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J Cannabis Ther 2001(1):001-4

Introduction

Introduction

Author
E. Russo

Abstract
It is with a great sense of anticipation and excitement that we present Volume 1, #1 of Journal of Cannabis Therapeutics: Studies in Endogenous, Herbal & Synthetic Cannabinoids.

This journal is devoted to the scientific examination of clinical cannabis, the biochemical mechanisms of endocannabinoids, and biosynthetic analogues that are based upon their cellular mechanisms. We hope to educate and enlighten a broad-based readership of physicians, researchers and other health professionals as to the historical record of this controversial healing herb, its putative clinical applications in modern medicine, as well as the biochemical and pharmacological functions of cannabinoids in animals and humans. Topics pertaining to toxicology, psychology, social effects, and even pertinent political aspects of cannabis and cannabinoids will be presented in this forum.

Initially, the JCT will consist predominantly of review articles on the medical applications of cannabis and biochemical role of cannabinoids, whether ''endo'' or ''nouveau.'' We will also present editorials, abstract listings, pertinent book reviews, meeting notices, and Letters to the Editor, much as other journals. Where illustrative and meritorious, we will republish archival material and translations concerning cannabis research. In the near future, we hope that contributors will submit a greater proportion of original research in these areas, as well as double-blind controlled clinical trials that are the sine qua non of modern human research, but have been rarely pursued in the last generation due to governmental prohibitions.

Through peer review and high standards of scientific merit and scholarship, we hope to present a publication that is educational, enlightening and relevant, if occasionally provocative.

Our format is quarterly, but will consist of two standard issues plus one double theme-related issue each year, so as to allow the in-depth treatment of particularly important topics.

We proudly initiate this inaugural issue with the latest contribution from the dean of American cannabis research, Leo Hollister. His legacy to our body of knowledge in this area of study is enormous, and he is well known for ''speaking his mind'' irrespective of the question on which side of the political fence his pronouncements may land. His review on clinical cannabis serves nicely as a point of departure on ''medical marijuana,'' focusing as it does on a foundation of peer-reviewed modern studies. Some among our readers are certain to criticize it as ''soft-pedaling'' possible clinical benefits of cannabis, while others will suggest he has been too supportive. Debate is only enhanced when the presentation promotes it through a solid discussion of the issues.

The contribution of Richard (Rik) Musty and Rita Rossi presents important new information on the clinical utility of cannabis and THC in the treatment of nausea and emesis in cancer chemotherapy. Their sources derive from state-sponsored studies, previously unpublished, or even politically suppressed. This paper was recently rejected by one of the premier medical journals in the USA based on the contention that its methods did not meet modern criteria of medical proof. Those of us who reviewed it for publication in JCT feel otherwise, and rather, that the information is relevant and compelling. Now a wider audience will have the ability to judge the material themselves.

Vincenzo Di Marzo presents a state-of-the-art review of endocannabinoids, and their possible application to clinical medicine. It is astounding to realize that this area of research has yet to exist for even one full decade. Despite its novelty, the discovery that our nervous and immune systems are regulated in part by endogenous mechanisms biochemically related to natural cannabinoids portends to be a fertile area of bench research and clinical investigation for many years to come. Dr. Di Marzo has done an admirable job in providing a suitable foundation for building a knowledge base on this topic for those of us to which it is new.

Indalecio Lozano is a name that will be new to most of our Anglophone readership. His background is quite distinct from our other authors, as an academic in the Humanities, and professor of Semitic Languages. His offering is one that deserves promotion on the subject of cannabis therapeutics, in that he brings to us a voice that is rarely heard: that of the medical historian, who is able to restore lost knowledge and enable us to integrate it into the larger picture of our subject. In this instance, he provides an excellent review of the use of cannabis in the Arabic medical tradition. Heretofore, this body of knowledge has been poorly presented in the Western literature, whether due to inaccessibility, barriers of language, inadequate scholarship, or outright cultural myopia. In this journal, we hope to rectify some of these oversights, and fill a few of our historical and scientific lacunae.

John McPartland presents an interesting and thought-provoking examination of anti-inflammatory effects of cannabinoid and non-cannabinoid components. Representing as it does a ''hot topic'' in modern medicine, this review will provide a great deal of material worthy of further reflection for anyone who ponders the clinical implications of inflammation, or wishes to divine new approaches to its treatment. In our effort to represent archival material on cannabis therapeutics, we will periodically feature a series titled ''Cognoscenti of Cannabis.'' The first pertains to Jacques-Joseph Moreau (de Tours), a French pioneer of psychopharmacology, and his attempts to treat a desperately ill patient, victim of ''lypemania,'' with an extract of cannabis. This article is presented in English for the first time.

Ultimately, Jon Gettman provides us a studied political and scientific analysis of perceived inconsistencies in the legislative classification of cannabis, natural tetrahydrocannabinol (THC), and its synthetic cousin, dronabinol (Marinol_). Serious issues are examined that remain open questions in the minds of many patients and their doctors who are seeking better tools in the battle against disease.

Reviews of two recent books, The Science of Marijuana by Leslie L. Iversen, and Hashish! by Robert Connell Clarke, round out the first issue.

Some parties will certainly question the scientific basis and therapeutic relevance of this journal. Skeptics as to its ultimate viability have even included members of its Editorial and Advisory Board. As this is written, legislation is under review in the US Congress that will challenge even its very legality. Any written or electronically published material that is perceived to encourage education and dissemination of knowledge pertaining to the promulgation of illicit drugs may be subject to legal proscription.

The editor's personal bias is that broader knowledge should not be considered subversive until or unless it is absolutely clear that it purposely harms others. In JCT, we have no such intent. Rather we present the hope that our efforts will enhance the health and well-being of many individuals. We will raise the questions. It will only be through further examination of the issues, and the passage of time, that proof or refutation will occur. Consensus is a slowly evolutive process, and one that is rarely complete.

The history of cannabis is a fascinating example of knowledge gained and knowledge lost. The medical writings of the Ancient Sumerians and Chinese may yet offer us insights of clinical value to modern humanity. Cannabis prohibition has been previously attempted in other cultures, and failed to stem the human instinct to challenge ordinary consciousness, and seek relief from bodily and spiritual distress. If one may forgive an irresistible etymological pun, this resilient phytomedicinal has ''hit the canvas'' many times in the past, only to arise once more to attain medical utility, and popular usage in a sort of historical cannabis interruptus.

In closing, it would seem that a remarkable herb provides us with insights and challenges as to what constitutes medicine. With modern developments on endogenous cannabinoids, cannabis has led to a better understanding of our internal biochemical make-up, and pointed the way to possible synthetic therapies that may control many current afflictions. Cannabis, the herb, remains controversial. Beyond its psychoactivity, this plant offers greater opportunities. A renewable resource for fiber, food, and nature's greatest source of healthful essential fatty acids has been made a pariah. That this occurred on the basis of a political agenda, rather than on actual danger or clinical deficiencies, is an error that history and the scientific method demand be rectified. The truth about cannabis as a therapeutic tool should be sought expeditiously, and independently of the prejudice that has hindered the advancement of our knowledge of it for some sixty years.

Ethan Russo, MD

Missoula, MT

Spring 2000

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