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Hep C and Cannabis Controversy


>Subject: Info About Hep C and Cannabis (letter for your Doc)
>To: ***@****
>
>The Lifevine Foundation
>2442 NW Market St. #508
>Seattle, WA 98107
>206-551-5559
>
>Practicing Physicians
>Medical Professionals
>State of Washington
>
>Dear Concerned Physician,
>
>The patient presenting this letter to you has been diagnosed with
>Hepatitis C. The Lifevine Foundation is a non-profit public education
>and legal assistance provider for medical marijuana patients and
>their physicians. We urge you to consider the following information
>when determining whether this patient will potentially benefit from
>the use of cannabis.
>
>Patients with even mild cases of Hepatitis C often experience
>nonspecific and intermittent symptoms such as nausea and vomiting,
>poor appetite, fatigue, depression, muscle and joint pains, weight
>loss, and mild right-upper-quadrant discomfort or tenderness. These
>symptoms may become more pronounced and chronic as the disease
>progresses.
>
>As you are probably aware, drug therapy for Hepatitis C usually
>consists of the use of combination therapy with alpha interferon and
>ribavirin in those patients where such therapy is indicated. Common
>side effects of treatment (occurring in more than 10 percent of
>patients) include: nausea and vomiting, depression, irritability,
>weight loss, fatigue, muscle aches, headaches, and low-grade fever.
>Substance abuse relapse is often a common result of the therapy due
>to the psychological side effects. Flare-ups of pre-existing
>auto-immune diseases such as rheumatoid ar
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Avatar universal
The bible states (in Genesis) that God gave us ALL the seed bearing plants to use as food. So neh...Smoking?...I dunno about.
Gen 1:29   And God said, Behold, I have given you every herb bearing seed, which [is] upon the face of all the earth, and every tree, in the which [is] the fruit of a tree yielding seed; to you it shall be for meat.
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Avatar universal
Man, where am I? The planet Bongwater?

What's happenin' dudes and chicks? Nice message board. I post regularly on another board, hcvanonymous.com, so if you're ever in the neighborhood, pop on over and check it out. Great bunch of heppers, and a really caring family.

Berlyn (I can't remember the exact spelling) thanks so much for the wonderful and really long post from Washington! That's the kind of thing I've been looking for, something concrete to hand to my doctor. I printed it out (after editing all the <'s out) and highlighted the headings. It looks great now, and I am planning to bring it to the VA doctor once I get in to see him.

I discovered my Hep C in January 2001, had a biopsy, and started the Interferon & Rebetol for 48 weeks. I'm genotype 1A, with stage 3 and grade 3 fibrosis and inflammation. The first round of treatment I was determined not to take anything but the treatment, plus Milk Thistle and vitamin E, and of course drink water like I was trying to drown myself. I lost 40 pounds in the first month because I was afraid to eat just anything and ended up eating almost nothing. I never toked for that first year, focusing instead on my battle and trying to optimize my chances by keeping spic and span on the inside. I was "undetectable" all the way from month 3 to the end. Then I had to wait 6 months to be retested and the virus was back but really strong. Then, 6 months later the doc started me on PegIntron & Rebetol, another 48 weeks of pure misery.

This time I said screw it, I smoked weed, but just a couple of tokes each night to help me sleep, and to help with all the pain I suffer from (had a wreck in Oct 2000 and sustained a lot of spinal and head injuries). Pot helped me a lot. I had less stress, less pain, ate like I was hungry, and finally could get a good night sleep. Before I had insomnia like crazy, and spent every night writing in the other message board. At first the insomnia drove me batty, but I finally just turned my hours around and took advantage of it (insomnia) and wrote like a madman. Kind of like I'm doing now. Pot was the only thing that kept me from just ending my life. I was very close to calling it quits, and I've never been that way before. But when you sit with a loaded Baretta in your mouth, it makes you think. I got rid of the gun, by the way.

If anyone really reads the article that Berlyn posted (from Washington doctors) you just cannot argue the benefits of cannabis on people like us. It is so obvious, and backed by scientific evidence. As far as smoke being harmful, the article points out the differences between pot and tobacco, and how pot doesn't have the same effect that tobacco has, and how many joints you'd have to smoke in order to get the same damaging effects that tobacco causes. There's just no comparison, and you'd have to smoke like all day long just to try to kill yourself off the way tobacco does with far less effort.

Kudos to you Berlyn, you really made my day with that post.

I think I'm going to like this place. I have little time each day, and like I said, I post in another board, but I'll surely be back for more of this good sh*t! Can't buy that kind of clinical backup. Thanks again!

Now where's my bowl.
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Avatar universal
I'm on a combination therapy for approx 8 wk's now. The riba rage has been my biggest issue. Do you know that volcanic eruption that just show's up, taking no prisoners? I've read the entire thread here about the pro's and con's of medicinal pot use, from research studies and their interpretation, personal opinion's and views, and, most important to me, the experience of the individual. It's all good! If you can make it through this treatment inwhichever way works for you...prayer's to you...get through the treatment and claim your life back. I personally am opting out of any and all pharmecueticals..and settling for rest...diet....light exercise...setting boundries..loads of meditation and prayer!

Sincere regard's and all the best to you all
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Avatar universal
Chev.....FUNNY JOKE>>> kinda like "candy is dandy, but sex won't rot your teeth!!!!! Remember that oldie????? LOL

Indy, I meant to say to you earlier, when you commented about "holding the button down"....LOL You could have used your tongue!!!!!!!! ps where are my e-mails???? Are you mad at me??? sniff-sniff (bottom lip sticking out...pouting) I do it sooooooo well!

Kim, please don't think you can't post because you feel some negative feelings these days. You know you can "vent" to us! The newbies will understand in the longgggggg haul!!!!

I Love You ALL....newbies too! Cindee
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Avatar universal
Good story..but what is the point in reference to the relevance of the topic of the post.   Some people take anti depressants to make them feel better....which is acceptable within the medical establishment....but if too many are taken, they are labled as pill poppers.....some people might find that THC makes them feel better, and if taken regularly, society labels them as dopeheads.

So.....what is better....to be a labled dopehead or pillpopper?

Or just fergettubout it and instead of judge other people, find happiness within oneself and as the bible says, though I am not one to be a biblical type, being a nuddist bhuddista and all....

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Avatar universal
a study some time back from the mayo clinic actually stated smoking cigarettes is as harmful to the liver as alcohol.  that shocked me.    so how could other smokables be any better for us?  THC  takes a long time to get out of the body, the black substance in marijuana.   most pot head s   are pretty unmotivated and not too clear thinkers.
   personally in my hippie days in the early 70s   pot started making me sick.  it lowered my blood sugar, made me weak and jittery, sick   and  paranoid.   great drug pot.
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28293 tn?1213136950
I just wanted to add a comment (heads up) about the Dronabinol (Marinol)--

I do realize that most of the members here are not at a stage where they are considering a liver transplant....
but for anyone out there who IS considering a transplant in the future--- you need to know that most centers will deny listing you if they detect THC. (Even if its legally prescribed)


P.S.- There's a pdf file at
http://www.projectsinknowledge.com/Init/G/1603/1603-TxReporter2.pdf
It gives guidelines on treating Hepatitis C patients---- it does say that Dronabinol is useful---- However--- page 4 and page 7 do say that Dronabinol (Marinol) should not be given to anyone considering a liver transplant.


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Avatar universal
<a href="http://www.usdoj.gov/dea/ongoing/marinol.html">Link to DEA Site</a>

In pill form, Marinol is a synthetic form of THC.  Some doctors prescribe it.
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Avatar universal
Donl,....thank you sooo much for putting things in perspective for me....and also for the very good questions put out there in response to TB
Befudd...I'm sorry honey....I promise not to do it again....sniffle ..sniffle

Cindee..you are so sweet, thanks.... I haven't felt like I should post lately cause I don't want to scare any newbies away.... I guess now I am glad that I found this site after I started tx...or  I would have been more worried about sides. It's not that it is THAT bad ...but...I still don't feel that I can add a positive touch to this board lately. I moved into the guest room so I didn't keep my SO up at night when I wake up hurting or hungry...hahahahaha.....and now I really have a desire to be reclusive and stay in my fluffy feather bed and snuggle under the warm covers...with a heating pad on my feet....hahaha ...and sleep, sleeep, sleep,.... (close your eyes newbies)...I have been having some hellatious head aches though and that has kept me in there as well.

Cindee,You are so brave to do this Duke thing. I am so proud of you.... You have a great attitude. thanks, kim


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Avatar universal
Kim, I am so sorry to hear you are mostly in the bed these days. I have missed you and your posts. I will not lie, when I was really sick I did smoke a bit here and there. I hope you feel better soon. When I go to Duke I will ask the doctor his in-put on this. I'll let ya know. I have 24 days to go and then I go to Duke for a clinical trial. I will keep you in my prayers. Much love, Cindee

Indiana, You have my e-mail addy.....want my home addy????? Now don't be selfish!!!!!! LOL I luv ya mann, Cindee
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Avatar universal
My guess is that it was dialectic.
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Avatar universal
We are discussing apples and oranges.

You are talking about SVR, which is a measure of the treatment, not the disease.

I am discusing histology (biopsy results) which is the measure of disease status, not the treatment.

As to marijuan, I have no opinion at all. This is a medical discussion, not a moral, legal or political one.

best,

thanbey
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Avatar universal
What is the link to fibrosis? I don't understand that part.

From what I understand about marinol (have not used it) it does not have any psychological effects. Part of the reason to use cannabis is for these effects. I agree that any smoking cannot be good for the lungs, etc. However, the amount of smoke consumed is much smaller than even half a tobacco cigarette. Also, there are alternatives to smoking.

I have little direct evidence as to its effect on tx: in 12 weeks with no cannabis, I went from 121,000 vl to undetectable (Heptamax, <5 IU/ml). In the next 12 weeks, with an average of 1 joint per two weeks, I stayed undetectable on the same test. My original bx showed some fibrosis. ("between 1 and 2" -- I do not have the specific results.) I will probably not have another bx unless my dr requests it, so cannot answer as to my case.

I don't mean to beat a dead horse here, but as I said, the studies seem to confirm one's prejudices pro or con, so I am trying to explore what facts are out there.
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Avatar universal
WOW!!!!  OK....Berlynn. YOU now have the record for the longest post in the history of this Forum! My finger got tired just holding down the scroll button to get to the bottom of that one!

I have absolutely no clue if smoking the "Evil Weed" can harm the tx "stew" or not. To my knowledge there have been no real tests to see what the effect of THC is to the effectiveness of the meds we do on tx. I do believe it can help with the side effects....but at what cost? I personally decided not to use it for that reason. That is the same reason I didn't use AD's. I avoided everything except certain vitamins while on my tx. I was already so anemic that my worry was that even things that normally don't harm us could have an even bigger negative effect while on tx. The reverse holds true too. It could also have a big positive effect.....maybe. The problem was that I didn't know. So....I decided not to use it. My thoughts were that if I failed at tx it wasn't gonna be because of anything "I" did.
Whats funny is that a lot of the high school kids came to me and gave me joints and told me that it would help. They were just trying to help me. I thanked them graciously......and stashed them all away. I managed to save up quite a collection in the year or so I dealt with my tx.
But NOW......heh, heh, heh.  I am all done and cured baby!!.....and my "collection" is shrinking.
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Avatar universal
It isn't cannibus, per se. It is the smoking of a plant substance that is linked to fibrosis, whether you smoke tobacco or anything else.

Why would smoking this plant be any less likely to contribute to fibrosis that nay other?

There is no question that it makes people feel better. And the NIH, for just one, says there are better pharmaceutical options, including marinol.

The factors I am concerned about have to do with the potential for working against any histological gains as a trade off for feeling better and staying on treatment longer for an increased chance of SVR. Surely pharmaceutical remedies have downsides, but medical marijuana is a pharmaceutical, too. And it, too has its issues. There are other options that do not  require a choice between the increased chance of an SVR versus the potential to interfere with a histological improvement.

There could be. I just don't know any.

th

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Avatar universal
OHC - it says that cannabis may not only help with various side effects, but the THC and other components may have a theraputic effect on various diseases.

Thanbey - OK, so histology is the study of tissue. Are you suggesting that cannabis may cause tissue damage? Or are you simply saying that since no one has documented it either way, we have to be concerned about tissue damage? I'm not saying you're right or wrong (I don't know), but is there any evidence that cannabis is more or less harmful than any of the ADs and other prescription drugs we routinely take during our adult lives? Is there any evidence to suggest that it affects fibrosis negatively? Or are you simply engaging in dialectic (i.e., raising the alternative to any position)?

The problem with cannabis research is that like stem cell research it is subject to politicization. This makes basic research more difficult and cloaks any findings, positive or negative, in the prejudices of the reader.
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Avatar universal
Reefer madness proponents will persist forever on beating the bushes for anything negative about this substance, I'm convinced.  For some balanced information on cannabis, check the site for the New Scientist.  You can even get the World Health Organization study which was suppressed because it wasn't sufficiently negative for some powerful interests (i.e. USA).
God Bless,  Dave
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Avatar universal
The potential to have a positive effect on side effects is not the issue. There are questions regarding the negative impact on liver histology and propgression of fibrosis.

That is not even addressed in this study.

thanbey
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Avatar universal
In a nutshell, whats it all about Alfie?
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Avatar universal
I'm not even on tx anymore and I can't sit still long enough to read all that ;)
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26471 tn?1211936521
Hey, I'm convinced!
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Avatar universal
Gosh Guys...I am sorry that this is so long. I just got it via email this morn and remmembered..there was some discussion on this earlier. Thought this might be interesting. I hope you are all well. Haven't been reading the threads lately...burying myself under the covers these days...but only 5 weeks left. Even though I'm not checking in much lately, my thoughts and prayers are with you all.take care my family, love, kim
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Avatar universal
Flare-ups of pre-existing
>auto-immune diseases such as rheumatoid arthritis, ulcerative colitis
>and Crohn's Disease are common. Marijuana can mitigate the majority
>of these side effects as well as offering effective help to those
>patients where alpha-interferon treatment is not indicated.
>
>Marijuana (Cannabis) is a powerful antiemetic2, 15, 18 that has been
>shown to be particularly effective controlling nausea and stimulating
>the appetites of immune surpressed patients such as those with HIV or
>undergoing chemotherapy. Cannabis has anti-depressant and
>anti-anxiety properties. It is an anti-inflammatory 3, 4, 6, 9, 10,
>14, 18, 19 and immuno-modulating, 7, 8, 11, 12, agent that can help
>minimize portal inflammation and slow the progression of both
>cirrhosis and Hepatocellular carcinoma. The cannabinoids have been
>shown to be powerful anti-inflammatories and anti-oxidants. They have
>also been shown to have anti-neoplastic activity, at least in gliomas
>(a form of brain cancer). Cannabinoids both slow programmed cell
>death (apoptosis) in normal cells while accelerating apoptosis in
>cancer cells. Cannabis has the added advantage of easing, or even
>completely eliminating, the muscle pains and cramping 1, 2, 5, 17,
>18, 21 that patients often experience. Marijuana is an effective
>analgesic.2, 3, 9, 14,15, 16, 20, 21 Cannabis has also been
>demonstrated as effective with rheumatoid arthritis, MS, and Crohn's.
>4, 7, 8, 20, it can aid in the prevention of inflammation associated
>with flare-ups of these conditions should they be present in your
>patient. Recent studies published this year (2002) have shown that
>cannabinoid receptors throughout the digestive tract act to reduce
>immune-reactivity and to surpress the vagal drive of the digestive
>system, slowing the digestive process, allowing more nutrients to be
>absorbed at a slower rate, thus putting less stress on the liver 1
>
>The Washington State Medical Quality Assurance Board has included
>Hepatitis C as a debilitating medical condition that could
>potentially benefit from the use of medical marijuana. Please review
>the following reference data. The minimal side effects of cannabis
>will be discussed following the data.
>
>Published Reference Data (Studies relevant to Hepatitis C, short
>synopsis - complete articles are available. Other references are
>located following the conclusion of this report.)
>
>1. Adami, Frati, Bertini, Kulkarni-Narla, Brown, de Caro, Coruzzi,
>and Soldani, "Gastric antisecretory role and immunohistochemical
>localization of cannabinoid receptors in the rat stomach" British
>Journal of Pharmacology Vol. 135, 2002, The study found cannabinoid
>receptors throughout the gastrointestinal organs of rats.
>"Immunoreactivity to the CB1 receptor was co-localized with that of
>the cholinergic marker choline acetyltransferase in neural elements
>innervating smooth muscle, mucosa and submucosal blood vessels of rat
>stomach fundus, corpus and antrum. These results indicate that
>gastric antisecretory effects of cannabinoids in the rat are mediated
>by suppression of vagal drive to the stomach through activation of
>CB1 receptors, located on pre- and postganglionic cholinergic
>pathways."
>
>2. Baron and Folan, "Ulcerative Colitis and Marijuana", Annals of
>Internal Medicine, Vol. 112, No.6, p 47, 1990, "The symptoms of
>ulcerative colitis were repeatedly relieved by smoked cannabis."
>
>3. Beltramo and Piomelli, "Functional role of high-affinity
>anandamide transport as revealed by selective inhibition." Science,
>Vol.277, No. 5329, pp1094, 1997, "Cannabinoid and non-cannabinoid
>compounds in marijuana reduce pain and inflammation."
>
>4. BW Healthwire, January 1998, "Pre-clinical studies show CT-3
>reduces chronic and acute inflammation and reduces destruction of
>joints." Atlantic Pharmaceuticals was evaluating CT-3, a cannabinoid
>derivative. The company reported "In recent studies, the agent was
>found to reduce inflammation and prevent the destruction of joint
>tissue."
>
>5. Egli, Elsohly, Henn and Spiess. International Journal of Clinical
>Pharmacology, Vol. 34, No. 10, pp46-452, 1988, "The effect of orally
>and rectally administered delta-9-tetrahydrocannabinol on spasticity"
>"THC was shown to relieve muscle spasms in human patients."
>
>6. Formukong, Evans, and Evans "Analgesic and anti-inflammatory
>activity of constituents of cannabis sativa l" Inflammation, Vol. 12
>No. 4, pp361-371, 1988, "Cannabidol is more effective than aspirin in
>reducing inflammation" (Cannabidol or CBD, is one of the scores of
>cannibinoids found in marijuana other than THC)
>
>7. Friedman, H.; Klein, T.W.; Newton, C.; and Daaka, Y., "Marijuana
>receptors and immunomodulation." Advances in Experimental Medicine
>and Biology 373: pp103-113, 1995, "The study suggested that the
>immunosuppressive effects of cannabinoids might be useful clinically;
>for example, in treating multiple sclerosis.
>
>8. Grotenhermen Dr. Franjo, IACM-Bulletin of 25 June 2000, (IACM):
>"We know from animal studies that THC inhibits the production of Th-1
>cytokines such as IL-1, IL-2, and IFN-gamma and stimulates the
>production of Th-2 cytokines such as IL-4, IL-10, and TGF-beta. This
>would give reason for a causal therapeutic use of THC in certain
>autoimmune diseases that appear to be Th-1 mediated such as Crohn's
>disease, a form of chronic intestinal inflammation, and rheumatoid
>arthritis."
>
>9. Holdcroft, et al., "Pain relief with oral cannabinoids in familial
>Mediterranean fever" Anesthesia, Vol. 52, No. 5, May 1997. This
>research paper done at Hammersmith Hospital in London confirmed
>cannabis' analgesic effects in the first UK clinical trial. The paper
>states "Cannabinoids have analgesic and possibly anti-inflammatory
>properties but their clinical use has been restricted by legislation"
>
>
>10. Hollister L.E, "Health Aspects of Marijuana" Pharmacological
>Review, Vol. 38, No. 1, 1986, "Constituents of marijuana; CBC,
>olivitol, and cannoflavin all have marked anti-inflammatory
>properties."
>
>11. Hollister L.E, "Marijuana and immunity" Journal of Psychoactive
>Drugs Vol.20 (1: 3-8, January-March, 1988, Cannabinoids found in
>marijuana are effective immunomodulators.
>
>12. Kaminsky N. E., "Evidence for a cannabinoid receptor in
>immunomodulation by cannabinoid compounds" Advances in Experimental
>Medicine and Biology, Vol. 335, 115-120, 1993, Identifies the
>receptors and process that allows marijuana to be an effective
>immunomodulator
>
>13. Kaminsky N. E. Journal of Neuroimmunology, 1998, "These
>[cannabinoids] might be useful as immune modulators, perhaps to be
>used as anti-inflammatory agents"
>
>14. Maurer, Henn, Dietrich and Hoffmann "Delta-9-tetrahydrocannibinol
>shows anti-spastic and analgesic effects in a single case
>double-blind trial" European Archive of Psychiatry and Neurological
>Science, Vol. 240 No. 1 pp1-4 1990, The trial compared Codeine, THC,
>and a placebo. The study found codeine and THC had comparable
>analgesic effects but only THC had a significant beneficial effect on
>spasticity and inflammation."
>
>
>15. National Academy of Science, Institute of Medicine, "Marijuana
>and Medicine; Assessing the Science Base " Executive Summary, 1999,
>"Conclusion: Scientific data indicate the potential therapeutic value
>of cannabinoid drugs, primarily THC, for pain relief, control of
>nausea and vomiting, and appetite stimulation;"
>
>16. Noyes and Barnes, Comprehensive Psychiatry, Vol. 15, No. 6, pp
>413s-416s, 1974, "There are indications that the active ingredients
>in marijuana may be an effective analgesic that is efficacious in
>functional pain"
>
>17. Petro and Ellenberger, "Treatment of human spasticity with
>delta-9-tetrahrdrocannibinol" Journal of Clinical Pharmacology, Vol.
>21, 1981, "THC can relieve a broad range of muscle spasms in humans
>and animals"
>
>18. Pharmos Corporation Press Release, May 21 1998, Researchers
>reported that experimental treatment of rats suffering from
>ulcerative colitis with Dexanabinol (synthetic cannabidiol-CBD)
>"significantly reduced the anorexia and the colonic inflammation
>associated with this condition compared with untreated rats."
>
>19. Richardson, Kilo, & Hargreaves, "Cannabinoids Reduce Hyperalgesia
>and Inflammation via Interaction with Peripheral CB1 Receptors". Pain
>Vol. 75, 1 pp. 111-119, 1998, Conclusion is in title.
>
>20. Society for Neuroscience Conference, symposium syllabus,
>Functional Role of Cannabinoid Receptors, Aug. '98, "Cannabinoids
>were shown to have a direct effect on the biochemical pain signals in
>the central nervous system, and to exhibit superior pain control to
>addictive opiate based narcotics. Cannabinoids prevented hyperalgia
>and were shown to be particularly effective in the treatment of
>arthritis and other inflammation induced pain.
>
>21. Zeltser, R.; Seltzer, Z.; Eisen, A.; Feigenbaum, J.J.; and
>Mechoulam, R "Suppression of neuropathic pain behavior in rats by a
>non-psychotropic synthetic cannabinoid with NMDA receptor-blocking
>properties" Pain Vol. 47(1): 95-103, October. 1991, The study found
>cannabis surpressed neuropathic pain which complicates many CNS
>diseases. Cannabis was effective when few available therapies
>provided even partial relief.
>
>Historical Data
>
>*The oldest medical text known to man was written over 5,000 years
>ago. The Chinese Pen Ts'ao, prescribed cannabis for rheumatism and
>digestive disorders among other illnesses.
>
>*The New English Dispensary of 1764 recommended hemp to reduce
>inflammation.
>
>*In 1814, Nicholas Culpepper published his Complete Herbal, which
>included "allaying humors of the bowels" and "reducing inflammation"
>among the applications of cannabis.
>
>*Surgeon William O'Shoughnessy in his 1839 paper titled On the
>preparation of the Indian Hemp found that cannabis relieved
>rheumatism, convulsions and muscle spasms.
>
>*The 1854 United States Dispensatory listed many uses for cannabis
>including "reduction of inflammation", "relax muscle contractions",
>"treatment of digestive disorders" and as "an analgesic and sedative"
>
>
>*Between 1840 and 1890 over 100 papers were published on the medical
>uses of cannabis.
>
>*Sir William Osler, known as the "father of modern medicine",
>proclaimed cannabis the best treatment for migraine pain in his
>authoritative 1915 textbook.
>
>*In 1937, when the Marijuana Tax Act was before Congress The American
>Medical Association protested vehemently, Dr William C. Woodward, the
>AMA's counsel, testified that the bill would deprive Americans of one
>of the most useful drugs known to medicine. He also complained that
>the only reason there hadn't been a larger public outcry was because
>the Act referred to the Mexican slang "marijuana" and not to
>cannabis, which everyone understood was a medicine
>
>Side Effects
>
>There has never been a reported death from overdose of marijuana 10,
>15, 22, 23, 26 27. There has never been a death or permanent health
>effect reported from long-term heavy use of marijuana 10, 22, 23, 27.
>Side effects include; a slight increase in heart rate24, 25, slight
>hypotension24, 25, increased appetite 15, 24, and of course, a mild
>euphoric effect. There are "no deleterious effects on the normal
>cardiovascular system" as a result of these side effects according to
>a 1997 WHO report27,. An Australian National Drug Strategy report
>states "Tolerance to the cardiovascular effects develop within 7-10
>days in persons receiving daily doses of THC" 24,.
>
>The euphoria also is subject to the effects of tolerance. Any effects
>on coordination and cognition dissipate within 7-10 days of daily
>use15, 24. However marijuana's effects continue to aid with the
>patient's stress reduction and to alleviate the depression and other
>emotional problems that Hepatitis C patients often suffer from 10,
>15, 28, 29, 30. Many patients find cannabis far superior to Valium,
>Serax, Elavil, or Sinequan; all are commonly prescribed to Hepatitis
>C sufferers. Please contact the Lifevine Foundation for published
>data regarding the anti-anxiety and anti-depressant properties of
>cannabis. Hepatitis C patients find the appetite stimulation10, 15,
>31, an added benefit. It is likely that your patient has already
>tried marijuana for their symptoms and feels the perceived benefits
>outweigh any side effects they have experienced.
>
>Risks
>
>The most obvious risk of smoking marijuana, is, of course, the risk
>incurred smoking any vegetable material. There are several factors to
>consider when determining this risk. If your patient is not suffering
>from malabsorbtion due to their Hepatitis C and they are able to keep
>food digesting for two hours, the patient may choose to eat their
>cannabis and avoid all smoking risks. Other smoking methods such as
>vaporizers (which heat the cannabis to a temperature high enough to
>"vaporize" the cannabinoids on the surface of the marijuana without
>igniting the vegetable matter) may minimize the smoking risks.
>
>The carcinogenic ingredients in both tobacco and cannabis are
>primarily the tars that reside in both plants - not the THC or other
>cannabinoids of cannabis. The main difference in the incidence of
>development of lung cancer is a matter of exposure to these tars,
>which is overwhelmingly greater with tobacco than with cannabis.
>
>It takes 20 - 25 pack/years or more (1 pack/year == smoking 1 pack of
>cigarettes/day for 1 year.) for most tobacco-induced lung cancers to
>develop. 20 - 25 pack/years worth of cigarettes == 150,000 to 200,000
>cigarettes. Of all those people who smoke 1 pack/day or more of
>tobacco cigarettes for all of their adult lives, only 1 in 5 (20%)
>will actually develop tobacco-induced lung cancer.
>
>Most patients who use marijuana medicinally develop their illness in
>mid to late life, and start smoking marijuana medicinally only when
>their projected remaining life span is already relatively short.
>Light medical marijuana users - (1-2 joints/day) in one year would
>smoke 365 - 730 joints; In ten years - 3650 - 7300 joints. In order
>to reach the equivalent of 200,000 cigarettes it would take them 270
>years, at which time 1/5 of them might develop a cancer.
>
>Very heavy use of medicinal marijuana may amount to 10 joints/day. In
>one year they would smoke roughly 3,650 joints; in ten years- 36,500
>joints It would take them 54 years to smoke the equivalent of 200,000
>tobacco cigarettes, at which time 1/5 of them might develop a cancer.
>These figures assume large (1 gm) joints are being smoked - similar
>in size to a tobacco cigarette
>
>Tobacco smoke is a bronchial constrictor known to penetrate the
>lung's smaller peripheral air passages and causes inflammation of the
>lung's absorbent microphages. Tobacco causes blockages which leads to
>emphysema. Dr. Donald Tashkin, a federally sponsored pulmonologist
>and professor of medicine at UCLA Medical School has determined that
>marijuana smoke acts as a bronchial dilator and surpresses
>inflammation of the lung's macrophages. In a 1997 UCLA study
>involving 394 participants32 Tashkin noted "Neither habitual
>long-term marijuana smokers nor intermittent marijuana smokers
>exhibited any significantly different rates of decline in lung
>function. No differences were noted between even quite heavy smoking
>and non-smoking of marijuana." In contrast, the tobacco-only smokers
>in the study experienced a rapid decline in lung function during the
>eight years this study ran. The study also found no connection
>between marijuana and tobacco smoking in those s ubjects who smoked
>both. The evidence from this exhaustive real-world study indicates
>that the pulmonary health of marijuana smokers is no different from
>that of the general population.
>
>In an article in American Journal of Respiratory Cellular and
>Molecular Biology 2001 Mar; 24(3): 339-44 titled "Induction and
>regulation of the carcinogen-metabolizing enzyme CYP1A1 by marijuana
>smoke and delta (9) tetrahydrocannabinol" by the Roth et al, Division
>of Pulmonary and Critical Care Medicine, Department of Pathology and
>Laboratory Medicine, UCLA School of Medicine, "Induction of the
>carcinogen-metabolizing enzyme cytochrome P4501A1 (CYP1A1) is a key
>step in the development of tobacco-related cancers." They determined
>THC had a significant inhibitory effect on the cancer-causing
>enzyme's induction into the body.
>
>Other tests conducted by Dr. Tashkin at UCLA have found a slightly
>higher risk of bronchitis and other upper respiratory infections in
>marijuana smokers33. This risk may be mitigated by the use of
>vaporizers or by the use of ice or water-cooled pipes
>
>Other risks include physical or psychological dependence. These risks
>are far lower than with any other psychotropic drug15. The addictive
>properties of marijuana are less than caffeine, ephedrine, or
>benzodiazepines (like Valium).15 Marijuana is similar to chocolate in
>it's potential for dependency34. Unlike alcohol, nicotine, opiates,
>barbiturates, amphetamines, cocaine or chocolate, marijuana does not
>effect the dopamine receptors of the brain35, 36. There is no
>physical withdrawal10, 15, 26, 27,36. Unlike steroids and other
>pharmaceuticals, one can cease use immediately; there is no need to
>"taper down" dosages.
>
>Conclusion
>
>There is compelling evidence that cannabis is an effective
>antiemetic, anti-inflammatory, immune modulating, analgesic and anti
>spasmodic agent. These properties are indicated for patients
>suffering from Hepatitis C. Five thousand years of recorded medical
>of use, has shown no long-term consequences. Side effects from the
>use of medical marijuana are much milder than the side effects of the
>traditional drugs used to treat Hepatitis C. Many patients who use
>cannabis report they are able to continue the use of their
>prescription medications only when the side effect can be mitigated
>with cannabis. Marijuana also has recognized anti-anxiety,
>anti-depressant and stress reducing qualities which ease
>psychological symptoms and side effects as well as helping to prevent
>substance abuse relapse. Cannabis has the ability to stimulate
>appetite, which many Hepatitis C patients find beneficial. Patients
>without prescription insurance find the ability to grow their own
>medicine at li ttle or no cost to be an additional benefit.s
>
>RCW 69.51A states that for a patient to qualify for use of medical
>marijuana, their physician must find that "It is their medical
>opinion that the potential benefits of the medical use of marijuana
>would likely outweigh the health risks for this patient." We urge you
>to sign the enclosed "Documentation of Medical Authorization to
>Possess Marijuana for Medical Purposes in Washington State." The
>Washington State Medical Association has prepared this document for
>use by our state's physicians. The link between stress and Hepatitis
>C is well established. Eliminating the stress induced by the fear of
>arrest by patients who currently use marijuana for their symptoms is
>yet one more benefit of the medical marijuana act.

>Other Published reference data
>
>22. Mechoulam R. 1986. The pharmacology of cannabis sativa. In
>Cannabinoids as Therapeutic Agents, ed. R Mechoulam, pp. 1
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