Restore Cannabis to the Formulary Where it Belongs by Tod H. Mikuriya, M.D

"One of the most ignored area in the discussion of medicinal cannabis is its medicinal history. Because of my study of this area as part of my continuing education I can with confidence assert that cannabis has been proven safe and effective. It has been intensively researched in laboratories and pharmaceutical companies which parallels the development of science and technology. Cannabis prohibition has produced a dark ages of what was once known pharmaceutically and clinically. The situation is not unlike the Planet of the Apes with a retrograde and ignorance ridden dark age. Even definitions of the drug have become perverted and inaccurate."

One of the most ignored area in the discussion of medicinal cannabis is its medicinal history. Because of my study of this area as part of my continuing education I can with confidence assert that cannabis has been proven safe and effective. It has been intensively researched in laboratories and pharmaceutical companies which parallels the development of science and technology. Cannabis prohibition has produced a dark ages of what was once known pharmaceutically and clinically. The situation is not

unlike the Planet of the Apes with a retrograde and ignorance ridden dark age. Even definitions of the drug have become perverted and inaccurate.

Contemporary crude and refined cannabis products are of comparative low quality with products of questionable origin. We have no nomenclature except products of local idiosyncratic nicknames. Concepts of quality are distorted by hyperbole and self serving hubris and bereft of any testing standards. Before cannabis was functionally removed from availability by the 1937 Marihuana Tax Act where it was on formularies for some ninety years. At the time of removal the Food and Drug Control Laboratory in Washington maintained a supply of reference standard cannabis for quality control within the pharmaceutical industry.

Eli Lily and Parke Davis had a research grow at a jointly run farm in Parkedale, Michigan from 1906 to 1937 in response to an industry wide problem of variable potency cannabis imported from India.

An industry standard in the days before modern gas liquid chromatography and mass spectroscopy was determined through a sophisticated bioassay using medium sized short haired dogs weighing less than 15 kilos, of fair degree of intelligence, preferably fox terriers that showed specific behavioral signs with the standard dose:

Fluid extract 0.1 Gm/Kg

Tincture 1 cc/Kg

Solid extract 4 mg/Kg

Powdered extract 40 mg/Kg

All of this knowledge lost. Replaced by ignorance and chaos. The current quality of available cannabis products falls below the pre 1938 pharmaceutical industry standards as reflected in the review of the literature done by Michael Aldrich and me in 1988.

More important, clinical and pharmaceutical intelligence has also been lost. Replaced by ignorance through removal from availability the data base has not only been removed but replaced by incorrect information and myth. Institutional territoriality and censorship expunge and revise history. Not unlike the perversion of reproductive information with septic abortions and maternal death, the misinformation about cannabis causes significant avoidable morbidity.

Starting with a questionnaire and list of conditions mentioned in pre 1937 medical and pharmaceutical literature my interviews with over 5500 patients has confirmed the apparent efficacy in these conditions and significantly added to the uses in which cannabis appears to be useful. The results of these interviews lead me to categorize the therapeutic effects thusly:

Analgesic Immunomodulator

Muscle relaxant antispasmodic

Mood modulator and easement

Harm reduction substitute

The significant advantages of conventional pharmacological interventions is a level of morbidity and side effects less by an order of magnitude.

Cannabis is also unique in that it may be therapeutic for apparently unrelated conditions in the same person.

Drinking from the poisoned font of knowledge designated authorities enable and facilitate the process to the detriment of society. The ignorance and fear resulting from lack of direct clinical knowledge leads to great harm to both patients and institutions. The mal and misfeasance destroys the most precious commodity of governance- trust.

A simple but improbable solution is simply to restore cannabis to the prescriptive and OTC availability with definitions and standards from formularies and pharmaceutical listings. Put cannabis back in the pharmacy from whence it was illegitimately removed.

Neither the composition of cannabis nor human physiology has changed since it was removed from availability- only the politics.

Tod H. Mikuriya, M.D