Last night, as part of the ongoing "AC 360" series on marijuana, Dr. Sanjay Gupta weighed in on marijuana's medical benefits and health risks. The transcript of the show is here (scroll down about 2/3 through the page to get to Dr. Gupta).

It's no secret that we haven't always been thrilled by CNN's coverage, but Gupta -- given time constraints that inevitably truncated his answers a bit -- gave a balanced, accurate assessment of the science of marijuana that was remarkably solid, much more so than one usually sees on TV. Among other things, Gupta explained about the cannabinoid receptors in the human brain and noted:

For example, someone who's having terrible malnourishment or terrible nausea as a result of chemotherapy or the effect of HIV/AIDS, using marijuana could stimulate appetite.

 Neuropathic pain, Anderson, something I deal with quite a bit as a neurosurgeon. It's that lancinating nerve pain that's often caused by trauma or some sort of injury or surgery. Sometimes it can be very refractive to pain medications. Marijuana can help there, as well.

Multiple sclerosis, something else that I treat. That's something that can cause significant tremors, for example. Marijuana can help.

Gupta did discuss pulmonary risks of smoking and the possibility of dependence, but in a factual, non-hysterical way that made it clear that dependence rates for marijuana are far lower than for other drugs, including alcohol.

There were rumors for a while that Dr. Gupta might be appointed U.S. Surgeon General. I'm starting to wish he'd gotten the job.

P.S. It does appear that I'll be on CNBC tonight, around 8:45 p.m. Eastern time, though as of this writing it's unclear who, if anyone, I'll be debating and how broad the discussion will be.

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On Thursday night's edition of "Anderson Cooper 360," former drug czar John Walters and I were interviewed separately about a new government report claiming an increase in average potency of marijuana seized by law enforcement (we'll have a video link posted soon). I pointed out an obvious fact: When the marijuana is more potent, users smoke less, just as people typically drink a much smaller quantity of bourbon than of beer. Thus, higher-potency marijuana doesn't necessarily mean users take in more THC. And, given that the most significant health issue connected to marijuana is the respiratory harm from smoke, smoking less to get the same effect is clearly healthier.

Asked about this, Walters said flatly, "There is no evidence of that."

He lied. I know this won't be a huge shock to faithful readers of this blog, but I think it's worth putting the facts on the record.

In a study titled "Vaporization as a Smokeless Cannabis Delivery System: A Pilot Study," published in May 2007 by the journal Clinical Pharmacology and Therapeutics, University of California researchers looked at smoking and vaporization using marijuana of 1.7%, 3.4% and 6.8% THC. Because the idea of the study was to compare smoking and vaporization, participants were guided through a standardized puff procedure.

Although the high-strength marijuana was four times as potent as the weakest, it produced a peak plasma THC level only about 20% higher, smoked or vaporized. This, the researchers wrote, suggests that either less is absorbed at the higher potency levels or  there is "self-titration of THC intake," meaning that "smokers adapt their smoking behavior to obtain desired levels of THC." Among the evidence for self-titration, researchers found that their subjects tended "to take more puffs at lower THC concentrations" -- despite having been given a fairly regimented smoking procedure to follow. Similarly, the subjective "high" reported by participants was only modestly more intense at 6.8% THC than at 1.7%.

Prohibitionists are entitled to their own opinions. They aren't entitled to invent their own facts.

One final note: I was disappointed that perhaps the most important thing I said to the interviewer didn't get on the air. If potency is a concern, there is an obvious solution: Regulate marijuana as we do alcoholic beverages, and require the cannabinoid levels to be listed on the label. If consumers know what they're getting -- as they do now with beer, wine, or Bacardi 151 -- they can adjust their behavior to avoid unpleasant surprises.

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MPP's Bruce Mirken will appear on CNN's "Anderson Cooper 360" tonight to add a little rationality to the latest pronouncement regarding rising THC levels in marijuana from the National Institute on Drug Abuse-funded Marijuana Potency Project.

Drug warriors love to exaggerate small increases in marijuana potency over time and make vague proclamations linking those increases to increases in marijuana's potential danger, even though no credible research supports such a connection. Of course, if they were truly concerned about the potential danger of higher potency marijuana, then they should favor regulating the drug and requiring manufacturers to label the product's potency, just as we do with alcohol.

The show is scheduled to air tonight at 10 p.m. EST, but the hysteria surrounding one of the drug warriors' favorite imaginary fears is sure to last much longer.

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Last November, I mentioned here that I'd undergone treatment for prostate cancer  -- implantation of 85 tiny, radioactive seeds designed to zap the tumor before it zaps me. I'm happy to report that, six months later, it seems to have worked, according to the latest lab tests. Though the risk of recurrence never goes away entirely, I'm as close as one can be to being an official cancer survivor.

Endless thanks to all who sent kind thoughts. And since someone is bound to ask: No, I didn't ever need medical marijuana. My treatment was happily quite low-impact: no chemo, no nausea, no hair loss, etc. I almost feel like I should refer to it as Cancer Lite, it was so comparatively easy. 

But the point I made last November still remains. If I had needed medical marijuana, that decision should have been between me and my doctor. Cops and politicians have no place in medical treatment decisions.

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In what turns out, sadly, to be the last episode of CNN's "D.L. Hughley Breaks the News," aired Mar. 28 and 29, D.L. devoted a large block of the show to proposals to make marijuana a legally regulated and taxed product for adult consumption. The first segment included an interview with yours truly, followed by Ronald Brooks of the Narcotic Officers Associations Coalition, who wants to keep arresting and jailing marijuana users.

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Something is stirring in the U.S. news media that I was beginning to think I'd never see: In last two or three months, a complete rethinking of our marijuana laws has become a legitimate issue in the eyes of the mainstream media -- something it hasn't been for a long time.

To illustrate how big this is, let me take you back to early 2002, shortly after I started as MPP's communications director. The first time I ever called CNN to try to pitch them a story on marijuana policy, it went like this:

I said, "Hello, this is Bruce Mirken from the Marijuana Policy Project --" and the woman who answered the phone burst out laughing. She had to put me on hold for a minute to compose herself. When she came back on the line, she said, "Okay Mr. Marijuana, what can I do for you?" While this was not the actual producer I was trying to reach, she was the one you had to get through in order to speak to that person. And I never got through. 

Things have changed. 

Earlier this month, CNN called me to set up an interview with D.L. Hughley about marijuana prohibition. That interview is currently set to air this weekend on what turns out to be the final episode of "D.L. Hughley Breaks the News," which airs on Saturdays at 10 p.m. Eastern and 7 p.m. Pacific and repeats on Sunday (though TV news schedules have a way of changing at the last minute). This comes on the heels of appearances by MPP executive director Rob Kampia and myself on CNBC, MSNBC and Fox News, among others.

Meanwhile, columns and editorials questioning prohibition seem to be nearly everywhere in recent weeks, including the Providence Journal, CNN's Web site, the Pittsburgh Post-Gazette , Chicago Sun-Times, Los Angeles Times and many other outlets.

What was once dismissed as a fringe issue is suddenly mainstream. 

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"If something is not legal, you can't regulate it very effectively."

            -- Prof. Robin Room, School of Population Health, University of Melbourne

On October 2, the Global Cannabis Commission, a group of top scientists commissioned by the Beckley Foundation, issued its groundbreaking report, "Cannabis Policy: Moving Beyond Stalemate." Your faithful correspondent was able to attend the daylong seminar in which the report was discussed, held in the distinctly imposing Moses Room of the House of Lords in the Palace of Westminster.

This is a highly condensed summary of the 175-page report. I wrote a lengthier summary here, and the full document can be downloaded here.

The report was written by five leading marijuana and drug policy researchers: Benedikt Fischer of Simon Fraser University in Vancouver, Peter Reuter of the University of Maryland, and three Australians: Wayne Hall of the University of Queensland, Simon Lenton of the National Drug Research Institute at the Curtin University of Technology, and Robin Room of the University of Melbourne. A number of other important researchers joined the discussion (and contributed advice and research to the report).

Some highlights:

RISKS ASSOCIATED WITH MARIJUANA USE:

Marijuana is not harmless. Intoxication "increases the risk of motor vehicle crashes 2-3 times" -- not trivial, but "far more modest than that of alcohol." There is clearly an increased risk of bronchitis among heavy marijuana smokers, but no evidence of increased rates of emphysema, while the evidence regarding lung cancer is mixed, the report states.

Marijuana almost certainly exacerbates symptoms of schizophrenia in vulnerable individuals, but epidemiologic evidence argues against it causing psychosis in healthy people. As for worries about increased potency, more research is needed. If users adjust their intake in relation to potency, dangers are minimal. Perhaps most important, "All of these trends [toward increased potency] have been encouraged by prohibition, which favors the production of more concentrated forms."

Overall, the report finds the risks of marijuana use are "modest" compared with those of legal drugs like alcohol and tobacco. 

POLICY AND REFORM:

While causing obvious harm to those arrested and convicted, criminalization of marijuana possession has not succeeded in preventing marijuana from being widely available. Contrary to wild claims being made in Massachusetts right now, decriminalization measures have not increased use rates. "If a nation chooses to use the criminal law for controlling cannabis use, there is no justification for incarcerating an individual for a cannabis possession or use offense, nor for creating a criminal conviction," the report concludes.

While not firmly advocating one policy alternative, the report lays out many advantages to a system of legal regulation like that used for alcohol. As report co-author Prof. Robin Room noted succinctly, "If something is not legal, you can't regulate it very effectively."

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Every year around this time,  Project Censored recognizes the 25 "most censored" news stories from the prior year -- stories of great public significance that got little or no attention from the mass media. This year, they've honored MPP and NORML's Paul Armentano for pointing out the alarming rise in marijuana arrests.

Since The Project Censored materials were written, the latest FBI Uniform Crime Reports survey has been released, showing yet another marijuana arrest record.

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A systematic review and accompanying commentary in the June 17 issue of CMAJ, the medical journal published by the Canadian Medical Association, look at the side effects of cannabinoid medications. The results are generally reassuring.

Researchers reviewed published studies of various cannabinoid preparations, including Marinol, the THC pill, and Sativex, a marijuana-based oral spray (but not, unfortunately, smoked or vaporized whole marijuana). They found no increase in serious or life-threatening reactions to the drugs as compared to placebo. The less serious side effects that did occur were just what you'd expect -- dizziness, for example. But the commentators expressed concern over the relative lack of data on smoked marijuana and on long-term use of other cannabinoids.

We could have such data if the U.S. government wanted us to. The Feds have been giving medical marijuana to a small number of patients for over 30 years in a program closed to new enrollment in 1992, but have never published any data on these patients, of whom only four now survive. And back in 1999 the Institute of Medicine raised the possibility of doing "n-of-1 studies" (for example, by reopening that closed federal program) in order to collect data while allowing access to medical marijuana for patients in great need. The suggestion was ignored.

Once again, our government is doing everything it can to avoid knowing that medical marijuana is safe and effective.

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The other day I had a lengthy discussion with two producers at a national TV network. It was an unnerving lesson in what we're up against as we try to educate the mainstream media.

The network had just broadcast a completely uncritical story on a report from a private think tank that serves as a drug war cheerleader. It had reported completely preposterous claims about supposed dangers of increased marijuana potency causing lung cancer or sending thousands to emergency rooms as if they were undisputed fact. I'd called to complain, and to their credit the producers called back.

Also to their credit, they asked tough questions about the points I was making. I want reporters to do that, as I never make statements to journalists that I can't back up with published scientific evidence. And I do think the discussion made some progress (which is why I'm not naming names). But it also became clear that they never applied the same level of skepticism to claims made by prohibitionists. 

As we discussed the evidence that marijuana smokers don't have higher lung cancer rates and that THC and other cannabinoids have documented anti-cancer activity, I mentioned that the 1999 Institute of Medicine report stated that marijuana has not been proven to cause any type of cancer. "But that was 1999," one of the producers said. "With the increased potency now, it's a whole different drug!" 

She had no idea she'd just repeated a completely fictional White House talking point as if it were revealed truth. 

I patiently explained that the notion that the claimed doubling of THC levels makes today's marijuana "a whole different drug" makes no more sense than to claim that wine is a different drug than beer because it contains about three times the alcohol -- a notion no one would take seriously. I also noted that higher potency would decrease any lung cancer risk, because users would get more THC (which fights cancer) with less smoke, and it's the smoke that contains any potentially carcinogenic compounds. 

The producers believed they had done due diligence in researching the think tank's claims: "We checked them with the National Institute on Drug Abuse." The idea that a government agency that has long been an integral part of the drug war might not be a completely impartial source regarding marijuana had not occurred to them.

They listened to me. I think they heard. I hope they understood.

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