MEDICAL MARIJUANA | A therapeutic alternative in diseases and conditions

Ordinary people considers as a taboo the use of cannabis, also known as "marijuana"; it is because it’s an illegal drug because produce psychotropic effects as well it alters the CNS with a dose of > 30 mg / day; most people relate it with dependence or addiction, criminal behavior, use of other addictive and stronger substances, etc.; ignoring that legal and massively commercial substances, such as alcohol and tobacco are more harmful to humans and they’re positioned in the first 5 places of the annual rates of morbidity and mortality according to the WHO, which means, that produces more diseases and deaths due to their consumption per year compared to illegal drugs.

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Marijuana can be used for different purposes, both as medicinal / therapeutic and as recreational. My goal with this post is to focus on the medicinal uses of marijuana and ask you to let yourselves be educated, leave prejudices aside and open your minds about this plant sadly considered "not pleasant" in many countries.

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The use of Cannabis dates back thousands of years and is part of the idiosyncrasy of many cultures. Currently their legal prohibition have lead to criminalization, quality control problems and the lack of relevant education have worked against the scientist and doctors leaving them swimming in the seas of ignorance about the use of Cannabis as a treatment.

To begin with, I will give a brief description of the active components of Cannabis, which are mainly responsible for the therapeutic effects of this plant.

Tetrahydrocannabinol (THC):

It’s the chemical compound and the main psychoactive constituent of cannabis, it’s responsible for providing an euphoric state to the person. THC is commonly known for getting you “high”, but it is not the only thing is capable of. It has a multitude of benefits that have been scientifically related to THC. However, it can also have adverse effects on some people. The psychoactive effects of THC vary from person to person depending on the variety of marijuana used and how it is taken.

Cannabidiol (CBD):

It is a cannabinoid that is part of the 113 chemical compounds of cannabis, being the main component of the plant. Unlike THC, it’s less powerful and does not produce psychoactive effects, I mean, it doesn’t get you "high".

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THERAPEUTIC USE

Marijuana has a promising horizon in the treatment of many rare diseases or conditions that don’t have effective therapeutic alternatives, or where the side effects of such treatments outweigh the benefits.

These are some diseases or conditions in which cannabis has benefits based on conclusive evidence:

• Chronic pain in adults
• Spasticity symptoms of multiple sclerosis
• Nausea and vomiting induced by chemotherapy
• Seizures in the Dravet and Lennox-Gastaut syndromes.

Benefits in diseases or conditions based on moderate evidence of efficacy:

• Individuals with sleep disorders associated with chronic pain, multiple sclerosis, fibromyalgia, obstructive sleep apnea syndrome.
• Decrease in intraocular pressure in glaucoma.
• Symptoms of dementia
• Symptoms of Parkinson's disease
• Positive and negative symptoms of schizophrenia.
• Symptoms of PTSD.
• Appetite and decreased weight loss associated with HIV / AIDS

Diseases or conditions with insufficient evidence of effectiveness or ineffectiveness in:

• Abstinence from addictions
• Symptoms of irritable bowel syndrome
• Cancers, including glioma.
• Anorexia associated with cancer, cachexia syndrome and anorexia nervosa.
• Symptoms of amyotrophic lateral sclerosis.
• Chorea and some neuropsychiatric symptoms associated with Huntington's disease.
• Dystonia

CONTRAINDICATIONS

• Pregnancy
• Lactation
• Psychosis (except in preparations with CBD)
• COPD
• Asthma
• Heart conditions such as: angina, tachycardia.

ADVERSE EFFECTS

Cannabis has a higher safety profile compared to many other medications, with no documented deaths due to an overdose of THC or cannabis use. Although the adverse effects (more frequent) that I will mention next are dose-dependent, which means that these effects depends on the amount of cannabis consumed:

• Drowsiness / fatigue
• Dizziness
• Dry mouth
• Cough, phlegm, bronchitis (if smoked)
• Anxiety
• Sickness
• Cognitive effects
• Euphoria
• Blurry vision
• Headache

I should mention that the most common route of administration of cannabis is by respiratory route (smoking), but it’s not the recommended one since its combustion allows the release of toxic products such as: tar, carbon monoxide, PAH (polycyclic aromatic hydrocarbons), ammonia. Its chronic use is associated with bronchitis, cough, phlegm, but NO LUNG CANCER OR COPD (only if it’s cannabis only, that is, if it is not combined with tobacco). If it’s mixed with tobacco increases the risk of these mentioned diseases occur.

Currently there are 2 FDA approved pill medications that are synthetic derivatives of cannabinoids: Dronabinol and Nabilone; and Sativex ® (Nabiximol) for the treatment of muscle spasticity in multiple sclerosis is approved in 29 countries, but doesn't have the approval of the FDA. The use of the marijuana plant as such is not approved as medicine, although its consumers argue that the use of marijuana provides better results to alleviate their affections.

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It’s curious that having verified the positive effects in the treatment of certain diseases and that a few countries have approved both medicinal and recreational use, the use and cultivation of the plant is still strictly penalized. Furthermore, the fact that cannabis is legalized and decriminalized in certain countries (such as the Netherlands and Uruguay) has reduced the consumption of other drugs, not to mention that it hasn't affected socially and moral speaking their population as some conservatives think. Legalizing and decriminalizing marijuana has positive horizons both in the reduction of drug trafficking cases and in the promotion of standardization of medical research with marijuana.

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For me it’s a very interesting topic to deal with, besides that it has a lot of material to debate. I would like to continue writing about cannabis from other aspects and points of view. It would be great if you let me know in the comments if you liked it, what your opinions are and if you want to read more about it or not.

Revised sources:

Practical considerations in medical cannabis administration and dosing
The Potential Side Effects of THC (Tetrahydrocannabinol)
Cannabis medicinal
La marihuana como medicina