"Marijuana does 100 different things¿it¿s good for everything," says Billy R. Martin, chair of the department of pharmacology and toxicology at the Virginia Commonwealth University. "You want an agent that has some selectivity." Cannabis has been found to be helpful in controlling nausea or vomiting ("emesis"), in pain and anxiety relief and as an eating stimulant. Research suggests that cannabinoids can control some movement disorders, such as Parkinson¿s disease and Tourette¿s syndrome, and the presence of a CB1 receptor in the eye may explain how marijuana eases glaucoma and relieves intraocular pressure (IOP). There is even some evidence that CB1 receptors play a role in some forms of hypertension, and a recent report suggests that cannabinoids actually protect neural processes during brain trauma.
With so many different uses, marijuana looks like manna from heaven to most pharmaceutical companies, who stand to gain by selling it in as many forms as possible. Nevertheless, they must first isolate the beneficial aspects of cannabis and find ways to avoid its side effects. In fact, the "high" that so many recreational users of marijuana seek is considered such an adverse effect, especially if it results in dysphoria. Patients taking drugs for therapeutic reasons don't normally expect potent psychotropic reactions.
It won't be easy to find the most useful and efficient ways of delivering marijuana derivatives. Synthetics in pill form such as Marinol have not been entirely popular. So GW Pharmaceuticals in Britain has developed a spray applied under the tongue. The product has now entered Phase Three of the British trials procedure. GW Pharmaceuticals grows its own marijuana plants in highly controlled greenhouse environments and clones the plants for different potencies. Eventually they intend to determine the best combinations of certain cannabinoids to treat various diseases.
Martin¿s lab is working on an aerosolized delivery method, much like an asthma inhaler. "With smoke, the biggest issue is that you are delivering a mixture of a large number of substances," Martin says. "With a spray, you are delivering two to three compounds in a matrix." The advantage with smoke, he continues, is that it delivers much larger particle sizes of a desired substance than an inhaler does. "The onset of action and the duration of action," he adds, "should be comparable as far as the patient¿s concerned."
With funding from the American Cancer Society, Audra Stinchcomb, a pharmacologist at the University of Kentucky, is working on skin-patch delivery systems using about a dozen different synthetic cannabinoids. "Some patches can actually be left on for a week, so a patient doesn¿t need to remember to take their drugs," she says, "and they get a steady level of medicine for a week." Stinchcomb, who has yet to test the patches on people, estimates that she will publish the results next year. In her own trials, she now administers the test patches to surgical waste skin.
With all of this new research¿and the distilled ingredients and application methods that are growing out of it¿pharmaceutical companies are bound to get involved, if they're not already. But will the final product be as good as the real thing? Donald Abrams of the University of California at San Francisco finds the new research exciting, but he argues that marijuana is a natural drug and, according to Chinese herbology, should be used as a whole herb to receive its complete benefits¿"the yin and yang, so to speak." At any rate, it may take another 10 to 15 years before we learn whether synthetic cannabinoids will fulfill their promise. And that's a long time to wait for patrons of the California cannabis clubs.