Austin Vote

Professor Campbell

UWRT 1104

3/30/17

Medical Marijuana: Whats the Issue?

For centuries, marijuana has found itself embedded in cultures around the world. For the

longest time, unabashed. It is with good reason Governments are hesitant to jump head first into

legalization, but their trepidation may be causing unnecessary problems for people that need

something to improve their quality of life. The Drug Enforcement Agency (DEA) is the federal

agency that is tasked with enforcing federal drug laws. The DEA continues to defend their

scheduling of marijuana; it remains classified in the same category as Heroin, LSD, MDMA

(Ecstasy), Psilocybin (the psychedelic component of mushrooms), and bath salts. Schedule 1

drugs are defined as drugs, substances, or chemicals with no currently accepted medical use and

a high potential for abuse. As I will demonstrate, marijuana is an effective medicine for cancer

patients, epileptics, muscle degeneration, and many types debilitating diseases. It has been found

to relieve symptoms and work as an anti-tumor agent. Recent scientific studies pose significant

questions to the reasoning behind the DEA keeping marijuana as a Schedule 1 substance. As I

will demonstrate, the current scheduling is inaccurate and barring to more research.

Marijuana was classified as Schedule 1 after the passing of the Controlled Substances Act

in 1970; and was continuously targeted as a dangerous illegal substance throughout the war on

drugs. The war on drugs has existed for around 100 years. We can see its initial vigor and aim

was during prohibition, when alcohol sales were forbidden. Later, especially during the
presidency of Ronald Raegan, the war on drugs shifted heavily, and set its sights on marijuana. I

will focus almost exclusively on the medicinal benefits of marijuana, in order to objectively

justify why marijuana should be rescheduled. I will also give a brief overview of other reasons it

is still illegal, because they are relevant to the debate at large. Lobbyists remain the single

greatest barrier against marijuanas legalization, with pharmaceutical companies being the most

influential. Public data shows that in 2012, 22 million dollars was given to federal candidates,

committees, and parties (OpenSecrets). Why? Retired police officer Howard Wooldridge, who

lobbies for marijuanas legalization, explained that next to police unions, the second biggest

opponent on Capitol Hill is big PhRMA, because marijuana can replace everything from Advil

to Vicodin and other expensive pills. As Woolridge explains, big PhRMA is worried about

market share. Right now, the market for medication is pills: pills that can be replaced in many

cases by other substances, such as marijuana. Thus, their lobbying is clearly anti-progress and

pro continuation on the dependence of the medications produced my pharmaceutical companies.

From physicians to our own ancestors, marijuana has been used extensively in the past, not only

as medicine, but also in textiles and food. In Modern History of Medical Cannabis, is explained

that The millennial history of Cannabis, which effectively goes along that of human kind,

testifies to its extensive usefulness for many purposes, as fiber, food, and medicine, beyond its

use as a psychotropic substance. For example, in the mid-1800s, an Irish physician, William

Brooke OShaughnessy, Having ascertained its safetyhe administered alcoholic tinctures

of Cannabis to some selected patients who suffered from epilepsy, rheumatisms, cholera, or

tetanus and deduced that the plant had interesting analgesic and myorelaxant properties He

proposed that Cannabis could be a powerful remedy for seizures. In addition to this, he noted
that while not able to treat tetanus, it was effective in response to symptoms. Clearly, even in

cases where it cant directly combat ailments, it can work especially well treat symptoms.

Moving forward, I will now focus on the science behind marijuana; first starting with its

safety. Of course, for thousands of years, marijuana has been used as a natural medicine in many

cultures. In the United States, it was used by apothecaries until the late 1800s. Marijuanas fall

from grace was not in reaction to any specific event or sense of danger; rather, its psychotropic

effects. In fact, as early as the 1940s, the American Medical Association stated that the

pharmacological potential of marijuana was greater than its adverse effects; and unlike other

classes of drugs in use today (most notably Opioids), negative effects on society and the user are

rarely appreciable (Pharmacological Sciences).

There exists, without doubt, an opioid crisis in the United States. According to CDC

data, there were 33,000 opioid overdoses in the United States in 2015, and nearly half of them

were due to prescription opioids (CDC). Inhalation of smoke remains the most clear and

dangerous effect of marijuana use, recreational or medicinal; however, in these cases, the smoke

from marijuana is less dangerous than smoke from cigarettes, which are legal. In addition, if the

health risks from smoking are a concern, edible forms of cannabis exists as both food and oils.

Edibles are also noted for offering a more potent and longer THC therapeutic effect, which is

most important when being used as an adjuvant for symptom relief (Pharmacological Sciences).

It should be noted that the auxiliary effects of opioids are also highly addictive, exponentially

moreso than marijuana. In the Trends in Pharmacological Sciences journal, they concluded that

they were at least hopeful for the future of medical marijuana and its research, stating Now that

the scientific evidence collected on the pharmacological potential of Cannabis is in agreement

with the economic interests linked to this enormous new market, moral and social concerns have
been bypassed. Exactly now, the lesson from the past is pivotal to manage the Cannabis affair in

the right way, emphasizing first of all the health benefits for patients. I would like to stress that

while safety is a concern, it is not the only one, and that is why we still see entire classes of

comparatively dangerous drugs (like opioids) still in use. In fact, as I will address, the efficacy

of both opioids and marijuana increase as they are used together, furthing asserting the value of

marijuana as a medicine.

As I have laid out a groundwork asserting that medical marijuana is a safe and reasonable

idea, I will now address its efficacy in symptomatic relief. I will address the efficacy of

marijuana as a treatment later. Medical marijuana is currently prescribed to treat a number of

various diseases and disabilities, ranging from, but not limited to: Cancer, Glaucoma, Anorexia,

Migraines, HIV/AIDS, ALS, Depression, Anxiety, Panic Disorder, PTSD, chronic pain, chronic

nausea, seizures, and cachexia (wasting syndrome, a disease which is characterized by

excessive muscle atrophy, fatigue, weakness and loss of appetite). My goal in addressing the

efficacy of medical marijuana in symptom treatment was to focus on disabilities and diseases

with the most current research, as medical marijuana is definitely still in an infantile state.Out of

cancer patients, at least half report moderate to severe pain, which further increases in patients

with metastatic cancer or advanced cancer. This pain negatively impacts on their life quality,

functional status, and life expectancy (Agents). Currently, pain this severe and chronic requires

opioid treatment. These drugs have dose-limiting side-effects, and can be extremely

dangerous. For example, McMaster University reported that 52% of women, and 38% of men

admitted their first use of opioid drugs was via a doctors prescription. Opioid drugs often

prescribed include OxyContin and codeine.(McMaster University). Numerous studies have

shown that physician directed system administration of cannabinoids reduce pain in animal
models, including humans. Cannabinoids are lipid molecules (fat) and are the active components

of marijuana, and there are many kinds. The two most common are CBD and THC. THC is a

largely recreational cannabinoid, responsible for the therapeutic high of marijuana; however, it

still has medicinal effects that I will describe later. THC is a recreational cannabinoid because of

its psychotropic nature. CBD, while sometimes used in recreational settings, is more often used

for medical purposes, because its effects are not on the mind. Different cannabinoids prefer

different cannabinoid receptors. THC usually bonds to receptors in the brain, whereas CBD

usually bonds to receptors in the body. Cannabinoids produce anti-nociception (pain-signal

blocking) by activating CB1 receptors in the brain, the spinal cord and nerve terminals.

Endocannabinoids naturally function to suppress pain by inhibiting nociceptive

neurotransmission (Agents). As suggested, cannabinoids activate CB1 receptors in the brain

which suppress the bodys pain signals. That is why marijuana can be an effective pain

management tool.THC has also been found to be an effective stimulant for patients with anorexia

(this particular journal referenced studies on anorexia due to cancer treatment).

Some pain is too severe for marijuana or its synthetic versions to treat alone, and it is

often used in tandem with other medicines; however, in some cases marijuana is also the only

medicine that has been found to be effective against pain (Current Oncology). Current Oncology

also found that medical marijuana was effective in combating nausea from chemotherapy,

insomnia, and depression. Neuropathic pain, characterized usually by tissue damage, is another

type of pain common in cancer patients. A review from Current Oncology which analyzed six

controlled medical trials of cannabinoids, found that lose doses of marijuana were effective in

treating pain. It was also found effective against neuropathic pain, common in people with

diabetes. Neuropathic pain occurs when nerve cells have died or degenerated. Another study
which included patients with neuropathic pain from HIV found vaporized cannabis to be

effective against pain. (Current Oncology). As previously mentioned, some pain is too severe for

marijuana alone to combat. In these cases, when combined with other analgesics (pain

medications), marijuana was found to increase the effectiveness of the other analgesic used. This

effect was not unique to cancer patients, and was reported with diabetics with neuropathic pain.

This is because cannabinoids and opioids have been found to have synergetic effects. The pain-

relieving effects of marijuana are not reduced by opioids, and they work on different receptors

throughout the body. In laymans terms, the two substances can work together because they are

not necessarily fighting over the same space within the body (Current Oncology).

A source cited by NPR found that in states with legal medical marijuana, the number of

opioid prescriptions dropped. A reduction in opiate dependence will lead to less abuse in the

United States, and the first step in stopping the opioid epidemic is reducing prescriptions.

Marijuana does not remove the necessity, but it lowers it, which is a very good start. A

commonly ignored side-effect of long term opioid use is an overall decrease in cognition, often

reaching a point where patients have a hard time communicating with their loved-ones during

end of life care (Current Oncology). A WebMD survey reported that 82% of oncologists and

hematologists were in favor of patients having access to medical cannabis. This was the highest

approval rating among all subspecialties that responded. A doctor writing for Current Oncology

reported that Clinically, I have observed that many cancer patients benefit from adding cannabis

to their pain regimen. In Cannabinoids for Medical Use Dr. Penny F. Whiting summarized her

research as such: there is moderate-quality evidence to support the use of cannabinoids for the

treatment of chronic pain

 To conclude, I would also to mention that in Integrating Cannabis into Clinical Cancer

Care, Abrams mentioned that not only is cannabis effective versus pain, but that evidence

suggests that cannabinoids are not only effective in the treatment but also in the prevention of

chemotherapy-induced peripheral neuropathy suggesting that cannabis can also be considered a

preventative medicine, at least in the realm of neuropathy. More research is needed in

understanding the reason for this.

I would lastly like to focus on using cannabis to combat illness, not just alleviate its

symptoms. Medical marijuana in recent years has offered potential applications in combating

illness, especially as anti-tumor medicine. This is because evidence supports the claim that some

cannabinoids can limit tumor cell proliferation (tumor growth). Marijuana can also induce

tumor-selective cell death, while keeping nearby cells unharmed. This same principle can be

extended further than just tumors. In the Curative Agents article, doctors emphasized that an

altered endocannabinoid system, via using cannabis, showed an interesting role for

pharmacological intervention (treatment). The endocannabinoid system is where cannabinoids

bond all throughout the body. More research is needed in this young field of medicine, but

researchers have been able to replicate results.

Anti-tumor results are due to the ability of certain cannabinoids to inhibit several key

functions of tumor cells. Firstly, cannabinoids are effective at stopping tumors from undergoing

angiogenesis, which is essential for tumor growth. Angiogenesis is the creation of new blood

vessels. Cancer sprouts blood vessels everywhere it goes, stealing nutrition from our bodies and

further feeding itself, spreading throughout the affected persons body. Cannabinoids can choke

out cancer in this sense: remove the source of nutrition, and the cancer will wither. That is not

the only way cannabinoids combat cancer, however Research analyzed a team of scientists lead
by Simona Pisanti, an Italian scientist, found that cannabinoid agonists inhibit cell growth and

directly combated the advance of cancer. This was done by increasing the levels of

endocannabinoids in cells, via the use of medical marijuana. Basically, by directly manipulating

the endocannabinoid system by introducing various cannabinoids, cell chemistry is changed in

ways that either kill cancer, or reduce its ability to spread. Important to note, is that in addition to

being effective, cannabinoids are also rated as having a good-safety profile (Agents). Some fear

that the psychoactive effects of THC and other mind-altering cannabinoids would make them a

bad candidate for cancer-treatment; however, THC delivery in glioma patients was done safely

and without psychotropic effects. Another alternative is simply using non-psychoactive

cannabinoids such as CBD, which is commonly used by people with seizures. It is also

important to consider that compared to all other currently used chemotherapeutic drugs, which

all have toxic adverse effects, marijuana has a good-safety profile. Potential adverse

effects of cannabinoid agonists are within the range believed acceptable for other drugs,

especially anticancer drugs. It is well known that the therapeutic activity of most anticancer

drugs in clinical use is limited by their general toxicity to proliferating cells, including normal

cells. Novel cytotoxic agents with known mechanisms of action have been developed, but they

still lack tumour selectivity and have not been therapeutically useful. Cannabinoid agonists do

seem to selectively target tumour cells, while normal cells are less sensitive or even protected.

In laymens terms, marijuana has not only been shown to be effective against cancer, it has done

it without destroying healthy, unaffected cells, which can lead to even more damage in

conventional cancer treatment.

As demonstrated, marijuana is much more than what is commonly accepted. Our own

Government demonizes it, leaving it Schedule 1, insisting it is good only as a path to harder
drugs. As I have laid out, marijuana is a drug that has been found to aid in several fields of

medicine, such as mental health, oncology, and rheumatology. It is effective both as a treatment,

and as a symptom-relief. I am confident that as more research is done, we will find new and

even more innovative ways to use this medicine. The DEA should immediately, if they have the

people of the United States good fortune in mind, reschedule marijuana, and allow for

unimpeded research to be done with it.

 Works Cited

Abrams, D.I. "Integrating Cannabis into Clinical Cancer Care." Current Oncology. Current
Oncology. 2017. Web. 12 Mar. 2017.
"After Medical Marijuana Legalized, Medicare Prescriptions Drop For Many Drugs". NPR.org.
NPR.org. 2017. Web. 12 Mar. 2017.
"Cannabis and Cannabinoids." National Cancer Institute. National Cancer Institute. Web. 12
Mar. 2017.
McMaster University. "Prescription painkillers source of addiction for most women."
ScienceDaily. ScienceDaily, 9 November 2015.
<www.sciencedaily.com/releases/2015/11/151109220353.htm>.
"Medical Marijuana And Parkinson's Part 3 Of 3". YouTube. 2017. Web. 12 Mar. 2017.
"Opioid Overdose." Centers for Disease Control and Prevention. Centers for Disease Control
and Prevention, 09 Feb. 2017. Web. 06 Apr. 2017.
Pisanti, Simona, and Maurizio Bifulco. "Modern History of Medical Cannabis: From Widespread
Use to Prohibitionism and Back." Science Direct. Trends in Pharmacological Sciences,
Mar.-Apr. 2017.
Pisanti, Simona, PhD, Anna Maria Malfitano, PhD, Claudia Grimaldi, PhD, Antonietta Santoro,
PhD, Patrizia Gazzerro, PhD, and Maurizio Bifulco, PhD. "Use of Cannabinoid Receptor
Agonists in Cancer Therapy as Palliative and Curative
Agents." Https://www.elsevier.com/. Science Direct
Whiting, PhD Penny F. "Cannabinoids for Medical Use." JAMA. American Medical Association,
23 June 2015. Web. 06 Apr. 2017.