CHAPTER 1. INTRODUCTION | 1 |
How This Study Was Conducted | 3 |
Marijuana Today | 4 |
Who Uses Medical Marijuana? | 9 |
Cannabis and the cannabinoids | 18 |
Organization of the Report | 23 |
References | 24 |
Chapter 1. Introduction
How This Study Was Conducted
relevant and methodologically rigorous studies available, and treats the results of more limited studies cautiously. In addition, study results are presented in such a way as to allow thoughtful readers to judge the results themselves.
Marijuana, Today
The Changing Legal Landscape
charged with unlawful possession of marijuana claimed that they were using the drug to treat medical conditions and that violation of the law was therefore justified (the so-called "medical necessity" defense). Although most courts rejected these claims, some accepted them.8
Medical Marijuana Legislation Among the States
Marijuana and Medicine
Who Uses Medical Marijuana?
Table 1.1 Self-Reported Disorders Treated with Marijuana by Members of San Francisco Cannabis Cultivators Club
Disorder | Number of Subjects |
HIV | 60 |
Musculoskeletal disorders and arthritis | 39 |
Psychiatric disorders (primarily depression) | 27 |
Neurological disorders and nonmusculoskeletal pain syndromes | 9 |
Gastrointestinal disorders (most often nausea) | 7 |
Other disorders glaucoma, allergies, nephrolitiasis, and the skin manifestations of Reiter syndrome | 7 |
Total disorders | 149 |
Total number of respondents | 100 |
Table 1.2 Self-Reported Disorders Treated with Marijuana by Members of Los Angeles Cannabis Resource Center (LACRC) According to Center Staffa
Treated Disorder | Number of Subjects |
Percent of Subjects |
HIVb | 528 | 71 |
Cancer | 40 | 5.4 |
Terminal cancer | 10 | 1.4 |
Mood disorders (depression) | 4 | .05 |
Musculosketetal (multiple sclerosis, arthritis) | 30 | 4.1 |
Chronic pain and back pain | 33 | 4.5 |
Gastrointestinal | 17 | 2.3 |
Neurological disorders (epilepsy, Tourette syndrome, brain trauma) | 7 | 0.9 |
Seizures or migrainec | 13 | 1.8 |
Glaucoma | 15 | 2.0 |
Miscellaneous | 42 | 5.7 |
Total number | 739 | 100 |
a Results are based on review of 739 individual records by LACRC staff members. In contrast with Mendelson's survey of SFCCC (table 1.1), only the primary disorder is indicated here. Membership in LACRC is contingent on a doctor's letter of acknowledgment, but diagnoses are not independently confirmed.
b HIV patients use marijuana to control nausea, increase appetite (to combat wasting), and relieve gastrointestinal distress caused by AIDS medications. These uses are not indicated separately.
c As described by LACRC staff; some of these cases might also be neurological disorders.
d Because of rounding error, percentages do not add up to 100.
Table 1.3 Summary of Reports to IOM Study Team by 43 Individuals
Symptoms | Dominant Disease |
Anorexia, nausea, vomiting | AIDS(7) AIDS and cancer Cancer Testicular cancer Cancer and multiple sclerosclerosis Thyroid conditione Migraine Wilsons disease |
Mood disorders | Depression(2) Depression and anxiety(2) Manic depression(2) Posttraumatic stress Premenstrual syndrome |
Pain | Migraine Injury(2) Epilepsy and Postpolio syndrome Trauma and epilepsy Degenerative disk disease Rheumatoid arthritis Nail-patella syndrome Reflex sympathetic dystrophy Gulf War chemical exposure Multiple congenital cartilaginous exostosis Histiocytosis X |
Muscle Spasticity | spasticitye Multiple sclerosis(3) Paralysis Spinal cord injury Spasmodic torticollis |
Intraocular pressure | Glaucoma |
Diarrhea | Crohn's disease |
Table 1.3. This table lists the people who reported to the IOM study team during the public workshops, or through letters, that they use marijuana as medicine, it should not be interpreted as a representative sample of the full spectrum of people who use marijuana as medicine. Each dominant disease represents an individual report.
e Not specified.
Table 1.4 Primary Symptoms of 43 Individuals who Reported to IOM Study Team
. | Symptom Frequency | Multiple Symptoms | ||
Primary Symptom | Number of Reportsf | % of Total Symptoms Reported | Number who Reported (Primary) Additional Symptoms | % of those who reported Primary Symptoms |
Anorexia, nausea, vomiting | 21 | 31 | 13 | 62 |
Diarrhea | 4 | 6 | 3 | 75 |
Intraocular pressure | 2 | 3 | 1 | 50 |
Mood disorders | 12 | 18 | 7 | 58 |
Muscle spasticity | 12 | 18 | 7 | 58 |
Pain | 16 | 24 | 13 | 81 |
Totals | 67 | . | 44 | 66 |
f Forty-three persons reporting; 20 reported relief from more than one symptom.
Boxes 1.1-1.3: Selected Cases From the Public Sessions
G.S. spoke at the IOM workshop in Louisiana about his use of marijuana first to combat AIDS wasting syndrome and later for relief from the side effects of AIDS medications.
B.D. spoke at the IOM workshop in Louisiana She is one of eight patients who are legally allowed to smoke marijuana under a Compassionate Use Protocol She uses marijuana to relieve nausea, muscle spasticity, and pain associated with multiple sclerosis.
J.H.spoke at the IOM workshop in Washington, DC. He was was seriously injured in an accident, suffers from a form of arthritis associated with abnormal activity of the sympathetic nervous system known as reflex sympathetic dystrophy, and has hepatitis C. He uses marijuana to relieve nausea from liver disease, pain, and muscle spasms.
g This is an unlikely consequence of hepatitis C; it is more
likely that the patient's liver was
damaged.
Cannabis and the cannabinoids
secreted by the supporting bracteole (the small, leaf-like part below the flower). The amounts of cannabinoids and their relative abundance in a marijuana plant vary with growing conditions, including humidity, temperature, and soil nutrients (reviewed in Pate 199414). The chemical stability of cannabinoids in harvested plant material is also affected by moisture, temperature, sunlight, and storage. They degrade under any storage condition.
Figure 1.1 Cannabinoid Biosynthesis
Table 1.5 cannabinoids Identified in Marijuana
66 Cannabinoids Identified in Marijuana | ||
Cannabinoid Group | Common Abbreviation | Number of cannabinoid Variants known in each group |
![]() | ![]() | 9 |
![]() | ![]() | 2 |
Cannabichromene | CBC | 5 |
Cannabicyclol | CBL | 3 |
Cannabidiol | CBD | 7 |
Cannabielsoin | CBE | 5 |
Cannabigerol | CBG | 6 |
Cannabinidiol | CBND | 2 |
Cannabinol | CBN | 7 |
Cannabitriol | CBT | 9 |
Miscellaneous types | . | 11 |
Organization of the Report
References
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Chapter 2 ---->>>>