HIV / AIDS Marijuana Treatments
Published by medicalmarijuana.com
Acquired immunodeficiency syndrome (AIDS) refers to a
specific group of diseases or conditions resulting from severe
suppression of the immune system. Scientists have identified the human
immunodeficiency virus, or HIV, to be the infectious agent causing
AIDS. HIV destroys the immune system by attacking T-cells in the
blood. Like chemotherapy for cancer patients, the standard treatments
for HIV infection are highly toxic. Conventional drugs used to treat
HIV infection such as zidovudine (AZT), lamivudine (3TC) and various
protease inhibitors cause significant nausea, so patients have
difficulty withstanding treatment. The nausea also heightens the loss
of appetite and weight associated with AIDS. This can lead to a
condition known as AIDS wasting syndrome. Wasting syndrome is one of
the leading causes of death from AIDS, as it leaves the body weak and
susceptible to rare cancers and unusual infections.
Patients living with HIV typically take antiretroviral drugs to prolong
the onset of AIDS. However, side effects of antiretroviral therapy—,
which include nausea, vomiting, loss of appetite and severe pain in the
nerve endings (polyneuropathies)—are often unbearable. Other side
effects of HIV/AIDS include wasting syndrome or cachexia and intractable
pain. Many patients use medical marijuana to help manage their
symptoms. According to a 2005 study published in the Journal of
Acquired Immune Deficiency Syndromes, more than 60% of HIV patients
use cannabis as a medicine.
Medical Marijuana is widely recognized as an effective
treatment for symptoms of HIV/AIDS as well as the side effects related
to the antiretroviral therapies that constitute the first line of
treatment for HIV/AIDS. Its value as an anti-emetic (stops vomiting)
and analgesic (relieves pain) has been proven in numerous studies and
has been recognized by several government-sponsored reviews.
According to the Institute of Medicine (IOM), "
For patients such
as those with AIDS or who are undergoing chemotherapy and who suffer
simultaneously from severe pain, nausea, and appetite loss, cannabinoid drugs might offer broad-spectrum relief not found in any other single medication."
Columbia University published clinical trial data in 2007 reporting
that HIV/AIDS patients who inhaled cannabis four times daily experienced
"substantial ... increases in food intake ... with little evidence of
discomfort and no impairment of cognitive performance.” They
concluded, "
Smoked marijuana ... has a clear medical benefit in HIV-positive subjects."
In 2008, researchers at the University of California at San Diego
concluded that cannabis “significantly reduced neuropathic pain
intensity in HIV-associated … polyneuropathy compared to placebo, when
added to stable concomitant analgesics. Mood disturbance, physical
disability, and quality of life all improved significantly during study
treatment.”
"The profile of cannabinoid drug effects suggests that they are
promising for treating wasting syndrome in AIDS patients. Nausea,
appetite loss, pain, and anxiety are all afflictions of wasting, and all
can be mitigated by marijuana.”
Consumer Reports believes that, “
for patients with advanced AIDS
and terminal cancer, the apparent benefits some derive from smoking
marijuana far outweighs any of the negatives”.
The effectiveness of cannabis for treating symptoms related to HIV/AIDS
is widely recognized. Its value as an anti-emetic and analgesic has
been proven in numerous studies and has been recognized by several
comprehensive, government-sponsored reviews, including those conducted
by the Institute of Medicine (IOM), the United Kingdom’s (House of
Lords) Science and Technology Committee, the Australian National Task
Force on Cannabis, and others.
Research published in 2004 found that nearly one-quarter of AIDS
patients were using cannabis. A majority reported relief of anxiety
and/or depression and improved appetite, while nearly a third said, “
it also increased pleasure and provided relief of pain“.
AIDS wasting syndrome was a very frequent complication of HIV infection
prior to the advent of protease-inhibitor drugs, and has been
associated with major weight loss and cachexia, conditions that further
debilitate its victims, who are already weakened by immune system
failure and opportunistic infections. Cannabis has been a frequently
employed alternative medicine for the condition, particularly in the
USA, because of its reported benefits on appetite and amelioration of
other AIDS symptoms. In the rest of the world, where such medications
are seldom affordable, AIDS wasting remains a common problem to the
extent that it is known in Africa as ‘slim disease'.
Research findings on cannabis and HIV/AIDS
Beginning in the 1970s, a series of human clinical trials established
cannabis' ability to stimulate food intake and weight gain in healthy
volunteers. In a randomized trial in AIDS patients, THC significantly
improved appetite and nausea in comparison with placebo. There were
also trends towards improved mood and weight gain. Unwanted effects
were generally mild or moderate in intensity. The possible benefit of
cannabis in AIDS made it one of the lead indications for such treatment
in the judgment of the American Institute of Medicine in their study.
When appropriately prescribed and monitored,
Medical Marijuana (cannabis) can provide immeasurable benefits for the health and well-being for people suffering from many symptoms of HIV/AIDS
Research findings on Other Resorces
Medical cannabis
From Wikipedia, the free encyclopedia
This article is about the medical uses of cannabis. For general drug information, see Cannabis (drug). For other uses, see Cannabis (disambiguation).
Cannabis indica fluid extract, American Druggists Syndicate, pre-1937.
Medical cannabis (or
medical marijuana) refers to the use of cannabis and its constituent cannabinoids, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), as medical therapy to treat disease or alleviate symptoms. The
Cannabis plant has a history of medicinal use dating back thousands of years across many cultures.
[1]
Cannabis has been used to reduce nausea and vomiting in chemotherapy and people with AIDS, and to treat pain and muscle spasticity;
[2]
its use for other medical applications has been studied but there is
insufficient data for conclusions about safety and efficacy. Short-term
use increases minor adverse effects, but does not appear to increase
major adverse effects.
[3] Long-term effects are not clear,
[3]
and there are safety concerns including memory and cognition problems,
risk for dependence and the risk of children taking it by accident.
[2]
Medical cannabis can be administered by a variety of routes, including vaporizing
or smoking dried buds, eating extracts, and taking capsules. Synthetic
cannabinoids are available as prescription drugs in some countries,
examples include; dronabinol, available in the United States and Canada, and nabilone,
available in Canada, Mexico, the United Kingdom, and the United States.
Recreational use of cannabis is illegal in most parts of the world, but
the medical use of cannabis is legal in certain countries, including
Austria, Canada, Finland, Germany, Israel, Italy, the Netherlands,
Portugal and Spain. In the US, federal law outlaws all cannabis use,
while 20
states and the District of Columbia have decided they are no longer
willing to prosecute individuals merely for the possession or sale of
marijuana as long as the individuals are in compliance with the state's
marijuana sale regulations. But an appeal court ruled in January
2014 that federal government has a right to crack down on California pot
dispensaries and many counties and cities in California have local
rules the prohibit shops that sell medical marijuana.
[4]
Contents
- 1 Medical uses
- 1.1 Nausea and vomiting
- 1.2 HIV/AIDS
- 1.3 Pain
- 1.4 Multiple sclerosis
- 2 Adverse effects
- 3 Pharmacology
- 3.1 Methods of consumption
- 3.2 Cannabinoid compounds
- 3.3 Botanical strains
- 3.4 Pharmacologic products
- 4 History
- 5 Society and culture
- 5.1 Methods of acquisition
- 5.2 Programs
- 5.3 National and international regulations, classification and patent
- 6 Research
- 6.1 Cancer
- 6.2 Dementia
- 6.3 Diabetes
- 6.4 Epilepsy
- 6.5 Glaucoma
- 6.6 Tourette syndrome
- 7 See also
- 8 References
- 9 Further reading
- 10 External links
Medical uses
Cannabis as illustrated in Köhler's book of medicinal plants from 1897
Medical cannabis has several potential beneficial effects.
[5][6] Cannabinoids can serve as appetite stimulants, antiemetics, antispasmodics, and have some analgesic effects,
[1]
may be helpful treating chronic non-cancerous pain, or vomiting and
nausea caused by chemotherapy. The drug may also aid in treating
symptoms of AIDS patients.
[citation needed]
The U.S. Food and Drug Administration
(FDA) has not approved smoked cannabis for any condition or disease as
it deems evidence is lacking concerning safety and efficacy of cannabis
for medical use.
[7] The FDA issued an 2006 advisory against
smoked
medical cannabis stating; "marijuana has a high potential for abuse,
has no currently accepted medical use in treatment in the United States,
and has a lack of accepted safety for use under medical supervision."
[7] The National Institute on Drug Abuse NIDA
states that "Marijuana itself is an unlikely medication candidate for
several reasons: (1) it is an unpurified plant containing numerous
chemicals with unknown health effects; (2) it is typically consumed by
smoking further contributing to potential adverse effects; and (3) its
cognitive impairing effects may limit its utility".
[8]
The Institute of Medicine, run by the United States National Academy of Sciences, conducted a comprehensive study in 1999
[dated info]
assessing the potential health benefits of cannabis and its constituent
cannabinoids. The study concluded that smoking cannabis is not to be
recommended for the treatment of any disease condition, but that nausea,
appetite loss, pain and anxiety can all be mitigated by cannabis. While
the study expressed reservations about smoked cannabis due to the
health risks associated with smoking, the study team concluded that
until another mode of ingestion was perfected providing the same relief
as smoked cannabis, there was no alternative. In addition, the study
pointed out the inherent difficulty in marketing a non-patentable herb,
as pharmaceutical companies will likely make smaller investments in
product development if the result is not patentable. The Institute of
Medicine stated that there is little future in smoked cannabis as a
medically approved medication, while in the report also concluding that
for certain patients, such as the terminally ill or those with
debilitating symptoms, the long-term risks are not of great concern.
[9][10] Citing "the dangers of cannabis and the lack of clinical research supporting its medicinal value" the American Society of Addiction Medicine
in March 2011 issued a white paper recommending a halt on use of
marijuana as medication in the U.S., even in states where it had been
declared legal.
[11][12]
Nausea and vomiting
Medical cannabis is somewhat effective in chemotherapy induced nausea and vomiting (CINV)
[2] and may be a reasonable option in those who do not improve following preferential treatment.
[13] Comparative studies have found cannabinoids to be more effective than some conventional antiemetics such as prochlorperazine, promethazine, and metoclopramide in controlling CINV,
[14] but there are used less frequently because of side effects including dizziness, dysphoria, and hallucinations.
[3][15] Long-term cannabis use may cause nausea and vomiting, a condition known as cannabinoid hyperemesis syndrome.
[16]
A 2010 Cochrane review
said that cannabinoids were "probably effective" in treating
chemotherapy-induced nausea in children, but with a high side effect
profile (mainly drowsiness, dizziness, altered moods, and increased
appetite). Less common side effects were "occular problems, orthostatic
hypotension, muscle twitching, pruritis, vagueness, hallucinations,
lightheadedness and dry mouth".
[17]
HIV/AIDS
Evidence is lacking for both efficacy and safety of cannabis and
cannabinoids in treating patients with HIV/AIDS or for anorexia
associated with AIDS; studies as of 2013 suffer from effects of bias,
small sample size, and lack of long-term data.
[18]
Pain
Cannabis appears to be somewhat effective in treatment of chronic pain, including pain caused by neuropathy and possibly also that due to fibromyalgia and rheumatoid arthritis.
[19][20] A 2009 review states it was unclear if the benefits were greater than the risks,
[19] while a 2011 review considered it generally safe for this use.
[20] In palliative care the use appears safer than that of opioids.
[21]
Multiple sclerosis
Studies of the efficacy of cannabis in treating multiple sclerosis
have produced varying results. The combination of
Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) extracts give
subjective relief of spasticity, though objective post-treatment
assessments do not reveal significant changes.
[22] A trial of cannabis is deemed to be a reasonable option if other treatments have not been effective.
[2] Its use for MS is approved in ten countries.
[2][23] A 2012 review found no problems with tolerance, abuse or addiction.
[24]
Adverse effects
See also: Long-term effects of cannabis
A 2013 literature review said that exposure to marijuana had
biologically-based physical, mental, behavioral and social health
consequences and was "associated with diseases of the liver
(particularly with co-existing hepatitis C), lungs, heart, and
vasculature".
[25]
There are insufficient data to draw strong conclusions about the safety
of medical cannabis, although short-term use is associated with minor adverse effects such as dizziness. Although supporters of medical cannabis say that it is safe,
[26] further research is required to assess the long-term safety of its use.
[3][27]
Pharmacology
The genus
Cannabis contains two species which produce useful amounts of psychoactive cannabinoids:
Cannabis indica and
Cannabis sativa, which are listed as Schedule I medicinal plants in the US;
[2] a third species,
Cannabis ruderalis, has few psychogenic properties.
[2] Cannabis contains more than 460 compounds;
[1] at least 80 of these are cannabinoids
[28][29] – chemical compounds that interact with cannabinoid receptors in the brain.
[2] As of 2012, more than 20 cannabinoids were being studied by the U.S. FDA.
[30]
The most psychoactive cannabinoid found in the cannabis plant is tetrahydrocannabinol (or delta-9-tetrahydrocannabinol, commonly known as THC).
[1] Other cannabinoids include delta-8-tetrahydrocannabinol, cannabidiol (CBD), cannabinol (CBN), cannabicyclol (CBL), cannabichromene (CBC) and cannabigerol (CBG); they have less psychotropic effects than THC, but may play a role in the overall effect of cannabis.
[1] The most studied are THC, CBD and CBN.
[25]
Methods of consumption
Smoking is the means of administration of cannabis for many consumers,
[31] and the most common method of medical cannabis consumption in the US as of 2013.
[2]
It is difficult to predict the pharmacological response to cannabis
because concentration of cannabinoids varies widely as there are
different ways of preparing cannabis for consumption (smoked, applied as
oils, eaten, or drunk) and a lack of production controls.
[2] The potential for adverse effects from smoke inhalation makes smoking a less viable option than oral preparations.
[31]
Cannabis vaporizers
have gained popularity because of the perception among users that less
harmful chemicals are ingested when components are inhaled via aerosol
rather than smoke.
[2]
Cannabinoid medicines are available in pill form (dronabinol and nabilone) and liquid extracts formulated into an oromucosal spray (nabiximols).
[2]
Oral preparations are "problematic due to the uptake of cannabinoids
into fatty tissue, from which they are released slowly, and the
significant first-pass liver metabolism, which breaks down Δ9THC and
contributes further to the variability of plasma concentrations".
[31]
Cannabinoid compounds
Tetrahydrocannabinol
(THC), or delta-9-tetrahydrocannabinol, was identified in the 1960s as
the cannabinoid primarily responsible for the psychoactive effects of
cannabis;
[2] in the 1990s, after the discovery of the cannabinoid receptors CB
1[1] and CB
2, researchers began to study and better understand how cannabinoids acted on these receptors.
[2] THC is associated – more than any other cannabinoid – with most of the pharmacologic effects of cannabis.
[2]
Cannabidiol (CBD) is a major constituent of medical cannabis; it is a nonpsychotropic and how it works on brain receptors is not known.
[2] CBD represents up to 40% of extracts of
Cannabis sativa.
[32] A 2007 review said CBD had shown potential to relieve convulsion, inflammation, cough, congestion and nausea, and to inhibit cancer cell growth.
[33] Preliminary studies have also shown potential over psychiatric conditions such as anxiety, depression, and psychosis.
[32] Because cannabidiol relieves the aforementioned symptoms, cannabis strains with a high amount of CBD may benefit people with multiple sclerosis or frequent anxiety attacks.
[22][33]
Cannabinol (CBN) is a product of THC and has mild psychtropic effects.
[25]
Botanical strains
Cannabis sativa,
Cannabis indica, and
Cannabis ruderalis
Cannabis indica produces a higher level of cannabidiol (abbreviated CBD) relative to THC (the primary psychoactive component in medical and recreational cannabis).
Cannabis sativa, on the other hand, produces a higher level of THC relative to CBD.
[medical citation needed]
Medical use of
sativa is associated with a cerebral high, and many patients experience stimulating effects. For this reason,
sativa
is often used for daytime treatment. It may cause more of a euphoric,
"high" sensation, and tends to stimulate hunger, making it potentially
useful to patients with eating disorders or anorexia.
Sativa also exhibits a higher tendency to induce anxiety and paranoia, so patients prone to these effects may limit treatment with pure
sativa, or choose hybrid strains.
[medical citation needed]
Cannabis indica is associated with sedative effects and is often preferred for night time use, including for treatment of insomnia.
[medical citation needed] Indica is also associated with a more "stoned" or meditative sensation than the euphoric, stimulating effects of
sativa, possibly because of a higher CBD-to-THC ratio.
[medical citation needed]
Many strains of cannabis are currently cultivated for medical use,
including strains of both species in varying potencies, as well as
hybrid strains designed to incorporate the benefits of both species.
Hybrids commonly available can be heavily dominated by either
Cannabis sativa or
Cannabis indica, or relatively balanced, such as so-called "50/50" strains.
[citation needed]
Cannabis strains with relatively high CBD-to-THC ratios, usually
indica-dominant strains, are less likely to induce anxiety. This may be due to CBD's receptor antagonistic effects at the cannabinoid receptor, compared to THC's partial agonist effect. CBD is also a 5-HT
1A receptor agonist, which may also contribute to an anxiolytic effect. This likely means the high concentrations of CBD found in
Cannabis indica mitigate the anxiogenic effect of THC significantly.
[medical citation needed]
Pharmacologic products
In the U.S., the FDA has approved two oral cannabinoids for use as medicine: dronabinol and nabilone.
[2]
Dronabinol, synthetic THC, is listed as Schedule III, meaning it has
some potential for dependence, and nabilone, a synthetic cannabinoid, is
Schedule II, indicating high potential for side effects and addiction.
[30] Nabiximols, an oromucosal spray derived from two strains of
Cannabis sativs and containing THC and CBD,
[30] is not approved in the U.S., but is approved in several European countries, Canada, and New Zealand as of 2013.
[2]
Generic
medication |
Trade
name(s) |
Country |
Licensed indications |
| Nabilone |
Cesamet |
U.S., Canada |
Antiemetic (treatment of nausea or vomiting) associated with chemotherapy that has failed to respond adequately to conventional therapy[2] |
| Dronabinol |
Marinol |
U.S., Canada |
Antiemetic (treatment of nausea or vomiting) associated with chemotherapy that has failed to respond adequately to conventional therapy[2] |
|
U.S. |
Anorexia associated with AIDS–related weight loss[2] |
| Nabiximols |
Sativex |
Canada, New Zealand,
eight European countries
as of 2013 |
Limited treatment for spasticity and neuropathic pain associated with multiple sclerosis and intractable cancer pain.[2] |
As an antiemetic,
these medications are usually used when conventional treatment for
nausea and vomiting associated with cancer chemotherapy fail to work.
[2]
Nabiximols
is used for treatment of spasticity associated with MS when other
therapies have not worked, and when an initial trial demonstrates
"meaningful improvement".
[2] Trials for FDA approval in the U.S. are underway.
[2] It is also improved in several European countries for overactive bladder and vomiting.
[30] When sold as Savitex as a mouth spray, the prescribed daily dose in Sweden delivers a maximum of 32.4 mg of THC and 30 mg of CBD; mild to moderate dizziness is common during the first few weeks.
[34]
Relative to inhaled consumption, peak concentration of oral THC is
delayed, and it may be difficult to determine optimal dosage because of
variability in patient aborption.
[2]
History
Main article: History of medical cannabis
The use of cannabis, at least as fiber, has been shown to go back at least 10,000 years in Taiwan. "Dà má" (Pinyin
pronunciation) is the Chinese expression for cannabis, the first
character meaning "big" and the second character meaning "hemp."
Ancient
Cannabis, called
má 麻 (meaning "hemp; cannabis; numbness") or
dà má 大麻 (with "big; great") in Chinese, was used in Taiwan for fiber starting about 10,000 years ago.
[35]
The botanist Li Hui-Lin wrote that in China, "The use of Cannabis in
medicine was probably a very early development. Since ancient humans
used hemp seed as food, it was quite natural for them to also discover
the medicinal properties of the plant."
[36]
Emperor Shen-Nung, who was also a pharmacologist, wrote a book on
treatment methods in 2737 that included the medical benefits of
cannabis. He recommended the substance for many ailments, including
constipation, gout, rheumatism, and absent-mindedness.
[37] Cannabis is one of the 50 "fundamental" herbs in traditional Chinese medicine.
[38]
The Ebers Papyrus (ca. 1550 BCE) from Ancient Egypt has a prescription for medical marijuana applied directly for inflammation.
The Ebers Papyrus (ca. 1550 BCE) from Ancient Egypt describes medical cannabis.
[39] The ancient Egyptians used hemp (cannabis) in suppositories for relieving the pain of hemorrhoids.
[40]
Surviving texts from ancient India
confirm that cannabis' psychoactive properties were recognized, and
doctors used it for treating a variety of illnesses and ailments,
including insomnia, headaches, gastrointestinal disorders, and pain,
including during childbirth.
[41]
The Ancient Greeks used cannabis to dress wounds and sores on their horses,
[42] and in humans, dried leaves of cannabis were used to treat nose bleeds, and cannabis seeds were used to expel tapeworms.
[42]
In the medieval Islamic world, Arabic physicians made use of the diuretic, antiemetic, antiepileptic, anti-inflammatory, analgesic and antipyretic properties of
Cannabis sativa, and used it extensively as medication from the 8th to 18th centuries.
[43]
Modern
An advertisement for
cannabis americana distributed by a pharmacist in New York in 1917
An Irish physician, William Brooke O'Shaughnessy,
is credited with introducing the therapeutic use of cannabis to Western
medicine, to help treat muscle spasms, stomach cramps or general pain.
[44]
Albert Lockhart and Manley West began studying in 1964 the health effects of traditional cannabis use in Jamaican communities. They developed, and in 1987 gained permission to market, the pharmaceutical Canasol: one of the first cannabis extracts.
[45]
In the 1970s, a synthetic version of THC was produced and approved for use in the United States as the drug Marinol.
[46]
Voters in eight US states showed their support for cannabis
prescriptions or recommendations given by physicians between 1996 and
1999,
[dated info]
including Alaska, Arizona, California, Colorado, Maine, Michigan,
Nevada, Oregon, and Washington, going against policies of the federal
government.
[47]
Society and culture
Methods of acquisition
Medical marijuana dispensary
The method of obtaining medical cannabis varies by region and by
legislation. In the US, most consumers grow their own or buy it from
dispensaries in the states and the District of Columbia which permit the
use of medical cannabis.
[2]
The authors of report on a 2011 survey of medical cannabis users say
that critics have suggested that some users "game the system" to obtain
medical cannabis ostensibly for treatment of a condition, but then use
it for nonmedical purposes – though the truth of this claim is hard to
measure.
[48] The report authors suggested rather that medical cannabis users occupied a "continuum" between medical and nonmedical use.
[48]
Marijuana vending machines for selling or dispensing cannabis are in use in the United States and are planned to be used in Canada.
[49]
Programs
As of 2011, 16 US states and the District of Columbia have public
medical cannabis programs, but its use remains illegal by federal law.
[23][dated info] In 1978 the US government created a program called the Compassionate Investigational New Drug program which dispenses cannabis cigarettes to 20 people with debilitating conditions
[1] including glaucoma and a rare bone disease.
[citation needed] The program was "closed to new candidates in 1991",
[1] but as of 2013, allowed four people previously in the program to continue receiving medical cannabis.
[citation needed]
National and international regulations, classification and patent
See also: Legal and medical status of cannabis, Cannabis in the United Kingdom, and Medical cannabis in the United States
Worldwide laws on cannabis possession for medical purposes
The Health and Human Services Division of the Federal government of the United States holds a patent for medical cannabis.
[50]
Medical use of cannabis or preparation containing THC as the active
substance is legalized in Austria, Belgium, Canada, Belgium, Finland,
Israel, Netherlands, Spain, the UK and some states in the US, although
it is illegal under US federal law.
Cannabis is in Schedule IV of the United Nations' Single Convention on Narcotic Drugs, making it subject to special restrictions. Article 2 provides for the following, in reference to Schedule IV drugs:
[51]
A Party shall, if in its opinion the prevailing conditions in its
country render it the most appropriate means of protecting the public
health and welfare, prohibit the production, manufacture, export and
import of, trade in, possession or use of any such drug except for
amounts which may be necessary for medical and scientific research only,
including clinical trials therewith to be conducted under or subject to
the direct supervision and control of the Party.
The convention thus allows countries to outlaw cannabis for all
non-research purposes but lets nations choose to allow medical and
scientific purposes if they believe total prohibition is not the most
appropriate means of protecting health and welfare. The convention
requires that states that permit the production or use of medical
cannabis must operate a licensing system for all cultivators,
manufacturers and distributors and ensure that the total cannabis market
of the state shall not exceed that required "for medical and scientific
purposes."
[51]
A number of medical organizations have endorsed reclassification of
marijuana to allow for further study. These include, but are not limited
to:
- The American Medical Association[52][53][54]
- The American College of Physicians – America's second largest physicians group[55]
- Leukemia & Lymphoma Society – America's second largest cancer charity[56]
- American Academy of Family Physicians opposes the use of marijuana except under medical supervision[57]
Other medical organizations recommend a halt to using marijuana as a medicine in U.S.
- The American Society of Addiction Medicine[11][12]
The National Institutes of Health holds a US patent for medical cannabis.
[50] The patent is entitled "Cannabinoids as antioxidants and neuroprotectants" and was issued in October 2003.
[58]
Research
"Victoria", the United States' first legal medical marijuana plant grown by The Wo/Men's Alliance for Medical Marijuana
The Schedule I classification of cannabis in the US makes the study of medical cannabis difficult.
[2] Another issue for research is the habit to mix cannabis with tobacco or switch between tobacco and cannabis.
Anecdotal evidence and pre-clinical research has suggested that cannabis or cannabinoids may be beneficial for treating Huntington's disease or Parkinson's disease, but follow-up studies of people with these conditions has not produced good evidence of therapeutic potential.
[59] A 2001 paper argued that cannabis had properties that made it potentially applicable to the treatment of amyotrophic lateral sclerosis, and on that basis research on this topic should be permitted, despite the legal difficulties of the time.
[60]
A 2005 review and meta-analysis said that bipolar disorder
was not well-controlled by existing medications and that there were
"good pharmacological reasons" for thinking cannabis had therapeutic
potential, making it a good candidate for further study.
[61]
Cannabinoids have been proposed for the treatment of primary anorexia nervosa, but have no measurable beneficial effect.
[62] The authors of a 2003 paper argued that cannabinoids might have useful future clinical applications in treating digestive diseases.
[63] Laboratory experiments have shown that cannabinoids found in marijuana may have analgesic and anti-inflammatory effects.
[64]
Cancer
Cannabinoids have shown some promise as anti-cancer therapies.
[65] Laboratory experiments have suggested that cannabis and cannabinoids have anticarcinogenic, antitumor and anticancer effects,
[66] including a potential effect on breast and lung cancer cells.
[64] The National Cancer Institute reports that as of November 2013 there have been no trials on the use of cannabis to treat cancer in people, and only one small trial using delta-9-THC.
[67]
Although there is a large and growing volume of research, claims that
there is evidence showing that cannabis cures cancer are, according to Cancer Research UK, "highly misleading", and prevalent on the internet.
[68]
There is no firm evidence than cannabis helps reduce the risk of
getting cancer; whether it increases the risk is difficult to establish,
since most users combine its use with tobacco smoking, and this
complicates research.
[68]
Dementia
Cannabinoids have been proposed as having the potential for lessening the effects of Alzheimer's disease.
[69]
A 2012 review of the effect of cannabinoids on brain ageing found that
"clinical evidence regarding their efficacy as therapeutic tools is
either inconclusive or still missing".
[70] A 2009 Cochrane review
said that the "one small randomized controlled trial [that] assessed
the efficacy of cannabinoids in the treatment of dementia ... [had] ...
poorly presented results and did not provide sufficient data to draw any
useful conclusions".
[71]
Diabetes
There is emerging evidence that cannabidiol may help slow cell damage in diabetes mellitus type 1.
[72]
There is a lack of meaningful evidence of the effects of medical
cannabis use on people with diabetes; a 2010 review concluded that "the
potential risks and benefits for diabetic patients remain unquantified
at the present time".
[73]
Epilepsy
A 2012 Cochrane review said there is not enough evidence to draw conclusions about the safety or efficacy of cannabinoids in the treatment of epilepsy.
[74]
There have been few studies of the anticonvulsive properties of CBD and
epileptic disorders. The major reasons for the lack of clinical
research have been the introduction of new synthetic and more stable
pharmaceutical anticonvulsants, the recognition of important adverse
effects and the legal restriction to the use of cannabis-derived
medicines.
[75] Epidiolex, a cannabis-based product developed by GW Pharmaceuticals for experimental treatment of epilepsy, will undergo stage-two trials in the US in 2014.
[76]
Glaucoma
The American Glaucoma Society noted that while cannabis can help lower intraocular pressure,
it recommended against its use because of "its side effects and short
duration of action, coupled with a lack of evidence that it use alters
the course of glaucoma."
[77] As of 2008 relatively little research had been done concerning effects of cannabinoids on the eye.
[78]
Tourette syndrome
A 2007 review of the history of medical cannabis said cannabinoids showed potential therapeutic value in treating Tourette syndrome (TS).
[79] A 2005 review said that controlled research on treating TS with Marinol showed the patients taking the pill had a beneficial response without serious adverse effects;
[80] a 2000 review said other studies had shown that cannabis "has no effects on tics and increases the individuals inner tension".
[81]
A 2009 Cochrane review
examined the two controlled trials to date using cannabinoids of any
preparation type for the treatment of tics or TS (Muller-Vahl 2002, and
Muller-Vahl 2003). Both trials compared delta-9-THC; 28 patients were
included in the two studies (8 individuals participated in both
studies).
[31]
Both studies reported a positive effect on tics, but "the improvements
in tic frequency and severity were small and were only detected by some
of the outcome measures".
[31] The sample size was small and a high number of individuals either dropped out of the study or were excluded.
[31]
The original Muller-Vahl studies reported individuals who remained in
the study; patients may drop out when adverse effects are too high or
efficacy is not evident.
[31] The authors of the original studies acknowledged few significant results after Bonferroni correction.
[31]
Cannabinoid medication might be useful in the treatment of the symptoms in patients with TS,
[31] but the 2009 review found that the two relevant studies of cannibinoids in treating tics had attrition bias,
and that there was "not enough evidence to support the use of
cannabinoids in treating tics and obsessive compulsive behaviour in
people with Tourette's syndrome".
[31]
