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HARDBACK price:$42.95 add to cart Rights & Permissions Free PDF Access Sign in to download PDF book and chapters Free Resources PDF SUMMARY Display this book on your site! Related Titles Pathways of Addiction: Opportunities in Drug Abuse Research Marijuana As Medicine?: The Science Beyond the Controversy Other Related Titles Marijuana and Medicine: Assessing the Science Base (1999) Institute of Medicine (IOM) Citation Manager Export the bibliographic data for this book in your chosen format Web Search Builder Use this book's key terms to search within this book, across our collection, or across the Web. Skim This Chapter Skim this chapter and use this chapter's key terms to search within this book. Reference Finder Paste in your own text to find books that relate to your topic. Citation Manager National Research Council. "Index." Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press, 1999. 1. Print. Please select a format: Page 259   E-mail  Buzz This  Facebook  Delicious  Stumble  Twitter More The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy. Page 259 INDEX A Addiction, see Craving; Dependence; Tolerance; Withdrawal symptoms Adjunctive therapy, general, 4, 10, 145, 153, 157, 167, 172, 247 see also Pain, treatment of Administration of drugs, see Drug delivery Adolescents, 6, 15, 16, 90, 91, 96, 97, 98, 99, 101, 102, 104, 123, 126 Affinity, receptors, 42, 44, 46, 51 defined, 42 (footnote) African Americans, 173 Age factors, 9, 16, 22, 92-93, 94, 95, 100, 117 adolescents, 6, 15, 16, 90, 91, 96, 97, 98, 99, 101, 102, 104, 123, 126 children, 96, 97, 101, 124-125, 139, 149, 167, 210 clinical trials, 139, 142 prenatal exposure, effects of, 124-125 see also Elderly persons Agonists, receptor, 34, 37, 38, 39, 43-47, 54, 56-57, 58, 64, 70 glaucoma, 176-177 listed, 44 market considerations, 209, 210, 212 neurological disorders, 166, 167, 168 see also SR 141716A; SR 144528 AIDS, viii, 16, 18, 21, 22, 23, 107, 115-117, 120-121, 145, 178, 252 AIDS wasting, 4, 8, 23, 154-158, 159, 177, 204-205, 207, 209, 234, 246, 248 clinical trials, 8, 156, 213, 245 defined, 154 individual patient account, 27-28 smoking of marijuana, 27-28, 156 Alaska, vii, 17 Alcohol use and abuse, 6, 88, 90, 92, 95, 96, 97, 100, 101, 117, 254 nausea and vomiting, 147 Alternative medicine, general, 19, 20, 180, 215, 216, 217-218, 254-255 Alzheimer's disease, 173, 204, 205, 209 American Medical Association, 180, 244-255 (passim) Amotivational syndrome, see Motivation Amphetamines, 21, 88, 240 Analgesia, see Pain, treatment of Anandamide, 34, 41, 43-47, 48, 54, 194 Animal studies, 3, 35, 36-81, 88, 89, 91, 111, 120, 122-123, 125, 140, 145, 195, 199, 212, 246 movement disorders, 164-165, 167, 170 relevance of, general, 36 Anorexia, see Appetite; Wasting syndrome Anorexia nervosa, 159 Antagonist, receptor, 34, 37, 39, 44, 55, 58, 70 market considerations, 205, 210, 211 nausea and vomiting, 151, 152-153 Antiemesis, see Vomiting Page 259 Front Matter (R1-R18) Executive Summary (1-12) 1 Introduction (13-32) 2 Cannabinoids and Animal Physiology (33-82) 3 First, Do No Harm: Consequences of Marijuana Use and Abuse (83-136) 4 The Medical Value of Marijuana and Related Substances (137-192) 5 Development of Cannabinoid Drugs (193-222) Appendix A Individuals and Organizations That Spoke or Wrote to the Institute of Medicine About Marijuana and Medicine (223-231) Appendix B Workshop Agendas (232-239) Appendix C Scheduling Definitions (240-241) Appendix D Statement of Task (242-243) Appendix E Recommendations Made in Recent Reports on the Medical Use of Marijuana (244-255) Appendix F Rescheduling Criteria (256-258) Index (259-267)

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Page 259 INDEX A Addiction, see Craving; Dependence; Tolerance; Withdrawal symptoms Adjunctive therapy, general, 4, 10, 145, 153, 157, 167, 172, 247 see also Pain, treatment of Administration of drugs, see Drug delivery Adolescents, 6, 15, 16, 90, 91, 96, 97, 98, 99, 101, 102, 104, 123, 126 Affinity, receptors, 42, 44, 46, 51 defined, 42 (footnote) African Americans, 173 Age factors, 9, 16, 22, 92-93, 94, 95, 100, 117 adolescents, 6, 15, 16, 90, 91, 96, 97, 98, 99, 101, 102, 104, 123, 126 children, 96, 97, 101, 124-125, 139, 149, 167, 210 clinical trials, 139, 142 prenatal exposure, effects of, 124-125 see also Elderly persons Agonists, receptor, 34, 37, 38, 39, 43-47, 54, 56-57, 58, 64, 70 glaucoma, 176-177 listed, 44 market considerations, 209, 210, 212 neurological disorders, 166, 167, 168 see also SR 141716A; SR 144528 AIDS, viii, 16, 18, 21, 22, 23, 107, 115-117, 120-121, 145, 178, 252 AIDS wasting, 4, 8, 23, 154-158, 159, 177, 204-205, 207, 209, 234, 246, 248 clinical trials, 8, 156, 213, 245 defined, 154 individual patient account, 27-28 smoking of marijuana, 27-28, 156 Alaska, vii, 17 Alcohol use and abuse, 6, 88, 90, 92, 95, 96, 97, 100, 101, 117, 254 nausea and vomiting, 147 Alternative medicine, general, 19, 20, 180, 215, 216, 217-218, 254-255 Alzheimer's disease, 173, 204, 205, 209 American Medical Association, 180, 244-255 (passim) Amotivational syndrome, see Motivation Amphetamines, 21, 88, 240 Analgesia, see Pain, treatment of Anandamide, 34, 41, 43-47, 48, 54, 194 Animal studies, 3, 35, 36-81, 88, 89, 91, 111, 120, 122-123, 125, 140, 145, 195, 199, 212, 246 movement disorders, 164-165, 167, 170 relevance of, general, 36 Anorexia, see Appetite; Wasting syndrome Anorexia nervosa, 159 Antagonist, receptor, 34, 37, 39, 44, 55, 58, 70 market considerations, 205, 210, 211 nausea and vomiting, 151, 152-153 Antiemesis, see Vomiting

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Page 260 Antigens, 59, 64, 66, 120 Anxiety, 4, 10, 36, 84, 90, 109, 127, 142, 153, 165, 168, 203 see also Dysphoria; Euphoria; Sedation Appetite, viii, 3, 4, 10, 21, 23, 142, 144, 156-159 (passim), 173, 205, 209, 245, 248 set also Nausea; Vomiting; Wasting syndrome Arachidonic acid, 46, 47, 57 Arachidonyl glycerol (2-AG), 43, 45, 46, 47, 64, 65 Arizona, vii, 1, 17, 18, 104 (footnote) Arthritis, 28-29 Attitudes patients, 27-29, 153, 205-206 physicians, prescribing marijuana, 152, 202 risk perception, 104 B Barbiturates, 143, 172 Basal ganglia, 48-52, 164-166, 168 B cells, 62, 64, 65, 66, 112 see also Lymphocytes, general Benzodiazepines, 3, 70, 161, 164, 168 Blood pressure hypertension, 48, 84, 86, 90, 121, 158, 175 hypotension, 121, 150, 151, 175 Brain, general, 3, 35, 36-37, 48-49, 69, 70, 92, 170 basal ganglia, 48-52, 164-166, 168 cannabinoid receptors, 37-65, 69-70 cerebellum, 46, 49, 50, 51, 53, 121, 122 endogenous cannabinoid system, 43-51, 70 globus pallidus, 49, 52, 53, 167 hippocampus, 45-46, 49, 53 putamen, 49, 52, 53, 166 striatum, 46, 51, 53 substantia nigra, 49, 51, 52, 53, 167, 168 thalamus, 46, 49, 51, 52, 53, 55, 165, 167, 169 see Neurons, general British Medical Association, 180, 244-255 (passim) Bronchi, 113-114, 115, 119 Buyers' clubs, see Cannibis buyers' clubs C Cachexia, 145, 154, 155, 158 see also AIDS wasting; Appetite; Wasting syndrome Caffeine, 88 California, vii, 1, 16, 17, 18, 101-102, 104, 204, 207 Canada, 150 Cancer smoking of marijuana as cause, 5, 114, 115, 117-121, 237 treatment of, 22, 23, 142, 145, 154, 158, 159, 204-205; see also Chemotherapy Cannabidiol (CBD), 3, 36-37, 47, 60-61, 66, 122, 166, 171-172, 214 Cannabinoids, general, vii, viii-ix, 2-4 defined, 2, 25-26, 194 defined substances, 4 standards, general, 19, 213, 216, 217 see also THC Cannabinol, 25, 37, 64, 66, 110 see also THC Cannibis buyers' clubs, viii, 16, 20, 21, 22, 207 defined, 20 Cardiovascular system, 121-122, 251 see also Blood pressure Case studies, 15, 27-29, 117, 119-120, 254 individual patient accounts, 27-29 single-patient clinical trials, 139, 162 CBD, see Cannabidiol Cellular biology, 5, 25, 35-59, 69-70, 118-119, 120-121 see also Genetics; Immune system; Receptors; Signal transduction Cerebellum, 46, 49, 50, 51, 53, 121, 122 Cesamet, see Nabilone Chemotherapy, viii, 4, 16, 23, 144, 146-153 (passim), 177, 205, 207, 234, 245, 247, 248 Children, 96, 97, 101, 124-125, 139, 149, 167, 210 see also Adolescents Chronic obstructive pulmonary disease, 114-115 Clinical studies, 15, 30, 34-35, 137, 206, 233-234 glaucoma, 177, 251 movement disorders, 166, 169-170 smoking of marijuana, 9-10 Clinical trials, 7-8, 9-10, 34, 137, 141, 142-143, 203, 209, 211, 218 age factors, 139, 142 AIDS wasting, 8, 156, 213, 245 animal studies vs, 36 epilepsy, 170-172, 173 Investigational New Drugs, 195, 196

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Page 261 movement disorders, 167, 168 nausea and vomiting, 7-8, 142, 145-154, 179, 245, 247 pain, 7-8, 141-145, 179 psychological effects, 5, 10, 109, 149 recommendations, 4, 5, 7-8, 9-10, 178, 179-180, 215, 245-255 (passim) regulatory requirements, 195, 196, 200, 202, 208, 211, 213, 218, 256-257 single-patient trials, 139, 162 spasticity, 160-164, 165, 249 standards for, 7-8, 10, 138-139, 179-180 Cocaine, 3, 20, 70, 88, 90, 95, 102, 240 Colorado, vii, 1 Codeine, 143, 241 Cognitive effects, 49, 83-84, 89, 105, 106-107, 108, 124-125 disorientation, 4, 142, 203 memory, 35, 49, 53, 56, 84, 89, 106, 144, 173, 212 see also Psychological effects Connecticut, 17 Controlled Substance Act, 16-17, 102, 198-204 (passim), 210, 213-219 (passim) scheduling, 17, 102, 194, 198-213 (passim), 216-217, 218, 240-241, 256-257 Convulsions, see Seizures Cost factors, 9, 16, 206-207, 243 antiemetics, 151, 152 drug development, 195, 196, 203, 206, 217-218 CP 47,497, 210 CP 55,244, 210 CP 55,940, 44, 46, 56, 201 Craving, 9, 90, 91-92 CT-3, 67, 209 Cytokines, 62, 66, 67, 112, 120, 157 D DEA, see Drug Enforcement Administration Delivery modes, see Drug delivery Department of Health and Human Services, 199, 200, 201, 217 see also National Institutes of Health Dependence, 6, 9, 57-59, 70, 84, 86, 237 animal research, 35 criteria, 87 legal issues, 16 marijuana as a gateway drug, 6-7, 9, 20-21, 98-101 predictors of, 93-98, 99, 100, 101, 126 see also Craving; Tolerance; Withdrawal symptoms Depression, 22, 23, 29, 84, 95, 105, 155, 159 fluoxetine, 48 see also Dysphoria Diagnostic and Statistical Manual of Mental Disorders, 84, 87 Diarrhea, 24, 155 District of Columbia, 17 Dizziness, 27, 121, 150, 158, 203 Dopamine, 58, 88, 92, 167, 168 Dosage factors, 137, 245, 248, 256 affinity, 42 (footnote) AIDS wasting, 156, 157, 158 caffeine, 88 cardiovascular effects, 121 CBD, 36, 60-61 cognitive effects, 107 glaucoma treatment, 176, 177, 251 immune system effects, 60-63, 64-67, 68 morphine, 37 multiple sclerosis treatment, 163 neurological disorder treatment, 166, 169 overdosing, 37, 109, 206 pain treatment, 102, 142, 143, 149 psychological effects, 84, 85, 105 psychomotor effects, 51, 53, 85 reproductive effects, 122, 125 respiratory effects, 113 THC, 88, 89, 91, 122, 142, 176, 203, 206, 215, 255 anxiety, 36, 142, 149 glaucoma treatment, 176, 177, 251 pain treatment, 102, 142, 143, 149 psychoactive doses, 85 vomiting, 147, 154 vomiting, 147, 151, 152, 154 see also Dependence; Tolerance Dronabinol, see Marinol Drug Awareness Warning System, 102-103 Drug delivery, 7, 9, 151, 197, 199, 217, 239, 242, 245 inhalation, 7, 9, 57, 94, 150, 154, 165, 175, 197, 203, 206, 215 (footnote), 216, 242, 247, 251, 255; see Smoking, marijuana injection, 39, 54, 57, 66, 67, 68, 85, 88, 94, 100, 122, 150, 151, 152, 159, 174, 175, 203

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Page 262 oral, 4, 9, 16, 57, 84, 89, 91, 121, 122, 142, 148-156 (passim), 163, 164, 165, 171, 174, 175, 202, 203, 205, 206, 207, 215, 242, 247, 249, 251 suppositories, 206 topical, 175, 176, 251 Drug Enforcement Administration (DEA), 137, 198-202, 203-204, 208, 213, 214, 217 Dysphoria, 5, 84, 126, 150, 159, 203 sec also Anxiety; Depression Dystonia, 166, 168, 245, 250 E Economic factors access and availability, general, 9, 194-198, 206-208, 213-214 health insurance, 207 malnutrition, 154, 155 private investment, 178, 195-219 public investment, 4, 137, 178, 211, 214, 218 set' also Cost factors Efficacy, 9, 11, 14, 19, 20, 30, 54, 57, 88, 107, 108, 126, 144, 179, 217, 243, 256 defined, 4-5 regulatory requirements, 197, 212, 215 see also Clinical studies; Clinical trials Elderly persons, 21 clinical trials, 139 psychological effects, 4, 175 Emesis, see Vomiting Emotional factors, see Psychological effects Endorphins (endogenous opioids), 35, 43 Epidemiological Catchment Area Program, 97 Epilepsy, 29, 170-173, 177, 245, 250-251 Euphoria, 5, 16, 83-84, 85, 87, 88, 89, 92, 108, 144, 150, 203 Eye diseases, see Glaucoma F Federal government, 194-202 see also Department of Health and Human Services; Drug Enforcement Administration; Food and Drug Administration; Legal issues and legislation; Public investment Fluoxetine, 48 Food and Drug Administration, 17, 20, 137, 138, 149, 156, 194-198, 199, 200, 202-203, 204, 205, 208, 209, 213, 215, 216, 217, 257 Food and Drug Administration Modernization Act, 197 (footnote) Food, Drug, and Cosmetic Act, 194, 213, 215, 256 Foreign countries, see International perspectives; specific countries France, 69 Funding, see Public investment G Gamma-aminobutyric acid (GABA), 50 Gateway theory, 6-7, 9, 20-21, 98-101 Gender factors, 20, 22, 94, 95, 115, 170-171 Genetics, 5, 38, 42, 69, 118-119, 120 dependence, 94, 97-98 drug development, 19-20 gene regulation, 37, 38 reproductive system effects, 122-125 transduction, 37, 38, 40-41, 43, 57; see also Agonists, receptor see also Cellular biology; Receptor binding; Receptors Glaucoma, 9, 22, 24, 173-177, 234, 251-252 agonists, receptor, 176-177 dose effects, 176, 177, 251 intraocular pressure, 175, 176, 251-252 smoking of marijuana, 174, 175, 177, 251 Globus pallidus, 49, 52, 53, 167 H Hallucinations, 84, 90, 106 Headaches, 151 see also Migraine headaches Health insurance, 207 Heart, see Cardiovascular system Herbal medicine, general, see Alternative medicine, general Heroin, 88, 90, 92, 95, 99, 100, 240 Hippocampus, 45-46, 49, 53 Hispanics, 94-95 Historical perspectives, 118 antiemetics, 151 legal issues, 16-18 medicinal uses of marijuana, 16-19

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Page 263 research on marijuana, 33-34, 244-255 HIV, see AIDS Hormones, 37, 48, 58-59, 66, 122, 123, 155, 157 HortaPharm, 214-215, 218 HU-210/HU-211, 44, 60, 64, 66, 67, 176, 201, 209, 211, 250 Huntington's disease, 49, 166, 198 Hyperalgesia, 54, 56, 141 Hypertension, 48, 84, 86, 90, 121, 158, 175 Hypotension, 121, 150, 151, 175 I Immune system, 5, 37, 42, 51, 59-68, 70, 109-111, 112-113, 116-117, 120, 156, 158, 212, 233, 236, 245, 248, 252 antigens, 59, 64, 66, 120 cytokines, 62, 66, 67, 112, 120, 157 dose effects, 60-63, 64-67, 68 infections, 66-67, 112-113, 155, 236 inflammatory/antiinflammatory effects, 67-68, 112-113, 142, 155, 209 leukocytes, 59, 62, 64, 109-111, 120 lymphocytes, general, 59, 62, 64, 112, 118, 155 B cells, 62, 64, 65, 66, 112 T cells, 59, 62, 64-65, 66, 112 macrophages, 66, 112-113, 121 multiple sclerosis, 160 see also AIDS Inactivation, 36, 46, 47, 48, 212 Infections, 66-67, 112-113, 155, 236 see also AIDS; Receptors Inflammatory/antiinflammatory effects, 67-68, 112-113, 142, 155, 209 Information dissemination, see Public information Insurance, see Health insurance International perspectives, 180, 244-255 exporter of marijuana for research, 214-215, 218 marijuana laws, 103-104 seizure treatment, 171 Single Convention on Narcotic Drugs, 217 see also specific countries Internet, viii, 16, 245 Intraocular pressure, see Glaucoma Investigational New Drug applications (FDA), 195, 196, 198, 206, 213 Israel, 209 L Legal issues and legislation, 14, 16-18, 86, 126, 206-207, 215-216 Controlled Substance Act, 16-17, 102, 198-204 (passim), 210, 213-219 (passim) scheduling, 17, 102, 194, 198-213 (passim), 216-217, 218, 240-241, 256-257 Food and Drug Administration Modernization Act, 197 (footnote) Food, Drug, and Cosmetic Act, 194, 213, 215, 256 foreign/international, 103-104, 217 Marijuana Tax Act, 16 National Organization for the Reform of Marijuana Legislation, 17, 18, 200, 213 Orphan Drug Act, 198, 205, 211 patent law, 208-210 Prescription Drug User Fee Act, 195 referenda, vii, 1, 17, 18 Single Convention on Narcotic Drugs, 217 state legislation, 17, 18, 102-103, 200, 206-207 see also Regulatory issues Lethargy, see Motivation Leukocytes, 59, 62, 64, 109-111, 120 Levonantradol, 44, 57, 142, 148, 149, 210 Ligands, 37, 39, 40-41, 42, 45, 53, 64, 194 see also Agonists, receptor; Antagonist, receptor; Receptor binding Lipophilic substances, 25, 39, 175, 206 Louisiana, 17 LSD, 240 Lungs, 5, 111-115, 117, 118, 119, 126, 236, 253 Lymphocytes, general, 59, 64, 112, 118, 155 B cells, 64, 65, 66, 112 T cells, 59, 64-65, 66, 112 M Macrophages, 66, 112-113, 121 Malnutrition, see Appetite; Nutrition Marijuana, general active constituents, 36-37 defined, 2, 24-25 prevalence of use, 92-93, 137

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Page 264 Marijuana and Health, 2, 33 Marijuana Tax Act, 16 Marinol (dronabinol), 16, 44, 137, 149, 156, 158, 173, 194, 195, 240, 248 development of, 193-194, 195, 197, 202-208, 210, 211, 216, 218 Medical Use of Cannabis, 244-245 Memory, 35, 49, 53, 56, 84, 89, 106, 144, 212 Alzheimer's disease, 173 Men, see Gender factors Metabolic processes, 36-37, 65, 110, 203 starvation, 154-155 Methadone, 92, 240 Methodology drug development, 19-20, 137, 193-219, 238-239, 255; see also Drug Enforcement Administration; Food and Drug Administration costs of, 195, 196, 203, 206, 217-218 other research, 20-22, 24, 119-121, 162, 163, 213-214 recommendations by non-committee organizations, 244-257 psychological research, 104-105 study at hand, 15-16, 225-243 see also Case studies; Clinical studies; Clinical trials Migraine headaches, 22, 23, 143-144, 209, 213 Minority groups, see Racial/ethnic factors Mood effects, 21, 69, 84, 89, 92, 99, 105, 108, 143, 144, 153, 154, 161, 165, 248 see also Anxiety; Depression; Dysphoria; Euphoria; Sedation Morphine, 37, 41, 55, 240 Motivation, 58, 105, 107-108, 158, 168, 237, 254 Motor effects, see Movement disorders; Psychomotor effects Movement disorders, 4, 160, 165-170, 177, 233, 245, 249-250 animal studies, 164-165, 167, 170 Parkinson's disease, 49, 167, 168, 198, 209 seizures, 22, 29, 90, 170-173, 177, 245, 250-251 Tourette's syndrome, 167-168 see also Basal ganglia; Psychomotor performance; Spasticity Mucositis, 144 Multiple sclerosis, 9, 22, 23, 143, 160-161, 162, 163, 170, 198, 209, 245 individual patient account, 28 Muscle spasticity, see Spasticity N Nabilone, 44, 148, 149, 161, 162, 163, 174, 202, 246, 248, 249 Naloxone, 37, 92 National Cancer Institute, 202 National Household Survey on Drug Abuse, 104 National Institute of Drug Abuse, 213-214 National Institutes of Health, 178, 180, 194-195, 202, 213-214, 215, 244-255 (passim) National Organization for the Reform of Marijuana Legislation, 17, 18, 200, 213 Nausea antagonist, receptors 151, 152-153 clinical trials, 7-8, 142, 145-154, 245, 247 opioids, 140 palliation, 3, 4, 7-8, 9, 10, 16, 21, 23, 27, 29, 142, 144, 145-154, 159, 164, 202, 205, 207, 234, 245, 247, 248 withdrawal symptoms, 6, 90, 127 see also Appetite; Vomiting Netherlands, 103-104, 180, 214, 244, 245, 246, 249-255 (passim) Neurology and neurological disorders, 233, 234, 242, 245, 246, 251 Alzheimer's disease, 173, 204 dizziness, 27, 121, 150, 158, 203 glaucoma, 173-176 (passim) seizures, 22, 29, 90, 170-173, 177, 245, 250-251 see Brain; Movement disorders; Multiple sclerosis; Spasticity; Spinal cord Neurons, general, 2, 37, 38, 46, 47, 48, 49-50, 53, 55, 167, 211 Neuroprotection, 47, 67, 70, 176, 209, 211 Neurotransmitters, 37, 38, 43, 48, 50, 53, 54, 88, 147, 168, 211 dopamine, 58, 88, 92, 167, 168 see also Endorphins; Gamma-aminobutyric acid; Serotonin Nevada, vii, 1, 17 New drug applications (FDA), 195-197, 203, 215, 257 New Hampshire, 17 Nicotine, 3, 70, 88, 90, 92, 96, 97, 100 see also Tobacco Norway, 104 Nutrition, 154-156, 158 anorexia nervosa, 159 see also Appetite; Wasting syndrome

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Page 265 O Office of National Drug Control Policy, vii, 1 Ohio, 17 Older persons, see Elderly persons Opioids, 3, 35, 37, 43, 53, 54, 55, 58, 69, 70, 88, 92, 102, 233, 246 heroin, 88, 90, 92, 95, 99, 100, 240 morphine, 37, 41, 55, 240 pain treatment, 140, 142 Oregon, vii, 1, 17 Orphan Drug Act, 198, 205, 211 P Pain, treatment of, viii, 3, 4, 7, 9, 10, 11, 20-22, 23, 24, 28-29, 84, 159, 164, 210, 233, 234, 241, 245-247 clinical trials, 7-8, 141-145, 179 dose effects, 102, 142, 143, 149 hyperalgesia, 54, 56, 141 market for, 210, 212 neurophysiology of, 35, 53-56, 70 sedation, 5, 10, 109, 127, 140, 144, 145, 150, 161, 164, 168, 241 standards of analgesic usefulness, general, 140-141 usefulness of analgesics, general, 140-141 Pain, types of, 141-145, 166 acute, 54, 67-68, 141-142 chronic, 8, 21, 22, 23, 30, 53, 54, 67-68, 138, 142-143 definitional issues, 139-140, 141 depression, 22, 23, 29, 48, 84, 95, 105, 155, 159 dysphoria, 5, 84, 126, 150, 159, 203 inflammatory/antiinflammatory effects, 67-68, 112-113, 142, 155, 209 surgical, 142, 145, 247 withdrawal, 3, 6, 35, 58-59, 70, 84, 86, 87, 89-91, 127, 143-144 Paranoia, 84, 105 Parkinson's disease, 49, 167, 168, 198, 209 see also Substantia nigra Peer review, 9, 15 Performance, see Psychomotor performance Pharmaceutical companies, see Private sector Political and social factors, vii, 1, 2, 6-7, 13-15, 17-19, 92, 93, 94, 98, 99, 202, 234 National Organization for the Reform of Marijuana Legislation, 17, 18, 200, 213 see also Legal issues and legislation; Referenda Polycyclic aromatic hydrocarbons, 117, 119 Potency, 41, 46, 214-215 Pregnancy, 122-125, 126, 139, 145 Prescription Drug User Fee Act, 195 Private sector, 178, 195-219 Prostaglandins, 44, 46, 176 Prozac, see Fluoxetine Psychiatric disorders, see Schizophrenia Psychological effects, 3, 4-5, 44, 54, 65, 83-92, 101, 104-109, 126, 233, 237, 253-254 anorexia nervosa, 159 anxiety, 4, 10, 36, 84, 90, 109, 127, 142, 153, 165, 168, 203 clinical trials, 5, 10, 109, 149 dependence predictors, 95-96, 99, 100, 101, 126 depression, 22, 23, 29, 48, 84, 95, 105, 155, 159 dose effects, 84, 85, 105 DSM-IV, 84, 87 dysphoria, 5, 84, 126, 150, 159, 203 elderly patients, 4, 175 euphoria, 5, 16, 83-84, 88, 92, 108, 150, 203 hallucinations, 84, 90, 106 mood disorders, general, 23, 24 motivation, 58, 105, 107-108, 158, 168, 237, 254 paranoia, 84, 105 receptor physiology, 35 schizophrenia, 105, 106, 159, 253 seizures, impacts of, 172 smoking of marijuana, 5-6, 10-11, 104-109 withdrawal, 3, 6, 35, 58-59, 70, 84, 86, 87, 89-91, 127, 143-144 see also Cognitive effects Psychomotor performance, 5, 85, 89, 107, 108, 125-126, 254 dizziness, 27, 121, 150, 158, 203 dose effects, 51, 53, 85 movement disorders physiology of, 35, 49, 51-53, 55 see also Spasticity Public information, viii, 101 Internet, viii, 16, 245 Public investment, 4, 137, 178, 211, 214, 218 Putamen, 49, 52, 53, 166

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Page 266 R Racial/ethnic factors, 94-95, 173 Receptor binding, 37, 39-45, 64, 194, 211 affinity, 42, 44, 46, 51 ligands, 37, 39, 40-41, 42, 45, 53, 64, 194 potency, 41, 46 see also Agonists, receptor; Antagonist, receptor Receptors, 2, 3, 33, 34, 35, 37-65, 69-71, 86, 110, 144, 159, 169, 172, 176-177 anandamide, 34, 41, 43-47, 48, 54, 194 brain, 41, 49, 51-59 immune system, 59-64 nausea and vomiting, 146, 147, 152, 153 serotonin, 48, 151, 152-153, 159, 205 Referenda, vii, 1, 17, 18 Regulatory issues, 14, 211, 213-218 clinical trials, 195, 196, 200, 202, 208, 211, 213, 218, 256-257 THC, 200-208, 214-215 see also Drug Enforcement Administration; Food and Drug Administration; Legal issues and legislation; Standards Reproductive system effects, 122-125, 126, 139, 145, 253 Research methodology, see Methodology Respiratory system, 5-6, 10, 88, 113-115, 119-120, 127, 146, 236, 253 see also Lungs S Scheduling, 17, 102, 194, 198-213 (passim), 216-217, 218, 240-241, 256-257 Schizophrenia, 105, 106, 159, 253 Sedation, 5, 10, 109, 127, 140, 144, 145, 150, 161, 164, 168, 241 Seizures, 22, 29, 90, 170-173, 177, 245, 250-251 types of, 170 Serotonin, 48, 151, 152-153, 159, 205 Side effects, general, 9, 27, 28, 127, 138, 140, 151, 203, 243, 246 marijuana use, 34, 145, 150, 152, 158, 161, 170, 172, 173, 177 see also Anxiety; Chemotherapy; Memory; Nausea; Sedation; Vomiting Signal transduction, 37, 38, 40-41, 43, 57 see also Agonists, receptor; Cellular biology Single Convention on Narcotic Drugs, 217 Sleep, 6, 27, 37, 49, 83, 90, 127, 160, 164, 165 Smoking, marijuana, 2, 4, 5, 7-8, 47, 83, 85, 91, 104, 111-127, 177-178, 216, 254-255 AIDS wasting, 27-28, 156 carcinogenic effects, 5, 114, 115, 117-121, 237 defined, 2 glaucoma, 174, 175, 177, 251 individual patient accounts, 27-29 movement disorders, 167 physiological effects, 5-6, 10-11, 104-109 spasticity, 161, 163 tolerance, 57, 89 vomiting, control of, 150, 152, 153, 154, 179, 247 wasting syndrome, 27-28, 156, 159 Smoking, tobacco, see Tobacco Social factors, see Political and social factors Spasticity, 23, 24, 143, 169, 245, 249 clinical trials, THC, 160-164, 165, 249 multiple sclerosis, 9, 22, 23, 28, 143, 160-161, 162, 163, 198 smoking of marijuana, 161, 163 Spinal cord, 49, 54, 55-56, injury, 23, 145, 159-160, 161, 163-164, 198, 245, 249 Spleen, 46, 59, 64, 66 SR 141716A, 34, 44, 57-58, 65, 69 SR 144528, 34, 44 Standards analgesic usefulness, general, 140-141 cannabinoid drugs, 19, 213, 216, 217 clinical trials, 7-8, 10, 138-139, 179-180 DSM-IV, 84, 87 State-level action legislation, 17, 18, 102-103, 200, 206-207 referenda, vii, 1, 17, 18 see also specific states Striatum, 46, 51, 53 Substantia nigra, 49, 51, 52, 53, 167, 168 T Tardive dyskinesia, 166, 168 Taxes, 16 T cells, 59, 62, 64-65, 66, 112, 120 see also Lymphocytes, general Tetrahydrocannabinol, see Marinol; THC Thalamus, 46, 49, 51, 52, 53, 55, 165, 167, 169

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Page 267 THC, viii, 2, 3, 4, 5, 10, 25, 26, 36-37, 39, 41, 71, 85, 88, 107, 109, 127, 177, 212, 234, 246, 247, 255 analogues, 44 Alzheimer's disease, 173 cardiovascular system, 121-122 dependence, 57-59 dose effects, 88, 89, 91, 122, 142, 176, 203, 206, 215, 255 anxiety, 36, 142, 149 glaucoma treatment, 176, 177, 251 pain treatment, 102, 142, 143, 149 psychoactive doses, 85 vomiting, 147, 154 endogenous cannabinoids and, 43-48 epilepsy, 170 glaucoma, 174-175, 176-177, 251-252 immune system, 59-68 (passim), 110, 117 levonantradol, 44, 57, 142, 148, 149, 210 Marinol (dronabinol), 16, 44, 137, 149, 156, 158, 173, 194, 195, 240, 248 development of, 193-194, 195, 197, 202-208, 210, 211, 216, 218 pain treatment, 7-8, 102, 141-145, 149, 179 regulatory issues, 200-208, 214-215 reproductive system effects, 122-125 spasticity, clinical trials, 160-164, 165, 249 tolerance, 56-57, 89, 121 vomiting, clinical trials, 148-150, 153 Tobacco, viii, 5, 6, 95, 96, 97, 111-112, 113-114, 117, 118-119, 123 see also Nicotine Tolerance, 3, 56-57, 70, 84, 86, 88-89, 121, 126-127, 233, 237 analgesics, usefulness of, 140 defined, 86, 87 smoking of marijuana, 57, 89 THC, 56-57, 89, 121 see also Dependence Tourette's syndrome, 167-168 2-AG, see Arachidonyl glycerol U Unimed Pharmaceuticals, Inc., 202-205 United Kingdom, 180, 209, 211, 218, 244-255 (passim) V Vermont, 17 Virginia, 17 Vomiting, 3, 4, 10, 21, 23, 27, 29, 202, 205, 207, 210, 234, 248 antagonists, receptors, 151, 152-153 clinical trials, 7-8, 142, 145-154, 179, 245, 247 cost of antiemetics, 151, 152 dose effects, 147, 151, 152, 154 drug delivery route, 148-154 (passim), 179, 247 smoking of marijuana, 150, 152, 153, 154, 179, 247 THC, 148-150, 153 see also Nausea W Washington, D.C., sec District of Columbia Washington State, vii, 1, 17 Wasting syndrome, 9, 23, 24, 28-29, 144, 154-159, 234, 248 Alzheimer's disease, 173 definitions, 153-154 smoking of marijuana, 27-28, 156, 159 see also AIDS wasting; Appetite WIN 55, 212, 42, 44, 64, 65, 88 Wisconsin, 17 Withdrawal symptoms, 3, 6, 35, 58-59, 70, 84, 86, 89-91, 127, 143-144 defined, 86, 87 Women, sec Pregnancy; Reproductive system effects World Health Organization, 244-255 (passim) World Wide Web, set Internet

Representative terms from entire chapter:

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