The Cannabis Conundrum

"Cruel Hoax" or Solid Science?

The push to develop plant-based and synthetic cannabinoid medicines has been building since the early 1990s, when researchers identified nerve receptors in the brain that are stimulated by marijuana's active ingredient, THC, as well as the natural body chemical that binds to those receptors. The discovery of an entirely new class of brain receptors and the neurotransmitters that act on them--the endocannabinoid system--proved to be an astounding development, opening a whole new area of therapeutics. Investigators believe that the system plays a critical role in mediating pain, appetite, movement, and memory. The giants of the drug industry, including Lilly, Merck, Pfizer, and Schering-Plough, are now hard at work in the lab, attempting to cook up synthetic versions of the 61 cannabinoid compounds found in marijuana plants. These are complex molecules with 21 carbons unique to cannabis, of which THC is the best known. Big Pharma has high hopes for these synthetics for the treatment of obesity, smoking, cancer pain, migraines, and MS symptoms. But such efforts are still in the early stages of development.

Investigators believe that the system in the brain that is stimulated by marijuana also plays a critical role in mediating pain, appetite, movement, and memory.

At the more controversial end of the aboveground marijuana economy, developers are using the plant itself instead of synthetic compounds. "At least in the near future, it seems extremely unlikely that one of these companies will come up with a single synthetic agent that's as widely applicable as a cannabis-based medicine," says Russo. GW is taking whole extracts from the marijuana plant and recombining them to produce drugs that treat specific ailments. This plant-based approach has enabled the company to develop and test Sativex in five years, at a price tag of about $60 million. It's a remarkable feat, considering that Big Pharma on average shells out $800 million on a new drug and can easily devote a decade or more to animal research and first-dose-in-man testing. GW did minimal animal testing, taking Sativex rapidly to controlled, double-blind human trials. "Something like 400 million people a year take cannabis in one form or another, and yet there's never been a recorded fatality from it," says Guy.

But you won't find any commercial development of plant-based marijuana medicines being pursued in the United States. Andrea Barthwell, a deputy director in the White House Office of National Drug Control Policy and President Bush's point person on medical marijuana, says cannabis medicines aren't compatible with modern science. They do not constitute "a serious line of research," she says.

"The people who are advancing marijuana as a medicine are perpetuating a cruel hoax that exploits our compassion for the sick," Barthwell says. "They are using patients' pain and suffering in an attempt to change America's drug control policy. Marijuana is a crude plant product that most definitely is not a medicine."

It's a curious statement, given that it seems to reflect neither the views of the international scientific community nor those of the government's own regulatory agencies. For one thing, the Food and Drug Administration is reviewing 139 new-drug applications involving botanical research products, so plant-based medicines certainly aren't anathema. As for cannabis, in 1999 the Institute of Medicine, working at the behest of the White House drug czar's office, issued a lengthy report that assessed the scientific evidence concerning potential medical uses of marijuana. Its preeminent recommendation: "Research should continue into physiological effects of synthetic and plant-derived cannabinoids."

Barthwell, however, says that marijuana hasn't been standardized for pharmaceutical production. Nor is there any evidence, she says, that the plant's various compounds can be reliably produced in consistent concentrations. Clearly, she hasn't visited the world's most futuristic pot farm.

Down on the Farm

At a secret location in southeastern England, GW Pharmaceuticals has built what might well be the most high-tech pot palace on the planet. Surrounded by electrified razor wire, video cameras, and motion detectors, the greenhouse sprawls across more than an acre of land. At any one time, more than 15,000 marijuana plants are growing under its 14-foot ceiling, with its banks of lights. Inside is a sea of green, comprised of some of the world's most potent strains of pot: Hindu Kush, White Widow, Skunk, Northern Lights. Outside of the Netherlands, GW is the only commercial organization in Europe licensed to cultivate cannabis on this scale.