Marijuana, a mixture of leaves, stems and flowering tops of the hemp plant, has a long and distinguished history as a medical herb (“Marijuana” 2004). It is composed of at least 421 chemicals 61 of which, known as cannabinoids, exist nowhere else in nature. Marijuana products were used in China and India as early as 3000 B. C. to treat a variety of illnesses from easing the pain of childbirth to relieving asthma and epilepsy, and improving appetite (Parker 2006). In Western medicine marijuana attained importance during the 19th Century. In the 1830s, Dr.
William O’Shaughnessy, a British physician, began experimenting with various cannabis preparations. He found that the drug was safe and effective in treating rabies, rheumatism, epilepsy and tetanus and published his studies in 1839. This marked the beginning of an intensive period of cannabis study in Europe and America. In America, the first extensive study of cannabis in medicine was completed in 1860 by the Ohio Medical Society. In this study, the physicians reported good results in treating such disorders as psychosis, neuralgia, stomach pain and chronic cough.
Between 1840 and 1900, European and American journals published more than 100 articles on the therapeutic use of marijuana (“Cannabis and Medicine” 2006). However, in the 20th century, marijuana use declined because the potency of preparations was variable and alternatives, such as injectable opiates and synthetic drugs like aspirin and barbiturates, became available. In the U. S. , the Marijuana Tax Act, designed to prevent nonmedical use, made cannabis so difficult to obtain for medical purposes that it was removed from the pharmacopeia in 1942 (“Cannabis and Medicine” 2006).
Marijuana was confined to “Schedule I under the Controlled Substances Act as a drug that has high potential for abuse, lacks an acceptable medical use and is unsafe under medical supervision” (Grinspoon 2002). Only in the 1970s, when marijuana smoking exploded throughout the world, did researchers begin to re-examine the drug’s possible therapeutic uses. Clinical studies and informal findings of patients themselves revealed marijuana’s effect in the treatment of symptoms of several serious illnesses.
Federal regulations, however, made research with marijuana very difficult, and physicians still were not allowed to prescribe it to their patients (“Cannabis and Medicine” 2006). Polls and voter surveys have shown that the majority of Americans think marijuana should be medically available (Grinspoon 2002). Last fall California voters approved a measure that permits patients, on the advice of a doctor, to use marijuana to ease the symptoms of any illness. Arizona voters passed a similar initiative (Grinspoon 2002). Advocates are now pushing for laws in other states.
One of marijuana’s therapeutic benefits is its ability to suppress the nausea and vomiting suffered by many patients undergoing chemotherapy. Conventional anti-nausea medications often fail to control these symptoms, and the main active substance in marijuana, tetrahydrocannabinol (THC), taken orally appeared to be less effective than crude marijuana. Marijuana’s vapor is easily absorbed and acts quickly. Moreover, other cannabinoids in the marijuana plant may modify the action of THC (Grinspoon 2002). Marijuana reefers allow users to fine-tune the dose for themselves.
Chemotherapy constantly reminds patients of their life-threatening illness. Having marijuana cigarettes under their control, patients tend to ease their feelings of helplessness (“Marijuana as a Medicine” 2004). In a 1990 poll of American oncologists, nearly 70% of physicians said that they would prescribe marijuana to their patients if it were legal. More than 40% of oncologists said that they had suggested that patients smoke marijuana for the relief of nausea induced by chemotherapy (“Cannabis and Medicine” 2006).
Marijuana’s ability to stimulate appetite, known to mankind for centuries, is particularly significant now in the treatment of AIDS. A large number of patients with AIDS smoke marijuana to combat the human immunodeficiency virus infection and associated wasting syndrome. Smoking appears to be more effective in enhancing appetite than taking THC in the capsule form. Even though insurance will pay for synthetic version of THC, some patients spend their money and risk breaking the law for the more effective marijuana (Conant 2005).
The best alternative to smoked marijuana for combating AIDS is human growth hormone, which has been found to restore muscle and improve chances of survival. However, the cost of this hormone for a year’s supply is $ 36,000 whereas marijuana treatment for the same period costs $500 (“Marijuana as a Medicine” 2004). The other important therapeutic effect of marijuana involves people with neuropathic pain and with spastic disorders such as multiple sclerosis. Many of these patients suffer from spasms and intensive burning sensations in their limbs, particularly at night.
In some cases, when conventional muscle relaxants and analgesics were not effective, marijuana relieved the suffering. For example, 39 year-old Andrew Hasenfeld, a patient with multiple sclerosis, tried the prescription drug Baclofen, but it never relieved the spasms, the stiffness, or the sensation of “being all locked up”. At the urging of fellow sufferers he started to use marijuana, and the improvements were dramatic (Cowley 2004). It is well known that marijuana can help control glaucoma by reducing pressure within the eyeball.
Elevated intraocular pressure in patients with glaucoma damages the optic nerve and leads to blindness: “This is why, until 1991, America’s Food and Drug Administration (FDA) permitted ophthalmologists to prescribe the marijuana to patients for whom other treatments had failed” (“Marijuana as a Medicine” 2004). Recently new topical treatments of glaucoma have been developed. However, no approved drug actually makes the eye’s drainage system more efficient. If marijuana improves the outflow, it would be a valuable addition to currently used medications (“Marijuana as a Medicine” 2004).
On the basis of therapeutic benefits which marijuana demonstrates for people suffering from serious and terminal illnesses, several attempts have been made to shift the drug from Schedule I to Schedule II, which would allow physicians to prescribe marijuana for medical purposes. However, these attempts have been unsuccessful, and the National Institute of Health (NIH) has consistently refused to fund research on marijuana. Many anti-marijuana advocates express a fear that medical availability of the drug would lead to increased non-medical recreational use.
These fears are unwarranted because morphine, a drug with both abuse and therapeutic potential, have always been available as a prescription drug, but no one believes that its availability is a significant cause of illicit use (Grinspoon 2002). The other argument which opponents of medical use of marijuana bring forth is that there is no reliable scientific proof that marijuana has better therapeutic effect than other approved and available medications and that the medical usefulness of the drug has not been demonstrated by controlled clinical studies (Annas 2004).
It is true that there have been no studies controlled according to standards required by FDA; however, several experiments involving large numbers of patients suggest an advantage for marijuana over oral THC and other medicines. For example, a state research program in New Mexico from 1978 to 1986 provided marijuana and synthetic THC to about 250 cancer patients receiving chemotherapy after conventional medications failed to control their nausea. This study showed that marijuana was clearly superior to both chlorpromazine and THC (Grinspoon 2004).
Because the federal government is the only legal source of the drug for research purposes in America, controlled trials without federal government permission and NIH approval are impossible. Some opponents of medical marijuana raise the question that marijuana smoking would be especially hazardous for patients with AIDS because of marijuana’s inhibitory effect on the immune system (Nahas 2002). The recent studies, however, do not support this claim.
In a trial done on 5,000 homosexual men for 18 months, scientists found that the use of marijuana “was not correlated with the immune status of AIDS patients and did not affect the rate of progression of disease” (Grinspoon 2004). The argument that marijuana smoking could damage lungs is also prominent. Marijuana smoke could be dirtier than tobacco smoke and could have negative effects on health. However, in medical use the amount smoked is less than conventional smokers inhale. Moreover, different solutions may be found. The use of water pipes could potentially be one such solution.
Besides, the medically useful ingredients in marijuana could be extracted and inhaled as vapors by patients (Grinspoon 2004). Marijuana is a useful palliative medicine for many seriously ill patients, and it is inhumane to prohibit physicians from helping their suffering patients. Marijuana should be made available by prescription without the requirement of controlled clinical studies. Research will go on, and, while it does, marijuana should become available for the sick and dying. We should legalize the medical use of marijuana nationwide. References
Annas, George J. “Reefer Madness? The Federal Response to California’s Medical Marijuana Law. ” The New England Journal of Medicine, 7 Aug. 2004: 435? 39. “Cannabis and Medicine. ” [Brochure] Robert C. Randall, 2006. Conant, Marcus. “This Is Smart Medicine. ” Newsweek, 3 Feb. 2005. 28 Nov. 2005. EbscoHost. Online. Ebsco Publishing. Cowley, Geoffrey. “Can Marijuana Be Medicine? ” Newsweek, 3 Feb. 2004. 1 Dec. 2004. EbscoHost. Online. Ebsco Publishing. Grinspoon, Lester and James B. Bakalar. “Marijuana as Medicine: A Plea for Reconsideration.
” JAMA, 21 Jun. 2002: 1875? 76. Grinspoon, Lester and James B. Bakalar. “Marijuana as Medicine: In Reply. ” JAMA, 20 Dec. 2002: 1838. Grinspoon, Lester and Jack Lewin. “Should Americans Be Allowed to Smoke Marijuana as Medicine? ” Health, Mar. 2004: 29. “Marijuana. ” Encyclopedia Americana, 2004 ed. “Marijuana as a Medicine: A Subtle Syllogism. ” Economist, 16 Aug. 2004: 63-64. Nahas, Gabriel G. and William M. Manager. “Marijuana as Medicine. ” Letter to the Editor. JAMA, 20 Dec. 2002:1837-38. Parker, Jim. “Marijuana: Medical Uses. ” [Brochure] .