What is medical marijuana?

Medical and Therapeutic Uses

Medical marijuana, cannabis, and its constituent cannabinoids, such as THC
(delta-9
tetrahydrocannabinol), were used as early as 2700 BCE in
China and India and then spread worldwide to treat pain, seizure, muscle spasm,
poor appetite, nausea, insomnia, asthma, depression, and menstrual cramps. In 2000
BCE Egyptians used marijuana to treat sore eyes. The Greek doctor Galen prescribed marijuana for flatulence.

The Chinese in 200 CE used marijuana as an anesthetic. In twelfth-century Africa, marijuana (known as "dagga") was used to treat snakebites, anthrax, dysentery, and malaria. Marijuana, which tends to dry out mucous membranes, was used in fifteenth-century India to treat congestion, and the juice of the marijuana seed was used for earaches.

In the eighteenth century in the United States, marijuana was used to treat sexually transmitted diseases and incontinence. A tincture of marijuana (marijuana soaked in alcohol) was used in the nineteenth century to improve appetite, sexual interest, mental disorders, gout, cholera, and hydrophobia. The British in the nineteenth century used marijuana to treat facial tics and the pain, nausea, and spasms associated with rabies and tetanus.

Beginning in the 1970s, marijuana was used around the world to treat
glaucoma (high intraocular pressure). People who used other
glaucoma treatments experienced headache and blurred vision and could develop a
tolerance for conventional drugs. However, treating glaucoma with marijuana is of
short duration because eye pressure increases after three to four hours.

Other medical and therapeutic uses of marijuana now include adrenal and airway
diseases, adult attention deficit hyperactivity disorder, nausea associated with
acquired immunodeficiency syndrome (AIDS), anorexia, anxiety, arthritis, bruxism
(teeth grinding), bulimia, chemotherapy-associated nausea and vomiting, chronic
fatigue, chronic pain, constipation, depression, diabetes symptoms, diarrhea,
epilepsy (seizures), intestinal disorders, kidney problems, migraines (associated
pain, nausea, and vomiting), obesity, phantom limb pain, post-traumatic stress
disorder, schizophrenia, spasticity (uncontrollable muscle flexing, loss of fine
motor functioning, and choking resulting from spinal cord injury, stroke, cerebral
palsy, or multiple sclerosis), stuttering, tinnitus, tooth and gum pain, and
whiplash.

Persons with AIDS or cancer often lose lean body tissue through a process called wasting. Because marijuana is known to stimulate appetite, it is often prescribed for persons needing to gain weight. However, the THC in marijuana increases levels of fat more so than lean tissue, which could lead to unhealthy weight gain in people with diabetes and in persons who are obese.

Other hazardous consequences of marijuana use that may outweigh any therapeutic benefits include paranoia, pneumonia, diarrhea, short-term problems with thinking and working memory, and a decrease in immune function. Smoked marijuana contains high levels of tar, four times as much as in tobacco cigarettes, according to the American Lung Association, thus leading to an increased risk of lung and throat damage. Also, marijuana may potentiate the effects of alcohol.

Marijuana users can experience withdrawal symptoms
such as restlessness, anxiety, irritability, insomnia, muscle tremor, sweating,
and changes in heart rate. Medicinal marijuana can be addictive too.
(Approximately 9 percent of people who use marijuana become addicted, especially
if marijuana is used for long periods of time, according to the National Institute
on Drug Abuse.) A person who smokes marijuana for the first time may experience
anxiety and panic attacks, and persons with bipolar disorder who smoke marijuana
may notice increased mania and rapid cycling.

The correct dosing of marijuana can be difficult. Marijuana, in addition to being smoked, can be delivered in the following ways: through vaporizers, which may reduce harmful chemicals entering the lungs (takes effect within minutes and lasts for two to four hours); through topical applications, which are useful for reducing pain and inflammation; through nasal spray; through rectal suppository; sublingually (sprayed under the tongue); through lozenges; and through ingestion. The effects of marijuana take longer (up to two hours) if ingested because the compounds have to be digested before entering the bloodstream. The effects can last four to eight hours. There have been no documented cases of fatal marijuana overdose.

Marinol (generic dronabinol) is a synthetic THC in pill form available by prescription. However, some say the medicinal effect of marijuana requires many compounds found in the plant, of which THC is only one. In addition, it might be difficult to swallow a pill if one is nauseous or vomiting, and the effects of Marinol do not appear rapidly. Furthermore, Marinol is expensive, and dosage is not as easy to modify as smoked marijuana. Cannabidiol, or CBD, is an ingredient found in cannabis that offers the medical benefits but not the psychoactive effects of marijuana; therefore, it is increasingly being prescribed by doctors and distributed by dispensaries for myriad medical conditions.

The Law

Marijuana has been illegal in the United States since 1937, though, as of 2015,
Colorado, Alaska, Oregon, Washington State, and Washington, DC, have legalized it
for recreational use. Before that date, marijuana was prescribed for many
different conditions. The Marijuana Tax Act of
1937 required expensive taxes and paperwork and discouraged
medicinal and recreational uses of the drug. The 1970 Comprehensive Drug Abuse
Prevention and Control Act classified marijuana as a schedule
I controlled substance (along with heroin
and LSD); a schedule I categorizations holds that the drug has no approved medical
value, making it unavailable for medical use. In contrast, schedule II drugs have
an accepted medical use.

According to California’s Proposition 215 (the Compassionate Use Act of 1996), a person may use medical marijuana with a physician’s recommendation. The law allows for marijuana cultivation and gives caregivers the right to buy marijuana for the patient. A patient must see a licensed physician to document a medical condition that merits the use of marijuana. As of 2015, twenty-three states and Washington, DC, have legalized medical marijuana. However, possession of marijuana, even for medicinal use, remains a federal offense. According to the National Conference of State Legislatures, as of 2015, sixteen states allow the use of CBD products as medical treatment in certain situations. In 2015, House Republicans let a bill die on the House floor that proposed to have the National Institutes of Health and the Drug Enforcement Administration conduct research into the benefits and risks of using marijuana to treat certain medical conditions, such as glaucoma and cancer.

The US Department of Veterans Affairs (VA) allows veterans to use marijuana for medical reasons while still accessing government-sponsored health care. Veterans must obtain the marijuana from a state in which medical marijuana is legal; they cannot get the marijuana from the VA.

Opponents of decriminalizing medical marijuana argue that its use will lead to recreational use, addiction, and increased crime. They also fear that marijuana is a gateway to harder drugs.

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