Part 1: The many definitions of medical marijuana

     Many people use the term “medical marijuana” loosely to refer to many variations and components of marijuana that are used to alleviate symptoms of a medical condition. Marijuana’s primary psychoactive ingredient—THC—was synthesized into a pill form called Marinol and has been available by prescription since 1985. It is sometimes prescribed for nausea and appetite stimulation. Another drug, Cesamet, mimics chemical structures that naturally occur in the plant and also is prescribed for nausea. When many people think of “medical” marijuana, they don’t think of a pill with an isolated component of marijuana, but rather the smoked, vaporized, or edible version of the whole plant.

     Some individuals who support the legalization of marijuana advocate for smoked, vaporized, or edible marijuana to be used as medicine. The science on smoking any drug is clear, especially highly potent whole marijuana. Smoking any medicine or drug presents many risk factors for the user. Other delivery methods, such as vaporizing or consuming edibles, make it impossible to ensure a reliable dose due to the variations in potency among various marijuana products now available.

     Derivatives of the marijuana plant are currently passing through the rigorous FDA approval process and, if proven effective for treating medical conditions, may be available for use soon. One drug, Sativex, is in the late stages of FDA approval in the U.S., particularly for Multiple Sclerosis (MS) spasticity. Sativex is an oral mouth spray developed from a blend of two marijuana extracts, THC and CBD. THC is the psychoactive ingredient in marijuana, while CBD counteracts THC’s psychoactive effect and carries many of the promising medical benefits of the marijuana plant. Epidiolex, another medication with CBD from the marijuana plant, has shown tremendous promise for young people with seizure disorders and is likely to be available for prescription later in 2017.

     Sativex and Epidiolex are both medications that have been tested in double-blind clinical trials with known and reliable dosage amounts, and have been proven to be more effective than a placebo. Whole plant marijuana is not under the FDA scientific review process. This process is the only scientific and legally recognized procedure for bringing safe and effective medications to the American public.

     To date, no major medical association has come out in favor of the crude marijuana plant for widespread medical use. The American Cancer Society stated, “The ACS is supportive of more research into the benefits of cannabinoids. Better and more effective treatments are needed to overcome the side effects of cancer and its treatment. The ACS does not advocate the use of inhaled marijuana or the legalization of marijuana.” Along similar lines are position statements from the American Glaucoma Foundation, the National Multiple Sclerosis Society, the American Medical Association, the American Society of Addiction Medicine, the Institute of Medicine, and Center for Adolescent Substance Abuse Research at Children’s Hospital Boston, as well as others. For all of these statements, please go to www.jonescountycoalition.org/blog.

     Part 2 will be published in next week’s Express, discussing two more definitions of medical marijuana and the potential impacts that our entire community should be aware of.