CBS News: Does the pot pill work?

(CBS News) “Medical marijuana,” the U.S. Drug Enforcement Administration says, “already exists.”

They don’t just mean in California. A pill known as Marinol has been legal and approved by the Food and Drug Administration for use with a prescription anywhere in America since 1985.

It’s active ingredient? Dronabinol, better known as THC, the primary psychoactive element of the cannabis plant.

“Marinol provides standardized THC concentrations, does not contain the other 400 uncharacterized substances found in smoked marijuana, such as carcinogens or fungal spores, and is not associated with the quick high of smoked marijuana,” said Neil Hirsch, a spokesman for Marinol manufacturer Solvay Pharmaceuticals.

Once again, it’s about “smoked marijuana”.  Prohibitionists cannot conceive of a vaporizer of a pot brownie.  The lack of quick relief (not a high) and lacking the other cannabinoids (not uncharacterized substances) are exactly the problems with Marinol.

“[One] problem with Marinol is that it’s orally administered,” Dr. Mitch Earleywine, an associate professor of Clinical Psychology at the State University of New York at Albany, said in an email. “Therefore, it takes longer to work than cannabis inhaled from a vaporizer. (Usually 90 minutes at best rather than 15 seconds – a meaningful amount of time to the nauseated.)”

“It’s harder to control dosage, too, so folks end up discombobulated or without symptom relief,” he added. “In addition, folks who are vomiting can’t hold down the pills.” Earleywine also said that a dose Marinol costs three to five times as much as a comparable dose of medical marijuana.

The supporters of Marinol will cling to the “smoked marijuana” point in order to have some measure of harm, like the negative health effects of smoking anything and the presence of carcinogens in any smoke, while blissfully ignoring all the research showing cannabis to have an anti-tumoral effect and actually reducing the risk of head and neck cancers.

But what it really boils down to is the “high”.  They just can’t stand the idea that people feel a certain euphoria from using cannabis.

Dr. Herbert Kleber, a professor of Psychiatry at Columbia University and the former deputy drug czar under President George H.W. Bush… said he has prescribed Marinol to a patient and found it to be effective, [and] points to what he characterizes as a significant advantage of the pill over traditional marijuana: “People don’t abuse it.”

“Marijuana addiction is becoming common and as a result I’m seeing an increasing number of people who have trouble stopping marijuana,” he said. “Contrary to popular beliefs that there is no marijuana withdrawal, there is marijuana withdrawal. It’s very clear cut.”

Yes, there is a clear-cut definition of marijuana withdrawal.  It happens to about 9% of the people who try marijuana, compared to 32% of tobacco users and 15% of alcohol users.  Symptoms of the withdrawal, according to the Institute of Medicine, may include restlessness, irritability, mild agitation and sleep disruption, and this has been observed only under unique patient settings. These remain limited to adolescents in treatment facilities for substance abuse problems, and in a research setting where subjects were given marijuana or THC daily.

But let’s think about this idea of dependence and withdrawal.  Anybody here ever try to quit smoking cigarettes?  How would you compare a tobacco “nicky fit” to a cannabis “dry spell”?  Anybody here ever help an alcoholic quit drinking?  How would you compare an alcoholic “dry drunk” to a cannabis “dry spell”?  Anybody here ever known or been a cocaine or heroin or meth addict?  How would you compare quitting those drugs “cold turkey” to a cannabis “dry spell”?  Heck, even quitting a long-term coffee habit is tougher than putting down the joint!

Part of the problem here is the concept of marijuana as a medicine rather than as a supplement.  Medicines are either a short-term fix that you quit once the particular affliction is cured or a long-term fix that you use for the rest of your life to cope with an incurable affliction.  So medical marijuana causes cognitive dissonance in the minds of the prohibitionist; they might accept the notion of smoking a joint to deal with a migraine or chemo, but when that person is feeling well and smoking a joint anyway, that is as odd to them as someone chugging Pepto-Bismol just for the taste of it.

I prefer Lanny Swerdlow’s notion that cannabis is a supplement you take to mitigate the effects of aging, a supplement like multi-vitamins, fiber powders, or calcium chewables, something you take to maintain your body’s health, not something you take to cure your body’s sickness.  Our body has an endocannabinoid system and this flower has evolved to supplement it, thereby attracting creatures that will reproduce it, much like other flowers evolved to provide honeybees with food so they’d pollinate the flowers.  I’ve always felt cannabis was nature’s gift to us to make up for the curse of sentience, knowing our death is inevitable and having the tools to extend our life far beyond the years our bodies were designed for.

Do some people get restless, irritable, mildly agitated and sleep disruption when they stop using cannabis?  Well, if cannabis was helping them relax and sleep, then sure!  You might as well call excessive thirst a symptom of water withdrawal!  The point is that you can only consider cannabis withdrawal a problem if you believe regular cannabis use is somehow problematic.  Since most of the problems associated with regular cannabis use are caused by prohibition, not cannabis itself, in a legalized world regular cannabis use would be seen as something akin to regular coffee use – some people like it, a few use it a lot, can’t get through their day without it, and have trouble quitting it if they are having problems with it, but nobody considers a coffee jones serious enough to require rehab.