Tuesday, March 08, 2005

Medical Marijuana studies in more depth

Wanted to synthesize the core numbers from state studies from this link. Several of the studies did not provide sample sizes, so will skip them. This is a pretty long section despite my trimming (did not note cuts in any fashion, but the write-up can be found in the link above).

New Mexico: This study involved 250 patients.The study compared marijuana to THC capsules. Patients were permitted to choose marijuana or the THC pill. Both objective (e.g., frequency of vomiting, amount of vomiting, muscle biofeedback, blood samples and patient observation) and subjective measures were made to determine the effectiveness of the drug.

The study found that [m]ore than ninety percent of the patients who received marijuana . . . reported significant or total relief from nausea and vomiting." data accumulated over all five years

Michigan: The Michigan research compared marijuana to Torecan. It involved 165 patients. Upon admission to the program patients were randomized into control groups with some randomized on the conventional antiemetic Torecan and the remainder randomized to marijuana. When failure on the initial randomized drug occurred, patients could elect to crossover to the alternate therapy.

The Michigan study reported 71.1 percent of the patients who received marijuana reported no emesis to moderate nausea. Ninety percent of the patients receiving marijuana elected to remain on marijuana. Only 8 of 83 patients randomized to marijuana chose to alter their mode of antiemetic therapy. This was almost the inverse of patients randomized to Torecan, there more than 90 percent - 22 out of 23 patients - elected to discontinue use of Torecan and switched to marijuana.

Tennessee: This study involved an evaluation of 27 patients. The study found an overall success rate of 90.4 percent for marijuana inhalation therapy. In comparison it found a 66.7 percent success rate for THC capsules. In the under 40 age group, the study found a 100 percent success rate for marijuana inhalation therapy. We found an approximate 23 percent higher success rate among those patients administered THC capsules. We found no significant differences in success rates by age group. We found that the major reason for smoking failure was smoking intolerance; while the major reason for THC capsule failure was nausea and vomiting so severe that patient could not retain the capsule.

New York: By 1985, the New York program had extended marijuana therapy to 208 patients through 55 practitioners. Of that, 199 patients were evaluated. North Shore Hospital reported marijuana was effective at reducing emesis 92.9 percent of the time; Columbia Memorial Hospital reported efficacy of 89.7 percent; Upstate Medical Center, St. Joseph's Hospital and Jamestown General Hospital reported 100 percent of the patients smoking marijuana gained significant benefit. The report concludes: Patient evaluations have indicated that approximately ninety-three (93) percent of marijuana inhalation treatment episodes are reported to be effective' or highly effective' when compared to other antiemetics."

Georgia: The Georgia program evaluated 119 patients. It compared THC to standardized smoking of marijuana and with patient-controlled smoking. To enter the program a patient had to have failed on other antiemetics. Patients were randomized to either patient-controlled smoking of marijuana, standardized smoking of marijuana or THC pills.

The report found that both THC and marijuana were effective in providing antiemetic relief for patients who were previously unresponsive to antiemetics. The rate of success was 73.1 percent. Patient controlled smoking of marijuana was successful in 72.2 percent, standardized smoking was successful in 65.4 percent and THC was effective in 76 percent of the cases. In comparing the reasons for failure between marijuana and THC the report found: The primary reasons for failure of THC capsules were due to either adverse reaction (6 out of 18) or failure to improve nausea and vomiting (9 out of 18). The primary reason for failure of smoking marijuana were due to smoking intolerance (6 out of 14) or failure to improve the nausea and vomiting (3 out of 14).

California: California conducted a series of studies from 1981 through 1989. Each year approximately 90 to 100 patients received marijuana. In 1981 the California Research Advisory Panel reported: Over 74 percent of the cancer patients treated in the program have reported that marijuana is more effective in relieving their nausea and vomiting than any other drug they have tried." In 1982, a 78.9 percent effectiveness rate was found for smoked marijuana.

Best items are having an objective standard & the reasons why each therapy would work: smoke intolerance vs. vomiting up pills. Healthy sample sizes in all cases except for the Tennessee study.

A couple of weak items in these summaries: (1) outside of the California study, I don't see the illness, just the symptoms. The studies obviously would have to state, but these summaries don't provide that information. Looks like mostly cancer or AIDS. Does not appear to be any M.S. patients. (2) Do not see any statistics beyond providing percentages. Would be nice to see some binomial comparisons. Looks like every case uses comparisons of proportions - would like to see the base studies. Also do they ever try and make the subjective matter objective? Cannot detect that in any of these cases.

Conclusion: my setup isn't very close to what exhibited above.

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