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5.29.2009

Shredded Weed - Taking the fun out of marijuana.


By William SaletanPosted Wednesday, May 27, 2009, at 9:04 AM ET

We've taken the caffeine out of coffee, the alcohol out of beer, and the smoke out of tobacco. What's next?

Taking the fun out of pot.

What's that? Do I hear you snickering at your keyboard? You think this is a backdoor way of legalizing weed?

For shame, says the company:

Sativex is a cannabinoid pharmaceutical product standardized in composition, formulation, and dose, administered by means of an appropriate delivery system, which has been, and continues to be, tested in properly controlled preclinical and clinical studies. Crude herbal cannabis in any form—including a crude extract or tincture—is none of those things.

So there. Sativex isn't pot. It's a carefully refined derivative: "Once the plants have matured, they are harvested and dried. GW then extracts the cannabinoids and other pharmacologically-active components … [to] arrive at a pharmaceutical grade material." Patients are further expected to regulate their intake to separate pot's approved effects—relief of pain and spasms—from its unapproved effects:

By careful self-titration (dose adjustment), most patients are able to separate the thresholds for symptom relief and intoxication, the 'therapeutic window', so enabling them to obtain symptom relief without experiencing a 'high'.

Bummer, eh? The company knows exactly what you're thinking:

Why not just let patients smoke cannabis?
In GW's opinion, smoking is not an acceptable means of delivery for a medicine. We believe that patients wish to use a medicine that is legally prescribed, does not require smoking, is of guaranteed quality, has been developed and approved by regulatory authorities for use in their specific medical condition and is dispensed by pharmacists under the supervision of their doctor.

That's a sensible approach. From the standpoint of medicinal as opposed to recreational use, it certainly makes more sense than letting everybody grow and smoke the herb, with all the resulting variability, fraud, and side effects. But GW's anti-pot evangelism goes further:

GW has never endorsed or supported the idea of distributing or legalizing crude herbal cannabis for medical use. In both our publications and presentations, we have consistently maintained that only a cannabinoid medication—one that is standardized in composition, formulation, and dose, administered by means of an appropriate delivery system, and tested in properly controlled preclinical and clinical studies—can meet the standards of regulatory authorities around the world, including those of the FDA.

And don't even think of breaking in and stealing the raw goods:

GW's cannabis plants are grown under computer-controlled conditions in secure glasshouses at a secret location in the UK. … The facility is situated in the South of England but for clear security reasons we do not divulge the precise location.

In your wildest dreams, did you imagine that a recreational drug could be so thoroughly, piously sterilized? But here it is. First came Cesamet (a "synthetic cannabinoid"), then Marinol (also synthetic). Only one pesky side effect has remained: Cesamet produces "euphoria in the recommended dosage range," and Marinol causes "easy laughing" and "elation." We can't have that. So the quest to "separate the thresholds for symptom relief and intoxication" continues. According to GW, delivery of Sativex as a spray "enables patients to titrate (adjust) their dose to achieve symptom relief without incurring an unacceptable degree of side effects."

All of which underscores Human Nature's basic question about the war on drugs. Namely: What do you mean by drugs? A war on cigarettes or on nicotine? A war on caffeinated but not alcoholic beer? Legalization of "cannabinoid medication" but not cannabis?

Drugs can be, and are being, re-engineered every day. Nicotine and caffeine appear in new forms. Cannabis is an herb, then a powder, then a capsule, and now a spray, with significant chemical adjustments along the way. How do you fight an enemy that keeps changing? How do you recognize when it's no longer your enemy?

Every feat of re-engineering challenges our moral and legal assumptions. In the case of Sativex, two positions are under attack: the left's lazy tolerance of recreational marijuana in the guise of legalizing medical marijuana and the right's opposition to medical marijuana on the grounds that it's just a pretext. By refining, isolating, and standardizing pot's medicinal effects, pharmaceutical companies are showing us how to separate the two uses. Are you for symptom relief or getting stoned? That used to be a fuzzy question. Now it's concrete: Do you want the reefer or the spray?


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