Marijuana is also known as pot, grass and weed but its formal name is clearly cannabis. It comes 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 possibility of abuse and haven’t any proven medical use. Over time several studies claim that some substances present in marijuana have medicinal use, especially in terminal diseases such as cancer and AIDS. This started a fierce debate over the professionals and cons of the use of medical marijuana. To stay 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 give a clear cut yes or no answer. The contrary camps of the medical marijuana issue often cite the main report within their advocacy arguments. However, even though report clarified many things, it never settled the controversy once and for all.
Let’s look at the conditions 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 this day and age when the natural and organic are essential health buzzwords, a naturally occurring herb like marijuana could 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 may be used as analgesic, e.g. to take care of pain. Several studies showed that THC, a marijuana component works well in treating chronic pain experienced by cancer patients. However, studies on acute pain such as 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 negative effects of cancer chemotherapy and radiation therapy. Some researchers are convinced that cannabis has some therapeutic potential against neurological diseases such as 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 been shown to stop high intraocular pressure (IOP), an important risk factor for glaucoma. Drugs that have active ingredients present in marijuana but have been synthetically manufactured in the laboratory have been approved by the US FDA. One example is Marinol, an antiemetic agent indicated for nausea and vomiting connected with cancer chemotherapy. Its active ingredient is dronabinol, a manufactured delta-9- tetrahydrocannabinol (THC).
(3) Among the major proponents of medical marijuana may be the Marijuana Policy Project (MPP), a US-based organization. Many medical professional societies and organizations have expressed their support. As an example, The American College of Physicians, recommended a re-evaluation of the Schedule I classification of marijuana within their 2008 position paper. buy cannabis online amsterdam 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 accordance 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 are able to get it done, 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 will also be allowing exemptions.
Now here would be the arguments against medical marijuana.
(1) Not enough data on safety and efficacy. Drug regulation is founded on safety first. The safety of marijuana and its components still has to first be established. Efficacy only comes second. Even though marijuana has some beneficial health effects, the benefits should outweigh the risks because of it 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 can be a long shot. Based on the testimony of Robert J. Meyer of the Department of Health and Human Services having usage of a drug or medical treatment, without knowing how exactly to put it to use as well as if it is effective, does not benefit anyone. Simply having access, without having safety, efficacy, and adequate use information does not help patients.
(2) Unknown chemical components. Medical marijuana can just only be easy to get at and affordable in herbal form. Like other herbs, marijuana falls underneath the category of 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 there is any future of marijuana as a medication, it is based on its isolated components, the cannabinoids and their synthetic derivatives. To totally characterize different components of marijuana would cost so enough time and money that the expenses of the medications that will come from it would be too high. Currently, no pharmaceutical company seems thinking about investing money to isolate more therapeutic components from marijuana beyond what’s 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 cocaine; nevertheless it cannot be denied that there’s a potential for substance abuse connected with marijuana. It has been demonstrated with a few studies as summarized in the IOM report.
(4) Not enough a secure delivery system. The most typical form of delivery of marijuana is through smoking. Considering the existing trends in anti-smoking legislations, this form of delivery will never be approved by health authorities. Reliable and safe delivery systems in the form of vaporizers, nebulizers, or inhalers remain at the testing stage.
(5) Symptom alleviation, not cure. Even though marijuana has therapeutic effects, it’s only addressing the symptoms of certain diseases. It doesn’t treat or cure these illnesses. Given that it’s effective against these symptoms, you will find already medications available which work equally well as well as better, without the medial side effects and danger of abuse connected with marijuana.
The 1999 IOM report couldn’t settle the debate about medical marijuana with scientific evidence offered at that time. The report definitely discouraged the use of smoked marijuana but gave a nod towards marijuana use through a medical inhaler or vaporizer. Additionally, the report also recommended the compassionate use of marijuana under strict medical supervision. Furthermore, it urged more funding in the research of the safety and efficacy of cannabinoids.
So what stands in how of clarifying the questions mentioned by the IOM report? The health authorities do not 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 available 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. Due to the complicated legalities involved, hardly any pharmaceutical companies are purchasing cannabinoid research. In many cases, it’s unclear how exactly 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 cheaper cannabinoid in the form of marijuana. Needless to say, the issue is further clouded by conspiracy theories relating to the pharmaceutical industry and drug regulators.