Marijuana is also referred to as pot, grass and weed but its formal name is clearly 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 have a very high potential for abuse and don't have any proven medical use. Over time several studies claim that some substances within 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 usage of medical marijuana. To be in 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 opposite camps of the medical marijuana issue often cite area of the report in their advocacy arguments. However, even though report clarified many things, it never settled the controversy once and for all.
Let's look at the problems that support why medical marijuana must certanly be legalized.
(1) Marijuana is just 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 important health buzzwords, a naturally occurring herb like marijuana may 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 can be used as analgesic, e.g. to take care of pain. A few studies indicated 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. A few 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 component of marijuana, has been shown to have antipsychotic, anticancer and antioxidant properties. Other cannabinoids have already been shown to prevent high intraocular pressure (IOP), an important risk factor for glaucoma. Drugs that have substances within marijuana but have already been synthetically manufactured in the laboratory have already been approved by the US FDA. One example is Marinol, an antiemetic agent indicated for nausea and vomiting connected with cancer chemotherapy. Its ingredient is dronabinol, an artificial delta-9- tetrahydrocannabinol (THC).
(3) One of many major proponents of medical marijuana could be the Marijuana Policy Project (MPP), a US-based organization. Many medical professional societies and organizations have expressed their support Doja Dispensary . For example, The American College of Physicians, recommended a re-evaluation of the Schedule I classification of marijuana in 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 relating 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 are able to take action, why don't you 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 are 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 really has to first be established. Efficacy only comes second. Even when marijuana has some beneficial health effects, the benefits should outweigh the risks because of it to be viewed for medical use. Unless marijuana is which can be better (safer and more effective) than drugs currently available 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 use of a drug or medical treatment, without knowing how exactly to utilize it 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 be easily accessible and affordable in herbal form. Like other herbs, marijuana falls underneath the group 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 you have any future of marijuana as a medicine, it lies in its isolated components, the cannabinoids and their synthetic derivatives. To completely characterize different aspects of marijuana would cost so enough time and money that the costs of the medications that may come out of it could be too high. Currently, no pharmaceutical company seems enthusiastic about investing money to isolate more therapeutic components from marijuana beyond what is already obtainable 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's a possibility of substance abuse connected with marijuana. This has been demonstrated by way of a few studies as summarized in the IOM report.
(4) Not enough a safe delivery system. The most common type of delivery of marijuana is through smoking. Considering the present trends in anti-smoking legislations, this type of delivery won't ever be approved by health authorities. Reliable and safe delivery systems in the shape of vaporizers, nebulizers, or inhalers remain at the testing stage.
(5) Symptom alleviation, not cure. Even when marijuana has therapeutic effects, it's only addressing the apparent symptoms of certain diseases. It generally does not treat or cure these illnesses. Given it is effective against these symptoms, you can find already medications available which work as well or even better, without the side effects and risk of abuse connected 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. Furthermore, the report also recommended the compassionate utilization of marijuana under strict medical supervision. Furthermore, it urged more funding in the study of the safety and efficacy of cannabinoids.
What exactly stands in the way of clarifying the questions raised by the IOM report? The authorities don't appear to be interested in having another review. There is limited data available and whatever can be acquired is biased towards safety issues on the undesireable effects of smoked marijuana. Data available on efficacy mainly come 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. Because of the complicated legalities involved, very few pharmaceutical companies are buying cannabinoid research. In many cases, it's not clear how exactly to define medical marijuana as advocated and opposed by many groups. Does it only make reference 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 available in the market are really expensive, pushing people towards the cheaper cannabinoid in the shape of marijuana. Obviously, the issue is further clouded by conspiracy theories involving the pharmaceutical industry and drug regulators.