Marijuana can also be referred to as pot, grass and weed but its formal name is obviously cannabis. It originates from the leaves and flowers of the plant Cannabis sativa. It is known 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 employ a high potential for abuse and don’t have any proven medical use. Through the years several studies claim that some substances found in marijuana have medicinal use, especially in terminal diseases such as for instance cancer and AIDS. This started a fierce debate over the pros and cons of the usage 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 offer a clear cut yes or no answer. The contrary camps of the medical marijuana issue often cite the main report inside their advocacy arguments. However, even though report clarified many things, it never settled the controversy once and for all.
Let’s go through the problems that support why medical marijuana ought to be legalized.
(1) Marijuana is 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 natural and organic are very important health buzzwords, a naturally occurring herb like marijuana could 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 can be utilized as analgesic, e.g. to treat pain. A couple of studies showed 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 couple of 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 for instance multiple sclerosis. Specific compounds extracted from marijuana have strong therapeutic potential. Cannobidiol (CBD), an important part of marijuana, has been shown to own antipsychotic, anticancer and antioxidant properties. Other cannabinoids have now been shown to stop high intraocular pressure (IOP), an important risk factor for glaucoma. Drugs that contain ingredients within 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 associated with cancer chemotherapy. Its active ingredient is dronabinol, a manufactured delta-9- tetrahydrocannabinol (THC).
(3) One of 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 instance, weed online amsterdam 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 in 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 found in many developed countries The argument of if they can 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 utilization of marijuana under strict prescription control. Some states in the US may also be allowing exemptions.
Now here will be the arguments against medical marijuana.
(1) Lack of data on safety and efficacy. Drug regulation is founded on safety first. The safety of marijuana and its components really has to first be established. Efficacy only comes second. Even if marijuana has some beneficial health effects, the advantages should outweigh the risks for it to be viewed 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 access to a drug or medical treatment, without knowing how exactly to put it to use or even if it’s effective, doesn’t benefit anyone. Simply having access, with no safety, efficacy, and adequate use information doesn’t help patients.
(2) Unknown chemical components. Medical marijuana can only just be easily accessible and affordable in herbal form. Like other herbs, marijuana falls under 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 when there is any future of marijuana as a medicine, it lies in its isolated components, the cannabinoids and their synthetic derivatives. To fully characterize the different aspects of marijuana would cost so much time and money that the costs of the medications that will come out of it will 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) Prospect 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 surely is a possibility of substance abuse associated with marijuana. It’s been demonstrated with a few studies as summarized in the IOM report.
(4) Lack of a safe delivery system. The most frequent kind of delivery of marijuana is through smoking. Considering the present trends in anti-smoking legislations, this kind of delivery won’t ever be approved by health authorities. Reliable and safe delivery systems in the form of vaporizers, nebulizers, or inhalers are still at the testing stage.
(5) Symptom alleviation, not cure. Even if marijuana has therapeutic effects, it is only addressing the apparent symptoms of certain diseases. It does not treat or cure these illnesses. Given that it’s effective against these symptoms, there are already medications available which work equally well or even better, without the side effects and threat 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 usage of smoked marijuana but gave a nod towards marijuana use through a medical inhaler or vaporizer. Additionally, the report also recommended the compassionate utilization of marijuana under strict medical supervision. Furthermore, it urged more funding in the investigation of the safety and efficacy of cannabinoids.
What exactly stands in how of clarifying the questions brought up by the IOM report? The 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 available on efficacy mainly originate 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, very few pharmaceutical companies are buying cannabinoid research. In many cases, it is not clear how exactly 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 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.