Medical Benefits of Cannabis

People have been using the Cannabis plant (marijuana) for recreation, medication and spirituality for thousands of years. The line between recreation and medication is often a blurry one, as skeptics say - of course you feel better, you’re high, and chronic users reply that all who use have some kind of physical, mental, or social deficit which cannabis helps them compensate for. However, medical can encompass both recreational and spiritual; cannabis is a mind - altering drug, but if the mind is altered correctly, one is often able to gain a better perception on life. Is this not also medicinal? For if one were to assert that wellness is comprised of physical, mental, social, intellectual, spiritual and environmental factors, then cannabis is the perfect medicine. Currently, California and 15 other states recognize the medical benefits of cannabis, and have legalized it for approved patients (NORML, 2004). While the federal government has finally decriminalized medical use when approved by the state, it is still not legally available for all people in the United States to use it medically, in spite of many studies, including federal studies, which continually show the benefits, and fail to show the significant risks, of acute and chronic marijuana usage (Russo, 2002). Cannabis is a beneficial, effective, and safe alternative medicine, and needs to be recognized as such.

Prior to discussing the individual benefits of cannabis, it is important to understand the concept of wellness. Wellness is defined as reaching optimal health and vitality, not just absence of disease. It is comprised of six dimensions, physical, emotional, intellectual, interpersonal, spiritual and environmental, and each of these areas are continuously interacting with one another (Insel & Roth, 2008). Without being healthy in all areas, it is impossible to be considered fully healthy in any of the areas. When attempting to study dimensions of wellness other than physical and environmental, it is often difficult to obtain evidence other than anecdotal, as things such as self esteem, self confidence, ability to accept, understand, and share feelings with others, motivation to master new skills, forgiveness, having a sense of meaning and purpose, a sense of humor, and compassion are things which only the individual knows about themselves; similarly, the benefits of using cannabis on each of these areas of wellness is also anecdotal, such as relief from depression, anxiety, etc, and thus makes it difficult to prove in court these benefits (Insel & Roth, 2008). However, if one were to look at the side effects as described by the DEA, it is impossible not to conclude that cannabis is effective in treating mood disorders. Marijuana induces euphoria, relaxation, laughter, heightened sensory perception, altered perception of time and increased appetite (NIDA, n.d.). This provides the gateway for treating inconsistencies in a person’s normal personality. According to Lester Grinspoon, emeritus professor of psychology at the Harvard School of Medicine, “ ‘cannabis has a lot of potential in the treatment of mental illness’ ... and can be effective for treating bipolar disorder and depression... though like every medicine, its not for everyone” (Roger, 2007). For example, after consuming cannabis, a person suffering from anxiety disorder would be calmed, a depressed person would have their mood lifted, one suffering from attention deficit disorder would find their attention focused on only one thing, and those suffering from anorexia would have their appetite stimulated. As with any substance which produces change in the body, it is important to self regulate the appropriate time and place for consumption, just as drinking a highly caffeinated beverage prior to going to sleep is not conducive of a healthy sleep cycle. However, when used appropriately, the changes which cannabis produce are beneficial. 

Cannabis has been condemned over the last 70 years due to the fact that it produces psychoactive effects; however many of the thousands of prescription medications produce similar, if not more extreme effects. Antidepressants are one of the most commonly prescribed medications in the US (NDC Health, 2004). The mild psychoactive effects of cannabis are nowhere near as dangerous in comparison to current FDA approved prescription drugs. The US National Institute of Health warns that antidepressants can cause the patient to “become suicidal, especially at the beginning of [the] treatment and any time that [the] dose is increased or decreased” and that “Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions” (US National Library of Medicine, 2009). With marijuana, patients are able to titrate their dosages, and tailor the needed amount to the specific moment (Russo, 2002). Additionally, even if the medication relieves depression as intended, there are many other extreme side effects. A common antidepressant, Zoloft, has been reported to cause “nausea, diarrhea, constipation, vomiting, dry mouth, gas or bloating, loss of appetite, weight changes, drowsiness, dizziness, excessive tiredness, headache, pain, burning, or tingling in the hands or feet, nervousness, uncontrollable shaking of part of the body, sore throat, changes in sex drive or ability, excessive sweating, blurred vision, seizures, fever, sweating, confusion, fast or irregular heartbeat, abnormal bleeding or bruising, hair loss, fainting, and hallucinations” (US National Library of Medicine, 2009). Not only are the physical side effects more harmful than those of cannabis but Zoloft also can cause hallucinations, “hearing voices or seeing things that aren’t there” (US National Library of Medicine, 2009). Conversely, the psychoactive effects of cannabis are mild, and, as discussed earlier, include a relaxed attitude and altered perception of time. When a person uses cannabis chronically, they develop the ability to cope with these changes, such as becoming vigilant about checking the time to compensate for the loss of time perception. This change in perception aids in the reduction of anxiety for some, specifically those who are chronic worriers; it allows a person the freedom to relax and forget about the stress in their lives when they are unable to relax otherwise.

One of the leading causes of health problems today is chronic stress; in 2007, 77% of Americans report that they have developed stress related health problems (Insel & Roth, 2008). The physiological effects of stress are extremely damaging. When the body experiences a stressor, it begins the fight or flight response, which causes the body to release hormones such as adrenaline and cortisol, liver releases glucose in the blood, digestion, reproduction, and growth are slowed, and the immune response is altered. Short term, this benefits the body, but when the body is unable to return to homeostasis over a long period of time, the constant flood of hormones negatively impacts all body systems (MFMER, 2010). Chronic stress can cause muscle tension, neck pain, stomachache, impaired immune function, cardiovascular disease, high blood pressure and accelerated aging (Insel & Roth, 2008). Chronic stress also causes neurons in the brain to shrink and die, and inhibiting the brain’s ability to generate new cells, thus decreasing a person’s ability to focus, make judgments or think clearly; it has also been attributed to psychological problems such as depression, anxiety, panic attacks, eating disorders, and post traumatic stress disorder (Insel & Roth, 2008). Stress also causes the release of cortisol into the blood stream which “causes fat stores and excess circulating fat to be relocated and deposited deep in the abdomen”; when stress is chronic, this can cause or enhance obesity, placing individuals at a greater risk for developing cardiovascular disease, type II diabetes mellitus, and cerebrovascular disease. “In addition, hypertension (high blood pressure), hyperlipidemia (elevated lipids), and hyperglycemia (elevated glucose) have been linked to elevated cortisol levels” (Maglione-Garves, Kravitz, & Schneider, n.d.). Even at a recreational level, cannabis would medically benefit these people. It would provide a safe outlet for stress relief, in addition to treating some of the many symptoms of chronic stress; interestingly enough, some of the symptoms of chronic stress are similar to those of cannabis usage, such as dry mouth, fatigue, inability to concentrate, and trouble remembering things (Insel & Roth, 2008). Cannabis has been prescribed for the treatment of anxiety and depression, and also it reduces irritability, improves eating and sleeping habits, and encourages socialization (Roger, 2007 ). While it wouldn’t treat the disorders caused by stress, such as obesity and cardiovascular disease, it would work preventatively to lower levels of stress hormones by reducing stress, and thus reducing the impact of those hormones.

Cannabis research is just starting to discover the numerous physical benefits of using cannabis medically. In 1990, researchers discovered the cannabinoid receptor in the brain, and have since discovered the existence of endocannabinoid, neurotransmitters which activate the same receptors as tetrahydrocannabinol, the active ingredient in marijuana (Melamede, 2005). Researchers have also found that the endocannabinoid receptors are the most common G protein - coupled receptors in the brain, and that these receptors are also on immune cells. Endocannabinoid have been found to contribute to learning and memory, neuronal development, control of appetite, and suppression of nausea; these neurotransmitters are retroactive, meaning they are synthesized and released on demand to inhibit the release of other neurotransmitters (Marieb & Hoehn, 2010). “It is now known that [the endocannabinoid system] maintains homeostasis within and across the organizational scales of all animals. within a cell, cannabinoids control basic metabolic processes such as glucose metabolism... [and] regulates intercellular communication, especially in the immune and nervous systems” (Melamede, 2005). Since the endocannabinoid regulatory system enervates multiple body systems, including cardiovascular, digestive, endocrine, excretory, immune, muscoskeletal, nervous, reproductive, and respiratory systems, it is hypothesized that the purpose of the system is as a natural harm- reduction system, protecting the body “by fine-tuning and regulating dynamic biochemical steady states within the ranges required for healthy biological function” (Melamede, 2005). Currently, many pharmaceutical companies, such as Bayer AG, and GW pharmaceuticals, and university researchers are focused on discovering exactly how the endocannabinoid system works in terms of activating or suppressing certain receptors (Melamede, 2005). The prevalence and wide range of organ systems which the endocannabinoid regulatory system affects is most likely the reason why the medical benefits of cannabis encompass such a wide variety of symptoms and diseases.

Due to the government forcing criminalization in 1937, despite protests from the American Medical Associations legislative council, Dr. William C. Woodward, medical research has been inhibited for the past 70 years (NORML, 2002). However, the small amounts of research which have been able to be conducted are not only promising, but potentially will lead to the improved treatment or cures of many chronic and life threatening diseases. Preliminary research is showing that use of cannabis not only alleviates the symptoms of many disorders, such as nausea and pain, or side effects of treatments such as chemotherapy, but that cannabis in fact modifies the disease in such a way as to reduce the impact (NORML, 2010). Cannabinoids work differently in each area of the body, and produce a variety of responses simply by triggering the endocannabinoid receptors; the cannabis plant contains approximately 60 varieties of cannabinoids, each which acts differently in the body. Some activate receptors, and some inhibit, with research suggesting that they bind to the receptors as needed; thus the use of cannabis replaces the natural endocannabinoid in the body, supplementing this extensive harm reduction system (Pacher, Bátkai, & Kunos, 2006).

Cannabis has been found to help treat diseases which include, but are not limited to multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease, Alzheimer's disease, amyotrophic lateral disease (Lou Gherig’s disease), diabetes mellitus, fibromyalgia, acquired immune deficiency syndrome(AIDS), hypertension, osteoporosis, sleep apnea, Tourette’s syndrome and cancer (NORML, 2010). A collection of such studies were summarized and posted by the National Organization for the Reform of Marijuana Laws (NORML) online. These studies only begin to show the potential of cannabis as medicine. A study by the Cajal Institute in Spain and Madrid’s compultense University, published in 2005, investigated the effects of cannabis on Alzheimer’s disease, finding that “cannabinoids succeed in preventing the neurodegenerative process occurring in the disease," and helps to reduce brain inflammation. Investigators at the Scripps Research Institute found in 2006 that THC inhibits the enzyme responsible for the aggregation of plaque in the brain far better than current Alzheimer’s medication. Furthermore, they stated that it “may provide an improved treatment [option]...[by] simultaneously treating both the symptoms and the progression of [the] disease”. A study published the following year from Ireland’s Trinity College Institute of Neuroscience not only confirmed the resulted of the previous studies, but also found that cannabinoids support the brain’s repair mechanism, enhancing neurogenesis. (NORML, 2009, a.). REsearch into cannabis’s effects on the treatment of diabetes is still being conducted on animals, but the results are promising. In a study recently published in the Journal of Autoimmunity, experiments conducted on mice showed that cannabis may have protective properties against diabetes. Two studies were conducted which showed that when mice are treated with cannabis over a period of time, the chance of developing diabetes is significantly reduced, from 86% of the untreated mice, to only 30% of the cannabinoid -treated mice developing diabetes. In the second study, over a period of 17 weeks, all mice in the control, untreated, group developed diabetes, while in the group treated with cannabis, 60% remained diabetes free at 26 weeks. Researchers at the Medical College of Virginia also reported that rats treated with cannabinoids experienced significant protection from diabetic retinopathy, the leading cause of blindness in working age adults (NORML, 2009, b.). Fibromyalgia is the third of many chronic diseases which research suggests cannabis aids with. Researchers at Germany’s University of Heidelberg studied 9 fibromyalgia patients over a period of three months, where half were given an oral administration of varying doses of THC, but no other pain medication; “all [given THC] reported a significant reduction in daily recorded pain and electronically induced pain” (NORML, 2009, c). Many other studies showed similar protective and harm reduction effects following the administration of cannabis to patients with a variety of disorders.

A major concern with cannabis usage are the possibility of adverse side effects, especially when smoked. According to the federal government, marijuana contains 50-70% more carcinogens than tobacco (NIDA). However, there has been no research linking smoking marijuana to lung cancer, and has shown evidence of anti-carcinogenic properties- being protective against the development of cancer (Russo). A second common concern is the effect on brain development; however cannabinoids have been also proven to aid in neuronal growth (Melamede, 2005). A presentation at the Cannabis Therapeutics Conference in 2002 by Dr. Ethan Russo gave an overview of several federal studies on long term use of cannabis, specifically one study which followed the first four federal medical patients. All information following is from that presentation, which was recorded on video and posted to the internet. Patient A suffers from glaucoma, Patient B has nail patella syndrome, Patient C has multiple congenital cartilaginous exostosis, and patient D has multiple sclerosis; the patients had been using cannabis for twenty, twenty seven, twenty six and eleven years, respectively, at the time of the study. For this study, the patients were put through a series of tests examining them for changes in lung function, endocrine and immune function, neuropsychological and brain wave tests, and brain atrophy. The patients all smoked cannabis during the tests, and only showed mild difficulty with attention and concentration, though this cannot be solely attributed to the cannabis, as similar disfunction has been shown in patients with chronic diseases who do not use cannabis. The tests found that there were no significant changes in any necessary body functions. None of the patients showed more than mild irritation to lung tissue, even though three were also cigarette smokers; there were no signs of brain atrophy that deviated from normal brain aging; there was a mild decrease in exhalation capacity, but an increased force vital capacity; and all immune and endocrine tests were normal. Patient D who is suffering from multiple sclerosis, actually had her condition improve; she had fewer MS plaques than in previous brain scans. She was not on interferon treatment, and cannabis is only medicine she is taking which could be protective. Patient B also had their condition improve with cannabis usage; he had been prescribed narcotics for years to handle his pain prior to cannabis use, but they were ineffective. At the time of the study, he no longer needed any pain medication other than cannabis, despite the fact that naturally his condition should have worsened and he should have needed more medication. Other studies which were discussed also showed the lack of harmful effects of cannabis. The first study which was discussed was the first documented study on cannabis; it was conducted in ancient Greece in which 60 subjects smoked hashish over a period of ten years. The study found no significant physical differences between cannabis and non cannabis users. A study conducted in Costa Rica over a period of ten years observing forty-one subjects found that people who smoke both tobacco and cannabis had better pulmonary function than those who smoked cigarettes alone. It also concluded that THC produces a cytotoxic effect which prevents the development of cancer. Dr Melanie Dreyer published a book following her participation in a federal research study; her book, Working Men and Ganja, conclusively showed that when it comes to hard manuel labor or boring work, workers who smoke cannabis have their stamina increased. Dr. Dreyer also published a study in the Journal of Pediatrics, which observed a cohort of Rastafarian women who used cannabis during pregnancy to treat morning sickness. She found that not only were the children healthy, but they showed developmental gains compared to babies of mothers who did not smoke cannabis. The final federally funded study of cannabis was in 1976, and was ran by the New York Academy of Science. It was a 94 day study during which patients were allowed to smoke as much for 3 months, then studied the effects one they stopped. The study found that patients felt “out of sorts” for a day, but ultimately showed no withdrawal effects, proving that there were no true physiological addiction to cannabis (Russo, 2002).

For this report, a survey of twenty medical cannabis patients was conducted. Patients were asked to describe how their overall functionality has been effected since beginning their treatment with cannabis, and to compare their cannabis usage to treating their conditions with prescription medication. Length of usage ranged from two months to forty years, with the average length of use being about ten years. Patients seemed to prefer vaporizing as their method of consumption, and daily amounts ranged from less than half a gram to over seven grams, with the average being 1.45 grams per day. Every patient reported that they use cannabis to treat multiple conditions. The most common condition treated was anxiety in 17% of the patients, followed by depression at 16.5%, 12.7% reported using for muscle pain and joint pain, 11% for sleep disorders, 10% to treat Attention Deficit/ Hyperactivity Disorder, 6% to treat side effects of prescription medication, 5% for treating nausea, 5% for eating disorders, and 2% for Post Traumatic Stress Disorder. Prior to their start of cannabis therapy, half of the patients reported that they were moderately functional in daily life, where their condition impaired their ability to participate in some activities; in the other ten patients, nine reported as being barely functional and struggling with daily life, and one reported that they were unable to function independently. When asked to rate their level of wellness on a scale of one to ten, one being unable to function independently, and ten being fully able to participate in all desired activities, the average response was five. After using cannabis, eleven reported that functionality increased significantly, eight had functionality increase moderately, and one experienced no change; the reported average wellness level also increased to eight following cannabis usage. Within this group of patients, 80% had also used prescription medications to treat the conditions for which they currently use cannabis; of those, 40% replaced prescription medication with cannabis, and 60% started using cannabis because their prescription medications were not sufficiently treating their condition. All of the patients who stopped using prescription medication found that their conditions have improved since. Within this sample, nineteen of twenty patients either worked, went to school, or did volunteer work; all reported that cannabis had no impact on their ability to function while participating in these activities, and seven patients felt that they would not be able to participate in these activities if they were not using cannabis. Patients were also asked to list negative side effects of both prescription medication and cannabis. The side effects of prescription medication which were reported included dizziness, paranoia, insomnia, hemorrhaging, anxiety, falling asleep, jitteriness, loss of motivation, depression, suicidal thoughts and mood swings; conversely, the side effects of cannabis that were reported were dry mouth, sleepiness, forgetfulness and red eyes. Overall, patients reported only mild side effects, and many noted that side effects such as drowsiness are also beneficial when in the right situation. Patients were also asked to comment on the impact of cannabis on their lives: 

“Marijuana provides immediate relief. I feel as though I can enjoy life, relax and concentrate”... “I am able to cope with and understand my feelings”... “I am able to keep a job, relax, connect with people around me, focus, feel good about my self and overall feel at peace”... “When I use cannabis, I am able to work full time and volunteer over twenty hours a week!” ... “Its uncompromising ability to work makes its value in my life very significant”

Every patient who participated in the survey strongly felt that using cannabis has made an impact on their lives in a positive manner, and not only did not impair their motivation or ability to function, but also it played a significant role in their increased functionality.

Politics have impeded cannabis research for 70 years, but in spite of government warnings of ‘reefer madness’ cannabis continues to prove itself as medically beneficial. Preliminary research has shown that cannabis has the potential to not only treat the symptoms of many debilitating conditions, but also to slow the progression of the disease itself. If we are to allow doctors to prescribe medications which have known physically damaging side effects, in addition to the potential mental disturbances, cannabis also needs to be available as an option. To not offer safe access to a natural, safe, effective alternative to current prescription drugs, which often replace one problem with more problems, is cruel; to be arresting sick people for choosing health over the law is inhumane. 


References

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