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Janet E. Joy, Stanley J. Watson, Jr., and John A. Benson, Jr., Editors
Division of Neuroscience and Behavioral Health
Institute of Medicine
National Academy Press, Washington, D.C.

"Marijuana and Medicine. Assessing the Science Base"

(...) “Advances in cannabinoid science over the past 16 years have given rise to a wealth of new opportunities for the development of medically useful cannabinoid-based drugs. The accumulated data suggest a variety of indications, particularly for pain relief, antiemesis, and appetite stimulation. For patients who suffer simultaneously from severe pain, nausea, and appetite loss, such as those with AIDS or who are undergoing chemotherapy, cannabinoid drugs might offer broad-spectrum relief not found in any other single medication”. (...) “the report concludes that the future of cannabinoid drugs lies not in smoked marijuana but in chemically defined drugs that act on the cannabinoid systems that are a natural component of human physiology. Until such drugs can be developed and made available for medical use, the report recommends interim solutions”.

John A. Benson, Jr., and Stanley J. Watson, Jr.

Co-principal investigators:

Marijuana and Medicine - Preface.

"Marijuana and Medicine. Assessing the Science Base"


Executive Summary, 1

1. Introduction, 13

How This Study Was Conducted, 15

Marijuana Today, 16

Marijuana and Medicine, 19

Who Uses Medical Marijuana? 20

Cannabis and the Cannabinoids, 24

Organization of the Report, 30

2. Cannabinoids and Animal Physiology, 33

Introduction, 33

Cannabinoid Receptors, 39

The Endogenous Cannabinoid System, 43

Sites of Action, 48

Cannabinoid Receptors and Brain Functions, 51

Chronic Effects of THC, 56

Cannabinoids and the Immune System, 59

Conclusions and Recommendations, 69

3. First, Do No Harm: Consequences of Marijuana Use and Abuse, 83

The Marijuana ’’High’’, 83

Drug Dynamics, 84

Marijuana Use and Dependence, 92

Link Between Medical Use and Drug Abuse, 101

Psychological Harms, 104

Physiological Harms: Tissue and Organ Damage, 109

Summary and Conclusions, 125

4. The Medical Value Of Marijuana and Related Substances, 137

Standards for Evaluating Clinical Trials, 138

Analgesia, 139

Nausea and Vomiting, 145

Wasting Syndrome and Appetite Stimulation, 154

Neurological Disorders, 159

Glaucoma, 173

Summary, 177

Other Reports on Marijuana as Medicine, 180

5. Development of Cannabinoid Drugs, 193

Federal Drug Development Policy, 194

Development and Marketing of Marinol, 202

Market Outlook for Cannabinoids, 208

Regulation of and Market Outlook for Marijuana, 213

Conclusions, 218


 A. Individuals and Organizations That Spoke or Wrote to the Institute of Medicine About Marijuana and Medicine, 225

B. Workshop Agendas, 232

C. Scheduling Definitions, 240

D. Statement of Task, 242

E. Recommendations Made in Recent Reports on the Medical Use of Marijuana, 244

F. Rescheduling Criteria, 256

Index, 259

(24 de setiembre de 2010)

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