Medical Marijuana

The renewed patients’ interest and support for marijuana have led to the revamped curiosity of scientists about the applicable uses of the drug with special interest on its cannabinoids. In the 1990s, this renewed interest by scientists, although promising, was hampered by the drug’s illegal status. This meant that the drug could not be included in human clinical trials. By the mid-1990s, there were many requests by citizens from various states in the United States to legalize the drug for medical use. More states in the country soon joined in asking for a referendum in the decriminalization of the drug. Canada became a trendsetter when it legalized the medical use of the drug in 1999. Amongst other notable nations that legalized medical marijuana include the Netherlands (2003), Israel (2001), Switzerland (2011), Australia (2016), and Czech (2013). Germany (2017) is also a notable example of countries that have legalized medical marijuana. Although these countries legalized the drug, its use has special implications and conditions. All the while, the continued research into cannabinoids has provided strong backing for the legalization of cannabis. Presently, the revamped campaign efforts for the drug’s recognition across the globe has led to many European Union countries to re-evaluate their stance on the medical usage of the drug. However, there are different regulatory frameworks for different countries, especially the form of its consumption.

What is the Evidence Supporting Cannabis Medical Use?

Before most countries, especially developed countries, can consider the legalization or use of any new drug, adequate research must be presented to back up the credibility. For any drug to get a market authorization, there are extensive clinical trials that must be done where the new product has to be tested for its effectiveness, safety, and side effects. The general methodology used in clinical studies involves the use of a placebo, cannabinoid, and an active treatment option for the condition (Bello, 12). Such trials aim to determine if the proposed drug is more effective than the current ones already in the market. As such, cannabinoids must outperform the placebo and the active drug. The trial must also identify the side effects associated with the use of medical marijuana and justify why the benefits outweigh the risks. Predicated on all the evidence brought forth, market authorization can be granted or denied.

Evidence from multiple clinical trials suggests that the use of cannabinoids is effective in relieving symptoms of various illnesses. More specific to their use is that cannabinoids are utilized as adjunctive drugs. This means that cannabinoids are often a supplement of other medical treatments and not used as an independent treatment. Moreover, it is usually the last resort if the patient is not responding positively to the current regime of treatment.

Medical Uses of Marijuana

Cannabinoids as Anti-emetics

Several clinical trials have made comparisons between THC’s anti-emetic properties with placebos and other active anti-emetic drugs popular in treating nausea and vomiting. The anti-emetic facet of medical marijuana is very important especially for patients undergoing chemotherapy which is notorious for inducing vomiting and nausea. Systematic reviews of clinical trials reveal that the THC contained in cannabis offered a better option to the placebo and better yet, active anti-emetic drugs. Together with the cannabinoid agonists, the THC proved to effectively ease nausea symptoms in cancer patients. Be that as it may, other contrasting clinical trials claim that the effectiveness of medical marijuana as an anti-emetic drug is "too low" to be considered a viable treatment option. However, this discrepancy is usually explained by the failure to include participants who discontinued the use by evaluating their outcome.

Cannabinoids for Stimulating Appetite

In 1999, the United States granted Marinol (also dronabinol) market authorization as a go-to drug for stimulating the appetite of patients plagued with AIDS-related illnesses that were characterized by the patients’ wasting. Cannabinoid substrates were the main ingredient in the creation of Marinol. The approval of this drug was controversial as there were very few trials conducted in support of its effectiveness due to the underlying risk of substance dependency. However, further clinical trials into dronabinol stopped as the “wasting” as a result of AIDS-related ailments was no longer an issue because of the invention of powerful antiretroviral drugs. Conversantly, it is important to note that “munchies,” which is a ravenous appetite is common amongst marijuana users qualifying the drug as an effective appetite stimulant.

Cannabinoids for Neuropathic Pain and Spasticity in Multiple Sclerosis

Multiple clinical trials and studies into the effectiveness of cannabinoids for the treatment of neuropathic pain and muscle spasm have been conducted in patients suffering from neurodegenerative disorder multiple sclerosis. To this effect, nabiximols (Sativex) have been a common cannabis extract used in many clinical trials which are often administered as an oromucosal spray. In the random clinical trials, nabiximols was found to be a more effective adjunctive drug compared to the placebos. Patients who used nabiximols reported less muscle spasticity compared to those who used the placebo. However, the measure of the effects of nabiximols based on the evidence suggested that it was “moderate.” The conclusion being that cannabinoids are “probably effective” in treating muscle spasticity in patients.

Cannabinoids for Chronic Non-cancer Pain

In the United States, a common reason patients cite for using medical marijuana is to control chronic pain that is unrelated to cancer or CNCP (non-cancer pain). Namely, back pain, neuropathic pain, neck and shoulder pain, arthritis, and headaches. Although there are insufficient studies that robustly support cannabis effectiveness in non-cancer pain relief, the drug still has wide support from patients contending with various pains. Also important in this aspect is that patients reported that cannabis improved their sleep patterns.

Cannabinoids in Palliative Cancer Care

Often during media discussions into the benefits of marijuana in the medical perspective, the palliative cancer care comes up. Palliative cancer care involves the management of pain in cancer patients with an emphasis on managing the pain and not the treatment of cancer. There are thousands of cases where patients suffering from advanced stages of cancer have failed to respond well to treatment options like chemotherapy. In such cases, palliative cancer care is very crucial for the easement of the patients in regards to pain management. The use of cannabinoids has proven effective in managing pain in cancer patients. Also, other benefits such as appetite stimulation, reduced anxiety, and improvement of sleep patterns in cancer patients have been confirmed. Further studies have confirmed that cannabinoids are effective in treating cachexia or anorexia for patients with cancer. With every new dimension added in research and clinical trials into medical marijuana, discoveries are being made in relation to palliative cancer care.

Cannabinoids for Intractable Childhood Epilepsy

Although there exists a polarizing debate about the use of cannabis and cannabinoids in children from an ethical standpoint, parents whose children suffer from intractable epilepsy have confirmed that the drug is effective. Bio oils rich in CBD from cannabis extracts is the form in which parents administer the drug to their children. Parents have confirmed that the use of cannabinoids significantly reduces the severity and frequencies of the seizures (Gillard, 19). Building on this discovery, it was found that adding CBD to conventional anti-epileptic drugs further increases the drugs’ effectiveness in controlling seizures. However, there are fundamental issues about the required dosage of CBD that these drugs should contain with drug dependency and other adverse effects of the use of cannabinoids becoming a common concern.

Short-term Risks of Medical Cannabis use

There is copious research into the short-term risks of using medical cannabinoids and cannabis in general. The research involves evaluating the short-term effects of cannabis on three fronts, firstly as an anti-emetic, secondly, as an appetite stimulant, and thirdly as a pain reliever. Reports proved that the short-term effects of cannabinoids were very similar to other conventionally used drugs. Short-term symptoms include disorientation, nausea, dizziness, euphoria, dry mouth, somnolence, and confusion. These short-term side effects are classified as mild with more serious adverse effects as a result of using cannabinoids being rare. The Institute of Medicine, US National Academies of Science concluded in their numerous reviews of clinical studies into medical marijuana use that there was no significant evidence that indicates the occurrence of adverse short-term risk. However, an important aspect to note is that the pool of participants in the various studies was too narrow and more subjects should be included in future research.

Long-term Risks of Medical Marijuana use

Currently, there exists insufficient evidence that highlights the long-term risks of using cannabinoids and cannabis. Although there is a great similarity between the short-term and the long-term use. As patients indulge the drug for an extended period, reports have claimed that it induces adverse events. However, these adverse events are usually mild episodes. The importance of researching the long-term effects of using cannabinoids cannot be emphasized enough especially when considering its treatment in childhood epilepsy. As mentioned in a previous section, many ethical connotations have made a section of antagonists to marijuana use to strongly rebuke its use in children. The cited reasoning is usually based on the possible long-term effects of the drug on the children being treated for epilepsy. Although the attitude towards the importance of medical marijuana is slowly gaining momentum, the operating perception of the majority of society is that it is a narcotic. And as such, it must have adverse effects on the health and well-being of the children in their adulthood. While many opponents of medical marijuana do not offer definitive proof of the long-term effects of marijuana, their efforts do not help the plant's image. To quell this argument once and for all, more research needs to be done into the long-term effects of the drug. As mentioned, the observable long-term effects mirror those of short-term that include disorientation, nausea, dizziness, euphoria, dry mouth, somnolence, and confusion.

Cannabis Dependence

Also called cannabis use disorder, cannabis dependence is often wrongly identified as a long-term effect of cannabis use when in fact it is just a consequence of its long-term use. Patients who initially used medical marijuana for legitimate medical purposes for extended periods have claimed to have difficulty in quitting. While using medical marijuana as a treatment option of pain relief, patients often discover other added advantages of using it. For instance, many people use the drug to alleviate or cope with stress especially in the current economic climate which offers myriads of challenges. In terms of its recreational use, cannabis, in general, has become a common feature in society especially among the young population. Fears of its abuse have been cited with claims that the use of recreational marijuana reduces brain power and hence alters the individual’s perceptions. Other notable negative effects include the undermining of performance of the user in both academics and professional capacities. In contrast to this, many recreational users of marijuana insist that it enhances their “creative side” and helps them develop their crafts. In recent years, the use of marijuana has been widely publicized especially in the entertainment industry where popular artists have blatantly smoked it in their music videos. The continued legalization of marijuana in several states in the United States has been blamed for the increased levels of cannabis dependence.

Although there are side effects in using medical marijuana, the benefits outweigh the risks. As mentioned, medical marijuana has proven to be a competent option in alleviating pain and controlling symptoms of childhood epilepsy like seizures. Granted, there is a need for more research into the long-term effects of medical marijuana use, however, it remains a better option for long-term pain management with minimal risk.

Works Cited

Bello, Joan. The Benefits of Marijuana: Physical, Psychological and Spiritual. , 2011. Internet resource.

Berlatsky, Noah. Marijuana. Farmington Hills, MI: Greenhaven Press, 2012. Internet resource.

Gillard, Arthur. Medical Marijuana. , 2014. Print.