Episodes

Medical Marijuana

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OK, so here are our magic videos.  Leave a comment and let us know who you think had the best tricks! A special apology to Mitch, the video didn’t switch for the first bit of his trick. You can see him in the little video on the bottom though.

Medical Marijuana content is below the videos.

 


 


 

History:
Marijuana has been in use medically, ritualistically, and recreationally for at least 5000 years.  The first reference to medical marijuana is thought to have been an ancient pharmacopoeia used by Chinese emperor Shen-Nung in 2700 B.C.  This ancient text, which is considered to be the world’s oldest pharmacopoeia, recommends marijuana for more than 100 ailments, including gout, rheumatism, malaria, and absentmindedness, and sits among other common herbal remedies such as ginseng and ephedra.  Interestingly, it was originally used as a tea; smoking marijuana has been a relatively recent form of ingestion of the drug.  From east Asia, marijuana moved west to Persia, Syria, Egypt, Greece, and Italy between 2000 and 1500 B.C.  Here, it began to be used not only for its physiologic properties, but also in the form of hemp for clothing, rope, and paper.  Many sources actually suggest that the Declaration of Independence was written on hemp-based paper!In 1854, marijuana was included in the US dispensary for the first time.  Many of the doctors we imagine as making “house calls” carried marijuana extracts in their black bags.  The drug was especially useful for insomnia, headaches, and anorexia, though it was commonly prescribed for pain, whooping cough, asthma, and sexual dysfunction.  Fast-forward to 1999, and you’ll find a report from the institute of medicine which summarized existing peer-reviewed literature, and found that there was at least some benefit in smoking marijuana for stimulating appetite, especially in AIDS-related wasting syndrome.  It also was found to be helpful for nausea and vomiting after chemotherapy.Throughout the 20th and 21st century, the popularity of marijuana has remained consistent.  Many people smoke marijuana for its mind-altering effects, but others maintain that, despite a lack of good randomized controlled clinical trials proving its efficacy, it is an excellent “organic” alternative to many of the drugs synthesized in laboratories.

Vocab:
Cannabis =
comes from the latin name for the common marijuana plant, of which there are 3 species; Cannabis sativa, Cannabis indica, and Cannabis ruderalis.  C. sativa is the most commonly cultivated species in the US.Cannabinoids = chemical compounds that activate receptors in the brain and in the immune system, causing euphoria, decreased pain sensation, and reducing inflammation.  There are 3 major types of cannabinoids: 1) endocannabinoids, which are produced naturally in human tissue.  2) phytocannabinoids, which are produced by plants.  3) synthetic cannabinoids, which are produced in a laboratory.  

THC = short for tetrahydrocannabinol, one of the main phytocannabinoids responsible for feelings of euphoria

Cannabidiol = the second of the two main phytocannabinoids – maximizes euphoria and minimizes anxiety

Recreational Use Today:
Marijuana is the most widely-used illicit drug in the world.  UN estimates report that at least 190 million people consumed the drug in 2007.  Most people smoke marijuana for a few reasons.  First, the drug is much more predictable this way.  The drug is absorbed very consistently through the lungs, especially when compared to the stomach.  As such, it allows for more effective titration of the drug to reach a desired effect.  Most people experience a mild euphoria, relaxation, and perceptual alterations (time distortion, intensification of ordinary experiences).  Unfortunately, some users react to the drug with anxiety and paranoia, whether they are using the drug recreationally or medically.  It is thought that unfamiliar situations can predispose to these negative effects.  The concentration of THC and Cannabidiol in marijuana does make a difference in the sensations a user can experience.  Greater levels of THC can cause a more potent euphoria, but may also cause a greater degree of anxiety and paranoia.  It is thought that an increase in cannabidiol is beneficial in two ways; it increases the euphoric effects of THC, and decreases the anxiety and paranoia.  As such, preparations with a large cannabidiol to THC ratio are the most sought-after.  

Medical Use Today:
So far, only 4 pharmaceutical cannabinoids have been marketed.  2 of these have been available in the US since 1985 (dronabinol and nabilone), the other two are available in Canada and Europe, but have not been approved for use in the US.  Both of the US drugs are used for appetite stimulation and anti-nausea effects, especially in chemotherapy and AIDS patients.  They’re administered in pill form, which is easier to market and sell, but, as mentioned earlier, makes them more difficult to administer safely.  Their variable absorption results in a tiny therapeutic window (the amount of drug that gives a benefit without causing adverse effects).  It begs the question: Why should we prescribe these pills over the inhaled form of THC?  Of course, there is a risk of medical side-effects when inhaling marijuana smoke.  Much research has been conducted on the effects of cigarette smoke on lungs, and they have shown greatly increased risk of cancers, COPD, asthma, and overall decreased lung function.  However, most cigarette smokers inhale 8-10 cigarettes per day.  Most marijuana users smoke a considerably smaller amount of marijuana.  One recent study found that marijuana smokers with fewer than 7 “joint years” (equivalent of one joint per day for one year) had no deleterious effects on their lung function, while those with greater than 10 joint years had at least some increased risk for COPD, asthma, and persistent pneumonias.  Unfortunately, it has been difficult to give marijuana the amount of research that it probably deserves.

Where’s the Research?
The story of the illegalization of marijuana in America goes back to the 1930s.  In 1936, the movie “Reefer Madness” portrayed marijuana as a substance that induced insanity and anarchy.  In 1937, the Federal Bureau of Narcotics passed the Marijuana Tax Act (despite objections from the American Medical Association), which taxed medical cannabis at $1 per ounce and recreational marijuana at $100 per ounce.  Some researchers suggest that this movement started with law enforcement officers in the southwest, who associated marijuana with stereotypes of low-income Mexicans and migrant workers, who they thought were instigators of crimes and social decline in the area.  In 1942, it was removed from the US dispensatory due largely to the economic costs imposed by the Marijuana Tax Act.  In 1970, the US Congress declared marijuana to have no medical value – bypassing many of it’s own review processes, and made it illegal, despite a lack of scientific testimony and evaluation.  Marijuana was subsequently classified as a Schedule 1 drug, meaning that it had no medical benefit and had a high abuse potential (other drugs in this category include heroine and LSD).  As such, researchers have had to jump through hoops in order to study the drug’s effects.  In fact, the only federally authorized source of cannabis is a strain from the University of Mississippi.  Researches can only access this strain by applying to the National Institute on Drug Abuse, an organization which has historically been very much aligned with opponents of marijuana use.

Currently, 16 states plus the District of Columbia allow legal use of marijuana with very strict restrictions, despite a federal stance that marijuana is an illicit substance.  This means that people living in these states can simultaneously be following state laws and breaking federal laws.  The American Medical Association, the Institute of Medicine, and the American College of Physicians maintain a stance that the “current patchwork of state laws do little to establish clinical standards for marijuana use,” and continue to push the federal government to re-classify marijuana as a Schedule 2 drug, making it much more accessible to the normal channels of research that are used to scrutinize other drugs.

What do you think?

http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881

Inspiration for, and large parts of this summary were pulled from a recent Mayo Clinic Proceedings article which you can find here:  http://www.mayoclinicproceedings.org/article/S0025-6196(11)00021-8/fulltext

2 Comments

  1. An impressive share, I just given this onto a colleague who was doing a little analysis on this. And he in fact bought me breakfast because I found it for him.. smile. So let me reword that: Thnx for the treat! But yeah Thnkx for spending the time to discuss this, I feel strongly about it and love reading more on this topic. If possible, as you become expertise, would you mind updating your blog with more details? It is highly helpful for me. Big thumb up for this blog post!

  2. Perek wins the magic challenge, considering the sheer amount of tricks he likely spent hours perfecting. However, I don’t care how dumb I sound, but I think Mitch’s Coke trick left me the most “WHAAAAA?!”

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