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Medical Cannabis Trial

New South Wales government is set to do Australia’s first trial for the medical use of cannabis.  University of New South trial Wales’ Chief Investigator Associate Professor Meera Agar – who has led several research studies into the management of terminally ill patients – will lead the research team and focus on how medicinal cannabis can improve poor appetite and appetite-related symptoms, such as nausea, in terminally ill adult cancer patients in their final stages of life.

The first part of the trial will be held at the Calvary Mater Newcastle Hospital in early 2016 and involve about 30 patients with the goal of discovering whether cannabis can be successfully inhaled as a vapour, what its side effects are and the frequency and size of the ideal dose, with initial results expected by the end of 2016.

Part two of the study could see it rolled out to major NSW regional and metropolitan hospitals with a larger number of patients. The next step will be for the research team to seek review and approval of the trial by a Human Research Ethics Committee.
Associate Professor Agar said the trial would evaluate two types of cannabis products – vaporised leaf cannabis and a pharmaceutical.
“It will be undertaken in two parts, and will assess the potential ability of cannabis to alleviate distressing symptoms including fatigue, low appetite, altered taste and smell for food, low mood, weight loss, nausea, insomnia and pain relief,” Professor Agar said.  “This will add to the existing body of evidence based research to help better understand and evaluate the potential benefits that medical cannabis products may have for terminally ill patients.” (ref:SMH)

Meanwhile, the Queensland Premier Annastacia Palaszczuk and Victoria Premier Dan Andrews have both publicly backed the NSW trials. Mr Andrews has indicated he would work in partnership with NSW next year to run them, including those targeting children with serious epilepsy.
More parents are turning to cannabidiol (CBD) oil, a cannabis extract with little or none of the psychoactive compound THC, to treat their children who have cancer and epilepsy. The oil is currently legal in dozens of states in USA, but its supply is limited. And the science lags the law—dosing standards haven't been set, and the effects of long-term use are unclear.
“[Cannabis] is a complex medication – it contains over 500 different compounds and can be used for a huge variety of conditions, from depression to cancer.
“It’s just not feasible to do individual clinical studies to determine what it should be used for, for the sake of satisfying a peer reviewed study, when there is a desperate need for this medicine now.”
In 23 states of USA and the District of Columbia cannabis is legal for some medical uses, and a majority of Americans favor legalization for recreational use. Other countries are rethinking their relationship to pot too. Uruguay has voted to legalize it. Portugal has decriminalized it. Israel, Canada, and the Netherlands have medical marijuana programs, and in recent years numerous countries have liberalized possession laws.

Medical use is not decriminalization.

The approval of cannabis for medical purposes does not necessarily lead to decriminalization of marijuana. It is still a habit forming bad habit with bad phyiologicals effect through smoking, a drug with proven developmental effects, and some potentially serious psycological effects.
Cannabis, Marijuana or Ganja is simply around us more, its unmistakable but increasingly unremarkable smell hanging in the air. Yes, smoking it may lead to temporary laughing sickness, intense shoe-gazing, amnesia about what happened two seconds ago, and a ravenous yearning for junk food. Though there’s never been a death reported from an overdose, marijuana—especially today’s stout iterations—is also a powerful and in some circumstances harmful drug.

Still, for many, cannabis has become a tonic to dull pain, aid sleep, stimulate appetite, buffer life’s thumps and shocks. Pot’s champions say it peels back layers of stress. It’s also thought to be useful as, among other things, an analgesic, an antiemetic, a broncho-dilator, and an anti-inflammatory. It’s even been found to help cure a bad case of the hiccups. Compounds in the plant, some scientists contend, may help the body regulate vital functions—such as protecting the brain against trauma, boosting the immune system, and aiding in “memory extinction” after catastrophic events.
In the apparent rush to accept weed into the mainstream, to tax and regulate it, to legitimize and commodify it, important questions arise.

Cannabis is still largely an enigma.

The active component in Cannabis was largely unknown, then one day in 1963 a young organic chemist in Israel named Raphael Mechoulam, working at the Weizmann Institute of Science outside Tel Aviv, decided to peer into the plant’s chemical composition.
It was just a plant,” says Mechoulam, now 84. “It was a mess, a mélange of unidentified compounds.”
Mechoulam, along with a colleague, had discovered tetrahydrocannabinol (THC) as an active ingredient in marijuana. This compound is the plant’s principal active ingredient, its mind-altering essence—the stuff that makes you high.
He and his team also elucidated the chemical structure of cannabidiol (CBD), another key ingredient in marijuana, one that has many potential medical uses but no psychoactive effect on humans.
Despite that, he’s not particularly in favor of legalizing cannabis for recreational use. He doesn’t think anyone should go to jail for possessing it, but he insists that marijuana is “not an innocuous substance”—especially for young people. He cites studies showing that the prolonged use of high-THC strains of marijuana can change the way the developing brain grows. He notes that in some people cannabis can provoke serious and debilitating anxiety attacks. And he points to studies that suggest cannabis may trigger the onset of schizophrenia among those who have a genetic predisposition to the disease.

They isolated the chemical made by the human body that binds to the same receptor in the brain that THC does.Since then several other so-called endocannabinoids and their receptors have been discovered. Scientists have come to recognize that endocannabinoids interact with a specific neurological network—much the way that endorphins, serotonin, and dopamine do. Exercise, Mechoulam notes, has been shown to elevate endocannabinoid levels in the brain, and “this probably accounts for what jogging enthusiasts call runner’s high.” These compounds, he explains, apparently play an important role in such basic functions as memory, balance, movement, immune health, and neuro-protection. (ref:National Geographic)
Endocannabinoids appear to be neurotransmitters in some nerve pathways in some primitive invertebrates. Cannabis may be stimulating some ancient neurological pathways in the brain.

Cannabis in Medicine

Cannabis can play a palliative role for cancer sufferers, especially in alleviating some of the nasty side effects of chemotherapy. There’s no question that pot can stave off nausea, improve appetite, and help with pain and sleep. The majority of these claims are anecdotal at best and fraudulent at worst. Critics contend that the Realm of Caring parents are using their kids as guinea pigs, that not enough studies have been done, that many, if not most, of the claims can be dismissed as the result of the placebo effect.“CBD is not a silver bullet—it doesn’t work for everybody,” she cautions. “But I’m impressed. It clearly can be a very effective treatment for many people. (ref: M.J.of A.)

Recreational use does not respect legality.

World Health Organization mental health surveys of 17 countries found that “countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones”. There is no rational basis for the view that weakening prohibition to permit use for medical conditions would lead to a surge in general use.
* Politicians are nervous about being “soft on drugs”, especially before an election.
The clinical trial proposed, if successful, presumes that cannabis would then be approved and regulated as a pharmaceutical substance.Cannabis can never be a pharmaceutical agent in the usual sense for medical prescription, as it contains a variety of components of variable potency and actions, depending on its origin, preparation and route of administration. Consequently, cannabis has variable effects in individuals. It will not be possible to determine universally safe dosage of cannabis for individuals based on a clinical trial.
On the one hand, some assert that cannabis is a dangerous, highly addictive drug which causes schizophrenia, and that any move to relax prohibition would be a disaster. This view defies published evidence. The trials will explore the development and use of safe, pharmaceutical product(s) derived from cannabis to treat particular medical conditions; such as children with severe, drug-resistant epilepsy.
Cannabis it appears to raise just as many questions as it advocates suggest it solves?   What do you think?