A good weed | |
Cannabis in medical practice. A legal, historical and pharmacological overview of the therapeutic use of marijuana. Mary Lynn Mathre. Jefferson, North Carolina: McFarland and Company 1997 (vii + 239pp., $42.70). ISBN: 0 7864 0361 6. |
Cannabis remained on
the US pharmacopoeia until 1941, when new, more effective antiemetic medication and police campaigning led to the prohibition of recreational and medicinal use of cannabis. In 1970, cannabis was classified as a Schedule 1 drug, a category reserved for drugs considered unsafe, without accepted medical use and with a high potential for abuse. However, a small body of literature has built up in recent decades suggesting that cannabis may well have some useful medicinal properties. In 1988, an administrative law judge of the Drug Enforcement Administration (DEA) concluded "it would be unreasonable, arbitrary, and capricious for DEA to continue to stand between those sufferers and the benefits of this substance in light of the evidence of this record". In November 1996, voters in California and Arizona supported state referenda enabling medical use of marijuana. Thirty-six states in the USA have now passed legislation recognising the therapeutic value of cannabis. Cannabis has useful antiemetic properties which can assist patients undergoing cancer chemotherapy. It may also reduce weight loss in patients with cancer or with the AIDS wasting syndrome. Cannabis can reduce intraocular pressure, resulting in preservation of sight in some patients with glaucoma who fail to respond to conventional medication. However, as this multi-author volume makes clear, the case for medicinal cannabis is not without its problems. The body of supportive scientific evidence is relatively small, yet this is a direct result of the prohibition of recreational use of cannabis. Titration of dose is far more accurate and prompt by inhalation of cannabis smoke than oral ingestion. For most health professionals, the notion of administering a drug by smoke inhalation is repellent. This book is written largely for an American audience. Countries like Australia are unlikely to accept medicinal use of cannabis unless there is a major change in American policy. Authors range from the anecdotal to the erudite. Some of the more interesting chapters are by patients writing about their own lives and experiences. Although some other publications provide a more up to date and comprehensive account of the scientific aspects of the subject, this book covers very recent political developments. It should be of interest to all doctors who believe that the medical profession has a duty to relieve suffering. Alex Wodak
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