“Marijuana” is often used interchangeably with “cannabis,” but the two are not necessarily the same. The latter refers to the plant, Cannabis sativa, from which marijuana is derived. Marijuana refers to parts of the plant that hold substantial amounts of tetrahydrocannabinol (THC), which is responsible for the “high” (altered mental state). The use of cannabis, specifically herbal marijuana, comes along with negative stigma throughout the world. For medicinal purposes and recreational use, general apprehensiveness about opportunities for potential abuse persists despite the proliferation of scientific studies and technological discoveries in support of cannabis’ medical benefits. The aspect of Jekyll versus Hyde when talking about benefit vs. abuse has also impeded the legalization of marijuana in many places for all uses. However, as a silver lining for marijuana supporters, many medical professionals, researchers, and the general population support the drug’s medicinal assets.
THC and cannabidiol (CBD) are the two main cannabinoids, or substances in the plant that induces euphoria, increased appetite, and dry mouth, among other effects [1]. The FDA has yet to approve the cannabis plant for medical use but has approved multiple drugs that contain cannabinoids, including Epidiolex and Marinol. Epidiolex treats seizures associated with two forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome. Marinol, which contains synthetic THC, treats nausea and vomiting induced by cancer chemotherapy. As marijuana has proven beneficial for ameliorating a wide variety of symptoms, research on its application for treating other conditions is necessary and expanding.
In a 2015 study conducted by the PEW Research Center, among the 53% of participants in support of marijuana legalization, 41% cited its medicinal benefits as a reason for legalization [2]. First, cannabinoids, a type of chemical in herbal marijuana, are suitable alternatives to antiemetics for patients experiencing chemotherapy-induced nausea and vomiting [3]. Moreover, in a prospective observational study about medical cannabis for patients’ chronic pain, significant improvements in the severity and interference of pain were seen in participants as early as one month after starting treatment and were maintained over the course of the 12-month observation period (mean BPI-S score was 5.58 ± 1.53 at baseline, indicating moderate to severe pain, and 3.49 ± 2.17 at M12, indicating mild to moderate pain) [4]. Lastly, cannabis administration for patients with multiple sclerosis (MS) is associated with decreased symptom severity and may have a positive impact on the cytokine and clinical profiles in cases [5].
Legalization, or lack-there-of, of medical marijuana, varies between states. As of November 2020, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and 36 states in the U.S. have passed legalization for the decriminalization of medical marijuana. 11 states legalized the use of “low THC, high cannabidiol (CBD)” products in medical situations [6]. All legalized use is tightly regulated to avoid abuse of the Schedule 1 substance, therefore lowering the risks for drug abuse. Evidenced in part by the recent legalization of marijuana for recreational purposes in New York, regulations have and will likely become more progressive as research continues to back its multifaceted functions in medicine.
References:
1. U.S. Department of Health and Human Services. (n.d.). Cannabis (Marijuana) and Cannabinoids: What You Need To Know. National Center for Complementary and Integrative Health.https://www.nccih.nih.gov/health/cannabis-marijuana-andcannabinoids-what-you-need-to-know.
2. Pew Research Center. (2020, May 30). Why Americans Support or Oppose Legalizing Marijuana. Pew Research Center - U.S. Politics & Policy. https://www.pewresearch.org/politics/2015/04/14/in-debateover-legalizing-marijuana-disagreement-over-drugs-dangers/.
3. Tramèr, M. R., Carroll, D., Campbell, F. A., Reynolds, D. J., Moore, R. A., & McQuay, H. J. (2001). Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. BMJ (Clinical research ed.), 323(7303), 16–21. https://doi.org/10.1136/bmj.323.7303.16
4. Safakish, R., Ko, G., Salimpour, V., Hendin, B., Sohanpal, I., Loheswaran, G., & Yoon, S. Y. (2020). Medical Cannabis for the Management of Pain and Quality of Life in Chronic Pain Patients: A Prospective Observational Study. Pain Medicine, 21(11), 3073–3086. https://doi.org/10.1093/pm/pnaa163
5. Mustafa, W., Elgendy, N., Salama, S., Jawad, M., & Eltoukhy, K. (2021). The Effect of Cannabis on the Clinical and Cytokine Profiles in Patients with Multiple Sclerosis. Multiple sclerosis international, 2021, 6611897. https://doi.org/10.1155/2021/6611897
6. Karmen Hanson, A. (n.d.). State medical marijuana laws. Retrieved April 27, 2021, from https://www.ncsl.org/research/health/statemedical-marijuana-laws.aspx