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Medical Marijuana Legalization: Opportunities and Obstacles

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Humans have been using marijuana for centuries, and yet, there are always some health concerns, controversies and stigma surrounding its use. Some of the concerns may have some legitimacy, while others are simply unfounded. Legally and illegally, millions of people are using cannabis, for medical reasons and recreationally. The ‘high’ effects of THC make it controversial – to some extent – and the long-term side effects of cannabis use remain unclear. Like any other drug, a complete understanding of marijuana and its possible side effects are essential to use it safely and effectively.

In this article, I’ve tried my best to neutrally analyze the pros and cons of marijuana use for medicinal purposes.

What are the Pros of Medical Marijuana?

If we look at its history, cannabis has been used as a medicine for 4,000 years all over the world. Currently, only 6% of research studies are focused on cannabis clinical trials and the strength of available evidence is remarkable to demonstrate the efficacy of cannabis against various diseases and disorders.

Medical Benefits of Marijuana

  • Marijuana use can likely prevent and treat cancer and slow cancer progression.
  • Research studies have shown that cannabis can relieve nausea and vomiting, including chemotherapy-associated gastrointestinal disturbances.
  • Marijuana can be useful in treating neuromuscular disorders, including multiple sclerosis and related muscle spasticity.
  • Due to its anti-inflammatory properties, cannabis can be employed to treat various pain disorders including fibromyalgia, osteoarthritis, rheumatoid arthritis and chronic neuropathic pain with varied etiologies. In fact, marijuana is a safer option to treat chronic pain disorders, compared to prescription opioid drugs and non-steroidal anti-inflammatory drugs.
  • Studies have shown that marijuana can lower intra-ocular pressure and treat glaucoma.
  • The research and anecdotal evidence of marijuana’s anti-epileptic potential is mounting. The anti-epileptic benefits of cannabis are mainly due to THC, which acts centrally and controls neuroexcitability.  
  • Similarly, the brain-specific action of cannabis can be helpful to relieve anxiety, depression, nightmares and insomnia. By reducing brain inhibitory mechanisms via dopamine-related actions, marijuana can likely increase the brain’s creative thinking.
  • Contrary to popular belief (it’s a myth, actually), cannabis smoking does not cause lung problems, but actually helps asthmatic patients to breathe more freely.
  • Good news for weed users: cannabis can help us to maintain optimal body weight.

The above said medical benefits of cannabis are not meant to be an exhaustive list and many more could be added. Proven and anecdotal evidences have shown that cannabis can improve appetite, treat Crohn’s disease, relieve non-cancer pain including neuropathic pain, and protect the brain from trauma and concussions.

You can get all these benefits with few side effects. Yes, marijuana has its own side effects, but they are temporary and non-toxic. Most of the side effects are mild to moderate and include dry mouth, balance difficulties, temporary memory loss, psychoactive effects, dizziness and fatigue.

I don’t want to say cannabis has no recreational or abusing potential. However, marijuana has irrefutable medical benefits, albeit with fewer side effects than many conventional drug therapies.

Some experts have expressed their concern that prolonged cannabis use can lead to psychological dependence in 10% of cannabis users. Yes, it may happen in long-term, heavy cannabis users. But we should note that psychological dependence is different from chemical dependence and true addiction. There is no evidence available to show that cannabis can cause true addiction, which is common in cigarette smokers, alcoholics and hard drugs users.

To our surprise, one study has reported that marijuana may improve lung function and pulmonary capacity among tobacco smokers. This particular benefit may possibly reverse some of the negative pulmonary effects of tobacco smoking.  

Likewise, there are no studies to clearly define withdrawal syndrome in cannabis users. In addiction medicine, occurrence of withdrawal syndrome is the hallmark of true addiction.

Unlike cigarette smokers, most cannabis users do not use cannabis on a daily basis. Recreational cannabis users (not heavy users) who are in their early twenties tend to quit recreational cannabis use after, or within, a decade.

Research evidence has shown that marijuana smoking is 114 times safer than alcohol. Survey studies have noted that more than 17.6 million U.S. people are addicted to alcohol, while just 9% of heavy marijuana users are getting psychologically addicted. Fortunately, there is no chance for cannabis overdose and related deaths, which is quite common among alcoholics and hard drugs users.

Other Non-medical Benefits of Marijuana

With piling evidence that supports the positive view of medical cannabis use, we can also see more economical benefits of marijuana legalization.

In states with legalized medical cannabis, the medical crop accounts for over 3% of total tax revenue. While healing the sick, marijuana farming, secured supplying and licensed dispensing can generate more job opportunities and stimulus to the economy.

Individuals who are predisposed to hard drug use could gain more opportunity to use marijuana. Due to legalization and widespread availability, they tend to prefer marijuana over hard drugs, naturally. While these benefits can reduce the risk of opioid use, overdose related deaths and healthcare economic burden; legalized marijuana use can pump domestic funds into the legalized drug market (instead of illegal hard drugs), and help the nation’s economy.

Medical marijuana legalization can bring down the annual sales of illegal weed, as well as billions of dollars that are being spent towards prohibition efforts by law enforcement agencies.

Studies have alleviated our health concerns of cannabis use and the fears about the gateway theory of marijuana use. But even with these amazing health benefits, the long-term effects of marijuana use are still unclear, and remain a concern.

Still, we can say with certainty that pot is safer than commonly abused drugs, alcohol and tobacco.

What are the Cons of Medical Marijuana?

At some point, we must accept that marijuana is not a panacea, or a cure-all for every illness. However, there is no question about its efficacy and safety, which is significantly better than conventional therapeutic drugs. Yes, certainly there are some downsides in medical marijuana use. It can cause mild to moderate side effects, albeit temporarily. We should understand that marijuana is also a medicine, like any other drug.

If someone cannot accept these side effects, they should not even take acetaminophen or aspirin for their headache. These pain relievers can cause intestinal bleeding, anaphylaxis and other serious side effects. If aspirin can gets its way into the market, why not cannabis?

Smoking cannabis can temporarily cause psychosis, dry mouth, dizziness, increased heart rate, red eyes and also respiratory problems in the long run, in heavy users. Frequent and prolonged marijuana use may negatively affect your short-term memory and cognitive abilities. Some studies have found reduction in verbal memory among long-term marijuana users. A few studies have suggested that long-term marijuana use has resulted in reduction of brain volume, but these studies lacked statistical and clinical significance. Studies have found that 9% of heavy, long-term recreational marijuana users are becoming addicted to the weed. Encouragingly, the study concluded that cannabis was comparatively less harmful than alcohol and tobacco.

Most of the studies that voiced concerns about long-term effects are attributed to recreational use. These side effects are more likely common in schizophrenia patients with or without psychotic episodes, and a familial history of psychosis, heart patients due to altered heart rate after marijuana use, men with low testosterone levels (cannabis can lower testosterone levels), and immunocompromised individuals with increased risk of opportunistic infections. These adverse events can be evident in prolonged, heavy users. These problems can be mitigated by contraindicating medical cannabis use in these patients, or until the long-term observational research studies clear the cloud.  

Even some medical marijuana activists have voiced their concern that there is a massive diversion of legally grown medical cannabis to recreational use, and also to other U.S. states where cannabis use is illegal for all purposes. These problems can be eliminated by forming a secure supply chain between the licensed marijuana growers, doctors and licensed pharmacists.

Conclusion

As you know, I’m an ardent advocate of medical marijuana, and have been for years. Still, I’m not unaware of the social and medical problems associated with medical cannabis use. Nothing comes without problems.

Despite this, I see several good reasons to legalize and prescribe cannabis for medicinal use. For long-term treatments, such as chronic pain management, definitely there are some concerns. To eliminate these issues, long-term, controlled clinical trials and observational studies should be initiated to determine the long-term efficacy and safety in these patients.

Honestly, in my opinion, cannabis is better and safer than any other pharmaceuticals, including prescription opioids. Let’s make it available for those in need!

At the moment, my opinion stands to make medical cannabis legal all over the world for the well-being of this generation, as well as future generations.

 

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