10 million people in the UK admit to having tried cannabis (1). Whether a serial smoker or a chronic sufferer, a one-time taster or a concerned loved one, an intrigued scientist or someone who simply loves an argument, the use of marijuana in medicine is a topic that sparks (no joke intended!) an interest in the masses.
The pharmacology
Despite over 500 chemical compounds in the marijuana plant, the psychotic effects commonly observed following ingestion or inhalation result primarily from a single constituent - delta-9-tetrahydrocannabinol (THC). Just like a key fitting a lock, THC binds to complimentary receptors in our body. But, instead of opening doors, enzymes with essential regulatory roles are inhibited, and our brain and immune system are affected in an unpredictable way. This is the “high”.
The history of illegalisation
Cannabis is one of the oldest psychotropic drugs known to humanity, with its therapeutic effects recorded as far back as 2737 BC! (2) However, in 1970, due to “a considerable void in [the] knowledge of the plant and effects of the active drug contained in it”, the U.S. government classified marijuana as a Schedule I drug - a substance with high abuse potential and no accepted medical purpose. A decision that was not based on scientific evidence of cannabis proving ineffective or displaying severe toxic side effects, but because a lack of evidence.
The medical efficacy
The use of marijuana to induce therapeutic effect is not limited to a few conditions. Research has demonstrated efficacy in the treatment of nausea and vomiting associated with cancer chemotherapy, loss of appetite, pain, multiple sclerosis, spinal cord injuries, Tourette’s syndrome, epilepsy, glaucoma, Parkinson disease and dystonia (2).
Synthetic cannabinoids are available as prescription drugs in some countries. Dronabinol (U.S. and Canada), a low-dosage formulation of synthetic THC that comes in capsule form and is used to stimulate appetite in people with HIV and control the nausea and vomiting that’s associated with chemotherapy. Nabilone is another synthetic analogue of THC that is effective in chronic pain management.
However, no substance is without side effects. In 2012, researchers found that people who started smoking cannabis before age 18 showed a greater decline in IQ and cognitive functioning than people who started taking as adults. Furthermore, a 2014 study identified that the number of children receiving treatment for marijuana addition is in excess of 13,000, with the age at which it is first tried declining with time; now only 11. A terrifying statistic.
The future
Much like many things in science and medicine, the future use, efficacy and acceptance of marijuana in medicine is unknown. For me, a scientist by trade, I know what I would like – more data!
A lot of existing research has focused on the negative, such as “Bad trip due to anticholinergic effect of cannabis\", or \"Cannabis induced pancreatitis”. A few exciting studies underway include investigations into whether it can help alleviate symptoms of PTSD, and assessing the anti-cancer effects of marijuana – let’s find out what works, what doesn’t, and why.
Don’t let the treatments be untested, unauthorised or unpredictable - by filling in the gaps, this burning question could be answered: is using marijuana in medicine a marvel, or an excuse to use?
(1) Cannabis; DrugScope, 2011.
(2) Ben Amar M (2006), "Cannabinoids in medicine: a review of their therapeutic potential", Journal of Ethnopharmacology (Review), 105 (1–2), 1–25.
Author - Gemma Craig
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