Rgirl said:
Drug studies are based on the efficacy and safety of a given drug for a large enough number of people that makes it lucrative for the drug companies to sell and gives confidence to medical practitioners to prescribe it. It works, in it's most basic form, on the one standard deviation principle. That is, if a drug is safe and efficacious for about 66% of those tested, it's approved.
My point they i.e. big bad $$$ grabbing pharma have to provide the data of benefits v risks to get approval. If the FDA sets it at 66% (you mean 3 std deviation instead) FDA is Ok with 66%, then let it be 66% (about the same percentage of efficacy of insulin) Even if the big pharma is out there for $$ they still need to provide safety / efficacy data.
However, drug testing as it stands now does nothing for the individual who, for reasons of individual differences, cannot tolerate TCB in it's chemical form or for whom it does not work.
Didn 't I advocate for more research?
In many individuals, smoking cannibis in its herbal form, which contains natural TCB works whereas chemical TCB taken in tablets doesn't or the tablets make them sick. With the millions of people with cancer, AIDS, multiple sclerosis and other diseases that cause nausea and loss of appetite, smoking marijuana is the only way they can get relief from the horrendous symptoms of these diseases.
Didn't I say there should be more research?? BTW, Millions of pts only respond to the smoking form of cannabinoids, you stating that as a fact re: millions and not thousands a few hundred or a few just curious?
89 citings in PUbMed is not that many. I looked at the first 2, then #13 (by the title of the abstract) And the data again is not robust. That means there needs to be more research
I am pasting the abstract of 1, 2 and 13 here. I am not willing to pay for 20 cents a page for the library to get the entire articles.
So we are just looking at abstracts and know nothing about the design of these studies, large scale studies or small, placebo controlled double blind or open label. Without knowing the detail, I am not willing to assume all 89 are scientifically sound. I am sure some are solid studies and some may not be worth the pieces of papers printed. I don't know whether they are using synthetic or cannabinods from the entire plant i.e. smoking. The first article abstract stated that evidence for MS treatment is not as yet convincing. The second abstract is about the cancer risks of cannabinoid. The third is the most interesting, it talks about endogenous receptors for endogenous cannabinoids. Last time I sat in a poster session about endogenous cannabinoids there were some very prelim data connecting that to stroke protection.
Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago, Dunedin, New Zealand.
[email protected]
The evidence for the therapeutic efficacy of cannabinoids in the treatment of multiple sclerosis (MS) is increasing but is not as yet convincing.
Although several trials have reported no significant effect, the majority of the evidence which supports a beneficial effect on spasticity and pain is based on subjective measurements in trials where unblinding was likely to be a problem. The available clinical trial data suggest that the adverse side effects associated with using cannabis-based medicinal extracts (CBMEs) are generally mild, such as dry mouth, dizziness, somnolence, nausea and intoxication, and in no case did toxicity develop. However, most of these trials were run over a period of months and it is possible that other adverse side effects, not seen in these short-term studies, could develop with long-term use. Despite the evidence that cannabinoids can disrupt cognitive function and promote depression, on the basis of current data, such adverse effects seem unlikely to be associated with the use of CBMEs. Likewise, there is no evidence to suggest that their effects on balance and motor control, or immune function, may be clinically significant. There is, however, reason to be concerned about the use of therapeutic cannabinoids by people predisposed to psychosis and by pregnant women, given the increasing evidence of their adverse effects on the fetus. In conclusion, given the modest therapeutic effects of cannabinoids demonstrated so far, and the risk of long-term adverse side effects, there is reason to be cautious about their use in the treatment of MS
Office of Public Policy and Ethics, Institute for Molecular Bioscience, University of Queensland, St Lucia, Queensland, Australia.
[email protected] <
[email protected]>
This review discusses three different associations between cannabinoids and cancer. First, it assesses evidence that smoking of cannabis preparations may cause cancers of the aerodigestive and respiratory system. There have been case reports of upper-respiratory-tract cancers in young adults who smoke cannabis, but evidence from a few epidemiological cohort studies and case-control studies is inconsistent. Second, there is mixed evidence on the effects of THC and other cannabinoids on cancers: in some in vitro and in vivo studies THC and some synthetic cannabinoids have had antineoplastic effects, but in other studies THC seems to impair the immune response to cancer. As yet there is no evidence that THC or other cannabinoids have anticancer effects in humans. Third, Delta(9)-tetrahydrocannabinol (THC) may treat the symptoms and side-effects of cancer, and there is evidence that it and other cannabinoids may be useful adjuvant treatments that improve appetite, reduce nausea and vomiting, and alleviate moderate neuropathic pain in patients with cancer. The main challenge for the medical use of cannabinoids is the development of safe and effective methods of use that lead to therapeutic effects but that avoid adverse psychoactive effects. Furthermore, medical, legal, and regulatory obstacles hinder the smoking of cannabis for medical purposes. These very different uses of cannabinoids are in danger of being confused in public debate, especially in the USA where some advocates for the medical use of cannabinoids have argued for smoked cannabis rather than pharmaceutical cannabinoids. We review the available evidence on these three issues and consider their implications for policy.
Walsh D, Nelson KA, Mahmoud FA.
The Harry R Horvitz Center for Palliative Medicine, The Cleveland Clinic Taussig Cancer Center, Cleveland Clinic Foundation - M-76, Cleveland, OH 44195, USA.
[email protected]
Cannabis occurs naturally in the dried flowering or fruiting tops of the Cannabis sativa plant. Cannabis is most often consumed by smoking marihuana. Cannabinoids are the active compounds extracted from cannabis. Recently, there has been renewed interest in cannabinoids for medicinal purposes. The two proven indications for the use of the synthetic cannabinoid (dronabinol) are chemotherapy-induced nausea and vomiting and AIDS-related anorexia. Other possible effects that may prove beneficial in the oncology population include analgesia, antitumor effect, mood elevation, muscle relaxation, and relief of insomnia. Two types of cannabinoid receptors, CB1 and CB2, have been detected. CB1 receptors are expressed mainly in the central and peripheral nervous system. CB2 receptors are found in certain nonneuronal tissues, particularly in the immune cells. Recent discovery of both the cannabinoid receptors and endocannabinoids has opened a new era in research on the pharmaceutical applications of cannabinoids. The use of cannabinoids should be continued in the areas indicated, and further studies are needed to evaluate other potential uses in clinical oncology.
PS. just looked at one more abstract, #9. It is a complicated issue, there need to be more research and studies. Maybe it is miracle drug for some. But cannabinoids synethic or smoked is not w/o adverse side effects. AMA is not endorsing it.
A peek into Pandora's box: the medical excuse marijuana controversy.
Voth EA.
The Institute on Global Drug Policy, St. Petersburg, FL, USA.
[email protected]
The smoking of marijuana for medicinal applications is a volatile and difficult issue for the medical and regulatory communities which has reached the forefront of discussions of public policy. Any consideration of this issue must take into account the substantial toxicity, impurity, and morbidity associated with marijuana use. Several states have passed ballot initiatives or legislation that allow a medical excuse for possession of marijuana.
These initiatives bypass the Food and Drug Administration process of proving safety and efficacy, and they have created serious regulatory dilemmas for state regulatory boards. Several examinations of the issue have consistently drawn question to the validity of smoking an impure substance while voicing concern for the well being of patients in need. The historical, social, medical, and legal issues are examined.
Maybe you are right if MDs under treat pain, then they need to be trained and
I have voted republican and non republican in the past. I guess unlike you I don't have a litmus test about who is a republican and who is a democrate.