Marijuana: Therapeutic use

Last modified: Sunday, 31. May 2009 - 5:02 pm

Perhaps no other aspect of marijuana use causes so emotional a response as the question of its medical value. Long before government mandates dictated medical policy, ancient physicians and healers used cannabis to try to relax muscle spasms, ease anxiety, and relieve pain. In the West, cannabis entered the medical lexicon only in the 1800s. As in the ancient world, the list of conditions it was thought to treat was extensive, including rabies, cholera, tetanus, gonorrhea, and angina, along with nausea, menstrual cramps, and depression. As the century progressed and medicine advanced from art to science, articles were published in medical journals touting the drug’s effectiveness. Cannabis appeared in both the United States Dispensatory and the United States Pharmacopeia (where it was listed until 1942) as an approved medicament. It was also a frequent component of patent medicines, many of them produced by well-known pharmaceutical companies. These patent medicines were freely available and could be purchased with or without a doctor’s prescription.
During the twentieth century, the Pure Food and Drug Act of 1906 and the Marijuana Tax Act of 1937 removed cannabis from pharmacy shelves and medicine bottles, turning marijuana into an illegal substance and an underground drug. In 1985, the FDA approved synthetic THC, or dronabinol (Marinol) as an antiemetic for cancer patients undergoing chemotherapy. Seven years later it was approved as an appetite stimulant for AIDS patients. Originally released as a tightly controlled Schedule II drug (the same class as morphine), in 1999 the DEA reclassified Marinol as a Schedule III drug, giving it the same restrictions as codeine and making it far easier for patients to fill their prescriptions.
Natural marijuana (as distinct from the synthetic THC in Marinol) may indeed have medical uses, and research, both private and federally sponsored, is underway to determine its effectiveness. Proponents claim it may help reduce elevated eye pressure in glaucoma, soothe the muscle spasms that accompany diseases like multiple sclerosis, prevent epileptic seizures, reduce inflammation, and relieve pain, especially that of migraine headaches and arthritis. Studies suggest possible benefits as an anti-asthmatic and anxiolytic/antidepressant. In 1997, the Institute of Medicine (IOM), a branch of the National Academy of Sciences, published the report, Marijuana: Assessing the Science Base, which concluded that cannabinoids showed significant promise as analgesics, appetite stimulants, and antiemetics, and that further research into producing these medicines was warranted. Evidence supporting their therapeutic potential for glaucoma, epilepsy, and other neurological/movement disorders was less encouraging, however.
Medically, the problem with marijuana is that currently the most effective way to deliver the drug is through smoking, which brings with it a host of cautions and health concerns. To counter this, at least one pharmaceutical company is investigating alternative delivery systems for the active compounds found in marijuana, such as a sublingual spray of THC and CBD that began clinical trials in Great Britain and Canada in 2001. Other companies have developed a vaporizer that heats marijuana to a temperature below its burning point but still high enough to release the drug’s active chemicals, which are then breathed in via an inhaler.

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