Marijuana can be referred to as pot, grass and weed but its formal name is clearly cannabis. It arises from the leaves and flowers of the plant Cannabis sativa. It is recognized as an illegal substance in the US and many countries and possession of marijuana is an offense punishable by law. The FDA classifies marijuana as Schedule I, substances which possess a high potential for abuse and have no proven medical use. Over the years several studies claim that some substances present in marijuana have medicinal use, especially in terminal diseases such as for instance cancer and AIDS. This started a fierce debate over the good qualities and cons of the use of medical marijuana. To be in this debate, the Institute of Medicine published the famous 1999 IOM report entitled Marijuana and Medicine: Assessing the Science Base. The report was comprehensive but did not provide a clear cut yes or no answer. The contrary camps of the medical marijuana issue often cite part of the report inside their advocacy arguments. However, although the report clarified many things, it never settled the controversy once and for all.
Let’s go through the problems that support why medical marijuana should really be legalized.
(1) Marijuana is really a naturally occurring herb and has been used from South America to Asia as an herbal medicine for millennia. In today and age when the all natural and organic are essential health buzzwords, a naturally occurring herb like marijuana might be more desirable to and safer for consumers than synthetic drugs.
(2) Marijuana has strong therapeutic potential. Several studies, as summarized in the IOM report, have observed that cannabis may be used as analgesic, e.g. to treat pain. A few studies revealed that THC, a marijuana component works well in treating chronic pain experienced by cancer patients. However, studies on acute pain such as for instance those experienced during surgery and trauma have inconclusive reports. A few studies, also summarized in the IOM report, have demonstrated that some marijuana components have antiemetic properties and are, therefore, effective against nausea and vomiting, which are normal unwanted effects of cancer amsterdam weed shop online chemotherapy and radiation therapy. Some researchers are convinced that cannabis has some therapeutic potential against neurological diseases such as for instance multiple sclerosis. Specific compounds extracted from marijuana have strong therapeutic potential. Cannobidiol (CBD), a major element of marijuana, has been shown to possess antipsychotic, anticancer and antioxidant properties. Other cannabinoids have been shown to avoid high intraocular pressure (IOP), a major risk factor for glaucoma. Drugs that have substances present in marijuana but have been synthetically manufactured in the laboratory have been approved by the US FDA. One of these is Marinol, an antiemetic agent indicated for nausea and vomiting associated with cancer chemotherapy. Its active component is dronabinol, an artificial delta-9- tetrahydrocannabinol (THC).
(3) Among the major proponents of medical marijuana could be the Marijuana Policy Project (MPP), a US-based organization. Many medical professional societies and organizations have expressed their support. For example, The American College of Physicians, recommended a re-evaluation of the Schedule I classification of marijuana inside their 2008 position paper. ACP also expresses its strong support for research to the therapeutic role of marijuana in addition to exemption from federal criminal prosecution; civil liability; or professional sanctioning for physicians who prescribe or dispense medical marijuana in respect with state law. Similarly, protection from criminal or civil penalties for patients who use medical marijuana as permitted under state laws.
(4) Medical marijuana is legally used in many developed countries The argument of if they could take action, why don’t you us? is another strong point. Some countries, including Canada, Belgium, Austria, the Netherlands, the United Kingdom, Spain, Israel, and Finland have legalized the therapeutic usage of marijuana under strict prescription control. Some states in the US may also be allowing exemptions.
Now here would be the arguments against medical marijuana.
(1) Insufficient data on safety and efficacy. Drug regulation is dependant on safety first. The safety of marijuana and its components still has to first be established. Efficacy only comes second. Even when marijuana has some beneficial health effects, the huge benefits should outweigh the risks for this to be looked at for medical use. Unless marijuana is which can be better (safer and more effective) than drugs currently available in the market, its approval for medical use might be a long shot. According to the testimony of Robert J. Meyer of the Department of Health and Human Services having access to a drug or medical treatment, without knowing just how to put it to use as well as if it is effective, doesn’t benefit anyone. Simply having access, without having safety, efficacy, and adequate use information doesn’t help patients.
(2) Unknown chemical components. Medical marijuana can only be readily available and affordable in herbal form. Like other herbs, marijuana falls underneath the group of botanical products. Unpurified botanical products, however, face many problems including lot-to-lot consistency, dosage determination, potency, shelf-life, and toxicity. According to the IOM report when there is any future of marijuana as a medicine, it lies in its isolated components, the cannabinoids and their synthetic derivatives. To totally characterize the different the different parts of marijuana would cost so long and money that the expenses of the medications which will come from it could be too high. Currently, no pharmaceutical company seems enthusiastic about investing money to isolate more therapeutic components from marijuana beyond what is already for sale in the market.
(3) Possibility of abuse. Marijuana or cannabis is addictive. It may possibly not be as addictive as hard drugs such as for instance cocaine; nevertheless it can’t be denied that there is a potential for substance abuse associated with marijuana. This has been demonstrated with a few studies as summarized in the IOM report.
(4) Insufficient a secure delivery system. The most common type of delivery of marijuana is through smoking. Considering the existing trends in anti-smoking legislations, this type of delivery will never be approved by health authorities. Reliable and safe delivery systems in the form of vaporizers, nebulizers, or inhalers continue to be at the testing stage.
(5) Symptom alleviation, not cure. Even when marijuana has therapeutic effects, it is only addressing the apparent symptoms of certain diseases. It generally does not treat or cure these illnesses. Given it is effective against these symptoms, there are already medications available which work equally well as well as better, without the side effects and risk of abuse associated with marijuana.
The 1999 IOM report could not settle the debate about medical marijuana with scientific evidence offered by that time. The report definitely discouraged the use of smoked marijuana but gave a nod towards marijuana use via a medical inhaler or vaporizer. In addition, the report also recommended the compassionate usage of marijuana under strict medical supervision. Furthermore, it urged more funding in the study of the safety and efficacy of cannabinoids.
What exactly stands in how of clarifying the questions mentioned by the IOM report? Medical authorities don’t seem to be interested in having another review. There’s limited data available and whatever can be obtained is biased towards safety issues on the adverse effects of smoked marijuana. Data on efficacy mainly result from studies on synthetic cannabinoids (e.g. THC). This disparity in data makes an objective risk-benefit assessment difficult.
Clinical studies on marijuana are few and difficult to conduct because of limited funding and strict regulations. Because of the complicated legalities involved, hardly any pharmaceutical companies are buying cannabinoid research. In many cases, it is not clear just how to define medical marijuana as advocated and opposed by many groups. Does it only refer to the use of the botanical product marijuana or does it include synthetic cannabinoid components (e.g. THC and derivatives) as well? Synthetic cannabinoids (e.g. Marinol) available in the market are extremely expensive, pushing people towards the less expensive cannabinoid in the form of marijuana. Of course, the issue is further clouded by conspiracy theories involving the pharmaceutical industry and drug regulators.