Tuesday, December 4, 2018

Pros and Cons of Medical Marijuana


Currently THC and CBD are under a lot of scrutiny, as they both are cannabinoids in marijuana that can have a significant medical effect for those afflicted with symptoms such as nausea and weight loss (Bradford, Bradford, Abraham, & Bagwell Adams, 2018). Right now medical marijuana is not a FDA approved medicine mainly because the FDA requires clinical trials among hundreds or even thousands of individuals before they can stamp their approval (“What is marijuana”, 2018).

                Much of the current research that is against the use of marijuana stems from the fact that at a young age, a psychedelic like marijuana can have the potential to alter normal brain development and function (“What is marijuana”, 2018). In the short term, THC from marijuana overloads brain receptors that normally react to THC like chemicals and can often cause effects like altered senses, changes in mood, impaired body movement, impaired memory, and delusions among other symptoms (“What is marijuana”, 2018). In the long term, marijuana can affects brain growth as seen by cohort studies that followed users from a young age while tracking IQ. Twin studies have conveyed similar results showing IQ deficits after long term marijuana use, and in these studies there was no proof of return of such mental abilities. Another big con is that the most popular intake method of marijuana is through smoking, which comes with a plethora of respiratory issues.

                More recently there has been research advocating the use of medical marijuana to solve several ailments, and experiments are currently being done to view marijuana’s effects on cancer, HIV, and MS. Although medical marijuana is not FDA approved, there have been 2 oral drugs that use the cannabinoids THC and CBD from marijuana and are FDA approved (“What is medical marijuana”, 2018). Other studies have shown that in states with medical marijuana laws, Medicare Part D prescriptions filled for all opioids decreased significantly, and such states were also associated with lower opioid prescribing rates. CBD, which does not have any of the psychedelic effects of THC, has also been FDA approved through a liquid based drug called Epidiolex that treats Dravet syndrome and Lennox-Gastaut syndrome, which are two forms of severe childhood epilepsy.

                Even though marijuana has been legalized in several states now, one can clearly see that there are both pros and cons to utilization of the drug. Do the pros outweigh the cons?




Bradford, A. C., Bradford, W. D., Abraham, A., & Bagwell Adams, G. (2018). Association Between US State Medical Cannabis Laws and Opioid Prescribing in the Medicare Part D Population. JAMA Internal Medicine, 178(5), 667. https://doi.org/10.1001/jamainternmed.2018.0266

NIDA. (2018, June 27). Marijuana as Medicine. Retrieved from https://www.drugabuse.gov/publications/drugfacts/marijuana-medicine on 2018, December 4


2 comments:

  1. I do believe in some cases that the pros of medical marijuana usage do outweigh the cons. For example, studies have shown that it has great benefits for patients with parkinson's disease. After using cannabis, thei motor symptoms such as tremors, rigidity, and bradykinesia improved significantly (Lotan, Treves, Roditi, & Djaldetti, 2014). Patients also had improved pain and sleep scores (Lotan, Treves, Roditi, & Djaldetti, 2014). So, for some illnesses I do believe the benefits justify its use. However, it should be controlled and not prescribed to children and adolescents.

    Lotan, I., Treves, T. A., Roditi, Y., & Djaldetti, R. (2014). Cannabis (Medical Marijuana) Treatment for Motor and Non–Motor Symptoms of Parkinson Disease: An Open-Label Observational Study. Clinical Neuropharmacology, 37(2), 41–44. https://doi.org/10.1097/WNF.0000000000000016

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  2. To address Tabitha's comment above,
    Yes, marijuana can have positive effects on the motor symptoms of Parkinson's patients. Dopamine is the primary neurotransmitter responsible for coordinated movements, and we don't call marijuana "dope" for nothin'. However, we need to keep in mind that motor symptoms are not the only symptoms in Parkinson's! This is a neurodegenerative disease, and brain structures and pathways outside of the substantia nigra are at risk for damage and degeneration. That being said, Parkinson's patients are a severely at risk population for developing dementia. In fact, 80% of Parkinson's patients will develop dementia within the 10-20 years after diagnosis (Gao, et al., 2017). Giving psychoactive chemicals such as THC to a dementia prone population may not be the best form of treatment, especially when we have a large arsenal of FDA approved medications that are shown to be safe and effective for treating the motor symptoms of Parkinson's (and really cool new mechanisms in current clinical trials!). I know there are viral internet videos of Parkinson's patients tremoring out of control, and then having their tremors completely disappear after puffing a joint of "the reefer", but these are very much outliers. I would certainly lecture Parkinson's patients on how psychoactive chemicals may further increase their already high risk for cognitive impairment, but if a patient wants to spark one up to some Pink Floyd, we must respect that autonomy.

    Citations:

    1. Gao, Y., Nie, K., Huang, B., Mei, M., Guo, M., Xie, S., . . . Wang, L. (2017). Changes of brain structure in Parkinson’s disease patients with mild cognitive impairment analyzed via VBM technology. Neuroscience Letters, 658, 121-132. doi:10.1016/j.neulet.2017.08.028

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