The history of medical marijuana
Medical marijuana has a history dating back to 2737 BC when Emperor Shen-Nung in China prescribed its use for absentmindedness, beri-beri, constipation, 'female weakness,' gout, malaria and rheumatism. A Chinese script, written in 1578 by Li Shih Chen, reported that marijuana could be used as an anti-nausea agent, an antibiotic, and a means to stop hemorrhaging. The first modern English medical article on cannabis dates back to 1839 and was published by Irishman William Brooke O'Shaughnessy who was working in the service of the British in India. Throughout the nineteenth century marijuana products were in widespread use throughout the United States and sold by pharmacists over-the-counter as an ingredient in numerous remedies. Then in 1937, the US Congress passed the Marijuana Tax Act which made use of marijuana a criminal offense and effectively led to its removal from the American pharmacopoeia in 1941. In the late 1970s and early 1980s, 20 state legislatures responded to the demands of patients and scientists for solid research on marijuana. In order for officially sanctioned research programs to begin, legislation was needed to carve out exemptions under state marijuana laws for study participants, and processes and regulations were needed to guide implementation. Yet, here we are in 2005, after hundreds of studies, experiments and reports, still debating the use of marijuana as a medicine. Why is it so difficult to reach a consensus of opinion about its effects and its use? With such lack of agreement between scientists, is it any wonder that patients are confused? Myths concerning marijuana use, safety and effectiveness abound. Medical journalists are also guilty of clouding the issue running headlines on the medicinal use of marijuana but referring to it under it street names of pot, ganga, weed, and grass etc.
Medical vs. recreational use
Advocates for legalizing the use of marijuana tout claims of its effectiveness in providing relief to patients with life-threatening illnesses where other conventional therapies have failed. The fact that marijuana is purported to help patients suffering from chronic pain, and a host of other debilitating illnesses shows us that it is a powerful drug and one that should be fully researched and controlled. However, just because its use clearly requires regulation doesn’t mean that it should be made illegal. Too often, the debate on medical marijuana becomes entwined with the issue of legalizing marijuana for recreational use. These are two distinct matters and should be seen as such.
Vaporized marijuana
Another problem complicating the legalization of medical marijuana is that its route of administration is conventionally by inhalation. When a person inhales marijuana smoke, somewhere between 400 and 2,000 chemicals are distributed throughout the body. In a healthy individual this is undesirable leading to an increased risk of cancer, lung damage and poor pregnancy outcomes but for a sick person these inhaled chemicals may further compromise treatment and recovery. One proposed solution to this problem is to vaporize the drug by heating the drug to a point, just prior to combustion, where vapors are formed and released. This vaporization technique creates a clear substance that, advocates say, is practically free of many of the toxins found in marijuana smoke. The nation's first clinical human study on vaporization has just been completed by Dr. Donald I Abrams, University of California, San Francisco. Results from the two-year study are still being compiled, and will compare the level of cannabis absorbed using a vaporizer with that of smoking a marijuana cigarette. The hope is that the study of 18 healthy, regular marijuana smokers will shed light on how well vaporization delivers the palliative ingredients found in cannabis. Medical marijuana advocates have rallied behind the vaporizer technology and the hope making the drug smoke-free should be the drug more palatable as a medicine to federal officials, scientists and regulators who are dubious about the health value of a smoked drug. Manufacturers of vaporization devices are not waiting of the results. Marijuana vaporizers are readily available ranging from small soda-can size devices at around $22 to the latest high-end cone-shaped 5-pound device that is roughly the size of a blender and sells for almost $500.
Potential for abuse
The FDA continues to exercise caution. Despite much rhetoric and confusion, marijuana is currently classified as a Schedule I controlled substance. This classification means that federal law considers it to have a high potential for abuse and that there is no currently accepted medical use in treatment in the United States. Potential for abuse is another often cited reason against the legalization of marijuana but surely this applies to a host of other drugs. If potential for abuse is applied as a criterion in assessing the therapeutic value of a drug under consideration then a host of other drugs including Adderall, OxyContin, Ritalin, and Valium should all be made illegal.
If the law is wrong
As scientists we need to concentrate on determining if there really is an accepted medical use of marijuana and if so seeking routes of administration that are safe and effective for patients. The data should then be subjected to the same rigorous standards that the FDA applies to other therapies. Just because a substance may make someone “feel” better is not sufficient under our current system to classify the substance as a medicine. Access to marijuana for medical use does not benefit anyone unless the efficacy and safety profile is investigated and understood. Rigorous scientific research into the medicinal uses of botanical marijuana and other cannabinoids is needed before the drug is distributed to the sick. An education program is required to distinguish between medicinal and recreational marijuana use and caution should be used when interchanging the drugs chemical name with current “street name”. Surely it is wrong to be selective in what laws are applied and to whom they are applied? While marijuana remains a banned substance, authorities have no option but to prosecute its illegal use. The sick should not be exempt from the law; the sick should be protected by the law. If the law is wrong we need to work to change it and not just its application. As Greek philosopher and scientist Aristotle (384-322 B.C.) said “Even when laws have been written down, they ought not always to remain unaltered.”
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