Pot by prescription
Alexey Vodovozov, Telegraph "Around the World"Recent studies confirm that marijuana has good therapeutic potential.
It is not surprising that in a number of countries drugs based on it can be legally purchased at a pharmacy – more than half of the substances that make up this plant are used for peaceful purposes.
In Los Angeles, in January of this year, marijuana vending machines began operating. This is not a mistake or a trick of drug dealers. The devices distribute packaged cannabis as prescribed by a doctor. The access procedure is quite complicated – identity cards and fingerprints are checked. But the fact remains that marijuana is sold, even if only for medical purposes.
With drugs in medicine, there is about the same story. At first, they are opened as a remedy, say, for a cough or for migraines. After a while, it turns out that in fact the "medicine" causes a real addiction, and the remedy is withdrawn from free access. Then useful components are extracted from the cover and a whole line of assorted medicines is made from them. So, one of the alkaloids of the opium poppy – codeine – is used as a powerful cough remedy, and its second alkaloid – morphine – as an analgesic. In addition, after studying the molecular structure of these compounds, a number of synthetic drugs have been created – trimeperidine, tramadol, fentanyl and others. All of them are used as highly effective analgesics in emergency situations, when the victim may die from pain shock with wounds, injuries, myocardial infarction, as well as to relieve pain, for example, with malignant neoplasms.
With marijuana, although it is one of the most widespread and easily accessible drugs, a slightly different story happened. It has not been possible to tame cannabis for medical purposes so far. Serious passions are boiling around cannabis.
An excursion into historyBritish colonial ambitions cost humanity dearly.
Take, for example, cholera, which was released from its natural Indian enclave. For the distribution of marijuana, you can also thank the British military – it was from the East that army doctors took out a "wonderful" drug, Indian cannabis, which has been used in local medicine for thousands of years. The new drug had an impressive spectrum of action – it was used to treat epilepsy and rheumatism, and was widely used as an analgesic. Marijuana was used as an extract for ingestion or dried mass for smoking.
And although there is evidence of the use of cannabis preparations for medical purposes in Europe of the XIII century, the real boom occurred only six centuries later. With the help of the British, the new drug quickly spread across Europe and the United States. From 1850 to 1942, marijuana was included in the US Pharmacopoeia – the official collection of documents on quality control of medicines used in medicine. In the British Pharmacopoeia, marijuana lasted until 1971.
The body has its own cannabisOver the past half century, the medical properties of cannabis have been studied quite intensively.
And the conclusion of many studies sounds quite definite – marijuana has a good therapeutic potential. However, what is there to be surprised about, because more than four hundred and fifty psychoactive substances have been found in this plant, and only sixty of them somehow affect the formation of addiction. The rest may well be used for "peaceful" purposes.
The journal Nature has published the results of a revolutionary study in its own way. Scientists from the Laboratory of Cell Biology of the US National Institute of Mental Health (Laboratory of Cell Biology, National Institutes of Mental Health) have identified CB1 cannabinoid receptors in our body. Most of them were found in the basal ganglia, cerebellum and hippocampus. It is CB1 that is responsible for the loss of control over the coordination of movements and problems with short-term memory that occur when smoking marijuana. It became obvious that the human body has long been very familiar with the psychoactive substances that are part of Indian cannabis.
It is known that inside the human body there are small biochemical laboratories in which drugs are produced. Everyone has heard about endorphin, which is released during various kinds of pleasures, including sexual ones. It turned out that people also have an endocannabinoid system, and it is represented by a number of biologically active substances.
Nerve cells (neurons) are in contact with each other and with the cells of the organs whose work they affect, through special formations – synapses. This is a place where the membranes of two cells are closely adjacent to each other. When an impulse travels along one neuron and reaches a synapse, special molecules are released from its membrane – chemical carriers, the so-called neurotransmitters. They quickly cross the intermembrane space and bind with receptors on the membrane of the second neuron, after which, as a result of the partial opening of the membrane for ions, an impulse arises in this neuron as well. If simplified to the limit, the scheme looks like this: an electric pulse stimulates the release of neurotransmitters into the synaptic cleft, and they, having reached the receptors of the "receiving" site, cause a certain response.
As it turned out, the endocannabinoid system directly affects the main neurotransmitters of the brain. Thus, the neurotransmitter glutamate plays an important role in epilepsy and the death of nerve cells in stroke. Gamma-aminobutyric acid is responsible for anxiety syndrome. Neurotransmitter norepinephrine – for homeostasis disorders, hormonal background, depression. Migraine, Parkinson's disease, schizophrenia – neurotransmitters are responsible for these and other diseases and disorders to one degree or another.
No wonder some supporters of medical legalization of marijuana call it "aspirin of the XXI century" – the spectrum of cannabis is huge. But this is in theory, but in practice difficulties begin.
The very first difficulty is that cannabis contains several hundred active components, and the concentration of these substances in the plant is a very unstable indicator. It depends on the type of plant (three main species and a huge number of hybrids), the place of origin, the harvest period, storage conditions and many other factors. And in order for any studies to be compared with each other, it is necessary to observe the principle of reproducibility of experimental conditions.
Scientists have managed to synthesize the main active ingredient of cannabis – tetrahydrocannabinol (TNC). But comparative studies have shown that it is significantly weaker than marijuana in its native (unprocessed) form. Apparently, the other components of the plant enhance the effect of tetrahydrocannabinol. But it has not yet been possible to find out which ones and how they strengthen them.
So there is no systematic data on cannabis, and even tested in full-fledged clinical trials, yet. And it is not expected in the near future. At least because it is not possible to create an adequate animal model on which it would be possible to study the psychotropic effects of the active components of cannabis – the influence of marijuana on human behavior is too unique.
And if you can't create a model, then you can't test the safety of the drug. And in this regard, the US Food and Drug Administration (FDA) has a very tough position. Since there is not sufficient and weighty evidence of safety and efficacy collected according to all the rules, there will be no approval for the use of cannabis in clinical practice. This is explicitly stated in the Administration's statement of April 20, 2006. And it is specially emphasized that this is the only regulatory body in the United States that can make such decisions. No state laws adopted by referendums or after the introduction of relevant bills have the right to allow the use of marijuana for medical purposes. People who will receive or grow marijuana according to the norms of such laws, from the point of view of federal legislation, commit an offense and can be prosecuted both administratively and criminally. Apparently, it was a stone in the garden of California and some other "advanced" US states that legalized cannabis for medical purposes.
What is goodTo date, scientists have managed to identify a number of diseases in the treatment of which marijuana drugs could help.
One of the active substances of cannabis – cannabidiol – is able to prevent the metastasis of breast cancer, scientists from the California Pacific Medical Center have found. The effect, according to the authors of the study, is achieved by blocking the specific Id-1 gene responsible for the spread of the tumor in breast cancer cells. The big plus is that cannabidiol is not a psychoactive substance. But it is unrealistic to achieve therapeutic concentration of cannabidiol in the blood by smoking, which is specifically stipulated in the article.
Specialists of the University of Bonn (Rheinische Friedrich-Wilhelms-Universität Bonn) have found out that tetrahydrocannabinol has good antiallergic properties, which makes it possible to use it in the treatment of immunological pathologies. Scientists explained allergic reactions in experimental animals by insufficient production of endogenous cannabinoids. The introduction of tetrahydrocannabinol eliminated the resulting deficiency and normalized the state of the immune system.
The discovery of the CB1 and CB2 cannabinoid receptors made it possible to identify the endocannabinoid family. Subsequent study of the complex biochemical pathways of their synthesis, release, transport and degradation gave an idea of a new signaling system, which was called endogenous cannabinoid, or endocannabinoid. The main physiological effect of cannabinoids is to regulate the release of neurotransmitters in the brain. The study of endocannabinoids has opened up new strategies in the treatment of a number of human diseases.
In addition, tetrahydrocannabinol is able to suppress the growth and spread of lung cancer. Doctors at Harvard University (Harvard University) in experiments managed to reduce the size of the tumor in mice by almost half. The exact mechanism of anti-tumor action, however, remained unknown. Scientists have only suggested that this may be due to the interruption of the life cycle of cancer cells in the early stages and the cessation of the germination of blood vessels in the course of tumor growth.
In a study by specialists of the Hannover Medical School, tetrahydrocannabinol also showed efficacy against Tourette's syndrome. Sixteen people were treated, and only five of them reported minor and transient side effects. Tourette's syndrome refers to hereditary pathology and manifests itself in the form of tic-like twitching of the muscles of the face, neck and shoulder girdle, involuntary movements of the lips and tongue with frequent coughing and spitting, as well as in the form of coprolalia (involuntary and uncontrolled shouting of obscene words).
Tetrahydrocannabinol is effective as a remedy against painful muscle spasms in multiple sclerosis. Since the spring of 2005, the use of the drug Sativex, which includes tetrahydrocannabinol and cannabidiol, has been allowed in Canada. In November 2005, the same drug for 85 thousand patients with multiple sclerosis was allowed to be imported by the United Kingdom. Research conducted in March 2007 by scientists of the British National Health Service showed that the decision, in general, was correct. Out of 189 people, objective indicators of 40% improved by almost a third.
And what is badHowever, not everything is so clear.
The use of marijuana in its native form leads to the development of psychoses. Physical dependence on this drug does not develop, but those psychopathological shifts that occur with regular use of cannabis, as well as with its overdose, are more than enough to treat such a drug with great caution. Schizophrenia, of course, will not happen, but delirium or paranoid psychosis can be earned. New Zealand researchers agreed on this in 2006, and two groups of British researchers in 2004 and 2007.
Moreover, marijuana leaves a very powerful and long-lasting trace of its presence in the brain. As experts of the American National Institute on Drug Abuse have found, changes in cerebral circulation remain even a month after a person has stopped smoking marijuana.
Another very big disadvantage of cannabis is the side effects associated with smoking it. Canadian scientists have studied the composition of tobacco cigarette smoke and marijuana cigarettes. It turned out that the qualitative chemical composition of the fumes is about the same. But the quantitative characteristics of some indicators differed significantly. Thus, the smoke of marijuana turned out to contain 20 times more ammonia and 3-5 times more prussic acid, nitrogen oxides and cyclic amines. All the listed substances are carcinogens.
So, what happens? Yes, indeed, among the substances found in cannabis, there are several compounds that are promising in terms of creating new medicines. However, the traditional way of using marijuana – that is, smoking it – does not provide an adequate level of safety, moreover, the potential harm from such a method of introducing the active principles of cannabis into the body many times outweighs the potential benefits. This applies, however, to any type of use of native marijuana.
Even if cannabis is allowed to be used everywhere for medical purposes, it will not be a whole plant, but extracted or synthesized analogues of biologically active substances, as in the case of the aforementioned Sativex. That is, one of the main requirements of the supporters of "medical ligaliza" – to allow patients to grow a "medicinal" plant themselves and smoke it in the form of self–medication - is unlikely to be satisfied.
In the end, marijuana will suffer the fate of the opium poppy: only what can really benefit humanity will be taken from the plant. Time will tell which way medicine will prefer – the preparation of extracts or the use of synthetic analogues. The experience of pharmacology shows that both can take root. This depends, among other things, on the results of ongoing research to this day. Well, as "weed" was banned in most countries of the world, it will remain so.
Portal "Eternal youth" www.vechnayamolodost.ru01.04.2008