Difference between revisions of "Medical marijuana"

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[[Image:Cannabis sativa extract.png|frame|right|A catalog page offering ''Cannabis sativa'' extract.]]
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'''Medical marijuana''' is [[marijuana]] used for its (supposed) analgesic or otherwise therapeutic effects (see [[Glaucoma]]).
  
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'''Medical cannabis''' refers to the use of the drug [[Cannabis (drug)|cannabis]] as a physician-recommended herbal therapy, most notably as an [[antiemetic]]. The term '''''medical marijuana''''' post-dates the U.S. [[1937 Marijuana Tax Act|Marijuana Tax Act]] of 1937, the effect of which made cannabis prescriptions illegal in the United States.
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Critics doubt that there are any medicinal effects of marijuana, other than an overall effect sought by drug addicts. "Medical beer," "medical heroin," "medical pornography" and "medical gambling" are not recognized either, for good reason.
  
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Due to widespread illegal use of cannabis as a [[Recreational drug use|recreational drug]] and several other reasons, its legal or licensed use in medicine is a controversial issue.
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Opponents of [[drug abuse]] charge that efforts to legalize medical marijuana are intended to be a step towards complete decriminalization and generally decry marijuana as a "[[gateway drug]]".
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[[category:law]]
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There are many studies regarding the use of cannabis in a medicinal context.<ref>http://www.medicalmarijuanaprocon.org/pop/studychart.htm </ref><ref>http://www.norml.org/index.cfm?Group_ID=3376 </ref><ref>http://www.mpp.org/site/c.glKZLeMQIsG/b.1086505/k.AF5A/About.htm </ref><ref>{{cite web |url=http://www.alternet.org/drugreporter/56753/ |title=AlterNet: DrugReporter: New Studies Expose Government Lies About Medical Pot |accessdate=2007-07-13 |format= |work=}}  </ref> Cannabis was listed in the United States Pharmacopeia from 1850 until 1942.{{Fact|date=February 2007}} The United States federal government does not currently recognize any legitimate medical use, although there are currently seven patients receiving cannabis for their various illnesses through the Compassionate Investigational New Drug program that was closed to new patients by President [[George H. W. Bush]].  Francis L. Young, an administrative law judge with the [[United States|US]] [[Drug Enforcement Agency]], in 1988, declared that "''in its natural form, (cannabis) is one of the safest therapeutically active substances known.''"<ref>http://www.druglibrary.org/olsen/MEDICAL/YOUNG/young.html</ref> However, smoked cannabis is today not approved by the U.S. Food and Drug Administration, [[FDA]] <ref name ="FDAm">[http://www.fda.gov/ola/2004/marijuana0401.html</ref> or comparable public authorities in any Western European country as a licensed medicine for any disease; a common view is that if there is any future of marijuana as a medicine, it lies in its isolated components, the cannabinoids and their synthetic derivatives.
 
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== History ==
 
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[[Image:Marijuana.jpg|thumb|right|[[Cannabis]] plant]]Cannabis has been used for medicinal purposes for over 4,800 years.<ref>http://www.zauberpilz.com/golden/g31-40.htm</ref> Surviving texts from [[Ancient India]] confirm that its psychoactive properties were recognized, and doctors used it for a variety of illnesses and ailments. These included a whole host of gastrointestinal disorders, insomnia, headaches and as a pain reliever, frequently used in childbirth.
 
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Cannabis as a medicine was common throughout most of the world in the 1800s.  It was used as the primary pain reliever until the invention of [[aspirin]].<ref>http://news.bbc.co.uk/1/hi/programmes/panorama/1632726.stm</ref> Modern medical and scientific inquiry began with doctors like [[William Brooke O'Shaughnessy|O'Shaughnessy]] and [[Jacques-Joseph Moreau de Tours|Moreau de Tours]], who used it to treat [[melancholia]], [[migraine]]s, and as a sleeping aid, [[analgesic]] and [[anticonvulsant]].
 
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By the time the [[United States]] banned cannabis (the third country to do so) with the [[1937 Marijuana Tax Act]], the plant was no longer extremely popular.  Skepticism about marijuana arose in response to the bill.  One of the main opponents to the bill was the representative of the [[American Medical Association]].<ref>http://www.marijuanalibrary.org/AMA_opposes_1937.html</ref>
 
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Later in the century, researchers investigating methods of detecting cannabis intoxication discovered that smoking the drug reduced intraocular pressure.<ref>http://www.zauberpilz.com/golden/g31-40.htm</ref> High intraocular pressure causes blindness in [[glaucoma]] patients, so many believed that using the drug could prevent blindness in patients.  Many [[Vietnam War]] veterans also believed that the drug prevented muscle spasms caused by battle-induced spinal injuries.  Later medical use has focused primarily on its role in preventing the wasting syndromes and chronic loss of appetite associated with [[chemotherapy]] and [[AIDS]], along with a variety of rare muscular and skeletal disorders.  Less commonly, cannabis has been used in the treatment of [[alcoholism]] and [[addiction]] to other [[drug abuse|drugs]] such as  [[heroin]] and the prevention of [[migraine]]s. In recent years, studies have shown or researchers have speculated that the main chemical in the drug, THC, might help prevent [[atherosclerosis]].
 
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In 1972 [[Tod H. Mikuriya, M.D.]] reignited the debate concerning marijuana as medicine when he published "Marijuana Medical Papers 1839-1972".
 
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Later, in the 1970s, a [[synthetic]] version of [[Tetrahydrocannabinol|THC]], the primary active ingredient in cannabis, was synthesized to make the drug [[Marinol]].  Users reported several problems with Marinol, however, that led many to abandon the pill and resume smoking the plant.  Patients complained that the violent nausea associated with chemotherapy made swallowing pills difficult.  The effects of smoked cannabis are felt almost immediately, and is therefore easily dosed.<ref>http://www.lycos.com/info/cannabis--effects.html</ref> Marinol (Dronabinol), like ingested cannabis, is very psychoactive, and is harder to titrate than smoked cannabis.<ref>http://www.ardpark.org/reference/synmjcompare.htm</ref> Marinol has also consistently been more expensive than herbal cannabis.<ref>http://www.medicalmarijuanaprocon.org/pop/cost.htm</ref> Some studies have indicated that other chemicals in the plant may have a synergistic effect with THC.<ref>http://www.cannabis-med.org/membersonly/mo.php?aid=2001-03-04&fid=2001-03-04-7&mode=a&sid=</ref>
 
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In addition, during the 1970s and 1980s, six US states' health departments performed studies on the use of medical marijuana.  These are widely considered some of the most useful and pioneering studies on the subject.{{Fact|date=February 2007}}
 
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In May 2001, "The Chronic Cannabis Use in the Compassionate Investigational New Drug Program: An Examination of Benefits and Adverse Effects of Legal Clinical Cannabis" (Russo, Mathre, Byrne et al) was completed. This three-day examination of major body functions of four of the five living US federal cannabis patients found "mild pulmonary changes" in two patients.<ref>http://www.medicalcannabis.com/PDF/Chronic_Cannabis.pdf</ref>
 
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== Early studies on efficacy ==
 
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=== New Mexico ===
 
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Approved by the [[United States Food and Drug Administration|Food and Drug Administration]], the study included 250 patients and compared smoked cannabis to oral THC.  All participants were referred by a medical doctor and had failed to control vomiting using at least three alternative antiemetics.  Patients chose smoking cannabis or taking the THC pill.  Multiple objective and subjective standards were used to determine the effectiveness.
 
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* Conclusion: cannabis is far superior to the best available drug at the time of testing, [[Compazine]], and smoked cannabis is clearly superior to oral THC.  "More than ninety percent of the patients who received cannabis ... reported significant or total relief from nausea and vomiting."  No major side effects were reported, though three patients reported adverse reactions that did not involve cannabis alone.  The report can be read [http://www.medmjscience.org/Pages/science/pierson.bhtml here].
 
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=== Tennessee ===
 
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27 patients had failed on other [[antiemetics]] therapies, including oral THC.
 
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* Conclusion: 90.4% success for smoked cannabis; 66.7% for oral THC.  "We found both marijuana smoking and THC capsules to be effective antiemetics. We found an approximate 23% higher success rate among those patients administered smoked marijuana. We found no significant differences in success rates by age group. The major reason for THC capsule failure was nausea and vomiting so severe that the patient could not retain the capsule."
 
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=== California ===
 
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A series of studies throughout the 1980s involved 90–100 patients a year.  The study was designed to make it easier for patients to enter the oral THC part of the study.  Patients who wanted to smoke cannabis had to be over 15 years old (oral THC patients had to be over 5) and use the drug only in the hospital and not at home.  Smoked cannabis patients also had to be receiving rare and painful forms of chemotherapy to qualify.
 
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* Conclusion: Despite the bias towards oral THC, the California study concluded that smoked cannabis was more effective and established a safe dosage regimen that minimized adverse side effects.  The full text of the study can be seen [http://www.druglibrary.org/schaffer/hemp/medical/ctptoc.htm here].
 
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[[Image:Vaporong 001.jpg|thumb|200px|right|A Vapor-Bong for use with medicinal herbs prescribed by a physician.]]
 
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=== Georgia ===
 
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119 patients that had failed using other antiemetics were randomly assigned to oral THC pills and either standardized or patient-controlled smoking of cannabis.
 
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* Conclusion: All three categories were successful — patient controlled smokers at 72.2%; standardized smokers at 65.4%; oral THC at 76%.  Failure of oral THC patients was due to adverse reaction (6 out of 18) or failure to improve (9 out of 18); failure of smoking cannabis was due to intolerance for smoking (6 out of 14) or failure to improve (3 out of 14).
 
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==Harm reduction==
 
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Many medical cannabis opponents note that smoked cannabis is harmful to the respiratory system. However, this harm can be minimalized or eliminated by the use of a [[vaporizer]] or [[ingesting]] the drug in an [[edible]] form or other non-smoking modes of delivery like [[tinctures]]. Vaporizers are devices that vaporize the active constituents ([[cannabinoids]]) and the [[incense|fragrant]] [[aromatic]] substances in the preparation without combusting the plant material and thus preventing the formation of toxic substances. Studies have shown that vaporizers can dramatically reduce<ref name="Gieringer 2004">''Cannabis Vaporizer Combines Efficient Delivery of THC with Effective Suppression of Pyrolytic Compounds'' By  D. Gieringer et.al. Journal of Cannabis Therapeutics, Vol. 4(1) 2004, [http://www.maps.org/mmj/Gieringer-vaporizer.pdf] </ref> or even eliminate<ref name="Hazekamp 2006">''Evaluation of a Vaporizing Device (Volcano) for the Pulmonary Administration of Tetrahydrocannabinol''. By A. HAZEKAMP,  R. RUHAAK, et.al. JOURNAL OF PHARMACEUTICAL SCIENCES, VOL. 95, NO. 6, JUNE 2006 [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16637053&query_hl=1&itool=pubmed_docsum abstract]</ref> the release of irritants and toxic compounds.
 
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== Indications ==
 
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According to a survey on the recommendation of cannabis in California<ref>Dale Gieringer, "Medical Use of Cannabis in California," in Franjo Grotenhermen, M.D. & Ethan Russo, M.D.,  ed.,  Cannabis and Cannabinoids: Pharmacology, Toxicology and Therapeutic Potential,  Haworth Press, 2002
 
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[http://www.canorml.org/prop/MMJIndications.htm]</ref>, cannabis is indicated for over 250 conditions. Cannabis is most importantly indicated as an [[antiemetic]] for the treatment of [[nausea]] and [[anorexia (symptom)|anorexia]] associated with treatments for [[cancer]], [[AIDS]], and [[hepatitis]].
 
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Cannabis also acts as an antispasmodic and anticonvulsant and is indicated for neurological conditions such as [[epilepsy]], [[multiple sclerosis]], and [[spasms]]. As an analgesic and an immunomodulator it is indicated for conditions such as [[migraine]], [[arthritis]], spinal and [[skeletal disorders]]. As a [[bronchodilator]] it is beneficial for [[asthma]]. It also reduces the [[intraocular pressure]] and is indicated for [[glaucoma]]. Cannabis is also used to treat some [[mood disorders]] such as [[post traumatic stress disorder]], [[clinical depression]], [[obsessive-compulsive disorder]], [[panic disorder]], and [[bipolar disorder]]. It is also indicated for [[premenstrual syndrome]], [[hypertension]], and [[insomnia]].
 
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In the United States, the [[Federal Food, Drug, and Cosmetic Act]] makes the [[Food and Drug Administration]] (FDA) the sole government entity responsible for ensuring the safety and efficacy of new prescription and over-the-counter drugs, overseeing the labeling and marketing of drugs, and regulating the manufacturing and packaging of drugs.<ref> [http://www.fda.gov/cder/regulatory/applications/default.htm]</ref> The FDA defines a drug as safe and effective for a specific indication if the clinical benefits to the patient are felt to outweigh any health risks the drug might pose. [[FDA]] and comparable authorities in Western Europe in including the [[Netherlands]], have not approved smoked marijuana for any condition or disease.  <ref>{{cite web|url=http://www.fda.gov/ola/2004/marijuana0401.html|title=Testimony before the Subcommittee on Criminal Justice, Drug Policy, and Human Resources, Committee on Government Reform|author=Meyer, Robert J.|publisher=U.S. Food and Drug Administration|accessdate=2007-09-15}}</ref>  <ref>[http://www.fda.gov/bbs/topics/NEWS/2006/NEW01362.html]</ref> Cannabis remains illegal throughout the United States and is not approved for prescription as medicine, although 12 states - Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington - approve and regulate its medical use. (The federal government continues to enforce its prohibition in these states.)  However, there are also 2 states, Arizona and Maryland, whose drug laws are favourable towards the medicinal use of marijuana,{{huh}} but which still explicitly ban it.
 
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== Notable pro- and anti- medical cannabis individuals ==
 
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=== Proponents ===
 
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* Mary Lynn Mathre, RN, MSN, CARN. President, Patients Out of Time; Cannabis spokesperson for the Virginia Nurses Association. Editor, "Cannabis in Medical Practice: A Legal, Historical and Pharmacological Overview of the Therapeutic Use of Marijuana."
 
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[[Image:Willie Nelson.jpg|thumb|right|Willie Nelson performing at the Chumash Casino Resort in Santa Ynez, California.]]
 
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* [[Willie Nelson]] - Singer and songwriter.
 
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* [[Rick Steves]] - PBS Travel Show Host and on NORML's advisory board.
 
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* [[Steve Kubby]] - Key Organizer of California's [[Proposition 215]] [http://www.mapinc.org/images/DennisPeronLetter.gif], Founder and National Director [[American Medical Marijuana Association]].
 
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* [[Marc Emery]] - ''[[Cannabis Culture Magazine]]'', former seed merchant facing extradition to the US.
 
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* [[Rob Kampia]] - Founder of [[Marijuana Policy Project]].
 
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* [https://medicalmarijuanaofamerica.com/content/category/1/1/60/ Vanessa Nelson] - Journalist specializing in covering medical marijuana cases.
 
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* Al Byrne, Co-founder and COO, Patients Out of Time. Co editor, Marijuana as Medicine." (video)
 
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* [[Peter McWilliams]] - Author who used cannabis to relieve pain.
 
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* [[Bill Maher]] - Comedian and host of ''[[Real Time with Bill Maher]]'' on HBO.
 
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* [[Bill Mescher]] - A [[South Carolina]] state senator who proposed legalization of medical cannabis.
 
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* [[Ethan Nadelmann]] - President of [[Drug Policy Alliance]].
 
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* [[Loretta Nall]] - Founder of the [[United States Marijuana party]]
 
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* [[Angel Raich]] - U.S. activist, respondent in ''[[Gonzales v. Raich]]''.
 
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* [[Dana Rohrabacher]] - [[United States]] Congressman who proposed a bill to stop [[United States Department of Justice|Department of Justice]] from arresting medical cannabis patients.
 
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* [[Keith Stroup]] - Founder of [[NORML]].
 
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* [[Ed Rosenthal]] - A horitcultarist that fights for the right to grow marijuana for medicinal purposes.
 
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*[[Penn Jillette]] - Of Penn and Teller. Strong advocate. Has never taken recreational drugs.
 
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*[[Woody Harrelson]] - American actor.
 
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*[[Stephen Jay Gould]] - American paleontologist and evolutionary biologist.
 
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=== Emerging Medical Consensus ===
 
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Dozens of medical organizations have endorsed allowing patients access to medical marijuana with their physicians' approval.  These include, but are not limited to, the following:
 
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* [[Leukemia & Lymphoma Society]] - America's second largest [[cancer]] charity.<ref>[http://www.mpp.org/site/c.glKZLeMQIsG/b.2776465/k.C758/Medical_Marijuana_Endorsements_and_Statements_of_Support.htm]
 
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</ref>
 
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* [[American Academy of Family Physicians]]<ref>[http://www.mpp.org/site/c.glKZLeMQIsG/b.2776465/k.C758/Medical_Marijuana_Endorsements_and_Statements_of_Support.htm]
 
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</ref>
 
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* [[American Public Health Association]]<ref>[http://www.mpp.org/site/c.glKZLeMQIsG/b.2776465/k.C758/Medical_Marijuana_Endorsements_and_Statements_of_Support.htm]
 
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</ref>
 
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* [[American Nurses Association]]<ref>[http://www.mpp.org/site/c.glKZLeMQIsG/b.2776465/k.C758/Medical_Marijuana_Endorsements_and_Statements_of_Support.htm]
 
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</ref>
 
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* [[British Medical Association]]<ref>[http://www.mpp.org/site/c.glKZLeMQIsG/b.2776465/k.C758/Medical_Marijuana_Endorsements_and_Statements_of_Support.htm]
 
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</ref>
 
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* AIDS Action<ref>[http://www.mpp.org/site/c.glKZLeMQIsG/b.2776465/k.C758/Medical_Marijuana_Endorsements_and_Statements_of_Support.htm]
 
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</ref>
 
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* American Academy of HIV Medicine<ref>[http://www.mpp.org/site/c.glKZLeMQIsG/b.2776465/k.C758/Medical_Marijuana_Endorsements_and_Statements_of_Support.htm]
 
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</ref>
 
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* Lymphoma Foundation of America<ref>[http://www.mpp.org/site/c.glKZLeMQIsG/b.2776465/k.C758/Medical_Marijuana_Endorsements_and_Statements_of_Support.htm]
 
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</ref>
 
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* Health Canada<ref>[http://www.mpp.org/site/c.glKZLeMQIsG/b.2776465/k.C758/Medical_Marijuana_Endorsements_and_Statements_of_Support.htm]
 
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</ref>
 
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=== Opponents ===
 
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* [[Hamid Ghodse]] - [[International Narcotics  Control Board]] president.
 
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* [[John P. Walters]] - Current Director of the White House Office of National Drug Control Policy of United States.
 
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* [[Mark Souder]] - U.S. Congressman who filed an [[amicus brief]] in support of the U.S. government in ''[[Gonzales v. Raich]]''. The federal government may ban the use of marijuana even where states approve its use for medicinal purposes.
 
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*[[Andrea Barthwell]] - Former deputy director of the White House Office of National Drug Control Policy under [[George W. Bush]].
 
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*[[Paul Clement]] - Current [[Solicitor General]] who argued on behalf of the federal government in ''Gonzales v. Raich''.
 
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*[[Dan Lungren]] - Former Attorney General of California who presided over crackdown of medical marijuana dispensaries.
 
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==Pharmacologic THC and THC derivatives==
 
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In the USA, the FDA has approved two cannabinoids for use as medical therapies: [[dronabinol]] and [[nabilone]].  It is important to note that these medicines are not smoked. [[Dronabinol]] is a synthetic THC medication<ref>[http://www.fda.gov/bbs/topics/ANSWERS/ANS00457.html| FDA Press Release]</ref>, while [[nabilone]] is a synthetic cannabinoid, never marketed in the U.S.<ref>[http://www.fda.gov/ola/2004/marijuana0401.html| Congressional Testimony of Robert J. Meyer, M.D., April 1, 2004]</ref>
 
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{| class="wikitable"
 
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|-
 
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! Medication
 
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! Year approved
 
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! Licensed indications
 
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|-
 
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| Nabilone
 
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| 1985
 
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| Nausea of cancer chemotherapy that has failed to respond adequately to other antiemetics
 
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|-
 
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| Marinol
 
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| 1992
 
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| Nausea of cancer chemotherapy that has failed to respond adequately to other antiemetics, [[AIDS]] wasting
 
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|}
 
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These medications are usually used when first line treatments for nausea fail to work.  In extremely high doses and in rare cases there is a possibility of "[[psychotomimetic]]" side effects.  The other commonly-used antiemetic drugs are not associated with these side effects.
 
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The prescription drug [[Sativex]], an extract of cannabis administered as a sublingual spray, has been approved in [[Canada]] for the treatment of [[multiple sclerosis]];<ref name="SativexC">Koch, W. 23 Jun 2005. [http://www.usatoday.com/news/health/2005-06-23-pot-spray_x.htm Spray alternative to pot on the market in Canada]. ''USA Today'' (online). Retrieved on 27 Feb 2007</ref> this medication may now be legally imported into the [[United Kingdom]] and [[Spain]] on prescription.<ref name="SativexEu">{{cite web|url=http://stopthedrugwar.org/chronicle/411/sativex.shtml|title=Europe: Sativex Coming to England, Spain|accessdate=2006-03-25}}</ref> Dr. William Notcutt is one of the chief researchers that has developed Sativex, he has been working with GW and founder Geoffrey Guy since the company's inception in 1998. Notcutt states that the use of MS as the disease to study "had everything to do with politics."<ref name="Respectable Reefer">{{cite news|last=Greenberg|first=Gary|title=Respectable Reefer|publisher=Mother Jones|date=[[2005-11-01]]|url=http://www.motherjones.com/news/feature/2005/11/Respectable_Reefer-3.html|accessdate=2007-04-03}}</ref>
 
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== Criticism ==
 
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{{seealso|Health issues and the effects of cannabis}}
 
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On 4-20-2006, The United States [[Food and Drug Administration]] (FDA) issued an advisory against medical marijuana stating that, "marijuana has a high potential for abuse, has no currently accepted medical use in treatment in the United States, and has a lack of accepted safety for use under medical supervision. Furthermore, there is currently sound evidence that smoked marijuana is harmful." [http://www.fda.gov/bbs/topics/NEWS/2006/NEW01362.html].
 
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Some prominent American societies have been reluctant to endorse medicinal cannabis.
 
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For example: [http://www.ama-assn.org/apps/pf_new/pf_online?f_n=browse&doc=policyfiles/HnE/H-95.952.HTM], the National Multiple Sclerosis Society [http://www.nationalmssociety.org/Sourcebook-Marijuana.asp]
 
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, the American Academy of Ophthalmology [http://www.aao.org/education/library/cta/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=1216] and the American Cancer Society [http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Smoking_Marijuana_May_Increase_Cancer_Risk.asp]. (Federal Register, 1992).
 
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On June 6, 2005, the U.S. Supreme Court handed down a decision which approved the Federal Government's position that federal law permits the prosecution of persons possessing cannabis regardless of the defense that they are medicinal cannabis patients, even in states that exempt its prohibition for medicinal purposes. [http://a257.g.akamaitech.net/7/257/2422/06jun20051130/www.supremecourtus.gov/opinions/04pdf/03-1454.pdf]
 
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The [[Institute of Medicine]], run by the [[United States National Academy of Sciences]] and funded by the United States federal government, conducted a comprehensive study in 1999 to assess the potential health benefits of cannabis and its constituent cannabinoids. The study concluded that smoking cannabis is not recommended for the treatment of any disease condition, but did conclude that nausea, appetite loss, pain and anxiety can all be mitigated by marijuana. While the study expressed reservations about smoked marijuana due to the health risks associated with smoking, the study team concluded that until another mode of ingestion was perfected that could provide the same relief as smoked marijuana, there was no alternative. In addition, the study pointed out the inherent difficulty in marketing a non patentable herb. Pharmaceutical companies will not substantially profit unless there is a patent. For those reasons, the Institute of Medicine concluded that there is little future in smoked cannabis as a medically approved medication. The report also concluded for certain patients, such as the terminally ill or those with debilitating symptoms, the long-term risks are not of great concern.<ref>Cannabis and Medicine: Assessing the Science Base," Institute of Medicine, 1999. </ref>
 
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In an unpublished 2001 study by the Mayo Clinic, Marinol was shown to be less effective than megestrol acetate in helping cancer patients regain lost appetites.<ref>Cannabis Appetite Boost Lacking in Cancer Study" The New York Times, May 13, 2001. </ref>
 
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In 2003, the [[American Academy of Ophthalmology]] released a position statement asserting that "no scientific evidence has been found that demonstrates increased benefits and/or diminished risks of marijuana use to treat glaucoma compared with the wide variety of pharmaceutical agents now available." <ref name="AOA">American Academy of Ophthalmology. [http://www.aao.org/education/library/cta/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=1216 Complementary Therapy Assessment: Marijuana in the Treatment of Glaucoma.] Retrieved August 2, 2006.</ref>
 
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== Legal and medical status of cannabis ==
 
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{{main|Legal and medical status of cannabis}}
 
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[[Image:World-cannabis-laws.png|right|thumb|401px|World laws on [[cannabis]] possession (small amount). Data is from multiple sources detailed on the [[Image talk:World-cannabis-laws.png|full source list]]]]
 
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[[Image:European-cannabis-laws.png|right|thumb|401px|European laws on [[Cannabis (drug)|cannabis]] possession (small amount).  Data is from multiple sources detailed on the [[Image talk:World-cannabis-laws.png#Europe|full source list]]]]
 
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Cannabis is in Schedule IV of the [[Single Convention on Narcotic Drugs]], making it subject to special restrictions. [http://www.incb.org/e/conv/1961/articles.htm#2 Article 2] provides for the following, in reference to Schedule IV drugs:
 
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: ''A Party shall, if in its opinion the prevailing conditions in its country render it the most appropriate means of protecting the public health and welfare, prohibit the production, manufacture, export and import of, trade in, possession or use of any such drug except for amounts which may be necessary for medical and scientific research only, including clinical trials therewith to be conducted under or subject to the direct supervision and control of the Party.''
 
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This provision, while apparently providing for the limitation of cannabis to research purposes only, also seems to allow some latitude for nations to make their own judgments. The official Commentary on the Single Convention indicates that Parties are expected to make that judgment in good faith.
 
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== Further reading ==
 
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*[http://www.fda.gov/bbs/topics/NEWS/2006/NEW01362.html Official FDA Statement Regarding Claims of Smoked Marijuana as medicine]
 
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* [http://www.druglibrary.org/schaffer/hemp/medical/medpaper.htm Report on and index of marijuana medical studies] by Todd Mikuriya, M.D.]
 
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* [http://jul.2006.med-bib.com/16849753.htm Cannabis-In-Cachexia-Study-Group; Strasser F, Luftner D, Possinger K, Ernst G, Ruhstaller T, Meissner W, Ko YD, Schnelle M, Reif M, Cerny T: Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. J Clin Oncol. 2006 Jul 20;24(21):3394-400.]
 
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** Synthetic [[THC]] or low doses of cannabis extract administered orally for cancer-related cachexia (anorexia, weight-loss, emaciation) not better than placebo.
 
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* [http://www.nap.edu/html/marimed/ Janet E. Joy, Stanley J. Watson, Jr., and John A Benson, Jr., "Marijuana and Medicine: Assessing the Science Base", Division of Neuroscience and Behavioral Research, Institute of Medicine (Washington, DC: National Academy Press, 1999).]
 
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** "The accumulated data indicate a potential therapeutic value for cannabinoid drugs, particularly for symptoms such as pain relief, control of nausea and vomiting, and appetite stimulation." and "At this point there are no convincing data to support (the concern that medical marijuana would lead to an increase in recreational use). The existing data are consistent with the idea that this would not be a problem if the medical use of marijuana were as closely regulated as other medications with abuse potential."
 
−
* [http://www.druglibrary.org/schaffer/hemp/medical/ms_mj_ref.htm Index of studies involving marijuana and multiple sclerosis]
 
−
* [http://www.druglibrary.org/schaffer/hemp/mariem1.htm Doblin et al., Marijuana as Antiemetic Medicine: A Survey of Oncologists' Experiences and Attitudes," ''Journal of Clinical Oncology'', Vol. 9, No. 7, July 1991.]
 
−
* [http://www.connotea.org/add?uri=news/2005/050404/full/050404-7.html Khamsi, R: Cannabis compound benefits blood vessels. Nature, 4 Apr 2005 (premium content).]
 
−
** [[Tetrahydrocannabinol|THC]] has been found to combat formation of arterial blockages. A random survey of oncologists found that 44% had illegally recommended marijuana for the control of vomiting and that 48% would do so if it were legal; 54% thought it should be available by prescription.
 
−
* [http://www.medmjscience.org/Pages/science/vinciguerra.html Vinciguerra et al., Inhalation Marijuana as an Antiemetic for Cancer Chemotherapy," ''The New York State Journal of Medicine'', pgs., 525-527, October 1988]
 
−
** 56 Patients who had achieved no success with other antiemetics; 72% found success — the study also concluded that smoked marijuana was more effective than oral THC pills.
 
−
* [http://www.medmjscience.org/Pages/science/chang.bhtml Chang et al., Delta-9-Tetrahydrocannabinol as an Antiemetic in Cancer Patients Receiving High Dose Methotrexate; ''Annals of Internal Medicine'', Volume 91, Number 6, pg. 819-824, December 1979]
 
−
** A double-blind controlled study found a 72% reduction in nausea and vomiting; the study also concluded that smoked marijuana was more effective than oral THC
 
−
* [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3774823&dopt=Citation Foltin RW, Brady JV, Fischman MW: Behavioral analysis of marijuana effects on food intake in humans. Pharmacol Biochem Behav. 1986 Sep;25(3):577-82.]; [http://aug.1988.med-bib.com/3228283.htmFoltin RW, Fischman MW, Byrne MF: Effects of smoked marijuana on food intake and body weight of humans living in a residential laboratory. Appetite. 1988 Aug;11(1):1-14.]; and [http://aug.1976.med-bib.com/822452.htm Greenberg I, Kuehnle J, Mendelson JH, Bernstein JG: Effects of marihuana use on body weight and caloric intake in humans. Psychopharmacology (Berl). 1976 Aug 26;49(1):79-84.]
 
−
** These three studies concluded that marijuana increases appetite.
 
−
* [http://oct.1975.med-bib.com/1099449.htm Sallan SE, Zinberg NE, Frei E 3rd: Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. N Engl J Med. 1975 Oct 16;293(16):795-7.]
 
−
** Study concluded that smoked marijuana was more beneficial than synthetic THC for some patients.
 
−
* Donald P. Tashkin, MD, "Effects of Smoked Marijuana on the Lung and Its Immune Defenses: Implications for Medicinal Use in HIV-Infected Patients"; ''Journal of Cannabis Therapeutics'', Vol. 1, No. 3/4, 2001, pp. 87-102
 
−
** "Frequent marijuana use can cause airway injury, lung inflammation and impaired pulmonary defense against infection. The major potential pulmonary consequences of habitual marijuana use of particular relevance to patients with AIDS is superimposed pulmonary infection, which could be life threatening in the seriously immonocompromised patient.  In view of the immonosuppressive effect of THC, the possibility that regular marijuana use could enhance progression of HIV infection itself needs to be considered, although this possibility remains unexplored to date."
 
−
* Guy A. Cabral, PhD, "Marijuana and Cannabinoids: Effects on Infections, Immunity, and AIDS"; ''Journal of Cannabis Therapeutics'', Vol. 1, No. 3/4, 2001, pp. 61-85
 
−
** "However, few controlled longitudinal epidemiological and immunological studies have been undertaken to correlate the immunosuppressive effects of marijuana smoke or cannabinoids on the incidence of infections or viral disease in humans.  Clearly, additional investigation to resolve the long-term immunological consequences of cannabinoid and marijuana use as they relate to resistance to infections in humans is warranted."
 
−
* [http://dec.1979.med-bib.com/231736.htm Ekert H, Waters KD, Jurk IH, Mobilia J, Loughnan P: Amelioration of cancer chemotherapy-induced nausea and vomiting by delta-9-tetrahydrocannabinol. Med J Aust. 1979 Dec 15;2(12):657-9.]
 
−
** In children receiving cancer chemotherapy delta-9-tetrahydrocannabinol (THC) has an antinausea and antivomiting effect.
 
−
* [http://jan.1980.med-bib.com/6985702.htm Sallan SE, Cronin C, Zelen M, Zinberg NE: Antiemetics in patients receiving chemotherapy for cancer: a randomized comparison of delta-9-tetrahydrocannabinol and prochlorperazine. N Engl J Med. 1980 Jan 17;302(3):135-8.]
 
−
** THC seems to be an effective antiemetic in many patients who receive chemotherapy for cancer and for whom other antiemetics are ineffective.
 
−
*[http://www.alternet.org/drugreporter/51277/ New Studies Destroy the Last Objection to Medical Marijuana]
 
−
 
 
−
== See also ==
 
−
* Patients Out of Time
 
−
* Coalition to Reschedule Cannabis
 
−
* [[Health issues and the effects of cannabis]]
 
−
* [[Ed Rosenthal]]
 
−
* [[Tilden's Extract]]
 
−
* [[Sativex]]
 
−
* [[Victor Robinson]]
 
−
* [[Steve Kubby]]
 
−
* [[NORML]]
 
−
* [[California Cannabis Research Medical Group]]
 
−
* [[Cannabis Buyers Club]]
 
−
* [[Multidisciplinary Association for Psychedelic Studies]]
 
−
* [[Proposition 215]]
 
−
* [[Legality of cannabis by country]]
 
−
 
 
−
==References==
 
−
* [http://www.incb.org/e/conv/1961/ Single Convention on Narcotic Drugs 1961], International Narcotics Control Board.
 
−
* Dominik Wujastyk, "Cannabis in Traditional Indian Herbal Medicine" in Ana Salema (ed.), ''Ayurveda at the Crossroads of Care and Cure'', Lisbon, [http://cham.fcsh.unl.pt/engl/ayurveda.htm Centro de História del Além-Mar], Universidade Nova de Lisboa, 2002, pp.45--73.  ISBN 972-98672-5-9.  [http://www.ucl.ac.uk/~ucgadkw/papers/cannabis.pdf Early pre-publication draft.]
 
−
 
 
−
==Notes==
 
−
<div class="references-small">
 
−
<references/>
 
−
</div>
 
−
 
 
−
== External links ==
 
−
* [http://www.antiquecannabisbook.com The Antique Cannabis Book]
 
−
* [http://ahp.yorku.ca/?p=59 Bibliography: Cannabis canadensis]. Advances in the History of Psychology, [[York University]]
 
−
*[http://www.compassioncorner.org Cannabis Compassion Corner] A not-for-profit online cannabis compassion club.
 
−
* [http://www.drugscience.org. DrugScience.org] provides scientific and other material regarding the medical use of cannabis.
 
−
* [http://marijuana-ro.com/index.php?page=medical-usage Marijuana Ro Medical Club Medical Usage]
 
−
* [http://www.medicalmarijuanaprocon.org Medical Marijuana ProCon.org] - Should marijuana be a medical option?
 
−
* [http://www.waitingtoinhale.org ''Waiting to Inhale''] - The first documentary to examine the movement to legalize cannabis for medical use
 
−
 
 
−
 
 
−
;International organizations
 
−
* [http://www.acmed.org/english/home.htm International Association for Cannabis as Medicine (IACM)]
 
−
 
 
−
;National organizations
 
−
* [http://www.mpp.org/ The Marijuana Policy Project]
 
−
* [http://www.americansforsafeaccess.org/ Americans for Safe Access]
 
−
* [http://www.medicalmarijuanamuseum.org The Medical Marijuana Museum] Medical Cannabis Archive
 
−
* [http://www.letfreedomgrow.org American Alliance for Medical Cannabis]
 
−
* [http://www.compassionatecoalition.org Compassionate Coalition]
 
−
*[http://www.medicalmarijuanaofamerica.com Medical Marijuana of America:] Resource for pot prisoner support, medicinal cannabis prequalification.
 
−
* [http://www.norml.org/index.cfm?Group_ID=3376 NORML - National Organization for the Reform of Marijuana Laws Medical Use]
 
−
* [http://www.medicalcannabis.com. Patients Out of Time]
 
−
 
 
−
;Local organizations
 
−
*[http://www.amop.org Alternative Medicine Outreach Program] Douglas County, Oregon
 
−
* [http://thecompassionclub.org/ The BC Compassion Club Society] British Columbia
 
−
* [http://www.iowamedicalmarijuana.org Iowans for Medical Marijuana]
 
−
* [http://www.occaregivers.com OC Caregivers] - Orange County, California
 
−
* [http://www.ripatients.org Rhode Island Patient Advocacy Coalition]
 
−
* [http://www.wamm.org The Wo/Men's Alliance for Medical Marijuana] Santa Cruz, California
 
−
*[http://www.weedconnection.com WeedConnection] Southern California
 
−
 
 
−
{{Cannabis resources}}
 
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[[Category:Antiemetics]]
 
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[[Category:Cannabis]]
 
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[[Category:Medical ethics]]
 
−
[[Category:Medicinal plants]]
 
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[[Category:United States controlled substances law]]
 
−
 
 
−
[[de:Cannabis als Medizin]]
 
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[[fr:Cannabis médical]]
 
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[[no:Cannabis (medisin)]]
 

Revision as of 22:26, September 19, 2007

Medical marijuana is marijuana used for its (supposed) analgesic or otherwise therapeutic effects (see Glaucoma).

Critics doubt that there are any medicinal effects of marijuana, other than an overall effect sought by drug addicts. "Medical beer," "medical heroin," "medical pornography" and "medical gambling" are not recognized either, for good reason.

Opponents of drug abuse charge that efforts to legalize medical marijuana are intended to be a step towards complete decriminalization and generally decry marijuana as a "gateway drug".

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