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Handbook of Cannabis Therapeutics: From Bench to Bedside

Handbook of Cannabis Therapeutics: From Bench to Bedside, Ethan Russo and Franjo Grotenhermen (eds). New York: The Haworth Press; 2006. Paperback; 471 pages. ISBN-13: 978-0-7890-3097-9. $39.95. Hardcover; ISBN 13: 978-0-7890-3097-2. $69.95

Between 2001 and 2004, under Russo's editorship, Haworth Press published the Journal of Cannabis Therapeutics: Studies in Endog-enous, Herbal, and Synthetic Cannabinoids, the journal of the International Association for Cannabis as Medicine. The journal's publica-tion coincided with increased international interest in, and research on, the compounds found in cannabis (a.k.a. marijuana, hemp, ma, ganja, dagga, and many other names, in many languages; Cannabis spp. of the family Cannabaceae). Now-defunct, the journal provided a venue for scholarly peer-reviewed articles created by authors of many disciplines worldwide on a plant long neglected under withering political prohibition in the United States, and most everywhere else.

This book is an anthology of 20 key journal articles, organized into 5 sections: historical notes on cannabis' therapeutic uses, the herb's pharmacology and pharmacokinetics, endocannabinoids and cannabinoid receptors, demonstrated medical uses of cannabis, and side effects. The editors have updated 16 articles with brief reports on findings since 2004, demonstrating that cannabis research continues to progress, with new articles now seen regularly in less specialized publications. Russo, a neurologist-perhaps the best-known and prolific writer and lecturer on medicinal cannabis today-provides 15 updates in addition to authoring or contributing to 5 chapters. Groten-hermen-whose many works on therapeutic uses, pharmacology, and toxicology of cannabis and cannabinoids have mostly appeared in German-updates his own chapter on cannabinoids' clinical pharmacodynamics in 1 of the 2 chapters he contributes to this book.

Following a brief foreword by pre-eminent Israeli researcher, Rapahael Mechoulam, in which cannabis' current position is elegantly summarized, the handbook opens with a piece by Indalecio Lozano (affiliated with the University of Granada in Spain) on therapeutic uses of cannabis known to classical era Arab physicians. All of the uses subsequently investigated have been found to have some eviden-tiary basis, while others remain uninvestigated. Additionally, none of the seventh century CE and later Arabic uses seem unreasonable in terms of what is known today of cannabis' attributes. For example, Arab sources describe using crushed hempseeds to dry excess moisture in the ear. While translated instructions at such a temporal distance are not always clear, hempseed oil, rich with essential fatty acids, seems as likely a topical remedy for swimmer's ear as others, although no one has yet reported studying this application.

The book contains very detailed, substantive articles on use of cannabis to counter debilitating effects of multiple sclerosis in women; treat addiction to crack cocaine (from coca, Erythroxylum perveilli, Erythroxylaceae); and stimulate the appetite after cancer chemo-therapy, in hyperemesis gravidarum, and in individuals with HIV and AIDS. However, the title is still a bit wishful, partially because all of the articles together make it clear that the true scope of cannabis' therapeutic potential has barely been sketched. Until cannabis research is brought completely out of the political shadows and no longer limited to a few select institutions in the United States, canna-bis medications are unlikely to be at the bedsides of the patients it would benefit. Still, this book should be in clinicians' libraries and studied for its glimpses of the therapeutic possibilities of this extraordinarily versatile and infinitely variable plant, as well as the natural and synthetic compounds which may be derived from it.

This handbook also places a refreshing emphasis, wherever appropriate, on problems affecting women's health. As is evident in many chapters, marijuana folk medicine has played a central role for centuries worldwide in women's unique health concerns, from menstrual cramps to menopausal mood swings. Patent medicines made with cannabis, before their prohibition in the United States in 1937, were often used for women's problems, including post-partum depression and “hysteria.” The ban on marijuana medicine, not inconsequently, has removed a valuable substance from women's common knowledge and use in childbirth and nursing, as well as in other events. Simul-taneously, conventional medicine seemed to become impatient with such matters, deeming them of little consequence unless severe enough to require vigorous medical measures.

In addition to being an informational resource, including an extensive index and well-prepared references, tables, and figures in each chapter, this handbook is, editorially, an unabashed work of advocacy. Grotenhermen, in his introduction, credits medical patients around the world for putting cannabis back on the scientific agenda through courageous activism. Some of these patients-a tiny group of American long-time legal medical cannabis users-are discussed in the book's final chapter.

Chapters such as Russo's wide-ranging vision of the future of cannabis and cannabinoid therapeutics, Ester Fride's chapter on the role of endocannabinoids as a nursing-trigger for infants, and nurse Mary Lynn Mathre's compassionate discussion of harm reduction, begin to clarify the handbook's agenda, which points toward specific research needs. Every chapter contains food for thought, although the potential health effects of hempseed as food are unmentioned, except rather misleadingly in one purely historical piece: an inconclusive linguistic examination of a brief mention of hempseed by an 11th century CE Byzantine physician. As for the essential fatty acids, as well as protein and other nutrients in hempseed, a dearth of relevant research may be laid at the doorstep of American economic poli-cies. Still, it is unfortunate the handbook doesn't include an article on hempseed's potential contributions to health through dietary consumption.

More exciting than many reference works, Handbook of Cannabis Therapeutics leaves one anticipating rapid advances on many fronts in cannabis research such as England, Canada, Israel, and Germany, if not in the United States. Fortunately, pain relief, appetite, addic-tion, and anti-spasticity and anticonvulsant action are just a few areas where research is well-launched. Although this handbook alone cannot fill the regrettable lack of a journal devoted specifically to cannabis, its overall presentation is handsome, conveniently sized, well-organized, and very readable.

-Mariann Garner-Wizard HerbClip Writer Austin, Texas