Medical Marijuana: Benefits, Risks & State Laws

Medical marijuana is legal in 26 states, the District of Columbia and Guam. Proponents of marijuana,
backed by several studies, say the drug has many therapeutic uses. Opponents — and the U.S.
government — however, say it has a high potential for abuse and no legitimate therapeutic value.
Marijuana's medicinal uses can be traced back as early as 2737 B.C., when the emperor of China,
Shen Neng, touted cannabis tea as a treatment for gout, rheumatism, malaria and even poor
memory, writes Mitch Earleywine, a professor of psychology at the State University of New York at
Albany who researches drugs and addiction, in "Understanding Marijuana: A New Look at the
Scientific Evidence" (Oxford University Press, 2005). The drug's popularity as a medicine spread
throughout Asia, the Middle East and then to Africa and India, where Hindu sects used it for pain and
stress relief.
William O'Shaughnessy, an Irish doctor, popularized medical use of cannabis in England and
America after noting its effects in India.
But by the late 1800s, with morphine addiction rampant in the United States, attitudes toward drugs
such as marijuana shifted dramatically. As a result, the Food and Drug Administration was formed in
1906. While marijuana wasn't specifically mentioned in the original FDA guidelines, the move to
control chemical substances curtailed its use as treatment.
By 1937, the Marihuana Tax Act [sic] imposed such high taxes on physicians prescribing cannabis,
retail pharmacists selling cannabis, and those cultivating medical cannabis that it essentially fell out
of favor as a treatment.

Health benefits
Medical marijuana is available in several different forms. It can be smoked, vaporized, ingested in a
pill form or an edible version can be added to foods such as brownies, cookies and chocolate bars.
Because the federal Drug Enforcement Administration has classified marijuana as a schedule 1
drug — meaning it has a high potential for abuse and no legitimate therapeutic uses — it is
exceptionally difficult to do high-quality studies on its medicinal effects in the United States, said
Donald Abrams, an integrative medicine specialist for cancer patients at the University of California,
San Francisco.
But the idea that marijuana may have therapeutic effects is rooted in solid science. Marijuana
contains 60 active ingredients known as cannabinoids. The body naturally makes its own form of
cannabinoids to modulate pain, Abrams said.
The primary psychoactive cannabinoid in marijuana is THC, or tetrahydrocannabinol. THC targets
the CB1 receptor, a cannabinoid receptor found primarily in the brain, but also in the nervous
system, liver, kidney and lungs. The CB1 receptor is activated to quiet the response to pain or
noxious chemicals.
CBC, another cannabinoid, may be used to reducing pain and inflammation. It may also help in
controlling epileptic seizures and treating mental illness and addictions, according to the National
Institute on Drug Abuse.
A marijuana derivative, cannabidiol (CBD), was found to be beneficial in the treatment of severe
epilepsy in a 2017 large-scale, randomized clinical trial published in the New England Journal of
Medicine. Almost 40 percent of study participants experienced a significant reduction in seizures.
In a placebo-controlled, 2007 study in the journal Neurology, Abrams and his colleagues found that
marijuana is effective at reducing neuropathic pain, or pain caused by damaged nerves, in HIV
patients. Opiates, such as morphine, aren't effective at treating that sort of pain. Abrams said.
In another study, they found that marijuana, in addition to opiates, led to dramatic levels of pain
relief. (Animal models have found similar effects).
"Cannabinoids plus opiates are synergistic in their relief of pain, so that 1+1 = 5 and not 2," Abrams
told Live Science.
Researchers at the American Academy of Neurology have also found that medical marijuana in the
form of pills or oral sprays seemed to reduce stiffness and muscle spasms in multiple sclerosis (MS).
The medications also eased certain symptoms of MS, such as pain related to spasms, and painful
burning and numbness, as well as overactive bladder, according to a number of studies.
A well-known effect of marijuana use is the "munchies," so it has been used to stimulate appetite
among HIV/AIDS patients and others who have a suppressed appetite due to a medical condition or
treatment. Medical marijuana is also frequently used to treat nausea induced by chemotherapy,
though scientific studies of the smoked form of the plant are limited.
"You do not need a randomized, placebo-controlled trial to tell you that cannabis is effective as an
antinausea therapy for patients getting chemotherapy," Abrams said. "It works. It's like needing to do
a placebo-controlled trial of penicillin as an antibiotic."
Two FDA-approved, chemically altered forms of THC, dronabinol and nabilone, have been shown to
reduce chemotherapy-related nausea and vomiting in cancer patients. It is also used to help with the
symptoms of AIDS, according to the U.S. National Library of Medicine.
Medical marijuana has also been touted as a treatment for glaucoma, which is an elevated pressure
in the eyeball that can lead to blindness. While smoking marijuana may reduce intraocular pressure,
marijuana must be consumed numerous times during the day to have the desired effect and other
drugs are more effective, according to the American Cancer Society. Cannabidiol (CBD) is a non-
psychoactive component of marijuana that has therapeutic benefits, but because it does not target
the CB1 receptor, it doesn't leave people feeling stoned.
For example, a 2012 study published in the journal Translational Psychiatry found that cannabidiol
may be effective in treating schizophrenia. In the study at the University of Cologne, 42 patients
randomly received either cannabidiol or amisulpride, an effective drug used for the treatment of
schizophrenia, for 28 days. Comparison of the clinical effects found "no relevant difference" between
the two treatments.
A 2014 study by the College of Pharmacy of the University of South Florida that THC could be
helpful in the therapeutic treatment of Alzheimer's disease, as well.

Side effects
Marijuana does have side effects. THC binds to cannabinoid receptors, which are concentrated in
areas of the brain associated with thinking, memory, pleasure, coordination and time perception. The
effects of marijuana can interfere with attention, judgment and balance.
Studies have produced conflicting results on whether smoking marijuana carries a significant cancer
risk. Medical marijuana "prescriptions" are termed "recommendations" or "referrals" because of
federal laws prohibiting the prescribing of cannabis.
A 2016 study on 108 people by the University of Michigan Health System found that marijuana use
may also make other addictions worse.

Medical marijuana availability: state by state

The states and districts with medical marijuana laws are: Alaska, Arizona, Arkansas, California,
Colorado, Connecticut, Delaware, the District of Columbia, Florida, Guam, Hawaii, Illinois, Louisiana,
Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New
York, New Jersey, New Mexico, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont
and Washington.
All the states require a doctor's approval. Many of the states that allow medical marijuana have an
online application process.
In most states, patients need to fill out the application, pay a fee and provide identification
information. To successfully receive an ID card in most states, patients need a signed statement
from a doctor diagnosing the condition and a document stating that medical marijuana is the
treatment recommended for the patient's particular condition and situation.
Most of the laws allow dispensaries and outline specific conditions for which medical marijuana can
be prescribed. The restrictions also vary by state as to the format and amount of medical cannabis
that can be obtained at each visit for personal use.

Reference:
Zimmermann, K. (2017, June 6). Medical Marijuana: Benefits, Risks & State Laws. Retrieved
February 6, 2018, from https://www.livescience.com/24554-medical-marijuana.html
Jeremiah A. Carandang February 07, 2017
Grade 11-Pearl STEM

Marijuana as medicine
While President Rodrigo Duterte maintains a violent, hardline approach to ridding the Philippines of
illegal drugs, a groundbreaking bill is said to be gaining support in the House of Representatives to
legalize medical marijuana in the country.
The contrast is so glaring, it’s hard to ignore: While the war on drugs has led to thousands of deaths,
House Bill No. 180, or the proposed Philippine Compassionate Medical Cannabis Act, would improve,
if not prolong, the lives of people who ingest marijuana as medicine.
The bill is being reviewed by a technical working group, said Isabela Rep. Rodito T. Albano III, its
principal author.
Albano is pushing for the bill’s approval despite opposition from what he calls “uninformed” quarters.
In the Philippines, marijuana is at the top of the list of dangerous drugs under Republic Act No. 9165,
or the Comprehensive Dangerous Drugs Act of 2002.
Medical need
But in that same law is a provision, in Section 2, Paragraph 2, second sentence, that does not entirely
prohibit the use of dangerous drugs:
“The government shall, however, aim to achieve a balance in the national drug control program so that
people with legitimate medical needs are not prevented from being treated with adequate amounts of
appropriate medications, which include the use of dangerous drugs.”
When the Inquirer asked Albano if he had set a time frame for the bill’s passage, Albano said: “That’s
what I’ll discuss with the Speaker (Davao del Norte Rep. Pantaleon Alvarez).”
Albano said he filed the bill in 2014 “to let patients have access to medical cannabis.”
The medical conditions of those patients range from autism to epilepsy to cancer.
There are no official statistics, but private groups estimate the number of Filipinos with autism at more
than 1 million and epilepsy, more than 500,000.
A study by the University of the Philippines’ Institute of Human Genetics, National Institutes of Health
showed that 189 in 100,000 Filipinos are afflicted with cancer, while four Filipinos die of cancer every
hour.
Efficiacy
Although Filipino doctors are divided on legalizing medical cannabis, a growing number of them are
convinced of its efficacy in, for instance, pain management.
“There is already compelling scientific evidence for the use of medical cannabis,” the department head
of a top hospital in Metro Manila, who requested not to be named, told the Inquirer.
He said cannabis had been proven to prevent nausea, ease pain and stimulate the appetite, especially
among chemotherapy patients.
“My son has global retardation with autistic features,” the doctor said. “He does not talk but
understands most things that the family tells him. He has seizures, too. Medical cannabis helps him
calm down.”
The doctor said he was prepared to work slowly for the legalization of marijuana.
“We can start with research, where patients can gain access to it. There are patients who need it. We
cannot turn our eyes in the other direction. There is a need for it,” he said.
He added: “Its uses in other conditions are equivocal. That is what medical science should work on, to
find more evidence and show its benefits.”
Evidence
The primary evidence is contained in the scientific papers written by Dr. Raphael Mechoulam, an
Israeli chemist who, in his research on cannabis in 1964, discovered that among its numerous
chemical compounds, only one is active: delta 9-tetrahydrocannabinol (THC), which is responsible for
the drug’s psychoactive effects (the “high” that is felt when marijuana is smoked).
Another compound, cannabidiol (CBD), acts on many of the same receptors as THC, but without the
psychoactive side effects.
CBD is the main ingredient in cannabis oil.
In the paper, Mechoulam says THC can be used as “an antivomiting and antinausea drug for cancer
chemotherapy, and as an appetite-enhancing agent.”
He says THC is being tested to help patients suffering from multiple sclerosis, and that “recent work
with cannabidiol in animal models of rheumatoid arthritis may lead to clinical investigations. A synthetic
cannabinoid, HU-211 (Dexanabinol), is in advanced clinical stages of investigation as a
neuroprotectant in head trauma.”
In 1988, scientists Allyn Howlett and William Devane of St. Louis University Medical School in Missouri
made what Mechoulam called “an important discovery about cannabis:” the human brain contains a
receptor for THC, which they named CB1 (cannabinoid receptor No. 1)
CB1 has been identified for its compatibility, or its ability to interact with certain parts of the human
brain called the endocannabinoid system.
The endocannabinoid system helps regulate sleep, appetite, digestion, hunger, mood, motor control,
immune function, reproduction and fertility, pleasure and reward, pain, memory and temperature
regulation.
The discovery confirmed what recreational users believe, based on their own experience, that
marijuana induces a natural, or safe, interaction with the human body—which itself has elements of
cannabis.
Cannabis Oil
Medical cannabis comes in various forms, including vapor, capsules, lozenges, dermal patches and oil.
In the Philippines, cannabis oil is made by private sources to help cancer patients.
A few years ago, an American residing in the Philippines was diagnosed with a “high-grade AA” brain
tumor.
In 2013, he underwent open brain surgery, then went through 42 days of radiation, which was followed
by six months of chemotherapy in 2014.
After a short period of remission, the American, who requested anonymity, said the tumor came back
in mid-2015, which required another round of radiation and chemotherapy.
In late 2016, the tumor returned for a third time. That was when he decided to try cannabis oil and go
on a vegetarian diet.
“I take the oil three times a day in very small dosages,” he said. “I still battle cancer, but I feel healthy
and strong and I’m able to live a normal life and go to work daily.”
He added: “I look forward to the day when medical cannabis will receive the credit it deserves and
becomes available for all people suffering from cancer.”
Cancer free
A female doctor, who also requested anonymity, decided to administer cannabis oil to a brother-in-law
who was suffering from mouth cancer.
Another doctor, who facilitated the supply of cannabis oil to his colleague’s brother-in-law, told the
Inquirer that the patient was declared “cancer-free in two weeks, with no need for chemo.”
But the most astounding case the Inquirer has learned about was that of an 8-year-old boy afflicted last
year with stage 4 brain cancer. His father, who also requested anonymity, recounted his son’s dramatic
journey.
When tests confirmed that the boy had multiple tumors in the brain, doctors recommended five days of
radiation for six weeks, and chemotherapy once a week for 10 months.
The father said three weeks of radiation therapy made his son “sluggish, weak, moody, have a hard
time sleeping, lose his appetite as well as his concentration.”
When friends told him about cannabis oil, he researched the subject and was willing to give it a try. He
met a doctor who helped him get the oil and advised him on administering it to his son.
He, however, did not inform his son’s doctors that he would be trying out cannabis oil on the kid.
Starting with a dose of one drop, thrice a day, of 1 ml cannabis oil through rectal suppository, the boy
was observed to “sleep soundly, had energy to play and his mood swings lessened.”
On the advice of his cannabis oil source, the father gradually increased his son’s dosage while
continuing radiation.
Two months later, the boy was taken off radiation, but went on taking the oil till the dosage reached
five drops, thrice a day.
The attending neurosurgeon requested an MRI (magnetic resonance imaging) procedure before the
boy started his chemotherapy. The MRI results showed “all four tumors in the brain shrank significantly
up to the point that one of the tumors disappeared.”
When the boy started undergoing chemotherapy, his father continued giving him cannabis oil for five
months.
A second MRI yielded results that the father described as “mind-boggling to the point of disbelief: All
tumors are now gone except for one that is suspected as a ‘scar tissue’ and is yet to be ruled out in the
next MRI. I asked the doctor if we are on track with my son’s progress, and his answer was, ‘No, we
are way ahead. I have never seen such a case respond so fast to this medical protocol. We’ve been
praying for a miracle. I believe this is a miracle.”
On June 12, attending doctors declared the boy “in remission, no maintenance meds needed, patient
in very good condition, is steadily gaining weight and his energy is back. Patient is still taking the oil
five drops, thrice daily, orally but stopped the suppository.”
Skeptics may dismiss such testimonies as merely anecdotal evidence. Yet marijuana—from which
cannabis oil is made—has, for thousands of years, been regarded as medicine, until the US
government outlawed its cultivation and use, and the Philippines adopted that law.

Reference:
Concepsion, P. (2017, August 15). Marijuana as medicine. Retrieved February 5, 2018, from
http://newsinfo.inquirer.net/922738/marijuana-as-medicine