Medical marijuana takes a hit.

August 22, 2002 12:10 PM

Medical marijuana takes a hit.
Ajulemic acid (also known as CT-3) is a new synthetic THC analog that helps relieve arthritis pain without the side effects of other non-steroidal analgesics, such as aspirin and ibuprofen -- and without the high of its chemical cousin. More inside...
posted by me3dia (36 comments total)

According to Dr. Sumner Bernstein, author of the study, "this research might provide a possible solution to the current controversy over the medical use of marijuana. This would be accomplished by the discovery of synthetic analogs of THC, such as ajulemic acid, that would provide the medicinal benefits of Cannabis without the accompanying mood altering effects and abuse potential."
Ajulemic Acid is still early on in clinical trial process (just started Phase II studies in Europe), but Marinol, has been on the market for years and is currently prescribed to fight nausea in chemotherapy patients and as an appetite stimulant for AIDS patients, but it is associated with psychotropic highs, considered an undesirable side effect by doctors (though not necessarily by the patients).

Further reading:
+ Medical marijuana report from the Academy of Sciences
+ A summary of CT-3 technology from Atlantic Technology Ventures, from whom Indevus is licensing the compound
+ An article on Dr. Bernstein's study on DrKoop.com
posted by me3dia at 12:13 PM on August 22, 2002

As someone who suffers severe joint pain and is allergic to marijuana (and all other members of the mint family, oddly enough), the potential of this medicine is extremely exciting. Too bad for pot advocates that it might just kill the medical marijuana debate once and for all.
posted by me3dia at 12:14 PM on August 22, 2002

Thank goodness. It would really suck if a pharmaceutical couldn't make money off of this.
posted by holycola at 12:20 PM on August 22, 2002

Argh -- further technical difficulties. That second paragraph should read as follows:

Ajulemic Acid is still early on in clinical trial process (just started Phase II studies in Europe), but Indevus Pharmaceuticals has licensed the compound for pharmaceutical production.

The bit about Marinol would then be a third paragraph.

While I'm at it, here's another reference link: medical marijuana report from the Academy of Sciences
posted by me3dia at 12:31 PM on August 22, 2002

The natural evolution of pharmaceuticals is the noting of an effect from some natural product, then attempting to refine those effects. For example, early neuroleptic medications for treating schizophrenia (eg Thorazine) affected all sorts of dopaminergic pathways (and unfortunately, a whole lot of other pathways as well, leading to a broad side effect spectrum). Newer atypical neuroleptics target more specific receptors and paths, and in many instances are more effective, with fewer side effects.

But as an aside, my experience has been that Marinol isn't nearly as effective as smoking marijuana in controlling nausea in chemotherapy patients. It will be interesting to see the clinical efficacy of CT-3.

Thank goodness. It would really suck if a pharmaceutical couldn't make money off of this.

Touche. One longs for the day when medical, pharmaceutical, and hell, even all scientific knowledge travels along the Linux league instead of the Microsoft mile.
posted by fold_and_mutilate at 12:37 PM on August 22, 2002

I can't say that I feel very bad about this. While the repeal of drug prohibition is a wonderful thing, it's disingenuous and dirty of the pot community to try to sneak in decriminalization by presenting it as a medical issue. The same goes for those who tout hemp as the salvation of both industry and the environment while ignoring its most common use. Developments like this are only sorely deserved. If you're going to come to the poker game of public debate, don't try to sneak in any aces up your sleeve. While honesty may not trump every other argument, at least you don't come off as a slimeball lobbyist when you stand up to plead your case.
posted by bunnytricks at 12:46 PM on August 22, 2002

Touche. One longs for the day when medical, pharmaceutical, and hell, even all scientific knowledge travels along the Linux league instead of the Microsoft mile.

Out of curiosity, do you have a model for how open-source pharmaceuticals might work?
posted by ptermit at 12:47 PM on August 22, 2002

"and without the high of its chemical cousin."

Strike one right there. ; )

The stuff that helps you and gets you high that you could even grow yourself is bad. Here, buy this new stuff.
posted by stifford at 12:48 PM on August 22, 2002

I don't see what all the fuss about. Marijuana the plant has a 10,000 year safety record and contains far more psychoactive and physiologically beneficial substances than just THC. Why not stick to a plant that you can grow yourself instead of a chemical that you'll need to buy from a drugstore?
posted by sid at 12:51 PM on August 22, 2002

bunnytricks, I don't think its about anyone being disingenuous about the issue. Rather, I think cannabis advocates see an essential first step to legalizing the drug for recreation use is the repeal of prohibitions that appear (to them) to make no sense: ie, the prohibition surrounding the medical use of the plant, and, also importantly, the prohibition on the cultivation and industrial use of hemp. And FYI, industrial hemp DOES NOT get you stoned. Its completely different from its cousin that you may have smoked once.
posted by pjgulliver at 1:02 PM on August 22, 2002

While the repeal of drug prohibition is a wonderful thing, it's disingenuous and dirty of the pot community to try to sneak in decriminalization by presenting it as a medical issue.

What are you talking about? Neither I nor the sources I quoted said anything about decriminalizing marijuana. I can't even touch the stuff. I can't vouch for anyone else here, but I'm psyched about my knees and hips potentially not hurting anymore.

As far as marijuana's "safety record" goes, sid, how can you argue that smoke inhalation is unhealthy? Pot is more carcinogenic when smoked than cigarettes.
posted by me3dia at 1:02 PM on August 22, 2002

sid: Why not stick to a plant that you can grow yourself instead of a chemical that you'll need to buy from a drugstore?

The point being made by others is that the pharmaceutical companies want you to rely on chemicals you purchase from drug stores, as they make tremendous amounts of money charging premium prices for them. That plant of which you speak is (in most places) illegal to grow, use, or sell, which is ideal condition for drug manufacturers who want to guarantee you use their product.

(On a side note, I have to congratulate fold_and_mutilate. This is the first post I've seen from you that hasn't been snide, confrontational, or obnoxious. Hell, I actually agree with your position on this matter!)
posted by Danelope at 1:04 PM on August 22, 2002

I can't say that I feel very bad about this. While the repeal of drug prohibition is a wonderful thing, it's disingenuous and dirty of the pot community to try to sneak in decriminalization by presenting it as a medical issue.

it may be disingenuous , but it has been effective. by pushing a novel legislative agenda, the pro crowd has been able to *win referendums*. which resulted in press coverage. a lot of it. and now when those who want strict drug laws go before the public, they are forced to deal with the fact that the public doesn't buy all, of even most of what they are saying anymore.

and compared to the tactics of the drug warriors, promoting medical marijuana is a petty misdemeanor.
posted by lescour at 1:05 PM on August 22, 2002

"it's disingenuous and dirty of the pot community to try to sneak in decriminalization by presenting it as a medical issue. "

Last I checked war is (still) hell. And this here's a dirty war son, on both sides.

And its not like the direct and honest path to legalization over the last 30 years prompted the federales to play any fair-er. In fact just the opposite happened.

maybe its a little too cunning to use medical use, but crying "disingenuity" in the face of an emperor wearing no clothes kind of stretches credulity.

-sheesh
posted by BentPenguin at 1:07 PM on August 22, 2002

ptermit: Out of curiosity, do you have a model for how open-source pharmaceuticals might work?

There's a great essay about intellectual property and the pharmaceutical industry at On Deciding Better.
posted by Danelope at 1:11 PM on August 22, 2002

Bunnytricks: I couldn't agree more.

The fact is people use marijuana recreationaly, just like alcohol. Anti-prohibition movements worked the medical-marijuana arguement as a disingenuous tactic to bring the meddle/middle class on board. These are disingenuous days....

On preview I see Bunnytricks had lead to an arguement. I disagree with the medical-marijuana tactic since it hurts the credibility of those really working on the issue. Not all the press generated by medical marijuana has been good.


Marijuana should be legalized, just to help relieve prison overcrowding. We're going to need the room for people who download pirated mp3's and programs.
posted by elwoodwiles at 1:20 PM on August 22, 2002

And don't forget the people who sell smutty comics.
posted by beth at 1:34 PM on August 22, 2002

Pot is more carcinogenic when smoked than cigarettes.

People do not chain smoke pot the way they smoke cigarettes.
posted by oh posey at 1:37 PM on August 22, 2002

People do not chain smoke pot the way they smoke cigarettes.

very true. If we want kids not to smoke cigarettes, then maybe we should tell them to save all the lung mileage for the reefer... ; )
posted by stifford at 1:46 PM on August 22, 2002

jerry garcia must be rolling in his grave


... a joint.
posted by tsarfan at 1:54 PM on August 22, 2002

To teach you kids a lesson, we're going to make you smoke the whole bag.
posted by ODiV at 1:56 PM on August 22, 2002

I have multiple sclerosis, and I've used pot both for recreation and as an analgesic. Even though I occasionally like to get high, I would welcome the ability to use it as an analgesic without getting high. I can't tell you how many times I've wanted some pain relief but haven't wanted to get stoned. (and then, of course, are the times when I've really wanted to get stoned and couldn't care less about the pain relief.)

On the other hand, I doubt that this is the end of medical marijuana. This substance seems to have an anti-inflammitory effect. Many people, including me, use mm for its ability to control neuropathic pain, i.e. pain that appears localized in certain body parts but which is actually caused by damage to the central nervous system. Traditional analgesics, from aspirin to opium, don't help with neuropathic pain. Pot does.

Thirdly, I agree that it's a shame that our government is inclined to only allow you to use drugs that someone else owns a patent on and that you therefore have to pay for.

Finally, marijuana is among the safest psychoactive drugs; it has far fewer deleterious effects than alcohol; and there is no evidence that smoking pot causes lung damage.

There was a good radio show about this just the other day.
posted by alms at 1:57 PM on August 22, 2002

One longs for the day when medical, pharmaceutical, and hell, even all scientific knowledge travels along the Linux league instead of the Microsoft mile.

Oh, you mean so that they can continually reinvent the wheel on ideological grounds -- and take forever to do so? I agree with you that "one" is precisely the number of people who would long for that...
posted by kindall at 1:59 PM on August 22, 2002

there is no evidence that smoking pot causes lung damage.

For a long time there was no evidence that smoking tobacco caused lung damage -- they hadn't done any studies on it. I think that if you set something on fire and deliberately inhale the results, you'd be pretty dumb to think that there would be no adverse effects on your lungs, whether there is "evidence" or not.
posted by kindall at 2:01 PM on August 22, 2002

alms, ajulemic acid shows potential to treat neuropathic pain, and studies are being planned.

As much as I'd love to get high, I can't because of my allergy -- getting stoned for me means spending the following two days in bed, useless. So any pain-relief benefit marijuana holds for me is negated by my adverse reaction to the stuff. Ajulemic acid eliminates that downside.
posted by me3dia at 2:37 PM on August 22, 2002

Out of curiosity, do you have a model for how open-source pharmaceuticals might work?

Sure. NASA comes to mind, as do public works projects of all types. Indeed, public works (and not the products of pharmaceutical companies) are in fact responsible for most of the improvements in health we find throughout the world.

And to revisit my original comparison, I find technical achievements like GNU/Linux to be unbelievably superior to products put out by for-profit entities like Microsoft.

Capitalism in the guise of pharmaceutical company is designed for, and is most effective at producing one thing: money for the capitalist, rather than medicines for the ill. Byproducts of greed (like the fertilizing byproducts of rearing pigs) are occasionally useful, but most often the few benefit at the expense of the many. For example, 95% of those with HIV live in developing countries, but it is estimated that only 1% have access to the triple therapies that can keep the virus at bay. Consider the needs of Brazilian and African AIDS patients. The government of Brazil was right in threatening to break the patent on Roche's drug nelfinavir and produce it locally.

When, if ever, should patent and profits take precedence over health?

Never.

Sure, the drug companies whine that they need to use their profits to make newer drugs, but according to this article, these companies spend twice as much on marketing as they do on development, spend $75 billion a year on lobbying, and admit that they could sell AIDS drugs at a 90% discount in developing countries and still turn a profit. Thus, I find our current model for providing for the fundamental needs of sick people to be woefully inadequate...but extraordinarily adequate in providing for the fundamental needs of the greedy.

Altruism...a desire to relieve suffering....doing the right thing...sacrificing for the common good in place of the constant, odious, liar-lament of the greedy that they are acquiring individual wealth for the common good...cooperation instead of competition -- these old-fashioned virtues are what cure, and make us all into better people, as well. Greed does just the opposite.
posted by fold_and_mutilate at 2:56 PM on August 22, 2002

People do not chain smoke pot the way they smoke cigarettes.

I chain-smoke pot the way people do cigarettes.
posted by dfowler at 3:24 PM on August 22, 2002

Altruism...a desire to relieve suffering....doing the right thing...sacrificing for the common good in place of the constant, odious, liar-lament of the greedy that they are acquiring individual wealth for the common good...cooperation instead of competition -- these old-fashioned virtues are what cure, and make us all into better people, as well. Greed does just the opposite.

Unfortunately, we can't force people to sacrifice.
posted by Lord Chancellor at 3:42 PM on August 22, 2002

Homer: But isn't pot illegal?
Dr: HeeHee Only if you enjoy it!
posted by elwoodwiles at 3:47 PM on August 22, 2002

Fold&Mutilate: You're talking about a government-sponsored pharma industry, rather than open-source. Taking your Linux analogy a step further, would you argue that the government should produce an OS and software tools instead of having everyone rely upon Microsoft? I'm far from a fan of Microsoft, but you don't see anyone using Ada -- and NASA's stuck with decade-old computer chips on their state-of-the-art equipment. A government-sponsored software industry would be worse than the mess we have right now.

I agree that the Pharma industry is overly greedy, and should have a little more altruism. (The government has a few ways of trying to encourage altruism, e.g. the orphan drug act.) However, putting all drug development in the hands of the government is a sure way to kill innovation.

What you're not taking into account is that government agencies and politicians work because of incentive for reward, just as the Pharma industry does. The road system was built not because of altruism, but because Eisenhower wanted to make sure that we could mobilize our forces efficiently in case we went toe-to-toe with the Russkis. Now that that incentive is gone, you're seeing the deterioration of the national infrastructure -- local politicians have a "not on my budget" attitude and let the roads and other infrastructure deteriorate until it becomes critical to repair them at costs much more than what moderately decent upkeep would have cost. But to the politicians in office for a mere decade, it didn't matter; the piper had to be paid on someone else's watch.

And since you brought up NASA as a model, they're saddled with a $100 billion boondoggle that will produce no good science. Why? Because NASA saw the opportunity to take control of a large chunk of cash. Science wasn't the incentive. Greed was.

The Pharma industry isn't perfect by any means, but I think that a governmental pharmaceutical industry would be considerably worse.
posted by ptermit at 5:00 PM on August 22, 2002

I chain-smoke pot the way people do cigarettes.

The easiest way for smokers to avoid harmful smoke toxins may be simply to smoke stronger marijuana.
posted by oh posey at 6:24 PM on August 22, 2002

and NASA's stuck with decade-old computer chips on their state-of-the-art equipment

Off-topic, but that's largely because they have such a low tolerance for failure. By the time a chip proves it won't fail, you're dealing with a very old chip. As long as it gets the calculations done, and doesn't kill the passengers, then where's the problem? It's not like the shuttle pilot is up there trying to get higher frame rates on quake.
posted by willnot at 6:48 PM on August 22, 2002

and NASA's stuck with decade-old computer chips on their state-of-the-art equipment

Not to thread hijack, but... One of the main reasons that NASA uses older hardware is that they are more familiar with it's architecture and know what will cause it to fail, and when it will be totally reliable

[on preview: Damn willnot, you beat me to it.]
posted by quin at 6:56 PM on August 22, 2002

I thought it was more due to long design cycles rather than reliability -- and even though the astronauts aren't playing Quake, they are hurting for computing power, which is why they bring laptops up with them.

But that's irrelevant. The point I was trying to make was that a governmental body often has a different agenda than the consumer, and that the pace of innovation might suffer because of this.
posted by ptermit at 5:33 AM on August 23, 2002

For a long time there was no evidence that smoking tobacco caused lung damage

Do you really believe that no one has gotten around to studying the effect of marijuana smoke on the lungs? That our government, so desperate for so many years to find negative things to say about pot, would have let this obvious area go unresearched?

But why appeal to common sense when empirical research is at hand:

In studies of acute effects of smoked marijuana, not only have no
detrimental effects on lung function been observed but, in fact, potentially
desirable airway dialation has been a constant finding suggesting that
marijuana might have a therapeutic potential in the treatment of bronchial
asthma.
posted by alms at 5:42 AM on August 23, 2002

Pot being illegal is just silly and all the arguments against pot are null and void as long as booze is legal.

But in the terms of this article...if this helps one person I say bravo!

One thing I wonder is how the people on Marinol pay for it? It can't be cheap for someone who can't work due to a debilitating disease. Is it government subsidized? Are my tax dollars being spent to subsidize a drug that can be grown in your back yard/on your window sill? And we then spend big bucks for people to fly around in helicopters yanking that dirty weed out of the ground?

Cuz if thats the case my sense of irony will be happy and complete today.
posted by Yossarian at 7:54 AM on August 23, 2002