cannabis health - [jul/aug 2003]

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2 CANNABIS HEALTH the medical marijuana journ

Editorial ........................................................................................... 4

IACM .......................................................................................................................................9

Th e International A ssociation for Cannabis as Medicine

Dr. Ethan Russo....................................................................................................................11

W ho Is Dr. Eth an Russo?

Medically NORML ...............................................................................................................12

Physicians weigh in at NORML conference

Vancouver Island Compassion Society ............................................................................14

Compassion Club does more research than Health Canada

Dr. Dave West - Genetics 101.2 ........................................................................................16

Th e Hawaii Hemp Project

Canadians for Safe Access.................................................................................................18

Protectin g Canadians safe access to m edical m arijuana

Legal Eagle .........................................................................................................................19

Supreme Court of Canada A ppeals

Medical Marijuana Class Action .....................................................................................20

Compensation for medical users

What to do if you get busted ........................................................................................20

A lan Young advises on how to handle it

Advanced Research for Advanced Nutrients ..................................................................24University of Mississippi research

Jeffrys Journey..................................................................................................................28

A determined m others battle for medical marijuana for her son

Friendly Business Directory .......................................................................................30/31

Friends of t he Foundat ion, where you can pick up y our issue of Can nabis Health

Classifieds..........................................................................................32

i n s i d e @ c a n n b i s h e a l t hw w w . c a n n a b is h e a l th . c o m

Editor: Brian Taylor Production: Brian McAndrew Sales: Mona MatteAccounting Barb Cornelius Distribution: Mandy Nordahn Shipping &Receiving: Gordon Taylor Webmaster:Ron Morrison.Cannabis Health is published 6 times per year by Cannabis Health Foundation,P.O.Box 1481Grand Forks, B.C. Canada V0H 1H0, Phone: 1-250-442-5166 Fax: 1-250-442-5167No part of this magazine may be reproduced in any form,print or electronic,without writtenpermission of the publisher. For subscription information use phone or fax or [email protected] Health is also reproduced on the web in downloadablepdf format at cannabishealth.com/downloadable.

When you see this symbol,visit our website at cannabishealth.com

for extended versions of the stories andlinks to information and resources.

The Cannabis Health Foundation was formed in the springof 2002 as a non-profit foundation.

The foundation is dedicated to:

Promoting the safe medicinal use of cannabis. Research into eff icacy and genet ics of cannabis. Supporting and protecting the rights of the medical cannabis users Educating the public on cannabis issues.The first initiative of the foundation is this complimentary hard copypublication of Cannabis Health.Other activities will include financial and practical support for lowincome patients and the establishment of a legal defense fund.The free hard copy of Cannabis Healthis also reproduced in whole onthe World Wide Web at cannabishealth.com (the foundation website)with extended stories and hot links to resources and information.

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If you would like to receive 6 copies per year of the most informativeresource for medical marijuana available,subscribe to Cannabis Health

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F e a t u r e S t o r y

Dr. Lester GrinspoonT h e P h a r m a c e u t i c a l i z a t i o n

o f M a r i j u a n apage 5

NOTE:In the GW Ph armaceuticals article in issue

4, we did not give the full name of Valerie

Corral of WAMM, in the middle of the

photo, between Matt Elrod on the left and

David Hadorn on the right. The picture

was taken on the Sunshine Coast while

attending Rene Bojees wedding. WAMM was raided a few m onths earlier by

federal agents w ho were later prevented from leaving the WAMM property

by members blocking the driveway. Members took down the blockade when

after being released, Val asked them to. It was sort of a hostage exchange

Coincidental to the picture, Val and WAMM collaborated with GW on a

whole cann abis strain an alysis. WAMM recorded patient impressions of dif

ferent strains for treating various symptoms.

The cover picture of Dr.Grinspoon was recently

taken by his son David

when they were visiting

the San Luis Valley in

Colorado. Davids new

book,Lonely Planets: The

Natural Philosophy of

Alien Life will be pub-

lished this fall by Harper-

Collins.

COVER PHOTO


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also see adverisement on page

also seeadverisementon page 1


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4 C A N N A B I S H E A L T H t h e m e d i c a l m a r i j u a n a j o u r n a

e d i t o r @ c a n n a b i s h e a l t h

May 24th wastruly a landmarkday;a whole dayof national TVcoverage ofCanadas newnational drugstrategy.I am athome,finally,sit-ting in my com-fortable chair,asover the past t womonths I have

spent 45 days in hospital,had two majorsurgeries and cancer.My last minor pro-cedure is tomorrow,but today I amglued to the television. Never have weseen such a high level of discussion inthis country.The logic and the argu-ments by one credible witness afteranother lay to rest the myths.Not to bedeterred by science or the facts, the

usual proponents of prohibition rise tothe challenge and frankly sound l ikeidiots.Several times in the midst of thediscussion, the interviewer would saysomething like,now let me get thisstraight , the smoker gets a fine,andwhere exactly are people suppose toget this marijuana? Forced to back off,the interviewer finally gets the message

and realizes:None of this plan makesrational sense.I see this move by the Liberals as a posi-tive step in the wrong direction.Weneed to recognize that having poli ti-cians debating this without making awk-ward pot jokes is a breakthough.Wehave moved from total pot paranoia totreating possession like a speeding tick-et.On May 26th, despite the unworkabil-ity of the whole plan,or maybe becauseof i t, public acceptance of cannabis wentup. It is now bonified news and theissues are being discussed as currentevents in grade 11.More and more thedebate is sophisticated, considerate andintellectual.My forced sabbatical overthe past two months placed me outsidethe bubble of the cannabis movementand my life collided wit h a large numberof health care people and non-move-ment individuals. I am pleased to report

that through education we are winningover the hearts of the public.My thanksand appreciation to the medical staff inGrand Forks and in Kelowna who provid-ed excellent care and were respectful ofthe use of cannabis in my recovery.Special appreciation to Barb and all ofthe staff for the great job they havebeen doing,publishing the journal and

nursing me back to health. It is hearten-ing that our common cause has momen-tum and the commitment of so many.Have you wondered why (the US) isspending such inordinate amounts ofmoney and t ime on controll ing this rela-tively innocuous substance that Canadais about to decriminalize.News that theUS has similar or even more lenientdecriminalization laws in place in 12states has finally caught peoples atten-tion.Yes,marijuana is the most impor-tant drug in America,not because it isaddictive,or a gateway,but because,ifthe prohibit ionist lobbyists loose thepot war they will be forced to admitthey are wrong and have perpetratedmassive lies and deception.This is notyour fathers pot, this is about the break-down of the whole drug mind set.Could Canadas new laws be the slipperyslope? I certainly hope so!

This edition contains a number of wellwrit ten and t imely submissions byexperts in their perspective fields.Goodadvice for Canadian politicians as theymake this move to further remove thefear of pot .Bless the thin edge of the wedge.BT

Brian Tay lor

Editor-in-Chief

LOVE THE MAG, GREAT JOB

Dear Brian: Ive a little story to tell youwhile I subscribe to your journal. As a

section 56 exemptee since Oct. 19/01

expiring July 18/03 (6 month extension)

Ive seen the medical marijuana issue

become so complicated, it is failing those

in need the most. Ive told H.C. (Health

Canada) that their red tape was killing

me. Their lies didnt help.

One of my doctors pointed out to me

that in 1990 marijuana was the ultimate

pain killer. Its the only substance I know

of that has caused no deaths, compared to

pharmaceuticals. Cindy Cripps has

informed me that on Feb. 7/03 H.C. has

issued 541 authorizations to possess, and

257 have made the crossover to the

M.M.A.R.

My odyssey of applying has made me so

mad that I will take it to the steps of the

House of Commons. Im a citizen living

in Nor thumberland Coun ty, Ont. and Im

not allowed to talk to my M.P. I have

received some help from M.P. Dr. Keith

Martin - Esquimalt/ Juan de Fuca in deal-

ing with H.C. It is now up to me to stand

up for what I believe.

In short, the medical system has failedme and marijuana is the only medication

that I can tolerate without adverse side

effects. Its one substance for all my ail-

ments and it grows out of the ground.

(WOW!) Looking forward to witnessing

your success as an informative.

Gordon Strickland

A MIRACULOUS EFFECTIm sending this letter hoping some of

the many people suffering from the

never-ending agony of muscle, joint and

bone pain th at prescription drugs, includ-

ing morphia, dont relieve.Ive been smoking marijuana since

1977 to control glaucoma in both eyes.

Recently, by chance, I obtained a strain

called Hash Plant, that is having a mirac-

ulous effect on an extremely painful con-

dition diagnosed as Fibromyalgia. The

severity of the pain has kept me bedrid-

den, 18 to 20 hours a day since 1982. Im

not completely pain free, however, 80 to

90% of the pain has gone, allowing me to

function again.

On behalf of my family and myself,

thank you to whomever is responsible for

providing a Miracle.A nonym ous - due to social stigma of pot.

L e t t e r s

cartoon by Glenn Sm ith from Osoyoos, B.C.

Ned, testing new harm

reduction products!


7/36

by Dr.Lester Grinspoon MDThe government of the United States hasa problem where medical marijuana isconcerned.While there are many thou-sands of patients in the United States whocurrently use cannabis as a medicine,onlyseven are allowed to use it legally by thefederal government.They are the survivorsof the several dozen patients who wereawarded Compassionate Use INDs duringa period of t ime (from 1976 until 1991)when the government half-heartedlyacknowledged that marijuana has medici-

nal properties.This program was discon-tinued because of the exponentially grow-ing numbers of Compassionate INDapplications;the official reason was pro-vided by James O.Mason, then chief of thePublic Health Service:It gives a bad sig-nal. I dont mind doing that, if there is noother way of helping these people Butthere is not a shred of evidence thatsmoking marijuana assists a person withAIDS. Each of the surviving IND recipientsreceives monthly a tin containing enoughrolled marijuana joints to treat his or hersymptoms for that month.Because the

quality of the cannabis is poor,it requiresmore inhalation than a superior qualitymedicinal cannabis would.In fact,some ofthe recipients have been known to sup-plement this Government Issue with bet-ter qualit y street marijuana.Because of increasing pressure from themany patients who find cannabis usefulfor the treatment of a variety of symptomsand syndromes,and the passage ofProposition 215 in California in 1996,theU.S.government funded the Institute ofMedicine of the National Academy of

Science to study the

question ofcannabis uti lity as amedicine.Its report,Marijuana andMedicine:Assessingthe Science Base(published in 1999)timidly acknowl-edged that cannabisdoes indeed havetherapeutic value.The growing under-standing thatcannabis is useful as

a medicine presentsa problem to the United States govern-ment:how can it make it possible for peo-ple who need it as a medicine to haveunfettered access to marijuana,while atthe same time prohibiting it to peoplewho wish to use it for purposes the gov-ernment does not approve of.A possiblesolution to this problem might be found inthe pharmaceuticalization of cannabis:the development of prescribable isolatedindividual cannabinoids,synthetic cannabi-noids,and cannabinoid analogs.The IOM

Report states that if there is any futurefor marijuana as a medicine,it lies in its iso-lated components,the cannabinoids andtheir derivatives.It goes on:therefore,thepurpose of clinical trials of smoked mari-juana would not be to develop marijuanaas a licensed drug,but such trials could bea first step towards the development ofrapid-onset,non-smoked cannabinoiddelivery systems.Actually,the first attempt at pharmaceuti-calization occurred in 1985 when the Foodand Drug Administration (FDA) approveddronabinol (Marinol) for the treatment of

the nausea and vomiting of cancerchemotherapy.Dronabinol is a solution ofsynthetic tetrahydrocannabinol in sesameoil (the sesame oil is meant to protectagainst the possibil ity that the contents ofthe capsule could be smoked).Dronabinolwas developed by Unimed Pharmaceu-ticals Inc.with a great deal of financialsupport from the United States govern-ment.This was the first hint that the phar-maceuticalizationof cannabis might bewhat the government hoped would solveits problem with marijuana as medicine,the

problem of how to make the medicinal

propert ies of cannabis (insofar as the gov-ernment believes such properties exist)widely available,while at the same timeprohibiting its use for any other purpose.But Marinol did not displace marijuana asthe treatment of choice;most patientsfound the herb itself much more usefulthan dronabinol in the treatment of thenausea and vomiting of cancer chemother-apy.In 1992,the treatment of the AIDSwasting syndrome was added to dronabi-nols labeled uses.Again,patients reportedthat it was inferior to smoked marijuana.Marinol has not solved the marijuana-as-a-

medicine problem,because so few of thepatients who have discovered the thera-peutic usefulness of marijuana use dronabi-nol.In general,they find it less effectivethan smoked marijuana,it cannot be titrat-ed because it has to be taken orally,it takesat least an hour for the therapeutic effect tomanifest itself and even with the prohibi-tion tariff on street marijuana,Marinol ismore expensive.Thus,the first attempt atpharmaceuticalization proved not to be theanswer.In practice,for many patients whouse marijuana as a medicine the doctor-

prescribed Marinol serves primarily as acover from the threat of the growing ubiq-uity of urine tests.Some cannabinoid analogs may indeedhave advantages over whole smoked oringested marijuana in limited circum-stances.For example,cannabidiol may bemore effective as an anti-anxiety medicineand an anticonvulsant when it is not takenalong with THC,which sometimes gener-ates anxiety.Other cannabinoids andanalogs may prove more useful than mari-juana in some circumstances because theycan be administered intravenously.For

example,15 to 20% of patients lose con-sciousness after suffering a thrombotic orembolic stroke,and some people who suf-fer brain syndrome after a severe blow tothe head become unconscious.The newanalog dexanabinol (HU-211) has beenshown to protect brain cells from damagewhen given immediately after the strokeor trauma;in these circumstances, it willbe possible to give it intravenously to anunconscious person.Presumably,otheranalogs may offer related advantages.Some of these commercial products may

C A N N A B I S H E A L T H t h e m e d i c a l m a r i j u a n a j o u r n a l

Th e Ph a r m a c e u t i c a l i z a t i o n o f M a r i j u a n aDr Lester Grinspoon MD is on the facult y (emeritus) of the Harvard MedicaSchool in the Department of Psychiatry.He has been studying cannabis sin1967 and has published two books on the subject.In 1971 MarihuanaReconsidered was published by Harvard University Press.Marihuana, theForbidden Medicine,co-authored with James B.Bakalar,was published in 1by Yale University Press;the revised and expanded edit ion appeared in 199and is now translated into 10 languages.(Medical Uses www.rxmarijuana.cUses of Marijuana www.marijuana-uses.com)

Dr. Grinspoon and his grandchildren Zachary and Emma Sophia


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6 C A N N A B I S H E A L T H t h e m e d i c a l m a r i j u a n a j o u r n

also lack the psychoactive effects whichmake marijuana useful to some for non-medical purposes.Therefore,they will notbe defined as abusabledrugs subject tothe constraints of the ComprehensiveDrug Abuse and Control Act.Nasal sprays,vapourizers,nebulizers,skin patches,pills,and suppositories can be used to avoidexposure of the lungs to the particulatematter in marijuana smoke.The question iswhether these developments will makemarijuana itself medically obsolete.Surelymany of these new products would beuseful and safe enough for commercialdevelopment.It is uncertain,however,whether pharmaceutical companies willfind them worth the enormous develop-ment costs.Some may be (for example,acannabinoid inverse agonist that reducesappetite might be highly lucrative),but formost specific symptoms,analogs or com-binations of analogs are unlikely to be

more useful than natural cannabis.Nor arethey likely to have a significantly widerspectrum of therapeutic uses,since thenatural product contains the compounds(and synergistic combinations of com-pounds) from which they are derived.Forexample,the naturally occurring THC andcannabidiol of marijuana,as well as dexan-abinol,protect brain cells after a stroke ortraumatic injury.The cannabinoids in whole marijuana canbe separated from the burnt plant prod-ucts (which comprise the smoke) byvapourization devices that wil l be inex-

pensive when manufactured in large num-

bers.These devices take advantage of thefact that finely chopped marijuana releas-es the cannabinoids by vapourizationwhen air flowing through the marijuana isheld within a fairly large temperature win-dow below the ignit ion temperature ofthe plant material.Inhalation is a highlyeffective means of delivery,and fastermeans will not be available for analogs(except in a few situations such as par-enteral injection in a patient who isunconscious or suffering from pulmonaryimpairment).It is the rapidity of theresponse to inhaled marijuana whichmakes it possible for patients to titrate thedose so precisely.Furthermore,any newanalog will have to have an acceptabletherapeutic ratio.The therapeutic ratio (anindex of thedrugs safety) ofmarijuana is notknown,because it

has never causedan overdosedeath,but it isestimated,on thebasis of extrapola-tion from animaldata,to be an almost unheard of 20,000 to40,000.The therapeutic ratio of a new ana-log is unlikely to be higher than that; infact, new analogs may be much less safethan smoked marijuana,because it will bephysically possible to ingest more of them.And there is the problem of classificationunder the Comprehensive Drug Abuse

and Control Act for analogs with psy-choactiveeffects.Themore restrictivethe classificationof a drug,theless likely drugcompanies areto develop itand physiciansto prescribe it.Recognizing thiseconomic fact

of life,UnimedPharmaceuticalsInc.has fairlyrecently suc-ceeded in get-ting Marinol(dronabinol)reclassified fromSchedule 2 toSchedule 3.Nevertheless,many physicianswill continue to

avoid prescribing it for fear of the drugenforcement authorit ies.Now that the federal government hasembarked on a cruel and so far successfulcampaign to close down buyers clubs,what options are available to the manythousands of patients who find cannabisof great importance,even essential,to themaintenance of their health? They caneither use Marinol,which most find unsat-isfactory,or they can break the law anduse marijuana.Why is a government ,which considers itself compassionate(compassionate conservatism),criminal-izing these patients? What is the govern-ments problem with medical marijuana?The problem,as seen through the eyes ofthe government,is the belief that,as grow-

ing numbers ofpeople observe rel-atives and friendsusing marijuana as

a medicine,theywill come to under-stand that this is adrug which doesnot conform to thedescription the

government has been pushing for years.They will first come to appreciate what aremarkable medicine it really is; it is lesstoxic than almost any other medicine inthe pharmacopoeia;it is,like aspirin,remarkably versatile;and it is less expen-sive than the conventional medicines itdisplaces.They will then begin to wonder

if there are any propert ies of this drugwhich justify denying it to people whowish to use it for any reason, let alonearresting more than 700,000 citizens annu-ally.The federal government sees theacceptance of marijuana as a medicine asthe gateway to catastrophe,the repeal ofits prohibition. Insofar as the governmentviews as anathema any use of plant mari-juana,it is difficult to imagine it acceptinga legal arrangement that would allow forits use as a medicine,while at the sametime vigorously pursuing a policy of prohi-

bit ion for any other use.A somewhat different approach to thepharmaceuticalization of cannabis is beingtaken by a Brit ish company,G.W.Pharmaceuticals.It is attempting to devel-op products and delivery systems whichwill skirt the two primary popular con-cerns about the use of marijuana as amedicine:the smoke and the psychoactiveeffects (the high).To avoid the need forsmoking,G.W.Pharmaceuticals hasdevel-oped an electronically controlled dispenserto deliver cannabis extracts sublingually in

Th e Ph a r m a c e u t i c a l i z a t i o n o f M a r i j u a n a

If they note psychoactiveeffects at all,they speak of

a slight mood elevation-certainly nothingunwanted or

incapacitating.

Lester and Betsy Grinspoon at about the time

Marihuana Reconsidered was published


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carefully controlled doses.The companyexpects its products (extracts of marijua-na) to be effective therapeutically at dosestoo low to produce the psychoactiveeffects sought by recreational and otherusers.My clinical experience leads me toquestion whether this is possible in many,or even most,cases.The issue is compli-cated by tolerance to the psychoactive

effects.Recreational users soon discoverthat the more often they use marijuana,the less high they experience.A patientwho smokes cannabis frequently for therelief of,say,chronic pain or elevatedintra-ocular pressure will experience littleor no high.Furthermore,as a clinicianwho has considerable experience withmedical cannabis use,I have to questionwhether the psychoactive effect is alwaysseparable from the therapeutic.And Istrongly question whether the psychoac-tive effects are necessarily unde-

sirable.Many patients sufferingfrom serious chronic illnessesreport that cannabis generallyimproves their spirits.If they notepsychoactive effects at all, theyspeak of a slight mood elevation- certainly nothing unwanted orincapacitating.The great advantage of theadministration of cannabisthrough the pulmonary system isthe rapidity with which its effectsare experienced.This in turn allows for theself-titration of dosage,the best way of

adjusting individual dosage.With otherroutes of delivery the response time islonger and self-t itration becomes moredifficult.Thus,self-titration is not possiblewith oral ingestion of cannabis.While theresponse time for sublingual or oralmucosal administration of cannabis isshorter than it is with oral ingestion, it issignificantly longer than that from absorp-tion through the lungs and therefore aconsiderably less useful route of adminis-tration for self-tit ration.Furthermore,thedesign of the G.W.Pharmaceuticals dis-penser negates whatever self-titrationcapacity sublingual administration mayhave.The device has electronic controlsthat monitor the dose and prevent deliv-ery if the patient t ries to take more thanthe physician or pharmacist has set it todeliver during predetermined time win-dows.The proposal to use this cumber-some and expensive device apparentlyreflects a concern that patients cannotaccurately titrate the therapeutic amountor a fear that they might take more thanthey need and experience some degree of

high (always assuming,doubt fully,thatthe two can easily be separated,especiallywhen cannabis is used infrequently).Because these products will be consider-ably more expensive than natural marijua-na,they will succeed only if patients areintimidated by the legal risks,and patientsand physicians consider the health risks ofsmoking marijuana (with and without a

vapourizer) much more compelling than isjustified by either the medical or epidemi-ological literature and they believe that itis essential to avoid any hint of a psy-choactive effect.In the end,the commercial success of anypsychoactive cannabinoid product willdepend on how vigorously the prohibitionagainst marijuana is enforced.It is safe topredict that new analogs and extracts willcost much more than whole smoked oringested marijuana even at the inflated

prices imposed by the prohibition tariff. Idoubt that pharmaceutical companies

would be interested in developingcannabinoid products if they had to com-pete with natural marijuana on a levelplaying field.The most common reason forusing Marinol is the illegality of marijuana,and many patients choose to ignore thelaw for reasons of efficacy and cost.Thenumber of arrests on marijuana chargeshas been steadily increasing and has nowreached more than 700,000 annually,yetpatients continue to use smoked cannabisas a medicine.I wonder whether any levelof enforcement would compel enoughcompliance with the law to emboldendrug companies to commit the many mil-lions of dollars it would take to developnew cannabinoid products.Unimed is ableto profit from the exorbitantly priceddronabinol only because the U.S.govern-ment underwrote much of the cost ofdevelopment.Pharmaceutical companieswill undoubtedly develop useful cannabi-noid products,some of which may not besubject to the constraints of theComprehensive Drug Abuse and ControlAct.But,it is unlikely that this pharmaceu-

ticalization will displace natural marijuanafor most medical purposes.It is also clear that the realit ies of humanneed are incompatible with the demandfor a legally enforceable distinctionbetween medicine and all other uses ofcannabis.Marijuana use simply does notconform to the conceptual boundariesestablished by twentieth century institu-

tions.It enhances many pleasures and ithas many potential medical uses,but eventhese two categories are not the only rele-vant ones.The kind of therapy often usedto ease everyday discomforts does not fitany such scheme.In many cases,what laypeople do in prescribing marijuana forthemselves is not very different from whatphysicians do when they provide prescrip-tions for psychoactive or other drugs.Theonly workable way of realizing the fullpotential of this remarkable substance,

including its full medical potential,

is to free it from the present dualset of regulations - those that con-trol prescription drugs in generaland the special criminal laws thatcontrol psychoactive substances.These mutually reinforcing lawsestablished a set of social cate-gories that strangle its uniquelymultifaceted potential.The onlyway out is to cut the knot by giv-ing marijuana the same status asalcohol - legalizing it for adults for

all uses and removing it entirely from themedical and criminal control systems.

Two powerful forces are now colliding: thegrowing acceptance of medical cannabisand the proscription against any use ofthe marijuana plant,medical or non-med-ical.There are no signs that the U.S.is mov-ing away from absolute prohibition to aregulatory system that would allowresponsible use of marijuana.As a result ,we are going to have two distribution sys-tems for medical cannabis:the conven-tional model of pharmacy-filled prescrip-tions for FDA-approved cannabinoidmedicines,and a model closer to the distri-bution of alternative and herbal medi-cines.The only difference - an enormousone - will be the continued illegality ofwhole smoked or ingested marijuana.Inany case,increasing medical use by eitherdistribution pathway will inevitably makegrowing numbers of people familiar withcannabis and its derivatives.As they learnthat its harmfulness has been greatlyexaggerated and its usefulness underesti-mated,the pressure will increase for dras-tic change in the way we as a society dealwith this drug.

Th e Ph a r m a c e u t i c a l i z a t i o n o f M a r i j u a n a

These mutually reinforcinglaws established a set

of social categories thatstrangle its uniquely

multifaceted potential.


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FranjoGrotenhermen,M.D.,Chairman ofthe IACM

The International Association forCannabis as Medicine (IACM) is a youngscientific society dedicated to theimprovement of the situation for themedical use of cannabis and the cannabi-noids,through promotion of research anddissemination of information. Among themembers of the IACM are scient ists work-ing in the cannabinoid field,doctors fromhospitals and private practices, pharma-cists, lawyers, and patients who use

cannabis or THC medicinally.We encour-age an exchange of knowledge and expe-rience between these groups andbetween individuals from different coun-tries with different national backgrounds.The foundation of an international scien-tific society was initiated by members ofthe German ACM (Association forCannabis as Medicine) in 2000 after sug-gestions by people from other countriesto expand the ACM to an internationalorganization. Stil l, most members of theIACM are from the German-speaking

countries, but gradually membership isbecoming more international.Cannabis preparations have been usedas remedies for thousands of years.Todaythe potential medical applications of nat-ural cannabis products or individualpharmacologically active ingredients areconsiderably restricted by existing lawsand decrees. An important strategy tochange this situation is to increase theknowledge on cannabis, cannabinoidsand the cannabinoid system of thehuman body and to make this knowl-

edge available to the public, journalists,lawyers and lawmakers, so that they areable to argue on an informed basis andto make informed decisions.One of the major obstacles to an accepted

medical use of natural cannabis is thedearth of well-designed clinical studies.And even for THC (dronabinol) - which isapproved for medical use in several coun-tries,among them the USA,Canada,the UKand Germany - there is not much scientificknowledge available on the medical effica-cy in many ailments,e.g.spasticity in mult i-ple sclerosis,epilepsy, neuropathic pain ordepression.This sometimes causes a situa-tion of considerable disparity between theexperience of individual patients and doc-tors who see that cannabis and THC dowork, and the low level of scientific evi-

dence resulting in misunderstandings anddifferent judgments.

For several reasons this situation is improv-ing today,(1) because of the discovery of aneuromodulator/neurotransmitter systemwith specific cannabinoid receptors in manand animals and endogenous cannabi-

noids (endocannabinoids) that bind tothese receptors, (2) because severarespected institutions such as the House ofLords in the UK in 1998 and the Institute ofMedicine in the U.S. in 1999 conductedthorough investigations into the therapeu-tic potential of cannabis, and (3) becauselarge clinical trials with different prepara-tions (smoked cannabis,under-the-tonguespray,capsules filled with cannabis extract)are under way in several European coun-tries and North America.It is now well established that the endoge-nous cannabinoid system plays an impor-

tant physiological role.It is involved in painperception, short-term memory



12/36

immun-omodulation,regulation of muscletone,blood pressure,intra-ocular pressure,appetite,in reproduction and various otherbody functions.Insight into the natural andpathological function of this endocannabi-noid system has fundamentally facilitatedour understanding of the therapeuticactions of plant cannabinoids, as well astheir possible detrimental effects, and it

has increased the credibility of patientswho claim therapeutic effects fromcannabinoids that are in agreement withthis new area of basic science.In recent years moves to allow the medicaluse of cannabis in many countries havebeen increasingly successful, but the waysto realize access to the drug differ. WhileCanada and several U.S. states exemptsome qualified patients from the cannabislaws,allowing them the medical use of thedrug which they have to find or growthemselves, the Netherlands allow phar-macists to supply cannabis to patients witha doctors prescription,which is paid by thehealth insurance. It is expected that in theUK an under-the-tongue cannabis spraywill be approved for medical use by theMedicines Control Agency by the end of2003 or in 2004,and in Germany the gov-ernment wants to make a cannabis extract

available in pharmacies,which is standard-ized on THC and cannabiol (CBD) accord-ing to a formula of the German associationof pharmacists. The Swiss governmentintends to control cannabis use similar tothe use of alcohol and cigarettes, makingprivate use by adults legal and taxing thedrug, without distinguishing betweenrecreational and medical use.

The IACM is promoting exchange of politi-cal information and scientific knowledgeby different means, mainly by the IACMbulletin and scientific conferences. A bi-weekly internet newsletter is available inseven lan-guages (English,French, German,Spanish, Italian,Dutch andSwedish). Unlikethe scientificconferencesof the ICRS(InternationalCannabinoidResearchSociety) whichare much moreconcentrated onbasic research,

the scientific meetings of the IACM aremore focused on clinical research andexperiences of the efficacy of cannabis andcannabinoids in the treatment of patientsICRS and IACM may best be regarded ascomplementary societies and several sci-entists are members in both.We are happy about several co-operationsamong them an alliance with Haworth

Press which is publishing the Journal oCannabis Therapeutics,edited by our boardmember Ethan Russo,the official journal ofthe IACM,and with other groups and indi-viduals working on common aims.

Th e I n t e r n a t i o n a l A sso c i a t i o n f o r C a n n a b i s a s M e d i c i n e

Office:IACMArnimstrasse 1A 50825 CologneGermany Phone:+49-221-9543 9229Fax:+49-221-1300591E-mail:[email protected]:ht tp:/ /www.cannabis-med.orgBoard of Directors

Franjo Grotenhermen,MD,Germany,1st Chairman,Kirsten Mller-Vahl,MD,Germany,2nd Chairwoman,Ethan Russo,MD,USA ,WilliamNotcutt,MD,UK ,Ulrike Hagenbach,MD,Switzerland,Kurt Blaas,MD,Austria,Martin Schnelle,MD,Germany,Ricardo Navarrete-Varo,

MD,Spain ,Patient Representat iveClare Hodges,UK,Alliance forCannabis TherapeuticsAdvisory BoardRudolf Brenneisen,Switzerland,GregChesher,Australia,Vinzeno di MarzoItaly,Hinderk M.Emrich,GermanyRobert Gorter,Germany,Geoffrey

Guy,UK,Manuel Guzman,Spain,John McPa rt land,New Zealand,Raphael Mechoulam, Israel,TodMikuriya,USA,Richard Musty,USA,Roger Pertwee,UK2003 IACM 2nd Conference onCannabinoids in Medicinein Cologne,on 12-13 Sept.,2003



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Ethan Russo,MD,is a board-certi-fied child and adult neurologistwith Montana NeurobehavioralSpecialists in Missoula, MT, andresearcher in migraine, ethnob-otany,medicinal plants,cannabisand cannabinoids in pain man-agement, and the therapeutic

applications of Schedule I plantsand chemicals.Dr.Russo holds faculty positionsas adjunct associate professor inthe Department of

Pharmaceutical Sciences of the University of Montana,and clin-ical associate professor in the Department of Medicine of theUniversity of Washington.He has published numerous articles in scientific journals and isthe author of Handbook of Psychotropic Herbs: A Scientific

Analysis of Herbal Preparations for Psychiatric Conditions. He isco-editor with Franjo Grotenhermen of the book Cannabis andCannabinoids: Pharmacology, Toxicology and TherapeuticPotential,and author of the novel The Last Sorcerer:Echoes of theRainforest,all from Haworth Press.Dr. Russo is the founding editor of Journal of CannabisTherapeutics: Studies in Endogenous, Herbal and SyntheticCannabinoids,whose charter issue was released in January 2001.

Two double-issues are also published as books, CannabisTherapeutics in HIV/AIDS, and Women and Cannabis: Medicine,Science and Sociology.He has published over two dozen articleson topics of neurology,clinical cannabis,and medicinal plants.Dr.Russo has served as a consultant for private pharmaceuticalcompanies, medical-legal cases, and in conservation pol icieswith regards to medicinal herbs.He lives in the Blackfoot River Canyon surrounded by nature, ismarried to a pediatric nurse practit ioner,and has two teenagechildren.

Dr. Ethan Russo

W h o i s D r . E t h a n ?

Cannabis andCannabinoidsEdited by:FranjoGrotenhermen,MD,Nova-Institut GmBH,Hurth,GermanyAnd,Ethan Russo,MD,MontanaNeurobehavioral

Specialists,Missoula,MontanaStudy the latest research findings by interna-tional experts in this comprehensive bookcompiled by two of the worlds leading author-

it ies on the subject of Cannabis andCannabinoids.This book contains state-of-the-art scientific research on the therapeutic usesof cannabis and its derivatives.A glance at thetable of contents shows the book not onlycovers the chemistry and history of the plant,but also follows through with detailed infor-mation on medical uses and the extensiveresearch being conducted.

All too often discussions of the potential med-ical uses of Cannabis are distorted by polit icalconsiderations that have no place in a medicaldebate.This book offers fair,equitable discus-sion of this emerging and controversial medicaltopic by the worlds foremost researchers.Thebook deals with health aspects of the cannabisplant and the cannabinoids while mainly fac-toring our societal aspects.Some authors referto social topics that require discussion evenwithin the bounds of a narrow handling ofmedicinal aspects.Cannabis and Cannabinoids examines the

benefits,drawbacks and side effects of med-ical marijuana as a treatment for various con-dit ions and diseases.This book discusses thescient ific basis for marijuanas use in cases ofpain,nausea,anorexia,and cachexia.It alsoexplores its possible benefits in glaucoma,ischemia,spastic disorders,migraine andmany other medical conditions.Scientists with different views on the thera-

peutic benefits of the cannabis plant and withdifferent assessments of the potential harmsget a hearing,so that the book reflects andconsiders the frictions and controversies sur-rounding many themes in this area.Leading experts in their fields have con-tributed to this volume.Most are members ofthe International Cannabinoid ResearchSociety,which includes about 200 scientists.Some of them are also members of theInternational Association for Cannabis asMedicine,which deals particularly with themedical use of cannabis and the cannabi-

noids.(from Cannabis and Cannabinoids,Preface.)This reference work is destined to be indis-pensable to physicians,psychologists,researchers,biochemists,graduate students,and interested members of the public.Greatto recommend to your doctor who is support-ing you with medicinal marijuana,or tofriends who may be doctors or psychologists.

C a n n a b i s a n d C a n n a b i n o i d s Ph a r m a co l o g y ,

To x i c o l o g y a n d Th e r a p e u t i c Po t e n t i a l

a s k d r . e t h a nMedicine is an ever-changing science. W hile sug-

gestions for therapeutic use of cannabis or other

drugs may be made herein, this forum is designedsolely for educational purposes, and neither the

author, publisher, nor other parties, will assume

any liability whatever for application or misap-

plication of any information imparted. We can-

not claim scientific proof or accuracy of the mate-

rial discussed, and no warranty, expressed or

implied is advanced with regard to the informa-

tion. Cannabis is illegal in most jurisdictions,

and the reader must apply awareness of this fact

when considering its usage. Medical use of

cannabis may or may not be a viable legal

defense where you reside. Canadian clinical

cannabis patients are encouraged to seek exemp-

tions under existing law from Health Canada.

The proper forms and procedures are available on

their website. Full disclosure and discussion ofmedical issues with your health care providers is

encouraged, as is proper education with respect to

effects and side effects of existing medication.

Q 1:I have epilepsy and I have heard that mar-ijuana is good for people with epilepsy. Iwas wondering if this is true and if I couldget some info on that if you have any. Iused to use marijuana but have not for afew years now and have noticed myepilepsy to be worse. Any info would begreatly appreciated.Thank you.

A 1:Epilepsy, or seizure disorder, is a hetero-

geneous disorder producing convulsionsor other alterations of consciousness that

affects 0.5% of the population at anygiven time.However,about 5% of peoplewill experience one or more seizures dur-

ing their lifet ime. The issue of cannabisuse in epilepsy is controversial, but

increasingly should be less so as we learnmore.Once again, you can find numerous

attestations to its benefit from DrGrinspoon: http://www.rxmarihuana.com/_vti_bin/shtml.exe/search.htm



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a s k d r . e t h a nWe know that the cannabis componentCBD is anticonvulsant, as was determined

in pioneering studies in Brazil, butreviewed here:http://www.ncbi.nlm.nih.gov/entrez/quer

y.fcgi?cmd=Retrieve&db=PubMed&list_uids=12412831&dopt=Abstract

Previously it was thought that THC was

neutral with respect to seizures, or waseven pro-convulsant (made them morelikely). However, recent work done inVirginia by a brilliant young scientist,

Melisa Wallace,conclusively demonstratesthat THC also reduces the likelihood of

seizures: http :// www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=Pub

Med&list_uids=11779037&dopt=AbstractThe most famous patient with seizureswho uses cannabis is probably Valerie

Corral of the Wo/Mens Alliance forMedical Marijuana:http://wamm.org/

Their selfless work on behalf of patientswas thwarted by a DEA raid last fall.

As a neurologist, I can vouch for the factthat many of my seizure patients findcannabis to be a useful adjunct in control-

ling their seizures, occasionally as a sole

agent. Unfortunately, it remains illegal inmost areas of the world and more formal

studywill be necessary to convince physi-cians of its potential in this regard.

Q 2:My name is Meghan and I was diagnosedwith Lupus over 4 years ago. I take eight2.5mg tabs of methotrexate once a week

and was wondering if smoking marijuanawould react harmfully to this drug.A 2:Systemic lupus erythematosus is a verycomplex autoimmune disease more com-mon in women. It may affect any of 14organ systems in the body.Common man-ifestations include arthrit is, chronic pain,skin eruptions,psychiatric manifestations,seizures, and digestive disturbances.Although litt le or no formal investigationhas taken place with respect to cannabisin its treatment,many affected patients doemploy it to apparent advantage. Pleasego to Dr. Lester Grinspoons site,Marihuana, the Forbidden Medicine:http://www.rxmarihuana.com/search.htmand put the word lupus through thesearch engine. You will find interesting

testimonials as to its value as a painkilleranti-inflammatory, mood modulator, anddigestive aid. There is very solid evidencebehind these claims. Recently, the antiinflammatory and immunomodulatoryeffect of a cannabis component wasdemonstrated in the related autoimmunedisease, rheumatoid arthritis: Abstracthttp://www.ncbi.nlm.nih.gov/ entrez/

query.fcgi?cmd=Retrieve&db=PubMed&lst_uids=10920191&dopt=Abstract. Entirearticle as PDF: http://www.pnas.org

/cgi/reprint/97/17/9561In this instance, cannabidiol (CBD) wasresponsible for the benefits seen in theexperimental study.Most North Americancannabis strains contain litt le CBD.I was unable to find any specific information about interactions between cannabisand methotrexate,which is an anti-metabolic agent employed in autoimmune diseases and cancer treatment. Many

patients receiving chemotherapy employcannabis to their benefit, but certainlycaution is advised. Ideally, I hope that thiswould be a situation that you could discuss rationally with your physician.

By Mari KaneMari Kane is a freelance

writer covering sustainable

business and wine.Mari isthe publisher of the

International Hemp Journal formerly known as

HempWorld and the Hemp Pages,is an advisory

board member of the Hemp Industries

Association (HIA).Mari can be reached at:[email protected] and her writ ing may be

viewed at:http://www.marikane.com/

kanewrld/kwfeatur.html 707-887-7508,8080

Mirabel Ave,Forestville,CA USA 95436

Marijuana as medicine played big at theNORML Conference in San Francisco overthe 4/20 weekend.The eminent Dr.LesterGrinspoon gave a marvelous speech onThe Medical Marijuana Problem, whichhe says will be published in the Journal ofCognit ive Liberties. In answering a ques-tion from a Florida patient in need of a

physician recommendation, the 75-year-old retired Professor Emeritus of HarvardMedical School quipped,I wish we coulddevelop a drug that will give doctorsmore balls. John Morgan, MD, made ablanket condemnation of poorly writ tenmarijuana research, which can snowballinto unconquerable mountains of myth.In an area in which argument is so impor-tant and science is used as a politicalweapon, there are enormous numbers ofpapers by our friends in the marijuana istoo dangerous to use camp that do not

give us advice or debate on this is why Imright or wrong.Dr. Ethan Russo, a consultant to GWPharmaceuticals, explained t he equip-ment by which the companys sublinguaspray is delivered. The system used inEngland has no controls because peopleover there do as theyre told, he said,but

Dr.Lester Grinspoon at the conference

Medically NORML: Physicians Weigh in at National ConferenceMedically NORML: Physicians Weigh in at National Conference


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C A N N A B I S H E A L T H t h e m e d i c a l m a r i j u a n a j o u r n a l page


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in order to gain acceptance by the U.S.Food and Drug Administration (FDA) andDEA, GWP developed the AdvancedDelivery System.With it, the liquid or soliddrug is contained in a cartridge. Thedevice is failsafe and access-coded withBig Brotherish features such as a quantitymonitor that reports to doctors. In theU.S.this is how it will be, Russo resigned-

ly stated. Grinspoons attit ude towardmarijuana pharmaceuticals was decided-ly less enthusiastic.I doubt that pharma-ceutical companies would be interestedin developing cannabinoid products ifthey had to compete with natural mari-

juana on a level playing field, but it isunlikely that this pharmaceuticalizationwill displace natural marijuana for mostmedical purposes,he said.The Volcano vapourizer got high marks

among the panelists, with the crowdbreaking into applause at the sight of itspicture. GWPs Cannabis Based MedicalExtract (CBME ) proved effective after 15-45 minutes with rapidity depending onthe patients condition, Russo said. Testsshowed the appetite was most improvedwith pure THC,but CBD also had an effect.The THC/CBD mix worked well especially

for sleep improvement.Normls Paul Armentano summarized themany clinical trials occurring around theworld. At least 10 California State-fundedtrials are ongoing at UC San Francisco andSan Diego investigating whole smokedmarijuanas effects on HIV-related neu-ropathy, Mult iple Sclerosis and analgesia.They are working jointly with the New YorkState Psychiatric Institute, comparing oralTHC on patients with HIV/Aids.In England,GW Pharmaceuticals have sub-

mit ted their findings on 3 years of researchinto the sublingual use of cannabis extractand may gain approval from the BritishGovernment by the end of this year.The Israeli company Pharmos has createda neuroprotective product calledDexanabinol for the treatment of headtrauma and stroke, and recently gainedapproval from the U.S. government for a

Phase III trial in the US.Data from a German study on smokedmarijuanas effects on TourettesSyndrome is looking very positiveArmentano said, and in Spain there arestudies on how compounds in marijuanaalleviate certain types of brain tumors.Next years convention might return toSan Francisco or it may stay close toNORMLs home in Washington, DC. Thedecision will be made this summer.

When the VancouverIsland CompassionSociety opened itsdoors over 3 years

ago, we did so withthe hope of helpingthose with a legiti-mate need for medic-inal cannabis, and ofcorrecting some ofthe misinformationsurrounding thisastonishingly versa-tile herb. Althoughthere are numerousstudies suggestingthe usefulness andrelative safety ofmedicinal cannabis(including its anti-carcinogenic andanti-tumourific prop-erties1), artificialrestrictions imposedby the U.S.-led world-wide prohibition oncannabis have seri-ously affected theability of countries toconduct clinical

research on its medicinal propert ies. As aresult, most of what we know about mari-

juana comes from in vitro (test-tube) or invivo (animal testing) studies. Compassionclubs,however,have a very unique mem-bership, and can therefore play an impor-tant part in adding to our clinical knowl-edge and understanding of medicinacannabis. We quickly found that as themembership at the VICS increased, so didour understanding of the effects of medic-inal cannabis on different conditions and

symptomology.Amongst medicinal cannabis dispensariesit has long been known that certain strainsare more effective in alleviating certainsymptoms.A general rule of thumb is thatIndicas, because of their more narcoticeffect, are typically better at alleviatinggeneralized pain than Sativas, whichappear to be more effective in treatingdystonic movement disorders such as MSor epilepsy.There are many theories as towhy this might be: studies have shownthat CBD is an effective anti-convulsant

and anti-spasmatic, therefore it has beensuggested that t rue Sativas may be higherin CBD than their Indica cousins2. Evenwithin the sub-group of Indica and Sativathere are numerous strains that appearparticularly effective at treating certainsymptoms (for example, the White familysuch as White Widow and White Rhino,arevery good pain kil lers);it was in the interestof our society to find out why this might beso that we could better treat our membersIt has always been our hope to share someof the unique knowledge gleaned from

VICS heads up more research than Health Canada

Medically NORML: Physicians Weigh in at National ConferenceMedically NORML: Physicians Weigh in at National Conference

by Philippe Lucas.Philippe is the founder and director of the Vancouver Island CompassionSociety and Director of Communications for DrugSense.He uses cannabis to alleviate the

symptoms of hep-C.


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working in a compassion society with thegeneral populace. We wish to informthose currently self-medicating withcannabis3 on the effectiveness of differentstrains on different symptoms,but first wehave to see if there was any concensus onstrain/symptom correlations beyond therocky shores of Vancouver Island. It waswith this research in mind that we devel-

oped a strain/symptom survey protocolfor distribution to all of Canadas compas-sion clubs.By surveying the employees ofthese unique organizations, we will dis-cover if there is any strain/symptom con-sistency within Canadian clubs. Shouldwe find that our analysis suggests thatthere is a positive correlation betweencertain conditions and certain varieties,this may posit a more specific investiga-tion into the cannabinoid profile of thesestrains, as well as more specific clinicalresearch into why one variety might be

more effective than another in treatingspecific symptoms.Our survey is current-ly underway and should be done by thesummer of 2003.Last fall I heard about a researcher fromthe University of California, San Franciscowho had stumbled upon some remark-able results while researching the effec-tiveness of hepatitis-C Interferon/Ribovarin t reatment on intravenous drugusers currently on methadone mainte-nance. Dr. Diana Sylvestre had very lit tleexperience with cannabis use,but in hersurvey protocol she found that her study

subjects had a much higher Interferontreatment success rate if they were alsousing cannabis to alleviate the symptomsof hep-C and of the treatment itself. Theresults were so dramatic that, althoughhard drug use such as cocaine and hero-in were negative indicators for successfulInterferon treatment, if she includedcannabis users in the Drug Use duringTreatment category,it appeared as if thedrug users were doing better than thenon-drug users. When I forwarded herresult s to Dr. Ethan Russo, a neurobiolo-

gist with expertise in cannabis, he sug-gested that the results may be attributa-ble to an immunological response. If wecould prove that cannabis actually had a

positive impact on the immune system4,we could further defend and justify itsmedicinal use.With these results in mind, we contactedher to suggest a follow-up study using theVICS membership as a study group. Inorder to further expand upon the rele-vance of our results,we invited the Brit ishColumbia Compassion Club Society to

participate in the design and implemen-tation of the survey protocol.Together,wecare for almost 500 members with hepati-tis-C. If the results of our study (whichshould be completed by the summer of2003) show that cannabis has a positiveimpact on hep-C treatment outcomes, itwould not only seriously change thenature of hep-C treatment protocols, butalso completely alter the U.S. perceptionof cannabis as a drug of abuse with nomedical value.In other words,our hope isthat this research may result in a change

of our understanding of this medicinalherb as well as in the laws currently pro-hibiting its use.Additionally, we have recently beenapproached by a researcher from theUniversity of Victoria that wished to studythe effects of cannabis on nausea andemesis in pregnant women. With this inmind, we designed a retroactive study ofcannabis and pregnancy, as well as theeffects on symptomatic nausea resultingfrom other conditions. Were pleased toannounce that UBC and the BCCCS maybe joining us in this important research,

and that we hope to have preliminaryresults by early fall.The VICS plans to init iate further researchprotocols over the next twelve months,including clinical double-blind studies to

test the effectiveness of certain strains intreating specific symptoms.Over the nextyear, it is our goal to use our uniqueknowledge base and membership tooversee more medicinal cannabisresearch than any other government orprivate instit ution in North America.Thisinformation will not be the property ofthe Federal government or pharmaceuti-

cal interests;it will be made public so thatwe can all benefit from a further under-standing of cannabis and its incrediblemedicinal properties.

1) See www.davidhadorn.com.2) Interestingly,high THC plants typically contain onlytrace amounts of CBD;hemp has much higher concentrations of this cannabinoid.3) Health Canada estimates that there are around 1million Canadians currently claiming that their use ocannabis is medical.4) As has been suggested by Dr. Donald Abrams,anAIDSresearcher from the University of California, SanFrancisco

VICS heads up more research than Health Canada


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OK, Brian said after the first lecture, Ive gotgenes, alleles, loci, chromosomes and heterzygotesCan you bring that a lit tle closer to earth? What, forinstance,if anything,does that have to do with your

project in Hawaii?Actually everything. OK. Schools on again. Lets

assume you go back and read the first in this series cause youve forgot ten i t alalready,and well carry on from there.I left off saying wed be next looking at oneof the truly marvelous inventions of nature, the mechanism responsible for gen-erating all t he variation we observe within species.Im talking about what Darwinreferred to as variation under domestication.All the different breeds:dogs,catspigeons,people and pot.(The alliteration made me do it.)

Lets look at whats happening in the Hawaii project as an illustration.The issuein that case is one of adaptation.What we call hemp - or some prefer industriahemp though I think hemp is just fine - is a breed of cannabis generally foundin the temperate zones of the planet.The plants life cycle is driven by a geneti-cally programmed response to the length of the night. Nights in the temperate

zone begin to lengthen after summer solstice and the plants shift from vegeta-tive growth - which has resulted in long stems - to reproductive phase,so seedwill be set and matured by frost.

Now,if you take plants with that genetic program from temperate 45to t ropi-cal 20,where the days and nights are about equal in length most of the time,theplants immediately experience long nights characteristic of late season in thenorth. So immediately the plants fire up their reproductive gear and lit tle vege-tative growth occurs.Varieties that would easily reach 9 in London, Ontario, areonly 2 tall, done growing and setting seed after just 2 months in Hawaii.

Short aside: In the 20th century, the hemp fiber growers of Wisconsin developed acollaboration with the hemp seed producers of Kentucky by exploiting the photope-riod response in reverse. Heres how: When you plant seeds of Kentucky varieties(meaning varieties adapted to finishing seed in the limits of the Kentucky growing

season,approx.35) in Wisconsin (45) the plants stay vegetat ive longer,the reverseof what happens when you move varieties south of their zone of adaptation. If youare after fiber,you want the plants to remain vegetative as long as possible (more vertically elongat ing stem).So Kentucky produced the seed that Wisconsin planted forfibre. This collaboration lasted until 1957, the last year hemp was planted inWisconsin.This is the only case Im aware of where specialized industries developed toharness this feature of the plant in order to maximize productivity.

Alrighty then! We have two situations. One is the egregious misfortune that thegermplasm was lost.Two is that there are no tropically adapted industrialvarietiesof cannabis.These two situations are connected in that they are both a matter oflower latitude adaptation,one lower than the other.The lost germplasm,that of theunique American hemp called Kentucky Hemp,was bred to cornbelt latitudes.AsI have described in great detail elsewhere, this hemp arose in Kentucky from the

meeting of Chinese and European hemps after 1850.Of the European hemps,onlythe superior Italian hemp was adapted so far south. What this loss means is thatAmerican hemp farmers of some hoped-for future will not have proper varieties fortheir growing regions.There is a gap,a lag, that must be addressed eventually,andthat is what I set about to do in Hawaii. The State of Hawaii wanted crop diversifi-cation.Both goals involve the introduction of cannabis with differing photoperiodadaptations.How do we proceed?

If you look across the globe, there are cannabis plants that do grow abundant-ly in the t ropics.So the photoperiod adaptation of those plants needs to be com-bined with the internode elongation and fiber or seed characteristics of industrial cannabis. The plants architecture must be modified and it s growth habitaltered. We want to bring in the agronomic qualities that industrial varieties

Dr. Dave

Th e HaTh e Ha

above - 2 foot plant

below - 8 foot plant


G EN ETI C S 1 0 1 . 2 Th e H a w a i i Pr o j e c t


19/36

exhibit, such as tolerance to dense planting.An obvious focus of concern to someis the coincidence of high THC production with short-day photoperiod adapta-tion. This is a complicated situation because it takes years to create new plantvarieties.One must ask,will THC sti ll be a big issue in 10 years? After all, the whole

issue of THC in hemp varieties is poli tical.THC never used to matter in hemp. It sa made-up issue. It is as informed by science as were the tribunals of theInquisit ion.So, that means a new wind in Congress could sunder years of invest-ment in lowering THC to absurd levels.Looking at the rapid changes taking placeeverywhere butthe US,I can imagine there might come a day when someone willask,astounded,You mean you bred the THCout ofthe plant?!

So,without going off on too much of a tangent,whatever happens next,the firststep is the same: identi fy genetic sources of the traits of interest; cross them;select within the variation that emerges. The photos accompanying this art icleillustrate the range of variation released when you do that. These plants all hadthe same grandmother.They are all descended from seed born on a single femaleplant. As for Granpere,well Gramma mixed it up a bit ,had international affairs.

After the init ial critical cross was obtained and a large progeny harvested, thenext step was to recombine the population. Because this is an agronomic (asopposed to hort icultural) breeding program, pressure (artificial as opposed tonaturalselection) is applied to the population to urge it in the direction of agro-nomic traits.For instance,we are interested in plants that have achieved 8 feet ofgrowth and are sti ll vegetative after 3 months,as with the individual in the lowerleft photo.Her cousin (above) went reproductive very quickly and never got tallerthan 2,but it is sett ing seed.There could well be circumstances where the short-quick seed producer might be the preferred type. (Jargon alert: we say pheno-type for the manifest characteristics of the plant. The genetic underlayment isreferred to as genotype.This will be on the test...) In the photos on the right aretwo individuals intermediate between the extremes on the left, at 4 and 6 feet ofgrowth in the same 3 months.The characteristic heightwould be said to exhibit

continuousvariation.Pressure is applied by biasing the contribution of gametes from individuals inthe population. Example: we had an insect pest ident ified as the Chinese RoseBeetle.It really chomped down on some of the plants.Yet other plants were leftalone. There are two possibil it ies: that the beetle is leaving the plants alonebecause theres something i t doesnt like about them, they taste bad; or, thatsome plants lucked out, they escaped. If taste bad=TRUE, then there is a geneticbasis to the health of the uneaten plants and choosing those plants (removingthe affected ones before their pollen [male gamete] is shed) will improve thepopulation. However, if escape=TRUE, then selection wont do any good. So wehope the first hypothesis is true, make selections accordingly as humans havedone in the course of domesticating plants and animals over the millennia, andwait with anticipation the next cycle to see if we were effective. Selection is

applied to the population,so the character of the plants is gradually,over succes-sive cycles,morphed toward the desired type.The biological stuff is wonderfullyplastic this way.But the effectiveness of selection depends on there being a linkbetween the phenotype and genotype.The tighter that link, the more effectivewill be the selection. Its a wysiwyg situation.But if theres a lot of noise in the sys-tem - in this case escapees,not taste-bads - then the breeder wil l be less effectivein recovering in the next generation the trait he selected, and we will find thehappy beetles feasting again next cycle on unlucky individuals.

So now weve generated a population of individuals among which we canselect for those that combine the desired traits. And that population has beenthrough a round of recombination.What does that mean?

Oops,theres the bell.

wa ii Pro je c twa ii Pro je c t

above - 4 foot plant

below - 6 foot plant

G EN ETI C S 1 0 1 . 2 Th e H a w a i i Pr o j e c t



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As Health Canada continues to put the livesof critically and chronically ill Canadians in

jeopardy through its failed MarijuanaMedical Access Regulations,we must organ-ize to protect the right of Canadians to havesafe access to medicinal cannabis. It is withthis in mind that Im pleased to announcethe launch of a new organization dedicated

to defending the rights of Canadas sickestcitizens: Canadians for Safe Access(www.safeaccess.ca).Inspired by t he U.S. organizationAmericans for Safe Access (www.safeac-cessnow.org), Canadians for Safe Accesswill work to both pressure Health Canadato free-up access to medicinal cannabisand to defend the rights of all legitimateusers, cultivators, and distributors -including compassion clubs and societies- through legislative strategies, mediacampaigns,and non-violent direct action.

Canadians for Safe Access will work pro-actively with regional grassroots activistsand local, provincial, and federal politi -cians to protect the rights of those whoneed cannabis for medical reasons aswell as those who risk prosecution bysupplying them.Over 80% of Canadians support the distri-

bution of cannabis for therapeutic purpos-es, yet most of those who could benefitfrom it are still forced to risk arrest and tobuy it from of ten dangerous black-marketsources THIS HAS TO END NOW!In a modern liberal democracy it is morallyunacceptable to force the sick and dyinginto the street to scrounge for their medi-cine. Canadians for Safe Access will focus

the resources of all those interested in cor-recting this social injustice and worktowards the common goal of SAFE ACCESSto medicinal cannabis and anti-discrimina-tion towards users and suppliers.If youd like to help, you can go towww.safeaccess.ca and join our mailinglist and/or take the Pledge of Resistance(http://www.safeaccess.ca/pledge.htm).If you work with an organization that sup-ports safe access to medicinal cannabis,you can show your support by registeringas a Supportive Organization and allow-

ing us to link to your website(http://www.safeaccess.ca/endorse.htm).Help end this war on Canadas sickest citi-zens and those who supply them: joinCanadians for Safe Access!Thank you for your time and support ,Philippe Lucas,Alison Myrden,Hilary Black,and Rielle Capler

Ca n n a b is He a l th g i v e s

k u d o s t o M a r c o R e n d a

f o r a j o b w e l l d o n e .

Treating Yourself MedicalMarijuana Inc. is a club offeringFREE SEEDS with excellent genetics

to the medical marijuana growerthanks to the people at BadassBuds in the UK, Serious Seeds andNo Mercy Supply in Holland, andPeak Seeds and Hemp Depot herein Canada. In 8 weeks 4200 FREESEEDS have been sent out WORLD-WIDE. The club also offers HealthCanada Exemptees medical mari-juana AT COST FOR $75 OZ. Theyalso have sponsors such asCelebration Pipes,Bubble Bags andKIF Boxes by BC BOXES donating

products that are given away asprizes every month, along withFREE SEEDS and FREE MARIJUANA.http://www.treatingyourself.comMarco [email protected]


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On March 14th in P.E.I. court, the judge read out the decision on theRonald Barry Stavert case, who was charged with simple marijuan apossession an d m ade application to quash the information arguingthat it does not disclose an offence known to law. The accused basedhis application essentia lly on t he Ontario Court of A ppeal decision in

R. v. Parker (2000) 146 CCC (3d) 193, which declared the prohibi-tion against possession of marijuana in s.4 of the CDSA invalid dueto its failu re to provide for legal possession of marijuana for medicaluses. Below are some excerpts from the decision, with the full docu-

ment on the web at http://cannabislink.ca/legal/stavert.htm

The Supreme Court of Canada AppealsWell, we finally managed to argue the appeals of

Caine, Malmo-Levine and Clay in the Supreme Court of Canada onTuesday,May 6th,2003.Its hard to figure out how its going when youre in the thick of it andwaiting to get up next or trying to figure out just what the judgemeant by a certain question and how to respond.Consequently,it wasa bit of a t reat to watch the CPAC edition last night so soon after beingthere and to see it from the judges viewing perspective.I think we all did great. While they kept trying to throw Paul off withsome weird questions that I thought he had already answered,he kepthis cool and kept hitt ing back like a prize fighter,with important pointsthroughout. I thought he did an excellent job. David was also great.Whatever misgivings anyone may have had (myself included at an ear-lier t ime) about him arguing his own appeal,there should be absolute-ly none left.He covered everything very well and I hope they play thevideo back over and over again until they get it .Great job,David - youserved your community in an outstanding fashion and better thanmany lawyers with years of training behind them. I was also pleasedwith my own performance.They seemed to engage well throughout .In doing these post-mortems it is always easy to think of other thingsone wishes one had said. I forgot to ask for a break at 4:20 p.m.!! It wasa pity they cut out the Intervenors, though both Joe Arvay QC andAndrew Lokan for the B.C. and Canadian Civil Liberties Associationsalso made great submissions.Those of you that are interested can getan unedited video through CPAC.In last Saturday nights edited video replay The Crown, David FrankelQC, didnt start until around 1 a.m. Sunday and unfortunately I musthave fallen asleep on the couch,because I woke up to my own voice inreply,thus having missed the main reason I wanted to watch - David

Malmo-Levines reply.My memory of it in the court continues to makeme laugh when he pleaded with the court to ask him questions nowand the Chief Justice responded by saying Maybe its because we allagree with you,Mr.Malmo-Levine.Also when he invited them to be ourheroes. Again, I think it was great and Im sure they havent had thatmany laughs in a constitutional case ever before.Even Frankel got in agood line about whether Davids suit was more than .03% THC.There is only one thing I can think of that would have made it even bet-ter,and that is the presence of Alan Young. His contributions to thesecases has been tremendous and it was a very sad day that he was notable to be with us. I join all of you in offering sincere condolences tohim and his family at this difficult time.While the result is anybodys guess, I am more optimistic after watch-ing CPAC and focusing particularly on some of the Chief Justices ques-

tions as well as those of Binnie J.and Iacobucci J.Whatever they decidein about 6 or more months from now,it promises to be very interest-ing for future Charter challenges to criminal laws.We only need 5 outof 9.I think we have 3 for sure with us and probably 3 against us,so lets

hope for 2 more at leastof the remaining 3.The next few monthsand the rest of this yearwill bring some veryinteresting develop-ments. We will need tohammer our politiciansfor this

E-mail: jconroy@johncon roy.comWebsite: w ww.johnconr oy.com

CONROY & COMPANYBarristers and Solicitors

JOHN W.CONROY, Q.C.

Barrister and Solicitor

2459 Pauline StreetAbbotsford, B.C.Canada V2S 3S1

Ph: 604-852-5110

Toll Free:1-877-852-5110

Fax: 604-859-3361

Le g a l Ea g l eLe g a l Ea g l e

John Conroy, Q.C.,photo by Kim O'Leary

continued page 31


22/36

By: Christopher R. PentyChristopher Penty is a 48 y r. old trial law yer prac-tising out of his Kelowna office for over 20 years. He

tends towards unique litigation and has expertise inthe areas of personal injury , civil sexual assault,comm ercial, estate and tax litigation. He is married

and the proud father of a 10 yr. old girl. For recre-ation he enjoys reading, gardening, skiing and golf,in no particular order.

I am sure it is very well known by the read-ers of this magazine that there exists today

in Canada a serious dichotomy or inconsis-tency at law.On the one hand,the FederalGovernment has prohibited the posses-sion, cultivation, purchase or sale of mari-juana in any form.On the other hand,theyhave provided for the existence of a cer-tain class of people to be allowed to pos-sess marijuana for medicinal purposes.Init ially there was to be a supply source ofmarijuana to supply those who hold validSection 56 Certificates at the time thewhole scheme was envisioned by theFederal Government. Unfortunately, thathas not come to pass.Medical marijuana isstill high priced and purchased mostlyfrom illegal suppliers.The Canadian legal system provides 3mechanisms by which this inconsistencymight be remedied.The first method ariseswhen the criminal law, which prohibitsmarijuana possession, is challenged. To

date this has met with reasonable success.A recent ruling in R.v.Clarke heard in NovaScotia on March 31,2003 struck down thepossession laws, as Ontario and PrinceEdward Island did before. Unti l someappeal cases have been heard, as of now,possession of 30 grams or less of marijuanawill not be enforced by the Courts in thoseprovinces. In B.C. the courts have recog-nized the right to possess marijuana, but

only for medicinal purposes.The second legal means is to challenge thelaws on a constitutional basis. Earlier con-stitutional challenges did not meet withsuccess. Lawyers John Conroy, Q.C., AlanYoung, and Paul Berstein, together withDavid Malmo-Levine, have only just con-cluded arguing their case before theSupreme Court of Canada and it will beinteresting to see whether they are moresuccessful on this occasion.The third method is to bring a class action,which, by costing the Government finan-cially,will force them into action.This class

action would involve a RepresentativePlaintiff, likely one from each Province thatwishes to be a part of this class action.TheDefendant would be the FederalGovernment. The Representative Plaint iffwould have to be a holder of a Section 56Certificate who has been frustrated in hisattempts to obtain medical marijuana froma legitimate source. If the class action islarge enough, the collective damages maybe in the millions of dollars.The first step in such a lawsuit,and one of itskey components, is having the action certi-fied by the Courts as a class action. The

Courts look at a number of factors to deter-mine whether a class action lawsuit is appro-

priate such as whether the court action jus-tifies the recovery, whether the actioninvolves complex medical matters,whetherthe action will help resolve inconsistent lawsin the same area,or whether there are alter-native methods that might achieve thesame end. Such cases are extensively man-aged by the Courts and they are never to becommenced lightly.The Court will demand afull plan of action from the Representative

Plaintiff and his lawyer on how the action isto proceed in terms of what evidence is tobe gathered,how it is to be presented,howthe lawyers are to be paid,how the class is tobe identified,how the members of the classare to be notif ied, the common issues atlaw to be resolved, what expert evidencewill be put forward, along with a host ofother more minor considerations.One concern of such an action is what the cause ofaction and damages would be.The Plaintiffwould have to prove that the FederaGovernment was responsible for the lack oflegal marijuana source for medical certifi-

cate holders. This may be problematic, asthere are currently licensed growersHowever,these licensed growers act underextremely restrictive conditions and are sofew that they have not made any real dentin the high price of marijuana.The real question is whether a class actionwill bring about the desired results,that isaccess to a reasonably priced supply ofmarijuana for those holding medical certifi-cates,or whether the other actions current-ly ongoing,such as the constitutional argu-ments that have just been made, will havethat result.Failing that,one can always take

comfort that at least for now,and for someforeseeable period in the future, simplepossession of less than 30 grams of mari-juana is not a crime that will be enforced bythe Courts in some of Canadas provinces.

The question of the legaimpact of the Rogin deci-sion is rather muddyWhatever your view maybe it is still risky to smokepot walking down thestreet. Rogin is a SuperiorCourt judge,so stare deci-

sis (the law of precedent) dictates that lowercourt judges are bound.Therefore,any lowecourt judge (where 99% of marijuana pos-session cases are heard) is bound by thisdecision.Anyone appearing in court shouldnot be asking for an adjournment butshould emphatically demand that alcharges be stayed. Stare decisis does notgovern the police. They will continue tocharge. Until the Court of Appeal resolves

M e d i c a l M a r i j u a n a C l a s s A c t i o nM e d i c a l M a r i j u a n a C l a s s A c t i o n


Alan YoungPhoto by www.jere-mybenning.com

W h a t t o d o

you ge t bus te


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C A N N A B I S H E A L T H t h e m e d i c a l m a r i j u a n a j o u r n a l 2

the issue, it is business as usual on thestreets. If the Court of Appeal upholds Roginthen the police must abide by this decisionand once the Supreme Court of Canada

upholds the decision it would be bindingacross Canada. So,in actual fact there is novalid law currently in Ontario but a trialjudge must make this ruling in a given case

if you are unfortunate enough to becharged in this legal limbo. The police wilnot stop enforcing the law until directed todo so and they will not be directed to do sountil the Court of Appeal upholds Rogin(which is not an inevitable conclusion).

W h a t t o d o i f y o u g e t b u s t e d

Michael Patriquen Update: Michaelis currently dying and in tremendouspain. He is being denied medical mari-

juana in prison, even through he has alegal exemption from MMAR authoriz-ing use. Cannabis Health sent a formalrequest to the Honourable WayneEaster, Solicitor General Canada; to cor-rect this atrocity now before Michaelbecomes the first casualty of our gov-ernments dysfunction. As the deathpenalty does not match his crime ofcompassion.John Conroy stepped up to the plateand took on Michaels case with noregard to reimbursement for even hisown costs bless your heart, John. If

you would like to help,please send yourdonation to: John Conroy In trust forMichael Patriquen Every lit tle bithelpsThanks.There is an urgent application beforethe courts to be heard by the time youread this,June 2nd 2003

GW Update:German drugs and chemicalsgroup Bayer AG said on 21 May it had agreedwith GW Pharmaceuticals to market acannabis-based multiple sclerosis and pain

drug from the Brit ish company. Bayer said ithad received exclusive rights to market thedrug in the United Kingdom and had theoption for a limited period of time to negoti-ate rights in the European Union as well asCanada. The United States, however, is notpart of the deal and a launch in the worldslargest pharmaceuticals market is at least twoor three years away.The company said it hadpaid GW a signature fee and would later payadditional fees on regulatory approval in theUnited Kingdom for treatment of multiplesclerosis, neuropathic pain and cancer pain,totalling 41 million US dollars,.GW will supply

the product, and get a share of product rev-enues. Bayer will market the drug under thename Sativex. GW Pharmaceuticals had sub-mitted its medicine for approval by theMedicines Control Agency in March. UKapproval of the drug was likely by the end ofthe year, a spokesman of GW said. (Sources:Reuters of 21 May 2003)


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cannabis health - [jul/aug 2003]

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