to treatment with marijuana-based medicines. Most people with AIDS, for example, experience multiple symptoms that appear to be relieved by cannabinoids, including wasting, nausea, vomiting, pain, and anxiety. It might therefore be preferable to offer such patients a single medication that provides less-than-perfect relief for all of these symptoms than to treat each symptom with a different but more powerful drug.

Some of the most exciting possibilities that could unfold from our present medical knowledge of marijuana have little to do with the plant itself. The active compounds in marijuana may not only inspire scientists to develop a variety of useful synthetic medicines but also lead them to a greater understanding of the role of cannabinoids produced by the human body. Research has already revealed that cannabinoids influence numerous physiological processes and biochemical pathways, each of which represents a potential site of action for new highly specific drugs. With the advent of treatments designed to work with the body's own cannabinoid system, the medical use of marijuana should fade as a topic of heated debate to a footnote in the history of medicine.

NOTES

1. Health Council of the Netherlands, Standing Committee on Medicine. 1996. Marihuana as Medicine. Rijswikj, The Netherlands: Health Council of the Netherlands.

2. Voth EA, Schwartz RH. 1997. “Medicinal applications of delta-9-tetrahydrocannabinol and marijuana. ” Annals of Internal Medicine 126:791-798.

3. Hall W. 1997. “An ongoing debate.” Science 278:75.

4. Strassman RJ. 1998. “Marihuana: The Forbidden Medicine” (book review). Journal of the American Medical Association 279:963-964.



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