LEGALIZATION OF MEDICAL MARIJUANA

DISCUSSIONS
1. Has Legalizing Medical Marijuana Led to Increased Drug Abuse
among Children and Adolescents? (Retrieved from
http://medicalmarijuana.procon.org/view.answers.php?
questionID=000246)
The Office of National Drug Control Policy (ONDCP) noted in its Aug. 24, 2004 website
article titled "Marijuana and Teens: Fact Sheet":
"Marijuana is the most widely used illicit drug among America's youth. Among
kids who use drugs, approximately 60 percent use marijuana only. Of the 14.6
million past month marijuana users in 2002, about one third, or 4.8 million
persons,
used
it
on
20
or
more
days
in
the
past
month.
Between 1991 and 2001, the percentage of 8th graders who used marijuana
doubled from one in ten to one in five. From 2001 to 2003, current marijuana use
declined 11 percent. This is the first decline in youth drug use of such a
magnitude in more than a decade. Kids are using marijuana at an earlier age. In
the late 1960s fewer than half of those using marijuana for the first time were
under 18. By 2001, about two-thirds (67 percent) of marijuana users were
younger than 18."
PRO (yes)
The Office of National Drug Control Policy
(ONDCP) spokesman Scott Burns stated in
an Oct. 6, 2004 article by Becky Bohrer of
the Associated Press:
"Legalizing medical marijuana in Montana
will send the wrong message to kids
about
drug
use.
The debate is about our kids. The debate
is about the greater good for our society
and what kind of message we're sending.
And we don't need to go out of our way to
help our kids get addicted to drugs...

CON (no)
Joycelyn Elders, MD, former US Surgeon
General, wrote in a Mar. 26, 2004 editorial
published in The Providence Journal:
"That fear [that medical marijuana laws will
increase teen use of marijuana], raised in
1996, when California passed the first
effective medical-marijuana law, has not
come
true.
According to the official California Student
Survey teen marijuana use in California
rose steadily from 1990 to 1996, but began
falling immediately after the medicalmarijuana
law
was
passed.

If kids see marijuana as a medicine,

they're apt to dismiss its harms. Among Among ninth graders, marijuana use in the
those are effects on the respiratory last six months fell by more than 40 percent
system
and
impaired
judgment... from 1995-96 to 2001-02 (the most recent
available figures)."
If we make it acceptable in society to
smoke dope, our children are more Mar. 26, 2004 - Joycelyn Elders, MD
inclined to do that."
Oct. 6, 2004 - Office of National Drug Control Policy
(ONDCP)

Mitch Earleywine, PhD, Associate Professor

of Psychology at the State University of
New York at Albany, and Karen OKeefe, JD,

The Drug Free America Foundation stated

in its 2004 article on its website "Medical
Excuse Marijuana":
"Children
are
most
at
risk from
legalization
and
the
accompanying
availability
of
recreational
drugs.
If
drugs
become
more
available,
acceptable and cheap, they will draw in
greater numbers of vulnerable youth. And
because of marketing tactics of drug
promoters and the major decline in drug
use in the 1990s (due in great part to
antidrug,
education
and
awareness
campaigns), there is a growing perception
among young people today that drugs are
harmless. A decade ago, for example, 79
percent of 12th graders thought regular
marijuana use was harmful; only 58
percent
do
so
today.
Because peer pressure is such a factor in
inducing kids to experiment with drugs,
the way kids perceive the risks of drug
use
is
critical.
Legalizing
smoked
marijuana, giving it the governments
stamp of approval, sends the message to
kids that drug use is not only harmless,
but normal. This is precisely the opposite
message we should be conveying."

Attorney and Legislative Analyst for the

Marijuana Policy Project, stated in their Sep.
2005 report "Marijuana Use by Young
People: The Impact Of State Medical
Marijuana Laws":
"Nine years after the passage of the
nation's first state medical marijuana law,
California's Prop. 215, a considerable body
of data shows that no state with a medical
marijuana law has experienced an increase
in youth marijuana use since their law's
enactment. All have reported overall
decreases of more than the national
average decreases -- exceeding 50% in
some age groups -- strongly suggesting that
enactment of state medical marijuana laws
does not increase teen marijuana use....
When states consider proposals to allow the
medical use of marijuana under state law,
the concern often arises that such laws
might 'send the wrong message' and
therefore cause an increase in marijuana
use
among
young
people.
The available evidence strongly suggests
that this hypothesis is incorrect and that
enactment of state medical marijuana laws
has not increased adolescent marijuana
use."
Sep. 2005 - Mitch Earleywine, PhD
Karen O'Keefe, JD
2005 Teen Use Report (495 KB)

2004 - Drug Free America Foundation

Sue Rusche, Founder and President of

National Families in Action, wrote the
following for the Congressional Quarterly
(CQ) Researcher, published on Feb. 22,
2002:
"California voters passed Proposition 215,
the nation's first medical marijuana
initiative,
in
November
1996.
The issue received intense press coverage
and California's teenagers got the
message: their past-month marijuana use
increased by nearly one-third that year,
from 6.5% to 9.2% according to the
National Household Survey on Drug

Marijuana Policy Project (MPP), a marijuana

law reform advocacy organization, told
ProCon.org in a Dec. 20, 2001 email:
"The 1998 National Household Survey on
Drug
Abuse
released
by
the
U.S.
Department of Health and Human Services,
indicates that medical marijuana reform
does not lead to increased non-medical
marijuana
use.
Despite a nationwide debate about the
medical use of marijuana that has been
making headlines since 1996, the survey
found that 'past month' marijuana use in
1998 -- particularly among young people -dropped from 1997 and was at the same
level
as
in
1995.

Abuse.
Although use declined the next year, it
has increased every year since then. The
figures are 1995--6.5%, 1996--9.2%,
19976.8%, 19987.4%, and 19998.4%."
Feb. 22, 2002 - Sue Rusche

Despite the fact that since 1996, patients in

California have been allowed to grow and
use
marijuana
upon
their
doctors'
recommendation, there were no statistically
significant differences in reported marijuana
usage rates among 12- to 17-year-olds in
California than in the rest of the nation.
These findings should dispel the myth that
medical marijuana sends the wrong
message and leads to increased nonmedical marijuana use. Citizens across the
country, including teenagers understand
the difference between medicine and drug
abuse.
[Note: MPP issued a December 2006 report,
"Does Prohibition of Marijuana for Adults
Curb Use by Adolescents?," which showed
that marijuana-related arrests increased
from 400,000 in 1975 to 800,000 in 2005
while the percentage of 12th graders who
said marijuana was "very easy" or "fairly
easy" to get remained 80-90% for the same
time period. On Dec. 18, 2006 ProCon.org
independently verified this data using the
FBI's "Uniform Crime Reports" and the
Department of Health & Human Services'
"Monitoring the Future" reports.]"
Dec. 20, 2001 - Marijuana Policy Project (MPP)

2. MJ Patient stories (Retrieved from

https://www.medicaljane.com/category/patient-stories/)

JOURNALS
1. Illegal drug use as medicine: Marijuana by Collin D. Koschny of
Eastern Michigan University (Retrieved from
https://collinkoschny.wordpress.com/medical-marijuana-researchpaper/)
Conclusion
Although the federal government considers marijuana illegal, the evidence
supports that there is proven medical benefits associated with its use. Several
common medical conditions qualify for medical marijuana usage, making it an
affordable alternative from traditional treatments. Studies have showed that
marijuana is not addictive, and does not cause cancer as is commonly confused
with cigarette smoking, and is by no means harmful to smoke or ingest.

Limitations experienced during research include, not collecting information on a

wide enough scale such as worldwide or across the country, limited in what
resources were available during the research period, limited on the amount of
time allotted to conduct research, and the availability of people to interview.
Suggestions that I have for further research on the topic is to collect more widescale data and more in-depth information.
2. 2006 Medical Marijuana Revisited by Michael Koger, Sr. of The
University of Alabama, Tuscaloosa (Retrieved from
http://www.cjhp.org/Volume4_2006/Issue1/41-45-koger.pdf)
Conclusion
Medical marijuana has gained increased attention of the medical community and
of the general public. The medicinal value of this drug is well-known throughout
history, and the best researchers in the area acknowledge marijuanas effects.
There are, however, traditional drugs which can effectively treat many of the
same conditions for which some have used marijuana, and monitoring the dose
of marijuana may be difficult. More research is necessary to further delineate the
benefit of legalizing the hemp plant in the United States and in other countries.

3. 60 Peer-Reviewed Studies on Medical Marijuana - Medical Studies

Involving Cannabis and Cannabis Extracts (1990 - 2014) (Retrieved
from http://medicalmarijuana.procon.org/view.resource.php?
resourceID=000884)

Peer-reviewed studies on
medical marijuana, listed by
condition treated

# of studies

Pro

Con

Not
Clearly
Pro or Con

ALS

Bipolar Disorder

Cancer

General Use

Glaucoma

HIV/AIDS

Huntington's Disease

IBD/Crohn's

11

Nausea

Pain

Multiple Sclerosis

Parkinson's Disease

PTSD

Psychosis / Schizophrenia

Rheumatoid Arthritis

Tourette's Syndrome

TOTALS

41
14
5 (8.3%)
(68.3%)
(23.3%)

Our list includes only peer-reviewed studies from 1990 to present that have
been done using the marijuana plant or extracts derived from the plant, such
as Sativex and Epidiolex. Studies involving synthetic reproductions of isolated
compounds from the marijuana plant e.g. products such as Marinol,
Nabilone, Cannabinor, and others were not included. Double-blind studies
(in which neither the subjects nor the researchers know which patients are
receiving the placebo or actual treatment) have been noted as such.
4. 2012 Medical marijuana laws in 50 states: Investigating the
relationship between state legalization of medical marijuana and
marijuana use, abuse and dependence by Magdalena Cerd, Melanie
Wall, Katherine M. Keyes, Sandro Galea, and Deborah Hasin
(Retrieved from
http://www.drugandalcoholdependence.com/article/S03768716(11)00274-2/abstract)
Conclusion
States that legalized medical marijuana had higher rates of marijuana use.
Future research needs to examine whether the association is causal, or is due to
an underlying common cause, such as community norms supportive of the
legalization of medical marijuana and of marijuana use.
5. 2012 Medical Marijuana: Clearing Away the Smoke by Igor Grant, J.
Hampton Atkinson, Ben Gouaux, and Barth Wilsey (Rettrieved from
http://benthamopen.com/FULLTEXT/TONEUJ-6-18)
Cannabis provides pain relief superior to placebo because although placebo
effects were present, treatment effects were independent.
Subjects total dosage of 1% to 8% THC (tetrahydrocannabinol) ranged from 4
mg to 128 mg
Chronic pain: up to 25 mg of dronabinol (found in THC) significantly reduces 50%
pain

Nausea-emesis and appetite stimulation: 5 mg of dronabinol daily enhances

appetite from 8% to 38% after 6 weeks)
Cannabis-based extracts: daily doses of THC ranging from 7.5 mg to 27.5 mg
suggest improvements in pain and spasticity
Side effects: dizziness or lightheadedness, dry mouth, fatigue, muscle weakness,
myalgia and palpitations, euphoria
Oral sprays of cannabinoids or donabinol: can reduce the incidence and severity
of adverse effects by downward self-titration without loss of analgesia
Withdrawal: withdrawal from low daily dose commences by 24 hours and
diminishes within 12 hours; completed within 48-72 hours
Withdrawal side effects of heavy users: anxiety, irritability, restlessness,
insomnia, stomach pain, decreased appetite
Fatality: no recorded fatality from cannabis overdose
GUIDELINES FOR PHYSICIANS RECOMMENDING MARIJUANA
1. Take a history and conduct a good faith examination with the patient
2. Develop a treatment plan with objectives
3. Provide informed consent, including discussion of side effects
4. Periodically review treatments efficacy
5. Obtain consultations, as necessary
6. Keep proper records supporting the decision to recommend use of medical
marijuana
PATIENT SELECTION FOR CANNABOID THERAPY
1. Patient has persisting neuropathic pain
2. Patient has taken standard Rx (e.g. antidepressants, anticonvulsants, opioids,
nonsteroidal anti-inflammatory drugs)
3. Patient has good response to standard Rx (at least 30% reduction in pain
intensity)
4. Patient is willing to consider medical marijuana
5. Risk of patient from substance abuse must be determined.
6. If high risk or has history of substance abuse, coordinate with substance
abuse treatment program.
7. If favorable and coordinated with care, discuss mode of cannabis
administration.

8. If a patient prefers smoke, oral, or vaporizer, begin cannabis smoke and

monitor efficacy, side effects and diversion.

6. Medical Marijuana and Related Legal Aspects by Rita M. Marcoux, RPh,

MBA, E. Paul Larrat, RPh, PhD, and F. Randy Vogenberg, RPh, PhD
(Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3875249/)
Health care practitioners and P&T committees would be wise, therefore, to
heed the old Latin principle of caveat emptorlet the buyer bewarewhen
considering the emerging availability of marijuana for medical use.
USA - 18 states with approved usage of medical marijuana along with method
of dispensing, year of approval and the registry required.
Table 1
States With Approved Uses of Medical Marijuana

Registry

State

Alaska

Approved Uses

Method of

Year

Require

Dispensing

Approved

1999

Mandator

Cachexia, cancer, chronic

Individual caregivers.

pain, epilepsy (and other

No more than 1 ounce

disorders characterized by

of usable marijuana

seizures), glaucoma,

may be in the

HIV/AIDS, MS (and other

possession of a

disorders characterized by

caregiver or patient at

muscle spasticity), and

one time. Patients can

nausea.

home-cultivate up to

six plants, of which no

more than three may
be mature at one time.

Arizona

Cancer, glaucoma,

Individual caregivers or

2010

Mandator

Registry
Method of

Year

Require

Approved Uses

Dispensing

Approved

HIV/AIDS, hepatitis C, ALS,

compassion centers. A

Crohns disease,

single licensee may

Alzheimers disease,

possess up to 2.5

cachexia or wasting

ounces of usable

syndrome, severe and

marijuana for a 14-day

chronic pain, severe

supply. Home

nausea, seizures

cultivation is allowed if

(including epilepsy), and

patient lives more than

severe or persistent

25 miles from nearest

muscle spasms (including

compassion center.

MS).

Patient may have up to

State

12 plants in a locked
facility.

California

AIDS, anorexia, arthritis,

Individual caregivers or

cachexia, cancer, chronic

compassion centers. A

pain, glaucoma, migraine,

single licensee may

persistent muscle spasms

possess up to 8 ounces

(including spasms

of dried marijuana

associated with MS),

and/or 6 mature or 12

seizures (including

immature plants at one

seizures associated with

time. A patient may

epilepsy), severe nausea,

register to possess a

and other chronic or

greater quantity under

persistent medical

a physicians

1996

Voluntary

Registry

State

Colorado

Connecticut

Approved Uses

Method of

Year

Require

Dispensing

Approved

2001

Mandator

symptoms.

recommendation.

Cancer, glaucoma,

Individual caregivers

positive status for

and dispensaries. A

HIV/AIDS, cachexia, severe

single licensee may

pain, severe nausea,

possess no more than

seizures (including those

2 ounces of usable

that are characteristic of

marijuana and no more

epilepsy), and persistent

than six plants, only

muscle spasms (including

three of which may be

those that are

mature. Dispensaries

characteristic of MS).

are not empowered by

Other conditions subject

law; regulations have

to approval by Colorado

been enacted to

Board of Health.

control their operation.

Cancer, glaucoma,

Individual caregiver or

positive status for

dispensary. A single

HIV/AIDS, Parkinsons

licensee may possess

disease, MS, damage to

an amount of usable

nervous tissue of spinal

marijuana for a 1-

cord with objective

month supply. Home

neurological indication of

cultivation is illegal.

intractable spasticity,

2012

Mandator
y

Registry

State

Approved Uses

Method of

Year

Require

Dispensing

Approved

2011

Mandator

epilepsy, cachexia,
wasting syndrome,
Crohns disease, PTSD, or
any medical condition,
medical treatment, or
disease approved by
Connecticut Department
of Consumer Protection.

Delaware

Approved for treatment of

Individual caregiver or

debilitating medical

compassion center. A

conditions (defined as

single licensee may

cancer; HIV/AIDS;

possess up to a

decompensated cirrhosis;

maximum of 6 ounces

ALS; Alzheimers disease;

of marijuana and may

PTSD; or a medical

obtain a maximum of 3

condition that produces

ounces of marijuana

wasting syndrome, severe

only from a

debilitating pain that has

compassion center in a

not responded to other

given 14-day period.

treatments for more than

Each patient may be

3 months or for which

registered at only a

other treatments produced single compassion

serious side effects,
severe nausea, seizures,

center.

Registry

State

Approved Uses

Method of

Year

Require

Dispensing

Approved

2010

Mandator

or severe and persistent

muscle spasms).

District of

HIV/AIDS; glaucoma; MS;

Individual caregiver or

Columbia

cancer; and other

dispensary. A single

conditions that are

licensee may possess

chronic, long-lasting,

an amount of usable

debilitating, or that

marijuana for a 1-

interfere with the basic

month supply. Home

functions of life; serious

cultivation is illegal.

medical conditions for

which the use of medical
marijuana is beneficial;
patients undergoing
treatments such as
chemotherapy and
radiotherapy.

Hawaii

Cancer, glaucoma,

Individual caregiver

positive status for

only. A single licensee

HIV/AIDS, a chronic or

may possess only three

debilitating disease or

mature plants, four

medical condition or its

immature plants, and 1

treatment that produces

ounce of usable

2000

Mandator
y

Registry

State

Approved Uses

cachexia or wasting

Method of

Year

Require

Dispensing

Approved

1999

Mandator

marijuana at a time.

syndrome, severe pain,

severe nausea, seizures
(including those
characteristic of epilepsy),
and severe and persistent
muscle spasms (including
those characteristic of MS
or Crohns disease). Other
conditions subject to
approval by Hawaii
Department of Health.

Maine

Cancer, glaucoma,

Individual caregiver or

HIV/AIDS, hepatitis C, ALS,

compassion center. A

Crohns disease,

single licensee may

Alzheimers disease, nail

possess a maximum of

patella syndrome, chronic

2.5 ounces of usable

intractable pain, cachexia

marijuana and six

or wasting syndrome,

plants, of which only

severe nausea, seizures

three may be mature.

(epilepsy), severe and

persistent muscle spasms,
and MS.

Registry

State

Approved Uses

Method of

Year

Require

Dispensing

Approved

2012

Mandator

Massachuse

Cancer, glaucoma,

Compassion center. A

tts

positive status for

single licensee may

HIV/AIDS, hepatitis C, ALS,

possess up to a 60-day

Crohns disease,

supply for personal

Parkinsons disease, MS,

use.

and other conditions as

determined in writing by a
qualifying patients
physician.

Michigan

Approved for treatment of

Individual caregiver or

debilitating medical

self-cultivated only. A

conditions (defined as

single licensee may

cancer, glaucoma, HIV,

possess a maximum of

AIDS, hepatitis C, ALS,

2.5 ounces of usable

Crohns disease, agitation

marijuana. If the

of Alzheimers disease,

license is not

nailpatella syndrome,

registered to a

cachexia or wasting

caregiver, the patient

syndrome, severe and

may possess up to 12

chronic pain, severe

plants in a locked

nausea, seizures, epilepsy,

facility.

muscle spasms, and MS).

2008

Mandator
y

Registry

State

Montana

Approved Uses

Method of

Year

Require

Dispensing

Approved

2004

Mandator

Cancer, glaucoma, or

Individual caregiver or

positive status for

self-cultivated. A single

HIV/AIDS when the

licensee may possess

condition or disease

up to 12 seedlings

results in symptoms that

(less than 12 inches),

seriously and adversely

four mature plants,

affect the patients health

and 1 ounce of usable

status; cachexia or

marijuana.

wasting syndrome; severe,

chronic pain that is
persistent pain of severe
intensity that significantly
interferes with daily
activities as documented
by the patients treating
physician; intractable
nausea or vomiting;
epilepsy or intractable
seizure disorder; MS;
Crohns disease; painful
peripheral neuropathy; a
CNS disorder resulting in
chronic, painful spasticity
or muscle spasms; and
admittance into hospice
care.

Registry

State

Nevada

Approved Uses

Method of

Year

Require

Dispensing

Approved

2001

Mandator

AIDS; cancer; glaucoma;

Individual caregiver or

and any medical condition

self-cultivated. A single

or treatment of a medical

licensee may possess

condition that produces

three mature plants,

cachexia, persistent

four immature plants,

muscle spasms or

and 1 ounce of usable

seizures, severe nausea,

marijuana.

or pain. Other conditions

subject to approval by
health division of Nevada
Department of Human
Resources.

New Jersey

Seizure disorders

Compassion center

(including epilepsy),

only. A single licensee

intractable skeletal

must obtain a

muscular spasticity,

prescription from a

glaucoma; severe or

physician for the

chronic pain, severe

amount of marijuana

nausea or vomiting,

required. The

cachexia or wasting

maximum for a 30-day

syndrome resulting from

supply is 2 ounces.

HIV/AIDS or cancer; ALS,

MS, terminal cancer,
muscular dystrophy, or

2010

Mandator
y

Registry

State

Approved Uses

Method of

Year

Require

Dispensing

Approved

2007

Mandator

inflammatory bowel
disease (including Crohns
disease); terminal illness if
the physician has
determined a prognosis of
less than 12 months of life
or any other medical
condition or its treatment
that is approved by New
Jersey Department of
Health and Senior
Services.

New Mexico

Severe chronic pain,

Individual caregiver or

painful peripheral

self-cultivated only. A

neuropathy, intractable

single licensee may

nausea/vomiting, severe

possess a maximum of

anorexia/cachexia,

6 ounces of usable

hepatitis C infection,

marijuana, four mature

Crohns disease, PTSD,

plants, and 12

ALS, cancer, glaucoma,

seedlings. A caregiver

MS, damage to nervous

may provide for only

tissue of spinal cord with

four patients.

intractable spasticity,
epilepsy, HIV/AIDS, and

Registry

State

Approved Uses

Method of

Year

Require

Dispensing

Approved

1998

Mandator

hospice patients.

Oregon

Cancer, glaucoma,

Individual caregiver or

positive status for

self-cultivated only. A

HIV/AIDS, or treatment for

single licensee may

these conditions; a

possess a maximum of

medical condition or

24 ounces of usable

treatment for a medical

marijuana and six

condition that produces

seedlings. Between the

cachexia, severe pain,

caregiver and the

severe nausea, seizures

patient, a maximum of

(including seizures caused

18 plants is allowed.

by epilepsy), or persistent
muscle spasms (including
spasms caused by MS).
Other conditions subject
to approval by Health
Division of Oregon
Department of Human
Services. PTSD was added
in 2013.

Rhode

Cancer, glaucoma,

Individual caregiver,

Island

positive status for

compassion center, or

2006

Mandator

Compassi

Registry

State

Approved Uses

Method of

Year

Require

Dispensing

Approved

HIV/AIDS, hepatitis C, or

self-cultivation. A

the treatment of these

single licensee may

conditions; a chronic or

possess up to 2.5

debilitating disease or

ounces of usable

medical condition or its

marijuana and up to 12

treatment that produces

plants. A caregiver

cachexia or wasting

may possess a

syndrome; severe,

maximum of 24 plants

debilitating, chronic pain;

and 5 ounces of usable

severe nausea; seizures

marijuana.

on centers
in 2009

(including but not limited

to those characteristic of
epilepsy); severe and
persistent muscle spasms
(including but not limited
to those characteristic of
MS or Crohns disease); or
agitation of Alzheimers
disease; or any other
medical condition or its
treatment approved by
Rhode Island Department
of Health.

Vermont

Cancer, AIDS, positive

Individual caregiver,

2004

Mandator

Registry

State

Approved Uses

Method of

Year

Require

Dispensing

Approved

status for HIV, MS, or

compassion center, or

treatment of these

self-cultivation.

conditions if the disease or

Between a single

the treatment results in

patient and a

severe, persistent, and

caregiver, a maximum

intractable symptoms; or a of 2 ounces of usable

disease, medical

marijuana, two mature

condition, or its treatment

plants, and seven

that is chronic,

seedlings are

debilitating, and produces

permitted.

severe, persistent, and

one or more of the
following intractable
symptoms: cachexia or
wasting syndrome, severe
pain, nausea, or seizures.

Washington

Cachexia; cancer;

Individual caregiver or

HIV/AIDS; epilepsy;

self-cultivated.

glaucoma; intractable pain

Between a patient and

(defined as pain

a caregiver, there can

unrelieved by standard

be a 60-day supply,

treatment or medications);

defined as 24 ounces

and MS. Crohns disease,

of usable marijuana

hepatitis C with

and 15 plants.

1998

None

Registry

State

Approved Uses

Method of

Year

Require

Dispensing

Approved

debilitating nausea or
intractable pain, diseases
(including anorexia) that
result in nausea, vomiting,
wasting, appetite loss,
cramping, seizures,
muscle spasms, or
spasticity when those
conditions are unrelieved
by standard treatments or
medications. Other
conditions subject to
approval by Washington
Board of Health.

AIDS = acquired immunodeficiency syndrome; ALS = amyotrophic lateral sclerosis (Lou

Gehrigs disease); CNS = central nervous system; HIV = human immunodeficiency virus; MS
= multiple sclerosis; PTSD = post-traumatic stress disorder.

7. 2014 Cannabidiol: Pharmacology and potential therapeutic role in

epilepsy and other neuropsychiatric disorders by Orrin Devinsky,
Maria Roberta Cilio, Helen Cross, Javier Fernandez-Ruiz, Jacqueline
French, Charlotte Hill, Russell Katz, Vincenzo Di Marzo, Didier JutrasAswad, William George Notcutt, Jose Martinez-Orgado, Philip J.
Robson, Brian G. Rohrback, Elizabeth Thiele, Benjamin Whalley, and
Daniel Friedman (Retrieved from
http://onlinelibrary.wiley.com/doi/10.1111/epi.12631/full)

theoretical; no significant side effects; Dravet Syndrome

ARTICLES
1. Cannabis in the Clinic? The Medical Marijuana Debate (Retrieved
from http://learn.genetics.utah.edu/content/addiction/cannabis/)
Research suggests that there are conditions for which medical marijuana may be an
effective treatment:

Cancer - Relieves nausea during chemotherapy treatment, may prevent the

spread of some cancers.

HIV/AIDS - Increases appetite in patients experiencing severe weight loss,

eases neurological symptoms.

Neurological disorders (including spinal cord injury and multiple sclerosis) Reduces pain and spasticity resulting from nerve damage.

Inflammatory pain - Cannabinoids seem to be more effective than opiates in

treating long-term, chronic pain. (Opiates are better for treating short-term acute
pain.)

Autoimmune diseases (such as arthritis) - Suppresses the immune system,

decreasing pain and inflammation.
Cannabinoid Delivery Methods
The active compounds in marijuana are available in several forms and can be
administered in a variety of ways. Each delivery method has benefits and
disadvantages.
Smoking

(+) Delivers all of the plant's active compounds.

(+) Easy to regulate dose (patients smoke until symptoms are eased, but are
not intoxicated).

() No standardization. Amounts of active ingredients may vary.

() Burning marijuana produces toxins which can cause emphysema and lung
cancer.

() Illegal in most states.

Marinol - Synthetic THC in pill form

(+) Legal in the US.

(+) Delivers some of the benefits of the whole plant.

() Difficult to control dose.

() Contains only one of the plant's active compounds (THC).

() Patients report fewer of the positive effects and more negative side
effects.

Vaporizor

(+) Converts the active compounds to inhalable form without releasing

toxins.

(+) Delivers all of the plant's active compounds.

(+) Easy to control dose.

() No standardization. Amounts of active ingredients may vary.

() Illegal in most states.

Sativex (nabiximols) - Extract from plants delivered as a spray

(+) Contains all of the plant's active compounds.

(+) Concentrations of active ingredients are standardized.

(+) Relatively easy to regulate dose.

(+) Legally approved for the medical treatment of Multiple Sclerosis.

() Legal in a limited number of countries.

2. 2014 23 Health Benefits Of Marijuana by Jennifer Welsh and Kevin

Loria (Retrieved from http://www.businessinsider.com/healthbenefits-of-medical-marijuana-2014-4/#it-can-be-used-to-treatglaucoma-1)
1. It can be used to treat Glaucoma.
2. It may help reverse the carcinogenic effects of tobacco and improve lung
health.
3. It can help control epileptic seizures.

4. It also decreases the symptoms of a severe seizure disorder known as

Dravet's Syndrome.
5. A chemical found in marijuana stops cancer from spreading.
6. It may decrease anxiety.
7. THC slows the progression of Alzheimer's disease.
8. The drug eases the pain of multiple sclerosis.
9. Other types of muscle spasms could be helped too.
10.It lessens side effects from treating hepatitis C and increases treatment
effectiveness.
11.Marijuana treats inflammatory bowel diseases.
12.It relieves arthritis discomfort.
13.It keeps you skinny and helps your metabolism.
14.It improves the symptoms of Lupus, an autoimmune disorder.
15.While not really a health benefit, marijuana spurs creativity in the brain.
16.Marijuana might be able to help with Crohn's disease.
17.Pot soothes tremors for people with Parkinson's disease.
18.Marijuana helps veterans suffering from PTSD.
19.Marijuana protects the brain after a stroke.
20.It might protect the brain from concussions and trauma.
21.It can help eliminate nightmares.
22.Weed reduces some of the awful pain and nausea from chemo, and
stimulates appetite.
23.Marijuana can help people trying to cut back on drinking.

3. Can Cannabis Cure Cancer? By Jeremy Kossen (Retrieved from

https://www.leafly.com/news/health/can-cannabis-cure-cancer)
Oncologists, more than doctors in any other discipline within medicine, support
the option of recommending cannabis as part of a treatment program for patients
suffering from cancer. However, while the positive effects of using cannabis to
alleviate cancer symptoms have been well documented, the U.S. government
continues to classify cannabis as a Schedule I drug high potential for abuse and
no known medical use. Consequently, the federal governments position on
cannabis stifles much-needed research on cannabis as a cure for cancer.
Moreover, the federal governments position has fueled massive misinformation
about cannabis as a potential cure for cancer. On the one hand, the federal
government officially claims cannabis has no medicinal value. On the other hand,
many pseudoscience cancer quacks unethically exaggerate claims of cannabis as
the ultimate cure for cancer providing unsubstantiated help to thousands of cancer
patients.

Cannabis Cancer Research Shows Promise, But We Need to Do More

As we search for anti-cancer treatments, the anti-cancer potential of cannabis

has been examined in numerous scientific studies on cannabinoid receptors and
endocannabinoids, resulting in promising leads. Significant research has
demonstrated that cannabinoids may inhibit or stop the growth of cancers
including breast, brain, liver, pheochromocytoma, melanoma, leukemia, and other
kinds of cancer from spreading or growing. Moreover, cannabinoids have proven
to promote apoptosis, the programmed death of tumor cells, while stopping
angiogenesis, blood vessel production to the tumor. One study, conducted by
Madrid's Complutense University, showed that in one-third of rats treated, the
injection of synthetic THC eliminated malignant brain tumors while extending life in
another third.
The research is promising, but thus far it has been limited to preclinical studies,
which are studies of drugs or treatments in animals prior to being carried out in
humans. While the preclinical research offers hope, before anyone can confidently
claim that cannabis can provide a cure, clinical research needs to be done.

4. 2015 Law students debate on legalizing medical marijuana in PH by

Jee
Y.
Geronimo
(Retrieved
from
http://www.rappler.com/nation/95806-law-students-debate-medicalmarijuana)
ATENEO LAW SCHOOL
1st affirmative speaker: John Michael Villanueva
1. There is a necessity to pass this bill in order to comply with the constitutional
mandates and international obligations of promoting the right to health.
2. There is a need to distinguish between the ill and the criminals, which can
only be done by this bill.
2nd affirmative speaker: Pearl Simbulan
1. Legalizing medical marijuana is the only and the best comprehensive
approach to health. What we think in legalizing medical marijuana is that we
provide the optimal care: [providing] a range of options that a physician who
is in the best position to make these decisions can do for the patient.
2. Because we illegalized blanketly marijuana, research on these kinds of things
stopped, and it has become harder for us to discover even better uses of
marijuana.
3rd affirmative speaker: Patrick Vincent Cocabo
"The question should not be whether marijuana is good or bad, but rather, how can
we control it? What is the best strategy to save lives?"
1. Government regulation is important.

2. The bill provides an important mechanism of checks and balances of citizen

accountability.

UST LAW SCHOOL

1st negative speaker: Marie Sybil Tropicales
1. Medical marijuana should not be legalized because at present, its detriments
outweigh its benefits. Medical marijuana is not necessary for legislation
because essentially, it is not a cure in itself.
2nd negative speaker: John Paul Fabella
"The contentious documented benefits of medical marijuana cannot outweigh its
adverse effects to the government and society."
1. On a socio-political level: Legalization sends a wrong message to public,
especially to the youth, that marijuana is medically benevolent and not a
harmful drug. The state cannot afford to risk our society to the dangers of
increased marijuana use by implying a stance that it is not harmful.
2. Legalizing medical marijuana is not advantageous to the government.
o

Documented benefits are highly contentious at the moment and

inconclusive.

It undermines law enforcement by forcing officers to distinguish

medical users and recreational users.

3rd negative speaker: Jackielyn Bana

1. Is government ready for this? There are too much gray areas in the policy
implementation at present, that no matter how noble the objective of the law
is, that no matter how flawless its features are, it all go to waste because of
the corrupt implementation of the laws.
o

Example: Regulating tobacco, alocohol, sleeping pills, and prescription

drugs

2. This country has a problem with strict and faithful implementation of

government policies and regulations.
o

What guarantee do we have that a seriously addictive drug could be

regulated when simple regulations on tobacco and alcohol products
prove to be impossible to impose?

Once marijuana is legalized, there is no possibility of regulating it.

5. 2014 10 Reasons Why Doctors Support Medical Marijuana (Retrieved

from
http://www.leafscience.com/2014/01/02/10-reasons-doctorssupport-medical-marijuana/)
1. Marijuana has been used as medicine for more than 3,000 years
2. The American Medical Association supports research on medical marijuana.
3. The high is only from one component.
4. Our body contains a natural cannabinoid system that regulates health and
illness.
5. Smoking or vaporizing marijuana is better for pain relief.
6. Marijuana may be superior to narcotic painkillers for neuropathy, or nerve
pain.
7. When combined, marijuana can decrease the amount of narcotics needed for
pain relief.
8. Marijuanas main side effect is euphoria, or extreme feelings of well-being.
9. Unlike narcotic painkillers, marijuana has the same addictive potential as
caffeine.
10.Marijuana is being studied as a treatment for various forms of cancer.
6. 2015 Medical Marijuana: Benefits, Risks & State Laws by Kim Ann
Zimmermann (Retrieved from http://amp.livescience.com/24554medical-marijuana.html)

Marijuana's medicinal uses can be traced back as early as 2737 B.C., when
the emperor of China, Shen Neng, touted cannabis tea as a treatment for
gout, rheumatism, malaria and even poor memory.
Marijuana contains 60 active ingredients known as cannabinoids. The body
naturally makes its own form of cannabinoids to modulate pain, Abrams said.
In another study, they found that marijuana, in addition to opiates, led to
dramatic levels of pain relief. (Animal models have found similar effects).
The medications also eased certain symptoms of MS, such as pain related to
spasms, and painful burning and numbness, as well as overactive bladder,
according to the study published in the journal Neurology.
Medical marijuana has also been touted as a treatment for glaucoma, which
is an elevated pressure in the eyeball that can lead to blindness. While
smoking marijuana may reduce intraocular pressure, marijuana must be
consumed numerous times during the day to have the desired effect and
other drugs are more effective, according to the American Cancer Society.
Cannabidiol (CBD) is a non-psychoactive component of marijuana that has
therapeutic benefits, but because it does not target the CB1 receptor, it
doesn't leave people feeling stoned.
Health benefits
Glaucoma
reduce stiffness and muscle spasms in MS
stimulate appetite among HIV/AIDS patients stimulate appetite among
HIV/AIDS patients

treat nausea induced by chemotherapy

treatment of schizophrenia

Medical marijuana availability: State by state

The states and districts with medical marijuana laws are: Alaska, Arizona, California,
Colorado, Connecticut, Delaware, the District of Columbia, Guam, Hawaii, Illinois,
Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New
Hampshire, New York, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and
Washington.

7. What are the Pros and Cons of Medical Marijuana? (Retrieved from
https://www.verywell.com/what-are-the-pros-and-cons-of-medicalmarijuana-1132484)
The Pros of Medical Marijuana

The legalization of marijuana for medical reasons is viewed favorably by many

Americans, including members of the medial community and congress.
Some of the pros to medical marijuana that they argue include:

Marijuana is effective at relieving nausea and vomiting, especially caused

by chemotherapy used to treat cancer.

Marijuana can relieve the spasticity of the muscles that is sometimes

associated with multiple sclerosis and paralysis.

Marijuana can help treat appetite loss associated with HIV/AIDS and
certain types of cancers.

Marijuana can relieve certain types of pain.

Marijuana is safe, safer in fact than most other medications prescribed to

treat the same symptoms.

Studies show that smoking marijuana alone (without the concurrent use of
tobacco) does not increase the risk of lung diseases.

Marijuana has been used for centuries as a medicinal agent to good

effect.

The Cons of Medical Marijuana

For every person who is for the legalization of marijuana for medical purposes,
there is another who argues against it. Some of the arguments from the
opposition include:

Frequent marijuana use can seriously affect your short-term memory.

Frequent use can impair your cognitive ability.

Smoking anything, whether it's tobacco or marijuana, can seriously

damage your lung tissue.

Not enough evidence supports marijuana as an effective pain relieving

agent.

Marijuana carries a risk of abuse and addiction.

Smoked marijuana contains cancer-causing compounds.

Smoked marijuana has been implicated in a high percentage of

automobile crashes and workplace accidents.

Unfortunately, clinical trials to evaluate the effectiveness of marijuana to

treat certain conditions have been restrictive and limited. Until marijuana is
downgraded from a Schedule I drug of the Controlled Substances Act (CSA),
widespread clinical trials are unlikely to happen. If we really want a
conclusive answer as to whether marijuana is valuable for symptom
management, it needs to be evaluated using the same standards as other
medications.

8. 2012 Arguments Against Medical Marijuana And Why They Are

Wrong by TWB (Retrieved from
https://www.theweedblog.com/arguments-against-medicalmarijuana-and-why-they-are-wrong/)

Kids will increase consumption after medical marijuana is approved

Drugged driving will become more prevalent after medical marijuana is
approved
Marijuana is a gateway drug
More research is needed
Smoking marijuana causes lung cancer
The federal government doesnt recognize states medical marijuana laws
Patients can just use Marinol Patients can just use Marinol
Medical marijuana is hard to regulate

9. Legalize Medical Marijuana, Doctors Say in Survey By R. Scott

Rappold of WebMD Health News (Retrieved from
http://www.webmd.com/pain-management/news/20140225/webmdmarijuana-survey-web)
April 2, 2014 1,544 doctors were surveyed and majority says medical
marijuana should be legalized.
10.
2014 More doctors than consumers say medical marijuana
should be legal: Survey by By Robert Preidt (Retrieved from
http://www.cbsnews.com/news/more-doctors-than-consumers-saymedical-marijuana-should-be-legal-survey/)
Results of the Survey:
69% say it can help with certain treatments and conditions.
67% say it should be a medical option for patients.
56% support making it legal nationwide.
50% of doctors in states where it is not legal say it should be legal in their
states.
52% of doctors in states considering new laws say it should be legal in their
states.
11.
Medical cannabis facts (Retrieved from
http://www.druginfo.adf.org.au/drug-facts/medicinal-cannabis-facts)

Firstly, smoking is a particularly harmful way of taking cannabis, mainly

because carcinogenic substances are inhaled directly into the lungs. Smoking
cannabis is not recommended by health authorities, as the smoked form
contains at least 50 of the same carcinogens as tobacco.
An increasing number of studies suggest that medicinal cannabis in the form
of oral extracts, sprays or pills can reduce these symptoms and aid in the
treatment of some illnesses.
Medicinal cannabis can also cause unwanted side effects, such as difficulty
with concentration, dizziness, drowsiness, loss of balance, and problems with
thinking and memory.

12.
2015 Marijuana Kills Cancer Cells, Admits The U.S. National
Cancer Institute by Barbara Minton (Retrieved from
http://naturalsociety.com/marijuana-kills-cancer-cells-admits-the-u-snational-cancer-institute/)

These are the findings of studies NCI have included:

Cannabinoids may inhibit tumor growth by causing cell death, blocking cell
growth, and blocking the development of blood vessels needed by tumors to

grow. Laboratory and animal studies have shown that cannabinoids may be
able to kill cancer cells while protecting normal cells.
Cannabinoids may protect against inflammation of the colon and may have
potential in reducing the risk of colon cancer, and possibly in its treatment.
A laboratory study of delta -9-THC in hepatocellular carcinoma (liver cancer)
cells showed it damaged or killed the cancer cells. The same study of delta-9THC in models of liver cancer showed that it had anti-tumor effects. Delta-9THC has been shown to cause these effects by acting on molecules that may
also be found in non-small cell lung cancer cells and breast cancer cells.
A laboratory study of cannabidiol (CBD) in estrogen receptor positive and
estrogen receptor negative breast cancer cells showed that it caused cancer
cell death while having little effect on normal breast cells. Studies of
metastatic breast cancer showed that cannabinoids may lessen the growth,
number, and spread of tumors.
A laboratory study of cannabidiol in human glioma cells showed that when
given along with chemotherapy, CBD may make chemotherapy more
effective and increase cancer cell death without harming normal cells.
Studies showed that CBD together with delta-9-THC may make chemotherapy
such as temozolomide more effective.
These studies are considered by the NCI as preclinical. They were all done
using animals. According to them, no clinical trials of cannabis use for the
treatment of cancer in humans have been published.

13.
2016 25 HEALTH BENEFITS OF MARIJUANA by Lindsey Lewis
(Retrieved from https://www.greenrushdaily.com/2016/05/20/healthbenefits-of-marijuana/)
1. Medical marijuana has been found to reduce chronic pain in patients
significantly debilitating diseases.
2. Patients with epilepsy have found relief from chronic seizures. In fact,
in 2014, the FDA approved Epidiolex, a 99 percent CBD extract to help
children with epilepsy.
3. Medical Marijuana has been found to ease nausea and reduce
vomiting. This is especially beneficial to patients undergoing
chemotherapy.
4. Medical marijuana increases appetite in patients undergoing
chemotherapy and those who are malnourished
5. CBD is a powerful sleep aid and helps those suffering from insomnia
sleep at night.
6. CBD reduces anxiety and feelings of depression.
7. Medical marijuana has been shown to protect the liver from binge
alcohol-induced steatosis.
8. CBD stops the growth of cancer cells in lung cancer, prostate cancer,
and breast cancer.
9. Medical marijuana helps reduce side effects associated with
hangovers.
10.CBD lotion and salves successfully treat hives and allergy induces
rashes.

11.CBD offers relief in inflammatory bowel diseases.

12.CBD helps reduce anxiety in those suffering from Post Traumatic Stress
Disorder.
13.Medical marijuana may improve the quality of life for patients with
Parkinsons Disease.
14.CBD reduces muscle spasms.
15.Medical marijuana can promote healthy digestive function.
16.CBD has been shown to help ease the pain associated with female
menstrual cycles.
17.CBD has been shown to help some Sexually Transmitted Diseases such
as herpes.
18.Medical marijuana may increase sex drive as well as overall sexual
experiences.
19.CBD oil has been shown to calm colicky babies.
20.Medical marijuana helps athletes maintain focus throughout mundane
exercise regimes.
21.Cannabis salves relieve the itching associated with mosquito and other
bug bites.
22.One of many health benefits of marijuana, it can reduce blood sugar
levels in patients with diabetes.
23.CBD provides relief to those suffering from psoriasis.
24.Medical marijuana is successful in reducing pain associated with
multiple sclerosis.
25.CBD reduces inflammation and slows the progression of inflammatory
diseases.

14.
What Happens to Your Body When You Use Medical Marijuana?
By Dr. Mercola (Retrieved from http://articles.mercola.com/medicalmarijuana-uses.aspx)
Theres still ongoing research as to how far it impacts your health, but to
date, it's known that cannabinoid receptors play an important role in many
body processes, including metabolic regulation, cravings, pain, anxiety, bone
growth, and immune function.

Other common ailments being treated with medical marijuana include:

Mood disorders

Degenerative neurological disorders such as dystonia

Multiple sclerosis

Parkinson's disease
Post-traumatic stress disorder (PTSD)

Seizures

Medical marijuana can be administered to patients using one of the following

methods:

Inhalation Allows the patient to titrate the dosage. It has an instantaneous

effect as the medication is rapidly taken into the lungs and quickly absorbed
through the capillaries into the bloodstream. The effects of inhaled cannabis
will last approximately four hours.

Smoking Can be done using a joint or the cigarette form (hand-or machinerolled), a pipe, or bong (water pipe). While smoking medical marijuana by joint
is believed to be inefficient because the medication goes with the smoke as
the cigarette burns, smoking small amounts using a water pipe is more
advisable because the cool smoke is less irritating to the airway.

Vaporization Like a nebulizer treatment, cannabis can be heated to a

temperature that will release the medication in vapors to be inhaled by the
patient.

Sublingual (under the tongue) or oramucosal (in the oral cavity)

delivery Made possible using oils or tinctures, it is readily delivered into the
bloodstream and provides a rapid effect. Tinctures can be administered
through a dropper under the tongue or sprayed in the mouth to be absorbed in
the oral cavity. This is highly recommended for non-smoking patients.

Oral ingestion Non-smokers can also take medical marijuana through pills
or mandibles, which are edible cannabis products in the form of teas, cookies,
or brownies. The primary drawback of this approach is that because
cannabinoids are fat-soluble, there may be issues when it comes to absorption,
depending on the patients metabolism. A good workaround for this problem is
using cannabis butter, which fat-soluble cannabinoids blends well with.

Topical application Cannabis can be applied as an ointment, lotion, or

poultice for treating skin inflammations, arthritis, and muscle pain. It is unclear
how cannabinoids are absorbed transdermally, although its credit should also
go to the more soluble terpenoids and flavonoids that also have antiinflammatory properties.
Currently, marijuana is classified as a Schedule 1 controlled substance, a category
specifically for the most dangerous illicit drugs, such as heroin, lysergic acid
diethylamide (LSD), and ecstasy. Based on the 1970 Controlled Substance Act,
drugs from this group:

Have a high potential for abuse

Have no accepted medical use in the US

Have lack of accepted safety under medical supervision

15.
2016 After Medical Marijuana Legalized, Medicare
Prescriptions Drop For Many Drugs by Shefali Luthra (Retrieved from

http://www.npr.org/sections/healthshots/2016/07/06/484977159/after-medical-marijuana-legalizedmedicare-prescriptions-drop-for-many-drugs)
16.
2010 Medical Marijuana and the mind of Harvard Health
Publications (Retrieved from http://www.health.harvard.edu/mindand-mood/medical-marijuana-and-the-mind)

ENGLISH DEBATE RESEARCH

Anticancer mechanisms of cannabinoids

Cannabinoids impair tumour progression at various levels. Their most prevalent
effect is the induction of cancer cell death by apoptosis and the inhibition of cancer
cell proliferation. At least one of those actions has been demonstrated in almost all
cancer cell types tested17. In addition, in vivo experiments have shown that
cannabinoids impair tumour angiogenesis and block invasion and metastasis.

Induction of Cancer Cell Death

A significant amount of the research conducted so far on the mechanism of

cannabinoid antitumour activity has focussed on glioma cells. Initial studies
showed that thc and other cannabinoids induce the apoptotic death of
glioma cells by cb1- and cb2-dependent stimulation of the de novo synthesis
of the pro-apoptotic sphingolipid ceramide
To summarize, cannabinoids induce tumour cell death and inhibit tumour
angiogenesis and invasion in animal models of cancer, and there are indications
that they act similarly in patients with glioblastoma. Given that cannabinoids show
an acceptable safety profile, clinical trials testing them as single drugs or, ideally, in
combination therapies in glioblastoma and other types of cancer are both warranted
and urgently needed.
Velasco, G., Snchez, C., & Guzmn, M. (2016). Anticancer mechanisms of
cannabinoids. Current Oncology, 23(Suppl 2), S23S32.
http://doi.org/10.3747/co.23.3080
from (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791144/)

THC
Medicinal uses
According to the National Cancer Institute, marijuana has been used for
medicinal purposes for more than 3,000 years. In many areas of the United
States, the use of medicinal marijuana is legal. In several states, recreational
use is also legal.
THC can be extracted from marijuana, or synthesized, as is the case for the
FDA-approved drug dronabinol. Dronabinol is used to treat or prevent the
nausea and vomiting associated with cancer medicines and to increase the
appetites of people with AIDS, according to the U.S. National Library of
Medicine. It is a light yellow resinous oil.
http://www.livescience.com/24553-what-is-thc.html

MEDICINES CONTAINING MARIJUANA

Sativex
Manufacturer: GW Pharmaceuticals (GWPH on NASDAQ)
Cannabis-Related Properties
Mouth spray whose chemical compound is derived from natural extracts of the
cannabis plant. Sativex contains two cannabinoids: THC (delta-9-

tetrahydrocannabinol) and CBD (cannabidiol).

Suggested Medical Use
Treatment of neuropathic pain and spasticity in patients with Multiple Sclerosis (MS);
Analgesic treatment in adult patients with advanced cancer who experience
moderate to severe pain.
Approved and launched in the UK on June 21, 2010, making it the first cannabisbased prescription medicine in the world (rescheduled from UK Schedule 1 to
Schedule 4 on Apr. 10, 2013). Licensed to Bayer in the UK and to Almirall in Europe.
Approved to treat spasticity caused by multiple sclerosis in Spain (July 28, 2010),
Canada (Aug. 31, 2010), Czech Republic (Apr. 15, 2011), Denmark (June 8, 2011),
Germany (July 4, 2011), Sweden (Dec. 22, 2011), Austria (Feb. 7, 2012), Italy (May
7, 2013), and Switzerland (Nov. 27, 2013). Also approved in Finland, Israel, Norway,
and Poland.

Dronabinol / Marinol
Manufacturer: Unimed Pharmaceuticals, a subsidiary of Solvay
Pharmaceuticals
Cannabis-Related Properties
Synthetic Delta-9 THC.
Suggested Medical Use
Treatment of nausea and vomiting for patients in cancer treatment; appetite
stimulant for AIDS patients; analgesic to ease neuropathic pain in multiple sclerosis
patients.

Approval Status
FDA approved in United States as Schedule I drug for appetite stimulation
(1992) and for nausea (1985); moved to Schedule III effective July 2, 1999.
Approved in Denmark for multiple sclerosis (Sep. 2003).
Approved in Canada for AIDS-related anorexia (Apr. 2000) and for nausea
and vomiting associated with cancer chemotherapy (1988).
(http://medicalmarijuana.procon.org/view.resource.php?resourceID=000883 )

http://www.drugandalcoholdependence.com/article/S0376-8716(11)002742/abstract

- In NESARC residents of states with medical marijuana laws had higher odds of
marijuana use than residents of states without such laws.

- Marijuana abuse/dependence was not more prevalent among marijuana users in

these states suggesting that the higher risk for marijuana abuse/dependence in
these states was accounted for by higher rates of use.

- In NSDUH, states that legalized medical marijuana also had higher rates of
marijuana use.

http://jod.sagepub.com/content/34/4/751.short
This study found that although some marijuana-related attitudes changed between
1995 and 1999, use did not increase. These findings suggest that recent policy
changes have had little impact on marijuana-related behavior.
http://benthamopen.com/FULLTEXT/TONEUJ-6-18

- Evidence is accumulating that cannabinoids may be useful medicine for certain

indications. Control of nausea and vomiting and the promotion of weight gain in
chronic inanition are already licensed uses of oral THC ( dronabinol capsules).
Recent research indicates that cannabis may also be effective in the treatment of
painful peripheral neuropathy and muscle spasticity from conditions such as
multiple sclerosis [58].
- As these therapeutic potentials are confirmed, it will be useful if marijuana and its
constituents can be prescribed, dispensed, and regulated in a manner similar to
other medications that have psychotropic effects and some abuse potential

- The classification of marijuana as a Schedule I drug as well as the continuing

controversy as to whether or not cannabis is of medical value [59] are obstacles
to medical progress in this area.

- it is not accurate that cannabis has no medical value, or that information on

safety is lacking.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305083/

- Although many clinical studies suggest the medical utility of marijuana for some
conditions, the scientific evidence is weak

- The current regulatory system should be modified to remove barriers to clinical

research with marijuana.

- Marijuana should be held to the same evaluation standards of safety and efficacy
as other drugs (a major flaw in Proposition 215) but should not have to be proved
better than current medications for its use to be adopted.
http://aler.oxfordjournals.org/content/17/2/495.abstract

- Although policymakers and law enforcement officials argue that medical

marijuana laws (MMLs) send the wrong message to young people, previous
studies have produced no evidence of a causal relationship between MMLs and
marijuana use among teens.
- Our results are not consistent with the hypothesis that legalization of medical
marijuana leads to increased marijuana use among teenagers.
http://www.sciencedirect.com/science/article/pii/S2215036615002175

- Our findings, consistent with previous evidence, suggest that passage of state

medical marijuana laws does not increase adolescent use of marijuana. However,
overall, adolescent use is higher in states that ever passed such a law than in
other states. State-level risk factors other than medical marijuana laws could
contribute to both marijuana use and the passage of medical marijuana laws, and
such factors warrant investigation.

http://ajph.aphapublications.org/doi/abs/10.2105/ajph.2012.301117

- Our results suggest that, in the states assessed here, MMLs have not measurably
affected adolescent marijuana use in the first few years after their enactment.
Longer-term results, after MMLs are more fully implemented, might be different.

http://www.neurology.org/content/82/17/1556.short

- Spasticity: oral cannabis extract (OCE) is effective, and nabiximols and

tetrahydrocannabinol (THC) are probably effective, for reducing patient-centered

measures; it is possible both OCE and THC are effective for reducing both patientcentered and objective measures at 1 year.
- Central pain or painful spasms (including spasticity-related pain, excluding
neuropathic pain): OCE is effective; THC and nabiximols are probably effective

- Urinary dysfunction: nabiximols is probably effective for reducing bladder

voids/day; THC and OCE are probably ineffective for reducing bladder complaints.
- Tremor: THC and OCE are probably ineffective; nabiximols is possibly ineffective.

- Other neurologic conditions: OCE is probably ineffective for treating levodopainduced dyskinesias in patients with Parkinson disease.
- Oral cannabinoids are of unknown efficacy in non chorea-related symptoms of
Huntington disease, Tourette syndrome, cervical dystonia, and epilepsy. The risks
and benefits of medical marijuana should be weighed carefully. Risk of serious
adverse psychopathologic effects was nearly 1%. Comparative effectiveness of
medical marijuana vs other therapies is unknown for these indications.
http://www.medscimonit.com/abstract/index/idArt/882116/act/2

- recent studies have shown that medical marijuana is effective in controlling

chronic non-cancer pain, alleviating nausea and vomiting associated with

chemotherapy, treating wasting syndrome associated with AIDS, and controlling
muscle spasms due to multiple sclerosis. These studies state that the alleviating
benefits of marijuana outweigh the negative effects of the drug, and recommend
that marijuana be administered to patients who have failed to respond to other
therapies.
- After reviewing relevant scientific data and grounding the issue in ethical
principles like beneficence and nonmaleficence, there is a strong argument for
allowing physicians to prescribe marijuana. Patients have a right to all beneficial
treatments and to deny them this right violates their basic human rights.
http://www.nber.org/papers/w16795

- We find that current use and past use of cannabis are major determinants of
being in favor of legalization.

- We also find that cannabis users are more in favor of legalization the longer they

have used cannabis and, among past users, the more recent their own drug using
experience.

- This may reflect that experience with cannabis provides information about the
costs and benefits of using this substance. Finally, we uncover some evidence
that peers' use of cannabis impacts on preferences towards legalization.