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Autumn 2005
O'Shaughnessy's
Journal of the California Cannabis Research Medical Group

JAMA Acknowledgest The Endocannabinoid System ("ECS")

Just as the marketing of Prozac by Eli Lilly familiarized the public with “clinical depression” and “selective serotonin reuptake inhibitors” (SSRIs), so the marketing of Rimonabant as a weight-loss drug by Sanofi Aventis will educate millions about the endocannabinoid system (ECS).

This was foreseen by Philip Denney, MD, who forwards, as part of the mounting evidence, a full-spread advertisement placed by Sanofi Aventis in the Sept. 21, 2005 issue of JAMA, the Journal of the American Medical Association. Denney and others remain skeptical about the longterm safety profile of a synthetic “cannabinoid-antagonist” drug that works by blocking the natural receptor system.

The JAMA ad touts “A NEWLY DISCOVERED PHYSIOLOGICAL SYSTEM... The Endocannabinoid System (ECS).” It succinctly explains the role the ECS appears to play in “metabolic syndrome,” the condition for which Sanofi Aventis hopes to get FDA approval to market Rimonabant. Footnotes direct interested physicians to papers from reputable sources.

The significance of this carefully documented ad in such a prestigious journal is huge. It seems like only yesterday that the Drug Czar was ridiculing Tod Mikuriya as a practitioner of “Cheech and Chong medicine.” Now, plainly stated in JAMA by the world’s third-largest pharmaceutical company, is the biological basis for how marijuana affects so many systems within the body.

The text is faint and blurry. The left-hand page depicts an endocannabinoid floating like a stylized shark over a cell membrane from which cannabinoid receptors protrude like plugs in a distributor cap. Accompanying text asserts, “CB1-receptor activation triggers a cascade of intracellular events that impact cardiometabolic risk.”

Metabolic syndrome is defined on the right-hand page as a cluster of risk factors: decreased “good” cholesterol; elevated blood pressure, trigycerides and glucose levels; and a widening waistline. Adipose tissue is defined as “a metabolically active endocrine organ —more than just a storage facility for fat, it has metabolic effects.”

The endocannabinoid system “impacts metabolic functions” and “consists of signaling molecules and their receptors, including the cannabinoid receptors (CB1 and CB2). The CB1 receptors “may impact lipid levels and insulin sensitivity.” They are “located centrally in the brain and peripherally in liver, muscle and adipose tissue. ECS overactivity in adipose tissue is associated with decreases in the hormone adiponectiun, which may be linked to dylipidemia, insulin resistance, and intra-abdominal adiposity.”

Additionally, CB1 receptors are “at the center of a cascade of events with potential impact on cardiometabolic risk.” And they “May assist in regulating physiologic processes, e.g., lipid and glucose metabolism.”

O'Shaughnessy's
O'Shaughnessy's is the journal of the CCRMG/SCC. Our primary goals are the same as the stated goals of any reputable scientific publication: to bring out findings that are accurate, duplicable, and useful to the community at large. But in order to do this, we have to pursue parallel goals such as removing the impediments to clinical research created by Prohibition, and educating our colleagues, co-workers and patients as we educate ourselves about the medical uses of cannabis.
 
SCC
The Society of Cannabis Clinicians (SCC) was formed in the Autumn of 2004 by the member physicians of CCRMG to aid in the promulgation of voluntary standards for clinicians engaged in the recommendation and approval of cannabis under California law (HSC §11362.5).

As the collaborative effort continues to move closer to issueing guidelines, this site serves as a public venue for airing and discussing these guidelines.

Visit the SCC Site for more information.