What Do We Know About Medical Marijuana?

News about medical marijuana being legalized in several states (now 22 of them, plus the District of Columbia) has stirred much excitement and some controversy about its use. Although marijuana (Cannabis sativa) has been used for centuries as a medicinal substance as well as a recreational drug, its effectiveness and safety are still being studied today. Furthermore, in spite of the relaxation of state laws against its use, federal law still prohibits physicians from prescribing marijuana to patients. Under the Controlled Substances Act, medical marijuana is classified as a Schedule I drug, just like heroin or LSD, for which no prescriptions may be written. According to federal policy, a doctor who prescribes marijuana to a patient may be prosecuted and stripped of his federal license.

What is Medical Marijuana?

Supporters of the medical use of marijuana claim that this common tropical plant can relieve chronic pain, stimulate appetite and reduce nausea and vomiting in patients suffering from cancer or AIDS. Others also claim that it has anti-bacterial properties, it can reduce eye pressure in glaucoma, or that it can control seizures in epileptic patients. However, doctors are also aware that eating or smoking marijuana can cause many physical, mental and emotional side effects, including dizziness, rapid heart rates, confusion, euphoria, and depression. This is partly why there is a lot of debate among parents, health workers, patients, scientists and ordinary people about the benefits and risks of marijuana for medical use.

These are not recognized nor approved by the US Food and Drug Administration (FDA) as medicine. According to them, using marijuana leaves, flowers, stems or seeds for smoking, mixing with food or drinking as tea can be dangerous to one's health. Various strains of the plant, including how they are prepared and used, can yield different, unpredictable concentrations of the active ingredients (cannabinoids) of the plant, which can result in dangerous physical and mental effects. Therefore, possession or sale of raw or crude marijuana is still illegal, as far as US federal laws are concerned.

However, scientific study of the cannabinoids have led medical experts to demonstrate that their harmful side effects may be eliminated or reduced when the active ingredients are chemically purified and formulated into drugs. 

See Also: Therapeutic Uses Of Medical Marijuana

To clarify further, some states ( Arizona, Alaska, California, Connecticut, Colorado, Delaware, Illinois, Hawaii, Maine, Maryland, Minnesota, Massachusetts, Montana, Michigan, Nevada, New Jersey, New Mexico, New Hampshire, Rhode Island, Oregon, Vermont, Washington, and the District of Columbia) allow authorized patients to use marijuana with a doctor's recommendation under limited legal protection from arrest. However, doctors may not prescribe Schedule I substances without violating federal laws. Instead, physicians who believe their patients may benefit from the effects of cannabinoids may prescribe FDA-approved drugs that contain these ingredients, which are classified as Schedule II (just like morphine or amphetamine) or Schedule III controlled substances (just like codeine or barbiturates).

Legalization Of Marijuana For Medical Use: Yes Or No?

Many researchers, including specialists in criminology argue that legalization of marijuana for medical use does not necessarily mean that there will be an increase in crime rate or abuse among adolescents.

 Using data from FBI reports, they found that there was no significant increase in rates for robbery, burglary, assault, rape, homicide, larceny or auto theft. The researchers took into account many variables including sociodemographic and econometric factors that are usually linked to crime rates, such as poverty, college education, unemployment, and more. Furthermore, studies have found that there is no increase of marijuana use among adolescents when comparing data from states with marijuana decriminalization and those without marijuana laws. However, people must be aware of the possible risks of using raw marijuana for medical use.

Possible Risks of Medical Marijuana

At present, experts believe that there is a lack of scientific evidence that supports smoking marijuana as a form of treatment because of dosing problems with variable amounts cannabinoid compounds that may be delivered. Safety concerns include:

• altered moods

• sleepiness

• hallucinations

• psychosis

• reduced motor coordination

• slow reaction time

• severe anxiety or paranoia

• short-term memory impairment

• altered judgment and decision making

• impaired cognitive ability during adolescence

• addiction in 9% of users, and up to 50% of daily users

• accidental ingestion by children

• adolescent users at risk of developing schizophrenia

• changes in perception of space and time

• difficulty completing complex tasks

• reduced ability to concentrate

• Physical risks - fast heartbeat, low blood pressure, dizziness, dry mouth, palpitations, worsens respiratory problems

• use during pregnancy is linked with neurological problems and impaired school performance in children

FDA-Approved Cannabinoids

The Cannabis plant contains more than 100 cannabinoids, a large family of chemicals. The plant's main active ingredient is called delta-9-tetrahydrocannabinol (THC), which has psychoactive properties. It stimulates appetite, reduces nausea, decreases pain and inflammation, and helps control spasticity. Another active ingredient of the marijuana plant is cannabidiol (CBD), which is not psychoactive, but also helps reduce inflammation and pain, controls seizures and improves psychosis.

Dronabinol (Marinol) is made from synthetic THC and is prescribed to relieve nausea and vomiting in patients who are undergoing chemotherapy and do not respond to other treatments. It is also used to improve appetite in AIDS patients who have lost a lot of weight. Nabilone (Cesamet) is another approved cannabinoid-based drug used for nausea and vomiting related to chemotherapy. Dronabinol is classified as a Schedule III controlled substance, while nabilone is a Schedule II drug.

A CBD-based drug (Epidiolex) has been created recently to treat certain forms of epilepsy in children, but is still undergoing clinical trials.

See Also: The State (And States) Of Medical Marijuana In 2013

Another drug (Sativex), in the form of a mouth spray and containing both plant-derived THC and CBD (not synthetic), is now under clinical trial in the US to test its safety and effects on cancer pain. It is currently used in Europe for treating spasticity due to multiple sclerosis.

Other marijuana compounds are being tested for possible medical use.

Although these cannabinoid-based drugs are medically approved, patients are warned that they, too, may have side effects similar to those of marijuana. However, since their dosages can be controlled and monitored, and their chemical compositions are constant, they are safer for use compared to inhaled, raw marijuana.