Medical Marijuana: Dispelling the myths
So much discussion has been witnessed regarding legalising and the use of Marijuana in treating diseases and alleviating symptoms. This plant has a long history of use as a recreational and also spiritual component.
The current question is its medicinal value. According to the National Institute on Drug Abuse, US, Marijuana refers to the dried leaves, flowers, stems, and seeds from the Cannabis Sativa plant. The plant contains the mind-altering chemical Tetra-hydro cannabinoid (THC) and other similar compounds. Extracts can also be made from the cannabis plant.
The term medical marijuana refers to using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions. The US Food and Drug Administration (FDA) has not recognised or approved the marijuana plant as medicine because, for a drug to be considered for medical use approval, it must undergo extensive clinical trials in hundreds to thousands of human subjects to determine its benefits and risks. So far, none has been done to show that the benefits of the marijuana plant exceed its known risks.
However, some scientific studies of the chemicals in marijuana, called cannabinoids (cannabinoid oils), has shown that they are beneficial with less risks. The Marijuana plant contains more than 100 cannabinoids.
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The cannabinoids have scientific structures that are chemically similar to THC, the ingredient in Marijuana that makes people “high” but cannabinoids are not THC and thus do not make people high. Cannabinoids are similar to chemicals the body makes that are important in regulating pleasure, memory, thinking, concentration, body movement, awareness of time, appetite, pain, and the senses (taste, touch, smell, hearing, and sight).
The most compelling evidence on the positive outcomes on the use of cannabinoids is their effect on pain control, appetite stimulation and thus weight gain in patients suffering from life-threatening illnesses such as cancer and AIDS.
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Research shows that cannabinoids also reduce anxiety, control nausea and vomiting and relaxes tight muscles in people with Multiple Sclerosis.
The US Food and Drug Administration (FDA)has approved use of at least three extracts for use as pharmaceutical cannabinoids drugs for seizures, nausea and vomiting.
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There is some evidence from one cell culture study with rats that suggests purified extracts from marijuana can slow the growth of cancer cells while another study, still in rats, has revealed increased cancer-killing effects of radiation therapy on the extracts integration during treatment.
Scientists continue conducting preclinical and clinical trials with marijuana and its extracts to treat symptoms of illness and other conditions, such as epilepsy, substance use disorders and mental disorders.
Legalization varies by country, in terms of its possession, distribution, cultivation, and for medical use; how it can be used and for what conditions. More and more states in the US continue to legalize marijuana. A case in point is the Californian law that allows a doctor to prescribe marijuana for patients suffering from AIDS, anorexia, arthritis, cancer, migraine headaches, seizures, severe nausea, glaucoma, and chronic pain.
The California Medical Association (CMA) strongly supports its use in the treatment of neuropathic pain; pain caused by injury to the nerves and can be very debilitating. Though legalized in some states in the US, Marijuana use still remains federally illegal. Uruguay and Canada are the only sovereign states that have fully legalized the consumption and sale of recreational cannabis nationwide.
In South Africa, the constitutional court ruled in favour of legalisation of cannabis consumption, but not legal sales. The court said that the right to privacy was violated by prohibiting the possession, purchase, or cultivation of cannabis for personal consumption by an adult in a private dwelling. But there is still a challenge, the law must be repealed to align with this court ruling. A policy of limited enforcement has also been adopted in many other countries.
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It is evident that medical use of Marijuana and/or its extracts is a reality in a substantial number of countries and is gaining traction. In Kenya opinions on the legalization and use of Marijuana has become widespread with views from both sides of the divide. However, any discussion on medical use of Marijuana and/or its extracts must first of all aim to have the law align to this requirement and it could be the high time that sober, well-structured discussions among all stakeholders are held.
Dr Weru is a Consultant Palliative Medicine Physician at Aga Khan University Hospital Nairobi
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