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Gateway drug or non-addictive medical panacea? The pot debate has continued to stoke the passions of recreational and medicinal users and their opponents for millennia. While the fate of marijuana legalization and decriminalization hang in the balance, its medical use has been an accepted fact for centuries. Based on 2015 estimates, 22.2 million Americans listed themselves as current marijuana users – reflecting an increase in use over more than a decade . So why are we so fascinated with the dried form of the plant genus, Cannabis?
Sanskrit, Egyptian, and ancient Chinese text reference the medicinal properties of herb interchangeably referred to as pot or weed (see infographic). Mining plants for medicines has benefited humanity in many ways and marijuana is no exception. Choosing the correct drug candidate and appropriate way to administer the drug to a human being takes years of study. Such research revealed the narcotic and painkilling properties of constituents from the unripe seedpods of the opium poppy i.e., opiates. In 2017, there is now hope for non-addictive opioid painkillers to deal with the intractable health problem of chronic pain.
Cannabis continues to be the opium poppy’s maligned “stepsister.” It took hundreds of years for the message to sink in that components of marijuana could have therapeutic effects. Morphine was identified from poppies in the early 19th century, but the main psychoactive constituent of pot, tetrahydrocannabinol (THC), was only identified in 1964 (see infographic). Similarly, the discovery of receptors in the body for cannabinoids lagged behind the discovery of receptors in the body for opioids by decades. We now know that the body produces endocannabinoids naturally and that these compounds play diverse roles in short-term memory, appetite, pain, and blood-pressure regulation. Preclinical studies have also attributed a role for the non-psychotropic constituent, cannabidiol, in healing bone fractures . In addition, the Janus faces of endocannabinoids have been revealed in neurological conditions from Parkinson’s disease to Tourette’s syndrome, where the compounds can act as “heroes or villains” .
How one ingests pot is another matter. The merits/complications associated with smoking or eating weed versus the difficulty of accurately dosing the drug in order to maximize benefits versus risks are topics for another blog post. What is interesting, is the substantial body of evidence that marijuana and its constituents have been shown to be effective for treating chronic pain in adults, chemotherapy-induced nausea and vomiting, and the spasticity symptoms of multiple sclerosis . Limited research also suggests a use for marijuana in some headache disorders .
Because the US Drug Enforcement Administration has listed marijuana as a schedule 1 drug i.e., a substance of no medicinal value and with a high potential for abuse, there is a lack of randomized clinical trials to support the historical record and case-based studies suggesting marijuana’s health benefits. Nevertheless, at least 10 pharmaceutical drugs are based on cannabis and at least 3 medicines containing synthetic THC has recently been approved by the US Food and Drug Administration.
Global reggae icon, Bob Marley, revolutionized marijuana within the context of creative juices and social justice. For modern medicine, the trip is markedly different and the road towards uncovering the healing benefits of marijuana remains blocked by laws and biases.
1. Winters KC, Sabet KA. Marijuana and Health. Journal of Drug Abuse. 2017;3(1):1-4.
2. Kogan NM, Melamed E, Wasserman E, et al. Cannabidiol, a Major Non-Psychotropic Cannabis Constituent Enhances Fracture Healing and Stimulates Lysyl Hydroxylase Activity in Osteoblasts. J Bone Miner Res. 2015;30(10):1905-1913.
3. Mechoulam R. Blowing away the smokescreen. Nature. 2000;407:18-19.
4. Baron EP. Comprehensive Review of Medicinal Marijuana, Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a Long Strange Trip It's Been. Headache. 2015;55(6):885-916.