Marijuana: Medical Cure or Catastrophe?

The legalization of marijuana for medical purposes across various locations in the U.S. has ignited debates on the practicality and efficacy of such a treatment. Several "home grown" marijuana treatments have surfaced claiming to bridge the gap between marijuana and practical medicine through seemingly empirical results. On the other hand, medical researchers continually persist in saying that medical marijuana not only lacks any verifiable medical benefits, but also has significant health drawbacks.

The debate on making marijuana a legal drug is multifaceted from a medical perspective. Several studies have arisen attempting to forge links between medical marijuana and alleviation of HIV/AIDS, multiple sclerosis, nausea and cancer. Most recently, the use of medical marijuana as a treatment for debilitating epilepsy has drawn notable attention. Ultimately, mass production of medical marijuana for the purposes of treating epilepsy would have a profound impact on not only neurological research but also the health care industry as a whole.

The city of Philadelphia recently decriminalized the use of Marijuana. It seems as if every day, legislation is being passed across the United States legalizing and/or decriminalizing the drug's use for medical and other purposes. Although marijuana has temporarily been introduced into medicine in the United States several times over our short history, the Controlled Substances Act of 1970 ignited the most recent intense debates on medical usage. Declaring marijuana an illegal drug with no medical use infuriated both public policy makers and medical scientists alike.

Major opponents argue that the legalization/decriminalization of marijuana would open the floodgates up to anyone who wants to get their hands on the drug. However, this could not be more false. Patients in need of medical marijuana must obtain a qualified physician's letter (a state issued form) justifying the need for the drug, register for an identification card and finally register and check back in with a cultivation center and the dispensing organization. In spite of passage, several legislative predicaments limit use even for legitimate medical purposes. For example, just recently a committee of state legislators in Iowa approved an act legalizing the growth and distribution of medical marijuana. The issue is that most states, including Iowa, with legal medical marijuana do not have provisions that allow sales to nonresidents. Senator Bill Dotzler described the legislation as "a step sideways" rather than a leap forward.

Medical marijuana has especially gained popularity for its use as an alternative to invasive medical procedures. For diseases like epilepsy, common procedures such as spinal tapping have generated so much negative sentiment that individuals are desperately looking for other options. Research concerning the positive effects of medical marijuana on epileptic patients goes all the way back to the 1980s when scientists discovered that medical cannabis relieved seizure-like activity for periods of time. However, its use to treat epilepsy didn't gain a lot of traction until the airing of Dr. Sanjay Gupta's (Chief Medical Correspondent at CNN) documentary "Weed" in 2013. After watching five year old Charlotte Figi go from having 300 grand mal seizures (a serious form of epilepsy with muscle spasms and prolonged loss of consciousness) a week to only a few per month with the use of medical cannabis, hundreds of families across the United States started to try the same methods on their children.

Charlotte's case inspired the creation of a low dose treatment fittingly titled "Charlotte's Web" that allows parents to safely administer the treatment to their children. Fortunately, children receiving treatment do not demonstrate any major negative psychological or mental effects. In fact, most parents report positive results such as increased alertness, increased mental activity and decreased mood disorders.

The marijuana plant, cannabis, contains 85 different chemical compounds called cannabinoids. The most famous of these compounds is delta-9-tetrahydrocannabinol (i.e. THC), first identified and synthesized by by Dr. Raphael Mechoulam of the Hebrew University of Jerusalem in 1964. Unfortunately, THC does not have much medical use, as it is the chemical that was determined to cause the "high" associated with marijuana use. Anticonvulsant marijuana medications center on a different compound called Cannabidiol (CBD). Preliminary research indicates that CBD, low doses of which are used in Charlotte's Web, can relieve seizures within just a few weeks. In hundreds of other case studies, CBD was specifically analyzed and found to have positive effects in reducing the intensity of symptoms, reduced pain and depression, improvement of sleep, and much more.

Physicians make the claim that a lack of empirical evidence on the positive effects of medical marijuana, through clinical trial, undermines the entire movement. They argue that current available studies focus on very isolated cases and that it would be a health catastrophe to generalize results to the American public. Not only is there a lack of belief in the studies, but physicians also go further to drive in the factual negative effects of consuming marijuana. THC's structure is very similar to one of our brain's major chemicals, anandamide; consequently, the body recognizes and accepts THC, which then negatively alters brain behavior. The molecules effectively hijack receptors in the brain typically activated by chemicals naturally synthesized, altering neural communication. No only could excess THC cause future neurological disorders, but it has also been found to cause lung infections, mental illness, and suicidal tendencies. One of the main medical problems associated with medical marijuana use is that of addiction to the drug itself. However, proponents of the drug argue that addiction is primarily arises from a psychological dependence that users have on the drug which only happens to about 9% of patients. In addition, the treatments currently being developed aim to weed out the amount of THC, harmful chemical, and maximize CBD, the anticonvulsant compound. The problem we run into here is that trace amounts of THC can have very harmful effects, especially if used on children and young adults.

Brain development is very delicate during childhood, and studies show that early exposure to the compounds in marijuana results in slower performance on tasks, lower IQs, a higher risk of stroke, and much more. Again, here, we run into the problem of what specific compound causes these effects and how we can minimize its presence in medical treatment.

The American Epilepsy Society goes on to claim that evidence proving the benefits of medical marijuana, although inspiring hope, is anecdotal at best. Like many, they argue that the lack of evidence does not prove its ineffectiveness; rather it just proves that we need to learn more. Continuing research in this field is imperative to understanding the complex underpinnings of medical marijuana. Studies in the future will aim to isolate the genetic effects of marijuana usage and the genetic predisposition some have to its use medicinally.

References:

1. American Epilepsy Society. "AES Position on Medical Marijuana." AESNET (2014).

2. Compassionate Care New York. "Medical Marijuana for People with Severe Epilepsy." CCNY (2014).

3. Epilepsy Chicago. Roy Sucholeiki, M.D. "Epilepsy and Use of Medical Marijuana and other recreational Drugs and Alcohol." Cadence Health, Comprehensive Epilepsy Program (2013).

4. Cannabinoid Medicines. "Clinical Studies and Case Reports." International Association for Cannabinoid Medicines (2013).

5. CNN Health. Sandra Young. "Marijuana stops child's severe seizures." CNN (2013).

6. Epilepsy Foundation. Philip M. Gattone, Warren Lammert. "Epilepsy Foundation Calls for Increased Medical Marijuana Access and Research." Public Awareness (2014).

7. The Des Moines Register. Tony Leys. "Panel backs medical-marijuana production." News (2014).

8. Time. Kate Pickert. "Finally, Some Hard Science on Medical Marijuana for Epilepsy Patients." Health, Drugs (2014).

9. National Institute on Drug Abuse. "DrugFacts: Marijuana." The Science of Drug Abuse & Addiction (2014).

Image Credit: Mikael Haggstrom (Wikipedia), Trinitresque (Wikipedia), Hermann Adolf Kohler (Wikipedia)