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MARIJUANA AS MEDICINE?: The Science Beyond the Controversy
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INDEX
A
Addiction
clinical studies, 47-48
craving, 52, 53, 54
epidemiological studies, 47-48, 54, 57-58
gateway theory, 5, 62-65, 67-68
mental illness, 61
tolerance, 11, 48, 49, 50, 52-53, 78
withdrawal, 11, 41, 48, 49, 51-54
see also Dependence
Adolescents, 51-52, 54, 65, 66
attitudes, 66-67
dependence, 56
gateway theory, 63
peer pressure, 54, 55, 63
Africa, 15
African Americans, 56
glaucoma, 125
Age factors, 11
AIDS, 86
cellular biology of, 90
clinical trials, 74
elderly persons, 45, 74, 95, 125
gateway theory, 63
glaucoma, 124-125
prevalence of marijuana use, 54, 56, 73
side effects of medication, general, 19-21
smoking of marijuana by patients, 90, 93, 161, 185
see also Adolescents;
Children
AIDS, 3, 4, 5, 7, 10, 19-20, 43, 44-45, 86-94, 160, 164, 176-177, 185
age factors, 86
clinical studies, 75, 84, 87-94, 134, 135, 178-179
Marinol, 88, 89-90, 91, 92, 134, 135, 145
AIDS wasting, 8, 87-88, 101, 150, 166, 185
clinical studies, 84, 89-90, 93, 171
Marinol, 27, 144, 145, 147
patients' views, 19-21
smoking of marijuana, 90, 93, 161, 185
THC, 108, 109, 111-113
Alaska, 4, 164
Alcohol use, 39, 56, 58, 60, 61
gateway theory, 62-63, 64
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Alternative medicine, general, 11
historical perspectives, 13-14, 24
Alzheimer's disease, 121-122, 145, 150
American Medical Association, 17, 158, 178-179, 180
Amotivational syndrome, 60-61, 178-179
Anandamide, 29, 35, 141
Animal studies, 13, 53, 150
cannabinoids, general, 43-44
carcinogenic effects of smoking marijuana, 42-43
dystonia, 117
historical perspectives, 15-16
Huntington's disease, 117
immune system, 35, 44
muscle spasticity/multiple sclerosis, 35, 107, 110, 112
pain palliation, 33, 51, 79
psychomotor behavior, 31
in regulatory process, 134, 136
reproductive system, 45-46
smoking of marijuana, 42-43, 51
tolerance, 50-51
withdrawal, 52
Anorexia,
see Appetite;
Wasting syndrome
Antioxidants, 31, 151
Anxiety, 11, 24, 58, 61, 62, 96, 113, 174, 183
clinical trials, 74, 84, 87, 91, 92, 93, 109, 119, 143
THC, 108, 109, 111-113
tobacco smokers, 41
withdrawal, 52
Appetite, 174
Alzheimer's disease, 122, 145
cancer and, 101-102
clinical studies, 75, 93, 176
megestrol acetate, 89, 101-102
patients' views, 20, 23, 96
withdrawal, 51
see also AIDS wasting
Arizona, 4, 164
Attitudes
adolescents, 66-67
amotivational syndrome, 60-61, 178-179
illegality of marijuana, 24-25, 42
parental, 55
patients, 19-25, 87, 95-96, 100, 103-104, 108-109, 164
peer pressure, 54, 55, 63
physicians, 21
public opinion, 24-25, 42, 62, 149
users of marijuana, general, 19, 54;
see also “patients” supra
B
Bakalar, James, 19, 74-75
Birth weight, 38, 46
Black persons,
see African Americans
Brain, 59-60, 96-97, 115-116, 118
Alzheimer's disease, 121-122
cannabinoid receptors, 28, 31, 32, 51, 77-78, 83, 98, 107, 109, 117-118, 131-132, 152, 176, 181
Marinol, 143
serotonin, 29, 88, 98, 100
cognitive functions, general, 47, 59-60, 92, 119, 143;
see also Psychological effects;
“memory” infra
craving, 53, 54
epilepsy, 120-121, 134
headaches, 19, 22, 23, 77, 83, 164
pain, general, 77-78
memory, 31, 32-33, 50, 51, 59, 61, 84, 119, 121-122, 152, 176
multiple sclerosis, 107
muscle spasticity, 107
reward system, 53
Britain,
see United Kingdom
Bronchi, 40-41
Buyers' clubs,
see Cannabis buyers' clubs
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C
Cachexia,
see AIDS wasting;
Appetite;
Wasting syndrome
California, 4, 19, 65, 66-67, 86, 93, 95, 147, 164-169
Canada, 6, 113, 116, 171-172
Cancer, 91, 95-105, 164
animal studies, 42-43
appetite of patients, 101-102
clinical studies, 42, 81, 82, 84, 98-102, 134, 164, 171
National Cancer Institute, 136, 144
pain palliation, 81, 82, 95-96, 98
prostate cancer, 42, 101
smoking of marijuana as cause, 38, 41-43, 47, 67, 153-154, 183
smoking of marijuana as palliative, 95-96, 98
smoking of tobacco as cause, 41
THC, 81, 82, 91, 96, 98-102
treatment of, 3, 4, 7, 8, 10, 164;
see also Chemotherapy
wasting syndrome, 101-102, 171
Cannabidiol, 27, 31, 151
epilepsy, 121
Huntington's disease, 117
Cannabinoids, general, 8-9, 10, 25-31, 103, 142, 174, 175, 181-183
animal studies, 43-44
cellular processes, 27-36, 131;
see also Receptors and receptor binding
clinical trials, 43-44, 175, 178-179
glaucoma, 124, 127, 128
immune system, 28, 34-35, 43, 44, 176
nervous system, 28, 29, 30, 31-34, 119-120, 121, 122
novel medications, 148-153
pain, 79, 83-84, 176, 181-182
reproductive system, 44, 45-46
side effects, 24, 25, 28, 67
see also Drug delivery;
Marinol;
THC
Cannabis buyers' clubs, xii,
Carcinogens, 41, 183
Cardiovascular system, 44, 45, 47, 127-128
hypertension, 11, 48, 102
withdrawal, 52
Case studies (single-patient trials), 74, 93, 95, 107, 109, 177
Cellular biology, 13, 17, 25, 27-36, 42, 43-45, 131
AIDS wasting, 90
glaucoma, 124
multiple sclerosis, 107
smoking effects, 40-41, 42-45
THC, 28, 29, 30, 181
see also Genetics;
Immune system;
Receptors and receptor binding
Centers for Disease Control and Prevention, 88
Cesamet,
see Nabilone
Chemotherapy, 8, 95-101, 102
clinical studies, 75, 97-101, 164
Marinol, 27, 88, 144, 145, 147
patients' views, 19, 21-22
Children
clinical trials, 47
gateway theory, 63
peer pressure, 54, 55, 63
see also Adolescents
China, 14, 17
Chronic obstructive pulmonary disease, 41
Clinical studies, 6, 13, 24, 25, 73-128 (passim),
addiction, 47-48
age factors, 74
AIDS, 75, 84, 87-94, 134, 135, 178-179
AIDS wasting, 84, 89-90, 93, 171
Alzheimer's disease, 122
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anxiety, 74, 84, 87, 91, 92, 93, 109, 119, 143
appetite, 75, 93, 176
barriers to, 24-25, 42, 73, 169-171
cancer, chemotherapy, 75, 97-101, 164
cancer, marijuana as cause, 42
cancer, other, 81, 82, 84, 134, 171
cannabinoids, general, 43-44, 175, 178-179
children, cognitive function, 47, 74
cognitive effects, 47, 60
dependence, 56, 134
dosage factors, 84, 135
dystonia, 116-117
epilepsy, 121, 134, 178-179
federal government, general, 24-25
Food and Drug Administration, 134, 143-144, 152, 179
funding, 24-25, 73, 93, 134, 143-144, 171
glaucoma, 24, 127, 135, 171
Marinol, 88, 89-90, 91, 122, 143-145
muscle spasticity/multiple sclerosis, 24, 83, 107, 108-113, 119, 171, 178-179, 183-184
nausea, 24, 33-34, 73-74, 75, 87-88, 93, 97, 104, 164, 176, 178-179
neuropathy, general, 24, 83, 107, 108-113, 115, 117, 119-122, 178-179
pain, 24, 36, 75, 79-85, 93, 102-104, 171, 176, 178-179, 184
placebo effects, 74, 108-109
psychological effects, 24
regulatory process, 24-25, 42, 73, 134-138, 141, 169-171
respiratory effects, 39, 40
single-patient trials, 74, 93, 95, 107, 109, 177
smoking of marijuana, 39, 40, 42, 80, 83, 85, 90, 93, 161, 171, 178-179, 180, 183
smoking of tobacco, 40
state sponsorship, 19, 24-25, 73, 160, 163-164
THC, 74, 75, 79-83, 88, 89-90, 91, 98-101, 108-113, 117, 119, 122, 127, 128, 143-145, 151;
see also “Marinol” supra
tolerance, 50
Tourette's syndrome, 119
vomiting, 33-34, 87-88, 97-101, 104, 176, 178-179
wasting, 24, 178-179;
see also “AIDS wasting” supra
withdrawal, 51-52
Cocaine, 5, 8, 39, 53, 61, 64, 140
Codeine, 17, 65, 79, 82-83, 141, 158
Cognitive effects, 59-60, 92, 119, 143
children of marijuana smokers, 47
clinical trials, 47, 60
see also Memory;
Psychological effects
Colorado, 4
Compassionate Use Program, 4, 23, 124, 160, 164, 170
Comprehensive Drug Abuse Prevention and Control Act, 158
Controlled Substances Act, 18-19, 65, 138-139, 140-141, 149, 151, 158-159, 163, 169, 184
Cost factors,
see Economic factors
Craving, 52, 53, 54
CT-3, 150
D
Delivery modes,
see Drug delivery
Department of Health and Human Services, 54, 139, 169, 170
Centers for Disease Control and Prevention, 88
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National Cancer Institute, 136, 144
National Institute on Drug Abuse, 160, 170-171
National Institutes of Health, general, 134, 160, 169, 170, 171, 178-179
Public Health Service, 160
see also Food and Drug Administration
Dependence, 11, 47-48, 49, 54-58, 91, 140, 141
clinical studies, 56, 134
drug delivery methods and, 146-147
gateway theory, 64
see also Addiction;
Craving;
Tolerance;
Withdrawal
Depression, 59, 87, 91
Alzheimer's disease, 122
gateway theory, antidepressants, 64
patients' views, 19, 20
withdrawal, 52
Dermal delivery of drugs, 146
Dexanabinol,
see HU-211
Diagnostic and Statistical Manual of Mental Disorders,
Diarrhea, 14, 16, 20
Diet,
see Appetite
District of Columbia, 4, 164, 166
Dosage factors, 11, 12, 31, 34, 51, 53, 58-59, 176
clinical studies, 84, 135
overdoses, 50
see also Tolerance
Dronabinol,
see Marinol
Drug delivery, 11-12, 146-147, 148, 161, 162, 169, 174, 179
dependence and, 146-147
dermal, 146
inhalation, 11, 12, 92-93, 101, 103, 113, 127, 137, 143, 146, 153-154, 157, 176, 179, 183-184;
see also Smoking of marijuana;
Tobacco
injection, 51, 80-81, 116, 143
oral, 11, 12, 92, 146, 176;
see also Marinol;
THC
Drug Enforcement Administration, 133, 139, 140, 142, 144, 145, 154, 159
Dysphoria, 24, 59, 67
see also Anxiety;
Depression;
Paranoia
Dystonias, 116-117
E
Economic factors
cannabinoid-based drug development, 131, 133-155
health insurance, 147
Marinol, 134-135, 137, 140-141, 142-148, 149, 150, 152
Orphan Drug Act, 138, 144, 149
patents, 149, 151, 152, 154
see also Funding
Elderly persons, 45, 74, 95, 125
Emotional factors,
see Psychological effects
Epidemiological Catchment Area Program, 57-58
Epidemiological studies, xii
addiction, 47-48, 54, 57-58
amotivational syndrome, 61
gateway theory, 63-64
reproductive effects, 46
smoking, effects of, 39
Epilepsy, 120-121, 134
clinical trials, 121, 134, 178-179
Euphoria, 50, 53, 58, 59, 84, 91, 176
Europe, 15, 17, 116, 154
France, 150
Netherlands, 65, 66, 151, 152, 154
United Kingdom, 10, 143, 150, 151, 178-179, 180, 183-184
Eye diseases,
see Glaucoma
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F
Federal government, 4, 156-157
clinical studies, 24-25
Drug Enforcement Administration, 133, 139, 140, 142, 144, 145, 154, 159
see also Department of Health and Human Services;
Food and Drug Administration;
Funding;
Legal issues and legislation
Fertility, 46
Food and Drug Administration (FDA), 4, 133, 134-138, 140, 152, 153-153, 169
clinical trials, 134, 143-144, 152, 179
Investigational new drug applications (INDs), 134, 136, 138, 144, 146, 153, 171
Marinol, 8, 88, 142, 143-146, 159, 176
New drug applications (NDAs), 135-137, 153
Food, Drug, and Cosmetic Act, 134
Foreign countries,
see International perspectives;
specific countries
France, 150
Funding
clinical studies, 24-25, 73, 93, 134, 143-144, 171
Orphan Drug Act, 138, 144, 149
G
Gateway theory, 5, 62-65, 67-68
Gender factors
dependence, 55-56
epilepsy, 121
see also Pregnancy
Genetics, 43, 56-57
see also Cellular biology;
Immune system;
Receptors and receptor binding
Glaucoma, 3, 4, 7, 23, 124-128, 135, 159-160
African Americans, 125
age factors, 124-125
clinical trials, 24, 127, 135, 171
Great Britain,
see United Kingdom
Grinspoon, Lester, 19, 74-75
H
Hallucinations, 59, 61, 118
Headaches, 19, 22, 23, 77, 83, 164
Health insurance, 147, 149
Herbal medicine, general,
see Alternative medicine, general
Heroin, 5, 8, 17, 28, 50, 51, 64, 140
Historical perspectives, 6-7, 9-10, 13-19, 60, 131-132
alternative medicine, general, 13-14, 24
drug delivery, 11-12
glaucoma, 124, 128
legalization, 65-67
Marinol, 144-147
pain relievers, 15, 16, 17-18, 151-152
see also Legal issues and legislation
HIV,
see AIDS
HU-211, 128, 150, 151
Huntington's disease, 32, 116, 117-118, 138
Hypertension, 11, 48, 102
I
Immune system, 178-179
animal studies, 35, 44
cannabinoids, general, 28, 34-35, 43, 44, 176
inflammation, 35, 149, 150
multiple sclerosis, 107
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smoking of marijuana, 35, 44-45, 92
THC, 34, 44
see also AIDS;
Infections
India, 14, 16
INDs,
see Investigational new drug applications
Infections, 35, 43, 44
history of marijuana, 14
see also AIDS;
Immune system
Inflammation, 35, 149, 150
Inhalation, drug delivery, 11, 12, 92-93, 101, 103, 113, 127, 137, 143, 146, 153-154, 157, 176, 179, 183-184
see also Smoking of marijuana;
Tobacco
Injection, drug delivery, 51, 80-81, 116, 143
Insurance,
see Health insurance
Intellectual property,
see Patents
International perspectives, 86
Canada, 6, 113, 116, 171-172
Europe, general, 15, 17, 116, 154
France, 150
gateway theory, 65
historical, 14-16, 65, 66
legalization, 66
multiple sclerosis, 113
Netherlands, 65, 66, 151, 152, 154
United Kingdom, 10, 143, 150, 151, 178-179, 180, 183-184
United Nations Single
Convention on Narcotic
Drugs, 169-170
World Health Organization, 178-179
Internet, state legislation, 163
Investigational new drug applications (INDs), 134, 136, 138, 153, 171
Marinol, 144, 146
L
Legal issues and legislation, 8, 17, 48, 62, 65, 68, 131, 156-172
Cannabis buyers' clubs, xii,
Compassionate Use Program, 4, 23, 124, 160, 164, 170
Comprehensive Drug Abuse Prevention and Control Act, 158
Controlled Substances Act, 18-19, 65, 138-139, 140-141, 149, 151, 158-159, 163, 169, 184
Food, Drug, and Cosmetic Act, 134
gateway theory, 64
litigation, 4, 137, 159-160, 161-163, 165, 166, 168
Marijuana Tax Act, 17, 158
National Organization for the Reform of Marijuana Legislation (NORML) , 19, 142, 158-159, 163
Netherlands, 65, 66, 154, 180
Orphan Drug Act, 138, 144, 149
religious prohibitions, 15
research barriers, 24-25, 42, 73, 169-171
state legislation, xi,
state litigation, 4, 137, 159-160, 161-163, 165, 166, 168
state referenda, 19, 66-67, 95, 131, 164-165, 169
see also Regulatory issues
Levonantradol, 80-81, 98, 100
Litigation, 4, 137, 159-160, 161-163, 165, 166, 168
LSD, 8, 19, 140
Lungs, 38-39, 41-42, 43, 44-45, 67
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M
Maine, 4
Malnutrition,
see Appetite;
Wasting syndrome
Marihuana: The Forbidden Medicine,
Marijuana and Medicine: Assessing the Science Base,
Marijuana Policy Project, 163, 165-166
Marijuana Tax Act, 17, 157-158
Marinol (dronabinol), 8, 12, 27, 91, 92, 157, 176
AIDS patients, 88, 89-90, 91, 92, 134, 135, 145
AIDS wasting, 27, 144, 145, 147
Alzheimer's disease, 122
chemotherapy and, 27, 88, 144, 145, 147
clinical studies, 88, 89-90, 91, 122, 143-145
economics of, 134-135, 137, 140-141, 142-148, 149, 150, 152
Food and Drug Administration, 8, 88, 142, 143-146, 159, 176
historical perspectives, 144-147
multiple sclerosis, 146
nausea and vomiting, 27, 88, 89-90, 144, 145, 147
patients' views, 21
regulatory issues, 134-135, 137, 140-141, 142-148, 149, 150, 152, 159
Mass media, 6
Megestrol acetate, 89, 101-102
Memory, 31, 32-33, 50, 51, 59, 61, 84, 119, 152, 176
Alzheimer's disease, 121-122
Men,
see Gender factors
Mental illness, 61, 64
see also Psychological effects
Methadone, 53, 140
Methodology
basic research, 13
other research, 7
study at hand, xi-xii,
see also Animal studies;
Case studies (single-patient trials);
Clinical studies
Migraine,
see Headaches
Monitoring the Future, 65
Mood effects, 50, 54, 59, 91-92, 102, 112, 145
see also Anxiety;
Depression;
Dysphoria;
Euphoria;
Sedation
Mortality, 43
Motivation, amotivational
syndrome, 60-61, 178-179
Movement disorders,
see Psychomotor performance;
Spasticity
Multiple sclerosis, 3, 4, 10, 86, 106, 107-113, 150
animal studies, 35, 107, 110, 112
clinical studies, 24, 83, 107, 108-113, 119, 171, 178-179, 183-184
Marinol, 146
pain, 106, 107-108, 112
patients' views, 19, 23
THC, 108, 109, 111-113
Muscle spasticity,
see Spasticity
N
Nabilone, 98, 100, 109, 111, 112-113, 142-143, 180
National Cancer Institute, 136, 144
National Comorbidity Survey, 57-58
National Institute on Drug Abuse, 160, 170-171
National Institutes of Health, 134, 160, 169, 170, 171, 178-179
National Organization for the Reform of Marijuana Legislation (NORML) , 19, 142, 158-159, 163
Nausea, 25, 78
neurology, cellular processes, 31, 32, 33-34, 96, 97
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inflammation, 35
Marinol, 143
multiple sclerosis, 106, 107-108, 112
opiates, 17-18
patients' views, 19-20, 22, 23, 95-96
smoking of marijuana, 22, 23, 80, 83, 85, 91, 161, 177
spinal cord injuries, 106, 107, 112
surgical, 17, 78-79, 80-81, 84
THC, 79-83, 91, 181
see also Nausea
Paranoia, 24, 59
Parkinson's disease, 32, 116, 118, 138, 150
Patents, 149, 151, 152, 154
Peer pressure, 54, 55, 63
Placebo effect, 74, 108-109
Political and social factors, 7, 38, 62-67, 156
dependence, 49, 54
legalization of use, xi,
Marijuana Policy Project, 163, 165-166
market forces, 149
mass media, 6
National Organization for the Reform of Marijuana Legislation (NORML) , 19, 142, 158-159, 163
peer pressure, 54, 55, 63
public opinion, 24-25, 42, 62, 149
religion, perceptions of marijuana, 14, 15, 16
see also Legal issues and legislation
Polycyclic aromatic hydrocarbons, 41-42
Pregnancy, 38, 43, 44, 46, 47, 67, 74
birth weight, 38, 46
Prostate cancer, 42, 101
Psychological effects, 3, 5, 38, 50, 54, 58-62, 89, 91, 100, 113, 127, 143, 174
amotivational syndrome, 60-61, 178-179
dysphoria, 24, 59, 67;
see also Anxiety;
Depression
euphoria, 50, 53, 58, 59, 84, 91, 176
gateway theory, 64, 65
hallucinations, 59, 61, 118
marijuana psychosis, 61
mood effects, 50, 54, 59, 91-92, 102, 112, 145;
see also Anxiety;
Depression;
Dysphoria;
Euphoria
paranoia, 24, 59
placebo effects, 74, 108-109
psychiatric disorders, general, 56, 61, 64, 67
schizophrenia, 61, 178-179
sedation, 58, 78, 81, 82, 84, 112, 116, 174, 176
withdrawal, 11, 41, 48, 49, 51-54
Psychomotor performance, 31-32, 51, 59, 60, 62, 67, 107, 115-120, 176
dystonias, 116-117
Huntington's disease, 32, 116, 117-118, 138
Parkinson's disease, 32, 116, 118, 138, 150
Tourette's syndrome, 116, 118-119
see also Multiple sclerosis;
Spasticity
Public Health Service, 160
Public opinion, 24-25, 42, 62, 149
R
Race/ethnicity, 56
glaucoma, 124-125
Receptors and receptor binding, 27-34, 36, 51, 77-78, 83, 98, 107, 109, 117-118, 131-132, 152, 176, 181
Marinol, 143
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neurotransmitters and receptors, 28, 29, 30, 118-119
antioxidants, 31, 151
serotonin, 29, 88, 98, 100
Regulatory issues, 68, 134-154
animal studies, 134, 136
clinical trials, 24-25, 42, 73, 134-138, 141, 169-171
Investigational new drug applications (FDA), 134, 136, 138, 144, 146, 153, 171
Marinol, 134-135, 137, 140-141, 142-148, 149, 150, 152, 159
New drug applications (FDA), 135-137, 153
research barriers, 24-25, 42, 73, 169-171
side effects, 143, 149
THC, 139-140, 142, 151;
see also “Marinol” supra
see also Drug Enforcement Administration;
Food and Drug Administration;
Legal issues and legislation;
Standards
Religious factors, 14, 15, 16
Reproductive system effects, 44, 45-46
birth weight, 38, 46
pregnancy, 38, 43, 44, 46, 47, 67, 74
prostate cancer, 42, 101
THC, 45-46
Research methodology,
see Methodology
Respiratory system, 42, 47, 174, 183
bronchi, 40-41
chronic obstructive pulmonary disease, 41
clinical studies, 39, 40
lungs, 38-39, 41-42, 43, 44-45, 67
see also Smoking of marijuana;
Tobacco
S
Schizophrenia, 61, 178-179
Sedation, 58, 78, 81, 82, 84, 112, 116, 174, 176
Seizures, 4, 120-121
Serotonin, 29, 88, 98, 100
Side effects, general, 10, 11, 24, 117, 118, 120, 184
age factors, 19-21
AIDS medication, 19-21
cannabinoids, general, 24, 25, 28, 67
regulatory issues, 143, 149
smoking, immediate adverse reactions, 24, 43, 92, 164
THC, 59, 60, 81-82, 92, 101, 143
see also Anxiety;
Chemotherapy;
Memory;
Nausea;
Psychological effects;
Sedation;
Vomiting
Sleep, 14, 51, 104, 106, 108, 112, 113, 143
Smoking of marijuana, xii,
adverse reactions, immediate, 24, 43, 92, 164
age factors, patients, 90, 93, 161, 185
AIDS patients, 90, 93, 161, 185
animal studies, 42-43, 51
cancer, as cause of, 38, 41-43, 47, 67, 153-154, 183
cancer patients, palliation, 95-96, 98
cellular effects, 40-41, 42-45
children of smokers, cognitive effects, 47
clinical studies, 39, 40, 42, 80, 83, 85, 90, 93, 161, 171, 178-179, 180, 183
economic factors, 147-148
epidemiological studies, 39
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federal law allowing, 4, 23, 124, 160, 164, 170
gateway theory, 62-63
immune system effects, 35, 44-45, 92
movement disorders, 119
multiple sclerosis, 108
pain palliation, 22,
patients' views, 20-23, 24, 103-104
during pregnancy, 38, 43, 44, 46, 47, 67, 74
tobacco smokers who smoke marijuana, 39
tolerance, 50
vomiting, antiemetic effects, 98, 100-101, 103
Smoking of tobacco,
see Tobacco
Social factors,
see Political and social factors
Spasticity, 106-113, 138, 164, 182
animal studies, 35, 107, 110, 112
clinical studies, 24, 83, 107, 108-113, 119, 171, 178-179, 183-184
historical perspectives, 17
patients' views, 19
THC, 108, 109, 111-113
see also Multiple sclerosis
Spinal cord, 4, 31, 33, 75, 84, 106, 107, 112, 150, 178-179
pain, 106, 107, 112
Standards,
see Regulatory issues
State-level action
clinical studies, 19, 24-25, 73, 160, 163-164
legislation, xi,
litigation, 4, 137, 159-160, 161-163, 165, 166, 168
referenda, 19, 66-67, 95, 131, 164-165, 169
see also District of Columbia;
specific states
Substance abuse,
see Addiction;
Dependence
Surgical procedures
glaucoma, 127
pain, 17, 78-79, 80-81, 84, 184
T
Taxation, 17, 157-158
Tetrahydrocannabinol,
see Marinol;
THC
THC, 8, 10, 27, 47, 53, 59, 60, 67, 151, 152, 174, 180, 183-184
AIDS wasting, 89, 91, 96
Alzheimer's disease, 122
anxiety, 74, 75, 81-82, 91, 109, 113
cancer patients, 81, 82, 91, 96, 98-102
cellular processes, 28, 29, 30, 181
chemistry of, 26, 27, 28
clinical studies, 74, 75, 79-83, 88, 89-90, 91, 98-101, 108-113, 117, 119, 122, 127, 128, 143-145, 151
Marinol, 88, 89-90, 91, 122, 143-145
dystonia, 117
glaucoma, 127, 128
Huntington's disease, 118
immune system, 34, 44
multiple sclerosis/muscle spasticity, 108, 109, 111-113
nabilone, 98, 100, 109, 111, 112-113, 142-143, 180
nausea and vomiting control, 33-34, 82, 88, 98-101, 102
pain, 79-83, 91, 181
regulatory controls, 139-140, 142, 151
Marinol, 134-135, 137, 140-141, 142-148, 149, 150, 152, 159
reproductive system, 45-46
side effects, general, 59, 60, 81-82, 92, 101, 143
OCR for page 199
MARIJUANA AS MEDICINE?: The Science Beyond the Controversy
tolerance, 48, 50-51
withdrawal, 51-52
see also Drug delivery;
Marinol
Tobacco, 38-39, 40-41, 42, 45, 47, 58, 183
Tolerance, 11, 48, 49, 50, 52-53, 78
Tourette's syndrome, 116, 118-119
U
Unimet Pharmaceuticals, 122, 137, 142-147 ,(passim) 150, 159
United Kingdom, 10, 143, 150, 151, 178-179, 180, 183-184
United Nations Single Convention on Narcotic Drugs, 169-170
United States Pharmacopoeia,
V
Vomiting, 8, 27, 96-101, 103, 174, 182, 185
clinical studies, 33-34, 87-88, 97-101, 104, 176, 178-179
history of marijuana, 14, 15-16
Marinol, 27, 88, 89-90, 144, 145, 147
neurological processes, 31, 32, 33-34, 96, 97
patients' views, 20, 21, 87, 96
smoking, antiemetic effects, 98, 100-101, 103
THC, 33-34, 82, 88, 98-101, 102
see also Nausea
W
Washington, D.C.,
see District of Columbia
Washington State, 4, 164, 165
Wasting syndrome
cancer patients, 101-102, 171
clinical trials, 24, 178-179
see also AIDS wasting;
Appetite
Withdrawal, 11, 48, 49, 51-54
tobacco smokers, 41, 48
Women,
see Gender factors;
Pregnancy;
Reproductive system effects
World Health Organization, 178-179
World Wide Web,
see Internet
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