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Medical Marijuana

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It seems as though you can’t go more than a few minutes these days without hearing about medical marijuana, and there is no lack of hysterical ranting on any side of the questions posed. There are, however, a few rational voices, and some of them are even coming from the government, which has been staunchly in the “marijuana is bad” camp for decades. I thought I would check in with the National Institutes of Health (NIH), and see what they are saying these days.

It turns out they are saying quite a bit. Dr Nora Volkow is the director of the National Institute of Drug Abuse (NIDA), and writes a monthly blog about the work being done at NIDA. She has written about marijuana 4 times in the past year! Here is some of what is being said …

There are at least 100 different cannabinoid chemicals in marijuana. Cannabinoids are chemicals specific to marijuana, also known as cannabis. The two we know the most about are delta-9-tetrahydrocannabinol (no wonder we shorten it to “THC”) and cannabidiol (CBD). THC is responsible for the “high” or feeling of euphoria we associate with recreational use of cannabis, and reduces nausea and increases appetite. CBD has been studied since the 1970’s for the treatment of epilepsy, and there is preliminary evidence indicating it might be helpful in the treatment of autoimmune diseases, inflammation, pain, even addiction. In fact, CBD seems to reduce the “high” caused by THC. (Ironically, 1970 was also the year that marijuana was provisionally classified as a Schedule I drug, indicating “no accepted medical use,” joining heroin and LSD. This classification has been regularly challenged since 1972.)

Research is slowly increasing on the potential benefits of cannabinoids. CBD is being studied for the treatment of epilepsy, Huntington’s chorea, multiple sclerosis, schizophrenia, chronic pain disorders, cancer and substance abuse disorders. THC continues to be studied for its role in treating nausea and loss of appetite. There is very little research on the other 98 or so cannabinoids. Receptors for cannabinoids are found in nerves, the brain, several organs, connective tissue, several glands, and immune cells.

Like any medication that has an effect, cannabinoids have side effects, or potential undesirable effects. Marijuana can cause alterations in senses and mood, leading to hallucinations, euphoria, paranoia, depression and anxiety, and can trigger schizophrenic symptoms in susceptible people. There can be impairments in thinking, memory, problem-solving ability. In children and teens, these impairments seem to be permanent, leading to reduction in IQ and learning disabilities. Delayed reflexes and changes in the sense of time may increase the risk of falling, and motor vehicle accidents. Heart rate increases for about 3 hours after using, which is cause for concern in people with certain types of cardiac problems. Addiction occurs in about 9% of the people who use marijuana. Withdrawal after prolonged use can cause irritability, insomnia, decreased appetite, anxiety and cravings. Most of these adverse effects seem to be caused mostly by THC, but it is not entirely clear.

Currently, there are many different strains of cannabis. Varieties that are grown for recreational use are usually very high in THC, and often very low in CBD. Growers and dispensaries make claims about which variety is good for what problem, but there isn’t a lot of research evidence to support the claims. There is no way to determine the exact dose of cannabinoids, so it’s hard to determine exactly what you are getting. Cannabis can be taken in several different forms, including vaporizing, topical creams or oils, edibles such as cookies or candy, drops, and teas. We don’t know a lot about how taking one form of cannabis compares to other forms.

So, as you can see, there are a LOT of difficult questions. Marijuana is likely going to prove to be very helpful for some people, very problematic for other people, and somewhere along the spectrum for most people.


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