Reefer madness

Is marijuana medically useful? Many people, from patients to doctors and scientists think so. The US Food and Drug Administration appears to disagree. These ideas are in line with what the Whitehouse, Drug Enforcement Administration, and some vocal congressmen think. However, in eleven states around America compassion hasn't taken a back-seat to politics and laws allowing medical marijuana have been passed. More on this subject in this week's Economist...

Reefer madness
Apr 27th 2006
Marijuana is medically useful, whether politicians like it or not

IF CANNABIS were unknown, and bioprospectors were suddenly to find it in some remote mountain crevice, its discovery would no doubt be hailed as a medical breakthrough. Scientists would praise its potential for treating everything from pain to cancer, and marvel at its rich pharmacopoeia—many of whose chemicals mimic vital molecules in the human body. In reality, cannabis has been with humanity for thousands of years and is considered by many governments (notably America's) to be a dangerous drug without utility. Any suggestion that the plant might be medically useful is politically controversial, whatever the science says. It is in this context that, on April 20th, America's Food and Drug Administration (FDA) issued a statement saying that smoked marijuana has no accepted medical use in treatment in the United States. (more...)

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Update (12th May)
In response to this article, we have received a letter from John P. Walters, director of the White House Office of National Drug Control Policy--also known as the "Drug Czar". I would expect The Economist would publish this on its letter's page in the near future.

Commentary & comments from other blogs:
This article has inspired a lot of commentary, some of it useful.

One commentator here discusses the FDA's existing programme to supply cannabis medicinally. (more...)

From the Democratic Daily (here...)

Overview of the debate, Politics and Pot.

A critique of the Reefer Madness (here...)

More commentary, and my reply to one critique of the piece (more..)

Overview of the debate, Politics and Pot.

And a few more comments (here..)

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References

Nicoll, Roger & Alger, Bradley, 2004. The brain's own marijuana. Scientific American. December 2004.

Wilson, Clare, 2005. Miracle Weed, New Scientist, vol 185, issue 2485, p38.

Neuroprotection by delta-9-tetrahydrocannabinol, the main active compound in marijuana, against ouabain-induced in vivo excitotoxicity. The Journal of Neuroscience, 2001, 21 (17): 6475-6479.

Inter-agency advisory regarding claims that smoked marijuana is a medicine. FDA, April 20, 2006.

Medical Marijuana. American Medical Association, June 2001.

Marijuana and medicine: assessing the science base. 1999. Institute of Medicine.


Press releases
Doctor suggested cannabis for pain relief, says one in six medicinal users in the UK. Press release from McGill University.

Cannabis-based medicine relieves the pain of rheumatoid arthritis and suppresses the disease. Press release from Journal of Rheumatology, Oxford University Press.

Cannabis extract reduces pain in multiple sclerosis patients. Press release from British Medical Journal.

UK trial results on value of cannabis for multiple sclerosis patients. Press Release from the Medical Research Council.

Brain’s own cannabis compound protects against inflammation. Press release from journal Cell.

Hebrew University scientists develop prototype drug to prevent osteoporosis. Press release from Hebrew University of Jerusalem.

Cannabis-based drugs could offer new hope for inflammatory bowel disease patients. Press release from University of Bath.

Groups

Food and Drug Administration

Drug Enforcement Administration

Office of National Drug Control Policy

The National Organization for the Reform of Marijuana Laws

Multidisciplinary Association for Psychedelic Studies

Medical Marijuana ProCon.org

American Civil Liberties Union

GW Pharmaceuticals

Marinol

The magic of nano

At the end of March, a new bathroom cleaning product called MagicNano was released onto the German market. Within only a few days, almost 80 people had suffered respiratory complaints and six people had been hospitalised with fluid on their lungs.

Nano-watchers were quick to raise the question of whether this is the first example of a harmful nanotechnology product. This time, at least, it does not appear that nanotechnology is to blame. MagicNano was released in two versions: a pump spray and an aerosol spray. While the product inside the packaging was identical, only the aerosol spray caused respiratory problems. So it seems likely that the problem is down to the propellant in the aerosol.

This finding will not give much comfort to anyone. Companies making products that include nanoparticulates would very much like firm guidance from governments as to what tests they need to perform to demonstrate their product is safe. Governments, meanwhile, seem to be waiting for advice from scientists.

Has all the magic gone?
Apr 12th 2006
A nanotechnology product is recalled in Germany after health concerns (more...)

The drug trial that went wrong

This important story about a drug trial that went wrong in London has almost been buried by the alarm over a single case of H5N1 in a swan in Scotland. In the middle of last month, six people were taken seriously ill--with multiple organ failure--after taking part in a small clinical trial of an antibody treatment called TGN1412.

The mishap was so serious that Britain's Medicines and Healthcare products Regulatory Agency (MHRA), a government body, swiftly launched a full inquiry. On Wednesday of this week it announced interim findings. The trial had been run correctly, doses were given as they were supposed to, and there was no mistake in manufacturing. In other words, there was something unexpected about the drug itself, despite testing on animals and human-cell cultures, and despite the fact the doses given to humans were only 1/500th of what had been given to animals.

This is a difficult result for the drug business because it raises questions about the right way of testing medicines of this kind. TGN1412 is unusual in that it is an antibody. And it is an unusual antibody as well. Unlike all other antibody drugs it is what is called a “superagonistic” antibody, designed to increase the numbers of a type of immune cell known as regulatory T-cells.

Reduced numbers, or impaired function, of regulatory T-cells has been implicated in a number of illnesses, such as type 1 diabetes, multiple sclerosis and rheumatoid arthritis. Boosting the pool of these antibodies seemed like a good treatment strategy. Unfortunately, that strategy fell disastrously to pieces and it will take a little longer to find out why.

The result highlights concerns raised in a paper just published by the Academy of Medical Sciences, a group of experts based in London. It says there are special risks associated with novel antibody therapies. For example, their chemical specificity means that they might not bind to their targets in humans as they do in other species.

The MHRA has decided that a working group of experts is now needed to decide how trials of this sort of drug can be handled more safely. Its main concern is how to test protein molecules that have novel modes of action--particularly in the immune system. While this expert group is working (it could take around three months) the MHRA will authorise further trials of compounds of this kind only after taking advice.

Tales of the unexpected
Apr 6th 2006
Why a drug trial went so badly wrong
IN ANY sort of test, not least a drugs trial, one should expect the unexpected. Even so, on March 13th, six volunteers taking part in a small clinical trial of a treatment known as TGN1412 got far more than they bargained for. All ended up seriously ill, with multiple organ failure, soon after being injected with the drug at a special testing unit at Northwick Park Hospital in London, run by a company called Parexel. One man remains ill in hospital.
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