
Journal
of Cannabis Therapeutics: A Requiem by
Ethan Russo
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It is with great regret, but
sense of pride, that we now “close the book” on this journal and
allow it to stand on its previous offerings. This represents a decision
that has been very difficult, but considered after extensive
consultation with numerous Editorial Board members. I would like to
outline the issues we have faced, the background of this decision, and
review the accomplishments of the journal in its history. A
History of Our Goals
The Journal
of Cannabis Therapeutics began as an idea advanced by Lester
Grinspoon upon our first meeting in Washington, DC in November 1998. I
immediately saw the logic of his concept: a place to publish the
emerging abundance of information about clinical cannabis, the newly
discovered endocannabinoid system that modulates so many vital
physiological functions, as well as explore the clinical potential of
synthetic cannabinoids. We envisioned a publication that would highlight
the developing science, and hopefully serve as an educational resource
for physicians and scientists, as well as interested members of the lay
public.
I seized upon Lester’s idea, and advanced it to my friend,
mentor and editor of the Haworth Herbal Press, the late Dr. Varro (Tip)
Tyler, who paid it and me the ultimate compliment, by saying that it was
an idea whose time had come, but he would only support it if I were to
be its Editor-in-Chief. Next to consult was Bill Cohen, the president
and publisher of Haworth Press. He was wisely skeptical, but agreed to
educate himself on the issue. To his surprise, the available information
convinced him of the distinct advisability to proceed. Within three
weeks, the idea became a concept. Bill’s subsequent support has been
unwavering.
Very quickly, a distinguished group of physicians and scientists
agreed to take part as a core editorial advisory. A perusal of our
contingent, 24 strong, reads as a “Who’s Who” of influential
authorities and authors in the area. Again, many voiced doubts, but
agreed to lend their support. To their great credit, there have been no
defections from their ranks in the life of the journal.
From the beginning, I set a number of goals. I felt from the
onset that the journal should establish itself or cease publication
after three years. We have just crossed that threshold, but barely. I
naively thought at the time that JCANT
might be rendered superfluous within this time-frame by a widespread
acceptance of the concept of clinical cannabis. That, obviously, will
take a little longer.
A key benchmark I set was for a building subscriber base of 1000
or more. Another was acceptance of the journal in major university
libraries. Finally, was the gold standard: we sought recognition by
Index Medicus for that critical accolade of acceptance for listing in
that publication and the National Library of Medicine database.
We also wanted to be a home for expansive concepts and
discussions on the topics of cannabis and cannabinoids; the kind of
articles that would never gain acceptance in “mainstream” medical
journals. Annual theme double-issues would be co-published in book form. Obstacles
and Realities
After a year of planning, and
gathering material, JCANT’s charter
issue was released in early 2001, to critical surprise and reward.
Subsequently, numerous copies were circulated at major meetings, to
numerous compliments, including two letters of thanks from members of
the US Supreme Court as they were considering the landmark Oakland
Cannabis Buyers’ Club case. I will treasure those.
Advanced subscriptions were respectable in number, but despite
the endorsements, rose but slowly over time. Our 2001 theme issue became
Cannabis Therapeutics in
HIV/AIDS, which remains today the only book of its kind beyond the
late Bob Randall’s 1991 Marijuana
& AIDS. More acclaim followed, but the subscriber numbers did
not follow suit, nor approach our goal. North American physicians have
been particularly slow to familiarize themselves with the new
literature, and to attempt to understand what is motivated their
patients to employ clinical cannabis, frequently without their knowledge
or endorsement.
In 2002, we employed a generous grant from the Marijuana Policy
Project to attempt to enter the realm of medical libraries. Free sample
issues were offered to every such facility in the USA and Canada. Few
actual subscriptions resulted. A reality of modern publishing is that
such institutions have little shelf-space, and much sparser budgets for
the new. Even the University of Montana asked me, “What current
journal should be abandoned to make room for this offering?” Mass
mailings were met with similar ennui.
The year was capped off with our second theme issue, Women
and Cannabis: Medicine, Science and Sociology, ably co-edited by
Melanie Dreher and Mary Lynn Mathre. Once more, it was a unique offering
on a previously taboo topic.
A similar scenario played out in 2003: critical acclaim and
encouragement, but little advancement in subscriber base over a few
hundred. Our initial application for Index Medicus recognition was
turned aside negatively. The quest for double-blind controlled studies,
the gold-standard of current medical proof, continued, but quite
expectedly, the small numbers of available studies were placed in
better-recognized large circulation publications. This is right and
proper; the cannabinoid field has grown matured dramatically since the
inception of JCANT and these
new concepts deserve immediate attention by professionals and medical
consumers. I endorse the decision by the authors of these articles to
seek wider recognition of their work, as is currently taking place with
vaporizer research pioneered by Dale Gieringer with support from MAPS.
The 2003 year was completed with our last theme issue: Cannabis-From
Pariah to Prescription that documents the current state of the art
with respect to phytocannabinoids, endogenous and synthetic cannabinoids,
and advances our knowledge thereof as the first products approach
marketing and acceptance in Europe.
By this time, a critical juncture was reached. Although the
threshold of prescription clinical cannabinoids as a reality was
nearing, the available pool of articles that would advance the knowledge
and might lead to greater recognition has diminished. Prospects for
additional database listing seem less than promising, and subscriber
numbers have not risen despite additional grants-in-aid. A Personal Note Our
Accomplishments
I believe that the Journal
of Cannabis Therapeutics has in its short sojourn, advanced
knowledge and acceptance of this emerging field. We have gained notice
beyond the apparent subscriber numbers. Although JCANT
may not have influenced the Supreme Court to accept clinical
cannabis, our articles have been cited in major national commissions,
including A Report of the
National Commission on Ganja in Jamaica in 2001: and
even more prominently in Cannabis:
Our Position for a Canadian Public Policy, the report of the
Canadian Senate in 2002: http://www.parl.gc.ca/Common/Committee_SenRecentReps.asp?Language=E&Parl=37&Ses=1 Both
commissions strongly endorsed greater public access to clinical
cannabis.
I was very pleased that our lead article of volume 1, number 1,
was a review of the current state of cannabis therapeutics as conceived
by Leo Hollister, the American dean of scientific study of the herb, but
was saddened that it came to be his final publication. Another landmark
of the inaugural edition was the study of Musty and Rossi describing the
success of smoked cannabis in allaying nausea in several hundred
subjects in state-sponsored studies of previous decades that had never
before been published (for both, see link to JCANT
1(1) below).
Innovative articles on therapeutic possibilities of cannabis and
cannabinoids followed, including music appreciation, an examination of
ancient and ethnobotanical evidence, and many more. Surveys of clinical
cannabis use in various countries were offered, as well as closer
examinations of non-cannabinoid components, endogenous cannabinoids, and
novel delivery systems. Volume 2 saw the publication of the “Chronic
Use Study” in which for the first time, information was made available
concerning the benefits and side effects of cannabis for a small cohort
of legal patients in the US Compassionate Use Investigational New Drug
Program (see link below). This study has had an influence far beyond the
subscriber base, and has lead to many associated news stories and
publicity about the issues.
Further evolutionary ideas concerning cannabis were provided by
many authors. Volume 3 continued in a similar vein, with more
information on use surveys, vaporization technology, pharmacokinetics,
and the advent of cannabis-based medicine extracts and oro-mucosal
delivery. The
Future
I envision that the fields of
cannabis and cannabinoid therapeutics will flourish in the coming decade
as our understanding of the key role of endogenous mechanisms unfolds,
and governments slowly accept the wisdom that these medicines can play a
major role in alleviating human suffering from legion complaints. The
advancement of that concept should properly occur in venues with
greatest accessibility and visibility, and I will be working toward that
goal. I hope and expect to continue to publish review material in book
form with the continued largesse and support of Haworth Press.
Franjo Grotenhermen, the founder and president of the
International Association of Cannabis as Medicine, has graciously agreed
to expand the IACM-Bulletin so
that topical reviews and new ideas that might not see publication in
mainstream sources will have an outlet.
We will make further efforts to ensure that the useful legacies
of the Journal of Cannabis
Therapeutics will endure and be accessible. Currently, portions of
the content are available online: Charter
Issue, Journal of Cannabis
Therapeutics 1(1), 2001: http://www.cannabis-med.org/jcant/Jcant1(1).pdf Journal
of Cannabis Therapeutics articles
by Ethan Russo: Hemp
for Headache: http://www.cannabis-med.org/jcant/Jcant1(1).pdf McPartland/Russo:
Cannabis and Cannabis Extracts: Greater than the Sum of their Parts?: http://www.montananorml.org/docs/McPartland-Russo-JCANT-1-3-4-2001.pdf Chronic
Use Study: http://www.cannabis-med.org/jcant/russo_chronic_use.pdf
Cannabis
in OB/GYN: http://www.freedomtoexhale.com/russo-ob.pdf
We will secure additional availability of Journal
of Cannabis Therapeutics content at intervals after publication as
time progresses. Eventually, we would essay to have the entire body of
the work available electronically to all interested people.
In closing, I would like to thank Lester for his idea, Tip for
his support that has sustained me beyond his passing, Bill for his
enduring encouragement, Dale Gieringer, Franjo Grotenhermen, John
McPartland for their multitudinous submissions, GW Pharmaceuticals for
their commitment to the future of cannabinoid therapeutics, and all the
remaining board members and subscribers for their attention and
largesse. For this, I am extremely grateful. Sincerely, Ethan
Russo, MD Editor-in-Chief,
Journal of Cannabis Therapeutics October
2003
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