(are) likely to have a natural role in pain modulation,
control of movement and memory"
different cannabinoid receptor types found in the
body appear to play different roles in normal human
physiology. In addition, some effects of cannabinoids
appear to be independent of those receptors. The variety
of mechanisms through which cannabinoids can influence
human physiology underlies the variety of potential
therapeutic uses for drugs that might act selectively
on different cannabinoid systems."
data indicate the potential therapeutic value of cannabinoid
drugs, primarily THC, for pain relief, control of
nausea and vomiting, and appetite stimulation; smoked
marijuana, however, is a crude THC delivery system
that also delivers harmful substances.
trials of cannabinoid drugs for symptom management
should be conducted with the goal of developing rapid-onset,
reliable, and safe delivery systems."
psychological effects of cannabinoids, such as anxiety
reduction, sedation, and euphoria can influence their
potential therapeutic value Those effects are potentially
undesirable for certain patients and situations, and
beneficial for others. In addition,psychological effects
can complicate the interpretation of other aspects
of the drug effect."
effects of cannabinoids such as anxiety reduction
and sedation, which can influence medical benefits,
should be evaluated in clinical trials."
data on drug use progression neither support nor refute
the suggestion that medical availability would increase
drug abuse. However, this question is beyond the issues
normally considered for medical uses of drugs, and
should not be a factor in evaluating the therapeutic
potential of marijuana or cannabinoids."
use of smoked marijuana (less than six months) for
patients with debilitating symptoms (such as intractable
pain or vomiting) must meet the following conditions:
of all approved medications to provide relief
has been documented;
symptoms can reasonably be expected to be relieved
by rapid onset cannabinoid drugs;
treatment is administered under medical supervision
in a manner that allows for assessment of treatment
involves an oversight strategy comparable to an
institutional review board process that could
provide guidance within 24 hours of a submission
by a physician to provide marijuana to a patient
for a specified use."
a non-smoked, rapid-onset cannabinoid drug delivery
system becomes available, we acknowledge that there
is no clear alternative for people suffering from
chronic conditions that might be relieved by smoking
marijuana, such as pain or AIDS wasting. One possible
approach is to treat patients as e-of-1 clinical trials,
in which patients are fully informed of their status
as experimental subjects using a harmful drug delivery
system, and in which their condition is closely monitored
and documented under medical supervision, thereby
increasing the knowledge base of the risks and benefits
of marijuana use under such conditions.'