This article has been re-posted from the May – June 2005 Cannabis Health Journal.
By Valerie Leveroni Corral
WAMM initiated a study in 1993 designed to address the question of differential clinical effects between Cannabis sativa and C. indica strains and hybrids, and also examining effects of inhaled and ingested routes of administration. This study is ongoing and now includes “blind” trials where the varieties used are not apparent to the participating patient.
The data collected since 1993 from WAMM members suggest a trove of possibilities. That a single plant comprised of a myriad of components promises such a wealth of potential is not a novel consideration. It is no surprise to researchers investigating the earth’s flora in the hope of developing drugs to ease the ills of humankind. Nor to indigenous peoples who have relied on plant medicines to reduce suffering and even lay claim to “miracle” cures. It may well be that the symbiotic relationship between the components that make up each plant in our world could influence their efficacy. A “whole plant medicine” approach suggests that these combined properties may add a level of usefulness yet untapped in synthetically produced single compounds.
The most significant limitation to this type of research is the absence of a legal mechanism in the USA for analyzing cannabis samples for their biological constituent content. However, the value of clinical observation when further combined with the enduring relationship of observer to subject provides a depth of understanding that cannot be obtained in any short-term study.
Endocannabinoids (neuroprotective agents in our brains) appear to be part of a central system, interdependent with other systems of human physiology. (1) Restricted access to the use of whole plants may hinder a patient’s ability to effectively control symptoms and improve quality of life. Controlled studies of cannabis have revealed the varying therapeutic effectiveness of cannabinoids in treating illnesses such as cancer, AIDS and Lupus chemotherapies, AIDS wasting, MS, asthma, glaucoma, rheumatoid arthritis, epilepsy and other seizure disorders, and aiding in the retardation of tumor growth.
Our present collection of data also includes measures of effectiveness of cannabis on other autoimmune illnesses such as systemic lupus erythematosis, as well as on other disorders, including muscular dystrophy, epilepsy, quadriplegia, paraplegia, Parkinson’s disease, fibromyalgia, depression and migraine.
It is reported that THC may reduce spasms associated with both neurological and non-neurological disorders (Hollister, 1986; British Medical Association Report, 1997). The non-psychoactive cannabinoid cannabidiol has been shown to exhibit anticonvulsant properties in certain animal studies (Iversen 2000)(The Science of Marijuana,
L.L. Iversen, PhD). In the case of some patients it has been noted to reduce or prevent the onset of both spasm and seizures. It appears that there are receptor sites for cannabinoids that have beneficial effects on seizure activity.
M a r i j u a n a produces its medical and other effects by virtue of the concentration and balance of various active ingredients, especially the cannabinoids, which are unique to marijuana, but including also a wide range of terpenoids and f l a v o n o i d s (McPartland and Mediavilla 2001; McPartland and Pruitt 1999). The concentration and relative proportions of these ingredients depend on the plant’s genetic structure and applied hybridization tech- niques, and as such, allow for a substantially varied outcome.
Origin & Development of Strains
In this discussion of marijuana or cannabis we must articulate the origin of the plant. There exists some consensus that the genus is comprised of a single highly variable species, Cannabis sativa, and is easily adaptive throughout the world. It is considered by some researchers that the sub-species indica is actually a separate species (e.g., R. Clarke 1998). For purposes of discussion here we will divide the species into C. sativa, generally grown in northern latitudes and C. indica grown further south. It is noted that C. indica is cultivated for its psychoactive resin production and C. sativa, until modern times, mainly for fiber. The differentiation between the species is often characterized by physical distinctions; C. sativa exhibits taller growth, increased distance between nodes, long, thin, fingerlike leaf structure and an extended life cycle, 6- 9 months. C. indica is shorter in stature, with less distance between nodes, a wide leaf structure, and less time to maturation, 4-6 months. Marijuana produces three types of resin-(cannabinoid)- producing trichomes; small bulbous, capitate sessile, and capitate stalked. The highest levels of cannabinoids occur in the capitate stalked trichomes produced only by the female flowers. It is logical therefore, to attempt to breed plants that express more flowers and fewer leaves.
We began experimenting with marijuana cultivation in 1974. In the ensuing years we developed 32 strains. Of these we have chosen to focus on the cultivation of four particular strains: C. sativa, C. indica and two hybrids. We have traced our C. sativa to Eastern Malawi. We call her the African Queen (AF). This was initially selected for rapid growth, high yield and aromatic qualities. Our C. indica, named Purple Indica (PI), originated in Afghanistan. The qualities most noted include early flowering, significant production of resin, and a superior flower to leaf ratio. Utilizing these two distinct strains, as well as hybrids of both, has resulted in significant variation. Our method of cultivation was inspired by the wisdom of Luther Burbank, mentor to many a homespun gardener. We planted hundreds of seedlings and selected, from those, a few of the highest quality from each variety.
Distinction Between Strains
Observing the evidence provided by the test articles, we selected the varieties according to reported successful use by our collective. In 1998 a revised protocol was developed in which patients receive a one- week supply of cannabis without knowledge of the particular variety provided. Patients complete forms on a weekly basis. This blinding method confirms distinctions between C. sativa and C. indica. Results have implications for subsequent crossbreeding of strains to maximize therapeutic effects.
Each variety exhibited distinct effects on the symptoms of our mostly terminally ill membership. At the time these instruments were analyzed, our patient base (some with multiple diagnoses) consisted of the following:
- HIV/ AIDS 141 patients (48 HIV / 93 AIDS)
- Cancer 57 patients
- Neurological Disorders 7 patients
- MS 13 patients
- Epilepsy/ Seizure Disorder 13 patients
- Paraplegia/ Quadriplegia 11 patients
- Spinal Stenosis/ Nerve Injury 13 patients
Cannabis inhalation methods consisted mostly of smoking, with some use of vaporization, although patient reports of effectiveness appear substantially lessened when this technique was employed. This could certainly depend on the quality of the vaporizer design. Inhaled marijuana is uniformly effective in relieving symptoms across a wide range of diagnostic categories. Two symptoms, spasm and nausea, showed preferential improvement with smoking as compared to ingestion.
Initially, we observed that C. indica provided increased energy and improved appetite. The hybrid C. indica x C. sativa (PIxAF) shows a similar quality to that of C. indica (PI) in stimulating appetite. C. sativa and its hybrid AFxPI are less effective in stimulating appetite. In treating nausea in HIV/AIDS & orthopedic diagnosis groups, C. sativa and C. indica strains prove equivalent.
C. indica proved to significantly reduce discomfort in patients experiencing pain. Upon analysis of blinded therapeutic cannabis exposures, coupled with long-term observation, results indicate that the contributing factor of pain relief itself was largely responsible for reported increased energy.
When patients are exposed to the pure bred C. sativa (African Queen), or the hybrid C. sativa x C. indica (AFxPI), a significant increase in energy, not linked to the relief of pain, is contrasted to the lethargy and somnambulance reported by pain-free patients using C. indica.
Interestingly, we have found that the intraocular pressure of glaucoma can best be reduced with continuous use of low quality C. sativa throughout the day.
For more detail refer to http://www.marijuana-research.org/
WAMM’s ingested forms of cannabis consist of capsules (two grades), “mother’s milk” (a soymilk-based liquid), baked goods, and a whole cannabis tincture made from pure grain alcohol with leaf or a homogenized blend of leaf and flowers.
C. indica and C. sativa are employed in the preparation of these products. Consistency is maintained from year to year throughout production. Our blend of leaf and flowers is added to butter and cooked at about 150ºF for four hours. The mixture is cooled and put into capsules. Patients report that this alternative means of ingestion induces sleep and interrupts acute pain. Users of our tincture report relief of neuropathic pain in extremities, including reduction in joint ache symptomology.
A topical solution (Rub-a-Dub) is prepared by soaking the unusable parts of the plant in Isopropyl alcohol for 6-12 months and is administered by spraying on the skin. This liniment relieves the pain of arthritis and non-weeping shingles (Herpes Zoster).
Because the therapeutic effects of cannabis are sometimes ascribed to its mood- altering properties, we also performed a correlation analysis of the change in mood score with other outcome variables. Energy level was the only variable to show a significant correlation with mood. Mood was not correlated with any other outcomes, including pain relief. It appeared that mood was often independent of symptom expression. However written testimony by patients in their surveys indicated that they believe that changes in awareness or consciousness do affect overall healing.
Of all the symptoms that are touched by medical marijuana, perhaps the most profound effect reported by patients facing death has been described as a “shift in consciousness”… “a door opening to an alter- native reality”. Sitting at the deathbed of countless friends, it seems there is no more important “side-effect” than this ability to change awareness. On several occasions, terminally ill patients have remarked on this recurrent phenomenon which allows them to approach their impending death more “openly” or in a more “relaxed” manner. This is of particular interest, as each patient also reported a reduction in anxiety often associated with the dying process.
Patients come to WAMM seeking marijuana. They soon recognize something in one another, something simpatico. This provides insight for us to both meet our own needs and to see beyond them, by revealing the importance in serving others. We work together to provide for our whole collective. Patients and our caregivers work in our garden, our office, making medicines, at our weekly meetings and at each other’s bedsides. These plants have inspired the creation of a community for people who might otherwise be disenfranchised by illness. Since our inception in 1993 more than 150 WAMM members have died. Each life touches us in profound ways. We recognize that we are assisting each other on a journey that we all travel.
And while our hearts sometimes break, they are made richer with every turn of the soil, with every meeting of a new friend, with each day that brings us closer to the realization that our struggle for access to medical choice is also a struggle for liberty.
To contact us visit our website www.wamm.org.
To send donations or for information about our ongoing legal battle & updates & to purchase our grow video Cannabis Cultivation Outdoors; A 12-Step Guide For Growing Medical Marijuana Join us for our 3rd ANNUAL WAMMfest Celebration September 10, 2005 in Santa Cruz, CA.
1. Dr. Rafael Mechoulam, Mavericks of Medicine. D.J. Brown, 2005
Valerie Leveroni Corral founded the Wo/Men’s Alliance for Medical Marijuana, WAMM in 1993. WAMM is a collective of patients and caregivers attempting to create community, build hope, dissolve barriers, and provide support and medical marijuana at no cost to patient members who possess a signed and verified recommendation from a physician licensed to practice medicine in California. A genetically monitored, organic, communal garden is tended by WAMM clients / participants under the direction of Mike Corral and Valerie A. Leveroni Corral.