Sharpe and Smith (1) do a nice job discussing the potential benefits and drawbacks of the use of cannabinoids for pain and other therapeutic indications. Their downfall is that they jump from the appropriate point that cannabinoids have some probable utility, to the conclusion that cannabis has utility. That would necessitate the study of smoking as a delivery system for cannabinoids.
Schwartz and I (2) raised serious questions about the smoking of marijuana as a delivery system for cannabinoids. These same concerns have been voiced by the American Medical Association (3), National Institutes of Health (4), and the Institute of Medicine (5).
Clearly, there may be some benefits from the therapeutic use of cannabinoids, but let us stick to delivery of specific cannabinoids via oral routes, transdermal patches, metered inhalers, or suppositories. Smoking marijuana is not an appropriate delivery system for cannabinoids.
Eric A. Voth MD, FACP
References
1. Sharpe P, Smith G. Cannabis: time for scientific evaluation of this ancient remedy? Anesth Analg 2000; 90:237–40.
2. Voth EA, Schwartz RH. Medicinal applications of delta 9 tetrahydrocannabinol and marijuana: a perspective. Ann Intern Med 1997; 126:791–8.
3. American Medical Association Council on Scientific Affairs Report 10. Medical marijuana. Adopted by the AMA House of Delegates, December 1997.
4. Workshop on the Medical Utility of Marijuana. Report to the Director, National Institutes of Health.
http://www.nih.gov/news/medmarijuana/MedicalMarijuana.htm. Accessed April 17, 2000.
5. Marijuana and medicine: assessing the science base division of neuroscience and behavioral health, Institute of Medicine. Joy JE, Watson SJ, Benson JA Jr, eds. Washington DC: National Academy Press, 1999.
