Canvassing for Opinion - aka "Blairs Brain on Cannabis"

IMHO prohibition sentiment requires inherent addiction to status quo, an incapacity to visualise beyond the here and now and a desperate desire to know others might feel the same... Reform is not revolutionary, rather it is evolutionary. Having survived banging your head against a brick wall the evolutionist relishes having stopped. / Blair

Saturday, November 06, 2004

MP Marc Alexander on Yates, Medpot and Prohibition

Today, Christchurch United Future list MP and spokesperson on Justice issues, Marc Alexander published his regular newsletter online. It covered two matters, the latter was of interest as it was about Neville Yates. (see my blog http://mildgreens.blogspot.com/ )

While some of this public letter is shite even if well meaning, there follows an ounce of compassion here!

Because Marc is known to me, and he has on this matter given this subject some thought, I commend him for having met with Neville and done some good stuff for him regarding his Accident Compensation and even if a tad misguided on drug policy and some other things that we have differences on, he is approachable.

The law is in disrepute, no doubt, but the premise for Marc's 'there are harms' argument is flawed, none of this was upheld in the house select committee inquiry powerfully acknowledging that the harms are overstated. The committee's brief was really to test if prohibition is an appropriate control, even if these purported harms were true.

However Marc points out that in Nevilles case, the Judge (if not the jury) had a duty to arbitrate for the best outcome for both society and Neville, and that he (they) failed on both counts. This is a commendable insight and I thank him for taking this public position in the minefield of drug related political dialogue.

I have impinged on Alexanders' document with some mildgreen comments extracted from some papers that I reviewed published by a couple of internet colleagues, Robert Malamede, Ph.D., Associate Professor and Chairman Biology Department University of Colorado, Colorado Springs and Lester Grinspoon M.D. Professor Emeritus, Harvard Medical School, Boston USA.

Respective references are given to aid the reader.

Of course, Mr Alexander would also do well to review the NZ Health Select Committee Inquiry reports which allay fear of change, recommend progress on medpot and better informs on the state of the national drug policy's harm reduction goals and law review that Alexander's United Future NZ Party stymied. But thats not the goal here. / Blair


Marc writes; (and I write)

Marc Alexander MP
United Future NZ

PO Box 130037
C
hristchurch
Telephone 03-374 6804
Wellington email marc.alexander@parliament.govt.nz
Christchurch email marc.alex@xtra.co.nz

I have never apologised for my hard line against drugs and l sure as hell don�t intend to now. However a recent case concerning the use of cannabis screams for comment.
We know that most of the negative physiological effects of marijuana are well substantiated. These fall into six categories:

  • Brain � marijuana initiates changes in brain chemistry. Its use hinders the neurotransmitter acetylcholine, a chemical that triggers various types of signals throughout the nervous system.
    • (I was going to comment on this, but it really is a case of 'so what'.. people enjoy pot. If cannabis didnt do something to something else, they likely wouldnt experience anything and we wouldnt be having this conversation - it is a pity though that some people think an 'altered state or perception' can not be medicinal or moral. Sex, sleep and sunshine 'excite and hinder' neurotransmitters.The brain is a curious thing! What I do with it, is my business. Absent cognitive liberty there is no self will, no property right, home is no castle and Habeus Corpus dies. Blair)
  • Mood and behaviour � marijuana use leads to difficulties in concentration paying attention, and the ability to learn complex information. There is also an impairment in the perception of time (see below), as well as of certain aspects of memory.
  • The idea has persisted that in the long run smoking marihuana causes some sort of mental or emotional deterioration. In three major studies conducted in Jamaica, Costa Rica, and Greece, researchers have compared heavy long-term cannabis users with nonusers and found no evidence of intellectual or neurological damage, no changes in personality, and no loss of the will to work or participate in society (18-20). The Costa Rican study showed no difference between heavy users (seven or more marihuana cigarettes a day) and lighter users (six or fewer cigarettes a day). Experiments in the United States show no effects of fairly heavy marihuana use on learning, perception, or motivation over periods as long as a year (21-24).
  • Heart � marijuana affects heart rate and blood pressure and simulates those conditions found in people under high stress.
  • No more than walking up a single flight of stairs. (or sex, although relative to cannabis, some positions are more dangerous than others)
  • The therapeutic ratio of cannabis is not known because there has never been a documented death due to an overdose of cannabis. However, extrapolated data from animal experiments provides an estimate for the ratio of lethal dose to therapeutic dose to range from 20,000 to 40,000. (the corresponding relation for alcohol is 4 - 10./Blair) 6,7,11
  • Lungs � marijuana contains 50 per cent more tar than tobacco (compensated by the fact that cannabis is smoked in much smaller quantities than tobacco./Blair) and has an irritating effect on the upper airways, including the sinuses and larynx. There is some evidence that it may cause lung, head and neck cancers.
  • The modern oral forms of (cannabis extractions) dronabinol and nabilone offer a safe alternative to tar containing smoke. However, the absorption of the active drug that reaches the general circulation is only 10%-20% of the administered dose.12 This causes difficulty in the control of dosage because each patient responds differently. When a patient smokes cannabis they can more easily control the amount of THC administered, and avoid the psychotropic effects. Several other methods of delivery are available such as nasal sprays, nebulizers, skin patches, pills and suppositories. Nebulizers heat the THC in cannabis to temperatures below the ignition point of the dried plant material, causing it to vaporize.6
  • The cancer cell-killing62 and pain relieving properties of cannabinoids are less well known to the general public. Cannabinoids may prove to be useful chemotherapeutic agents.63 Numerous cancers types are killed in cell culture and in animals by cannabinoids. For example, cannabinoids kill the cancer cells of various lymphoblastic malignancies such as leukemia and lymphoma,64 skin cancer,65, glioma,66 breast and prostate cancer, 67 pheochromocytoma,68 thyroid cancer 69 and colorectal cancer. 70
  • Although conclusions derived from an often-cited study examining the carcinogenic effects of cannabis, tobacco, and cannabis and tobacco combined claims to show a link between cannabis smoking and head and neck cancer,91 However, these results do not hold up under scrutiny. The study does support a link between tobacco use that is exacerbated by concurrent cannabis use and the development of head and neck cancer. However, the �cannabis use only� group was only composed of two subjects, undermining the statistical relevance of conclusions regarding this group / Bob Malamede, Ph.D., Associate Professor and Chairman Biology Department University of Colorado, Colorado Springs
  • Sexual performance � studies have linked marijuana to a reduction in the number and quality of sperm. Sperm mobility is affected, with a consequent reduction in fertility. Considering that some of the people who have a drug lifestyle accompanied by the requisite criminal activities, this may actually be a positive!
  • <>Government experts concede that pot has no permanent effect on the male or female reproductive systems.1 A few studies have suggested that heavy marijuana use may have a reversible, suppressive effect on male testicular function.2 A recent study by Dr. Robert Block has refuted earlier research suggesting that pot lowers testosterone or other sex hormones in men or women.3 In contrast, heavy alcohol drinking is known to lower testosterone levels and cause impotence. A couple of lab studies indicated that very heavy marijuana smoking might lower sperm counts. However, surveys of chronic smokers have turned up no indication of infertility or other abnormalities.
    Less is known about the effects of cannabis on human females. Some animal studies suggest that pot might temporarily lower fertility or increase the risk of fetal loss, but this evidence is of dubious relevance to humans.4 One human study suggested that pot may mildly disrupt ovulation. It is possible that adolescents are peculiarly vulnerable to hormonal disruptions from pot. However, not a single case of impaired fertility has ever been observed in humans of either sex.
  • Blood flow � marijuana has been shown to decrease blood flow to the limbs. In extreme cases these may require amputation.
    • <>In 20 years of literature review, I have never seen this claim - indeed, I suspect the medical literature would evidence findings that are quite the contrary. The reported sense of wellbeing in many suffferers of arthritis is associated with the vasodilation, or opening of the blood vessels which also accounts for the apparent lowering of blood pressure (also taking strain of the heart). This is evident in the red eyes or flush cheeks experienced by some, if not most users. It is a tempory condition. Decreased blood flow to the limbs leading to amputation is by stark comparison a feature of common and increasingy so deiseases such as diabetes from fat uptake compounded by lack of excercise. Chronic tobacco smoking and other negative behavours such as execcive alcohol are also associated with poor circulation. It might also be notable to point out since this is my comment, PM10's, airborne particulates from mobile source diesel decreases blood flow to the limbs, elevates blood pressure, vaso-contricts arteries in heart and brain and leads to stroke and heart failure. That is proven. Wheras cannabis is optional, breathing city air is not. Cannabis's only medical association with amputation is as an effacous analgesic for phantom limb pain. NonSteroidals (what inflamation? what joint?) and Opiates are ineffective in chronic cases. /Blair
  • <>According to the NATIONAL ACADEMY OF SCIENCES, the effects of marijuana on blood pressure are complex, depending on dose, administration, and posture. Marijuana often produces a temporary, "moderate" increase in blood pressure immediately after ingestion; however, heavy chronic doses may slightly depress blood pressure instead. One common reaction is to cause decreased blood pressure while standing and increased blood pressure while lying down, causing people to faint if they stand up too quickly. There is no evidence that pot use causes persisting hypertension or heart disease; some users even claim that it helps them control hypertension by reducing stress. One thing THC does do is to increase pulse rates for about an hour. This is not generally harmful, since exercise does the same thing, but it may cause problems to people with pre-existing heart disease. Chronic users may develop a tolerance to this and other cardiovascular reactions. NATIONAL ACADEMY OF SCIENCES Report, pp. 66-67.

For anyone who argues the nature versus nurture nonsense, an Australian study of 311 pairs of identical and fraternal twins concluded that age and lifestyle were significant factors in drug dependency. A study of same-sex twins showed that those who experimented with marijuana before the age of seventeen were up to five times more likely to use harder drugs such as heroin and cocaine later, regardless of genetic and family background. (The Dutch Ministry of Justice estimates that 0.16% of cannabis users are heroin users. This figure does not support cannabis being a gateway drug.)

Anyway, enough said. (yeah, me too)

We know the damage that drugs can do and without going into an arduous menu of reasons (medical and legal) for maintaining harsh sanctions, I want to turn attention to one particular case.
<>
P
utting all the above aside, the recent case of Neville Yates deserves special consideration. He has received his fourth conviction for marijuana cultivation and a ninth on cannabis-related grounds. He claims that his use of cannabis is for medicinal reasons. Even so he was given a four (five) month sentence of imprisonment.

I met Neville in my Christchurch office and in my opinion he is no angel. But�before we rush to judge too harshly we should also note that he is a disabled man who is wheelchair-bound and brain damaged.

  • The ability to control these fundamental neurological activities, in conjunction with the anti-inflammatory properties of cannabinoids, is likely to have important regenerative health benefits for people suffering from neurological damage as occurs with stroke or injury.27

He suffers from chronic pain. Since a serious accident when he was 14 years old, he has had a stroke, suffered paralysis and has had one foot amputated.


Pain
Cannabinoids are effective analgesics in animal models with non-opiate mechanisms predominating. There are many anecdotal reports (Grinspoon & Bakalar, 1993) of benefits in bone and joint pain, migraine, cancer pain, menstrual cramps and labour..... THC is significantly superior to placebo and produces dose-related analgesia peaking at around 5 hours, comparable to but out-lasting that of codeine. Side-effects were also dose-related, and consisted of slurred speech, sedationand mental clouding, blurred vision, dizziness and ataxia. Levonantradol was also superior to placebo and notably long-acting,but almost half the patients reported sedation. Cannabinoids may have considerable potential in neuropathic pain (Institute of Medicine, 1999)

I certainly don�t want to diminish the prohibition against cannabis but I cannot see what is to be gained from incarcerating Neville Yates. What public interest will be served?

It will cost at least $20,000 to keep him in prison for that time. He will not be assured of much medical or therapeutic help; he�ll be a vulnerable target for the violent bullies who are in there for more serious offences; and he�ll come out no better, in all likelihood, worse. A more satisfactory scenario for Neville Yates would be a proper medical assessment and for him to be treated as a clinical rather than a criminal case; he should be given proper assistance to reclaim some semblance of a life that has been riddled with pain and tragedy. The point is he is not a dope fiend preying on others, but a heartbreaking example of a damaged person being further damaged by our lack of compassion � and no doubt immune to our sympathies because his brain damage has made him less sociably acceptable than most.

The issue here is less about the rights and wrongs of the marijuana debate but much more about how we fail to treat compassionately the less �cuddly� amongst us at the point where they need it most.
<><>
Marc Alexander MP
United Future NZ
PO Box 130037
Christchurch
Telephone 03-374 6804
Wellington email marc.alexander@parliament.govt.nz
Christchurch email marc.alex@xtra.co.nz



1. Dr. Christine Hartel, loc. cit.

2. NATIONAL ACADEMY OF SCIENCES Report, pp. 94-9.

3. Dr. Robert Block in Drug and Alcohol Dependence 28: 121-8 (1991).

4. NATIONAL ACADEMY OF SCIENCES Report, p. 97-8.

6. Grinspoon L. Whither medical marijuana?, Contemporary Drug Problems, New York. Spring 2000.

7. Hall W, Solowij N. Adverse effects of cannabis, The Lancet, London. Nov 14, 1998.

11.
Hubbard JR, Franco SE, Onaivi ES. Marijuana: Medical implications, American Family Physician, Kansas City. Dec1999.

12. Iverson LL. The Science of Marijuana. Oxford University Press, 2000. p121-175.

18. Carter WE. Cannabis in Costa Rica: a study of chronic marihuana use. Philadelphia: Institute for the Study of Human Issues; 1980.

19. Rubin VD, Comitas L. Ganja in Jamaica: a medical anthropological study of chronic marihuana use. The Hague: Mouton; 1975.

20. Stefanis CN, Dornbush RL, Fink M. Hashish: studies of long-term use. New York: Raven Press; 1977.

22. Braude MC, Szara S. Pharmacology of marihuana. New York: Raven Press; 1976.

22. Culver CM, King FW. Neuropsychological assessment of undergraduate marihuana and LSD users. Arch Gen Psychiatry 1974;31:707-711.

23. Lessin PJ, Thomas S. Assessment of the chronic effects of marihuana on motivation and achievement: a preliminary report. In: Braude MC, Szara S, editors. Pharmacology of marihuana. New York: Raven Press.; 1976.

24. Stefanis CN, Boulougouris J, Liakos A. Clinical and psychophysiological effects of cannabis in longterm users. In: Braude MC, Szara S, editors. Pharmacology of marihuana. New York: Raven Press; 1976.

27. Nagayama T, Sinor AD, Simon RP, et al. Cannabinoids and neuroprotection in global and focal cerebral ischemia and in neuronal cultures. J Neurosci 1999; 19:2987-2995.

62. Guzman M, Sanchez C, Galve-Roperh I. Cannabinoids and cell fate. Pharmacol Ther 2002; 95:175-184.

63. Parolaro D, Massi P, Rubino T, Monti E. Endocannabinoids in the immune system and cancer. Prostaglandins Leukot Essent Fatty Acids 2002; 66:319-332.

64. McKallip RJ, Lombard C, Fisher M, et al. Targeting CB2 cannabinoid receptors as a novel therapy to treat malignant lymphoblastic disease. Blood 2002; 100:627-634.

65. Casanova ML, Blazquez C, Martinez-Palacio J, et al. Inhibition of skin tumor growth and angiogenesis in vivo by activation of cannabinoid receptors. J Clin Invest 2003; 111:43-50.

66. Sanchez C, Galve-Roperh I, Canova C, Brachet P, Guzman M. Delta9-tetrahydrocannabinol induces apoptosis in C6 glioma cells. FEBS Lett 1998; 436:6-10.

67. Melck D, De Petrocellis L, Orlando P, et al. Suppression of nerve growth factor Trk receptors and prolactin receptors by endocannabinoids leads to inhibition of human breast and prostate cancer cell proliferation. Endocrinology 2000; 141:118-126.

68. Wilson RGJ, Tahir SK, Mechoulam R, Zimmerman S, Zimmerman AM. Cannabinoid enantiomer action on the cytoarchitecture. Cell Biol Int 1996; 20:147-157.

69. Portella G, Laezza C, Laccetti P, De Petrocellis L, Di Marzo V, Bifulco M. Inhibitory effects of cannabinoid CB1 receptor stimulation on tumor growth and metastatic spreading: actions on signals involved in angiogenesis and metastasis. FASEB J 2003; 17:1771-1773.

91. Zhang ZF, Morgenstern H, Spitz MR, et al. Marijuana use and increased risk of squamous cell carcinoma of the head and neck. Cancer Epidemiol Biomarkers Prev 1999; 8:1071-1078.
View blog reactions

2 Comments:

  • At 9:49 pm, November 07, 2004, Blogger Natalie said…

    Thanks Blair for putting Marc right. He's not the only person to 'get this wrong' about drug policy. My issue with his letter is the 'compassionate' part.
    Some guy cultivates dope with a sophisticated cannabis operation for his own medical use, and because he is an employer of 20 people, he gets a slap on the wrist, and a big fat fine.

    That's the issue Marc... the law is different for different tax payers.

    Remember the billionnaire guy who entered NZ waters during America's Cup? Yup, he got a real slap on the wrist as his fine was the same as a penny (remember, he's a billionaire. What's $10 grand for him).

     
  • At 9:50 pm, November 07, 2004, Blogger Natalie said…

    This comment has been removed by a blog administrator.

     

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