By Bala Poduval
The states of Washington and Colorado legalized cannabis
(both medicinal and recreational) through voter initiative.
While the medical benefits of cannabis is understandable, the
societal impact and civil liberties of legalizing it are less
convincing and must be addressed from all perspectives.
The medical use of cannabis in western medicine dates back to the 1800s.
Cannabis has been in medical use in the United States until the
Marihuana Tax Act of 1937, which severely restricted physicians
from prescribing it. Cannabis has widely been used in ancient
India, China, Egypt, Greece and Arabia for medical, recreational and
industrial purposes. Currently, medical use of cannabis is legal in many
countries, but in the United States, it is still outlawed by Federal
government. However, twenty states and the District of Columbia have
legalized it with restrictions. This law removes all state-level
criminal penalties on the use, possession and cultivation of cannabis
by patients having written documentation from their physicians stating
that he/she suffers from a debilitating condition and might benefit from
the medical use of cannabis. However, restrictions on the quantity, the
medical conditions qualify for the use of cannabis, and its cultivation
and sale vary from state to state.
Inhaling cannabis is claimed to be effective in reducing short-term pain,
motor problems, chemotherapy-induced nausea and vomiting, and cancer.
Other medical conditions qualified under medical legalization of cannabis
include multiple sclerosis, disorders characterized by muscle spasticity,
epilepsy, chronic nervous system disorders, glaucoma, movement disorder,
HIV, AIDS, cachexia, Alzheimer’s and Parkinson’s diseases, schizophrenia
and seizures. Also, it stimulates appetite in patients suffering from
cancer, may work against some types of malignant tumors and is
neuroprotective. There are also anecdotal evidence indicating the efficacy
of cannabis in dealing with aggression, anxiety, emotional tantrums and
attention problems associated with autism spectrum disorder (ASD).
Medicinal cannabis can be administered in several ways: smoking, oils,
liquids or capsules for oral consumption and cannabis vaporization. The
concentration of cannabinoids varies widely with each of these methods.
Inhalation of smoke is known to have the most adverse effects. The drug
is an extract containing tetrahydrocannabinol (THC: the chemical triggering
psychosis), and cannabidiol (CBD: the non–psychoactive component). Although
the way CBD works on brain receptors is still not clearly known, some
studies have shown that it has the ability to calm the electrical and
chemical activities in the brain leading to seizures. The cannabis used for
treatment of seizures is in liquid form which can be mixed with food or, in
the case of children, can be administered with a dropper.
Though the medicinal effects of cannabis appear “miraculous”, prescribing
untested and unregulated treatment for young children is very alarming. Little
is known about the effects of cannabis, particularly, on children. The negative
side effects of cannabis listed by the Department of Justice (DOJ) include:
adverse physical, mental, emotional and behavior effects and short–term memory
problems (DOJ, 2014). It is not the social stigma that raises this concern and
precaution but the dependability of the claim of its medicinal values, and the
long–term (adverse) effects, especially when the negative effects involve
cognitive impairment and poor motor performance, loss of concentration and
paranoia, aggressiveness and psychosis. These aspects may not be significant in
the case of patients who are terminally ill or have a life long disability but
in the case of adolescent and young patients these effects need to be addressed
and quantitatively analyzed before legalizing treatments with cannabis,
particularly, the inhaling of it.
Flowering Cannabis Plant. Courtesey: Wikipeadia
Cannabis is a Schedule I substance under the US Controlled Substance Act (CSA).
This means that smoked cannabis ``has a high potential for abuse, has no accepted
medicinal value in treatment in the United States, and evidence that there is a
general lack of accepted safety for its use even under medical supervision"
(FDA, 2006). Therefore, it is illegal for any person to cultivate, distribute
or dispense, or possess with intent to manufacture (cultivate), distribute or
dispense it. It is also illegal for doctors to prescribe. This makes research
into the medical benefits of cannabis difficult.The FDA has noted that, "there is currently sound evidence that smoked marijuana
is harmful", and therefore, "do not support the use of smoked marijuana for medical
purposes" (FDA, 2006). Department of Health and Human Services (HHS) agencies
including FDA, Substance Abuse and Mental Health Services Administration (SAMHSA)
and National Institute for Drug Abuse (NIDA) concluded that ``no sound scientific
studies support medical use of marijuana for treatment in the United States, and
no animal or human data support the safety or efficacyof marijuana for general
medical use." (FDA, 2006). Other medical communities that do not advocate the use
of inhaled cannabis or the legalization of cannabis include: American Medical
Association (AMA), American Cancer Society (ACS), American Glaucoma Society (AGS),
American Academy of Pediatrics (AAP), The American Academy of Child and Adolescent
Psychiatry (AACAP), and American Psychiatric Association (APA). Moreover, though
they are supportive of continued research into the benefits of cannabinoids
(DOJ, 2014), they are of the opinion that cannabis has a high potential for abuse
and it triggers psychiatric disorders, adversely affecting cognitive skills and
motor performance on complex skills, such as driving.The states of Washington and Colorado legalized (both medicinal and recreational)
cannabis through voter initiative. While the medical benefits of cannabis is
understandable, the societal impact and civil liberties of legalizing it is less
convincing and must be addressed from all perspectives. Is the casual use of cannabis
really beneficial to individual and the society as claimed by proponents of cannabis
legalization (NORML)?. Is it advisable for any society to legalize something so
dangerous as the negative effects of cannabis simply because it comes under the
basic right to ``the pursuit of happiness"? Are the benefits of cannabis really
worth ignoring its negative effects, or aren't there any reasonable substitutes
that are less harmful or addictive? The medical benefits of cannabis as we know
now are based on a few case studies, or anecdotal, and not based on clinical trials
which would have proved the benefits of cannabis beyond doubt. The high percentage
of popular support in legalizing the recreational use of cannabis may be a reflection
of lack of awareness of these negative effects including psychosis. They seemed to be
moved by emotion rather than by the facts of science.Citations
DOJ, 2014: http://www.justice.gov/dea/docs/dangers-consequences-marijuana-abuse.pdf
FDA, 2006: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2006/ucm108643.htm,
Inter--Agency Advisory Regarding Claims That Smoked Marijuana Is a Medicine", US Food
and Drug Administration, April~20, 2006.
