That alcohol causes cancer isn’t really news, but how it does so hasn’t been fully understood. A new study, published in the journal Alcoholism: Clinical and Experimental Research, adds an important new piece of information. Alcohol, it turns out, stimulates a type of cell transformation that turns cancer cells more aggressive and thus more likely to spread throughout the body.

As we’ve noted before, research shows that cannabinoids (marijuana’s unique, active components) interfere with tumor growth and may actually prevent cancer.

Anyone who wants to learn about these other cannabinoids should check out this recent review published in the journal Trends in Pharmacological Sciences.

The article devotes a lot of space to cannabidiol (CBD), the most studied of these compounds, noting that “CBD exerts several positive pharmacological effects that make it a highly attractive therapeutic entity in inflammation, diabetes, cancer and affective or neurodegenerative diseases.” Notably, CBD has antipsychotic actions, but fewer side effects than “typical antipsychotics.” Lots of other cannabinoids have potentially useful properties as well. For example, cannabichromene has antimicrobial and anti-inflammatory activity, plus “modest” analgesic effect.

The article tends to be a bit dismissive of THC because of its psychoactivity, and focuses mainly on cannabinoids as individual chemicals rather than as components of an herbal medicine that has proven extraordinarily useful in its natural form (biases that are pretty much typical in the medical literature), but even with these limitations, it’s an important read.

Okay, let me say right up front that a) I know that headline is provocative, and b) neither I nor anyone can answer the question with any certainty given what we know and don’t know so far about Michael Jackson’s death. But the question needs to be asked.

It needs to be asked because suspicions that prescription painkillers may have been involved in Jackson’s death are strong enough that the federal Drug Enforcement Administration has been brought into the investigation. And we know that he had a documented history of battling pain and at least some acknowledged problems with prescription painkillers.

We don’t know yet what pain drugs Jackson was on or what they were prescribed for. But if he was addicted to prescription painkillers, that addiction almost certainly started with legitimate and needed treatment for real pain. And that’s where medical marijuana might have helped.

We know — repeat, we know — that marijuana can be effective against certain types of pain. As The Lancet Neurology put it a few years ago, “cannabinoids inhibit pain in virtually every experimental pain paradigm.” We know that human clinical trials such as this one have found marijuana to be effective, particularly for neuropathic pain.

And there is considerable evidence that marijuana and cannabinoids can act synergistically with opioid painkillers, providing better pain relief at lower doses than either class of drugs by itself. For example animal studies such as this one have reported that such combination therapy avoids the development of tolerance and allows effective relief with lowered opioid doses — avoiding the pattern of escalating doses that can lead to addiction and overdose risk.

And there is evidence that this same effect occurs in people. For example, in a series of cases reported in the Journal of Pain and Symptom Management (which, alas, you can only access by paying for it — sorry!), patients on morphine and other narcotics were able to cut their doses roughly in half when smoked marijuana was added to their regimen.

At MPP, we hear similar stories from patients all the time: Again and again, patients tell us that use of medical marijuana allows them to cut back or eliminate the heavy doses of narcotic painkillers they’d been taking, while obtaining equal or better relief. There is enough science corroborating these accounts that they deserve to be taken seriously.

We can’t yet say that medical marijuana could have saved Michael Jackson, and we may never know that for sure. But there is simply no reasonable doubt that marijuana can help some chronic pain patients reduce both their suffering and their consumption of addictive and potentially deadly narcotics. If the U.S. government acknowledged that reality instead of denying it, lives could be saved — maybe lots of them.

The surprising finding that THC might help at least a small percentage of schizophrenia patients for whom conventional treatments have failed was reported in the June issue of the Journal of Clinical Psychopharmacology. 

This is surprising because, as the British government’s Advisory Council on the Misuse of Drugs reported last year, “there is clear evidence that the use of cannabis may worsen the symptoms of schizophrenia and lead to relapse.” The ACMD — a far more objective body than any U.S. government outfit remotely connected to drug policy — did not consider marijuana to be a significant cause of psychosis in otherwise healthy people; its report reflects a broad consensus that marijuana (and specifically THC) can worsen the prognosis of schizophrenics or those with a genetic vulnerability to schizophrenia.

But doctors at the Rockland Psychiatric Center in Orangeburg, New York, reviewing the records of one severely ill patient — a man who was “grossly psychotic, assaultive, disorganized” and not responding to conventional treatment — noticed that he had a history of “calm behavior when he was using marijuana.” So as an experiment, they prescribed THC capsules (dronabinol, brand name Marinol). “Remarkably,” they write, “he became calm, logical, nonviolent, and cooperative within days and was discharged within weeks.” 

They then tried the same thing with five other patients with a similar history — unresponsive to conventional treatments but showing some signs of improvement when they smoked marijuana. Three of these “improved to a clinically significant extent,” one showed no significant change, and one got somewhat worse. That’s a remarkable level of success in chronically ill patients for whom conventional antipsychotic drugs had failed, “in which success with any intervention might be unlikely.”

The article goes on to lay out some possible explanations, but at this point no one knows for sure why this small group of psychotic patients had an anomalous and positive reaction to THC. What is clear is that the relationship of cannabinoids to schizophrenia is more complex and variable than even many experts — much less anti-marijuana propagandists – have acknowledged.

The good news is that this study got a decent amount of media attention. The bad news is that much of the coverage lacked context or presented information in a confusing or misleading way. Case in point: the April 1 story from the Reuters wire service.

Reuters reporter Michael Kahn presents the finding as if it were something brand new, failing to note the extensive evidence accumulated since the 1970s that cannabinoids fight various types of tumors. It reports that “studies have suggested” that marijuana may cause cancer, omitting the fact that the largest, most well-controlled studies have found precisely the opposite.

And finally, in a warning of possible risks of cannabinoid drugs, the article hopelessly jumbles cannabinoids — drugs like THC and its plant and synthetic cousins — with drugs designed to block the CB1 receptor through which these substances operate, mistakenly referring to these CB1-blocking drugs as cannabinoids. In fact, they’re more like anti-cannabinoids, and if anything the harmful effects of these CB1 blockers (increased rates of depression and anxiety, for example) reaffirm that cannabinoids often have good and helpful effects.

The journal Clinical EEG and Neuroscience has just published a review of the data on the effects of substance use on the developing brains of adolescents. The unmistakable conclusion: While heavy substance use of any kind is a really bad idea for teens, the damaging effects of alcohol are clearly worse than marijuana. The researchers write:

Abnormalities have been seen in brain structure volume, white matter quality, and activation to cognitive tasks, even in youth with as little as 1-2 years of heavy drinking and consumption levels of 20 drinks per month, especially if >4-5 drinks are consumed on a single occasion. Heavy marijuana users show some subtle anomalies too, but generally not the same degree of divergence from demographically similar non-using adolescents.

Strikingly, in a couple of studies, the damaging effects of binge drinking were less if the drinker also used marijuana, suggesting — though not proving — a possible protective effect in some circumstances. That’s actually no shock, as the U.S. government holds a patent  on cannabinoids — marijuana’s unique, active components — as neuroprotectants (substances that protect nerve and brain cells from damage).

People suffering from Parkinson’s disease have a high rate of psychosis, which may be induced or worsened by drugs used to treat the illness. A recently published study in the Journal of Psychopharmacology suggests that a marijuana component called cannabidiol (CBD) may be a helpful treatment for this condition.

This was a small, uncontrolled pilot study, but CBD produced rapid and fairly dramatic reductions in psychotic symptoms. And the growing body of evidence regarding CBD’s anti-psychotic properties has important implications beyond Parkinson’s patients. For example, there is some evidence that THC can worsen psychotic symptoms, but at least one study has implied that CBD, if present in sufficient quantities, can counter this effect. 

It’s been known for a while that some cannabinoids, the active components in marijuana, have antibacterial properties (one of many useful facts you won’t find on ONDCP’s Web site). Now, as noted by stories in the New York Times and Web MD, five cannabinoids, including THC, have been shown to be active against a particularly worrisome form of staph infection that’s resistant to conventional antibiotics. It took these major media outlets a while to catch up with the study, published August 6 in the Journal of Natural Products, but at least they covered it. 

A new article in the European Journal of Cancer Care answers medical marijuana opponents who claim that cancer patients don’t need marijuana to relieve the nausea and vomiting from chemotherapy. Opponents claim that while studies in the past showed THC to be roughly comparable to other anti-nausea drugs, it wasn’t substantially better. Since those studies, they argue, better anti-nausea drugs have come into use, making medical marijuana irrelevant. In any case, they add, THC is available in pill form as Marinol.

Researchers at the University of Sao Paulo conducted a systematic review of studies of cannabinoid drugs for relief of chemo-induced nausea. Alas, the studies all involved oral THC or other cannabinoids, not whole marijuana, so the pill-vs.-plant issue isn’t addressed, but many of the other distortions put out by opponents are firmly debunked.

First, the analysis found clear advantages for cannabinoids over the other tested. In some cases there were statistically significant differences in efficacy, and with amazing consistency, patients preferred the cannabinoids.

Most important, the Sao Paulo researchers demolish the claim that we don’t need marijuana because we  now have better anti-nausea drugs. They note that these newer drugs still fail some patients, and “this cannot be corrected by an increase in dosage or frequency of administration,” adding that when the nausea hits a day or more after chemo treatment, the “gold standard” drug combination “rarely obtains 50% of the desired effect.”

And the coup de grace: “Cannabinoids seem to act through different mechanisms [than standard drugs] and can be effective for people who respond in an unsatisfactory way to the antiemetic drugs used today.”

That’s what some of us have been saying for years.