Marijuana – The Truth – Part 5

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 our fourth excerpt of that information:

In earlier excerpts, we discussed “What It Is,” “The Claims People Make about Marijuana,” “Study Findings,” and “Cautions.” In this, our final excerpt will review “Our Recommendations.”

Recommendations

Obey the law. That is first and foremost recommendation. Marijuana in most states and countries is illegal—to grow, possess, use, or sell. Our recommendations in no way ignore this most important aspect of any discussion on marijuana.

Recommendations about marijuana use must be carefully subdivided. First, there is clear evidence that marijuana contains powerful drugs with much potential for relieving nausea, vomiting, loss of appetite, pain, and muscle spasticity in multiple sclerosis, and also elevating mood. Very few preparations currently deliver these components safely.

Marinol (dronabinol) is available in the United States for these conditions, and another, nabilone, is available in the United Kingdom. Extracts of marijuana are now available as sublingual sprays.

However, other much more effective pharmaceuticals with fewer side effects are usually available for all these conditions and should be tried first. If they fail, you may benefit from your doctor prescribing one of the cannabinoids.

One reviewer of our book has much experience prescribing Marinol. This doctor found that a few people gained striking benefits with nausea or anorexia that was poorly controlled in other ways. However, there was no way to predict ahead of time who would gain such benefits. Research is needed to develop more effective and safer products.

Our second recommendation concerns patients for whom purified cannabinoids and other pharmaceuticals do not work well. For example, patients who already have nausea might not be able to tolerate any oral medicine. Should doctors be able to prescribe marijuana smoking for patients in these situations?

The evidence does not indicate that large numbers of people would benefit from smoking marijuana, although a few might. The serious adverse effects from smoking marijuana must also be taken into account. The most reasonable compromise seems to us to be to allow seriously ill patients who do not respond to conventional drugs to try marijuana as part of a short-term clinical trial (probably of the n-of-1 design).

However, as Christians we should obey the laws of our governments unless they conflict seriously with our faith. Paul stated it succinctly: “Everyone must submit himself to the governing authorities, for there is no authority except that which God has established. The authorities that exist have been established by God.

Consequently, he who rebels against the authority is rebelling against what God has instituted, and those who do so will bring judgment on themselves” (Romans 13:1–2; see also Matthew 22:21). Considering the availability of other medical approaches in most cases, we see no need for anyone to break the law to provide marijuana for medical reasons, and we strongly urge that the law be upheld.

This general approach to highly restricted availability of marijuana for medical use was allowed in thirty-six states between 1978 and 1992 under an FDA program called the Compassionate Investigational New Drug (IND) application.

The IOM review recommended that this program be restarted. Patients would need to be fully informed that they were enrolling in an experimental study and being given a potentially harmful drug-delivery system.

Meanwhile, research is urgently needed to develop new products that deliver the active ingredients in marijuana in effective, standardized, fast-acting systems that are legal.

Our third recommendation is that marijuana not be licensed as a medical drug.

We reiterate the conclusion of the IOM review: “If there is any future for marijuana as a medicine, it lies in its isolated components, the cannabinoids and their synthetic derivatives. Isolated cannabinoids will provide more reliable effects than crude plant mixtures. Therefore, the purpose of clinical trials of smoked marijuana would not be to develop marijuana as a licensed drug but rather to serve as a first step toward the development of non-smoked rapid-onset cannabinoid delivery systems.” In this way, the issue of medical marijuana would quickly become a thing of the past.

Our fourth recommendation is that a consistent effort should be maintained to discourage all use of marijuana even if at some future time its illegal status is changed. The risks of using marijuana are great. Every year, about 100,000 people seek help in kicking the marijuana habit. The church could play a significant role here as only Jesus Christ can fill the void that marijuana abusers experience.

Dosage

Marinol is usually prescribed by physicians in doses of 5 to 15 mg every two to four hours for nausea and vomiting due to chemotherapy, or 2.5 to 10 mg twice a day for appetite stimulation in people with AIDS.

Treatment Categories

Conventional

Orally, as pure cannabinoid (not the marijuana plant) for moderately effective relief of nausea and vomiting with chemotherapy and AIDS-related weight loss

Complementary

If the following four requirements are met, a short supervised trial with medical marijuana may be justified.

1.no currently legal therapy is effective;

2.marijuana is legal in that jurisdiction;

3.the physical and mental risks are understood by the patient; and

4.the possible benefits exceed the risks.

Here’s the entire series: