Showing posts with label Sativex. Show all posts
Showing posts with label Sativex. Show all posts

Saturday, July 30, 2011

White House admits marijuana has ‘some’ medical value

By Stephen C. Webster - RAW Story
Monday, July 11th, 2011

Just days after the Drug Enforcement Agency (DEA) insisted that there is no medical value to marijuana, the White House appeared to contradict the position, saying in a report that there may actually be "some" medical value to "individual components of the cannabis plant" after all.

The statement was just a small part of the Office on National Drug Control Policy's yearly update on the progress of the drug war and its goals moving forward. Overall, the document only serves to affirm the federal prohibition of marijuana and what it calls "'medical' marijuana," which it still views as illegitimate.

But a single passage, under their "facts about marijuana," seems to loosen a bit from the generation-old line that there is no value to cannabis whatsoever.

"While there may be medical value for some of the individual components of the cannabis plant, the fact remains that smoking marijuana is an inefficient and harmful method for delivering the constituent elements that have or may have medicinal value," the report says.

Still, today's medical marijuana patients and proprietors don't have much to cheer in the report, as it goes on to insist that smoking the marijuana plant itself is harmful and dangerous, especially for teens, and perpetuates the largely discredited "gateway drug" theory.

Critics are likely to see the passage as offering a bit of wiggle room for major pharmesutical producers looking to grow marijuana to extract its psychoactive ingredient, THC, or other cannabinoid compounds that have been demonstrated to help abate symptoms of some chronic diseases, like wasting syndrome in AIDS patients or nausea in cancer patients.

In 2007, GW Pharmaceuticals announced that it partnered with Otsuka to bring "Sativex" -- or liquefied marijuana -- to the U.S. The companies recently completed Phase II efficacy and safety trials testing and began discussion with the FDA for Phase III testing. Phase III is generally thought to be the final step before the drug can be marketed in the U.S.

Sativex is the brand name for a drug derived from cannabis sativa. It's an extract from the whole plant cannabis, not a synthetic compound. Even GW defines the drug (.pdf) as marijuana.
Yet as the FDA is poised to approve the drug for Big Pharma, state-licensed medical marijuana dispensaries that provide relief for thousands of Americans are under attack by other federal agencies.

The National Organization for the Reform of Marijuana Laws (NORML) has warned just as much, claiming that federal authorities may be looking to shift policy slightly, if only to legalize marijuana-based medicines for Big Pharma only, which could step in and  potentially eradicate the medical marijuana market.

The Obama administration said in a recent memo that it fully intends to enforce the federal ban on marijuana, regardless of whether individual states have legalized its use for medical purposes.

It added that a 2009 memo, which seemed to take the pressure off state-authorized medical marijuana clinics and patients, was merely a guidance on the best uses of federal funds and not actually a change in policy.

An ABC News poll found last year that eight in 10 Americans favor legalizing medical marijuana.

Saturday, July 16, 2011

How Cannabis Works

"What is the end of our revolution? The tranquil enjoyment of liberty and equality; the reign of that eternal justice, the laws of which are graven, not on marble or stone, but in the hearts of men, even in the heart of the slave who has forgotten them, and in that of the tyrant who disowns them."
-- Maximillien Robespierre

Wake Up and Smell the Terpenes!
By FRED GARDNER

The chemical structure of tetrahydrocannabinol (THC) was determined in 1964 by Raphael Mechoulam and Yechiel Gaoni. For more than three decades thereafter, its blatant psychoactivity induced scientists to define THC as the active ingredient in the plant.

Experienced marijuana smokers who tried the drug Marinol (pure, synthetic THC) when it became prescribable in the mid-1980s, reported that the effects were noticeably dissimilar. But it wasn’t until the late 1990s that the research establishment acknowledged that another compound, cannabidiol (CBD), was exerting significant effects, too. 

In 1999 a British start-up, G.W. Pharmaceuticals, began clinical trials of a plant extract containing equal amounts of THC and CBD. Multiple Sclerosis patients found the combination more effective in reducing pain and spasticity than a THC extract, and less psychoactive. The THC-CBD combo, “Sativex,” has now been approved for use by MS patients in England, Canada, New Zealand, and a growing list of European countries. 

Several of the so-called “minor cannabinoids” —notably tetrahydrocannabavarin (THCV), cannabigerol (CBG) and cannabichromene (CBC)— also show therapeutic promise, and plants with high levels of each have been grown out in G.W.’s glasshouses for research purposes.

Now scientists are formally acknowledging something else that Cannabis consumers have long taken for granted: aroma is associated with effect.

Plant cannabinoids —21-carbon molecules found only in Cannabis— are odorless. It’s the terpenoids —components of the plant’s “essential oils”— that create the fragrance. Terpenoids contain repeating units of a 5-carbon molecule called isoprene, and are prevalent in smelly herbs such as mints and sage, citrus peel, some flowers, aromatic barks and woods. The aroma of a given plant depends on which terpenoids predominate. They tend to be volatile molecules that readily evaporate, and they’re very potent —all it takes is a few reaching the nose to announce their presence. The cannabinoid content of a trichome might be 10 times heavier than the terpenoid content. 

Evidence that “phytocannabinoid-terpenoid interactions” enhance the therapeutic effects of cannabis was presented by Ethan Russo, MD, at a conference in Israel last fall and is about to be published in the British Journal of Pharmacology. Russo, a neurologist and ethnobotanist,, is senior medical adviser at G.W. Pharmaceuticals.

Terpenoids and cannabinoids are both secreted inside the Cannabis plant’s glandular trichomes and they have a parent compound in common (geranyl pyrophosphate). More than 100 terpenoids have been identified in Cannabis. The most common and most studied include limonene, myrcene, alpha-pinene, linalool, beta-caryophyllene, caryophyllene oxide, nerolidol and phytol. Anecdotal evidence suggests that alpha-pinene is alerting, limonene is “sunshine-y,” and beta-myrcene is sedating.

 As the names suggest, pinene is abundant in pine needles and limonene in lemons. Myrcene is found in hops (Humulus), the only other member of the Cannabicae plant family.

The fact that most terpenoid compounds are common components of the human diet and “generally recognized as safe” by the Food and Drug Administration has made research possible, and scientists employed by flavors and fragrances manufacturers have investigated their properties over the years. But the terpenoids “remain understudied” in terms of therapeutic potential, according to Russo. 

His paper mustered all the evidence —proof in some cases, mere hints in others—  that cannabinoid-terpenoid synergy is involved when Cannabis abates the symptoms of various conditions. He listed “pain, inflammation, depression, anxiety, addiction, epilepsy, cancer, fungal and bacterial infections (including methicillin-resistant Staphylococcus aureus).”

For example, as an indication that some terpenoids may, like CBD, be “antidotes to the intoxicating effects of THC,” Russo noted that traditional responses to Cannabis overdose include limonene-rich citrus and pinene-rich black pepper.

Jeffrey Hergenrather, MD, president of the Society of Cannabis Clinicians, who attended Russo’s talk in Israel, expects its publication to “generate great interest in terpenes among medical cannabis users as well as physicians.” The SCC recently began collecting data on patients’ responses to CBD-rich Cannabis. Future surveys will seek to document which terpenoids are having which effects.

The “Entourage Effect”

The conference at which Russo presented his paper was held at Hebrew University, Jerusalem, where Raphael Mechoulam directs a lab, in honor of Mechoulam’s 80th birthday.  

In 1999 Mechoulam co-authored a paper with Shimon Ben-Shabat suggesting that cannabinoids made in the body work by means of an “entourage effect.” They had found that the endocannabinoid 2-AG (2-arachidonoylglycerol), tested by itself, did not bind very strongly to the cannabinoid receptors or exert pronounced behavioral effect on mice. But when administered with two related compounds, it did both. 

To pharmacologists who customarily designed experiments aimed at finding the active ingredient, this had heavy implications. Mechoulam spelled them out: “Biochemically active natural products, from either plant or animal origin, are in many instances accompanied by chemically related though biologically inactive constituents. Very seldom is the biological activity of the active constituent assayed together with inactive ‘entourage’ compounds. 

Investigations of the effect of the active component in the presence of its ‘entourage’ compounds may lead to results that differ from those observed with the active component only.”
In 2001 John McPartland and Russo published a paper in the Journal of Cannabis Therapeutics applying the “entourage” concept to the plant itself.  “Good evidence shows that secondary compounds in cannabis may enhance the beneficial effects of THC... and reduce THC-induced anxiety, cholinergic deficits, and immunosuppresion,” they wrote. “Cannabis terpenoids and flavonoids may also increase cerebral blood flow, enhance cortical activity, kill respiratory pathogens, and provide anti-inflammatory activity.” 

A decade later, Russo is substantiating the molecular-teamwork hypothesis and expanding on it. His forthcoming BJP paper, “Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects,” contains 304 citations.

A really good scientific review paper is built like a stone wall by an artistic mason. Documented fact upon documented fact upon documented fact, with insights positioned fittingly. Russo, citing Robert Clarke (2010), suggests that “distinctions between available cannabis ‘strains’ are most likely related to relative terpenoid contents and ratios.” Citing David Potter (2009), he notes that “the mechanical stickiness of the trichomes [is] capable of trapping insects with all six leg.”  Citing Jirovetz et al, “Linalool is the likely suspect in the remarkable therapeutic capabilities of lavender essential oil to alleviate skin burns without scarring.”  

Citing investigators too numerous to list here, Russo reports the effects attributed to various terpenoids:
  • Limonene (also found in lemon): Potent immunostimulant via inhalation. Anxiolytic. Apoptosis of breast cancer cells. Active agent against acne bacteria. Dermatophytes. Gastro-esophaeal reflux. 
  • Alpha-pinene (found in pine needles): Bronchodilatory in humans. Acetylcholinesterase inhibitor, aiding memory.
  • Beta-myrcene (found in hops): Blocks inflammation via PGE-2. Analgesic, antagonized by naloxone. Sedating, muscle relaxant, hypnotic. Blocks hepatic carcinogenesis by aflatoxin.
  • Linalool (found in lavender): Anti-anxiety. Sedative on inhalation in mice. Local anesthetic. Anagesic via adenosine A2A. Anticonvulsant/anti-glutamate.
  • Beta-Caryophyllene (found in pepper, Echinacea): Potent anti-leishmanial. Gastric cytoprotective. Anti-malarial. Selective CB2 antagonist. Treatment of pruritis? Treatment of addiction? Decreases platelet aggregation. 
  • Caryophyllene Oxide (found in lemon balm): Anti-fungal. Insecticidal. 
  • Nerolidol (found in orange): Sedative. Skin penetrant. Potent antimalarial. Anti-leishmanial activity. Breakdown product of chlorophyll. 
  • Phytol (found in green tea): Prevents Vitamin-A teratogenesis. Increases GABA.
Cannabinoids Formerly Known as Minor
Although this article has focused on the terpenoids, Russo’s talk in Israel gave equal time to CBD, THC-V, CBC, and CBG (the parent compound of the others). Evidently the extensive breeding program directed by G.W.’s Etienne de Meijer has yielded plants rich in each of these cannabinoids, and probably others. At the 2011 meeting of the International Cannabinoid Research Society, held in Chicago in July, several talks and posters described promising results with G.W. extracts whose exact contents were not revealed by the investigators. 

Intrepid California cultivators are trying to follow G.W.’s lead. Labs have already begun testing for the cannabinoids that may not be “minor” after all, and for terpenoids.  

Projectcbd.org will help collect and report on patients’ responses to the newly identified active ingredients. Maybe we should have called it BeyondTHC.com… The “entourage effect” applies to politics, too. The drug policy reform movement, like all single-issue movements, is the political equivalent of Marinol... More on all this in O’Shaughnessy’s, due out next month. To order or place an ad (enabling us to pay the printer), contact the managing editor (me), fred@plebesite.com.

Thursday, May 5, 2011

DOJ plan to arrest state licensers, tax dispensaries to doom medical marijuana

By Stephen C. Webster - RAW Story
Wednesday, May 4th, 2011

A recent letter from the Department of Justice (DOJ), threatening state employees in charge of implmenting medical marijuana laws with prosecution, has forced some governors to re-evaluate and even veto popular legislation -- all seemingly in violation of what the medical marijauana community thought was a cease-fire with the federal government.

Facing the threat of seeing otherwise innocent state employees thrown in jail, lawmakers are responding in an entirely human fashion: what Allen St. Pierre, executive director of the National Organization for the Reform of Marijuana Laws (NORML), called "the old need to CYA -- cover your ass."

Ultimately, the administration's confusing legal position has led to a stagnation of medical marijuana reform efforts, with some states simply deciding it's not worth the risk.

It also represents a significant change in momentum for the prohibition reform movement as a whole, and one that's taken them almost entirely by surprise.

In 2009, Attorney General Eric Holder's Justice Department issued a memo stating that it would not prosecute medical marijuana patients, suppliers or caregivers in states that have passed voter initiatives to legalize the drug's use -- so long as they were all abiding by that state's laws.

Earlier this month, however, the Justice Department sent a letter to the governor of Washington, warning that state employees may be prosecuted if they are in any way involved in the licensing of production or distribution of marijuana.

"The prosecution of individuals and organizations involved in the trade of any illegal drugs and the disruption of drug trafficking organizations is a core priority of the Department," department attorneys wrote. "This core priority includes prosecution of business enterprises that unlawfully market and sell marijuana."

The letter did not state the laws they would be in violation of, but NORML director St. Pierre told Raw Story in an interview Tuesday that he believed feds would try to prosecute state employees under the The Racketeer Influenced and Corrupt Organizations Act.

Reacting to this highly specific language, Gov. Chris Gregoire vetoed the bill, but maintained that she supports moving the drug's classification to Schedule 2, similar to other potent and potentially addictive painkillers used in hospitals.

Similarly, New Jersey Governor Chris Christie (R) is reportedly hesitant to implement portions of his state's medical marijuana provisions, which passed the legislature before he took office. New rules drafted by Christie's administration would make New Jersey's medical marijuana system the most restrictive in the nation, but it requires the involvement of state employees. New Jersey's health department named in March just six private producers it would grant licenses to.

But now that's been delayed too, and the legislature has stalled as it debates whether to rewrite Christie's plans.

Meanwhile, the DOJ's letters are expected in other states too, posing a sobering argument that if governors are wary of waging legal battles with the feds to keep their employees out of jail, they should instead keep them far away from any and all private producers of medical marijuana.

NORML speculated in February that if the Obama administration followed Gov. Gregoire's lead and reclassify marijuana as Schedule 2 -- or potentially expand the definition of Schedule 3 to include pharmacological products -- major corporations are waiting in the wings to take over the market with cannabis-based drugs, like the liquefied marijuana medicine Sativex, from GW Pharmaceuticals plc.

So far, 15 states and the District of Colombia have passed laws permitting marijuana to be used as medicine.

But it's not just state workers who DOJ is currently targeting in its efforts to end the sale of marijuana for medical uses. As previously reported, the DOJ is coming after licensed growers and dispensaries with a very old tool: the tax code.

NORML's executive director St. Pierre told Raw Story that this marked a change in tactics for the Justice Department.

Chasing after medical marijuana dispensaries not with SWAT teams, but with tax attorneys, he said, was "like what they did to Al Capone" and represented a significant change in tactics for the DOJ.

To this effect, the Internal Revenue Service (IRS) sees § 280E of the federal tax code as license to come after businesses that sell marijuana if and when they file their taxes, as it prohibits any deductions for companies "trafficking in controlled substances."

"Every transaction you engage in is a separate offense and you are literally writing your own indictment every day on the registry of your cashier's tape," St. Pierre explained.

"The real quandary for these people who thought they had legitimate businesses is whether they can take tax exemptions," St. Pierre went on. "If they can do that, then that industry will continue to grow. If, however, if [a key court decision goes against producers], then for all intents and purposes, that is probably it for retail businesses that sell marijuana for another person."

He concluded: "Absent the federal government changing these laws, the razor blade this administration has now created for itself to crawl across is becoming pretty evident each week. It's hard to maintain both positions."

Thursday, April 21, 2011

Big Pharma set to take over medical marijuana market

By David Edwards - RAW Story
Wednesday, April 20th, 2011

Just as the federal government is clamping down on medical marijuana dispensaries, the Federal Drug Administration (FDA) may be set to give Big Pharma the clearance to take over the market.

In 2007, GW Pharmaceuticals announced that it partnered with Otsuka to bring "Sativex" -- or liquefied marijuana -- to the U.S. The companies recently completed Phase II efficacy and safety trials testing and began discussion with the FDA for Phase III testing. Phase III is generally thought to be the final step before the drug can be marketed in the U.S.

"GW Pharmaceuticals plc (AIM: GWP) today announces the initiation of the Phase III clinical trials programme of Sativex in the treatment of pain in patients with advanced cancer, who experience inadequate analgesia during optimized chronic opioid therapy," GW said in a statement. "This indication represents the initial target indication for Sativex in the United States."

Sativex is the brand name for a drug derived from cannabis sativa. It's an extract from the whole plant cannabis, not a synthetic compound. Even GW defines the drug (.pdf) as marijuana.

Yet as the FDA is poised to approve the drug for Big Pharma, state-licensed medical marijuana dispensaries that provide relief for thousands of Americans are under attack by other federal agencies.

Lynette Shaw, the owner and founder of Marin Alliance for Medical Marijuana (MAMM) in Fairfax, California, was stunned when the IRS audited her 2008 and 2009 tax returns and disallowed the foundation's business deductions, then demanded millions of dollars in back taxes.

The IRS pursued her under § 280E of the federal tax code, which states that no business deductions will be allowed for companies "trafficking in controlled substances".

Shaw is now suing the IRS to prevent them from destroying the entire medical marijuana industry.

Last week, the Justice Department even threatened to prosecute state employees who license medical marijuana dispensaries.

As a result, Washington state Gov. Chris Gregoire (D) said she would veto a bill that would have allowed the state to license growers.

In February, marijuana advocacy group NORML warned that the Drug Enforcement Administration (DEA) intended to legalize marijuana for Big Pharma only.

"The DEA's intent is to expand the federal government's schedule III listing to include pharmaceutical products containing naturally derived formations of THC while simultaneously maintain existing criminal prohibitions on the plant itself," Paul Armentano, the deputy director of the National Organization for the Reform of Marijuana Laws (NORML), wrote at AlterNet.

Tuesday, June 29, 2010

Big Pharma-Backed Marijuana Spray As Medicine?

by Paul Armentano | June 24, 2010


British health regulators have approved the sale and marketing of Sativex, an oral spray consisting of natural cannabis extracts (primarily the plant cannabinoids THC and cannabidiol aka CBD) as a treatment for symptoms of multiple sclerosis. (MS)

The spray, which has been legally available to patients in Canada since 2005,went on sale in Britain on Monday. The drug will be marketed in the United Kingdom by the Bayer Corporation which estimates that Sativex will cost the country’s state-run National Health Service roughly £11, or about $16, a day for each patient.
In clinical trials, Sativex has been demonstrated to reduce MS-associated spasticity, pain, and incontinence. Long-term investigational trials indicate that consistent use of the cannabis-based medicine may also slow the progression of the disease.
Surveys from the UK and elsewhere indicate that MS patients often report using cannabis therapeutically, with one study reporting that some four out of ten patients with the disease find relief from marijuana.
GW Pharmaceuticals, makers of the Sativex, is expected later this year to seek separate regulatory approval for the spray in Spain, France, Germany, and Italy.
In 2006, the US Food and Drug Administration authorized recruitment for the first-ever North American clinical trial of Sativex for cancer pain treatment. A Phase III trial is anticipated to begin the US later this year.
The approval of Sativex in the UK is newsworthy though hardly surprising, as thescientific evidence in support of marijuana’s medical safety and utility has been available for decades. However, the bigger question still remains. That is: ‘How can the US government continue to promote a policy that calls for the arrest and prosecution of patients who use a substance that fourteen states and much of the rest of the western world now acknowledges as a safe and legitimate medicine?’