, most of the good clinical trials didn’t use marijuana cigarettes as most patients get them, but rather either purified cannabinoids (or synthetic analogues) or cannabis cigarettes spiked with varying amounts of THC. Indeed, all of these studies tend to suggest that purified drugs from cannabis or synthetic drugs based on compounds designed to mimic either endocannabinoids or cannabinoids from marijuana will be the future. I realize that that’s not what medical marijuana activists want to hear. I also realize that it is likely I will be lambasted as a “pharma shill” or as so “conventional” that I can’t think outside the box, but I’ve endured those attacks before when I’ve criticized other forms of herbalism—and, make no mistake, medical marijuana is herbalism. In any case, mine, I believe, is a reasonable interpretation of the currently existing medical literature.

Moreover, contrary to what advocates will claim, cannabis, particularly smoked cannabis, is not without adverse health effects, as was recently reviewed in the New England Journal of Medicine. Potential medical effects reported in long time users include motor vehicle collisions (not unreasonable to expect because driving while high is not a good idea), chronic bronchitis (not surprising as a result of smoke inhalation), schizophrenia (one wonders whether correlation really suggests causation here), depression, and addiction to other drugs, although the risk for cancer due to marijuana smoke appears to be much lower than with tobacco cigarettes. True, drug warriors and moralists will frequently exaggerate the risks in order to promote their agendas, but that doesn’t mean that cannabis is perfectly safe and doesn't produce significant side effects or complications.

Then there’s the delivery problem.

Delivery, purity, highs

Let’s consider, for a moment, a generic herb that has medicinal properties. I began this post by briefly discussing the problems with herbs as medicine, but I didn’t discuss delivery. If one were to come up with a delivery method for an effective herb, one would be hard pressed to come up with a worse method than burning it and inhaling it. Consider the case of tobacco. The combustion of dried tobacco leaves produces a toxic stew of gases with carcinogenic effects. Of course, the main reason tobacco is so addictive is because it does have an active drug in it, specifically nicotine, which rapidly reaches the circulation through the alveolar sacs in the lungs. However, that nicotine is mixed with numerous combustion products that can cause cancer and contribute to the numerous other diseases to which smoking tobacco has been linked.

This brings us back to delivery. People have been using marijuana for the high and for medicinal purposes for a very long time, but cannabinoids were only first isolated from the plant in the 1940s, and the main active ingredient, (−)-trans-Δ⁹-tetrahydrocannabinol (THC), wasn’t discovered until the 1960s. Now, like the case with cigarette smoke and its delivery of nicotine to the bloodstream, the THC and other active cannabinoids delivered to the bloodstream through smoking marijuana are mixed in a similarly toxic stew of combustion products. While it is probably true that marijuana smoke is less carcinogenic than tobacco smoke, it has the same potential for respiratory irritation and deposits four times as much tar into the lungs as a typical cigarette, mainly because marijuana is usually smoked unfiltered. However, occasional marijuana use appears not to have a significant effect on lung function up to seven joint-years of lifetime exposure. (I chuckled when I read that term; it means one joint a day for seven years or one joint a week for 49 years). Of course, this hardly compares to a typical tobacco smoker, who smokes anywhere from a half pack to two packs a day (10-40 cigarettes), and those using medicinal marijuana can be expected to be smoking at least a couple of times a day. Medical cannabis advocates even basically admit that this is true.

In any case, if one were going to decide on a drug delivery device for cannabinoids, one could hardly design a worse device than burning the leaf and inhaling the gases, where the active drug is just one of hundreds of products of combustion, all loaded with particulate matter and tar. Sure, toking one joint a day probably doesn’t do appreciable lung damage in the intermediate term, but smoking one cigarette a day probably doesn’t either. In the case of glaucoma patients, a condition for which there is some evidence of efficacy, it’s been noted that patients would have to be toking up several times a day:

Since at least 2009, for instance, the American Glaucoma Society has said publicly that marijuana is an impractical way to treat glaucoma. While it does lower intraocular eye pressure, it works only for up to four hours, so patients would need to take it even in the middle of the night to achieve consistent reductions in pressure. Once-a-day eye drops work more predictably.

Yet glaucoma qualifies for treatment with medical marijuana in more than a dozen states, and is included in pending legislation in Ohio and Pennsylvania. At one point, it appeared in New York’s legislation, too.

And:

What’s more, for some of the ailments, such as glaucoma, patients would have to toke up every three to four hours day and night to maintain therapeutic levels in the bloodstream or tissues. Routinely consuming that much weed would be incapacitating.

Clearly, even if marijuana is efficacious for some conditions, there are serious drawbacks to burning the plant and inhaling the smoke as a drug delivery system. Other problems exist, not the least of which are the psychoactive effects of THC, which cause much of the “high” that pot smoking produces. To paraphrase one of the ophthalmologists in the NYT, his 60-year-old patients with glaucoma don’t want to be stoned all the time to get the beneficial effect of medical marijuana. The high is a particular problem for children, but none of this has prevented parents with autistic children from claiming that pot can treat autism, complete with seemingly-heartwarming anecdotes. One can imagine the temptation to simply keep the child toking until he becomes mellow and more “manageable.”
Of course, medical marijuana being in essence herbalism, with the same claims for efficacy of the “whole plant” due to synergy of its ingredients and the same attitude that “natural is better,” it’s not surprising that the same problems exist that are routinely observed for any herb sold for medicinal purposes. These problems include as inconsistent potency and purity, adulteration with contaminants—or even questions of whether the plant being sold is actually what is being claimed. Indeed, a fascinating story that sounds very familiar to those of us who have been paying attention to adulterated herbs and supplements was published a month ago in The Seattle Times:

Tonani, 38, decided several years ago to try pot. And it has worked for her, she said, especially strains low in the psychedelic chemical THC and high in the non-psychoactive ingredient cannabidiol, known as CBD.

As a medical-marijuana patient, Tonani knows it can be hard to find the rare strains that don’t make you high — and it can be even harder to get the same kind of pot consistently.

Testing shows that some marijuana strains are not what they purport to be in name, chemical content and genetics. This is particularly concerning for patients seeking pot low in intoxicants and high in pain-relief or other therapeutic qualities.

One strain widely known for its high-CBD and popular among medical-marijuana patients is called Harlequin. But when Tonani and a leading Seattle pot-testing lab analyzed 22 samples of Harlequin from various growers and dispensaries, five of them were high in THC and had virtually no CBD, which means people trying to take medicine were just getting high instead.

Again, this is a very common problem with herbal medicines, and cannabis, when smoked or ingested as the plant, is an herbal medicine.

Medical cannabis: Politics versus science

There’s no doubt that what is driving the legalization of medical marijuana in so many states has far more to do with politics than with science. Right now, for all but a handful of conditions, the evidence is slim to nonexistent that cannabis has any use as a medicine, and those conditions, such as CINV and chronic pain, can often be treated more reliably with purified or synthesized active components. Moreover, for one condition for which there is reasonably good evidence for the efficacy of cannabis and/or cannabinoids, namely chronic pain, politicians are reluctant to approve medical marijuana, as described in the recent NYT article:

Often state legislators have been motivated not just by constituents in distress, but also by the desire to restrict access to limited patient populations so that legal marijuana does not become widely available as a recreational drug in their states.

For example, while there is research suggesting that marijuana alleviates certain kinds of chronic pain, Mr. Lang noted, legislators in Illinois were reluctant to legalize its use in such a broad patient population. The state’s list of qualifying conditions is lengthy partly because lawmakers tried instead to specify a number of diagnoses that result in pain, some quite rare.

“I’ll bet there are hundreds of conditions that cause pain, and now 30 are listed,” Karen O’Keefe, director of state policies at the Marijuana Policy Project, said of Illinois’s legislation.

So, for one indication for which there is reasonably good evidence for the use of cannabis, legislators in Illinois were reluctant to approve its use, while approving its use for a lot of indications for which there is no evidence to support them. Clearly, this is a policy area that cries out for better science, given how legislators are being swayed by anecdotes that do not demonstrate that cannabis is effective and stories of “persecution” for growing medical marijuana, rather than by well-designed randomized clinical trials. Add to that the conflict with currently existing federal law, which outlaws cannabis as a schedule I drug, and the political situation is a mess, making doing research to find out for what indications cannabinoids have efficacy much more difficult. Antidrug zealots hugely exaggerate the danger of pot smoking, while pro-medical marijuana zealots claim that “cannabis cures cancer.” (It doesn’t, as I will discuss in the next installment.)

Moreover, THC can have biphasic activity:

THC has what doctors and researchers know as biphasic activity. “At low doses it has certain effects, and at high doses it has opposite effects,” Dr. ElSohly explains. “Somebody using to get high at the right dose will be calm, happy, getting the munchies, and all of that,” Dr. ElSohly says. Someone using at the right dose could see medicinal benefits, too. But take in too much THC, and you can become irritable, even psychotic. “There are more emergency room admissions today than ever because of marijuana use,” Dr. ElSohly says. “That’s simply because of the psychoactive side effects of the high THC content that the public uses.”

This makes standardization and getting the dose right more important for medical cannabis than for most other drugs, which is why I’m not enamored of smoking pot as a THC/CBD delivery system. At the risk of being too personal and “anecdotal,” I couldn’t smoke pot if I wanted to, for recreational or medicinal uses, whatever my feelings about its legalization. I can’t smoke cigarettes, either, and have never tried either pot or cigarettes. The reason is simple. Inhaling just secondhand smoke sends me into fits of coughing—and has since I was a child. Inhaling smoke directly into my lungs has been and still is more or less unthinkable. And I’d bet I’m not alone, either.

My personal sensitivities aside (which are obviously not shared by most people), I see two critical unaddressed questions with respect to cannabis. The first issue is standardization. I’m sorry, herbalists and pot smokers, but smoking a dried plant just isn’t it, particularly given the relatively low doses of active compound needed for optimal effects. That means pharmaceutical-grade material. If cannabis is a therapeutic drug, it should be treated like every other therapeutic drug and be subject to clinical trials. The second issue is comparative effectiveness research. It’s not enough just to say cannabis (or whatever cannabinoid drug or derivative you might wish to use) is “efficacious” against this disease or this condition. We need to know how efficacious it is compared to the existing standard of care. In most cases, even for indications for which there is evidence of efficacy, the existing evidence base suggests that cannabis is less effective than existing treatments, with the possible exception of its use as an antiemetic. Yet none of this sways the zealots, just as similar evidence with respect to other herbs doesn’t sway believers in herbalism. Meanwhile, medical cannabis is rapidly becoming big business.

That’s because cannabis is the new herbalism. With relatively few exceptions, it’s about belief first, and then trying to get the science to to support its magical properties.

oracknows Thu, 07/10/2014 - 04:00

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Orac, what a breath of fresh air! Well written, accurate, and accurately representing the state of research. You continue to impress me writing on an area that I usually cringe about.

I'm a bit frustrated by other medical sources and skeptics who deal with cannabis from a pro-legalization perspective.

Here's my position:
1. Medical uses should have no bearing on whether a drug can be used for recreation. Codeine makes a great cough syrup, but I don't think that means it should be legal to sell at the local gas station or 7-11. Likewise, hydrocodone is an indispensable drug for pain management, but legalizing its use for recreation makes no sense. If cannabis has medical applications, let it be treated the way we treat prescription drugs. We shouldn't mix and match and encourage self-medication.

2. Tobacco and alcohol are not legal because they are safe. Let's keep reminding ourselves that, combined, these two legal drugs are involved in causing more preventable deaths than any other single factor. They are only legal because we lack the political will to make them illegal.

To me, this is no different than saying we should release any serial murderer who killed fewer people than Jack the Ripper, because that guy never served any jail time, so why should anyone else? Let each drug stand or fall on the merits and harms shown by research.

I'll stop there. This is a sore issue for me. I'm a little frustrated with a lack of clear, rational thought on the issues around physicians encouraging the legalization of a recreational party drug. I appreciate this well-written article.

The article then goes on to give several examples, such as Alzheimer’s disease, lupus, Sjogren’s syndrome....

Yes, I can see why a substance well known for producing cottonmouth would be a natural therapeutic choice here.

On the antiemetic front, I don't know how long it would typically be prescribed for, but longer term use carries some risk of the peculiar cannabinoid hyperemesis syndrome.

You never smoked marijuana? Well your GPA was probably a lot better than mine.
The irony for me was that when I was prescribed Marinol for weight gain I hated it. Threw all the pills out. When you are taking a lot of meds as I was at the time, the last thing you want is another med with central nervous system side effects. IMHO. Plus I never really was one for getting the munchies - but I sure loved music & art! Sometimes I kind of miss it when I go to concerts now. sigh.

And because it's my job to basically pick from the bottom of the barrel in science blogging...

...Well, there's this guy.

http://phoenixtears.ca/

Specifically, his "how it works and what it does" page, where he writes, I shit you not:

"Many people who have taken the oil have stated that they thought it to be the fountain of youth. From my own experiences with the oil I believe this to be true."

I'm as much a fan of the odd johnny as the next fella, but seriously, backing up attempts to legalize a drug with dishonest science is just fucking dumb.

@c0nc0rdance
I seem to recall that alcohol had indeed been made illegal in the US, circa 1930?
Did it work SO AMAZINGLY well?

Prohibitioning aside, I am in agreement with 100% of what Orac said. Interesting possibilities indeed, but blown out of proportion.

I've been a long time lurker, finally commenting!

This was a great post. My nephew has Dravet, and my mother was talking a few years ago about taking him to CO for cannabis oil. I think I talked her out of it based upon dosage/quality arguments learned here from our esteemed host (or perhaps that's a bit egocentric-his mother may have simply nixed the idea). Been following epidiolox (sp?) for about a year now-they've opened up a trial in the midwest and that may be a possibility for my nephew if his neurologist agrees.

As much fun as this blog is, I rather miss some of our more "entertaining" visitors. I know Greg asked to be banned (still gives me the grins), but whatever happened to Augie, or Jen, or Sid? I know getting spanked isn't fun, but their apparent decisions to leave us left a deficit in my daily dose of giggles.

Trying to ban stuff that can be grown (tobacco, pot, grain for alcohol) and then easily produced with household ingredients/equipment (alcohol, there might be more but I don't know the facts there) is an enormous game of whack-a-mole that the moles definitely will win.

I've heard that synthetic pot is more dangerous than plant pot. Don't know if it's the usual anti-drug scaremongers, or if the unintended consequences have actually become a bigger problem than weed let well enough alone.

Disclosure: never been a user and I only say that to make clear I have no agenda other than wanting to see the end of the likes of the DEA and military involvement in stuff that is not in its charter. Way too much resources involved in chasing pot for no benefit and likely much harm.

I believe there's a place in the world for healthful, non-medicine products. For example, my wife will drink a cup of coffee when she's having asthma rather than jumping right to the emergency inhaler. Could that instead be an FDA regulated pure caffeine powder? Sure. But coffee works.

So certainly claims of Cancer and Glaucoma cures need to be treated as medicine and carefully studied with specifically extracted compounds. But if a cancer patient finds a pot brownie helps their nausea or appetite? Great! Even if it were just placebo, that's still a good thing.

I think that's where this confusion of marijuana and medicine comes in. It's not that it needs to be a medicinal appetite stimulant, it's that if a very sick person finds help in it, why not just let them consume it? Not as medicine, but as something fairly benign that helps them feel better. But since marijuana is illegal it needs to be couched in the terminology of medication to get a legal exemption for the individual. Which as you point out confuses the issue of what a medicine is.

I'll reiterate some other commenters, this was a remarkably clear-headed piece on this topic.

I’ve heard that synthetic pot is more dangerous than plant pot.

I'm willing to believe that synthetic pot is more potent than plant pot. It's easier to adjust the THC content of synthetic pot to what you want, and I would think[1] that for most users higher is better. Whether that's more dangerous depends on your perspective. A user who is used to plant pot could be overwhelmed by a similar dose of the more potent synthetic pot. But with synthetic pot, at least for medicinal purposes, you know how much you need, unlike with plant pot where the potency can vary from negligible (ditch weed) to quite strong. The latter comes up with other herbal medicines: in synthetic form you know how much you are getting, whereas with grown product you are never sure.

[1]Not that I have any personal experience on this topic….

I’m willing to believe that synthetic pot is more potent than plant pot. It’s easier to adjust the THC content of synthetic pot to what you want....

I think B&F may have been referring to compounds such as JWH-018, which are full agonists of the cannabinoid receptors.

I mostly agree with this but I think one of the reasons patients prefer to smoke is that it's actually easier to control the dose then with a pill, such as Marinol. I think most people who use it for medicinal purposes probably just take a puff or two at a time, wait to gauge their reaction and then smoke a little more if needed. I had a friend with abdominal cancer who after surgery and chemotherapy decided to quit treatment. He said narcotic pain medicine made his pain worse because it constipated him. Pot and hot baths in his jacuzzi were the only things that helped. And anyone who smokes a whole joint of todays' marijuana is hard core. I haven't smoked in years, but once they came up with the powerful strains, i found one or two tokes was all I could handle. As far as nausea meds, at least some of them have potential extrapyramidal side effects. I believe they black boxed Reglan for this. And I think compazine and phenergan also have that potential. Don't know about Zofran, though.

T: You're a bit off. the ban started in 1920, went through 1932 when it was finally repealed.

Some of the stuff sold as "synthetic pot" may not be the active ingredients in pot just derived synthetically. Some of the so-called "bath salts" are sold as synthetic pot.

How much they are really like the compounds in pot I don't know (as last I heard on the news they are whichever designer drugs hasn't been banned yet and as one gets banned a new compound gets put in the products). I assume they call the whatever they cooked up synthetic pot because people don't think of pot as dangerous so it makes them more likely to buy it than whatever chemical they put in it this month.

Some of the stuff sold as “synthetic pot” may not be the active ingredients in pot just derived synthetically. Some of the so-called “bath salts” are sold as synthetic pot.

I really doubt that MDPV and friends are smokable.

One thing smoking ones pain drugs would do would be to normalise it, to make it social. Everyone i know on opiates, and these are prescribed ones, is under constant censure and judgement from others, often their family, for taking them. Even when the pills are all that allows them to function.
Turning pain relief into a fag break would help.

note for merkins...fag in English means cigarette. If fag break sounds odd to you think how the reference to a johnny sounded to me upthread. As a johnny is a prophylactic...

As a johnny is a prophylactic…

Well, those are "jimmies" here, but I think that's mostly Black slang (as is "squares" for cigarettes, which seems to be falling out of use, although I still say it, sometimes to the surprise of the hearers; "that's jail talk, man").

I thought that jimmies were sprinkles. Live and learn.

MO'B, I didn't know you were a fellow Massachusettsian!

@Antaeus Feldspar - I lived in Mass for 4 years ago some time back. I learned the difference between a frappe and a milkshake and what a tonic is.

Google patent US 6630507 Heard of this?

Boy its hard to stay away from this place :)

I have personal experience and yes what I am going to do is provide an anecdote so keep that in mind.

I have cancer and have had chemotherapy for it. I did take cannabis to try and put a lid on my nausea. While it helped a bit it had no where near the effect that the anti emetics that were given to me did. Compared to Aprepitant it was pretty useless.

As for analgesia it works but for me it is no better than paracetamol. Codeine has a much greater effect. I know this as I also have Rheumatoid Arthritis. It is also claimed that cannabis is an effective anti inflammatory agent. Well compared to Celecoxib it really is ineffectual. As for modifying RA's effect on the joints compared to methotrexate it is useless.

I am a member of a cancer support forum. We regularly get people on board who claim that cannabis is protective against cancer. I really find that hard to believe as I personally know stoners who ended up with cancer. What I really want to see is a large scale study that investigates the incidence of cancer in people who regularly use Cannabis for recreational purposes. I could then point to the study and shut them up. Mind you it is a support forum so any argument is short lived. it would be nice though to have some evidence to educate the clueless.

Someone commented on political will to make things illegal. Well we tried that in the 1920's with alcohol and it was an unmitigated failure. Making things illegal does nothing but empower criminal organizations and turn decent citizens into criminals. We have had a war on drugs now for decades and nothing has happened except tens of thousands have died in drug related violence and the use of illegal drugs has skyrocketed. I applaud those countries and those states in the US who have made it legal for recreational purposes. Make them legal, tax them, then use the money in public health campaigns. It has worked for tobacco and it will work for cannabis, or any other illegal drug for that matter. In the US and Australia we have managed to get smoking rates down from over half of all men down to around 15%. We never had to resort to banning it and to do so I think would be counter productive.

So in passing if anyone can point to a large study showing cancer incidence in heavy cannabis users I would be most appreciative.

Cheers

I challenge you to a public debate, you paid-for, antiscientific shill! Continue to help the Prohibitches withhold God's healing plant and reap the karmic consequences...Repeal - Amnesty - Reparations! We will settle for nothing less. Respect existence or expect resistance ;)

Did you even bother to read the article, not-so-Bright?

AdamG, did you not notice the winking emoticon at the end of Drew Bright's comment? Drew is Poeing.

Google patent US 6630507 Heard of this?

Yup. But if your point was "there must be something to it, or they'd never have gotten a patent granted" then you're quite mistaken. Patents have been granted for many things that don't do what they're claimed to - for perpetual motion machines, or for infinite data compression methods (which, believe it or not, are actually more impossible than perpetual motion.)

infinite data compression methods

I'm still convinced that a really good compression method using deduplication and zero suppression should be able to take any data and compress it to a single bit.

Google patent US 6630507 Heard of this?

G—gle patented cannabis? Oh, wait.... Your point is that CB1/CB2 affinity is wholly unnecessary?

Who owns controls that patent?

@blinkyeb - are you here to make some point or to play 20 questions? If you'd like to make a point, please state it. Thanks.

Who owns controls that patent?

You didn't understand that whole receptor business, did you? Do you surmise that the best acute treatment for stroke is trying to figure out how to get a joint into the patient ASAP?

MOB "I’m still convinced that a really good compression method using deduplication and zero suppression should be able to take any data and compress it to a single bit."

Yes, but it only works reliably for political speech and marketing copy.

I’m still convinced that a really good compression method using deduplication and zero suppression should be able to take any data and compress it to a single bit.

There are any number of techniques that would suffice for compression to a single bit. None of them, however, have corresponding de-compression techniques.

rs - I've heard of a two-bit politician, so it's within reach.

Bill Price - that's where it all falls down, of course, unless one has a quantum computer.

that’s where it all falls down, of course, unless one has a quantum computer.
In other words, Deepitypak can do it, but not us regular folk?

I’m still convinced that a really good compression method using deduplication and zero suppression should be able to take any data and compress it to a single bit.

You're giving me flashbacks to Barnsley's "fractal compression" algorithms from the 1980s.

AdamG, did you not notice the winking emoticon at the end of Drew Bright’s comment? Drew is Poeing.

Oh I googled around before commenting, and sadly Mr. Bright is not a Poe.

If you were wrong about marijuana 20 years ago, maybe it's also possible that you're wrong now about some of the things you describe as "woo."

>"Inhaling just secondhand smoke sends me into fits of coughing—and has since I was a child. Inhaling smoke directly into my lungs has been and still is more or less unthinkable. And I’d bet I’m not alone, either."

Actually, unless you have allergies, asthma or some kind of respiratory condition, that's VERY unusual. Most people can inhale smoke no problem.

jacksvsworld, a quick question:

Did smoking pot make you stupid, or were you stupid before you started to smoke it?

I ask this because I spent two hours a couple of days ago waiting for old Honda that was parked in my driveway to be removed by the police. Not just blocking the driveway, but backed to being not far from the garage. In the back seat was a bong, and the police officer told me it was a stolen car.

What kind of intelligent person steals a old small car and then backs it up a driveway, while leaving their stuff in the back? Needless to say, I am not impressed with that person's cognitive function.

By the way I only smoked pot for a week in college because it gave me annoying "itchies", and I did not like that it made me stupid. I also have a real verifiable allergy to nicotine, so I don't like being around tobacco smoke. Or wood smoke. Or any other airborne particulates.

'Most people can inhale smoke no problem."

Really? Provide the PubMed indexed studies from qualified reputable researchers to prove otherwise. While we have had several in our family die from tobacco smoke inhalation (including a 42 year old who lost his jaw to cancer), I will only use the sixty plus years of epidemiological studies showing tobacco smoking is deadly.

Since pot smoking has only become legal in the past couple years in a few places, I predict there will be similar results from studies in the next forty years for marijuana.

By the way, I voted to legalize marijuana smoking in my state. I really don't care what chemicals you inhale, I just don't want doing it in my air space. Committing acts like stealing a car and abandoning it in someone's driveway may or may not be the affect of smoking pot.

It just does not reflect well on the users. So please clean up that image, unlike this city attorney. You can start by being coherent.

If you were wrong about marijuana 20 years ago, maybe it’s also possible that you’re wrong now about some of the things you describe as “woo.”

And it's also possible that "jackvsworld" is actually a criminal wanted by the FBI for sordid acts of bestiality against endangered species.

It's not enough to say something is 'possible'.

I also have a real verifiable allergy to nicotine

A small amine isn't able to act as an allergen. It would have to somehow function as a hapten, but with a protein that also ignored vitamin B3.

Narad, you'll have to take my skin tests results with the allergist MD who explained them to me. Personally I was glad in the late 1970s to have a verifiable piece of paper to bolster my annoyance at those who wanted to smoke tobacco in my presence.

That included my dorm roommate who chose a non-smoking room thinking it would help her quit. Oh, and the folks in movie theaters, and the woman seated in the nonsmoking section of the airplane, and the woman in our office who kept telling us how we should only eat organic food while sucking on a cigarette (so glad when the company went smoke free, and surprised when some tried to hide the lit cigs under their desks).

I just hope that we can convince the ones who wish to now legally smoke marijuana can be reminded that many of really find it annoying.

By the way, not all things that cause reactions are proteins. Though sometimes things that cause dermatitis do that as a combined reaction to items in the body, like nickel reacting to perspiration.

Note I was very upset that some idiot abandoned a stolen car with a bong in on my driveway that trapped me from driving somewhere before it closed. Plus waiting two hours after calling the police for it to be removed (had to resort to "911" after spending several minutes on hellish voice mail trying the "non-emergency" parking infraction police number).

That alone illustrates one reason why I detest the idiocy of folks like jacksvsworld. Oh, and pedantic comments that may follow. So if you'll excuse me I will still think very little of the intellectual capability of anyone who says "people can inhale smoke no problem."

Because it doesn't take a rocket scientist (fortunately I used to be one) to know that it is not healthy to intentionally inhale particles contained in any kind of smoke.

There are patients that have beat cancer and other llife threatening disease with cannabis, most have not let the Dr's give them the poison called chemo, they went straight to the oil made from the plant tha heals most anything it somes in contact with. With holding this plant from people (specially the seriously ill) is inhumane. Do your homework, there are tests showing the power of this plant , I have seen brain tumors gone with no evidence of cancer left after using the medical marijuana oil and eating a clean healthy diet. The most important thing you can do for yourself is to eat right, no GMO foods, no sugars etc and educate yourself on all the things this amazing plant can and does heal!

Nice prohibitionist hit piece, Orac. You lose when your already name calling with terms like quackery in the first paragraph. See, I can spot this thinly veiled pseudo science, limited hangout, feces a mile away.

Just word search "Ceramide" in the article.

Hmmm ..... it`s not there, Orac. That means your either not a very good researcher, or an author with an agenda who is suppressing some very important info some of your readers may find helpful.

In the words of Dennis Hill Bio-Chemist who cured his prostate cancer with cannabis oil.

"In every cell there is a family of interconvertible sphingolipids that specifically manage the life and death of that cell. This profile of factors is called the “Sphingolipid Rheostat.” If endogenous ceramide (a signaling metabolite of sphingosine-1-phosphate) is high, then cell death (apoptosis) is imminent. If ceramide is low, the cell is strong in its vitality.

Very simply, when THC connects to the CB1 or CB2 cannabinoid receptor site on the cancer cell, it causes an increase in ceramide synthesis which drives cell death. A normal healthy cell does not produce ceramide in the presence of THC, thus is not affected by the cannabinoid."

Cannabis, specifically THC, kills cancer Orac. There is zero doubt. It has been demonstrated endlessly for at least the last 20+ yrs. In a legalization debate, a retired DEA agent was forced to admit they knew of some 10,000 peer reviewed articles as of 2007. Who knows how many now.

And once a majority of world citizenry know this, the for-profit-not-for-healing big cancer industry is going to a multi-billion dollar financial hit.

Is that what your protecting Orac? Or are you just uninformed?

And Dennis Hills account is just one of countless Cannabis Therapy success stories. That`s why GW Pharmaceuticals applied for some 43 patent for various aspects of the production of their multi-spectrum medicine Sativex.

Do you really think the US gov. has multiple patents thru Health and Human Services for no reason?

Then, lets get one thing straight, so to speak. Smoking cannabis is a great way to get high, but a lousy way to take advantage of the super nutrient/medicinal value the plant has. It has to be eaten, preferably as a whole plant extract.

And then lets get another thing straight. We the People do not need, nor want any more research on this plant. It is the most researched plant in human history.

What we want is complete deregulation. Just like pre-1937. The world got along just fine with cannabis as it had for some 5000 years previous, and so far Colorado and Washington have proven it will be largely the same now.

We want to be able to grow this plant for any purpose we so desire. And since it is already well established that cannabis has an astronomical LD50 rating, we don`t need the medical/pharma complex to tell us what the proper dose is. After all their products, and dosing guidelines are responsible for many thousands of deaths and injury yearly. We`ll figure it out, thanks.

Nothing less than complete deregulation will do. And we will get it.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770515/

"Endogenous cannabinoids regulate the de novo synthesis of ceramides, lipid-based components of the cell membrane that perform both structural and signaling functions. It is becoming increasingly obvious that ceramide functions as a physiological signaling molecule, particularly with regard to the control of apoptosis, but also growth arrest, differentiation, cell migration, and adhesion.104 As such, the role and regulation of ceramide signaling is attracting increasing attention, and ceramide now has an accepted role in the development of some cancers.105 Activation of either CB1 or CB2 in glioma cells is associated with an increase in ceramide levels leading to the activation of the extracellular signal-regulated kinase (ERK) pathway via Raf-1 activation and p38 MAPK activation.14,106 Both these pathways ultimately cause apoptosis through caspase activation and/or cell-cycle arrest.14 In breast cancer cells, the CB1 antagonist SR141716 inhibited cell proliferation through the effects of ERK1/2 colocalized inside membrane lipid rafts/caveloae.59 Such rafts play a critical role in the growth and metastasis of breast tumors.107,108 A final component of the ERK pathway, p53, plays a crucial role in switching between cell-cycle arrest and apoptosis.109 In cultured cortical neurons, Δ9-THC activated p53 via the CB1 receptor, thereby activating the apoptotic cascade involving B-cell lymphoma (Bcl)-2 and Bcl-2-associated X protein, suggesting that the cannabinoid pathway ultimately causes cellular death via apoptosis.110"

@Danman

You missed the conclusion from that paper you linked to, in which the authors say that we cannot move forward with cannabinoids as a cancer treatment without more research to resolve disagreements in the litarature. To wit:

Overall, the cannabinoids may show future promise in the treatment of cancer, but there are many significant hurdles to be overcome. There is much still to be learned about the action of the cannabinoids and the endocannabinoid system. The current disagreements in the literature suggest gaps remain in the knowledge base around the normal signaling pathways used by endocannabinoids, the physiological systems that are involved, and the range of effects that these compounds cause. Future research will help clarify the actions of the cannabinoids, and particularly the endocannabinoid signaling pathway, which will be critical in the ongoing development of these compounds.

It is a distinct possibility that the cannabinoids may have a place in the future treatment of cancer. Several reports have shown that the synthetic cannabinoids in particular have the potential to show sufficient specificity and efficacy to be precursors to clinical treatments. However, at this point in time, the results from studies are lacking sufficient depth of understanding to allow this transition to occur. The contradictory nature of reports around the efficacy of compounds highlights our lack of detailed understanding of mechanisms of action. The resolution of the conflicting evidence around cannabinoid action will continue to be a research priority in the near future, and it is expected that developing a more robust understanding of the mechanisms of action underlying cannabinoid action will facilitate the acceptance of cannabinoid use in a clinical setting.

Marijuana Study Shows No Lung Cancer Risk
https://www.youtube.com/watch?v=_6pBw0bgmgA

"Dr. Donald Tashkin UCLA Geffen School of Medicine Pt 2 of 2. Conclusion of 2 part interview with the famous research doctor from UCLA Geffen School of Medicine. Pulmonary research on use of marijuana and interaction with the lungs was funded by the Federal Government to prove that lung cancer is caused by smoking marijuana, however the results proved cannabis does not cause lung cancer."

Citation via YouTube? How quaint.

PubMed is your friend and there are many more recent studies showing the deleterious effects on pulmonary functions and the risk for lung cancer:

http://www.ncbi.nlm.nih.gov/pubmed/?term=cannabis+and+lung+cancer+risk

Todd W ..... point taken. And absolutely, they can resolve the scientific differences til their blue in the face. No problem. After complete deregulation.

Because regardless of the exact science and bio-mechanisms involved, there is, and never was any credible justification for the prohibition of cannabis in the first place. That`s just a fact.

Prohibition is nothing more than the DEA enforced monopoly on what "We the People" can, and cannot, use for food, medicine, or to get high with if we so choose.

And fine, let the pharmaceutical industry have at it. If they want to make a cannabinoid profile certified whole plant treatment for any number of diseases, ala the GW Pharma approach, for say $2000 for a cancer treatment regime, that`s reasonable. Insurance could cover 75% and the patient could shell out $500 out of pocket. That would be a whole lot better than losing all your savings, your job, your house, everything, after a long, expensive, brutally torturous, and ineffective conventional treatment regime.

And some people will prefer that approach. But many of the rest of us are well acquainted with the various ways cannabis can be consumed as medicine and will continue to make and use it as we please, legal or not.

And unless the authorities_that_shouldn`t_be shut down the internet, it`s a genie that cannot be put back in the bottle.

"And once a majority of world citizenry know this, the for-profit-not-for-healing big cancer industry is going to a multi-billion dollar financial hit."

This has been said about Rife machine treatments, laetrile, Hoxsey therapy, essiac and many other forms of cancer quackery.

"We want to be able to grow this plant for any purpose we so desire."

Obviously. And I don't want to stand in the way of your legal high.

Just stop using cancer patients as a tool to get what you want.

Come on lilady, really?

There has been 50+ years of 100`s of millions of people smoking cannabis on a daily basis around the world. If the was any real threat of cancer, lung or otherwise, from cannabis, smoked, or eaten, the US Gov. would have been able to DEFINITIVELY prove it. Period.

It only took the gov, about 20 years to fully prove tobacco causes cancer, that despite the huge lobbying power of the cigarette industry.

They have not been able to prove a link to lung cancer because it does not exist.

Dangerous Bacon .... the QUACKERY is highly reactive toxins, and x-radiation for cancer..... unless you want to kill EVERYTHING, which it does.

Considering cannabis is mostly smoked in combination with tobacco and tobacco smoking raises the risks of getting lungcancer, it isn't that weird that there might not be much research to prove cannabis raises the cancer risks. It is proven to raise the risks of getting a psychosis.

And don`t get me wrong Bacon ..... your welcome to go for the modern QUACKERY. Enjoy.

Renate ....

A) Cannabis is not usually smoked with tobacco.

B) That would not be a cannabis lung cancer study. That would be a cannabis/tobacco cancer study.

C) If you sprinkle arsenic on your corn flakes you no longer have a healthy breakfast.

Just keep the cannabis away from me. It stinks to high heaven.

Now that it is legal in my state the idiots think they can smoke it anywhere. Even though the law explicitly states it must be done in private. And why do the dolts think that those of us who dislike smelling tobacco smoke think we would be okay dokay about sniffing the stench of their smoke?

Oh, and Danman, because the consumption of cannabis smoke was previously illegal, there could be no studies on lung issues. I suspect that the users may not be quite truthful on their habits to their treating oncologist.

After ten to twenty years of legal usage, then you might get a large enough sample to do an epidemiological study.

And hopefully by then they will realize that toking is as socially acceptable as tobacco smoking in public, so the stench will not invade my breathing space.

There are patients that have beat cancer and other llife threatening disease with cannabis,

Citations needed, Stacey.

There are patients that have beat cancer and other llife threatening disease with cannabis, most have not let the Dr’s give them the poison called chemo, they went straight to the oil [sic] made from the plant tha heals most anything it somes in contact with.

You'll have to excuse me if I wouldn't touch some half-assed butane extraction with a windowpole.

(Fun fact.)

the QUACKERY is highly reactive toxins, and x-radiation for cancer….. unless you want to kill EVERYTHING, which it does.

I assume by this you're referring to current standard-of-care radiation therapy and chemotherapy. I'll point out that there exists a large body of evidence, including large scale clinical studies, demonstrating the efficacy of these as treatments for cancer, alone or as an adjunct to other medical interventions such as surgery.

As no such body of evidence exists which suggests cannabis is effective at treating cancers, it's pretty clear who's promoting quackery here.

There is an official study showing cannabis extracts treated terminal acute lymphoblastic leukemia in the November 2013 Case Reports in Oncology issue (http://ncbi.nlm.nih.gov/pmc/articles/PMC3901602). It actually ruled out spontaneous remission and chemotherapy as potential causes.

I also suggest people check out CannabisExtractReport.com, which includes medical documentation of numerous terminal cancer patients in remission. I'm not going to argue this here, you can see the evidence for yourself and understand how real this is. Doctors, corporations, dispensaries, and small teams are all reporting these remarkable anti-cancer effects. See how deep the evidence is and judge it for yourself.

In breast cancer cells, the CB1 antagonist SR141716 inhibited cell proliferation through the effects of ERK1/2 colocalized inside membrane lipid rafts/caveloae.

THC is a CB1 agonist, Einstein.

Renate ….

A) Cannabis is not usually smoked with tobacco.

Apparently, you don't get out of "The US-of-A" much.

Renate ….

A) Cannabis is not usually smoked with tobacco.

Really? Everyone I knew who smoked cannabis, mixed it with tobacco. I''ve smoked it myself. Well, of course, there is spacecake, but that you don't smoke and I've never eaten it, not felt the need to.

Danman,

Cannabis is not some wonder drug, much as you'd like it to be. As noted above, it does promote psychosis in those predisposed toward it. Also, smoked cannabis, as with any smoked item, increases the risk of diseases of the lung, including cancer.

As to your study showing cancer risk, as also noted already, how exactly were these studies to be done when it was illegal? The study would also need to exclude those who smoke or have smoked tobacco products, since that would confound the results.

Finally, the whole plant would likely not be a particularly good medicinal treatment, since it has not only those compounds that would act as a treatment, but lots of other contaminants that would produce undesired side effects. I agree that it should be studied to see what active compounds can have a medicinal effect, but it is not a panacea.

"In breast cancer cells, the CB1 antagonist SR141716 inhibited cell proliferation through the effects of ERK1/2 colocalized inside membrane lipid rafts/caveloae."

THC is a CB1 agonist, Einstein.

----------------------------------------------

No it`s actually CB1/2
, Forest ....
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931553/table/tbl2/

Cannabis, specifically THC, kills cancer Orac. There is zero doubt. It has been demonstrated endlessly for at least the last 20+ yrs.

Citation needed.

After all, if it has actually been established as fact for 20 years that cannabis cures cancer there must by now be a substantial number of Phase III clinical trials attesting to its efficacy.

No it`s actually CB1/2

I know that. Please try to understand what you're cutting and pasting first before misunderstanding my reply. Jeezums, it was about as dumbed-down as possible already.

Also, smoked cannabis, as with any smoked item, increases the risk of diseases of the lung, including cancer.

In fairness, this is a more complicated question.

Sigh. Anecdotes of cancer cures are not good evidence. I suggest that "Danman" and Justin search this blog for "Stanislaw Burzynski" and "success story" or search it for "cancer testimonial." I've published more posts than I can remember describing how "cancer cure testimonials" almost certainly are not good evidence of a real cancer cure, coming, as they nearly all do, from misunderstandings about cancer.

A brief skim of Justin's case report does not convince me there's compelling dose-response data, contrary to the claim in the report. Also contrary to the claim in the report, spontaneous remission was not ruled out.

Daman, there's a fairly large body of literature regarding the potential of targeting ERK/MAPK pathways to treat cancers, and several large pharamceutical companies have ongoing research programs attemtping to develop novel inhibitors, which have identifed a number of small molecule inhibitors representing different classes.

What suggests cannabinoids as a class are likely to perform as well or better than all other ERK inhibitors?

Come on people, stop with the idiotic paradigms ...... Just because it`s illegal doesn`t mean a definitive link to cancer could not be established. That`s just silly talk.

I repeat;

It only took the gov, about 20 years to fully prove tobacco causes cancer, that despite the huge lobbying power of the cigarette industry.

They have not been able to prove a link to lung cancer because it does not exist.

Allow me to clarify SR141716 for you, Danman: For the grossly simplified level of discussion you apparently require, it's not all that dissimilar to a cannabis version of naloxone.

JGC ...... I think you don`t get it.

Most advocates DON`T care about any more studies. The plant has been researched up one side and down the other. There was never any credible justification for the prohibition of cannabis in the first place, and there is sure no reason today.

Study it for another 80 years. I don`t care. But not under a federal ban.

And if your serious about research, a climate of deregulation is far more conducive than under a restrictive prohibition.

BTW, Daman, re: Dennis Hill? I'll note that he was diagnosed with localized prostate cancer (Stage III--cancer local to the prostate and tissues near the prostate) around 2010. It's hardly surprising that he's still around: for patients with localized cancers adopting watch-and-wait strategies the 5 year survival rate is greater than 90%--there's no reason to attribute his success to the cannabis oil (especially since his case represents an n of one.)

"Most advocates DON`T care about [evidence]."

Fixed that for you, and believe me--I get that.

I get the feeling that neither Danman nor Justin will like part 2 of this series when I get around to it...

Rimonabant, Homer ..... a very bad diet drug.

Most advocates DON`T care about any more studies.

Does that mean that, in your opinion, the term "medical marijuana" is a farce? That the whole attempt to allow doctors to prescribe it and pharmacies/dispensaries to sell it has no provable medical justification? That really, the only reason that people advocate for "medical marijuana" is because they see it as either a stepping stone on the path to full legalization of recreational marijuana or as a path to de facto legalized recreational marijuana, with sufficiently compliant doctors writing scrips?

Is that what you're saying?

Justin: "See how deep the evidence is and judge it for yourself."

_Something_ is piled high and deep and that's for sure.

There is an official study showing cannabis extracts treated terminal acute lymphoblastic leukemia....

"Official"? Anyway, given the prompt death of the patient (blamed on chemotherapy, of course), it doesn't exactly seem to have been a promising therapeutic regime.

The authors do, however, suggest that Rick Simpson has been practicing medicine without a license.

JGG said; "It’s hardly surprising that he’s still around: for patients with localized cancers adopting watch-and-wait strategies the 5 year survival rate is greater than 90%–there’s no reason to attribute his success to the cannabis oil."

It wasn`t a watch and weight situation. His medical people had him setup for chemo. I think they gave him 6 months without treatment.

You think that just happens? Spontaneous remission, with terminal cancer?

Not "no change in 3-4 years" but total remission in less than a year.

Come on stop pretending here, people.

Rimonabant, Homer ….. a very bad diet drug.

You are the one that invoked it as an example of how cannabis cures breast cancer, moron.

You think that just happens? Spontaneous remission, with terminal cancer?

Um, well yeah:
http://www.ncbi.nlm.nih.gov/pubmed/2206563

Honestly, go do some actual research before commenting on stuff you clearly don't understand.

"You think that just happens? Spontaneous remission, with terminal cancer?"

Yes. All.The.Time. Now chances are that it happens to you, personally, quite low. Probability it will happen to someone, quite high.

@Narad

Oh, I agree that the effects of smoked products on the lungs is complex, in terms of the degree of impact, but from what I understand, the effects of inhaling smoke from combusted items acts as an irritant on lung tissue, thereby increasing the risk of lung-oriented diseases compared to those who do not inhale that smoke.

@Danman

[The government has] not been able to prove a link to lung cancer because it does not exist.

Or they just haven't spent the money to examine the question to the degree necessary. From studies that have been done, we actually don't know what the dose threshold is for cancer risk. We do know that it does have a negative impact on airflow. (see, e.g., http://www.ncbi.nlm.nih.gov/pubmed/24384575) Certainly the risk of lung cancer is plausible.

Most advocates DON`T care about any more studies.

Thankfully, physicians and researchers do care about more studies so they can find out what it does and does not work for, at what doses, and what the side effects are.

Mephistopheles O'Brien said; ...... "Does that mean that, in your opinion, the term “medical marijuana” is a farce? That the whole attempt to allow doctors to prescribe it and pharmacies/dispensaries to sell it has no provable medical justification?"

No doctors do not have the right to prescribe cannabis, any more than they have a right to prescribe carrots.

It`s a nutrient. And as a matter of fact if it`s not decarbed, it has no psycho-activity at all.

Now if they want to just recommend cannabis, that`s fine.

You think that just happens? Spontaneous remission, with terminal cancer?

It can, but more likely what happened is that the doctors were mistaken about the prognosis. That happens all the time.

Can you define 'nutrient,' danman?

However, Danman is quite wrong when he says that spontaneous regression of advanced cancer never occurs:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946665/

And:

http://www.ncbi.nlm.nih.gov/pubmed/24616911

AdamG said; ....."Can you define ‘nutrient,’ danman?"

No Adam, but you can. Just by a simple Google search.

Good luck, let us know what you find ....

Good luck, let us know what you find

You're cute! According to M-W, a nutrient is

a substance that plants, animals, and people need to live and grow

Now, can you please describe how cannabis fits this definition? do people need it to live and grow?

ROTFLMAO!!! .......Oh yes, I`m sure your doctor mentions Spontaneous Remission in the treatment plan all the time .....

Well Mr Smith, I`m sorry but the bone marrow killing chemo didn`t work, the radiation failed, our experimental treatment was a flop ...... But there`s always Spontaneous Remission!!! Good luck!!!

Good work Adam!!!

You`re one step closer to your answer, Grasshopper .....

For your next assignment find out how much protein is in a single tablespoon of cannabis seeds ......

For your next assignment find out how much protein is in a single tablespoon of cannabis seeds

Of course there's protein in cannabis, cupcake. PROTEIN is a nutrient. Cannabis is not. See the distinction?

And as a matter of fact if it`s not decarbed [sic], it has no psycho-activity at all.

Oh, for G-d's sake. You've already demonstrated that you think anything that mentions an endocannabinoid receptor is an automatic recommendation for smoking grass, even if it says the opposite (leaving aside any issue of getting it to the target in the first place).

Do yourself a favor and don't bother with aimless digressions into decarboxylation of THC acid (which might be interesting in and of itself, although I'm not going looking), particularly given that you're technically even wrong about this if one considers sedation a "psychoactive" effect.

No doctors do not have the right to prescribe cannabis, any more than they have a right to prescribe carrots.

The state of Illinois would disagree with that. Some states use the term "recommend" rather than "prescribe", prohibiting sales to persons without a doctor's recommendation. This provides an equivalent control to prescription, and I see minimal difference but you may believe otherwise.

Regardless, can I assume you agree with my basic conclusion - that backers of "medical marijuana" only really care about using that to gain effective legalization of recreational marijuana?

"Of course there’s protein in cannabis, cupcake. PROTEIN is a nutrient. Cannabis is not. See the distinction?"

No. Explain.

But there`s always

Just out of curiosity, what part of "The US-of-A" systematically and bizarrely eschews apostrophes?

Mephistopheles O'Brien ... do you have a learning disability?

Did you read any of my previous comments?

Here I`ll put it in caps so you can see it clearly;

THERE WAS NEVER A JUSTIFICATION FOR PROHIBITION IN 1937. AND THERE IS UNEQUIVOCALLY NO JUSTIFICATION TODAY.

I have no regard for any state, nor the federal ban. I, like millions around the world are going to do and use this plant however we choose, and for whatever we choose. Legal or not.

Is that clear?

Did you read any of my previous comments?

Here I`ll put it in caps so you can see it clearly

"It"? You've been running away from failed assertions willy-nilly. If you just had a claim that it is an illegitimate function of a state (construed broadly) to regulate The Herb, you could have said that and been done with it rather than making a sustained ass out of yourself.

Egad the stupid it burns.

Saying cannibis is a nutrient is a bit like saying my chair is a carbon atom.

There are nutrients in a cannibis plant (which you absorb by eating the plant, not smoking it). Macronutrients like protein and micronutrients like minerals and vitamins.

But just like my chair has a lot of things in it that are not carbon atoms any plant has a lot of things in it that are not nutrients.

You might say cannibis is nutritious as it has nutrients in it (assuming it has as much as any vegetable) but it is not a nutrient. Certainly not a single individual nutrients.

Although how many macronutrients and vitamins you get from a very tiny amount may not make a big difference in your diet. After all people don't normally eat cups of the leaves, nor do they usually eat the seeds to get high, even though seeds tend to be nutrient dense to help the new baby plant grow.

Chris: Just keep the cannabis away from me. It stinks to high heaven.

Seconded.

Danman: No doctors do not have the right to prescribe cannabis, any more than they have a right to prescribe carrots.

Fun fact, the 'carrots lead to better eyesight' theory was actually just government propaganda. The British needed to explain how their planes kept shooting German planes down at night. While cannabis may have some medical benefits (improving appetite in certain patients) I doubt it's a cure-all.

Danman's whole point seems to be that he likes cannabis. Therefore all positive claims about it are true, and all negative ones are false. Everyone who disagrees with any claim he makes automatically agrees with everything that is incorrect.

Egad the stupid it burns ..... yes it does KayMarie.

Like not being able to spell CANNABIS correctly then carrying on as though you know what your talking about.

madder said; ...... "Danman’s whole point seems to be that he likes cannabis"

Hot Damn that`s FN brilliant, madder.

Your an FN genius dude .... But that`s not my point.

A spelling troll, one of the lowest of the trolls. And yes, I usually end up committing a meme when using one.

At least my elementary school science and English teachers taught me the definition of nutrient and how it differs from a whole plant. I may have missed the spell the illegal drug properly lesson, but seems you missed a few more.

You might say cannibis is nutritious as it has nutrients in it (assuming it has as much as any vegetable)....

It's not much of a vegetable* as far as I can tell, for which the only sensible interpretation is the leafy portion. All the claims seem to be more random burbling about endogenous cannabinoid receptors magically inducing a flood of antioxidants. (NN, of course, has an item about juicing it; I didn't look to see whether it was lifted from the plethora of similar ones or vice versa.)

The crude leaf is basically rank as a foodstuff; the standard extraction for cooking purposes is to dry and then hold at a simmer in an oil–water mix, which limits the temperature and at least partially washes out the water-soluble components. The end product is waxy (which screws up standard baking recipes) and still desperately in need of flavor masking.

One can natter on all day about the EFA profile of the seeds, but this has very little to do with the medical claims, aside from being inversely correlated with the price of weed on the corner.

* Other than the time that Grady made a salad out of "wild parsley" on Sanford and Son.

Ya know, you geniuses here at Scienceblogs should let those silly guys at GW Pharmaceuticals know they`re just wasting time and money on this cannabis stuff .....

http://www.faqs.org/patents/assignee/gw-pharma-limited/

Egad the stupid it burns ….. yes it does KayMarie.

Like not being able to spell CANNABIS correctly then carrying on as though you know what your talking about.

I'd say that not knowing the difference between an agonist and an antagonist and "then carrying on as though you know what your [sic] talking about" is rather more damning.

Ya know, you geniuses here at Scienceblogs should let those silly guys at GW Pharmaceuticals know they`re just wasting time and money on this cannabis stuff …..

Oh, Jeezums, nobody expects the Spatent Inquisition.

Needless to say, Danman didn't look too closely at his list (which he likely blindly picked up from, oh, say, cureyourowncancer-dot-org or "Herblover's public profile"). Why anybody is supposed to be impressed by patent applications is an open question, but let's consider one, No. 20100317729: "New Pharmaceutical Formulation comprising Cannabidiol and Tetrahydrocannabidivarin."

Guess what THCV is? Yup, another antagonist. Paragraph 21 is rich:

In the applicant's co-pending International patent application WO 2005/120478, the application describes that THCV could be used in place of THC. It has been subsequently found that this is not the case. THCV has been discovered to work as a CB1 receptor antagonist, which is completely opposite from THC which acts as a CB1 agonist.

Whatever, patent the whole lot. In any event, the thing is effectively a demonstration of the irrelevance of THC per se.

I suppose I might as well wrap it up with something that has actually received a U.S. patent in this regard.

Narad said; ....... "In the applicant’s co-pending International patent application WO 2005/120478, the application describes that THCV could be used in place of THC. It has been subsequently found that this is not the case. THCV has been discovered to work as a CB1 receptor antagonist, which is completely opposite from THC which acts as a CB1 agonist.

Whatever, patent the whole lot. In any event, the thing is effectively a demonstration of the irrelevance of THC per se."

All that means is that for cancer, strains with low THCV and THC should be used if possible. Or more likely if you have a high THC strain, the plant inherently will have less THCV.

And this is well supported by cannabis caregivers who report that no significant tumor reduction starts until they have high THC content oils/edibles for their patients.

All that means is that for cancer, strains with low THCV and THC should be used if possible.

Holy F*cking Christ, you're stupid. No, the patent is about increasing THCV.

I can't wait to hear how these 'caregivers' are measuring tumor size, let alone how and where they're 'reporting' this data.

I can’t wait to hear how these ‘caregivers’ are measuring tumor size

How many joints are in a lid?

You-must-be-f*cking-stupid ......... agonist is good. THC is an agonist. THC promotes receptor activity and cancer killing ceramide production.

Antagonist is bad, like Rimonabant. It inhibits receptor activity and causes side effects.

So, Narad the Savant, if you were formulating a cannabis medicine and you knew one of the naturally occurring cannabinoids in the plant (THCV) was an antagonist, possibly working against the goal of receptor activity, you would try and limit the percentage of the cannabinoid.

That was my point. I can`t make it any more simple for you.

AdamG ..... "I can’t wait to hear how these ‘caregivers’ are measuring tumor size, let alone how and where they’re ‘reporting’ this data."

Join some of the Facebook groups. Cannabis Oil Success Stories has 36,000 members. Many cancer CO success stories. Some patient post scans, others post reports, others just post their personal accounts ... unless of course people just come there to lie and make stuff up.

That was my point. I can`t make it any more simple for you.

Then why the fυck are you repeatedly citing shіt that crucially depends on endocannabinoid receptor antagonism to try to demonstrate specific anticancer effects from fυcking blowing weed, which really does not seem to have treated your head all that fυcking well, given this collection of pratfalls?

Well i am fighting lung cancer with chemo and cannabis oil. I have been on the oil for about 3 months now, the only side effect i have is hair loss and it is on its way back. Before the oil i could not sleep, had high blood pressure and terrible nose bleeds. I don't know if it is a cure or not but the way i see it it sure can't hurt any...Legalize Now!!

Narad said; How many joints are in a lid?

Thirty ..... roughly half your IQ.

Not fucking talking about smoking it for cancer, Naradhole .... must be eaten to get enough THC to cause significant ceramide synthesis ....

No where on this blog did I say smoking it will cure cancer .... LIAR

Thirty ….. roughly half your IQ.

Although the joke* was indirectly about you, I will congratulate you on possessing adequate cognitive function to instantly know how many grams there are in an ounce while ciphering your way there and back.

* It's a Cheech & Chong reference.

Join some of the Facebook groups. Cannabis Oil Success Stories has 36,000 members. Many cancer CO success stories. Some patient post scans, others post reports, others just post their personal accounts … unless of course people just come there to lie and make stuff up.

A naive person who experience of the world has all been through a haze of marijuana smoke might well believe this false dichotomy, that either these patients are deliberately lying or everything they are saying is true.

However, someone who does not understand why a patient with a serious medical condition might post a glowing testimonial claiming that their condition is much better and they're almost certainly not going to die of it now, and actually believe everything they're saying is the absolute and complete truth, and it doesn't mean that their story is the absolute and complete truth, is a very naive person indeed.

do you have a learning disability?

Not that I'm aware of, thanks for asking. I learn better than many, less well than most. I do have many friends with various diagnosed learning disabilities (e.g. dyslexia); I'm sure they would appreciate your question as well.

THERE WAS NEVER A JUSTIFICATION FOR PROHIBITION IN 1937. AND THERE IS UNEQUIVOCALLY NO JUSTIFICATION TODAY.

This of course is completely different from the point you appeared to have been making, which is why I asked. You brought up a number of studies and patent applications regarding the medical use of cannabis and various compounds extracted from or derived from cannabis. You also brought up a number of testimonials for how well these products worked to treat various medical conditions. However, when people said that more research was needed to prove cannabis was effective as a treatment, you stated, "Most advocates DON`T care about any more studies." This suggests to me that either the medical benefits are proven (which they aren't, even according to many of the papers you cited) or that the whole discussion was unrelated the actual agenda.

I have no regard for any state, nor the federal ban. I, like millions around the world are going to do and use this plant however we choose, and for whatever we choose. Legal or not.

I recall Jesse James saying something similar.

"THC promotes receptor activity and cancer killing ceramide production.

and

must be eaten to get enough THC to cause significant ceramide synthesis

Citations needed, danman. Can you provide cites for studies in validated animal models (e.g., xenotransplants in SCID mice) where feeding subjects cannabis or giving them THC via oral administration reduced tumor burden, prolonged survival, etc., compared to untreated controls?

I mean, you do have SOME actual evidence to support your claims...right?

JGC said "I mean, you do have SOME actual evidence to support your claims…right?"

I thought you`d never ask .... :-)

This is just one. Since the DEA is aware of some 10,000 peer reviewed studies, as of 2007, I`m quite sure there are thousands of repeats since 1974. Up until recently, under prohibition, no human trials have been conducted. But I think it`s safe to assume research, when possible, would certainly have been done with mice.

http://www.alternet.org/story/9257/pot_shrinks_tumors%3B_government_kne…
"In 1974 researchers at the Medical College of Virginia, who had been funded by the National Institute of Health to find evidence that marijuana damages the immune system, found instead that THC slowed the growth of three kinds of cancer in mice -- lung and breast cancer, and a virus-induced leukemia"

I don`t think they knew the bio-mechanism (ceramide induced apoptosis) But cannabis science researchers more recently are well aware of the significance of ceramide with Cannabinoid medicine;
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770515/

"It is becoming increasingly obvious that ceramide functions as a physiological signaling molecule, particularly with regard to the control of apoptosis, but also growth arrest, differentiation, cell migration, and adhesion. Activation of either CB1 or CB2 in glioma cells is associated with an increase in ceramide levels leading to the activation of the extracellular signal-regulated kinase (ERK) pathway via Raf-1 activation and p38 MAPK activation.14,106 Both these pathways ultimately cause apoptosis through caspase activation and/or cell-cycle arrest"

And I know this absolutely to be the case, first hand. A friend of mine has Non-Hodgkins Lymphoma, diagnosed early this year. Early stage, and slow growing according their medical peeps, thankfully. The PC of course said chemo. The friend said no I`m going to try cannabis oil first. If it doesn`t help then we`ll consider chemo. The PC was at first hesitant, but reluctantly gave the nod.

I told the friend about the THC ceramide connection and how it in theory could be used to plot cancer cell death during treatment with CO. I also suggested that if your insurance will pay for it then include it with other blood work. So over a month they did 3 draws and profiles, with ceramide included. The second draw, two weeks after they started the oil showed, according to their PC "significant increases in blood ceramide levels and a sharp drop in tumor markers". The third test showed further increases in ceramide, but not as dramatic. They`re taking a high THC grain alcohol extract mixed with coconut oil taken orally 3x daily.

You do realize, don't you, that your anecdote proves pretty much nothing about whether cannabis oil has any efficacy against lymphoma. Ceramide is not a clinically validated biomarker for lymphoma, Hodgkins or non-Hodgkins. Moreover, tumor markers often fluctuate. Moreover, you yourself say that this is an early stage, slow growing tumor, which are exactly the sort of tumors that can appear to be having a response when they are not.

You'll have to do better than that.

Do these people even read their own cites? For god's sake the last line of the abstract is

Overall, there is still a great deal of conflicting evidence around the future utility of the cannabinoids, natural or synthetic, as therapeutic agents.

"Do these people even read their own cites?"

I believe that they are passed around on their own special forums, and many just do not go back and actually read what was on the actual webpage.

I recently encountered someone who posted a link and then a quote. The problem was that the quote he posted did not match what was written on the actual link. He insisted that he did not delete any words and how could we call him out on it!

Then there are those that will read it and not understand the actual words. Much like the anti-vax folks that claim diseases were going away before the vaccine was available and their proof is a graph of mortality, not morbidity. Basic vocabulary fail.

Orac said; ...... "Ceramide is not a clinically validated biomarker for lymphoma"

Duh ... Why are you playing dumbass? Of course Ceramide is not a biomarker for lymphoma specifically! It`s a direct marker for apoptosis generally! Why in the f*ck are you pretending like you don`t understand how significant that is?

You REALLY can`t understand how the normal process of cell death, cancerous or not, must be a major factor in ones overall health? And that a non-toxic plant that helps the immune system identify and target unhealthy cells, even cancerous, for apoptosis, would, and in reality is, quite beneficial for a variety of maladies?

And I haven`t even gotten into CBD. Even MSM hack Sanjay Gupta is on the CDB bandwagon for epilepsy. Why do think there are so many states coming on board, with at least "CBD Only" laws? The state prohibition dominoes are going down one after another. Possibly half the US could be
either, medical, or legal after the national midterms.

THC kills cancer cells by driving ceramide synthesis and apoptosis. That is a fact. I`ve more than made my case. I`ve demonstrated that professional researchers know this to be fact, and are very interested. I`ve provided the testimony of a scientific professional and his experience curing his own prostate cancer, and very eloquently explaining the role of THC and ceramide in cannabis oil cancer treatment.

Game, Set, Match ... you lose.

But you folks here at agendablog ......... oh I`m sorry, I meant scienceblog ..... can play ostrich as long you want.

But you folks here at agendablog

What the hell do you think the 'agenda' actually is? I personally am completely in favor of legalization. I know it can work as I live somewhere where it's already legal. I just believe we should take a measured approach when it comes to health claims regarding this natural product, just like I would for health claims surrounding any natural product, legal or otherwise.

AdamG said; ....... Do these people even read their own cites? For god’s sake the last line of the abstract is

"Overall, there is still a great deal of conflicting evidence around the future utility of the cannabinoids, natural or synthetic, as therapeutic agents"

Yawn ........ so what? That`s called scientific process. Every scientific theory has conflicting evidence. Edward Teller was said to be taking bets on whether they would incinerate the whole atmosphere, instead of just a piece of it at Alamogordo NM with the first A-test.

Uh, Danman, I'm a cancer surgeon AND a cancer researcher. I've forgotten more about apoptosis to make room for new science and new findings on apoptosis than you know now or will ever know. Back in the late 1990s, although I didn't work on a ceramide-related project, others in the lab did; so I heard about it during lab meetings every week.

Also, when it comes to biomarkers, it doesn't matter what the biomarker is. It still has to be validated in clinical studies to demonstrate that it has prognostic significance or predicts response to therapy. I don't care that it's a "general marker for apoptosis." That matters not one whit unless it's clinically validated.

Real cancer researchers and cancer doctors understand that. You, obviously, do not.

Every scientific theory has conflicting evidence.

Yes, but that's not evidence that your particular theory is true. Don't you see that I could use the same exact argument? "Well, there's conflicting evidence like every scientific theory, but it's definitely true without a doubt that there are no medicinal qualities to cannabis."

Until there's more research, we can't make the kind of claims that you are. That's why we need more research, particularly clinical trials. I believe that legalization, which should happen on its own merits, will lead to much higher quality research on this issue. That's one of the reasons I support legalization.

What part of this do you have an issue with? Why is this unreasonable?

I live in the same state as AdamG, and I voted for legalization. I don't care if you partake as long as you follow two simple requests:

1. Do it far away from me so I don't have to smell the stench of its smoke.

2. Don't make medical claims that you cannot support with verifiable citations (this assumes that you have actually read and understood the full paper).

Is that too much to ask?

By the way a couple of editorials from the local paper:

http://seattletimes.com/html/editorials/2024240972_editmarijuana05xml.h…

http://blogs.seattletimes.com/opinionnw/2014/07/30/smoking-marijuana-in…

Read them, and please learn to not be a jerk.

Adam ........ within the first paragraph the author whips out the term "quackademic".

You don`t see agenda there Adam?

THC kills cancer cells by driving ceramide synthesis and apoptosis. That is a fact. I`ve more than made my case.

You posted a review article that (1) you immediately demonstrated you couldn't even understand, (2) devotes a whopping two paragraphs to the ceramide angle, and (3) isn't really particularly interested in THC in the first place:

Cannabinoids are not yet approved for the treatment of tumor progression, although their antitumorigenic effects have been known for over 30 years.[52] Cannabinol and Δ⁸-THC inhibited tumor growth in a mouse model of Lewis lung adenocarcinoma after 20 days of treatment, whereas cannabidiol or Δ⁹-THC failed to show any effect.[52] ... In contrast, there are reports of pro-cancerous activity in breast, bronchial, hepatoma, and lung cell lines (Table 3).

You just see "cannabinoid receptor" and stupidly jump to "weed!" Agonist, antagonist, you can't be bothered to sort it out.

within the first paragraph the author whips out the term “quackademic”.

You don`t see agenda there Adam?

First of all, that's in reference to an entirely different subject (But I bet you have some...interesting thoughts about TCM too). Second of all, In the very next paragraph Orac clearly states his position with regards to legalization, namely that he's for it. So again, what is the agenda here? Why do you refuse to concretely state exactly what this supposed 'agenda' is?

Chris said; ..... "I live in the same state as AdamG, and I voted for legalization. I don’t care if you partake as long as you follow two simple requests:

1. Do it far away from me so I don’t have to smell the stench of its smoke.

2. Don’t make medical claims that you cannot support with verifiable citations (this assumes that you have actually read and understood the full paper).

A) You need to pay attention, understand, and acknowledge, that for the medicinal properties that I have cited, and many others I have not, which are supported by ABUNDANT PEER REVIEWED SCIENCE, along with countless thousands of patient reports worldwide, SMOKING WILL NOT BE EFFECTIVE ...... do understand that? The plant needs to be EATEN ...... NOT SMOKED.

B) I can sympathize with your right to not inhale second cannabis smoke, but PLEASE stop being a jerk and bellowing on about it.

within the first paragraph the author whips out the term “quackademic”.

You don`t see agenda there Adam?

"First of all, that’s in reference to an entirely different subject"

That`s called setting tone. Then, in the end he tries to link Cannabis Science to Chinese Herbalism, which he has already declared to be "quackademic" in the intro.

It`s a hit piece.

I'm sorry Danman, but you haven't presented anything here that contradicts Orac's claim that "it’s about belief first, and then trying to get the science to to support its magical properties."

In fact, you've provided a perfect example. You presented a single article that, in it's conclusion, states "Overall, the cannabinoids may show future promise in the treatment of cancer, but there are many significant hurdles to be overcome."

All we're doing is agreeing with the authors of your own citation. There are indeed many significant hurdles to overcome. You, however, have somehow twisted this article into definitive proof of medicinal benefit, without once acknowledging that more work is needed. In fact, you've basically condemned any further research. Isn't this exactly the kind of thinking that Orac calls out?

Oh wow, this one's in too deep. In addition to turning a list of "Peer-reviewed Articles on Cannabinoids and Cancer" into a list of 625 studies "in support" of the idea that "Cannabis Cures Cancer and whole lot of other diseases"

Danman even goes on to state

Cannabis is a medical panacea that you can grow in your own backyard.

and

The little "research" showing a link to mental illness was discredited, as lacking any credibility due to lousy scientific method, and small test numbers.

If that's really how you feel about the current state of the literature you really have no business discussing this topic whatsoever. Please, I implore you, just give that last link a good read.

"You need to pay attention, understand, and acknowledge, that for the medicinal properties that I have cited, and many others I have not, which are supported by ABUNDANT PEER REVIEWED SCIENCE, along with countless thousands of patient reports worldwide, SMOKING WILL NOT BE EFFECTIVE …… do understand that? The plant needs to be EATEN …… NOT SMOKED. "

Prove it. So far you have failed.

And you are being a jerk.

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http://weedbay.net/index.php/component/content/article/1974

ADD/ ADHD
Marijuana and ADD Therapeutic uses of Medical Marijuana in the treatment of ADD
http://www.onlinepot.org/medical/add&mmj.htm

Cannabis as a medical treatment for attention deficit disorder
http://www.chanvre-info.ch/info/en/...-treatment.html

Cannabinoids effective in animal model of hyperactivity disorder
http://www.cannabis-med.org/english...el.php?id=162#4

Cannabis 'Scrips to Calm Kids?
http://www.foxnews.com/story/0,2933,117541,00.html

Addiction risk- Physical
Women's Guide to the UofC
http://wguide.uchicago.edu/9substance.html

Cannabis Basics
http://www.erowid.org/plants/cannab...is_basics.shtml

10 Things Every Parent, Teenager & Teacher Should Know About Marijuana (4th Q)
http://www.erowid.org/plants/cannab...is_flyer1.shtml

Marijuana Myths, Claim No. 9
http://www.erowid.org/plants/cannab...bis_myth9.shtml

AIDS – see HIV

Alcoholism
Role of cannabinoid receptors in alcohol abuse
http://www.medicalnewstoday.com/articles/30338.php

Cannabidiol, Antioxidants, and Diuretics in Reversing Binge Ethanol-Induced Neurotoxicity
http://jpet.aspetjournals.org/cgi/c...ourcetype=HWCIT

Cannabis substitution
http://www.cannabis-med.org/studies...how.php?s_id=86

Cannabis as a Substitute for Alcohol
http://ccrmg.org/journal/03sum/substitutealcohol.html

ALS
Cannabinol delays symptom onset
http://www.ncbi.nlm.nih.gov/sites/e...t_uids=16183560

Marijuana in the management of amyotrophic lateral sclerosis
http://www.medscape.com/medline/abstract/11467101

Cannabis use in patients with amyotrophic lateral sclerosis.
http://www.medscape.com/medline/abstract/15055508

Cannabis Relieves Lou Gehrigs Symptoms
http://www.rense.com/general51/lou.htm

Cannabis' Potential Exciting Researchers in Treatment of ALS, Parkinson's Disease
http://66.218.69.11/search/cache?ei...&icp=1&.intl=us

Alzheimers
MARIJUANA SLOWS ALZHEIMER'S DECLINE
http://www.mapinc.org/drugnews/v05/n307/a10.html

Marijuana may block Alzheimer's
http://news.bbc.co.uk/2/hi/health/4286435.stm

Prevention of Alzheimer's Disease Pathology by Cannabinoids
http://www.jneurosci.org/cgi/content/abstract/25/8/1904

Marijuana's Active Ingredient Shown to Inhibit Primary Marker of Alzheimer's Disease
http://www.pacifier.com/~alive/articles/ca060809.htm

Dronabinol in the treatment of agitation in patients with Alzheimer’s disease with anorexia
http://www.cannabis-med.org/studies...how.php?s_id=61

Dronabinol in the treatment of refractory agitation in Alzheimer’s disease
http://www.cannabis-med.org/studies...how.php?s_id=92

Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer's disease.
http://www.cannabis-med.org/studies...how.php?s_id=59

Cannabinoids reduce the progression of Alzheimer's disease in animals
http://www.cannabis-med.org/english...el.php?id=187#1

Molecular Link between the Active Component of Marijuana and Alzheimer's Disease Pathology
http://www.unboundmedicine.com/medl...sease_Pathology

THC inhibits primary marker of Alzheimer's disease
http://www.cannabis-med.org/english...el.php?id=225#3

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Amotivational Syndrome
Amotivational Syndrome
http://leda.lycaeum.org/?ID=12454

Marijuana Myths, Claim No. 11
http://www.erowid.org/plants/cannab...is_myth11.shtml

Debunking 'Amotivational Syndrome'
http://www.mapinc.org/drugnews/v06/n400/a06.html

Amotivational Syndrome
http://www.bookrags.com/Amotivational_syndrome

Debunking the Amotivational Syndrome
http://www.drugscience.org/Petition/C3F.html

Cannabis Use Not Linked To So-Called "Amotivational Syndrome"
http://www.norml.org/index.cfm?Grou...tm_format=print

Anecdotal Evidence/First person stories
Shared Comments and Observations
http://www.rxmarihuana.com/comments...bservations.htm

Cannabis Sativa (Marijuana) for Fibromyalgia
http://www.fibromyalgia-reviews.com/Drg_Marijuana.cfm

ANECDOTAL ARTICLES
http://cannabislink.ca/medical/#medanecdotal

Testimonials
http://www.benefitsofmarijuana.com/testimonials.html

Excerpts of testimonials.
http://www.ganjaland.com/freemedicalseeds.htm

Appetite Stimulant
Dronabinol an effective appetite stimulant?
http://www.cannabis-med.org/studies...ow.php?s_id=188

THC improves appetite and reverses weight loss in AIDS patients
http://www.cannabis-med.org/studies...ow.php?s_id=189

Efficacy of dronabinol alone and in combination
http://www.cannabis-med.org/studies...ow.php?s_id=191

Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep.
http://www.cannabis-med.org/studies...ow.php?s_id=190

The synthetic cannabinoid nabilone improves pain and symptom management in cancer patients
http://www.cannabis-med.org/studies...ow.php?s_id=177

Dronabinol for supportive therapy in patients with malignant melanoma and liver metastases
http://www.cannabis-med.org/studies...ow.php?s_id=180

Safety and efficacy of dronabinol in the treatment of agitation in patients with Alzheimer’s disease
http://www.cannabis-med.org/studies...how.php?s_id=61

The perceived effects of smoked cannabis on patients with multiple sclerosis.
http://www.cannabis-med.org/studies...how.php?s_id=13

Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer's disease
http://www.cannabis-med.org/studies...how.php?s_id=59

Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS.
http://www.cannabis-med.org/studies...how.php?s_id=21

Delta-9-tetrahydrocannabinol for appetite stimulation in cancer-associated anorexia
http://www.cannabis-med.org/studies...how.php?s_id=52

Effect of dronabinol on nutritional status in HIV infection.
http://www.cannabis-med.org/studies...ow.php?s_id=150

Dronabinol stimulates appetite and causes weight gain in HIV patients.
http://www.cannabis-med.org/studies...how.php?s_id=20

Dronabinol effects on weight in patients with HIV infection.
http://www.cannabis-med.org/studies...how.php?s_id=45

Recent clinical experience with dronabinol.
http://www.cannabis-med.org/studies...how.php?s_id=90

Dronabinol enhancement of appetite in cancer patients.
http://www.cannabis-med.org/studies...ow.php?s_id=149

Effects of smoked marijuana on food intake and body weight
http://www.cannabis-med.org/studies...ow.php?s_id=117

Behavioral analysis of marijuana effects on food intake in humans.
http://www.cannabis-med.org/studies...ow.php?s_id=118

Cancer-related anorexia-cachexia syndrome
http://www.unboundmedicine.com/medl...xia_Study_Group

THC effective in appetite and weight loss in severe lung disease (COPD)
http://www.cannabis-med.org/english...el.php?id=191#2

Machinery Of The 'Marijuana Munchies'
http://www.sciencedaily.com/release...51226102503.htm

Arthritis
Cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis
http://www.pnas.org/cgi/content/full/97/17/9561

The Cannabinergic System as a Target for Anti-inflammatory Therapies
http://www.ingentaconnect.com/conte...000013/art00008

Sativex in the treatment of pain caused by rheumatoid arthritis
http://rheumatology.oxfordjournals....bstract/45/1/50

Suppression of fibroblast metalloproteinases by ajulemic acid,
http://ccicnewsletter.com/index.php...06_Rheumatology

The antinociceptive effect of Delta9-tetrahydrocannabinol in the arthritic rat
http://www.unboundmedicine.com/medl...binoid_receptor

Synergy between Delta(9)-tetrahydrocannabinol and morphine in the arthritic rat
http://www.unboundmedicine.com/medl...e_arthritic_rat

Cannabis based medicine eases pain and suppresses disease
http://www.medicalnewstoday.com/articles/33376.php

Pot-Based Drug Promising for Arthritis
http://www.webmd.com/rheumatoid-art...g-for-arthritis

Asthma
The Cannabinergic System as a Target for Anti-inflammatory Therapies
http://www.ingentaconnect.com/conte...000013/art00008

Acute and subacute bronchial effects of oral cannabinoids.
http://www.cannabis-med.org/studies...how.php?s_id=44

Comparison of bronchial effects of nabilone and terbutaline
http://www.cannabis-med.org/studies...how.php?s_id=43

Bronchial effects of aerosolized delta 9-tetrahydrocannabinol
http://www.cannabis-med.org/studies...ow.php?s_id=109

Bronchodilator effect of delta1-tetrahydrocannabinol administered by aerosol
http://www.cannabis-med.org/studies...how.php?s_id=60

Effects of smoked marijuana in experimentally induced asthma.
http://www.cannabis-med.org/studies...how.php?s_id=57

Marijuana and oral delta9-tetrahydrocannabinol on specific airway conductance
http://www.cannabis-med.org/studies...how.php?s_id=67

New Synthetic Delta-9-THC Inhaler Offers Safe, Rapid Delivery
http://www.medicalnewstoday.com/articles/22937.php

Smoked marijuana and oral delta-9-THC on specific airway conductance in asthmatic subjects
http://www.ukcia.org/research/Smoke...InAsthmatic.php

Atherosclerosis

Marijuana Chemical Fights Hardened Arteries
http://www.webmd.com/heart-disease/...rdened-arteries

Does Cannabis Hold the Key to Treating Cardiometabolic Disease
http://www.medscape.com/viewarticle/525040_print

Cannabis may keep arteries clear
http://www.gnn.tv/headlines/2634/Ca..._arteries_clear

The Cannabinergic System as a Target for Anti-inflammatory Therapies
http://www.ingentaconnect.com/conte...000013/art00008

Cannabis compound tackles blood vessel disease
http://www.medicalnewstoday.com/articles/22658.php

Medical marijuana: study shows that THC slows atherosclerosis
http://thenexthurrah.typepad.com/th...al_marijua.html

Cardiovascular Effects of Cannabis
http://www.idmu.co.uk/canncardio.htm

Atrophie Blanche
Atrophie Blanche Treated With Cannabis and/or THC
http://ccrmg.org/journal/04spr/clinical.html#thm

Autism
Autism and Medical Marijuana
http://www.autism.org/marijuana.html

THE SAM PROJECT: James D.
http://www.letfreedomgrow.com/articles/james_d.htm

Medical marijuana: a valuable treatment for autism?
http://www.autismwebsite.com/ari/ne...r/marijuana.htm

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Cancer – breast
Anandamide inhibits human breast cancer cell proliferation
http://www.pnas.org/cgi/content/abstract/95/14/8375

Inhibition of Human Breast and Prostate Cancer Cell Proliferation1
http://endo.endojournals.org/cgi/co...tract/141/1/118

Antitumor Activity of Plant Cannabinoids
http://jpet.aspetjournals.org/cgi/c...ract/318/3/1375

9-Tetrahydrocannabinol Inhibits Cell Cycle Progression in Human Breast Cancer
http://cancerres.aacrjournals.org/c...ract/66/13/6615

Cannabidiol inhibits tumour growth in leukaemia and breast cancer
http://www.cannabis-med.org/english...el.php?id=220#2

THC and prochlorperazine effective in reducing vomiting in women following breast surgery
http://www.cannabis-med.org/english...el.php?id=219#1

Cancer- colorectal
Anandamide, induces cell death in colorectal carcinoma cells
http://gut.bmj.com/cgi/content/abstract/54/12/1741

Cannabinoids and cancer: potential for colorectal cancer therapy.
http://www.medscape.com/medline/abstract/16042581

Cancer- glioma/ brain
Anti-tumor effects of cannabidiol
http://www.hempworld.com/HempPharm/...milanstudy.html

Pot’s cancer healing properties
http://www.november.org/stayinfo/br...ncerKiller.html

Cannabinoids Inhibit the Vascular Endothelial Growth Factor Pathway in Gliomas
http://cancerres.aacrjournals.org/c...hort/64/16/5617

Inhibition of Glioma Growth in Vivo
http://cancerres.aacrjournals.org/c.../61/15/5784.pdf

Delta(9)-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme.
http://www.cannabis-med.org/studies...ow.php?s_id=193

Cannabidiol triggers caspase activation and oxidative stress in human glioma cells.
http://www.ihop-net.org/UniPub/iHOP...l?pmid=16909207

Cannabinoid receptors in human astroglial tumors
http://www.brainlife.org/abstracts/...t_j20060800.pdf

Cannabis extract makes brain tumors shrink, halts growth of blood vessels
http://www.medicalnewstoday.com/articles/12088.php

THC tested against brain tumour in pilot clinical study
http://www.cannabis-med.org/english...el.php?id=222#1

Cancer- leukemia
Cannabis-induced cytotoxicity in leukemic cell lines
http://bloodjournal.hematologylibra...ract/105/3/1214

Cannabidiol-Induced Apoptosis in Human Leukemia Cells
http://molpharm.aspetjournals.org/c...stract/70/3/897

Marijuana's Active Ingredient Kills Leukemia Cells
http://www.treatingyourself.com/vbu...read.php?t=7107

Targeting CB2 cannabinoid receptors to treat malignant lymphoblastic disease
http://bloodjournal.hematologylibra...t/100/2/627.pdf

Cannabinoids induce incomplete maturation of cultured human leukemia cells
http://www.osti.gov/energycitations...osti_id=5164483

{Delta}9-Tetrahydrocannabinol-Induced Apoptosis in Jurkat Leukemia T Cells
http://mcr.aacrjournals.org/cgi/con...bstract/4/8/549

Cannabidiol inhibits tumour growth in leukaemia and breast cancer
http://www.cannabis-med.org/english...el.php?id=220#2

Cancer- lung
Antineoplastic activity of cannabinoids
http://www.ukcia.org/research/Antin...ds/default.html

Delta(9)-Tetrahydrocannabinol inhibits epithelial growth factor-induced lung cancer cell migration
http://www.unboundmedicine.com/medl...astasis_in_vivo

Smoking Cannabis Does Not Cause Cancer Of Lung or Upper Airways
http://ccrmg.org/journal/05aut/nocancer.html

No association between lung cancer and cannabis smoking in large study
http://www.cannabis-med.org/english...el.php?id=219#2

Marijuana Smoking Found Non-Carcinogenic
http://www.medpagetoday.com/Hematol...gCancer/tb/3393

CLAIM #4: MARIJUANA CAUSES LUNG DISEASE
http://www.erowid.org/plants/cannab...bis_myth4.shtml

Cancer- melanoma
Dronabinol for supportive therapy in patients with malignant melanoma and liver metastases.
http://www.cannabis-med.org/studies...ow.php?s_id=180

Intractable nausea and vomiting due to gastrointestinal mucosal metastases
http://www.cannabis-med.org/studies...how.php?s_id=35

Cancer – oral
Smoking of cannabis does not increase risk for oral cancer
http://www.cannabis-med.org/english...el.php?id=175#1

Marijuana use and Risk of Oral Squamous Cell Carcinoma
http://66.218.69.11/search/cache?ei...&icp=1&.intl=us

Cancer-pancreatic
Cannabinoids Induce Apoptosis of Pancreatic Tumor Cells
http://cancerres.aacrjournals.org/c...ract/66/13/6748

Cancer – prostate
Inhibition of Human Breast and Prostate Cancer Cell Proliferation
http://endo.endojournals.org/cgi/co...tract/141/1/118

Cannabinoid Receptor as a Novel Target for the Treatment of Prostate Cancer
http://cancerres.aacrjournals.org/c...t/65/5/1635.pdf

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Cancer – Risk Cannabis vs Tobacco
Cannabis Smoke and Cancer: Assessing the Risk
http://www.norml.org/index.cfm?Group_ID=6891

Cannabis and tobacco smoke are not equally carcinogenic
http://www.pubmedcentral.nih.gov/ar...i?artid=1277837

Smoking Marijuana Does Not Cause Lung Cancer
http://www.mapinc.org/drugnews/v05/n1065/a03.html

Blunt Smokers Link Dependence Potential To Nicotine
http://www.medicalnewstoday.com/articles/52838.php

Premiere British Medical Journal Pronounces Marijuana Safer Than Alcohol, Tobacco
http://cannabislink.ca/medical/safer.html

Why Doesn't Smoking Marijuana Cause Cancer?
http://www.healthcentral.com/drdean/408/14275.html

Marijuana Smoking Found Non-Carcinogenic
http://www.medpagetoday.com/Hematol...gCancer/tb/3393

Cancer - Skin
Inhibition of skin tumor growth
http://www.jci.org/cgi/content/full...y=MpUgjDbqHybAU

Cannabis Reduces Skin Cancer
http://www.onlinepot.org/medical/skincancerreport.htm

Cancer – Testicular
The antiemetic efficacy of nabilone
http://www.cannabis-med.org/studies...ow.php?s_id=127

Chemotherapy for Testicular Cancer
http://www.rxmarihuana.com/shared_c...icularchemo.htm

Cancer –various/ unnamed
Derivatives of cannabis for anti-cancer treatment
http://www.eurekalert.org/pub_relea...uo-do060605.php

Cancer Killer
http://www.november.org/stayinfo/br...ncerKiller.html

Anandamide Induces Apoptosis
http://www.jbc.org/cgi/content/abstract/275/41/31938

Nabilone improves pain and symptom management
http://www.cannabis-med.org/studies...ow.php?s_id=177

The effects of smoked cannabis in painful peripheral neuropathy
http://www.cannabis-med.org/studies...how.php?s_id=96

Delta-9-tetrahydrocannabinol for appetite stimulation
http://www.cannabis-med.org/studies...how.php?s_id=52

Dronabinol and prochlorperazine in combination
http://www.cannabis-med.org/studies...how.php?s_id=28

Dronabinol enhancement of appetite in cancer patients.
http://www.cannabis-med.org/studies...ow.php?s_id=149

Efficacy of tetrahydrocannabinol
http://www.cannabis-med.org/studies...how.php?s_id=31

Inhalation marijuana as an antiemetic for cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=155

Nabilone versus domperidone
http://www.cannabis-med.org/studies...ow.php?s_id=129

Inhalation marijuana as an antiemetic for cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=155

Nabilone vs. placebo in chemotherapy-induced nausea and vomiting
http://www.cannabis-med.org/studies...ow.php?s_id=156

The antiemetic activity of tetrahydrocanabinol versus metoclopramide
http://www.cannabis-med.org/studies...how.php?s_id=24

Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy
http://www.cannabis-med.org/studies...show.php?s_id=5

Delta-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate
http://www.cannabis-med.org/studies...how.php?s_id=23

Delta-9-tetrahydrocannabinol (THC) as an antiemetic in patients treated with cancer chemotherapy
http://www.cannabis-med.org/studies...how.php?s_id=27

Amelioration of cancer chemotherapy-induced nausea and vomiting by delta-9-THC
http://www.cannabis-med.org/studies...ow.php?s_id=107

Superiority of nabilone over prochlorperazine as an antiemetic
http://www.cannabis-med.org/studies...ow.php?s_id=126

Analgesic effect of delta-9-tetrahydrocannabinol.
http://www.cannabis-med.org/studies...how.php?s_id=16

The analgesic properties of delta-9-tetrahydrocannabinol and codeine.
http://www.cannabis-med.org/studies...how.php?s_id=17

Comparison of orally administered cannabis extract and delta-9-THC
http://www.unboundmedicine.com/medl...xia_Study_Group

Cannabis May Help Combat Cancer-causing Herpes Viruses
http://www.sciencedaily.com/release...40923092627.htm

Marijuana Smoking Found Non-Carcinogenic
http://www.medpagetoday.com/Hematol...gCancer/tb/3393

Cannabidiol
Cannabidiol, Antioxidants, and Diuretics in Reversing Binge Ethanol-Induced Neurotoxicity
http://jpet.aspetjournals.org/cgi/c...ourcetype=HWCIT

Cannabinol delays symptom onset
http://www.ncbi.nlm.nih.gov/sites/e...t_uids=16183560

Cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis
http://www.pnas.org/cgi/content/full/97/17/9561

Cannabidiol inhibits tumour growth in leukaemia and breast cancer
http://www.cannabis-med.org/english...el.php?id=220#2

Anti-tumor effects of cannabidiol
http://www.hempworld.com/HempPharm/...milanstudy.html

Cannabidiol triggers caspase activation and oxidative stress in human glioma cells.
http://www.ihop-net.org/UniPub/iHOP...l?pmid=16909207

Cannabidiol-Induced Apoptosis in Human Leukemia Cells
http://molpharm.aspetjournals.org/c...stract/70/3/897

Cannabidiol inhibits tumour growth in leukaemia and breast cancer
http://www.cannabis-med.org/english...el.php?id=220#2

Cannabidiol lowers incidence of diabetes in non-obese diabetic mice
http://www.ingentaconnect.com/conte...sn7o5efqr.alice

Neuroprotective and Blood-Retinal Barrier-Preserving Effects of Cannabidiol
http://ajp.amjpathol.org/cgi/content/full/168/1/235

Evaluation of cannabidiol in dystonic movement disorders
http://www.cannabis-med.org/studies...how.php?s_id=14

Cannabidiol in dystonic movement disorders.
http://www.cannabis-med.org/studies...ow.php?s_id=139

Beneficial and adverse effects of cannabidiol in a Parkinson patient
http://www.cannabis-med.org/studies...ow.php?s_id=142

Treatment of Meige's syndrome with cannabidiol.
http://www.cannabis-med.org/studies...ow.php?s_id=114

CANNABIDIOL TO HEALTHY VOLUNTEERS AND EPILEPTIC PATIENTS
http://web.acsalaska.net/~warmgun/es201.html

Chronic administration of cannabidiol to healthy volunteers and epileptic patients.
http://www.cannabis-med.org/studies...how.php?s_id=42

Neuroprotective effect of (-)Delta9-tetrahydrocannabinol and cannabidiol
http://www.unboundmedicine.com/medl...f_peroxynitrite

EFFECTS OF CANNABIDIOL IN HUNTINGTON'S DISEASE
http://www.druglibrary.org/schaffer...al/hunting1.htm

The therapeutic rationale for combining tetrahydrocannabinol and cannabidiol.
http://www.medscape.com/medline/abstract/16209908

Cannabidiol has a cerebroprotective action
http://www.unboundmedicine.com/medl...iting_mechanism

Cannabidiol as an antipsychotic
http://www.cannabis-med.org/studies...ow.php?s_id=171

Cannabidiol, a constituent of Cannabis sativa, modulates sleep in rats.
http://www.medscape.com/medline/abs...844117?prt=true

Who's Afraid of Cannabidiol?
http://www.counterpunch.org/gardner07142007.html

Chemical composition
Cannabis: A source of useful pharma compounds
http://www.medpot.net/forums/index.php?showtopic=18608

Pharmacokinetics and cannabinoid action using oral cannabis extract
http://www.pharma-lexicon.com/medic...hp?newsid=29638

Pharmacokinetics of cannabinoids
http://66.218.69.11/search/cache?ei...&icp=1&.intl=us

The chemistry and biological activity of cannabis
http://www.unodc.org/unodc/en/bulle....html?print=yes

Differential effects of medical marijuana based on strain and route of administration
http://www.medicalmarijuanaprocon.o...trainsstudy.pdf

What is THC?
http://www.medicalmarijuanaprocon.o...1.0373456855945

Cannabis / Marijuana ( ? 9 -Tetrahydrocannabinol, THC)
http://www.nhtsa.dot.gov/people/inj...gs/cannabis.htm

---------- Page 4

Chemotherapy
Efficacy of dronabinol alone and in combination
http://www.cannabis-med.org/studies...ow.php?s_id=191

Dronabinol for supportive therapy in patients with malignant melanoma and liver metastases
http://www.cannabis-med.org/studies...ow.php?s_id=180

Intractable nausea and vomiting
http://www.cannabis-med.org/studies...how.php?s_id=35

An efficient new cannabinoid antiemetic in pediatric oncology
http://www.cannabis-med.org/studies...show.php?s_id=7

Dronabinol and prochlorperazine in combination
http://www.cannabis-med.org/studies...how.php?s_id=28

Marijuana as antiemetic medicine
http://www.cannabis-med.org/studies...ow.php?s_id=134

Efficacy of tetrahydrocannabinol in patients refractory to standard anti-emetic therapy
http://www.cannabis-med.org/studies...how.php?s_id=31

Inhalation marijuana as an antiemetic for cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=155

Nabilone versus prochlorperazine
http://www.cannabis-med.org/studies...ow.php?s_id=120

Nabilone: an alternative antiemetic for cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=123

Antiemetic efficacy of nabilone and alizapride
http://www.cannabis-med.org/studies...ow.php?s_id=127

Nabilone versus domperidone
http://www.cannabis-med.org/studies...ow.php?s_id=129

THC or Compazine for the cancer chemotherapy patient
http://www.cannabis-med.org/studies...how.php?s_id=34

Comparison of nabilone and prochlorperazine
http://www.cannabis-med.org/studies...ow.php?s_id=128

Nabilone vs. prochlorperazine for refractory emesis
http://www.cannabis-med.org/studies...ow.php?s_id=146

Nabilone vs. placebo
http://www.cannabis-med.org/studies...ow.php?s_id=156

Tetrahydroannabinol (THC) vs prochlorperazine as chemotherapy antiemetics.
http://www.cannabis-med.org/studies...how.php?s_id=30

Comparative trial of the antiemetic effects of THC and haloperidol
http://www.cannabis-med.org/studies...how.php?s_id=64

Comparison of delta-9-tetrahydrocannabinol and prochlorperazine
http://www.cannabis-med.org/studies...show.php?s_id=3

Delta 9-tetrahydrocannabinol in cancer chemotherapy.
http://www.cannabis-med.org/studies...how.php?s_id=88

Antiemetic effect of tetrahydrocannabinol
http://www.cannabis-med.org/studies...show.php?s_id=6

Tetrahydrocanabinol versus metoclopramide and thiethylperazine
http://www.cannabis-med.org/studies...how.php?s_id=24

Effects of nabilone and prochlorperazine on chemotherapy-induced emesis
http://www.cannabis-med.org/studies...ow.php?s_id=131

Delta-9-tetrahydrocannabinol as an antiemetic
http://www.cannabis-med.org/studies...show.php?s_id=5

Delta-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate
http://www.cannabis-med.org/studies...how.php?s_id=23

THC as an antiemetic in patients treated with cancer chemotherapy
http://www.cannabis-med.org/studies...how.php?s_id=27

Amelioration of cancer chemotherapy-induced nausea and vomiting by delta-9-THC
http://www.cannabis-med.org/studies...ow.php?s_id=107

Superiority of nabilone over prochlorperazine
http://www.cannabis-med.org/studies...ow.php?s_id=126

Antiemetic effect of delta-9-tetrahydrocannabinol
http://www.cannabis-med.org/studies...show.php?s_id=4

Children
Experiences with THC-treatment in children and adolescents
http://www.cannabis-med.org/studies...how.php?s_id=80

An efficient new cannabinoid antiemetic in pediatric oncology.
http://www.cannabis-med.org/studies...show.php?s_id=7

Nabilone versus prochlorperazine for control of cancer chemotherapy-induced emesis in children
http://www.cannabis-med.org/studies...ow.php?s_id=120

Nabilone: an alternative antiemetic for cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=123

Marijuana and ADD Therapeutic uses of Medical Marijuana in the treatment of ADD
http://www.onlinepot.org/medical/add&mmj.htm

Oily fish makes 'babies brainier'
http://news.bbc.co.uk/2/hi/health/4631006.stm

Cannabis is a First-Line Treatment for Childhood Mental Disorders
http://www.counterpunch.org/mikuriya07082006.html

Ganja use among Jamaican women.
http://www.rism.org/isg/dlp/ganja/a...anjaBabyes.html

Dreher's Jamaican Pregnancy Study
http://www.november.org/stayinfo/br...reherStudy.html

Cannabis Relieves Morning Sickness
http://ccrmg.org/journal/06spr/dreher.html#morning

Moderate cannabis use not harmful to the brain of adolescents, M R I study finds
http://www.cannabis-med.org/english...el.php?id=218#3

No brain structural change associated with adolescent cannabis use
http://www.pubmedcentral.nih.gov/bo...l&artid=1524733

No 'Smoking' Gun: Research Indicates Teen Marijuana Use Does Not Predict Drug, Alcohol Abuse
http://www.sciencedaily.com/release...61204123422.htm

Pot May Not Shrink Teens' Brains After All
http://www.medpagetoday.com/Neurolo...urology/tb/3242

Chronic Cystitis
Cannabinoid rotation in a young woman with chronic cystitis
http://www.cannabis-med.org/studies...ow.php?s_id=115

CPOD
THC effective in appetite and weight loss in severe lung disease (COPD)
http://www.cannabis-med.org/english...el.php?id=191#2

Heavy Long-Term Marijuana Use Does Not Impair Lung Function
http://www.erowid.org/plants/cannab...is_media7.shtml

Diabetes
Cannabinoid Reduces Incidence Of Diabetes
http://www.norml.org/index.cfm?Group_ID=6909

Marijuana Compound May Help Stop Diabetic Retinopathy
http://www.sciencedaily.com/release...60227184647.htm

Cannabidiol lowers incidence of diabetes in non-obese diabetic mice
http://www.ingentaconnect.com/conte...sn7o5efqr.alice

Anticoagulant Effects of a Cannabis Extract in an Obese Rat Model
http://www.level1diet.com/research/id/14687

Neuroprotective and Blood-Retinal Barrier-Preserving Effects of Cannabidiol
http://ajp.amjpathol.org/cgi/content/full/168/1/235

The Cannabinergic System as a Target for Anti-inflammatory Therapies
http://www.ingentaconnect.com/conte...000013/art00008

Effect of tetrahydrocurcumin on blood glucose, plasma insulin and hepatic key enzymes
http://www.unboundmedicine.com/medl...d_diabetic_rats

Cannabidiol reduces the development of diabetes in an animal study
http://www.cannabis-med.org/english...el.php?id=219#3

Depression
Cannabinoids promote hippocampus neurogenesis and produce anxiolytic- and antidepressant
http://www.jci.org/cgi/content/full/115/11/3104

Antidepressant-like activity by blockade of anandamide hydrolysis
http://www.pubmedcentral.nih.gov/ar...bmedid=16352709

Decreased depression in marijuana users.
http://www.medscape.com/medline/abstract/15964704

Antidepressant-like activity
http://www.pubmedcentral.nih.gov/ar...bmedid=16352709

Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep.
http://www.cannabis-med.org/studies...ow.php?s_id=190

Nabilone improves pain and symptom management in cancer patients
http://www.cannabis-med.org/studies...ow.php?s_id=177

The perceived effects of smoked cannabis on patients with multiple sclerosis.
http://www.cannabis-med.org/studies...how.php?s_id=13

Cannabis and Depression
http://www.pacifier.com/~alive/cmu/...nd_cannabis.htm

Association between cannabis use and depression may not be causal, study says
http://www.cannabis-med.org/english...el.php?id=177#4

Marijuana use and depression among adults: Testing for causal associations.
http://www.ncbi.nlm.nih.gov/sites/e...Pubmed_RVDocSum

Do patients use marijuana as an antidepressant?
http://www.ncbi.nlm.nih.gov/sites/e...Pubmed_RVDocSum

Dermatitis
Efficacy of dietary hempseed oil in patients with atopic dermatitis.
http://www.medscape.com/medline/abs...ryText=hempseed

Dronabinol
Dronabinol in the treatment of agitation in patients with Alzheimer’s disease with anorexia
http://www.cannabis-med.org/studies...how.php?s_id=61

Dronabinol in the treatment of refractory agitation in Alzheimer’s disease
http://www.cannabis-med.org/studies...how.php?s_id=92

Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer's disease.
http://www.cannabis-med.org/studies...how.php?s_id=59

Dronabinol an effective appetite stimulant?
http://www.cannabis-med.org/studies...ow.php?s_id=188

Safety and efficacy of dronabinol in the treatment of agitation in patients with Alzheimer’s disease
http://www.cannabis-med.org/studies...how.php?s_id=61

Effect of dronabinol on nutritional status in HIV infection.
http://www.cannabis-med.org/studies...ow.php?s_id=150

Dronabinol stimulates appetite and causes weight gain in HIV patients.
http://www.cannabis-med.org/studies...how.php?s_id=20

Dronabinol effects on weight in patients with HIV infection.
http://www.cannabis-med.org/studies...how.php?s_id=45

Recent clinical experience with dronabinol.
http://www.cannabis-med.org/studies...how.php?s_id=90

Dronabinol enhancement of appetite in cancer patients.
http://www.cannabis-med.org/studies...ow.php?s_id=149

Dronabinol for supportive therapy in patients with malignant melanoma and liver metastases.
http://www.cannabis-med.org/studies...ow.php?s_id=180

Dronabinol and prochlorperazine in combination
http://www.cannabis-med.org/studies...how.php?s_id=28

Dronabinol enhancement of appetite in cancer patients.
http://www.cannabis-med.org/studies...ow.php?s_id=149

Efficacy of dronabinol alone and in combination
http://www.cannabis-med.org/studies...ow.php?s_id=191

Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep.
http://www.cannabis-med.org/studies...ow.php?s_id=190

Dronabinol and retinal hemodynamics in humans.
http://www.cannabis-med.org/studies...ow.php?s_id=202

Dronabinol reduces signs and symptoms of idiopathic intracranial hypertension
http://www.cannabis-med.org/studies...ow.php?s_id=181

Nausea relieved by tetrahydrocannabinol (dronabinol).
http://www.cannabis-med.org/studies...how.php?s_id=35

Dronabinol in patients with intractable pruritus secondary to cholestatic liver disease.
http://www.cannabis-med.org/studies...ow.php?s_id=116

Treatment of spasticity in spinal cord injury with dronabinol
http://www.cannabis-med.org/studies...ow.php?s_id=112

Cannabinoid Activator Mellows Out Colon
http://www.medpagetoday.com/MeetingCoverage/ACG/tb/4410

Drug testing
Hemp oil causes positive urine tests for THC
http://www.druglibrary.org/crl/drug...0JAnToxicol.pdf

Dystonia
Cannabis sativa and dystonia secondary to Wilson's disease.
http://www.medscape.com/medline/abstract/15390041

Experiences with THC-treatment in children and adolescents
http://www.cannabis-med.org/studies...how.php?s_id=80

Evaluation of cannabidiol in dystonic movement disorders
http://www.cannabis-med.org/studies...how.php?s_id=14

Cannabidiol in dystonic movement disorders.
http://www.cannabis-med.org/studies...ow.php?s_id=139

Beneficial and adverse effects of cannabidiol in a Parkinson patient
http://www.cannabis-med.org/studies...ow.php?s_id=142

Treatment of Meige's syndrome with cannabidiol.
http://www.cannabis-med.org/studies...ow.php?s_id=114

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Endocannabinoid Deficiency
Clinical Endocannabinoid Deficiency
http://www.freedomtoexhale.com/clinical.pdf

The endocannabinoid system is dysregulated in multiple sclerosis
http://brain.oxfordjournals.org/cgi...stract/awm160v1

Cannabinoids inhibit neurodegeneration in models of multiple sclerosis
http://brain.oxfordjournals.org/cgi...ull/126/10/2191

Epilepsy
Epilepsy patients are smoking pot
http://www.safeaccessnow.org/article.php?id=1638

CANNABIDIOL TO HEALTHY VOLUNTEERS AND EPILEPTIC PATIENTS
http://web.acsalaska.net/~warmgun/es201.html

Experiences with THC-treatment in children and adolescents
http://www.cannabis-med.org/studies...how.php?s_id=80

Chronic administration of cannabidiol to healthy volunteers and epileptic patients.
http://www.cannabis-med.org/studies...how.php?s_id=42

Anticonvulsant nature of marihuana smoking.
http://www.cannabis-med.org/studies...how.php?s_id=39

Cannabis may help epileptics
http://www.medicalnewstoday.com/articles/4423.php

Hypnotic and Antiepileptic Effects of Cannabidiol
http://www.thecompassionclub.org/me...rue&pageNumber=

Marijuana: an effective antiepileptic treatment in partial epilepsy?
http://www.cannabis-med.org/studies...ow.php?s_id=157

Familial Mediterranean Fever
Pain relief with oral cannabinoids in familial Mediterranean fever.
http://www.cannabis-med.org/studies...how.php?s_id=18

Fertility
Synthetic Cannabinoid May Aid Fertility In Smokers
http://www.medicalnewstoday.com/articles/58063.php

Medical marijuana uses - 700 medical marijuana clinical studies and papers

Fever
A Novel Role of Cannabinoids
http://ccicnewsletter.com/index.php...nfectious_Disea

A Cooling Effect From Cannabis?
http://ccrmg.org/journal/05aut/coolcannabis.html

Fibromyalgia
Delta-9-THC based monotherapy in fibromyalgia patients
http://www.medscape.com/medline/abstract/16834825

Clinical Endocannabinoid Deficiency
http://www.freedomtoexhale.com/clinical.pdf

Cannabis Sativa (Marijuana) for Fibromyalgia
http://www.fibromyalgia-reviews.com/Drg_Marijuana.cfm

THC Reduces Pain in Fibromyalgia Patients
http://www.illinoisnorml.org/content/view/63/35/

Gateway Theory
The Myth of Marijuana's Gateway Effect
http://www.druglibrary.org/schaffer/library/mjgate.htm

Endogenous cannabinoids are not involved in cocaine reinforcement
http://www.sciencedirect.com/scienc...a4e861a90579fac

No 'Smoking' Gun: Research Indicates Teen Marijuana Use Does Not Predict Drug, Alcohol Abuse
http://www.sciencedaily.com/release...61204123422.htm

CLAIM #13:MARIJUANA IS A "GATEWAY" TO THE USE OF OTHER DRUGS
http://www.erowid.org/plants/cannab...is_myth13.shtml

Glaucoma
Marijuana Smoking vs Cannabinoids for Glaucoma Therapy
http://archopht.ama-assn.org/cgi/co...act/116/11/1433

Dronabinol and retinal hemodynamics in humans.
http://www.cannabis-med.org/studies...ow.php?s_id=202

Effect of Sublingual Application of Cannabinoids on Intraocular Pressure
http://www.cannabis-med.org/studies...ow.php?s_id=201

Delta 9-tetrahydrocannabinol in cancer chemotherapy. Ophthalmologic implications.
http://www.cannabis-med.org/studies...how.php?s_id=88

Effect of marihuana on intraocular and blood pressure in glaucoma.
http://www.cannabis-med.org/studies...how.php?s_id=87

Effect of delta-9-tetrahydrocannabinol on intraocular pressure in humans.
http://www.cannabis-med.org/studies...how.php?s_id=40

Marihuana smoking and intraocular pressure.
http://www.cannabis-med.org/studies...how.php?s_id=47

Neuroprotective and Intraocular Pressure-Lowering Effects of (-)Delta-Tetrahydrocannabinol
http://www.unboundmedicine.com/medl...del_of_Glaucoma

Neuroprotective effect of (-)Delta9-tetrahydrocannabinol and cannabidiol
http://www.unboundmedicine.com/medl...f_peroxynitrite

Effects of tetrahydrocannabinol on arterial and intraocular hypertension.
http://www.medscape.com/medline/abstract/468444

Gynocology and obstetrics
Cannabis Treatments in Obstetrics and Gynecology: A Historical Review
http://www.freedomtoexhale.com/russo-ob.pdf

Heart Disease/ Cardiovascular
Marijuana Chemical Fights Hardened Arteries
http://www.webmd.com/heart-disease/...rdened-arteries

The endogenous cardiac cannabinoid system: a new protective mechanism
http://www.cannabinoid.com/boards/thd3x10073.shtml

Cardiovascular pharmacology of cannabinoids.
http://www.biowizard.com/story.php?pmid=16596789

Delta-9-tetrahydrocannabinol protects cardiac cells from hypoxia
http://www.ingentaconnect.com/conte...020001/00002346

Does Cannabis Hold the Key to Treating Cardiometabolic Disease?
http://www.medscape.com/viewarticle/525040_print

Cannabinoid Offers Cardioprotection
http://www.norml.org/index.cfm?Grou...tm_format=print

Heavy Cannabis Use Not Independently Associated With Cardiovascular Risks
http://www.norml.org/index.cfm?Group_ID=6972

Marijuana use, diet, body mass index, and cardiovascular risk factors
http://www.medscape.com/medline/abstract/16893701

Cannabinoids and cardiovascular disease
http://www.unboundmedicine.com/medl...ical_treatments

Cannabinoids as therapeutic agents in cardiovascular disease
http://www.unboundmedicine.com/medl...s_and_illusions

The in vitro and in vivo cardiovascular effects of {Delta}9-tetrahydrocannabinol
http://www.unboundmedicine.com/medl..._oxide_synthase

Cannabinoids prevented the development of heart failure in animal study
http://www.cannabis-med.org/english...el.php?id=145#2

Cannabis use not associated with risk factors for diseases of heart and circulation
http://www.cannabis-med.org/english...el.php?id=225#2

THC protects heart cells in the case of lowered oxygen supply
http://www.cannabis-med.org/english...el.php?id=212#1

Medical marijuana: study shows that THC slows atherosclerosis
http://thenexthurrah.typepad.com/th...al_marijua.html

Cardiovascular Effects of Cannabis
http://www.idmu.co.uk/canncardio.htm

Changes in middle cerebral artery velocity after marijuana
http://www.ncbi.nlm.nih.gov/sites/e...0&dopt=Abstract[/]

----- Page 6

Hepatitis
Moderate Cannabis Use Associated with Improved Treatment Response
http://www.hivandhepatitis.com/hep_...6/091506_a.html

Cannabis use improves retention and virological outcomes in patients treated for hepatitis C
http://www.natap.org/2006/HCV/091506_02.htm

Hepatitis C - The Silent Killer Can Medical Cannabis Help?
http://www.pacifier.com/~alive/cmu/hepatitis_c.htm

Herpes
Cannabis May Help Combat Cancer-causing Herpes Viruses
http://www.sciencedaily.com/release...40923092627.htm

THC inhibits lytic replication of gamma oncogenic herpes viruses in vitro
http://www.pubmedcentral.nih.gov/bo...ml&artid=521080

Suppressive effect of delta-9-tetrahydrocannabinol on herpes simplex virus infectivity in vitro
http://www.ebmonline.org/cgi/content/abstract/196/4/401

Inhibition of cell-associated herpes simplex virus
http://www.ebmonline.org/cgi/content/abstract/185/1/41

The Effect of {Delta}-9-Tetrahydrocannabinol on Herpes Simplex Virus Replication
http://vir.sgmjournals.org/cgi/cont...stract/49/2/427

Hiccups
Marijuana cures hiccups
http://www.yourhealthbase.com/database/a77k.htm

Marijuana For Intractable Hiccups
http://cannabislink.ca/medical/hiccups.html

HIV / AIDS
Marijuana Use Does Not Accelerate HIV Infection
http://paktribune.com/news/print.php?id=139255

THC improves appetite and reverses weight loss in AIDS patients
http://www.cannabis-med.org/studies...ow.php?s_id=189

Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep.
http://www.cannabis-med.org/studies...ow.php?s_id=190

Cannabis in painful HIV-associated sensory neuropathy
http://www.cannabis-med.org/studies...ow.php?s_id=199

Smoked cannabis therapy for HIV-related painful peripheral neuropathy
http://www.cannabis-med.org/studies...ow.php?s_id=172

Short-term effects of cannabinoids in patients with HIV-1 infection
http://www.cannabis-med.org/studies...how.php?s_id=62

Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS.
http://www.cannabis-med.org/studies...how.php?s_id=21

Effect of dronabinol on nutritional status in HIV infection.
http://www.cannabis-med.org/studies...ow.php?s_id=150

Dronabinol stimulates appetite and causes weight gain in HIV patients.
http://www.cannabis-med.org/studies...how.php?s_id=20

Dronabinol effects on weight in patients with HIV infection.
http://www.cannabis-med.org/studies...how.php?s_id=45

Recent clinical experience with dronabinol.
http://www.cannabis-med.org/studies...how.php?s_id=90

Marijuana as therapy for people living with HIV/AIDS: Social and health aspects
http://www.unboundmedicine.com/medl..._health_aspects

Marijuana and AIDS: A Four-Year Study
http://ccrmg.org/journal/05spr/aids.html

Historical studies
The La Guardia Committee Report
http://www.druglibrary.org/schaffer...lag/lagmenu.htm

Physical, Mental, and Moral Effects of Marijuana: The Indian Hemp Drugs Commission Report
http://www.druglibrary.org/schaffer/Library/effects.htm

MARIAJUANA SMOKING IN PANAMA
http://www.druglibrary.org/schaffer...ama/panama1.htm

The British Pharmaceutical Codex – 1934
http://www.druglibrary.org/schaffer...ical/brit34.htm

ON THE PREPARATIONS OF THE INDIAN HEMP, OR GUNJAH
http://www.druglibrary.org/schaffer...1850/gunjah.htm

DISPENSATORY OF THE UNITED STATES OF AMERICA Fifth Edition (1843)
http://www.druglibrary.org/schaffer...ry/dispensa.htm

New Remedies:Pharmaceutically and Therapeutically Considered Fourth Edition (1843)
http://www.druglibrary.org/schaffer...ry/dunglisn.htm

On the Haschisch or Cannabis Indica
http://www.druglibrary.org/schaffer...ry/bellhash.htm

ON INDICATIONS OF THE HACHISH-VICE IN THE OLD TESTAMENT
http://www.druglibrary.org/schaffer...tory/hashot.htm

The Physiological Activity of Cannabis Sativa
http://www.druglibrary.org/schaffer...istory/japa.htm

CANNABIS, U.S.P. (American Cannabis):
http://www.druglibrary.org/schaffer...ry/vbchmed1.htm

Hormones
Effects of chronic marijuana use on testosterone, luteinizing hormone, follicle stimulating …
http://www.anesth.uiowa.edu/readabs...sp?PMID=1935564

Marijuana: interaction with the estrogen receptor
http://jpet.aspetjournals.org/cgi/c...tract/224/2/404

Huntington’s Disease
EFFECTS OF CANNABIDIOL IN HUNTINGTON'S DISEASE
http://www.druglibrary.org/schaffer...al/hunting1.htm

Nabilone Could Treat Chorea and Irritability in Huntington’s Disease
http://neuro.psychiatryonline.org/c.../18/4/553?rss=1

Hysterectomy
Effect of nabilone on nausea and vomiting after total abdominal hysterectomy
http://www.cannabis-med.org/studies...ow.php?s_id=137

Idiopathic Intracranial Hypertension
Dronabinol reduces signs and symptoms of idiopathic intracranial hypertension
http://www.cannabis-med.org/studies...ow.php?s_id=181

IQ
Findings of a longitudinal study of effects on IQ
http://www.cmaj.ca/cgi/content/full/166/7/887

Heavy cannabis use without long-term effect on global intelligence
http://www.cannabis-med.org/english...el.php?id=115#2

Marijuana does not dent IQ permanently
http://www.newscientist.com/article...ermanently.html

Marinol/Synthetics/ cannabinoid mixtures
CANNABIS AND MARINOL IN THE TREATMENT OF MIGRAINE HEADACHE
http://www.druglibrary.org/schaffer/hemp/migrn2.htm

Marinol vs Natural Cannabis
http://www.norml.org/pdf_files/NORM...al_Cannabis.pdf

The therapeutic rationale for combining tetrahydrocannabinol and cannabidiol.
http://www.medscape.com/medline/abstract/16209908

Unheated Cannabis sativa extracts and its major compound THC-acid
http://www.medscape.com/medline/abs...504929?prt=true

Side effects of pharmaceuticals not elicited by comparable herbal medicines.
http://www.medscape.com/medline/abstract/10394675

Sativex in the treatment of pain caused by rheumatoid arthritis
http://rheumatology.oxfordjournals....bstract/45/1/50

Is dronabinol an effective appetite stimulant?
http://www.cannabis-med.org/studies...ow.php?s_id=188

Sativex in patients suffering from multiple sclerosis associated detrusor overactivity
http://www.cannabis-med.org/studies...ow.php?s_id=168

Sativex® in patients with symptoms of spasticity due to multiple sclerosis
http://www.cannabis-med.org/studies...ow.php?s_id=169

Nabilone improves pain and symptom management in cancer patients
http://www.cannabis-med.org/studies...ow.php?s_id=177

Dronabinol for supportive therapy in patients with malignant melanoma and liver metastases
http://www.cannabis-med.org/studies...ow.php?s_id=180

Synthetic cannabinomimetic nabilone on patients with chronic pain
http://www.cannabis-med.org/studies...ow.php?s_id=197

Nabilone significantly reduces spasticity-related pain
http://www.cannabis-med.org/studies...ow.php?s_id=200

Sativex produced significant improvements in a subjective measure of spasticity
http://www.cannabis-med.org/studies...ow.php?s_id=170

Analgesic effect of the synthetic cannabinoid CT-3 on chronic neuropathic pain
http://www.cannabis-med.org/studies...how.php?s_id=85

Cannabinoid rotation in a young woman with chronic cystitis
http://www.cannabis-med.org/studies...ow.php?s_id=115

Dronabinol in patients with intractable pruritus
http://www.cannabis-med.org/studies...ow.php?s_id=116

Cannabinoids reduce levodopa-induced dyskinesia in Parkinson's disease:
http://www.cannabis-med.org/studies...how.php?s_id=54

Nabilone on L-DOPA induced dyskinesia in patients with idiopathic Parkinson's disease
http://www.cannabis-med.org/studies...ow.php?s_id=153

Nabilone in the treatment of multiple sclerosis.
http://www.cannabis-med.org/studies...how.php?s_id=11

Big Pharma's Strange Holy Grail: Cannabis Without Euphoria?
http://www.counterpunch.org/gardner07082006.html

Sativex showed positive effects in 65 per cent of patients with chronic diseases
http://www.cannabis-med.org/english...el.php?id=230#4

Meige’s Syndrome
Treatment of Meige's syndrome with cannabidiol.
http://www.cannabis-med.org/studies...ow.php?s_id=114

Migraine/ Headache
CANNABIS AND MARINOL IN THE TREATMENT OF MIGRAINE HEADACHE
http://www.druglibrary.org/schaffer/hemp/migrn2.htm

Dronabinol reduces signs and symptoms of idiopathic intracranial hypertension
http://www.cannabis-med.org/studies...ow.php?s_id=181

Cannabis and Migraine
http://www.pacifier.com/~alive/cmu/...nd_migraine.htm

Clinical Endocannabinoid Deficiency
http://www.freedomtoexhale.com/clinical.pdf

Hemp for Headache
http://www.freedomtoexhale.com/hh.pdf

Chronic Migraine Headache
http://www.druglibrary.org/schaffer/hemp/migrn1.htm

Morning Sickness
Medical marijuana: a surprising solution to severe morning sickness http://www.findarticles.com/p/artic...124/ai_n6015580

Medicinal cannabis use among childbearing women
http://safeaccess.ca/research/cannabis_nausea2006.pdf

Mortality Rates
Marijuana use and mortality.
http://www.pubmedcentral.nih.gov/ar...i?artid=1380837

Marijuana Smoking Doesn't Lead to Higher Death Rate
http://ccrmg.org/journal/03sum/kaiser.html

How deadly is marijuana?
http://www.medicalnewstoday.com/articles/4426.php

----------- Page 7

MS
Sativex in patients with symptoms of spasticity due to multiple sclerosis
http://www.cannabis-med.org/studies...ow.php?s_id=169

Marijuana derivatives may provide MS treatment
http://www.healthypages.net/news.asp?newsid=5381

Marijuana Helps MS Patients Alleviate Pain, Spasms
http://www.mult-sclerosis.org/news/...smsAndPain.html

Cannabis-based medicine in central pain in multiple sclerosis
http://www.neurology.org/cgi/conten...t/65/6/812?etoc

Cannabis-based medicine in spasticity caused by multiple sclerosis
http://www.cannabis-med.org/studies...ow.php?s_id=192

Sativex in patients suffering from multiple sclerosis associated detrusor overactivity
http://www.cannabis-med.org/studies...ow.php?s_id=168

The effect of cannabis on urge incontinence in patients with multiple sclerosis
http://www.cannabis-med.org/studies...ow.php?s_id=185

Nabilone significantly reduces spasticity-related pain
http://www.cannabis-med.org/studies...ow.php?s_id=200

Cannabinoids in multiple sclerosis (CAMS) study
http://www.cannabis-med.org/studies...ow.php?s_id=160

Sativex produced significant improvements in a subjective measure of spasticity
http://www.cannabis-med.org/studies...ow.php?s_id=170

Cannabis-based medicine in central pain in multiple sclerosis.
http://www.cannabis-med.org/studies...ow.php?s_id=175

Do cannabis-based medicinal extracts have general or specific effects
http://www.cannabis-med.org/studies...how.php?s_id=56

Efficacy, safety and tolerability of an oral cannabis extract in the treatment of spasticity
http://www.cannabis-med.org/studies...how.php?s_id=63

cannabis-based extracts for bladder dysfunction in advanced multiple sclerosis.
http://www.cannabis-med.org/studies...how.php?s_id=81

Are oral cannabinoids safe and effective in refractory neuropathic pain?
http://www.cannabis-med.org/studies...ow.php?s_id=143

Dronabinol in the treatment of agitation in patients with Alzheimer’s disease with anorexia
http://www.cannabis-med.org/studies...how.php?s_id=61

Cannabis based medicinal extracts (CBME) in central neuropathic pain due to multiple sclerosis.
http://www.cannabis-med.org/studies...how.php?s_id=82

Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis
http://www.cannabis-med.org/studies...ow.php?s_id=108

Cannabis based medicinal extract on refractory lower urinary tract dysfunction
http://www.cannabis-med.org/studies...ow.php?s_id=103

Analgesic effect of the cannabinoid analogue nabilone
http://www.cannabis-med.org/studies...ow.php?s_id=203

The perceived effects of smoked cannabis on patients with multiple sclerosis.
http://www.cannabis-med.org/studies...how.php?s_id=13

Orally and rectally administered delta-9-tetrahydrocannabinol on spasticity
http://www.cannabis-med.org/studies...how.php?s_id=12

Nabilone in the treatment of multiple sclerosis
http://www.cannabis-med.org/studies...how.php?s_id=11

Effect of cannabinoids on spasticity and ataxia in multiple sclerosis.
http://www.cannabis-med.org/studies...show.php?s_id=2

Delta-9-THC in the treatment of spasticity associated with multiple sclerosis.
http://www.cannabis-med.org/studies...show.php?s_id=1

Tetrahydrocannabinol for tremor in multiple sclerosis.
http://www.cannabis-med.org/studies...show.php?s_id=9

Marihuana as a therapeutic agent for muscle spasm or spasticity
http://www.cannabis-med.org/studies...how.php?s_id=53

Cannabis-based medicine in spasticity caused by multiple sclerosis.
http://www.unboundmedicine.com/medl...tiple_sclerosis

Cannabis based treatments for neuropathic and multiple sclerosis-related pain.
http://www.unboundmedicine.com/medl...is_related_pain

The effect of cannabis on urge incontinence in patients with multiple sclerosis
http://www.unboundmedicine.com/medl...ial__CAMS_LUTS_

Can Cannabis Help Multiple Sclerosis? An International Debate Rages
http://www.pacifier.com/~alive/cmu/...bis_help_ms.htm

Cannabis' Potential Exciting Researchers in Treatment of ALS, Parkinson's Disease
http://66.218.69.11/search/cache?ei...&icp=1&.intl=us

The endocannabinoid system is dysregulated in multiple sclerosis
http://brain.oxfordjournals.org/cgi...stract/awm160v1

Cannabinoids inhibit neurodegeneration in models of multiple sclerosis
http://brain.oxfordjournals.org/cgi...ull/126/10/2191

Nabilone
The synthetic cannabinoid nabilone improves pain and symptom management in cancer patients
http://www.cannabis-med.org/studies...ow.php?s_id=177

Nabilone versus prochlorperazine
http://www.cannabis-med.org/studies...ow.php?s_id=120

Nabilone: an alternative antiemetic for cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=123

Antiemetic efficacy of nabilone and alizapride
http://www.cannabis-med.org/studies...ow.php?s_id=127

Nabilone versus domperidone
http://www.cannabis-med.org/studies...ow.php?s_id=129

Comparison of nabilone and prochlorperazine
http://www.cannabis-med.org/studies...ow.php?s_id=128

Nabilone vs. prochlorperazine for refractory emesis
http://www.cannabis-med.org/studies...ow.php?s_id=146

Nabilone vs. placebo
http://www.cannabis-med.org/studies...ow.php?s_id=156

Effects of nabilone and prochlorperazine on chemotherapy-induced emesis
http://www.cannabis-med.org/studies...ow.php?s_id=131

Superiority of nabilone over prochlorperazine
http://www.cannabis-med.org/studies...ow.php?s_id=126

Nabilone versus prochlorperazine for control of cancer chemotherapy-induced emesis in children
http://www.cannabis-med.org/studies...ow.php?s_id=120

Nabilone: an alternative antiemetic for cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=123

Effect of nabilone on nausea and vomiting after total abdominal hysterectomy
http://www.cannabis-med.org/studies...ow.php?s_id=137

Nabilone improves pain and symptom management in cancer patients
http://www.cannabis-med.org/studies...ow.php?s_id=177

Synthetic cannabinomimetic nabilone on patients with chronic pain
http://www.cannabis-med.org/studies...ow.php?s_id=197

Nabilone significantly reduces spasticity-related pain
http://www.cannabis-med.org/studies...ow.php?s_id=200

Nabilone on L-DOPA induced dyskinesia in patients with idiopathic Parkinson's disease
http://www.cannabis-med.org/studies...ow.php?s_id=153

Nabilone in the treatment of multiple sclerosis.
http://www.cannabis-med.org/studies...how.php?s_id=11

Nabilone significantly reduces spasticity-related pain
http://www.cannabis-med.org/studies...ow.php?s_id=200

Analgesic effect of the cannabinoid analogue nabilone
http://www.cannabis-med.org/studies...ow.php?s_id=203

Nabilone in the treatment of multiple sclerosis
http://www.cannabis-med.org/studies...how.php?s_id=11

Comparison of nabilone and metoclopramide in the control of radiation-induced nausea.
http://www.cannabis-med.org/studies...ow.php?s_id=130

Nabilone and metoclopramide in the treatment of nausea and vomiting
http://www.cannabis-med.org/studies...ow.php?s_id=121

Nabilone: an alternative antiemetic for cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=123

Comparison of the antiemetic efficacy of nabilone and alizapride
http://www.cannabis-med.org/studies...ow.php?s_id=127

Nabilone versus domperidone in the treatment of cytotoxic-induced emesis.
http://www.cannabis-med.org/studies...ow.php?s_id=129

Add-on treatment with the synthetic cannabinomimetic nabilone on patients with chronic pain -
http://www.cannabis-med.org/studies...ow.php?s_id=197

Comparison of bronchial effects of nabilone and terbutaline
http://www.cannabis-med.org/studies...how.php?s_id=43

Nabilone Could Treat Chorea and Irritability in Huntington’s Disease
http://neuro.psychiatryonline.org/c.../18/4/553?rss=1

Nausea
THC improves appetite and reverses weight loss in AIDS patients
http://www.cannabis-med.org/studies...ow.php?s_id=189

Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone
http://www.cannabis-med.org/studies...ow.php?s_id=191

Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep.
http://www.cannabis-med.org/studies...ow.php?s_id=190

Nabilone improves pain and symptom management in cancer patients
http://www.cannabis-med.org/studies...ow.php?s_id=177

Dronabinol for supportive therapy in patients with malignant melanoma and liver metastases.
http://www.cannabis-med.org/studies...ow.php?s_id=180

Nausea relieved by tetrahydrocannabinol (dronabinol).
http://www.cannabis-med.org/studies...how.php?s_id=35

An efficient new cannabinoid antiemetic in pediatric oncology.
http://www.cannabis-med.org/studies...show.php?s_id=7

Effect of nabilone on nausea and vomiting after total abdominal hysterectomy.
http://www.cannabis-med.org/studies...ow.php?s_id=137

Marijuana as antiemetic medicine
http://www.cannabis-med.org/studies...ow.php?s_id=134

Efficacy of tetrahydrocannabinol in patients refractory to standard anti-emetic therapy
http://www.cannabis-med.org/studies...how.php?s_id=31

Inhalation marijuana as an antiemetic for cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=155

Nabilone versus prochlorperazine for control of cancer chemotherapy-induced emesis in children
http://www.cannabis-med.org/studies...ow.php?s_id=120

Comparison of nabilone and metoclopramide in the control of radiation-induced nausea.
http://www.cannabis-med.org/studies...ow.php?s_id=130

Nabilone and metoclopramide in the treatment of nausea and vomiting
http://www.cannabis-med.org/studies...ow.php?s_id=121

Nabilone: an alternative antiemetic for cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=123

Comparison of the antiemetic efficacy of nabilone and alizapride
http://www.cannabis-med.org/studies...ow.php?s_id=127

Nabilone versus domperidone in the treatment of cytotoxic-induced emesis.
http://www.cannabis-med.org/studies...ow.php?s_id=129

THC or Compazine for the cancer chemotherapy patient--the UCLA study
http://www.cannabis-med.org/studies...how.php?s_id=34

Comparison of nabilone and prochlorperazine for emesis induced by cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=128

Acute and subacute bronchial effects of oral cannabinoids.
http://www.cannabis-med.org/studies...how.php?s_id=44

Nabilone vs. prochlorperazine for refractory emesis induced by cancer chemotherapy.
http://www.cannabis-med.org/studies...ow.php?s_id=146

Nabilone vs. placebo in chemotherapy-induced nausea and vomiting.
http://www.cannabis-med.org/studies...ow.php?s_id=156

Dose vs response of tetrahydroannabinol (THC) vs prochlorperazine
http://www.cannabis-med.org/studies...how.php?s_id=30 delta 9-

Comparative trial of the antiemetic effects of THC and haloperidol
http://www.cannabis-med.org/studies...how.php?s_id=64

Comparison of delta-9-tetrahydrocannabinol and prochlorperazine.
http://www.cannabis-med.org/studies...show.php?s_id=3

Tetrahydrocannabinol in cancer chemotherapy. Ophthalmologic implications.
http://www.cannabis-med.org/studies...how.php?s_id=88

Antiemetic effect of tetrahydrocannabinol
http://www.cannabis-med.org/studies...show.php?s_id=6

The antiemetic activity of tetrahydrocanabinol versus metoclopramide and thiethylperazine
http://www.cannabis-med.org/studies...how.php?s_id=24

The antiemetic effects of nabilone and prochlorperazine on chemotherapy-induced emesis.
http://www.cannabis-med.org/studies...ow.php?s_id=131

Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy
http://www.cannabis-med.org/studies...show.php?s_id=5

Delta-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate
http://www.cannabis-med.org/studies...how.php?s_id=23

THC as an antiemetic in patients treated with cancer chemotherapy
http://www.cannabis-med.org/studies...how.php?s_id=27

Amelioration of cancer chemotherapy-induced nausea and vomiting by delta-9-THC.
http://www.cannabis-med.org/studies...ow.php?s_id=107

Superiority of nabilone over prochlorperazine as an antiemetic
http://www.cannabis-med.org/studies...ow.php?s_id=126

Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy.
http://www.cannabis-med.org/studies...show.php?s_id=4

Receptor mechanism and antiemetic activity of structurally-diverse cannabinoids
http://www.unboundmedicine.com/medl...the_least_shrew

Neurons
Marijuana Promotes Neuron Growth
http://www.medpot.net/forums/index.php?showtopic=27460

Marijuana-Like Chemicals in the Brain Calm Neurons
http://www.medpot.net/forums/index.php?showtopic=9686

Marijuana May Spur New Brain Cells
http://www.treatingyourself.com/vbu...read.php?t=5921

Cannabinoids promote embryonic and adult hippocampus neurogenesis
http://www.jci.org/cgi/content/full/115/11/3104

Medical marijuana uses - 700 medical marijuana clinical studies and papers

--------------- Page 8

Neuropathic pain
Cannabinoids Among Most Promising Approaches to Treating Neuropathic Pain
http://www.redorbit.com/news/health...source=r_health

Cannabis-based medicine in central pain in multiple sclerosis
http://www.neurology.org/cgi/conten...t/65/6/812?etoc

Cannabis in painful HIV-associated sensory neuropathy
http://www.cannabis-med.org/studies...ow.php?s_id=199

Smoked cannabis therapy for HIV-related painful peripheral neuropathy
http://www.cannabis-med.org/studies...ow.php?s_id=172

Two cannabis based medicinal extracts for relief of central neuropathic pain
http://www.cannabis-med.org/studies...ow.php?s_id=143

Cannabis based medicinal extracts (CBME) in central neuropathic pain due to multiple sclerosis.
http://www.cannabis-med.org/studies...how.php?s_id=82

Analgesic effect of the synthetic cannabinoid CT-3 on chronic neuropathic pain
http://www.cannabis-med.org/studies...how.php?s_id=85

Smoked cannabis in painful peripheral neuropathy and cancer pain refractory to opiods.
http://www.cannabis-med.org/studies...how.php?s_id=96

Analgesic effect of the cannabinoid analogue nabilone
http://www.cannabis-med.org/studies...ow.php?s_id=203

The perceived effects of smoked cannabis on patients with multiple sclerosis.
http://www.cannabis-med.org/studies...how.php?s_id=13

Cannabis based treatments for neuropathic and multiple sclerosis-related pain.
http://www.unboundmedicine.com/medl...is_related_pain

Neuroprotectant
Marijuana Protects Your Brain
http://www.roninpub.com/art-mjbrain.html

The neuroprotective effect of cannabinoids in a rat model of Parkinson's disease
http://www.medscape.com/medline/abstract/17196181

Neuroprotective and Intraocular Pressure-Lowering Effects of (-)Delta-THC
http://www.unboundmedicine.com/medl...del_of_Glaucoma

Neuroprotective effect of (-)Delta9-tetrahydrocannabinol and cannabidiol
http://www.unboundmedicine.com/medl...f_peroxynitrite

Neuroprotection induced by Delta(9)-tetrahydrocannabinol in AF5 cells
http://www.unboundmedicine.com/medl...ol_in_AF5_cells

Cannabidiol has a cerebroprotective action
http://www.unboundmedicine.com/medl...iting_mechanism

Cannabidiol but not Delta(9)-THC has a neuroprotective effect without the development of tolerance..
http://www.unboundmedicine.com/medl...nt_of_tolerance

Delta(9)-THC) prevents cerebral infarction
http://www.unboundmedicine.com/medl...ent_hypothermia

Delta(9)-Tetrahydrocannabinol protects hippocampal neurons from excitotoxicity
http://www.unboundmedicine.com/medl..._excitotoxicity

Cannabis and Neuroprotection
http://www.pacifier.com/~alive/cmu/...oprotection.htm

Medical marijuana uses - 700 medical marijuana clinical studies and papers

Nutrition
Oily fish makes 'babies brainier'
http://news.bbc.co.uk/2/hi/health/4631006.stm

Efficacy of dietary hempseed oil in patients with atopic dermatitis.
http://www.medscape.com/medline/abs...ryText=hempseed

Effects of smoked mar

Alright. That's enough. Stop spamming my comment section with dozens and dozens of links. I won't approve any more such "link dumps."

You mean you won`t have your propaganda countered by overwhelming and irrefutable evidence.

Danman,

THC kills cancer cells by driving ceramide synthesis and apoptosis. That is a fact. I`ve more than made my case.

Only if you ignore the studies that showed the opposite, such as the following mentioned in the review you cited:

Results are not clear-cut as to whether Δ9-THC causes pro- or antiproliferative effects in breast cancer cells. A study of Δ9-THC in MCF-7 and MDA-MB-231 cells (≤5 μM) reported proliferation in response to cannabinoid treatment. This finding is supported by the work of Takeda et al, who also documented a proliferative response to Δ9-THC in MCF-7 cells. [...]
In mouse models of breast cancer, contradictory results have also been reported. [...]
In a xenotransplant model of 4T1 paw cells in BALB/c mice, an increase in tumor size was recorded following Δ9-THC (25 mg/kg, intraperitoneally, 21 days). [...]
One study using pure Δ9-THC at concentrations between 0.1 and 0.3 μM showed increased proliferation of NCI-H292 lung carcinoma cells. In the lungs of habitual marijuana smokers, significant increases in the proliferation marker Ki67 were observed along with changes in the expression of the epidermal growth-factor receptor, the human epidermal growth-factor receptor 2/neu receptor, p53, and DNA polyploidy. In hepatoma cells, Δ9-THC (2 μg/mL) induced the drug metabolizing enzyme cytochrome P450 1 A1, which is linked to the development of tobacco-related cancers. This induction effect was seen with both a marijuana-derived tar mixture and pure extracts of Δ9-THC.

This suggests to me that a great deal of caution is required, as blindly self-prescribing may result in making things worse. I do think cannabinoids have some very interesting and exciting properties, but we don't really have much of a clue what is going on; sometimes cancerous cells are inhibited and sometimes stimulated, possibly dose dependently, but even that's not clear. I think it is way too soon to start prescribing cannabis oil for cancer. If I were suffering from terminal cancer I might give it a try, but only after the failure of conventional cancer treatments that have been through clinical trials.

Sorry, last paragraph shouldn't be blockquoted.

A quick scan through Dim's copypasta URLs shows a whole lotta advocacy sites and a paucity of actual research articles.

Propaganda, indeed.

@Danman, Orac offers this comment section for *discussion*, not reams of copypasta, especially when you not only haven't read the articles linked to, you haven't even read your own copypasta!

Or perhaps you'd like to explain the importance of the following to your "overwhelming and irrefutable evidence" that pot cures cancer:

"Oily fish makes 'babies brainier'"

Danman, I note that in all the animal studies you're linking to the animals aren't being fed cannabis--they're receiving synthetic cannabinoids by different routes of adminstration (e.g., in one of the Alzhiemer's cites by direct injection into cerebral ventricles). There's no evidence in your list supporting your claim "The plant needs to be EATEN …… NOT SMOKED.”

Perhaps you meant to say "The plant needs to be INJECTED DIRECTLY INTO YOUR BRAIN…… NOT SMOKED”?

Danman: THC kills cancer cells by driving ceramide synthesis and apoptosis. That is a fact. I`ve more than made my case.

Krebiozen: Only if you ignore the studies that showed the opposite, such as the following mentioned in the review you cited:

Your confusing two different points, Krebiozen. THC induced Ceramide synthesis and cancer apoptosis remains an unimpeachable fact.

Now as far as Cannabinoid Therapy having paradoxical results, indeed that can be the case. And it is not going work for all patients, all the time, with any cancer. I`m certainly not saying that, nor would the vast majority of even die-hard advocates. I agree with the author that, delivery, dosage, all sorts of details need to be worked out. But always I remind; Cannabis has no known fatal dose. The US gov. has repeatedly tried, and failed to define a lethal dose since forever. Period. That salient fact cannot be overstated. Is there even one conventional cancer regime that has no known lethal dose?

I think one problem actual cannabis oil/medicine patients could, and may in some cases be experiencing is Tumor Lysis Syndrome.

http://en.wikipedia.org/wiki/Tumor_lysis_syndrome
"In medicine (oncology and hematology), tumor lysis syndrome (TLS, alternative spelling tumour lysis syndrome) is a group of metabolic complications that can occur after treatment of cancer,[1] usually lymphomas and leukemias, and sometimes even without treatment. These complications are caused by the breakdown products of dying cancer cells and include hyperkalemia, hyperphosphatemia, hyperuricemia and hyperuricosuria, hypocalcemia, and consequent acute uric acid nephropathy and acute renal failure."

I also would theorize that the rapid weight loss typically associated with cancer and/or cancer treatment, and breakdown of fatty tissues, and release of toxins within, must exacerbate the problem.

Which brings us back to the THC induced ceramide apoptosis bio-mechanism. A database of patients plotting ceramide blood levels throughout Cannabinoid Therapy will go a long way towards accurate dosing, and tumor status. Especially given often inaccurate conventional tumor markers.

So, Scottynuked .......... I post links to abundant science, much of it peer reviewed, in support of cannabis medicine generally, and all you can come up with is "Dim"?

I would suggest you look in the mirror.

in support of cannabis medicine generally

danman, it's pretty obvious you haven't even bothered to check out any of those citations in that list. For example, just take a look at the last one on your first spam list, "Marijuana smoking and head and neck cancer."

Do you think this study is "in support of cannabis medicine"? Think again. In fact, it's a study examining the association between marijuana use and head and neck cancer RISK, nothing to do with actually TREATING the cancer.

Again, since it's clear you haven't actually examined most of these citations, can you point to a single one that demonstrates the CLINICAL efficacy of cannabis use? If not, don't you agree that more research needs to be done?

You'd have to be crazy to think that no more research is needed into the relationship between cannabis use and mental illness, such as psychosis, for example: http://www.ncbi.nlm.nih.gov/pubmed/24904437 http://www.ncbi.nlm.nih.gov/pubmed/24904437

Orac said; ..... "Uh, Danman, I’m a cancer surgeon AND a cancer researcher.

That explains so much. Your livelihood is in no small way going to be effected. You have a severe conflict of interest here, Dr Orac. How can your position even remotely be taken as unbiased?

For you, and much of the medical/pharma complex, unless the internet is shutdown, there is going be a critical mass of public awareness reached about cannabis medicine/science. You can`t stop it. At that point the DEA/Gov. enforced monopoly the medical/pharma complex on curing is going to fall. And if our wholly corporately owned Gov. decides to try and get tough again, the people will merely return to the black market, or growing it themselves. It`s a genie that cannot be put back in the bottle.

And even if when the research chips fall as they may, and say cannabinoid therapy is shown be roughly as effective as conventional treatments why would one even consider expensive dangerous, toxic chemicals, and radiation bombardment vs. a totally non-toxic plant they can grow in the garden?

Danman,

Your confusing two different points, Krebiozen. THC induced Ceramide synthesis and cancer apoptosis remains an unimpeachable fact.

So how do you explain the studies that found THC-induced cancer cell proliferation and tumor growth? How is that consistent with, "THC induced Ceramide synthesis and cancer apoptosis" or with "confusing two different points"?

As for your claim that:

But always I remind; Cannabis has no known fatal dose. The US gov. has repeatedly tried, and failed to define a lethal dose since forever. Period. That salient fact cannot be overstated. Is there even one conventional cancer regime that has no known lethal dose?

That isn't true. The fatal dose is very high compared to a therapeutic (or recreational) dose, but it certainly isn't unknown. Oral delta-9 THC is actually more toxic (LD50 1,270 mg/kg) than oral acetaminophen (LD50 1,944 mg/kg), which kills hundreds of people every year through accidental overdose.

When you consider hash oil may contain up to 90% THC, a 70kg human might be expected to die after ingesting 5 ounces, which is very unlikely (not to mention unpleasant) but not impossible. IV or inhaled THC is even more toxic, with LD50 of 36–40 mg/kg.

Hyperbolic claims of complete non-toxicity won't help your cause.

Your livelihood is in no small way going to be effected.

You're delusional if you think that somehow cannabis will totally upend the standards of care for cancer treatment.

say cannabinoid therapy is shown be roughly as effective as conventional treatments

That's a pretty big "if" there, buddy. So you admit we don't actually know yet? Don't you think it's unethical to tell people that cannabis is a "medical panacea" until we do in fact how effective it is?

AdamG said; ..... "danman, it’s pretty obvious you haven’t even bothered to check out any of those citations in that list. For example, just take a look at the last one on your first spam list, “Marijuana smoking and head and neck cancer.”

Do you think this study is “in support of cannabis medicine”? Think again. In fact, it’s a study examining the association between marijuana use and head and neck cancer RISK" .....

..... "Study: Smoking Marijuana May Prevent Head And Neck Cancers 7/1/14 http://reset.me/story/study-smoking-marijuana-may-prevent-head-neck-can…

"Could smoking marijuana really prevent cancer? A recent study suggests that moderate marijuana use is associated with reduced risk of head and neck squamous cell carcinoma (HNSCC), better known as head and neck cancers. Numerous recent studies have shown that cannabinoids have anti tumor effects which most likely explains why marijuana smokers are less likely to get head and neck cancers.

(The Tashkin Study cited previously, shows that even HEAVY CANNABIS SMOKERS had slight decrease in those cancers)

Study conclusion:

Our study suggests that moderate marijuana use is associated with reduced risk of HNSCC. We found that moderate marijuana use was significantly associated with reduced risk of HNSCC. This association was consistent across different measures of marijuana use (marijuana use status, duration, and frequency of use). Further, we observed that marijuana use modified the interaction between alcohol and cigarette smoking, resulting in a decreased HNSCC risk among moderate smokers and light drinkers, and attenuated risk among the heaviest smokers and drinkers."

Why do you persist in fallacies and mythology that have long ago been dispelled?

I repeat; Since at least 1970 the US Gov. has spent gozillions of dollars trying to demonstrate a cannabis cancer link. If there was, they would be singing it to the heavens on every public service commercial spot they could possibly buy.

It does not exist Adam.

Cupcake, you cited that paper as being "in support of cannabis medicine generally."

Showing that there is no link between marijuana use and cancer risk says NOTHING about the use of cannabis in cancer treatment, which was the purpose of the list YOU presented.

Danman, now you're trumpeting a study taht found smoking marijuana for 10 years or more is associated with a reduced risk of HNSCC, when previously you have insisted multiple times that smoking isn't sufficient and it must be eaten instead to get enough THC exposure to cause significant ceramide synthesis? Clearly you're just throwing random cites at the wall in the hopes a few might stick.

Danman: "say cannabinoid therapy is shown be roughly as effective as conventional treatments"

AdamG: That’s a pretty big “if” there, buddy. So you admit we don’t actually know yet?

No that was a conservative prognostication. More likely is that Cannabinoid Therapy will be a FAR more effective AND SAFE first approach to most cancers.

And I`m betting these patients will really like the fact their hair won`t fall out, and they won`t spend several hours a day riding the porcelain bus, or have numerous, sometimes debilitating "forever" side effects, even with "successful" conventional treatment, like my in-law. And they`ll just love the fact they won`t have take more DANGEROUS TOXIC FDA APPROVED POISON to counteract the DANGEROUS TOXIC FDA APPROVED POISON to counteract more DANGEROUS TOXIC FDA APPROVED POISON.

And then they`ll be thrilled that instead of LOSING EVERYTHING when they can no longer afford the DANGEROUS TOXIC FDA APPROVED POISON, they can produce an effective, simple medication that at least will do no harm, just by growing a plant in their garden.

The link dump is predictably littered with things that say precisely the opposite of what Danman thinks (as well as trying to play the entiemetic card, which isn't going anywhere):

Sugamura, K. et al. Activated Endocannabinoid System in Coronary Artery Disease and Antiinflammatory Effects of Cannabinoid 1 Receptor Blockade on Macrophages. Circulation (2008).
Chung, S. C. et al. A high cannabinoid CB(1) receptor immunoreactivity is associated with disease severity and outcome in prostate cancer. Eur J Cancer (2008).

The first open-access and self-explanatory. The second isn't, so let's turn to a paper that cites it.

From the introduction, it might have been expected that a high CB1 tumour receptor expression would be beneficial to the patients, whereas the opposite was found to be the case, at least for the patients with stage II MSS tumours at surgery.... The question nevertheless remains as to why a high, rather than a low, CB1 expression should be associated with a poorer disease-specific survival. One possible explanation has been furnished by a recent study using cultured astrocytoma cells transfected with CB1 receptors [49]. In that study, the authors selected clones with different CB1 receptor expression levels and found that at a low receptor expression, the receptors coupled primarily to extracellular signal-regulated kinases, and that activation of the CB1 receptors led to apoptosis. In contrast, at a high level of CB1 receptor expression, activation of the receptors led additionally to the activation of the Akt survival pathway, and cannabinoids only produced apoptosis when this pathway was inhibited [49]. It is of course a long way from studies in transfected cells to the situation in solid tumours, but the postulation that a high CB1 receptor expression results in the switch from a pro-apoptotic to a predominantly pro-survival pathway would mean that the local endocannabinoid tone no longer acts to limit the damaging influence of the tumour but rather to exacerbate it and thereby result in a poorer prognosis for the patient.

You have provided papers that allow the inferences that THC (1) is atherogenic and (2) can promote tumor survival. Well done, Kumar.

JGC said; ...... Clearly you’re just throwing random cites at the wall in the hopes a few might stick.

No clearly YOUR confused, or acting stupid.

No that was a conservative prognostication. More likely is that Cannabinoid Therapy will be a FAR more effective AND SAFE first approach to most cancers.

And, exactly as Orac claimed, you have reached this conclusion based on absolutely no evidence. You simply want it to be true.

Without any clinical trials how can you possibly claim that cannabis treatment of "most cancers" is "FAR more effective"? How will you ever know definitely which cancers it's less effective for?

Hey nice to smell ya Narad

All hail ..... The Great and Powerful King Turd-Blossom himself.

"Without any clinical trials how can you possibly claim that cannabis treatment of “most cancers” is “FAR more effective”? How will you ever know definitely which cancers it’s less effective for?"

Every single FDA approved poison that killed someone went thru clinical trials. In the long run clinical trials prove nothing, except how much pull a given pharma co has at the FDA.

All hail ….. The Great and Powerful King Turd-Blossom himself.

What a substantial response! I think you're probably better off sticking to your drug-induced "lucid sleep," danny boy.

I finally found it!!! The documentary source for the prevailing opinions about cannabis science here at SB,

And it`s all TRUE ..... really .....
https://www.youtube.com/watch?v=V2FZgErvNTE

AdamG ...... "What a substantial response! I think you’re probably better off sticking to your drug-induced “lucid sleep,” danny boy"

LOL!!! ..... you obviously are excluding Turd-Blossom`s cute little patent link in the category of insubstantial responses.

Hmmm, posting lots of links that he had not read and/or comprehended, and random insults. Obviously not a jerk. {/sarcasm}

That explains so much. Your livelihood is in no small way going to be effected. You have a severe conflict of interest here, Dr Orac. How can your position even remotely be taken as unbiased?

Actually, because I'm a surgeon, I'd be overjoyed if there were a nontoxic treatment for breast cancer that could replace chemotherapy, which I do not administer. Unless cannabis is truly a miracle cure that could cure cancer without surgery (and you've presented exactly zero evidence that it is) surgery will still be required in the treatment of breast cancer. As for my research, there are many other things I could turn my attention to related to cancer. Indeed, I'm already doing that, but mainly because I discovered that putting all my eggs in one basket (i.e., having too narrow a research focus) is a good way to have one's lab go away when NIH funding gets as tight as it is.

But seriously, a variant of the "pharma shill" gambit? Really? It's one of the lamest ad hominems there is. I could equally ask: How can your position even be remotely taken as unbiased, given that you so relentlessly have hijacked this thread with dumps of links that don't prove your point?

For you, and much of the medical/pharma complex, unless the internet is shutdown, there is going be a critical mass of public awareness reached about cannabis medicine/science. You can`t stop it. At that point the DEA/Gov. enforced monopoly the medical/pharma complex on curing is going to fall. And if our wholly corporately owned Gov. decides to try and get tough again, the people will merely return to the black market, or growing it themselves. It`s a genie that cannot be put back in the bottle.

This is one that I like to call the fallacy of future vindication. It's a fantasy antivaccine cranks revel in, and it's not becoming of you to do the same.

And even if when the research chips fall as they may, and say cannabinoid therapy is shown be roughly as effective as conventional treatments why would one even consider expensive dangerous, toxic chemicals, and radiation bombardment vs. a totally non-toxic plant they can grow in the garden?

If that were the case, I would embrace cannabis. It's not, at least not at the moment. There's a corollary to your statement, though, whether you know it or not, though. It's best expressed as a question: If the research chips fall where they may and cannabinoid therapy is shown not to have significant anticancer effects, will you abandon your advocacy of it? I've already said that I'm willing to go where the science leads, including if it leads to the conclusion that cannabis is the miracle treatment you seem to think it is. Are you willing to go where the science leads if it fails scientific testing?

THC induced Ceramide synthesis and cancer apoptosis remains an unimpeachable fact.

With a whopping 19 Pubmed entries, 15 with Manuel Guzmán as an author? No, sorry. As I've already pointed out, THC itself doesn't seem to be of much clinical interest in this regard. The receptor system itself? Sure. Weed? Not really.

The second draw, two weeks after they started the oil showed, according to their PC “significant increases in blood ceramide levels...."

How do you suppose free-floating ceramide translates into a therapeutic effect? What were the S1P levels?

Adam G beat me to it, but certainly nothing in listss of cites you spammed these comments with suggests "Cannabinoid Therapy will be a FAR more effective AND SAFE first approach to most cancers".

And I will admit I am confused about one thing--you've claimed repeatedly that smoking marijuana isn't sufficient to acheive a therapeutic exposure level of THC--that it (direct quote) "must be eaten to get enough THC to cause significant ceramide synthesis".

Yet you're now claiming that smoking marijuana reduces the risk of developing head and neck squamous cell carcinomas.

So which is it--is smoking it enough, or is eating it an absolute requirement?

Every single FDA approved poison that killed someone went thru clinical trials. In the long run clinical trials prove nothing, except how much pull a given pharma co has at the FDA.

Successful completion of clinical trials has nothing to do with "pull", Danman, and clinical traisl are in fact very good at doing exactly what they're designed to do: establishing therapeutic window, characterizing safety and demonstrating efficacy.

And they're great at weeding out failures: for every drug that successfully completes Phase I, II and III clinical trials nine or more other candidates--typically with far greater evidence supporting their potential efficacy than marijuana or cannabinoids have to date--will fail to do so.

There's certainly no reason to predict that if ever marijuana or marijuana derived cannabinoids ever reach a stage of development where beginning cinical trials is warranted they will turn out to be among the fortunate ten per cent which acheive approval, rather than among the other promising leads that failed to pan out.

LOL!!! ….. you obviously are excluding Turd-Blossom`s cute little patent link in the category of insubstantial responses.

How precisely would you consider it to be an "insubstantial" response to your own crowing about the GW patent applications, which promptly blew up in your face because you didn't understand the difference between an agonist and an antagonist yet again? Remember, I'm the one who actually looked at the list.

It's not my fault that you've been reduced to so much Jell-O with fresh pineapple when your attempts at intimidation didn't play so well in front of an audience that's used to posturing blowhards stopping by.

More fun with Danman’s citation list!

“A combined preclinical therapy of cannabinoids and temozolomide against glioma.”
- explores the combined use of TMZ and THC. says nothing about the efficacy of THC or cannabis on its own.

“Simultaneous measurement of three N- acylethanolamides in human bio-matrices using ultra performance liquid chromatography-tandem mass spectrometry.”
- describes a new method to measure the amounts of endocannabinoids in bodily fluids. has absolutely nothing to do with the clinical efficacy of cannabis. A few articles on the list appear to be like this…just measuring endocannabinoid levels.

“Novel hexahydrocannabinol analogs as potential anti-cancer agents inhibit cell proliferation and tumor angiogenesis.”
-I fail to see how results surrounding synthetic hexahydrocannabinol analogs proves anything about the clinical effects of ingested, natural cannabis

“Modulation of the cannabinoid receptors by andrographolide attenuates hepatic apoptosis following bile duct ligation in rats with fibrosis.”
-invovles treating cholestatic liver disease with andrographolide, a natural derivative of a completely different plant with little relation to cannabis. it happens to mention the word ‘cannabinoid’ in the abstract so that’s how it probably got included in your list-of-articles-you-didn’t-read

I could keep going! Just admit it danman, most of your cites have little or nothing to do with your claim that natural cannabis is a “medical panacea.”

I'm aware our host doesn't like this line of critique, but I'm a say what ya mean type of guy, so:

@Danman

"No clearly YOUR confused, or acting stupid."

His confused what? He must possess a remarkable thing in this state of confusion, as it's spelled out extra loud, perhaps for those who can't read lowercase. Perhaps the acting skill you refer to following is employed to soothe the un-named possession beset with confusion.

Perhaps more cannabis will help you express yourself clearly. Can you copy paste another search result for that?

Don't bother reading any of the articles from your search. It's all Big Science tainted stuff, excepting a few sentences which you believe to mean "do moar dope, it's good for you".

most of your cites have little or nothing to do with your claim

Ever since our Fearless Box of Blinky Lights banned Gerg the Terminally Clueless it has been a little tame around here.

@Spectator:

I believe - and someone correct me if I'm wrong- but our gracious and magnanimous host only becomes ( righteously, I might add) peeved when his own words are unceremoniously critiqued for minor infractions.

@ shay:

it appears that Gergles has found a new home @ AoA where he serves as a consultant to the brain trust resident at that outlet.

Orac; .... "But seriously, a variant of the “pharma shill” gambit? Really? It’s one of the lamest ad hominems there is. I could equally ask: How can your position even be remotely taken as unbiased, given that you so relentlessly have hijacked this thread with dumps of links that don’t prove your point?"

They do prove my points, and you know it. Your in a state of deep denial.

Doctor, it is simply ludicrous to imply that an industry whose annual cancer treatment worth ALONE is somewhere around 3/4 of trillion annually worldwide would welcome a natural, non-toxic, plant based, and effective treatment with open arms. You have absolutely no integrity whatever if can come back and honestly say there are not intense economic interests involved, and being brought bear on legislators to protect the system.

http://www.cancer.org/aboutus/globalhealth/global-economic-cost-of-canc…
"The economic toll from cancer is nearly 20 percent higher than heart disease, the second leading cause of economic loss ($895 billion and $753 billion respectively). This figure does not include direct medical costs, which would further increase the overall economic impact of cancer"

They do prove my points, and you know it. Your in a state of deep denial.

Doctor, it is simply ludicrous to imply that an industry whose annual cancer treatment worth ALONE is somewhere around 3/4 of trillion annually worldwide would welcome a natural, non-toxic, plant based, and effective treatment with open arms.

That's a straw man so friggin' massive its lighting on fire with your burning stupid can be seen from space. I didn't say the INDUSTRY would welcome it. I said *I* would welcome it. God, you're dumb.

I think one problem actual cannabis oil/medicine patients could, and may in some cases be experiencing is Tumor Lysis Syndrome.....

“In medicine (oncology and hematology), tumor lysis syndrome (TLS, alternative spelling tumour lysis syndrome) is a group of metabolic complications that can occur after treatment of cancer,[1] usually lymphomas and leukemias, and sometimes even without treatment. These complications are caused by the breakdown products of dying cancer cells and include hyperkalemia, hyperphosphatemia, hyperuricemia and hyperuricosuria, hypocalcemia, and consequent acute uric acid nephropathy and acute renal failure.”

I also would theorize that the rapid weight loss typically associated with cancer and/or cancer treatment, and breakdown of fatty tissues, and release of toxins within, must exacerbate the problem.

Right, you cite a W—pedia article and follow it up with a random, completely unrelated "theory" that amounts to nothing other than the quack-classic "Herxing."

Hint: TLS has nothing to do with "toxins," unless you place potassium, phosphorus, and nucleic acids in this category.

Doctor, it is simply ludicrous to imply that an industry whose annual cancer treatment worth ALONE is somewhere around 3/4 of trillion annually worldwide....

For which you provide this:

“The economic toll from cancer is nearly 20 percent higher than heart disease, the second leading cause of economic loss ($895 billion and $753 billion respectively). This figure does not include direct medical costs, which would further increase the overall economic impact of cancer”

So, (1) you misread the text and confuse the heart-disease figure to obtain "around 3/4 of trillion [sic]" (2) from a source that explicitly is not talking about medical costs. In order to make a claim about medical industry profit.

Fantastic.

Do you know what these costs represent? Lost years of life and productivity, dumbass. You know, years during which the medical industry could be making money off of people.

@Danman, you need to work on your reading comprehension. More context from the site you yourself cited:

The report shows that cancer has the greatest economic impact from premature death and disability of all causes of death worldwide. The economic toll from cancer is nearly 20 percent higher than heart disease, the second leading cause of economic loss ($895 billion and $753 billion respectively). This figure does not include direct medical costs, which would further increase the overall economic impact of cancer.

See those words "premature death and disability"? That's what they're talking about in terms of economic impact: people who would have been productive tax-paying citizens, but died or became disabled, requiring support from others including governments, due to cancer. That is the cost of foregone productivity. That is *not* the cost of treatment. It even says so! You even quoted it saying so!

it appears that Gergles has found a new home @ AoA where he serves as a consultant to the brain trust resident at that outlet.

He also "trolls" (his words) the Austism Speaks comments using Disqustink.

I didn’t say the INDUSTRY would welcome it. I said *I* would welcome it. God, you’re dumb.

Danman needs to study up on game theory. Every oncologist may be better off if all oncologists keep quiet about pot* than if they all revealed the secret, but any individual oncologist would be better off if he revealed the secret than if he didn't.

*And of course all the other mutually exclusive 100% effective, inexpensive, all natural cures for cancer that various interested parties have touted.

"God, you're dumb" seems like the appropriate reply to all Danman's drivel.

More fun with Danman’s citation list!

It's mildly amusing that he was too out of it not to notice that nearly all of the links were broken in the second dump. Oh, sorry, salvo of "overwhelming and irrefutable evidence."

^ "too out of it not to notice"

Hint: "TLS has nothing to do with “toxins,” unless you place potassium, phosphorus, and nucleic acids in this category" ....

Narad the Conceptually Dense ..... did you read the word "exacerbate"?

Hint: As in "to exacerbate the problem" (TLS) As a separate, but possibly related issue.

You did see that I used the word toxin relating to fatty tissues, not TLS? Right?

Sweet Jesus ......this is like pulling teeth.

I like his very first line:

Peer Reviewed Cannabis and Cancer References (download PDF)

Really, if he's going to copy off a webpage, he could at least look at the *first line*.

And there's this cite, which you can see clearly focuses on cannabis as a cancer cure:

Karasu, T., Marczylo, T. H., Maccarrone, M. & Konje, J. C. The role of sex steroid hormones, cytokines and the endocannabinoid system in female fertility. Hum Reprod Update (2011).

To this layman, the following doesn't sound like a *good* thing:

Hu, G., Ren, G. & Shi, Y. The putative cannabinoid receptor GPR55 promotes cancer cell proliferation. Oncogene (2010).

Is salivary secretion something to do with cancer?

Fernandez-Solari, J., Prestifilippo, J. P., Ossola, C. A., Rettori, V. & Elverdin, J. C. Participation of the endocannabinoid system in lipopolysaccharide-induced inhibition of salivary secretion. Arch Oral Biol (2010).

I don't think there's any cannabis in alcohol:

Park, J. Y. et al. Alcohol intake and risk of colorectal cancer: Results from the UK Dietary Cohort Consortium. Br J Cancer (2010).

Those are just the ones I noticed before I gave up and scrolled (and scrolled and scrolled and scrolled) past the rest.

Oh, and he still hasn't explained the relevance of oily fish and brainier babies to whatever point he's making.

LW .... "To this layman, the following doesn’t sound like a *good* thing:

Hu, G., Ren, G. & Shi, Y. The putative cannabinoid receptor GPR55 promotes cancer cell proliferation. Oncogene (2010).

Well LW you should have read a bit more .... especially the part about "suggesting a novel cancer biomarker and a potential therapeutic target."
I guess you missed that.

http://www.ncbi.nlm.nih.gov/pubmed/21057532

"Cannabinoids, the active ingredients in marijuana, have dramatic effects on various organ systems. They exert their effects through two receptor types: CB1, primarily located in the brain, and CB2, primarily located in the immune system. Vertebrates also produce their own cannabinoid-like substances called endocannabinoids, including anandamide and 2-arachidonoylglyceral. Interestingly, some effects of endocannabinoids could not be explained by the signals through either CB1 or CB2. Recently, the orphan G protein-coupled receptor 55 (GPR55) was proposed to be an atypical cannabinoid receptor. In this issue of Oncogene, two groups demonstrated that GPR55 is expressed in various cancer types in an aggressiveness-related manner, suggesting a novel cancer biomarker and a potential therapeutic target."

Well LW you should have read a bit more …. especially the part about “suggesting a novel cancer biomarker and a potential therapeutic target.”

Bugger me Danman, you are a prized idiot.

The therapeutic action on this novel target would be to down-regulate GPR55 or make it not respond to cannabinoids in an attempt to reduce its promotion of cancer cell proliferation. Exactly the opposite of what you are suggesting.

"I guess you missed that."

That would be because there was no link and it's difficult for me to search on an iPhone with a barely functional Internet connection. Maybe it was in that list of links that showed up after scrolling thirty or so iPhone pages.

I did read the article about oily fish and brainier babies, did you?

LW:

“God, you’re dumb” seems like the appropriate reply to all Danman’s drivel.

I have a friend who stays far away from marijuana. She grew up in the 1960s/70s with the "cool" parents that regularly toked with friends. She said they would have what they thought were "brilliant" conversations, and all she heard was nonsensical drivel.

She made the decision before entering high school that she preferred to keep her brain cells intact.

Speaking of exacerbation, this was an excellent addition to the Gish gallop:

Cabral, G. A. & Marciano-Cabral, F. Cannabinoid-mediated exacerbation of brain infection by opportunistic amebae. J Neuroimmunol 147, 127-130 (2004).

Recent reports indicate a higher frequency of brain infections with opportunistic amebae of the genus Acanthamoeba among immune compromised individuals, including AIDS patients. We have demonstrated, using a murine model of Granulomatous Amebic Encephalitis (GAE), that the major psychoactive and immune suppressive component in marijuana delta-9-tetrahydrocannabinol (THC) exacerbates infection by these amebae. Mice administered THC and infected with Acanthamoeba exhibited dose-related higher mortalities than infected vehicle controls. The greater severity of disease for THC-treated mice was accompanied by decreased accumulation of macrophage-like cells at focal sites of infection in the brain. Furthermore, THC administration resulted in decreased levels of mRNA for the pro-inflammatory cytokines interleukin-1 alpha, interleukin-1 beta, and tumor necrosis factor alpha for neonatal rat microglia co-cultured with Acanthamoeba. These results indicate a potential for marijuana to alter the capacity of brain macrophage-like cells to mount a full complement of immune responsiveness to brain infection by opportunistic amebae.

Because sludging up microglia and inhibiting TNF-α is a really good idea for treating brain cancers.

Anyway,

I think one problem actual cannabis oil/medicine patients could, and may in some cases be experiencing is Tumor Lysis Syndrome....

I also would theorize that the rapid weight loss typically associated with cancer and/or cancer treatment, and breakdown of fatty tissues, and release of toxins within, must exacerbate the problem.

OK, you have pulled TLS out of your ass and concluded that a "release of toxins" that you have also pulled out of your ass "must exacerbate the problem." How? What "toxins"? What's "exacerbated"? What happened to the "simple medication that at least will do no harm"?

The therapeutic action on this novel target would be to down-regulate GPR55 or make it not respond to cannabinoids in an attempt to reduce its promotion of cancer cell proliferation. Exactly the opposite of what you are suggesting.

That's because he still thinks anything that has anything to do with cannabinoid receptors means "Weed!" He's gotten this backward repeatedly.

THC induced Ceramide synthesis and cancer apoptosis remains an unimpeachable fact.

How do you inhibit sphingosine kinase-1 and glucosylceramide synthase?

Apparently if you smoke enough weed, you see the sentence "suggests a potential therapeutic target" in a journal article but your mind interprets it as "CANCER CURE!"

That's some powerful stuff.

Danman @186

welcome a natural, non-toxic, plant based, and effective treatment

You mean like taxol? Oh, the industry did welcome it. Natural, plant-based, and effective. I hope you can allow that a treatment which needs to kill cancer cells in order to be effective cannot be “non-toxic” ̶ it has to be toxic to the cancer cells.

Danman, considering that you cannot seem to understand why your arguments are not working on this crowd I’d ask what you’ve been smoking, but I guess given the topic that’s obvious.

ChrisP: ...... "Bugger me Danman, you are a prized idiot."

"The therapeutic action on this novel target would be to down-regulate GPR55 or make it not respond to cannabinoids in an attempt to reduce its promotion of cancer cell proliferation. Exactly the opposite of what you are suggesting."

Get a carrot and bugger yourself ..... The point I have all along stressed is that CB1 and CB2 are the receptors that are known to be involved with THC induced ceramide synthesis and apoptosis.

Nowhere did I imply that in order to treat cancer GPR55 should be up or down regulated.

And ....... "Whether the orphan G-protein coupled receptor GPR55 is also a cannabinoid receptor remains unclear as a result of conflicting pharmacological studies" ....
http://www.ncbi.nlm.nih.gov/pubmed/19723626

"Nowhere did I imply that in order to treat cancer GPR55 should be up or down regulated."

Then why was the article in your gish gallop -- oh, I mean overwhelming and irrefutable evidence list?

God, you're dumb.

Get a carrot and bugger yourself ….. The point I have all along stressed is that CB1 and CB2 are the receptors that are known to be involved with THC induced ceramide synthesis and apoptosis.

Nowhere did I imply that in order to treat cancer GPR55 should be up or down regulated.

Let's review:

To this layman, the following doesn’t sound like a *good* thing

Well LW you should have read a bit more …. especially the part about “suggesting a novel cancer biomarker and a potential therapeutic target.”
I guess you missed that.

Really, were you saying that it's a good thing because you thought eliminating activation of the cannabinoid receptors fits right in with your hypothesis?

^ F*cking blockquotes.

To this layman, the following doesn’t sound like a *good* thing

Well LW you should have read a bit more …. especially the part about “suggesting a novel cancer biomarker and a potential therapeutic target.”
I guess you missed that.

Chemmomo; .... "welcome a natural, non-toxic, plant based, and effective treatment .......You mean like taxol?

No I meant cannabis, specifically THC. Cannabis has no known lethal dose. I`m guessing Taxol does.

You also apparently didn`t read, or don`t believe Dennis Hill?

http://www.cureyourowncancer.org/how-cannabis-oil-works.html
"First let’s look at what keeps cancer cells alive, then we will come back and examine how the cannabinoids CBD (cannabidiol) and THC (tetrahydrocannabinol) unravels cancer’s aliveness.

"In every cell there is a family of interconvertible sphingolipids that specifically manage the life and death of that cell. This profile of factors is called the “Sphingolipid Rheostat.” If endogenous ceramide(a signaling metabolite of sphingosine-1-phosphate) is high, then cell death (apoptosis) is imminent. If ceramide is low, the cell is strong in its vitality.

The cancer cell dies, not because of cytotoxic chemicals, but because of a tiny little shift in the mitochondria. Within most cells there is a cell nucleus, numerous mitochondria (hundreds to thousands), and various other organelles in the cytoplasm. The purpose of the mitochondria is to produce energy (ATP) for cell use. As ceramide starts to accumulate, turning up the Sphingolipid Rheostat, it increases the mitochondrial membrane pore permeability to cytochrome c, a critical protein in energy synthesis. Cytochrome c is pushed out of the mitochondria, killing the source of energy for the cell."

Cannabis has no known lethal dose.

Funny, you've already been provided an LD50. THC is more toxic in rats than taxol (PDF).

"Very simply, when THC connects to the CB1 or CB2 cannabinoid receptor site on the cancer cell, it causes an increase in ceramide synthesis which drives cell death."

Now you're simply ignoring the fact that you've been provided with multiple examples of cancer cells that do exactly the opposite and trying to start over.

Narad; ....... Funny, you’ve already been provided an LD50. THC is more toxic in rats than taxol (PDF).

Oops ..... Page Not Found!
Hmm, we couldn’t find the page you’re looking for. Care to try a search?

Oops ….. Page Not Found!

If you had used your remaining neurons, you could have easily enough found the payload in the link.

Then again, given that you've recently posted scores of broken links, I can see why that might have been a bit much for you.

"The cancer cell dies, not because of cytotoxic chemicals, but because of a tiny little shift in the mitochondria."

I hate to break this to you, but this is the effect of a cytotoxic chemical. Moreover, you're stuck with the Warburg effect.

Danman quoting Dennis Hill: ..... “Very simply, when THC connects to the CB1 or CB2 cannabinoid receptor site on the cancer cell, it causes an increase in ceramide synthesis which drives cell death.”

Narad: .... Now you’re simply ignoring the fact that you’ve been provided with multiple examples of cancer cells that do exactly the opposite and trying to start over.

Wait a minute ........ so what your saying is Dennis Hill is a liar? Didn`t have cancer? Didn`t cure it with cannabis oil? Has no idea what he`s talking about?

Go ahead, lets hear it.

Narad ..... “The cancer cell dies, not because of cytotoxic chemicals, but because of a tiny little shift in the mitochondria.”

I hate to break this to you, but this is the effect of a cytotoxic chemical.

..... so your saying the man did chemo? The man is a liar?

That exactly what I thought. Too f*cking cowardly to backup your own convictions.

I`m done here. I`ve made my points.

Danman, obviously the expression I should have used was Bugger me sideways.

You are a doubly prized idiot.

A hint, an excavator is a better tool for digging large holes than a teaspoon.

Do keep providing the chuckles.

Dennis was born in Houston Texas. He holds a Bio-Chemistry degree from the University of Houston. He attended post graduate studies at Baylor Medical School, Department of Physiology. Dennis worked in cancer research at M.D. Anderson hospital for ten years, and in hospital administration for another ten years after completing his M.B.A. studies at St. Edwards University, Houston. Dennis moved to California in 1993 to work in software engineering. He is currently working on software projects and teaching meditation.

You mean that Dennis Hill? Good thing he has an MBA, I bet he's great at making money off fools like you. Speaking of shills, did you notice that the first thing you see on his website is an ad for his own tshirts?

He even has his very own page on whale.to! That's how you know he's legit.

Oh, it gets better. In the most popular video of Mr. Hill (https://www.youtube.com/watch?v=WRJxauzFfNM) he starts off by saying

I took my degree in Biochemistry from University of Houston, after that I went to a non-credit program at baylor medical shcool for human physiology so i have a good deal of chemistry background.

You think he would've mentioned the ten years at MD Anderson!

Of course, he's not near brave enough to mention an association with either Baylor or MD Anderson on his LinkedIn page.

Narad: …. Now you’re simply ignoring the fact that you’ve been provided with multiple examples of cancer cells that do exactly the opposite and trying to start over.

Wait a minute …….. so what your saying is Dennis Hill is a liar? Didn`t have cancer? Didn`t cure it with cannabis oil? Has no idea what he`s talking about?

I'm talking about you, jackass. You were trying to reboot the screaming failure of link dumps by cycling back to where you started.

Narad ….. “The cancer cell dies, not because of cytotoxic chemicals, but because of a tiny little shift in the mitochondria.”

I hate to break this to you, but this is the effect of a cytotoxic chemical.

….. so your saying the man did chemo? The man is a liar?

Maybe he's an imbecile. Nobody's shown whether the intrinsic or extrinsic pathway is involved even if the ceramide routine were to hold water, but do you "think" that using a chemical to get mitochondria to disgorge cytochrome c to kill their cells is some magic thing that only the Goddess Herb can do? Oops.

That exactly what I thought. Too f*cking cowardly to backup your own convictions.

Oh, dear, Bitsy does have some impulse control issues, doesn't he?

I`m done here. I`ve made my points.

Do stick the flounce. And see if you can trade a bag for some apostrophes.

Narad:

I hate to break this to you, but this is the effect of a cytotoxic chemical.

No no no no, it's not cytotoxic! It just kills the cell. Totally a different thing, right?

First of all, to those who posted about prohibition: the belief that prohibition was a total failure is oversimplified and as a group of critical thinkers, you can do better. Look up the research. Just because it's part of our national mythology doesn't make it true.

Secondly, and more importantly, thank you for the interesting discussion. My dh has stage iv lung cancer (adeno). He had a complete response to first line doublet chemo and is currently NED. I'm sure glad he did the govt. approved "poison". We are one of the lucky 1-3% with a complete response, but I know many, many more who've extended their lives and eased their symptoms with chemo.

I look forward to reading more and await your article on cannabis oil and cancer. I'm looking for ideas when chemo options run out as they tend to do with stage iv.

PollylovesJoe: First of all, to those who posted about prohibition: the belief that prohibition was a total failure is oversimplified and as a group of critical thinkers, you can do better. Look up the research. Just because it’s part of our national mythology doesn’t make it true.

During Prohibition, consumption of alcoholic beverages actually rose, the number of deaths related to alcohol poisoning rose, organized crime expanded and became more deadly than ever, and a number of cities openly flouted federal law. To me, that smacks of failure. If Prohibition had any actual success, I'm unaware of it. I think you might be using a different dictionary or history than the rest of us use.

During Prohibition, consumption of alcoholic beverages actually rose

PGP, you've unsurprisingly fallen for the "national mythology" just as PollylovesJoe pointed out. A simple read of the wiki on US Prohibition would have told you that your claim above is not based in reality, and would've lead you to this source: http://www.nber.org/papers/w3675.pdf

It pays to search before you type, PGP.

You also apparently didn`t read, or don`t believe Dennis Hill?

As Hilll hasn't offered any evidence that the cannabis oil protocol he followed caused his cancer to remit bu seems to simply be embracing a post hoc ergo procter hoc logical fallacy (seasoned liberally with "What else could it be?"), and given the five year survival rates of untreated patients presenting with the same stage of prostate cancer, no: I don't believe his claim that his cancer was cured by cannabis oil--he's given me no reason to.

AdamG: Note that the paper itself says that the stats they're working off of are of dubious reliability. Even if consumption fell, my other three points are true.

Cirrhosis of the liver rates went down which does tend to indicate an overall decline as it tends to be dose dependent..

In any case I think the social issues with crime were much more what any failure was about even if the number of people who drank went down or the number of drinks per person per year went down.

And both those numbers, IMO could go down substantially and alcohol poisoning go up. Just the standard issue human foolishness of the I can't get it often so when I get it I better binge on it variety added to changes in distillation (or just greater variation in home distillation rather than large scale industrial) could have you end up with more poisoned people (assuming if those stats are purely ethanol and not including people drinking impure spirits) even with less overall drinking.

Even if consumption fell, my other three points are true

Knowing you I doubt you've actually bothered to research these points before stating this.

Cirrhosis of the liver rates went down which does tend to indicate an overall decline as it tends to be dose dependent..

The claim is for death rates, not prevalence. Take a look at Figures 2 and 3 in Dills & Miron; apparently, Prohibition magically immediately fixed the number of cirrhosis deaths but didn't cause any further decrease. The hypothesis of simple dose dependence is also belied by the the other-country data.

I'm not going to go through and look at how much they massaged the data, but I'd be a lot more confident in this conclusion if it were coming from epidemiologists rather than economists.

Kaymarie: There was a lot of alcohol poisoning during Prohibition, usually from impure spirits or people trying to drink alcohol not intended for human consumption (like wood or rubbing alcohol). Maybe the rates of cirrhosis went down because heavy drinkers either tried to extend their stock by drinking less, or they succumbed to other causes.

AdamG: Did you ever read Last Call? Or other actual historical accounts of Prohibition? I'd rather rely on historians than economists, who are to a man ignorant of history and tend not to get out in the fresh air.

You are speaking very well from a scientific,western medicine model. Marijuana is an herb and so expands out from that model and can not be understood through the limited double blind placebo test process.

Traditional herbalism has always included relationship in its equations, as relationship plays a big part in health and wellness. The relationship between practitioner, patient and tool used is multidimensional and can thus far is not well addressed by western model research, so those that think in that model, can not truly appreciated the multidimensional benefits of not just "weed" as you stated, but all weeds.

The idea that just because you can standardize a chemical to induce a response on a percentage of patients and may cause a multitude of side effects, makes it better to take than an herb that has constituents from nature and recognized by the body and used for centuries, so the body knows what to do with it and is in relationship, for me doesn't work. I have studied in traditional herbalism many years and hold a masters in herbal studies (a western perspective model). I love the science of phyto chemicals and all the left brained stuff. But it is only one side of the equation. Herbalism opens to the left brain too, relationship, change, growth, evolution, where most of us live and at least have experience. We don't have double blind placebo tests to help us navigate. But we do have herbs, the plants that have accompanied us for ever. Thank goodness.

Epilepsy in sea lions

dr. dolittle — Sat, 22 Mar 2014 00:34:10 +0000

Epilepsy in sea lions

Credit: Image courtesy of Stanford University Medical Center, from ScienceDaily

According to a press release from Stanford University, California sea lions develop epilepsy from exposure to a toxin produced by algae called domoic acid. The animals develop seizures which can result in memory loss, tremors, convulsions and even death. The hippocampal region in the brain of the affected sea lions shows similar damage as humans with epilepsy, with losses of about 50 percent of neurons. Dr. Paul Buckmaster, professor of comparative medicine at Stanford was quoted as saying, "We found there was a loss of neurons in specific patterns that closely matched what is found in people. And there is synaptic reorganization — a rewiring of surviving neurons. This also matches what is found in humans with temporal lobe epilepsy." This form of epilepsy is the most commonly observed in humans and there is currently no cure. It usually starts following a traumatic brain injury, fever or lack of oxygen that causes an initial seizure and later on progresses to epilepsy with periodic seizures.

According to the press release, hundreds of California sea lions have washed ashore every year. The problem is with recent increases in algae blooms small fish that sea lions feed on, such as anchovies, accumulate domoic acid.

The hope is that understanding epilepsy in sea lions may lead to better treatments for sea lions and humans alike. Dr. Buckmaster said, "What we need is an interventional treatment — both in humans and sea lions. You’d give the treatment right after the brain injury, and that would prevent them from developing epilepsy. That’s the dream, but we are not there yet."

- See more at: http://med.stanford.edu/ism/2014/march/sealion.html#sthash.RlEXJgTI.dpuf

dr. dolittle Fri, 03/21/2014 - 20:34

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Shannon Collins
u14137535
It is very interesting that epilepsy does not only effect humans but sea lions as well. Would any other animals be affected with epilepsy that consume the demonic acid founded in Algae blooms? Perhaps there are some similarities between the human brain and the sea lion brain that can develop epilepsy?

why not test the human epilepsy medication on the sea lions, since the same disturbances occur in both species?And i believe that would be another way to get to the real cure of similar epilepsy in all species that have similar effects

Is there any other sea creatures that feed on these particular fish? If so, could these creatures also develop epilepsy? Could epilepsy medication for humans be used in the treatment and understanding of epilepsy in sea lions and other animals with similar forms of epilepsy?

It is fascinating to know that epilepsy occurs not only in humans, but also in sea lions. Looking from a medical point of view, would it be possible to use sea lions to find a cure for epilepsy in humans? Meaning to test the treatment or cure for humans on sea lions. If they try to do this, will the sea lions and humans respond the same way to treatment? It may seem unethical to use the sea lions like “lab rats”, but if it works, both species could benefit!

its very interesting to find out that animals can also suffer from epilepsy. its bad enough to witness a person going though a seizure, i can imagine a helpless sea lion going though the same thing.
at least the good thing is that there are people currently working on preventing humans and creatures from developing epilepsy.

I have to agree with you Brits it may really seem unethical but but if its for a good cause like this one i am 100% behind it. I think some animals might definitely get sick from digesting the acid since animals have many similarities but, not all of them ofcourse as some have pro-active defence-mechanism.

My question is; is this something new e.g is this algae indigenous to the area doing this as a response to climate change or pollution etc? or is this something that has always been occurring?

what an educative blog, its quite surprising that animals also experience similar infections that humans experience. i am starting to have an idea that people might have caught the acid that causes epilepsy from sea food(animals that feed on sea lions or so)

Humans and Sea lions like dogs, dolphins etc, are able to co exist and often mutually benefit from one another because we all intelligent beings. Sea lions are also very calm beings which makes them easy to approach. This common feature is based around the structure and function of our brains. Sadly sharing intelligence is not the only outcome of a developed brain ( ie Hippocampus ), Deficits such as neural loss and seizures are also a possibility.
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Epilepsy medication reverses symptoms of Alzheimer's

dr. dolittle — Tue, 07 Aug 2012 18:03:11 +0000

Epilepsy medication reverses symptoms of Alzheimer's

Image from: Alzheimer's Association

Researchers Sanchez et al. from the Gladstone Institute, University of California San Franciso and Washington University School of Medicine discovered that an FDA-approved anti-convulsant medication used to treat epilepsy (levetiracetam) can also reverse memory loss in addition to reducing other Alzheimer's related symptoms in a mouse model of the disease.

Alzheimer's is currently the most common form of dementia (memory loss) representing 50-80% of cases. It is a disease that worsens over time. Although there are available medications to help slow the progression of the disease or lessen the symptoms, there is currently no cure. Presently, an estimated 5.4 million people have Alzheimer's disease in the United States and this number is expected to rise.

When administered to mice with Alzheimer's, levetiracetam was found to decrease abnormal signaling in the brain by 50% in just one day. By 2 weeks, neurons within the brain exhibited signs of improved communication. Using a maze test, the researchers were able to demonstrate improved learning and memory with the anti-convulsant medication. Moreover, proteins necessary for normal brain function were restored to normal levels in the treated animals.

More research is needed however, to determine whether this new use of levetiracetam in the treatment of Alzheimer's disease is effective and safe for humans. Although a recent trial showed that it could improve memory and brain function in patients with mild cognitive impairments:

Sources:

Sanchez PE, Zhua L, Verreta L, Vossela KA, Orra AG, Cirritoc JR, Devidzea N, Ho K, Yua G-Q, Palopa JJ, and Mucke L. Levetiracetam suppresses neuronal network dysfunction and reverses synaptic and cognitive deficits in an Alzheimer's disease model. Proceedings of the National Academy of Sciences. Epub ahead of print. doi: 10.1073/pnas.1121081109

Alzheimer's Association

dr. dolittle Tue, 08/07/2012 - 14:03

Tags

do you know that you can get infected to taeniasolium engesting the intamidiat host caring the worm. and the worm can even reach the brain and distub the brains work.

Well how do you extrapolate mouse memory to humans, this is creationism of a scientific kind Dr Donothing, LOL

That is precisely where more research is needed especially since these findings were made in mouse models of Alzheimer's disease. The way that they measure mouse memory is to determine how well a mouse remembers their way around a maze...like a recall test. It was also shown to improve levels of proteins required for normal brain function. So the big assumption would be that if the treatment improved levels of these proteins, then perhaps brain function overall is improved.

In a more recent study at Johns Hopkins, Levetiracetam was shown to improve memory and brain function in humans with cognitive impairments that lead to Alzheimer's. The hope is to be able to use this drug as a way to slow down the progression of the debilitating disease. A video report from this study has been added to the blog entry.

The anti-convulsant medication reverses which symptoms of Alzheimer's? How much memory loss is reversed and how was this studied?

Emeryville Pharmaceuticals

How have treatments for other diseases fared in the leap from mouse to man? What is the comparative data?Seems a bit underwhelming that I have not seen more comment on levetiracetam result in the press, given the lack of any other promising treatments and the potential disasterous scale of the issue.

Since I was injured in a major car accident in 1991, I have had memory gaps of my youth, college, classical music (3 degrees), work etc. My recent memories are easily accessible but I have difficulty recalling details prior to the accident. Could this promising epilepsy drug be effective in helping me with my brain injury? Is there a clinical trial I could join ?

I would suggest that you discuss this with your doctor. I don't think they have looked at whether or not it would be useful at helping to reverse memory loss resulting from a traumatic brain injury.

My husband has epilepsy from a brain tumor, brain infections and 4 brain surgeries AND has been on Levetiracetam / Keppra for 4 years. It really does work! He should have memory loss due to the area where the tumor damaged his brain , he still has seizures -- yet his memory is strong. I am hopeful!

Personally, I have some experience with the use of levetiracetam in patients with Alzheimer's disease and epilepsy on a case level. These are of course NOT study results and are only personal impressions in patients with rather advanced forms of the disease. In my personal experience, I have never seen any beneficial effect in patients. On the contrary, patients with probable, moderate to severe Alzheimer's disease (NOT MCI) on levetiracetam seem to display significantly more behavioral and psychiatric symptoms in dementia (BPSD) which improve after changing the treatment for epilepsy. FRIN!

Doctor I have been experiencing temporary memory loss for about 10 to 15 seconds when I am very stressed out since the past 05 yearsI have consulted a nuber of doctors but no one has diagnosed yet. currently am using tegrol but these days am experiencing a lot of atttacks. can you please diagnose what i am suffering from and how it can be treated?

I find it a little confusing as to how it is possible that this medication can improve brain and memory function but at the same time cause cognitive impairment? Is that not contradictory that the meds are suppose o help the brain but the side effects are related to the brain? Did the research account the facts that humans do not share all the same proteins as mice. For example the apoE4 gene in humans is not found in mice. It is this gene that is responsible for the degeneration in Alzheimer's patients. Was this gene taken into account when conducting the experiment?