What you need to know about medical marijuana

Lots of news coverage lately has been devoted to whether New York will legalize marijuana for medical use. Stepping away from the politics, here are some facts to consider:

iStock_000011843212LargeIt can be used to:

reduce muscle spasms. “It will release muscle spasms, for example, in people with multiple sclerosis who have spasticity,” says Upstate psychiatrist Gene Tinelli, MD. This may allow a person to use a walker rather than a wheelchair.

* provide a calming, euphoric effect.

* reduce intraocular pressure in people with glaucoma, although the effects are short-lived.

* help people forget suffering, such as in cases of post-traumatic stress disorder.

* reduce nausea and vomiting, especially after chemotherapy, and to a lesser extent after radiation therapy. “That’s a big thing,” Tinelli says, “because if people can eat, they can survive.”

* treat some seizure disorders.

* lessen the pain of shingles and other painful conditions.

* relieve suffering in patients with chronic pain who develop breakthrough pain. Many already take prescription opiates and don’t want to increase their opiate dosages.

* mask the pain of migraines, although scientists are still exploring exactly how.

Its side effects can include:

* slowed central nervous system and impaired motor coordination.

* increased high blood pressure and heart rate.

* worsening of some seizure disorders.

* impaired memory.

* lung irritation, if smoked.

* personality disturbances.

* irritability and psychosis, in high doses.

* addiction, if use becomes compulsive.

* possible learning and memory deficits in adolescent users.

* attention, memory and problem solving deficits in babies born to mothers who use marijuana in pregnancy.

Whether marijuana use permanently reduces IQ, cognitive functioning, learning and memory has not been proven.   

Patients don’t have to smoke it.

“Inhaling a burning plant is not healthy, period,” Tinelli says.

Herbal vaporizers allow the drug to be inhaled without ingesting toxins.

The active chemicals of the cannabis plant are available as alcohol elixirs or teas, or made into a spray that can be absorbed sublingually. A variety of edible products are made using butters or oils derived from the cannabis plant. Marijuana is also available as a salve, lotion or spray for the skin.

A synthetic version of THC, the chemical responsible for marijuana’s high, is available in the prescription drug, Marinol, but some patients dislike the drug’s side effects of dizziness, drowsiness, confusion, an exaggerated sense of well-being, red eyes, dry mouth, headaches and lightheadedness.

Its potency has increased.

Cannabis grown today contains higher levels of THC, short for tetrahydrocannabinol.

“In the 1970s, the THC content was around 1 or 2 percent. Today it’s more like 11 or 12 percent,” Mahmoud ElSohly, PhD, director of the University of Mississippi’s Marijuana Project, told Men’s Health magazine.

But it is cannabidiol, another of the more than 60 psychoactive compounds in cannabis, that captures the attention of patients and scientists. Cannabidiol and THC balance each other, cannabidiol tempering the stoned sensation caused by THC and maximizing the pain relieving effects.

It affects the body’s endocannabinoid system.

Scientists are still learning about the body’s endocannabinoid system, a neural communication network which plays an important role in normal brain development and function, and which some medical authorities consider the bridge between body and mind. It is this system that marijuana overactivates and, according to the National Institute on Drug Abuse, causes distorted perceptions, impaired coordination, difficulty with thinking and problem solving and disrupted learning and memory.

The first endocannabinoids were discovered in 1992. Anandamide and 2-AG are natural brain compounds that activate the same receptors as THC and cannabidiol. The function of the endocannabinoids is to maintain homeostasis, or to keep internal conditions the same, whether they’re physically located in the brain, abdominal organs, connective tissues, glands or immune cells. They play a role in appetite, memory, pain, mood and several other physiological processes.

Research is sparse.

Marijuana remains categorized by the Drug Enforcement Administration as a “schedule I” substance, like heroin, LSD and Ecstasy, meaning it has no medicinal value, a high potential for abuse — and is out of reach of scientists.

Removing it from the schedule would allow it to be regulated like alcohol and cigarettes, and available for research.

Listen to a radio interview with Dr. Tinelli about medical marijuana

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3 Responses to What you need to know about medical marijuana

  1. Jeff says:

    ” * attention, memory and problem solving deficits in babies born to mothers who use marijuana in pregnancy.” WRONG! More madness read this “When Dreher released solidly researched reports showing that children of ganja-using mothers were better adjusted than children born to non-using mothers, she encountered political and professional turbulence. Dr. Melanie Dreher is one of a handful of scientists who have researched marijuana objectively and intelligently in the last three decades. Dr Dreher is Dean of the University of Iowa’s College of Nursing, and also holds the post of Associate Director for the University’s Department of Nursing and Patient Services.

  2. Amber Smith says:

    Dr. Eugene Tinelli responds: In summary, we don’t know. There are some subtle differences in fetal/infant/child development but all signs of this are gone by age five. Given mammals intimate association of their endocannabinoid systems and the hemp plant over hundreds of thousands, maybe millions of years of evolution, I doubt their are any serious consequences of cannabis use during pregnancy on the development of children. And a question seldom asked: Are any of the effects of use of cannabis by pregnant woman positive? The reduction of stress and balancing of physiological systems by cannabis via the endocannabinoid system may have distinct positive effects on the fetus solely due to stress reduction in the mothers. Their are a plethora of studies indicating the delitorious effects of maternal stress on fetuses. In summary, there should be more research on this topic but it should not be an impediment to removing the prohibition of marijuana. Actually, removing the prohibition should allow better research to be done.

    http://www.cannabis-med.org/english/faq/01-pregnancy.htm

    http://link.springer.com/article/10.1007/s00406-009-0027-z#page-1

    http://www.sciencedirect.com/science/article/pii/S0149763405000953

    http://www.nejm.org/doi/pdf/10.1056/NEJM198903233201203

    http://www.sciencedirect.com/science/article/pii/S0014299908002999

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