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2006 Third Web Paper
Abigail was diagnosed with breast cancer the year she turned forty. While undergoing chemotherapy, she was sick and vomiting constantly as a result of her treatments. No legal drugs, including the synthetic "marijuana" pill Marinol, helped her situation. As a result, she turned to marijuana, which she was forced to obtain illegally. However, with it, she was able to keep her food down, was comfortable, and even gained weight. Everyday, people suffering from diseases such as AIDS, cancer, glaucoma, epilepsy, Tourette's syndrome, Huntington's disease, and Parkinson's disease, turn illegally to marijuana to help relieve their debilitating symptoms. Why is marijuana illegal if it has helped so many people cope with their illnesses? Should marijuana be legalized for medicinal use?
Marijuana is the common name for Cannabis sativa, a hemp plant that grows throughout temperate and tropical climates. Tetrahydrocannabinol (9-THC) is the primary psychoactive ingredient; depending on the particular plant, either THC or cannabidiol is the most abundant cannabinoid in marijuana.
When marijuana is ingested, THC binds to the CB1 canabinoid receptor in the brain. The presence of cannabinoid systems in key brain regions is strongly tied to the functions and pathology associated with those regions. For example, nausea and vomiting (emesis) are produced by excitation of one or a combination of triggers in the gastrointestinal tract, brain stem, and higher brain centers (2). There are numerous cannabinoid receptors in the nucleus of the solitary tract, a brain center that is important in the control of emesis. The clinical value of cannabinoid systems is best understood in the context of the biology of these brain regions.
In both AIDS and cancer patients, weight loss due to nausea and vomiting is very common. "Weight loss of as little as 5% is associated with decreased survival and a body weight about one-third below ideal body weight results in death" (2). In addition, patients may even break bones or rupture the esophagus while vomiting. Many patients decide to stop chemotherapy treatments in order for the nausea and vomiting to cease, even though they know it might mean death. Although there are appetite stimulating drugs available on the market, many patients find that they are not effective or cause unpleasant side effects. Smoking marijuana seems to stimulate appetite and enhance the flavor of food. In a 1971 study done by L. Hollister, Hunger and appetite after single doses of marijuana, alcohol, and dextroamphetamine, four groups of subjects received either marijuana, alcohol, dextroamphetamine (a stimulant), or a placebo after fasting for twelve hours. Then they were periodically offered milkshakes and asked to say how hungry they were and how much they enjoyed the food. "The subjects who took marijuana felt hungrier and ate more, those who took dexatroamphetamine felt less hungry and ate less, and the effect of alcohol was negligible" (1).
However, the most compelling concerns regarding marijuana smoking in AIDS and cancer patients are the possible effects of marijuana on immunity. AIDS and cancer patients already have weak immune systems, if marijuana decreases their immune response, then they won't be able to fight off the disease. The human body protects itself from invaders, such as bacteria and viruses through the elaborate and dynamic network of organs and cells. Cannabinoids, especially THC, can modulate the function of immune cells in various ways, in some cases enhancing and in others diminishing the immune response. However, the natural function of cannabinoids in the immune system is not known. "Immune cells respond to cannabinoids in a variety of ways, depending on such factors as drug concentration, timing of drug delivery to leukocytes in relation to antigen stimulation, and type of cell function" (2). Should the risk of a diminished immune system by ingestion of marijuana keep patients from not obtaining it to relieve their nausea and vomiting?
The question is really not whether or not marijuana can be used as an herbal remedy, but rather how well this remedy meets today's standards of efficacy and safety. We understand much more than previous generations about medical risks. Our society generally expects its licensed medications to be safe, reliable, and of proven efficacy; contaminants and inconsistent ingredients in our health treatments are not tolerated (2). That refers not only to prescription and over-the-counter drugs, but also to vitamin supplements and herbal remedies purchased at the grocery store. Are we willing to outweigh the risks associated with smoking marijuana: tolerance, dependence, withdrawal, decreased immunity and cognitive ability, and changes in mood with the positives: decrease in nausea and vomiting, weight gain, diminished pain perception, relief from muscle spasticity in neurological disorders, and lower arterial systolic blood pressure? According to the FDA, the risks associated with smoking marijuana for medicinal purposes outweigh the positives. It seems to me, that medicinal marijuana should only be used when no other treatments are successful and if the patient is made fully aware of the consequences of ingestion. Lots of medications on the market today have adverse side effects, no drug is perfect. Why have people suffer when there is relief available?
1. 1) Hollister, L.E.. "Hunger and Appetite after Single Doses of Marihuana, Alcohol, and Dextroamphetamine". Clinical Pharmacology and Therapeutics 12 January 1971, 44-49.
2. 2)Assessing the Science Base of Marijuana and Medicine, information about medicinal marijuana
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