Marijuana can be referred to as pot, grass and weed but its formal name is really cannabis. It arises from the leaves and flowers of the plant Cannabis sativa. It is considered 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 employ a high potential for abuse and don’t have any proven medical use. Over the years several studies declare 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 usage of medical marijuana. To settle 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 offer a clear cut yes or no answer. The opposite camps of the medical marijuana issue often cite part of the report within their advocacy arguments. However, even though report clarified a lot of things, it never settled the controversy once and for all.
Let’s look at the conditions that support why medical marijuana must be legalized.
(1) Marijuana is really a naturally occurring herb and has been used from South America to Asia being an herbal medicine for millennia. In this very day and age once the all natural and organic are important health buzzwords, a naturally occurring herb like marijuana may be more inviting 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 can be used as analgesic, e.g. to treat pain. Several 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. Several 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 side effects of cancer 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), an important component of marijuana, has been shown to possess antipsychotic, anticancer and antioxidant properties. Other cannabinoids have now been shown to prevent high intraocular pressure (IOP), an important risk factor for glaucoma. Drugs which contain active ingredients contained in marijuana but have now been synthetically stated in the laboratory have now been approved by the US FDA. One of these is Marinol, an antiemetic agent indicated for nausea and vomiting connected with cancer chemotherapy. Its active component is dronabinol, a manufactured delta-9- tetrahydrocannabinol (THC).
(3) Among the major proponents of medical marijuana is 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, amsterdam weed for sale recommended a re-evaluation of the Schedule I classification of marijuana within their 2008 position paper. ACP also expresses its strong support for research into 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 utilized in many developed countries The argument of if they are able to do it, why not us? is another strong point. Some countries, including Canada, Belgium, Austria, the Netherlands, the United Kingdom, Spain, Israel, and Finland have legalized the therapeutic use of marijuana under strict prescription control. Some states in the US are also allowing exemptions.
Now here are the arguments against medical marijuana.
(1) Insufficient data on safety and efficacy. Drug regulation is based on safety first. The safety of marijuana and its components really has to first be established. Efficacy only comes second. Even when marijuana has some beneficial health effects, the benefits should outweigh the risks for this to be looked at for medical use. Unless marijuana is shown to be better (safer and more effective) than drugs currently available in the market, its approval for medical use might be a long shot. Based on the testimony of Robert J. Meyer of the Department of Health and Human Services having use of a drug or medical treatment, without knowing just how to put it to use or even if it is effective, doesn’t benefit anyone. Simply having access, with out 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 beneath the sounding botanical products. Unpurified botanical products, however, face many problems including lot-to-lot consistency, dosage determination, potency, shelf-life, and toxicity. Based on the IOM report if you have any future of marijuana as a medication, it is based on its isolated components, the cannabinoids and their synthetic derivatives. To totally characterize different the different parts of marijuana would cost so long and money that the expenses of the medications that will come from the jawhorse would be too high. Currently, no pharmaceutical company seems interested in investing money to isolate more therapeutic components from marijuana beyond what’s already available in the market.
(3) Possibility of abuse. Marijuana or cannabis is addictive. It might not be as addictive as hard drugs such as for instance cocaine; nevertheless it can’t be denied that there is a possibility of substance abuse connected with marijuana. This has been demonstrated with a few studies as summarized in the IOM report.
(4) Insufficient a secure delivery system. The most frequent kind of delivery of marijuana is through smoking. Considering the existing trends in anti-smoking legislations, this kind 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’s only addressing the symptoms of certain diseases. It does not treat or cure these illnesses. Given that it is effective against these symptoms, you will find already medications available which work as well or even better, without the medial side effects and danger of abuse connected with marijuana.
The 1999 IOM report could not settle the debate about medical marijuana with scientific evidence available at that time. The report definitely discouraged the usage of smoked marijuana but gave a nod towards marijuana use via a medical inhaler or vaporizer. Furthermore, the report also recommended the compassionate use of marijuana under strict medical supervision. Furthermore, it urged more funding in the study of the safety and efficacy of cannabinoids.
Just what exactly stands in how of clarifying the questions raised by the IOM report? The authorities don’t seem to be thinking about having another review. There’s limited data available and whatever is available is biased towards safety issues on the negative effects of smoked marijuana. Data on efficacy mainly come 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 as a result of limited funding and strict regulations. Due to the complicated legalities involved, not many pharmaceutical companies are investing in cannabinoid research. In many cases, it’s not yet determined just how to define medical marijuana as advocated and opposed by many groups. Does it only refer to the usage 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. Obviously, the issue is further clouded by conspiracy theories involving the pharmaceutical industry and drug regulators.