Marijuana is also known as pot, grass and weed, but its formal name is actually cannabis. It comes from the leaves and flowers of the Cannabis sativa plant. This is considered an illegal substance in the United States and in many countries, and possession of marijuana is a crime punishable by law. The FDA classifies cannabis as Schedule I, substances that have a very high potential for abuse and do not have proven medical use. Over the years, several studies have argued that some substances found in marijuana have medicinal uses, especially for terminal diseases such as cancer and AIDS. This started a fierce debate about the pros and cons of using medical marijuana. To solve this discussion, the Institute of Medicine published the famous IOM report in 1999, entitled "Marijuana and Medicine: Evaluation of the Scientific Base." The report was comprehensive, but did not give a clear answer "yes" or "no." Opposing camps for medical problems of marijuana often cite part of the report in their lawyer’s statements. However, although much was clarified in the report, he never settled the contradictions once and for all.
Let's look at the questions that help treat medical marijuana.
(1) Marijuana is a natural herb and has been used in Asia as a medicinal herb for thousands of years in South America. In this day and age, when all natural and organic are important health keywords, a naturally occurring herb, such as marijuana, can be more attractive and safe for consumers than synthetic drugs.
(2) Marijuana has a strong therapeutic potential. Several studies summarized in an IOM report have shown that cannabis can be used as an analgesic, for example, to treat pain. Several studies have shown that THC, a component of marijuana, is effective in treating chronic pain experienced by cancer patients. However, acute pain studies, such as those tested during surgery and injuries, have inconclusive reports. Several studies, also summarized in the IOM report, have shown that some components of marijuana have antimicrobial properties and are therefore effective against nausea and vomiting, which are common side 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 a strong therapeutic potential. It has been shown that cannobidiol (CBD), which is the main component of marijuana, has antipsychotic, anti-tumor and antioxidant properties. It has been shown that other cannabinoids prevent high intraocular pressure (IOP), which is a major risk factor for the development of glaucoma. Preparations containing the active ingredients present in marijuana, but synthetically prepared in the laboratory, have been approved by the United States Food and Drug Administration. One example is Marinol, an antitoxic agent for nausea and anomaly associated with cancer chemotherapy. Its active ingredient is dronabinol, a synthetic delta-9-tetrahydrocannabinol (THC).
3 One of the main advocates for medical marijuana is the United States marijuana policy project (MPP). Many medical professional societies and organizations have expressed their support. As an example, the American College of Physicians recommended a reassessment of the classification of marijuana on Schedule I in its 2008 position statement. The 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 authorization for doctors who prescribe or issue medical marijuana in accordance with state law. Similarly, protection against criminal or civil penalties for patients who use medical marijuana, as permitted by state law.
(4) Medical marijuana is legally used in many developed countries. Argument, if they can do it, why not? 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 also allow exemptions.
Now here are the arguments against medical marijuana.
(1) Lack of safety and efficacy data. First of all, drug regulation is based on safety. The safety of marijuana and its components still needs to be established. Efficiency only in second place. Even if marijuana has some health benefits, the benefits should outweigh the risks to be considered for medical purposes. It has been proven that without marijuana it is better (safer and more effective) than drugs currently 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 who have access to medicine or medical care, not knowing how to use it or even if it is effective, is not beneficial to anyone. Simple access, without ensuring safety, efficiency and adequate information on use, does not help patients.
(2) Unknown chemical components. Medical marijuana can be easily available and available in a herbal form. Like other herbs, marijuana belongs to the category of botanical products. However, unpurified botanical products face many challenges, including consistency in lot, dosage definitions, efficacy, shelf life, and toxicity. According to the IOM report, if there is any future marijuana as a drug, it is in its isolated components, cannabinoids and their synthetic derivatives. To fully characterize the various components of marijuana, it would cost so much time and money that the cost of drugs that go out of it would be too high. Currently, no pharmaceutical company is interested in investing money in order to isolate more therapeutic ingredients from marijuana beyond what is already available on the market.
(3) Potential for abuse. Marijuana or cannabis is addictive. It may not be as addictive as hard drugs like cocaine; nevertheless, it cannot be denied that there is a likelihood of substance abuse associated with marijuana. This has been demonstrated by several studies summarized in the IOM report.
(4) Lack of secure delivery system. The most common form of marijuana delivery is smoking. Given current trends in anti-smoking legislation, this form of delivery will never be approved by health sanctions. Reliable and safe delivery systems in the form of evaporators, nebulizers or inhalers are still at the testing stage.
5 Relieving symptoms, not treatment. Even if marijuana has a therapeutic effect, it only concerns the symptoms of certain diseases. He does not cure or cure these diseases. Given that it is effective against these symptoms, there are already medications that work just as well or even better, without the side effects and risk of abuse associated with marijuana.
An IOM report in 1999 failed to resolve the medical marijuana dispute with the scientific evidence available at the time. The report definitely did not encourage the use of smoked marijuana, but he nodded at the use of marijuana through a medical inhaler or vaporizer. In addition, the report also recommends the compassionate use of marijuana under strict medical supervision. In addition, he called for increased funding for research on the safety and efficacy of cannabinoids.
So, what prevents to clarify the issues raised in the IOM report? Health authorities do not seem interested in another review. There is limited data available, and all that is available, biased, relates to security issues with the adverse effects of smoked marijuana. The available data on efficacy mainly come from studies of synthetic cannabinoids (for example, THC). This inconsistency of data makes an objective assessment of risk and reward difficult.
Clinical research on marijuana is small and difficult to conduct due to limited funding and strict rules. Due to complex legal practice, very few pharmaceutical companies invest in cannabinoid research. In many cases, it is unclear how to define medical marijuana, which was advocated and opposed by many groups. Does this mean only the use of marijuana as a botanical product, or does it include synthetic cannabinoid components (for example, THC and derivatives)? Synthetic cannabinoids (such as Marinol) available on the market are extremely expensive, pushing people towards more affordable cannabinoid in the form of marijuana. Of course, the problem is even more overshadowed by conspiracy theories related to the pharmaceutical industry and drug regulators.
In conclusion, the future of medical marijuana and the resolution of debates will depend on more comprehensive and comparable research. In the near future, you need to update the IOM report.
