Just as the marketing of Prozac by Eli Lilly familiarized the public with “clinical depression” and “selective serotonin reuptake inhibitors” (SSRIs), so the marketing of Rimonabant as a weight-loss drug by Sanofi Aventis will educate millions about the endocannabinoid system (ECS). This was foreseen by Philip Denney, MD, who forwards, as part of the mounting evidence that he was right, a full-spread advertisement placed by Sanofi Aventis in the Sept. 21, 2005 issue of JAMA, the Journal of the American Medical Association. Denney and others remain skeptical about the longterm safety profile of a synthetic “cannabinoid-antagonist” drug that works by blocking the natural receptor system.
The JAMA ad touts “A NEWLY DISCOVERED PHYSIOLOGICAL SYSTEM… The Endocannabinoid System (ECS).” It succinctly explains the role the ECS appears to play in “metabolic syndrome,” the condition for which Sanofi Aventis hopes to get FDA approval to market Rimonabant. Footnotes direct interested physicians to papers from reputable sources. The significance of this carefully documented ad in such a prestigious journal is huge. It seems like only yesterday that the Drug Czar was ridiculing Tod Mikuriya as a practitioner of “Cheech and Chong medicine.” Now, plainly stated in JAMA by the world’s third-largest pharmaceutical company, is the biological basis for how marijuana affects so many systems within the body.
The left-hand page depicts an endocannabinoid floating like a stylized dolphin over a cell membrane from which cannabinoid receptors protrude like plugs in a distributor cap. Accompanying text asserts, “CB1-receptor activation triggers a cascade of intracellular events that impact cardiometabolic risk.” Metabolic syndrome is defined on the right-hand page as a cluster of risk factors: decreased “good” cholesterol; elevated blood pressure, trigycerides and glucose levels; and a widening waistline. Adipose tissue is defined as “a metabolically active endocrine organ -more than just a storage facility for fat, it has metabolic effects.”
The endocannabinoid system “impacts metabolic functions” and “consists of signaling molecules and their receptors, including the cannabinoid receptors (CB1 and CB2). The CB1 receptors “may impact lipid levels and insulin sensitivity.” They are “located centrally in the brain and peripherally in liver, muscle and adipose tissue. ECS overactivity in adipose tissue is associated with decreases in the hormone adiponectiun, which may be linked to dylipidemia, insulin resistance, and intra-abdominal adiposity.” CB1 receptors are “at the center of a cascade of events with potential impact on cardiometabolic risk.” And they “May assist in regulating physiologic processes, e.g., lipid and glucose metabolism.”
The Sheriff’s “Joke”
“Alameda County Sheriff Charles Plummer has a doctor’s letter stating on-the-job stress should qualify him to buy marijuana for medical needs,” according to a story by Karen Holzmeister of the Oakland Tribune, forwarded by Dr. Mikuriya, who thinks Plummer deserves credit for a groundbreaking gesture. “As a joke, Plummer’s physician wrote the note, which the sheriff showed to members of the district attorney’s office. They agreed the letter would be Plummer’s ticket to getting a card that would open doors at any of the six cannabis dispensaries in unincorporated areas.”
You don’t have to be a psychiatrist to know that things people say “as a joke” can reveal below-the-surface concerns. Being sheriff of a mostly urban county in an era of social breakdown is a stressful job, indeed. Either Plummer’s doctor didn’t think the request was a total joke, or s/he made an ethical stretch in signing a letter approving his use of cannabis. According to the Tribune, “After touring all the clinics [in Alameda County’s unincorporated areas], Plummer said he can’t see himself queuing up alongside patients who appear to be ‘unsavory people’ and ‘young men under 30 who look like people you would arrest a lot.”
What the sheriff sees as a diminution of his power to control the citizenry, the doctor sees as a positive. Mikuriya says, “Whatever other benefits a doctor may help a patient obtain by approving their cannabis use, the conferring of legitimacy is a benefit of the utmost importance for their well-being.” It’s understandable that the subset of Californians who have sought a doctor’s approval to medicate with cannabis includes a high percentage of the young, brave, macho, and poor. Middle-aged, middle-class people are more likely to have jobs, families, interests to protect. Many become “risk averse,” too embarassed to ask their regular physician to approve cannabis use, and afraid that going to a specialist might result in negative consequences with an employer, an insurance company, a family court judge, etc. Law enforcement’s relentless opposition to Prop 215 has resulted in the sheriff now having trouble finding a dispensary where a middle-aged professional would feel comfortable stopping by after work to see what strains are recommended for stress.
Seven years ago Candy Bergen as Murphy Brown smoked a joint to cope with chemotherapy, but it’s still news when someone does. Michelle Caruso of the New York Daily News made a story out of Melissa Etheridge’s comments on Dateline NBC 10/15. “Instead of taking five or six prescriptions, I just decided to go the natural route and smoke marijuana,” the singer said on TV. Her doctors had been supportive -“Every single one was, ‘Oh, yeah. That’s the best help for the effects of chemotherapy,’ and that it was the best thing to do.” Etheridge said “chemotherapy tests your sanity It’s the hardest thing I ever did in my life.” Caruso even got a second opinion: “Cancer expert Dr. John Gaspy says there are new drugs that do a much better job of combatting chemo side effects. ‘Medical marijuana has some effect on nausea and vomiting, but it is a weak effect, and it doesn’t compete well with the targeted [pharmaceutical] drugs that have been developed,’ said Gaspy, a specialist at UCLA’s Johnsson Cancer Center.” Sure, doc. Although 30% of people undergoing chemo decide they’d rather face death, you’ve got some great drugs now! “Cannabis appears to be the best drug we have for nausea,” says Dr. Denney, of the Society of Cannabis Clinicians. And you don’t have to swallow it, you can s—- it.
FRED GARDNER can be reached at: email@example.com
ALEXANDER COCKBURN, JEFFREY ST CLAIR, BECKY GRANT AND THE INSTITUTE FOR THE ADVANCEMENT OF JOURNALISTIC CLARITY, COUNTERPUNCH
We published an article entitled “A Saudiless Arabia” by Wayne Madsen dated October 22, 2002 (the “Article”), on the website of the Institute for the Advancement of Journalistic Clarity, CounterPunch, www.counterpunch.org (the “Website”).
Although it was not our intention, counsel for Mohammed Hussein Al Amoudi has advised us the Article suggests, or could be read as suggesting, that Mr Al Amoudi has funded, supported, or is in some way associated with, the terrorist activities of Osama bin Laden and the Al Qaeda terrorist network.
We do not have any evidence connecting Mr Al Amoudi with terrorism.
As a result of an exchange of communications with Mr Al Amoudi’s lawyers, we have removed the Article from the Website.
We are pleased to clarify the position.
August 17, 2005