More states are passing laws that allow people to use medical marijuana. So what does it treat, and who can and should use it? Pain is the main reason people ask for a prescription, says Barth Wilsey, MD, a pain medicine specialist at the University of California Davis Medical Center. It could be from headaches, a disease like cancer, or a long-term condition, like glaucomaor nerve pain.
By Dr. Mercola
Marijuana has been legalized in a number of US states; 20 states have legalized cannabis for medical purposes; two states—Colorado and Washington state—also permit recreational use. Certain forms of cannabis are actually very potent medicine, with few or no psychoactive effects.
In California, medical marijuana has been legal for 18 years. Dr. Allan Frankel, a board-certified internist in California, has treated patients with medical cannabis for the past seven years.
By and large, cannabis is highly favored by people across the US. According to Dr. Frankel, 85-95 percent of Americans are in favor of medical cannabis, and 58-59 percent are in favor of legalizing marijuana.
The federal government, meanwhile, wants to get rid of all medical use of marijuana, which of course begs the question: Why? According to Dr. Frankel, the answer is simple. “They want it. This is a huge market,” he says.
And yes, medical cannabis is clearly competition to the pharmaceutical industry, as the cannabis plant can take the place of a wide variety of synthetic drugs, especially for mood and anxiety disorders. The last thing they want is a therapy that's going to take away from their bottom line.
Cannabis as Medicine
Dr. Frankel initially learned about medical cannabis through glaucoma trials and cancer work performed at UCLA in the 70s and early 80s.
“I've always seen it as a medicine,” he says. “Eventually, I got interested in it. I thought my tool box was getting too small for typical issues with patients related to anxiety, pain, or the common issues where we just had inadequate medications.
I saw the cannabinoid future was something that was bright. Seven years ago, I kind of picked up my formal white coat and sprayed a little green on it…”
Green Bridge Medical is his professional corporation where he sees patients, performs research, and provides physician and patient education and outreach. For all its benefits, using cannabis in lieu of other medicines has many challenges.
“It's a complicated process, as a physician in particular, working inside the medical system, to work outside the medical system to make these dose-consistent extracts available.”
Many may find the idea of medical cannabis abhorrent or somehow “wrong,” as we've been indoctrinated to view marijuana as a dangerous gateway drug that will lead you down a path of illicit drug use.
Many fail to realize that prescription drugs actually have FAR greater potential to turn you into “a junkie.” Legal drug addiction is also taking lives in record numbers. In the UK, one million people are addicted to over-the-counter (OTC) and prescription painkillers and tranquilizers.
That's significantly more than the number addicted to illegal drugs. In the US, there were four times more deaths among women from prescription painkiller overdose than for cocaine and heroin deaths combined in 2010.
Pharmaceuticals in general are among the leading causes of death in the US, and some medicines have killed tens of thousands of individuals. The painkiller Vioxx is one classic example, which killed over 60,000 before being pulled off the market.
The diabetes drug Avandia is another, and most recently, a study estimated that in a five-year span, some 800,000 people in Europe were killed from inappropriate use of beta-blockers in non-cardiac surgery patients. Deaths attributed to cannabis barely registers in comparison.
“I think that any intervention, regardless of how benign (I would say in my 35 years of medical experience, cannabis should be considered a benign substance overall), there are potential uses and abuses,” Dr. Frankel says.
“For me, we're just talking about the real solid indications. The issue of abuse and neglect is there, but I think it's relatively small. I think the claim that it is a gateway drug has been pretty soundly proven not to be correct.
Even if cannabis to some extent is a gateway drug (which I do not believe it is), even if it is, it should be legalized to protect the gateway [drug] issue, because legalization opens up communication.”
What's the Difference Between Medical and Non-Medical Marijuana?
According to Dr. Frankel, cannabis has been cultivated in Northern Europe since before the last Ice Age. Even back then, there were two very distinct groups of strains. One is cannabis; the other is hemp. There's plenty of confusion about the similarities and differences between these two plants. While they are subspecies of the same plant species, they look very different, and are extremely different in ways that really matter when it comes to medicinal use.
The thing they have in common is that they both contain cannabidiol (CBD), which has medicinal properties. The amount of CBD however, differs greatly between the two. Dosing, therefore, is dramatically different where you to try to use hemp in lieu of cannabis, as the latter, cannabis, is up to 100-fold more potent. Another difference that appears to matter in terms of its usefulness as medicine relates to differing terpene profiles. Hemp contains very little of these valuable medicinal compounds.
Lastly, there's the tetrahydrocannabinol (THC) content. THC is the psychoactive component of marijuana; it's the molecule that makes you feel “stoned.” (While cannabidiol (CBD) also has certain psychoactive properties, it does NOT produce a high.) By legal definition, hemp cannot have more than 0.3 percent tetrahydrocannabinol (THC) in it. So to summarize:
- Hemp has less value for medicinal uses, as it only contains about four percent CBD and lacks many of the medicinal terpenes and flavonoids. It also contains less than 0.3 percent THC, which means it cannot produce a high or get you stoned. However, for many disease processes, THC is very much indicated and required. So, for many disease processes, CBD alone has much less value.
- Cannabis is potent medicine courtesy of high amounts (about 10-20 percent) of CBD, critical levels of medicinal terpenes, and flavanoids, as well as THC in varying ratios for various diseases. The higher the THC, the more pronounced its psychoactive effects
Medical marijuana is not monitored like FDA-approved medicines. When using it, you don’t know its potential to cause cancer, its purity, potency, or side effects. Only people who have a card from a doctor should use medical marijuana. Doctors will not prescribe medical marijuana to anyone under 18. Others who should not use it, people with heart disease, pregnant women, and people with a history of psychosis.
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