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Suggested Citation:"Index." Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press. doi: 10.17226/6376.
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INDEX

A

Addiction, see Craving; Dependence; Tolerance; Withdrawal symptoms

Adjunctive therapy, general, 4, 10, 145, 153, 157, 167, 172, 247

see also Pain, treatment of

Administration of drugs, see Drug delivery

Adolescents, 6, 15, 16, 90, 91, 96, 97, 98, 99, 101, 102, 104, 123, 126

Affinity, receptors, 42, 44, 46, 51

defined, 42 (footnote)

African Americans, 173

Age factors, 9, 16, 22, 92-93, 94, 95, 100, 117

adolescents, 6, 15, 16, 90, 91, 96, 97, 98, 99, 101, 102, 104, 123, 126

children, 96, 97, 101, 124-125, 139, 149, 167, 210

clinical trials, 139, 142

prenatal exposure, effects of, 124-125

see also Elderly persons

Agonists, receptor, 34, 37, 38, 39, 43-47, 54, 56-57, 58, 64, 70

glaucoma, 176-177

listed, 44

market considerations, 209, 210, 212

neurological disorders, 166, 167, 168

see also SR 141716A; SR 144528

AIDS, viii, 16, 18, 21, 22, 23, 107, 115-117, 120-121, 145, 178, 252

AIDS wasting, 4, 8, 23, 154-158, 159, 177, 204-205, 207, 209, 234, 246, 248

clinical trials, 8, 156, 213, 245

defined, 154

individual patient account, 27-28

smoking of marijuana, 27-28, 156

Alaska, vii, 17

Alcohol use and abuse, 6, 88, 90, 92, 95, 96, 97, 100, 101, 117, 254

nausea and vomiting, 147

Alternative medicine, general, 19, 20, 180, 215, 216, 217-218, 254-255

Alzheimer's disease, 173, 204, 205, 209

American Medical Association, 180, 244-255 (passim)

Amotivational syndrome, see Motivation

Amphetamines, 21, 88, 240

Analgesia, see Pain, treatment of

Anandamide, 34, 41, 43-47, 48, 54, 194

Animal studies, 3, 35, 36-81, 88, 89, 91, 111, 120, 122-123, 125, 140, 145, 195, 199, 212, 246

movement disorders, 164-165, 167, 170

relevance of, general, 36

Anorexia, see Appetite; Wasting syndrome

Anorexia nervosa, 159

Antagonist, receptor, 34, 37, 39, 44, 55, 58, 70

market considerations, 205, 210, 211

nausea and vomiting, 151, 152-153

Antiemesis, see Vomiting

Suggested Citation:"Index." Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press. doi: 10.17226/6376.
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Antigens, 59, 64, 66, 120

Anxiety, 4, 10, 36, 84, 90, 109, 127, 142, 153, 165, 168, 203

see also Dysphoria; Euphoria; Sedation

Appetite, viii, 3, 4, 10, 21, 23, 142, 144, 156-159 (passim), 173, 205, 209, 245, 248

set also Nausea; Vomiting; Wasting syndrome

Arachidonic acid, 46, 47, 57

Arachidonyl glycerol (2-AG), 43, 45, 46, 47, 64, 65

Arizona, vii, 1, 17, 18, 104 (footnote)

Arthritis, 28-29

Attitudes

patients, 27-29, 153, 205-206

physicians, prescribing marijuana, 152, 202

risk perception, 104

B

Barbiturates, 143, 172

Basal ganglia, 48-52, 164-166, 168

B cells, 62, 64, 65, 66, 112

see also Lymphocytes, general

Benzodiazepines, 3, 70, 161, 164, 168

Blood pressure

hypertension, 48, 84, 86, 90, 121, 158, 175

hypotension, 121, 150, 151, 175

Brain, general, 3, 35, 36-37, 48-49, 69, 70, 92, 170

basal ganglia, 48-52, 164-166, 168

cannabinoid receptors, 37-65, 69-70

cerebellum, 46, 49, 50, 51, 53, 121, 122

endogenous cannabinoid system, 43-51, 70

globus pallidus, 49, 52, 53, 167

hippocampus, 45-46, 49, 53

putamen, 49, 52, 53, 166

striatum, 46, 51, 53

substantia nigra, 49, 51, 52, 53, 167, 168

thalamus, 46, 49, 51, 52, 53, 55, 165, 167, 169

see Neurons, general

British Medical Association, 180, 244-255 (passim)

Bronchi, 113-114, 115, 119

Buyers' clubs, see Cannibis buyers' clubs

C

Cachexia, 145, 154, 155, 158

see also AIDS wasting; Appetite; Wasting syndrome

Caffeine, 88

California, vii, 1, 16, 17, 18, 101-102, 104, 204, 207

Canada, 150

Cancer

smoking of marijuana as cause, 5, 114, 115, 117-121, 237

treatment of, 22, 23, 142, 145, 154, 158, 159, 204-205;

see also Chemotherapy

Cannabidiol (CBD), 3, 36-37, 47, 60-61, 66, 122, 166, 171-172, 214

Cannabinoids, general, vii, viii-ix, 2-4

defined, 2, 25-26, 194

defined substances, 4

standards, general, 19, 213, 216, 217

see also THC

Cannabinol, 25, 37, 64, 66, 110

see also THC

Cannibis buyers' clubs, viii, 16, 20, 21, 22, 207 defined, 20

Cardiovascular system, 121-122, 251

see also Blood pressure

Case studies, 15, 27-29, 117, 119-120, 254

individual patient accounts, 27-29

single-patient clinical trials, 139, 162

CBD, see Cannabidiol

Cellular biology, 5, 25, 35-59, 69-70, 118-119, 120-121

see also Genetics; Immune system; Receptors; Signal transduction

Cerebellum, 46, 49, 50, 51, 53, 121, 122

Cesamet, see Nabilone

Chemotherapy, viii, 4, 16, 23, 144, 146-153 (passim), 177, 205, 207, 234, 245, 247, 248

Children, 96, 97, 101, 124-125, 139, 149, 167, 210

see also Adolescents

Chronic obstructive pulmonary disease, 114-115

Clinical studies, 15, 30, 34-35, 137, 206, 233-234

glaucoma, 177, 251

movement disorders, 166, 169-170

smoking of marijuana, 9-10

Clinical trials, 7-8, 9-10, 34, 137, 141, 142-143, 203, 209, 211, 218

age factors, 139, 142

AIDS wasting, 8, 156, 213, 245

animal studies vs, 36

epilepsy, 170-172, 173

Investigational New Drugs, 195, 196

Suggested Citation:"Index." Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press. doi: 10.17226/6376.
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movement disorders, 167, 168

nausea and vomiting, 7-8, 142, 145-154, 179, 245, 247

pain, 7-8, 141-145, 179

psychological effects, 5, 10, 109, 149

recommendations, 4, 5, 7-8, 9-10, 178, 179-180, 215, 245-255 (passim)

regulatory requirements, 195, 196, 200, 202, 208, 211, 213, 218, 256-257

single-patient trials, 139, 162

spasticity, 160-164, 165, 249

standards for, 7-8, 10, 138-139, 179-180

Cocaine, 3, 20, 70, 88, 90, 95, 102, 240

Colorado, vii, 1

Codeine, 143, 241

Cognitive effects, 49, 83-84, 89, 105, 106-107, 108, 124-125

disorientation, 4, 142, 203

memory, 35, 49, 53, 56, 84, 89, 106, 144, 173, 212

see also Psychological effects

Connecticut, 17

Controlled Substance Act, 16-17, 102, 198-204 (passim), 210, 213-219 (passim)

scheduling, 17, 102, 194, 198-213 (passim), 216-217, 218, 240-241, 256-257

Convulsions, see Seizures

Cost factors, 9, 16, 206-207, 243

antiemetics, 151, 152

drug development, 195, 196, 203, 206, 217-218

CP 47,497, 210

CP 55,244, 210

CP 55,940, 44, 46, 56, 201

Craving, 9, 90, 91-92

CT-3, 67, 209

Cytokines, 62, 66, 67, 112, 120, 157

D

DEA, see Drug Enforcement Administration

Delivery modes, see Drug delivery

Department of Health and Human Services, 199, 200, 201, 217

see also National Institutes of Health

Dependence, 6, 9, 57-59, 70, 84, 86, 237

animal research, 35

criteria, 87

legal issues, 16

marijuana as a gateway drug, 6-7, 9, 20-21, 98-101

predictors of, 93-98, 99, 100, 101, 126

see also Craving; Tolerance; Withdrawal symptoms

Depression, 22, 23, 29, 84, 95, 105, 155, 159

fluoxetine, 48

see also Dysphoria

Diagnostic and Statistical Manual of Mental Disorders, 84, 87

Diarrhea, 24, 155

District of Columbia, 17

Dizziness, 27, 121, 150, 158, 203

Dopamine, 58, 88, 92, 167, 168

Dosage factors, 137, 245, 248, 256

affinity, 42 (footnote)

AIDS wasting, 156, 157, 158

caffeine, 88

cardiovascular effects, 121

CBD, 36, 60-61

cognitive effects, 107

glaucoma treatment, 176, 177, 251

immune system effects, 60-63, 64-67, 68

morphine, 37

multiple sclerosis treatment, 163

neurological disorder treatment, 166, 169

overdosing, 37, 109, 206

pain treatment, 102, 142, 143, 149

psychological effects, 84, 85, 105

psychomotor effects, 51, 53, 85

reproductive effects, 122, 125

respiratory effects, 113

THC, 88, 89, 91, 122, 142, 176, 203, 206, 215, 255

anxiety, 36, 142, 149

glaucoma treatment, 176, 177, 251

pain treatment, 102, 142, 143, 149

psychoactive doses, 85

vomiting, 147, 154

vomiting, 147, 151, 152, 154

see also Dependence; Tolerance

Dronabinol, see Marinol

Drug Awareness Warning System, 102-103

Drug delivery, 7, 9, 151, 197, 199, 217, 239, 242, 245

inhalation, 7, 9, 57, 94, 150, 154, 165, 175, 197, 203, 206, 215 (footnote), 216, 242, 247, 251, 255; see Smoking, marijuana

injection, 39, 54, 57, 66, 67, 68, 85, 88, 94, 100, 122, 150, 151, 152, 159, 174, 175, 203

Suggested Citation:"Index." Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press. doi: 10.17226/6376.
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oral, 4, 9, 16, 57, 84, 89, 91, 121, 122, 142, 148-156 (passim), 163, 164, 165, 171, 174, 175, 202, 203, 205, 206, 207, 215, 242, 247, 249, 251

suppositories, 206

topical, 175, 176, 251

Drug Enforcement Administration (DEA), 137, 198-202, 203-204, 208, 213, 214, 217

Dysphoria, 5, 84, 126, 150, 159, 203

sec also Anxiety; Depression

Dystonia, 166, 168, 245, 250

E

Economic factors

access and availability, general, 9, 194-198, 206-208, 213-214

health insurance, 207

malnutrition, 154, 155

private investment, 178, 195-219

public investment, 4, 137, 178, 211, 214, 218

set' also Cost factors

Efficacy, 9, 11, 14, 19, 20, 30, 54, 57, 88, 107, 108, 126, 144, 179, 217, 243, 256

defined, 4-5

regulatory requirements, 197, 212, 215

see also Clinical studies; Clinical trials

Elderly persons, 21

clinical trials, 139

psychological effects, 4, 175

Emesis, see Vomiting

Emotional factors, see Psychological effects

Endorphins (endogenous opioids), 35, 43

Epidemiological Catchment Area Program, 97

Epilepsy, 29, 170-173, 177, 245, 250-251

Euphoria, 5, 16, 83-84, 85, 87, 88, 89, 92, 108, 144, 150, 203

Eye diseases, see Glaucoma

F

Federal government, 194-202

see also Department of Health and Human Services; Drug Enforcement Administration; Food and Drug Administration; Legal issues and legislation; Public investment

Fluoxetine, 48

Food and Drug Administration, 17, 20, 137, 138, 149, 156, 194-198, 199, 200, 202-203, 204, 205, 208, 209, 213, 215, 216, 217, 257

Food and Drug Administration Modernization Act, 197 (footnote)

Food, Drug, and Cosmetic Act, 194, 213, 215, 256

Foreign countries, see International perspectives; specific countries

France, 69

Funding, see Public investment

G

Gamma-aminobutyric acid (GABA), 50

Gateway theory, 6-7, 9, 20-21, 98-101

Gender factors, 20, 22, 94, 95, 115, 170-171

Genetics, 5, 38, 42, 69, 118-119, 120

dependence, 94, 97-98

drug development, 19-20

gene regulation, 37, 38

reproductive system effects, 122-125

transduction, 37, 38, 40-41, 43, 57; see also Agonists, receptor

see also Cellular biology; Receptor binding; Receptors

Glaucoma, 9, 22, 24, 173-177, 234, 251-252

agonists, receptor, 176-177

dose effects, 176, 177, 251

intraocular pressure, 175, 176, 251-252

smoking of marijuana, 174, 175, 177, 251

Globus pallidus, 49, 52, 53, 167

H

Hallucinations, 84, 90, 106

Headaches, 151

see also Migraine headaches

Health insurance, 207

Heart, see Cardiovascular system

Herbal medicine, general, see Alternative medicine, general

Heroin, 88, 90, 92, 95, 99, 100, 240

Hippocampus, 45-46, 49, 53

Hispanics, 94-95

Historical perspectives, 118

antiemetics, 151

legal issues, 16-18

medicinal uses of marijuana, 16-19

Suggested Citation:"Index." Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press. doi: 10.17226/6376.
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research on marijuana, 33-34, 244-255

HIV, see AIDS

Hormones, 37, 48, 58-59, 66, 122, 123, 155, 157

HortaPharm, 214-215, 218

HU-210/HU-211, 44, 60, 64, 66, 67, 176, 201, 209, 211, 250

Huntington's disease, 49, 166, 198

Hyperalgesia, 54, 56, 141

Hypertension, 48, 84, 86, 90, 121, 158, 175

Hypotension, 121, 150, 151, 175

I

Immune system, 5, 37, 42, 51, 59-68, 70, 109-111, 112-113, 116-117, 120, 156, 158, 212, 233, 236, 245, 248, 252

antigens, 59, 64, 66, 120

cytokines, 62, 66, 67, 112, 120, 157

dose effects, 60-63, 64-67, 68

infections, 66-67, 112-113, 155, 236

inflammatory/antiinflammatory effects, 67-68, 112-113, 142, 155, 209

leukocytes, 59, 62, 64, 109-111, 120

lymphocytes, general, 59, 62, 64, 112, 118, 155

B cells, 62, 64, 65, 66, 112

T cells, 59, 62, 64-65, 66, 112

macrophages, 66, 112-113, 121

multiple sclerosis, 160

see also AIDS

Inactivation, 36, 46, 47, 48, 212

Infections, 66-67, 112-113, 155, 236 see also AIDS; Receptors

Inflammatory/antiinflammatory effects, 67-68, 112-113, 142, 155, 209

Information dissemination, see Public information

Insurance, see Health insurance

International perspectives, 180, 244-255

exporter of marijuana for research, 214-215, 218

marijuana laws, 103-104

seizure treatment, 171

Single Convention on Narcotic Drugs, 217

see also specific countries

Internet, viii, 16, 245

Intraocular pressure, see Glaucoma

Investigational New Drug applications (FDA), 195, 196, 198, 206, 213

Israel, 209

L

Legal issues and legislation, 14, 16-18, 86, 126, 206-207, 215-216

Controlled Substance Act, 16-17, 102, 198-204 (passim), 210, 213-219 (passim)

scheduling, 17, 102, 194, 198-213 (passim), 216-217, 218, 240-241, 256-257

Food and Drug Administration Modernization Act, 197 (footnote)

Food, Drug, and Cosmetic Act, 194, 213, 215, 256

foreign/international, 103-104, 217

Marijuana Tax Act, 16

National Organization for the Reform of Marijuana Legislation, 17, 18, 200, 213

Orphan Drug Act, 198, 205, 211

patent law, 208-210

Prescription Drug User Fee Act, 195

referenda, vii, 1, 17, 18

Single Convention on Narcotic Drugs, 217

state legislation, 17, 18, 102-103, 200, 206-207

see also Regulatory issues

Lethargy, see Motivation

Leukocytes, 59, 62, 64, 109-111, 120

Levonantradol, 44, 57, 142, 148, 149, 210

Ligands, 37, 39, 40-41, 42, 45, 53, 64, 194

see also Agonists, receptor; Antagonist, receptor; Receptor binding

Lipophilic substances, 25, 39, 175, 206

Louisiana, 17

LSD, 240

Lungs, 5, 111-115, 117, 118, 119, 126, 236, 253

Lymphocytes, general, 59, 64, 112, 118, 155

B cells, 64, 65, 66, 112

T cells, 59, 64-65, 66, 112

M

Macrophages, 66, 112-113, 121

Malnutrition, see Appetite; Nutrition

Marijuana, general

active constituents, 36-37

defined, 2, 24-25

prevalence of use, 92-93, 137

Suggested Citation:"Index." Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press. doi: 10.17226/6376.
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Marijuana and Health, 2, 33

Marijuana Tax Act, 16

Marinol (dronabinol), 16, 44, 137, 149, 156, 158, 173, 194, 195, 240, 248

development of, 193-194, 195, 197, 202-208, 210, 211, 216, 218

Medical Use of Cannabis, 244-245

Memory, 35, 49, 53, 56, 84, 89, 106, 144, 212

Alzheimer's disease, 173

Men, see Gender factors

Metabolic processes, 36-37, 65, 110, 203

starvation, 154-155

Methadone, 92, 240

Methodology

drug development, 19-20, 137, 193-219, 238-239, 255; see also Drug Enforcement Administration; Food and Drug Administration

costs of, 195, 196, 203, 206, 217-218

other research, 20-22, 24, 119-121, 162, 163, 213-214

recommendations by non-committee organizations, 244-257

psychological research, 104-105

study at hand, 15-16, 225-243

see also Case studies; Clinical studies; Clinical trials

Migraine headaches, 22, 23, 143-144, 209, 213

Minority groups, see Racial/ethnic factors

Mood effects, 21, 69, 84, 89, 92, 99, 105, 108, 143, 144, 153, 154, 161, 165, 248

see also Anxiety; Depression; Dysphoria; Euphoria; Sedation

Morphine, 37, 41, 55, 240

Motivation, 58, 105, 107-108, 158, 168, 237, 254

Motor effects, see Movement disorders; Psychomotor effects

Movement disorders, 4, 160, 165-170, 177, 233, 245, 249-250

animal studies, 164-165, 167, 170

Parkinson's disease, 49, 167, 168, 198, 209

seizures, 22, 29, 90, 170-173, 177, 245, 250-251

Tourette's syndrome, 167-168

see also Basal ganglia; Psychomotor performance; Spasticity

Mucositis, 144

Multiple sclerosis, 9, 22, 23, 143, 160-161, 162, 163, 170, 198, 209, 245

individual patient account, 28

Muscle spasticity, see Spasticity

N

Nabilone, 44, 148, 149, 161, 162, 163, 174, 202, 246, 248, 249

Naloxone, 37, 92

National Cancer Institute, 202

National Household Survey on Drug Abuse, 104

National Institute of Drug Abuse, 213-214

National Institutes of Health, 178, 180, 194-195, 202, 213-214, 215, 244-255 (passim)

National Organization for the Reform of Marijuana Legislation, 17, 18, 200, 213

Nausea

antagonist, receptors 151, 152-153

clinical trials, 7-8, 142, 145-154, 245, 247

opioids, 140

palliation, 3, 4, 7-8, 9, 10, 16, 21, 23, 27, 29, 142, 144, 145-154, 159, 164, 202, 205, 207, 234, 245, 247, 248

withdrawal symptoms, 6, 90, 127

see also Appetite; Vomiting

Netherlands, 103-104, 180, 214, 244, 245, 246, 249-255 (passim)

Neurology and neurological disorders, 233, 234, 242, 245, 246, 251

Alzheimer's disease, 173, 204

dizziness, 27, 121, 150, 158, 203

glaucoma, 173-176 (passim)

seizures, 22, 29, 90, 170-173, 177, 245, 250-251

see Brain; Movement disorders; Multiple sclerosis; Spasticity; Spinal cord

Neurons, general, 2, 37, 38, 46, 47, 48, 49-50, 53, 55, 167, 211

Neuroprotection, 47, 67, 70, 176, 209, 211

Neurotransmitters, 37, 38, 43, 48, 50, 53, 54, 88, 147, 168, 211

dopamine, 58, 88, 92, 167, 168

see also Endorphins; Gamma-aminobutyric acid; Serotonin

Nevada, vii, 1, 17

New drug applications (FDA), 195-197, 203, 215, 257

New Hampshire, 17

Nicotine, 3, 70, 88, 90, 92, 96, 97, 100

see also Tobacco

Norway, 104

Nutrition, 154-156, 158

anorexia nervosa, 159

see also Appetite; Wasting syndrome

Suggested Citation:"Index." Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press. doi: 10.17226/6376.
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O

Office of National Drug Control Policy, vii, 1

Ohio, 17

Older persons, see Elderly persons

Opioids, 3, 35, 37, 43, 53, 54, 55, 58, 69, 70, 88, 92, 102, 233, 246

heroin, 88, 90, 92, 95, 99, 100, 240

morphine, 37, 41, 55, 240

pain treatment, 140, 142

Oregon, vii, 1, 17

Orphan Drug Act, 198, 205, 211

P

Pain, treatment of, viii, 3, 4, 7, 9, 10, 11, 20-22, 23, 24, 28-29, 84, 159, 164, 210, 233, 234, 241, 245-247

clinical trials, 7-8, 141-145, 179

dose effects, 102, 142, 143, 149

hyperalgesia, 54, 56, 141

market for, 210, 212

neurophysiology of, 35, 53-56, 70

sedation, 5, 10, 109, 127, 140, 144, 145, 150, 161, 164, 168, 241

standards of analgesic usefulness, general, 140-141

usefulness of analgesics, general, 140-141

Pain, types of, 141-145, 166

acute, 54, 67-68, 141-142

chronic, 8, 21, 22, 23, 30, 53, 54, 67-68, 138, 142-143

definitional issues, 139-140, 141

depression, 22, 23, 29, 48, 84, 95, 105, 155, 159

dysphoria, 5, 84, 126, 150, 159, 203

inflammatory/antiinflammatory effects, 67-68, 112-113, 142, 155, 209

surgical, 142, 145, 247

withdrawal, 3, 6, 35, 58-59, 70, 84, 86, 87, 89-91, 127, 143-144

Paranoia, 84, 105

Parkinson's disease, 49, 167, 168, 198, 209 see also Substantia nigra

Peer review, 9, 15

Performance, see Psychomotor performance

Pharmaceutical companies, see Private sector

Political and social factors, vii, 1, 2, 6-7, 13-15, 17-19, 92, 93, 94, 98, 99, 202, 234

National Organization for the Reform of Marijuana Legislation, 17, 18, 200, 213

see also Legal issues and legislation; Referenda

Polycyclic aromatic hydrocarbons, 117, 119

Potency, 41, 46, 214-215

Pregnancy, 122-125, 126, 139, 145

Prescription Drug User Fee Act, 195

Private sector, 178, 195-219

Prostaglandins, 44, 46, 176

Prozac, see Fluoxetine

Psychiatric disorders, see Schizophrenia

Psychological effects, 3, 4-5, 44, 54, 65, 83-92, 101, 104-109, 126, 233, 237, 253-254

anorexia nervosa, 159

anxiety, 4, 10, 36, 84, 90, 109, 127, 142, 153, 165, 168, 203

clinical trials, 5, 10, 109, 149

dependence predictors, 95-96, 99, 100, 101, 126

depression, 22, 23, 29, 48, 84, 95, 105, 155, 159

dose effects, 84, 85, 105

DSM-IV, 84, 87

dysphoria, 5, 84, 126, 150, 159, 203

elderly patients, 4, 175

euphoria, 5, 16, 83-84, 88, 92, 108, 150, 203

hallucinations, 84, 90, 106

mood disorders, general, 23, 24

motivation, 58, 105, 107-108, 158, 168, 237, 254

paranoia, 84, 105

receptor physiology, 35

schizophrenia, 105, 106, 159, 253

seizures, impacts of, 172

smoking of marijuana, 5-6, 10-11, 104-109

withdrawal, 3, 6, 35, 58-59, 70, 84, 86, 87, 89-91, 127, 143-144

see also Cognitive effects

Psychomotor performance, 5, 85, 89, 107, 108, 125-126, 254

dizziness, 27, 121, 150, 158, 203

dose effects, 51, 53, 85

movement disorders

physiology of, 35, 49, 51-53, 55

see also Spasticity

Public information, viii, 101

Internet, viii, 16, 245

Public investment, 4, 137, 178, 211, 214, 218

Putamen, 49, 52, 53, 166

Suggested Citation:"Index." Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press. doi: 10.17226/6376.
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R

Racial/ethnic factors, 94-95, 173

Receptor binding, 37, 39-45, 64, 194, 211

affinity, 42, 44, 46, 51

ligands, 37, 39, 40-41, 42, 45, 53, 64, 194

potency, 41, 46

see also Agonists, receptor; Antagonist, receptor

Receptors, 2, 3, 33, 34, 35, 37-65, 69-71, 86, 110, 144, 159, 169, 172, 176-177

anandamide, 34, 41, 43-47, 48, 54, 194

brain, 41, 49, 51-59

immune system, 59-64

nausea and vomiting, 146, 147, 152, 153

serotonin, 48, 151, 152-153, 159, 205

Referenda, vii, 1, 17, 18

Regulatory issues, 14, 211, 213-218

clinical trials, 195, 196, 200, 202, 208, 211, 213, 218, 256-257

THC, 200-208, 214-215

see also Drug Enforcement

Administration; Food and Drug

Administration; Legal issues and

legislation; Standards

Reproductive system effects, 122-125, 126, 139, 145, 253

Research methodology, see Methodology

Respiratory system, 5-6, 10, 88, 113-115, 119-120, 127, 146, 236, 253

see also Lungs

S

Scheduling, 17, 102, 194, 198-213 (passim), 216-217, 218, 240-241, 256-257

Schizophrenia, 105, 106, 159, 253

Sedation, 5, 10, 109, 127, 140, 144, 145, 150, 161, 164, 168, 241

Seizures, 22, 29, 90, 170-173, 177, 245, 250-251 types of, 170

Serotonin, 48, 151, 152-153, 159, 205

Side effects, general, 9, 27, 28, 127, 138, 140, 151, 203, 243, 246

marijuana use, 34, 145, 150, 152, 158, 161, 170, 172, 173, 177

see also Anxiety; Chemotherapy; Memory; Nausea; Sedation; Vomiting

Signal transduction, 37, 38, 40-41, 43, 57

see also Agonists, receptor; Cellular biology

Single Convention on Narcotic Drugs, 217

Sleep, 6, 27, 37, 49, 83, 90, 127, 160, 164, 165

Smoking, marijuana, 2, 4, 5, 7-8, 47, 83, 85, 91, 104, 111-127, 177-178, 216, 254-255

AIDS wasting, 27-28, 156

carcinogenic effects, 5, 114, 115, 117-121, 237

defined, 2

glaucoma, 174, 175, 177, 251

individual patient accounts, 27-29

movement disorders, 167

physiological effects, 5-6, 10-11, 104-109

spasticity, 161, 163

tolerance, 57, 89

vomiting, control of, 150, 152, 153, 154, 179, 247

wasting syndrome, 27-28, 156, 159

Smoking, tobacco, see Tobacco

Social factors, see Political and social factors

Spasticity, 23, 24, 143, 169, 245, 249

clinical trials, THC, 160-164, 165, 249

multiple sclerosis, 9, 22, 23, 28, 143, 160-161, 162, 163, 198

smoking of marijuana, 161, 163

Spinal cord, 49, 54, 55-56,

injury, 23, 145, 159-160, 161, 163-164, 198, 245, 249

Spleen, 46, 59, 64, 66

SR 141716A, 34, 44, 57-58, 65, 69

SR 144528, 34, 44

Standards

analgesic usefulness, general, 140-141

cannabinoid drugs, 19, 213, 216, 217

clinical trials, 7-8, 10, 138-139, 179-180

DSM-IV, 84, 87

State-level action

legislation, 17, 18, 102-103, 200, 206-207

referenda, vii, 1, 17, 18

see also specific states

Striatum, 46, 51, 53

Substantia nigra, 49, 51, 52, 53, 167, 168

T

Tardive dyskinesia, 166, 168

Taxes, 16

T cells, 59, 62, 64-65, 66, 112, 120

see also Lymphocytes, general

Tetrahydrocannabinol, see Marinol; THC

Thalamus, 46, 49, 51, 52, 53, 55, 165, 167, 169

Suggested Citation:"Index." Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press. doi: 10.17226/6376.
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Page 267

THC, viii, 2, 3, 4, 5, 10, 25, 26, 36-37, 39, 41, 71, 85, 88, 107, 109, 127, 177, 212, 234, 246, 247, 255

analogues, 44

Alzheimer's disease, 173

cardiovascular system, 121-122

dependence, 57-59

dose effects, 88, 89, 91, 122, 142, 176, 203, 206, 215, 255

anxiety, 36, 142, 149

glaucoma treatment, 176, 177, 251

pain treatment, 102, 142, 143, 149

psychoactive doses, 85

vomiting, 147, 154

endogenous cannabinoids and, 43-48

epilepsy, 170

glaucoma, 174-175, 176-177, 251-252

immune system, 59-68 (passim), 110, 117

levonantradol, 44, 57, 142, 148, 149, 210

Marinol (dronabinol), 16, 44, 137, 149, 156, 158, 173, 194, 195, 240, 248

development of, 193-194, 195, 197, 202-208, 210, 211, 216, 218

pain treatment, 7-8, 102, 141-145, 149, 179

regulatory issues, 200-208, 214-215

reproductive system effects, 122-125

spasticity, clinical trials, 160-164, 165, 249

tolerance, 56-57, 89, 121

vomiting, clinical trials, 148-150, 153

Tobacco, viii, 5, 6, 95, 96, 97, 111-112, 113-114, 117, 118-119, 123

see also Nicotine

Tolerance, 3, 56-57, 70, 84, 86, 88-89, 121, 126-127, 233, 237

analgesics, usefulness of, 140

defined, 86, 87

smoking of marijuana, 57, 89

THC, 56-57, 89, 121

see also Dependence

Tourette's syndrome, 167-168

2-AG, see Arachidonyl glycerol

U

Unimed Pharmaceuticals, Inc., 202-205

United Kingdom, 180, 209, 211, 218, 244-255 (passim)

V

Vermont, 17

Virginia, 17

Vomiting, 3, 4, 10, 21, 23, 27, 29, 202, 205, 207, 210, 234, 248

antagonists, receptors, 151, 152-153

clinical trials, 7-8, 142, 145-154, 179, 245, 247

cost of antiemetics, 151, 152

dose effects, 147, 151, 152, 154

drug delivery route, 148-154 (passim), 179, 247

smoking of marijuana, 150, 152, 153, 154, 179, 247

THC, 148-150, 153

see also Nausea

W

Washington, D.C., sec District of Columbia

Washington State, vii, 1, 17

Wasting syndrome, 9, 23, 24, 28-29, 144, 154-159, 234, 248

Alzheimer's disease, 173

definitions, 153-154

smoking of marijuana, 27-28, 156, 159

see also AIDS wasting; Appetite

WIN 55, 212, 42, 44, 64, 65, 88

Wisconsin, 17

Withdrawal symptoms, 3, 6, 35, 58-59, 70, 84, 86, 89-91, 127, 143-144

defined, 86, 87

Women, sec Pregnancy; Reproductive system effects

World Health Organization, 244-255 (passim)

World Wide Web, set Internet

Suggested Citation:"Index." Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press. doi: 10.17226/6376.
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Marijuana and Medicine: Assessing the Science Base Get This Book
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The medical use of marijuana is surrounded by a cloud of social, political, and religious controversy, which obscures the facts that should be considered in the debate.

This book summarizes what we know about marijuana from evidence-based medicine--the harm it may do and the relief it may bring to patients. The book helps the reader understand not only what science has to say about medical marijuana but also the logic behind the scientific conclusions.

Marijuana and Medicine addresses the science base and the therapeutic effects of marijuana use for medical conditions such as glaucoma and multiple sclerosis. It covers marijuana's mechanism of action, acute and chronic effects on health and behavior, potential adverse effects, efficacy of different delivery systems, analysis of the data about marijuana as a gateway drug, and the prospects for developing cannabinoid drugs. The book evaluates how well marijuana meets accepted standards for medicine and considers the conclusions of other blue-ribbon panels.

Full of useful facts, this volume will be important to anyone interested in informed debate about the medical use of marijuana: advocates and opponents as well as policymakers, regulators, and health care providers.

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