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OCR for page 129

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MARIJUANA AS MEDICINE?: The Science Beyond the Controversy This page in the original is blank.

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MARIJUANA AS MEDICINE?: The Science Beyond the Controversy Previous chapters reviewed what basic research and medical science have discovered so far about the medical use of marijuana. Cannabinoids —chemicals in marijuana and their synthetic relatives—were shown to affect a variety of physiological processes through their interactions with cellular receptors. The performance of marijuana and cannabinoids in clinical experiments designed to test their ability to relieve symptoms of several different disorders was also discussed. The next three chapters place this knowledge in a broader context while considering the future of medical research on marijuana. Chapter 10 examines the economic realities of developing drugs based on active compounds from marijuana. Although most researchers who study cannabinoids would agree that the scientific route to cannabinoid drug development is clearly marked, there is no guarantee that the fruits of scientific research will be made available to the public. Marijuana-based medicines will become available only if there is enough financial incentive for the pharmaceuticals industry to invest in producing and marketing them or if public funding is available for research and development. Meanwhile, despite the passage of several state referenda that support the medical use of marijuana, prescribing marijuana remains a federal offense. Marijuana is classified with heroin and LSD among federally controlled substances considered to have high potential for abuse and no accepted medical value. People suffering from debilitating symptoms that cannot be relieved with available drugs and who might find relief by smoking marijuana can take little comfort in a promise of a better cannabinoid drug 10 years from now. The health-related dangers of self-treatment with marijuana have already been addressed, but what about the legal consequences? Chapter 11 provides an overview of the current legal status of medical marijuana. While legal issues related to medical marijuana have captured public attention in recent years, scientists have also demonstrated an increased interest in discovering and exploiting marijuana's medicinal benefits. After an initial burst of scientific activity in the 1970s, today 's renewed interest grew out of several important discoveries made since 1986. These include the identification and cloning of human cannabinoid receptors, the discovery of natural

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MARIJUANA AS MEDICINE?: The Science Beyond the Controversy compounds in the body that activate these receptors, and the creation of synthetic compounds that also activate cannabinoid receptors. Chapter 12 discusses the Institute of Medicine's recommendations—as well as those of other expert organizations—for building on these findings as we contemplate the future of marijuana-based medicine.