Marijuana can be known as pot, grass and weed but its formal name is actually cannabis. It originates 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 a crime punishable by law. The FDA classifies marijuana as Schedule I, substances which possess a high prospect of abuse and have no proven medical use. Over time several studies declare 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 utilization 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 didn’t offer a clear cut yes or no answer. amsterdam weedshop The contrary camps of the medical marijuana issue often cite the main report inside their advocacy arguments. However, although the report clarified several things, it never settled the controversy once and for all.
Let’s look at the issues that support why medical marijuana must be legalized.
(1) Marijuana is just 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 important health buzzwords, a naturally occurring herb like marijuana could be more appealing 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 deal with 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 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 typical 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 element of marijuana, has been shown to own antipsychotic, anticancer and antioxidant properties. Other cannabinoids have now been shown to avoid high intraocular pressure (IOP), an important risk factor for glaucoma. Drugs which contain ingredients present in marijuana but have now been synthetically manufactured in the laboratory have now been approved by the US FDA. One example 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) 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. For instance, 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 into the therapeutic role of marijuana as well as 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 could 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 utilization of marijuana under strict prescription control. Some states in the US will also be allowing exemptions.
Now here are the arguments against medical marijuana.
(1) Insufficient 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 if marijuana has some beneficial health effects, the advantages should outweigh the risks because of it to be considered for medical use. Unless marijuana is which can be better (safer and more effective) than drugs currently available on the market, its approval for medical use can be a long shot. According to 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 to use it or even when it is effective, does not benefit anyone. Simply having access, with no safety, efficacy, and adequate use information does not help patients.
(2) Unknown chemical components. Medical marijuana can just only be readily available and affordable in herbal form. Like other herbs, marijuana falls beneath 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 medication, it lies in its isolated components, the cannabinoids and their synthetic derivatives. To fully characterize the various components of marijuana would cost so enough time and money that the costs of the medications that may come from 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 available in the market.
(3) Prospect of abuse. Marijuana or cannabis is addictive. It may not be as addictive as hard drugs such as cocaine; nevertheless it can’t be denied that there is a prospect of substance abuse associated with marijuana. This has been demonstrated by a few studies as summarized in the IOM report.
(4) Insufficient a safe delivery system. The most frequent type of delivery of marijuana is through smoking. Considering the existing trends in anti-smoking legislations, this type of delivery won’t 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 symptoms of certain diseases. It generally does not treat or cure these illnesses. Given that it’s effective against these symptoms, you can find already medications available which work just as well or even better, without the medial side effects and danger of abuse associated with marijuana.
The 1999 IOM report couldn’t settle the debate about medical marijuana with scientific evidence offered by that time. The report definitely discouraged the utilization of smoked marijuana but gave a nod towards marijuana use via a medical inhaler or vaporizer. Furthermore, 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 the way of clarifying the questions mentioned 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 acquired 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 as a result of limited funding and strict regulations. Due to the complicated legalities involved, hardly any pharmaceutical companies are buying cannabinoid research. Oftentimes, it is unclear how to define medical marijuana as advocated and opposed by many groups. Does it only reference the utilization 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 on the market are incredibly expensive, pushing people towards the less expensive cannabinoid in the form of marijuana. Needless to say, the problem is further clouded by conspiracy theories relating to the pharmaceutical industry and drug regulators.