In the book that I co-wrote with my good friend, Donal O’Mathuna, Ph.D., Alternative Medicine: The options, the claims, the evidence, how to choose wisely, we wrote an evidence-based article on marijuana. Here’s an excerpt of that information:
In this first excerpt, we’ll discuss “What It Is.” In later installments, we’ll address “Claims about Marijuana,” “Study Findings,” “Cautions,” and finally, “Our Recommendations.”
Marijuana – What it Is
Marijuana hardly needs any introduction. Whether it’s called cannabis, pot, grass, weed, Indian hemp, or any number of other names, the plant in question is Cannabis sativa (sometimes called Cannabis indica).
In some ways it could be viewed as the most popular herbal remedy of them all even though in most jurisdictions it is illegal to grow marijuana, illegal to have it in your possession, illegal to use it, and illegal to sell.
We have great concern about the illegal use of marijuana and the attempts to legalize the use of unsafe forms of marijuana.
The experiment with legalized medical marijuana in ten states received a very negative review in June 2005 when the U.S. Supreme Court found that California’s law was likely to increase the supply of marijuana for recreational use. The ruling basically stated that federal laws banning marijuana trump state laws that allow its use.
Apart from those covered by such laws, only a small number of people are legally allowed to use marijuana during research.
However, given the popularity of this herb, we have included it here to explore the medical claims being made and to provide a scientific evaluation of its active ingredients.
Marijuana’s illegal use in the United States peaked in the 1960s, but it remains very popular. About half of all people living in the United States are believed to have tried marijuana (most illegally) at some time in their lives. The 1992 National Household Survey on Drug Abuse found that approximately 5 million Americans illegally use marijuana on a weekly basis. Nearly 70 percent of high school students reported using it illegally in the previous month. A 2005 survey in the United Kingdom found that 24 percent of teenagers had used marijuana, and 15 percent had used it in the previous month. Use drops off dramatically as people enter their thirties.
Marijuana differs from all of the other herbal remedies we discuss because of its illegal status. Marijuana has been very difficult to obtain medically since passage of the Marijuana Tax Act of 1937. It is currently regulated in the United States as a Schedule I drug, which means it is viewed as having a high potential for abuse, to lack any accepted medical use, and to be unsafe for use under medical supervision. This means marijuana is unavailable even for physicians to prescribe.
Starting as far back as the 1970s, efforts were made to reclassify marijuana as a Schedule II drug, which would allow doctors to prescribe it for certain conditions. These efforts were quashed by the Drug Enforcement Agency in 1992, which led to proponents going directly to voters to change the laws. In 1996, voters in California and Arizona passed ballot initiatives permitting the use of marijuana as a medicine. Arizona’s referendum was invalidated, but by the time of the 2005 U.S. Supreme Court ruling, ten states had legalized the medicinal use of marijuana. Concerns have been expressed, even by some supporters of these initiatives, that in practice marijuana clinics simply make marijuana more easily available for anyone who wants it.
Marijuana has a very long history of medicinal use, being mentioned in ancient records from China and India. It was first introduced into Western medicine by an Irish doctor, William O’Shaugnessy, returning from India in 1842. Both its illegal and medicinal uses involve smoking or eating the unpurified leaves and flower tops. As with all herbs, there is great variability in the strength and quality of samples. However, it is generally acknowledged that the potency of marijuana available today is much higher than what was available on the street a couple of decades ago.
The active ingredients in marijuana are a group of about thirty compounds called “cannabinoids.” The most abundant and active of these is THC (delta–9-tetrahydrocannabinol, or delta-9-THC).
A manufactured form of THC has been available since 1985 as a Schedule II drug called Marinol®, or dronabinol. Marinol is FDA-approved for the treatment of chemotherapy-induced nausea and vomiting and for AIDS-induced weight loss. In 1999, this product was reassigned to Schedule III, meaning it is viewed as having less potential for abuse and dependence. (Schedule II drugs include narcotics, amphetamines, and barbiturates, which are viewed as highly susceptible to abuse with severe dependence.)
Some of the marijuana research has been conducted on pure THC and other cannabinoids and must be distinguished from that done on whole marijuana itself. Unless otherwise stated, “marijuana” in this entry refers to smoking or eating marijuana plant material.
Here’s the entire series: