The Positive and Negative Effects of Marijuana to Human

A Research Paper
Presented to
Passionist Sisters School
Upper Cahilsot, Calumpang
General Santos City

By
Kaila Mae S. Gajardo
Mark Aeron Jay F. Ducoy
Noemi Bridget T. Amba-an
August 22, 2016
 TABLE OF CONTENTS

Page
TITLE PAGE

CHAPTER
I THE PROBLEM ...
Introduction ....................................
Statement of the Problem ...................................
Significant of the Study ....................................
Scope and Delimitation ....................................
Definition of Terms ....................................

II Review of Related Literature ...

Foreign Literature .
Local Literature .
Foreign Studies
Local Studies

III Summary, Conclusions, and Recommendations .

Summary ..
Conclusions ..
Recommendations
 Chapter I

The Problem

Introduction

Marijuana is a commonly used illegal drugs made form dried leaves of hemp
plant. Smoking marijuana makes you high. Marijuana is a drug smoked on a joint, a
bowl, a bong, or other device but sometimes it can be eaten. Marijuana is illegal, but it is
considered a soft drugs as opposed to hard drugs like heroin or cocaine, which are
killers. People call marijuana pot and weed and a hundred other slang terms. Theres
also medical marijuana, which sick people, especially cancer patient, can get to relive
their pain.

The effect of marijuana to our body has positive and negative effects, almost
every part of your body especially our heart and lungs. Once you smoke marijuana you
will start to feel the effects. Due to frequent use of marijuana many users suffer from
addiction. They can feel relaxed, have mood swing, feel like they are in heaven/flying
and more feelings that related with relaxation and they can feel the effects after 30
minutes to 1 hour but they dont know that it has negative effects that go in their body.
There are people who used marijuana for fun, not knowing the effects of using it. They
dont know what will happen after they used it. They dont know how marijuana can
harm their body.

In Philippines the marijuana is illegal, but why is it illegal if marijuana can help
those people who have epileptic seizures and it can help to treat neuropathic diseases
such as Alzheimer's and multiple sclerosis. It can also treat lose of appetite after
chemotherapy pr following treatment for HIV or AIDS and all of this was according to Dr.
Junice L.D. Melgar.

In other country marijuana is legal because they used it as herb or medicine.

Marijuana has good effects to those who have disease especially those children who
have cancer. We cannot say that marijuana effects are all negative because there are
illnesses that can heal with the help of marijuana.

1
Statement of the Problem

This study attempted to examine the different effects of marijuana.

Especially this study sought answer to following: questions
1. What are the effects of excessive use of marijuana in our behavior?
2. Why is marijuana legal in other country?
3. Why is marijuana use for medical reasons? For example: treatment for HIV.
4. What is in marijuana that can affect our nervous system?
5. Can we genetically engineer marijuana to decrease the negative effects?

Significant of the Study

This topic will help you to understand the effects of marijuana to humans. This
will help you to have prior knowledge about what will happen after you take marijuana. It
can give you some advices how to prevent and what is the proper way of using
marijuana. We should know the positive and negative effects of using marijuana are.
This research can explain the uses of marijuana.

Scope and Delimitation

This topic will focus about the effects of marijuana if it is negative or positive. We
will show you the possible effects that you can get in using marijuana. It will focus on
the topic which is how marijuana can help us or how marijuana can harm humanity.

Definition of Terms

-Marijuana
a drug, illegal in many countries, that made from the dried leaves and flowers
of the hemp plant. Marijuana produces a pleasant feeling of being relaxed if smoked
or eaten.
-Harmful
a change that is a result or consequence of an action or other cause.
-Legal
of, based on, or concerned with the law.

2
-Treatment
 the manner in which someone behaves toward or deals with someone or
something.
-Humanity
the human race; human beings collectively.
-Prohibited
that has been forbidden; banned.

3
 Chapter II

Review of Related Literature

This chapter presents the review of related literature and studies that give
significant ideas which will help in the development of this study.

Foreign Literature

People who drive under the influence of marijuana double their risk of being in a
car crash, and about one in 10 daily marijuana users becomes dependent on the drug,
according to a new review.

Marijuana use has become increasingly prevalent over the years, and the review
of marijuana studies summarizes what researchers have learned about the drug's
effects on human health and general well-being over the past two decades.

In the review, author Wayne Hall, a professor and director of the Center for Youth
Substance Abuse Research at the University of Queensland in Australia, examined
scientific evidence on marijuana's health effects between 1993 and 2013.

He found that adolescents who use cannabis regularly are about twice as likely
as their nonuser peers to drop out of school, as well as experience cognitive impairment
and psychoses as adults. Moreover, studies have also linked regular cannabis use in
adolescence with the use of other illicit drugs, according to the review, published today
(Oct. 6) in the journal Addiction.

Researchers in the studies still debated whether regular marijuana use might
actually lead to the use of other drugs, Hall wrote in the study. However, he pointed to
longer-term studies and studies of twins in which one used marijuana and the other did
not as particularly strong evidence that regular cannabis use may lead to the use of
other illicit drugs. [Marijuana vs. Alcohol: Which Is Worse for Your Health?]
 The risk of a person suffering a fatal overdose from marijuana is "extremely
small," and there are no reports of fatal overdoses in the scientific literature, according
to the review. However, there have beencase reports of deaths from heart problems in
seemingly otherwise healthy young men after they smoked marijuana, the report said.

"The perception that cannabis is a safe drug is a mistaken reaction to a past

history of exaggeration of its health risks," Hall told Live Science.

However, he added that marijuana "is not as harmful as other illicit drugs such as
amphetamine, cocaine and heroin, with which it is classified under the law in many
countries, including the USA."

The risks of using marijuana

Marijuana use carries some of the same risks as alcohol use, such as an
increased risk of accidents, dependence and psychosis, he said.

It's likely that middle-age people who smoke marijuana regularly are at an
increased risk of experiencing a heart attack, according to the report. However, the
drug's "effects on respiratory function and respiratory cancer remain unclear, because
most cannabis smokers have smoked or still smoke tobacco," Hall wrote in the review.

Regular cannabis users also double their risk of experiencing psychotic

symptoms and disorders such as disordered thinking, hallucinations and delusions
from about seven in 1,000 cases among nonusers to 14 in 1,000 among regular
marijuana users, the review said. And, in a study of more than 50,000 young men in
Sweden, those who had used marijuana 10 or more times by age 18 were about two
times more likely to be diagnosed with schizophrenia within the next 15 years than
those who had not used the drug.

Critics argue that other variables besides marijuana use may be at work in the
increased risk of mental health problems, and that it's possible that people with mental
health problems are more likely to use marijuana to begin with, Hall wrote in the review.
 However, other studies have since attempted to sort out the findings, he wrote,
citing a 27-year follow-up of the Swedish cohort, in which researchers found "a dose
response relationship between frequency of cannabis use at age 18 and risk of
schizophrenia during the whole follow-up period."

In the same study, the investigators estimated that 13 percent of schizophrenia

cases diagnosed in the study "could be averted if all cannabis use had been prevented
in the cohort," Hall reported.

As for the effects of cannabis use in pregnant women, the drug may slightly
reduce the birth weight of the baby, according to the review.

Cannabis and Cancer

People with cancer who must undergo radiation and chemotherapy frequently
stop treatments rather than suffer the nausea, pain, and other unpleasant side effects.

5
Years before any state had authorized the medical use of cannabis, a 1991 Harvard
Medical School study revealed that nearly half (44%) of U.S. oncologists were
recommending cannabis to their patients as a way of mitigating the side effects of
cancer treatments.15

In its 1999 review, the Institute of Medicine concluded that cannabis could be a
valid alternative for many people living with cancer. Specifically, the IOM notes, In
patients already experiencing severe nausea or vomiting, pills are generally ineffective,
because of the difficulty in swallowing or keeping a pill down, and slow onset of the drug
effect.16

Since the release of the IOM report, new research has been published which
supports the use of cannabis to curb the debilitating effects of cancer treatment. In
2001, a review of clinical studies conducted in several states during the past two
decades revealed that, in 768 individuals with cancer, cannabis was a highly effective
anti-emetic in chemotherapy.17 Other studies have concluded that the active
components in cannabis produce palliative effects in cancer patients by preventing
nausea, vomiting and pain and by stimulating appetite.

The tumor-fighting properties of cannabinoids have also been demonstrated in

numerous laboratory studies, though not yet in human clinical trials. Researchers have
observed that these compounds have been shown to inhibit the growth of tumor cells in
culture and animal models by modulating key cell-signaling pathways. Cannabinoids are
usually well tolerated, and do not produce the generalized toxic effects of conventional
chemotherapies.

Local Literature
Several groups representing doctors and allied medical organizations have
expressed strong opposition to a bill seeking to legalize the use of marijuana for medical
purposes, saying this was already provided for in the mandate of existing regulatory
agencies and authorities.

The groups also raised questions on the safety and effectiveness of marijuana,
and said they feared the possible abuse of the drug should people be given wide
access to it.
But the Department of Health (DOH) said it was not entirely scrapping the idea, and
would review the bill for its response to possible problems of policing and preventing the
abuse of the drug.

At a press conference in Quezon City on Friday, the medical groups said they
were against House Bill No. 04477 on the compassionate use of cannabis or marijuana
since the effectiveness and safety of the drug for certain conditions were still being
tested in clinical trials.

6
Philippine Medical Association (PMA) president Dr. Minerva Calimag added that there
are already regulatory agencies that address the use of cannabis for medical purposes.

Existing procedures

In a joint statement issued on Saturday, the groups also raised disagreements

over the proposed mechanisms meant to enable the compassionate use of marijuana
as proposed in the measure.

The groups said having a separate office, the Medical Cannabis Regulatory
Agency to regulate the use of a single treatment of the drug, was both expensive and
redundant, as the Dangerous Drugs Board and Food and Drug Administration (FDA)
are already mandated to undertake the functions proposed for this agency.

`They added that having a separate legislation to approve the use of a single drug was
inefficient and unnecessary since there are already existing procedures within the FDA
to authorize the compassionate use of certain drugs.

These mechanisms are more rigorous than legislation, and can keep up with
changes in science more efficiently, said the groups composed of the PMA, the
Philippine College of Physicians (PCP), Child Neurology Society of the Philippines,
Group of Addiction Psychiatry of the Philippines, Pain Society of the Philippines,
Philippine League against Epilepsy Inc., the Philippine Neurological Association (PNA),
Philippine Psychiatric Association, the Philippine Society of Clinical and Occupational
Toxicology, UP-PGH National Poison Management and Control Center and the
Philippine Society of General Internal Medicine.

The House committee on health is set to hear the bill filed by Isabela Rep.
Rodolfo Albano III on Tuesday. The Compassionate Use of Medical Cannabis Act was
filed in May and had its first reading in June.

Dr. Leonor Cabral-Lim of the PNA said the FDA had already issued an
administrative order in 1992 providing terminally ill patients, who need drugs not
registered in the Philippines, a mechanism that will allow them to apply for these
medications in the country.

Accidental ingestion

After studying the bill, our conclusion is that we dont need this law, Lim said.

Dr. Rhea Quimpo of the Philippine League Against Epilepsy warned against the
possible abuse of the illegal drug. She noted that Colorado, the first state in the United
States to legalize the use of marijuana for medical and recreational purposes, had

7
observed a spike in emergency room visits due to accidental ingestion of marijuana that
had been put in brownies and other food.

Psychiatrist Dr. Lou Querubin listed the many adverse effects of marijuana on the
body, including addiction, psychosis and short-term memory deficit. She added that 25
to 50 percent of teenagers who used marijuana will develop addiction when they grow
older.
In an interview with reporters on the sidelines of the National Health Summit at the
Manila Marriott Hotel, Health Secretary Janette Garin said the DOH has to study the
measure thoroughly because of the clamor by doctors and affected families.

There are also questions on how (the drugs medical use) is going to be policed
and how to avoid (its) abuse. These are the aspects that we are looking into, said
Garin, adding that the agency was also looking at the extent of marijuana use for
medical purposes and the specific diseases that the drug could address.
The (bills) intention is very good. But we are also looking at the practicability. Is
it doable? Are we prepared for it? If we are not prepared, how long will it take us to be
prepared and when can it be implemented if ever the bill gets the full support of our
legislators? the health official said.

No consultation
 A consultation with various stakeholders, including doctors opposed to the bill,
was also needed as the bill should be tweaked to make it more applicable to the
Philippines, Garin said.

Among the challenges ahead was making sure that the illegal drug would be
given only to doctors who are capable of handling it, she added.

Former PCP president Dr. Anthony Leachon scored the proponent of the
measure for failing to invite and seek the advice of experts from the medical field in
crafting the bill.

How can we have a law (touching) on medicine if the experts are not involved?
Leachon said. When the sin tax law was being pushed, the medical society was there
(and) that was why it was enacted, he added.

The hot seat

Marijuanacommonly known by its street names: pot, weed, and jointis
produced from the Cannabis sativa or Cannabis indica plant, which can be consumed
recreationally or medically through smoke, tea, or as a special add-on for brownies.
Although it is legal to possess in some countries like Argentina, Chile, and Columbia,
marijuana carries a bad image as a leisure drug in the Philippines sensitive culture.
Because of this, marijuanas validity as a drug continues to be debated upon nationally
and locally.

Despite living in a conservative country, the Philippine Drug Enforcement Agency

reports that the Philippines Comprehensive Dangerous Drugs Act of 2002 continues to
remain unfelt as the illegal usage and cultivation of marijuana continues to plague the
country. Until now, cannabis is nurtured in the remote mountainous regions of Luzon
and Mindanao, and the black market remains prevalent that even students are granted
easy access to it.

Yet earlier this year, the Philippines preservation of the conservative status quo
was tested when a bill concerning the legalization of marijuana for medicinal purposes
was introduced. The House Bill 4477 or the Compassionate use of medical cannabis
act led by Isabela Representative Rodolfo Albano III was proposed in 2014 and is still
being analyzed by the Department of Health. This bill came into the spotlight supported
by groups like the Philippine Cannabis Compassion Society and the Philippine Moms
for Marijuana. Both cannabis advocates composed mostly of patients and parents of ill-
stricken children came with the hope of experiencing the medical benefits of marijuana.

However, this bill immediately faced oppositions, especially since the word
marijuana is enough to make most Filipinos cringe. At the same time, the bill seemed
unnecessary since the Republic Act 9165, an act concerning dangerous drugs already
exists. The R.A. 9165 can be considered as the source of this new bill as its aims are
almost the sameto achieve a balance in the national drug control program and
medical needs from potentially dangerous drugs like marijuana.

In relation with a medical experts remark, the chair of the Committee on Public
Order and Dangerous Drugs Senator Grace Poe says that there is a need to ensure the
countrys preparedness to regulate marijuana production and distribution to guarantee
that it would not get abused.

On the other hand, it would take a long time before this drug becomes accepted
in a conservative Catholic country, but if ever that does happen, the Philippines will be
the first country to legalize marijuana in the culture-bound Asia.

The medical marvel

Despite the debates around this new bill concerning the legalization of
medicalmarijuana, discoveries and claims of the therapeutic benefits of marijuana are
being reported worldwide. A CNN report spotlighted Charlottes web, a type of cannabis
produced by the Realm of Caring Foundation in Colorado, United States (US). It was
named after Charlotte Figi who has experienced a reduction of epileptic seizures
brought on by dravet syndrome, a severe myoclonic epilepsy of infancy, after her first
dose of medical marijuana at age five. Used as oil, Charlottes web is a kind of
marijuana with high levels of a chemical calledcannabidol, which has psychiatric
medication qualities like anxiolytic, antipsychotic, and anti-inflammatory properties; and
low levels of tetrahydrocannabinol (THC), which makes marijuana beneficial as THC
induces hallucinations and delusions.

Other than this form of marijuana, the United Kingdoms approved

medicine Sativex, which contains a compound called Nabiximol, is a specific chemical
extract of Cannabis used as an oral spray designed to treat the stiff muscles and
spasms of multiple sclerosis spasticity and control the chronic pain state of neuropathic
pain, according to medicines.org.uk.

Meanwhile, smoking marijuana doesnt impair lung function, in fact, it can even
increase lung capacity through deep breathing and inhaling the drug. A study published
in the Journal of the American Medical Association states that low to moderate

marijuana users showed escalated lung capacity compared to non-smokers on two

exhalation tests.
 Marijuana is also known for the treatment of anorexia associated with the
appetite loss in patients with Acquired Immunity Deficiency Syndrome (AIDS). The THC
in marijuana improves the sensory aspects of food like taste and smell, as noted by Dr.
Donald I. Abrams, professor of clinical medicine at the University of California, San

Francisco. This substance in marijuana can also be used as a treatment of nausea and
vomiting associated with chemotherapy.

Because of marijuanas major components: cannabidol and THC, the medical

usage of the drug when accompanied with proper dosage can become a cheap and
flexible corrective for various diseasesa huge asset in todays generation of rising
medication costs.

A dirty trick

Despite the relief marijuana can bring, it can play a sullied scheme to those who
misuse it. Since researches have not conducted enough large-scale clinical trials that
support the medical use of marijuana, many experts doubt its validity. The US Federal
Drug Enforcement Administration has even classified marijuana as a schedule one
drug, suggesting that it has a high potential for abuse and is not approved by the US
Food and Drug Administration.

Among the arguments, marijuanas characteristic as a gateway drug or a drug

that leads users to use more illicit drugs remains persistent. The US Institute of
Medicine of the National Academy of Sciences proves that marijuana use typically
foreshadows ingestion of more seriously addictive drugs like cocaine, meth, and heroin.

Another downside of marijuana is that when smoked, the drug is releases quickly
into your bloodstream on its way to your brain and other organs, and targets the
respiratory, circulatory, digestive, immune, and central nervous system. While a regular
smoker has an increased risk of developing bronchitis, lung infections, and even lung
cancer; a marijuana smoker is in further danger as users are more prone to heart
attack. At the same time, although the THC can increase ones appetite, it can be mind-
altering and damaging to the immune system, making users more prone to physical
illnesses.

As for brain health, the earlier people start their marijuana habit, the worse their
brain gets damaged, particularly those who started using the drug in their adolescent
years when the brain is still developing, as reported by Melbournes Murdoch Childrens
Research Institute Australian researcher team led by Dr. Marc Seal. The long-term
effects of cannabis affects the brains white matter, which is responsible for
communication between the different areas of grey matterthe part responsible for
thinking. Aside from reducing more than 80 percent of white matter in the brains of
marijuana users, long term marijuana usage may also lead to memory impairment and
shortfalls in learning and concentration ability.

Weed symbolizes freedom, bliss, and tranquility to cannabis adherents in todays

10

culture, but for what its worth, marijuana can be alarming as it poses many dangers to
its consumers. Enticing people to use the drug with its guarantee to amplify your senses
may seem a little too promising as it covers the underlying horrid side effects of
marijuana.

Foreign Studies

The combustion of this vegetable material into smoke and its inhalation into the
lungs is inherently unhealthy. The extent to which an individual can make an informed
decision to assume the risks of smoke inhalation can only be gauged by an assessment
of the risks and dependence liability associated with the unique chemicals in the plant
material. Considerable research has been done on the effects of marijuana smoke on
the lungs by Donald Tashkin of UCLA and his colleagues.

A 1987 paper explains the research dilemma.

"Evidence regarding the potential long-term pulmonary consequences of regular

marijuana smoking is mixed. Several studies conducted during the past decade on
whole animals and isolated cell systems exposed to marijuana smoke, as well as some
clinical observations, suggest that marijuana can be harmful to the lung. Conversely,
human studies carried out abroad have failed to find any evidence of respiratory
dysfunction or disease in long term heavy users of marijuana."(5)
 This study reviewed the history of heavy marijuana smoking on self-reported
histories of symptoms of respiratory and pulmonary disease. Tashkin's findings in this
review serve as a baseline for a great deal of his subsequent research; this review
established marijuana and tobacco smokers had similar symptoms of respiratory
problems.

"A significantly larger proportion of smokers of marijuana and/or tobacco than

nonsmokers reported chronic cough, chronic sputum production, more than 1 episode
of acute lower respiratory tract illness within the past 3 years (increased cough and
sputum lasting more than 3 wk), and wheezing. No significant differences were found
when prevalence of these respiratory symptoms was compared across the 3 smoking
groups: smokers of marijuana alone, tobacco alone, and marijuana plus tobacco.
Breathlessness was reported by relatively few subjects and was similar in frequency
across the 4 subject groups, with 1 exception: tobacco smokers reported a higher
prevalence of shortness of breath than did marijuana smokers."(6)

The author's basic hypothesis is that marijuana smoke, like tobacco smoke, is
harmful to the lungs, and that exposure of the lungs to both marijuana and tobacco
smoke is even worse. Their findings in this and subsequent studies provide no reason
to reject this hypothesis. The public wants to know if marijuana smoking is more or less

11

dangerous for the lungs than tobacco smoking. If one were to insist on a simple answer,
that answer would be this: any smoke is damaging to the lungs, and continued
exposure to smoke will likely cause lung cancer. However if the public insists on using
tobacco smoke as a reference, Tashkin's research demonstrates that describing
marijuana smoke in reference to tobacco smoke is complicated. On a simple numerical
scale, in some areas marijuana produces higher indices of risk than tobacco, and in
other areas, a lower indication of risk. The conclusion of this 1987 study is as follows.

"We conclude that habitual, heavy marijuana smoking, irrespective of

concomitant tobacco smoking, leads to symptoms of chronic bronchitis and an
increased frequency of acute bronchitic episodes. In addition, heavy, habitual smoking
of marijuana, whether alone or with tobacco, has an adverse effect on large airway
function, but marijuana use alone, unlike regular tobacco smoking, has no demonstrable
impact on small airways function or on diffusing capacity. The combination of heavy,
habitual marijuana and regular tobacco smoking does not appear to worsen chronic
respiratory symptoms or lung function abnormalities associated with smoking either
substance alone. The implications of these findings with respect to the subsequent
development of clinically significant chronic air-flow obstruction in continuing heavy
smokers of marijuana is as yet unclear."(7) (emphasis added)

Marijuana smokers smoke less material by weight per day than tobacco
smokers, but they inhale the smoke deeper into their lungs and retain it longer. In a
1988 paper, Tashkin and his colleagues report on their attempts to establish that
marijuana smoking delivers a greater quantity of smoke particulates and noxious gases
to the lungs than tobacco smoke.

"[M]arijuana smoking resulted in a tar burden to the respiratory tract that was 3.5
to 4.5 times greater than that produced by tobacco smoking in the same subjects.
Furthermore, smoking a single marijuana cigarette caused a fourfold greater increment
in carboxyhemoglobin saturation than did smoking a single tobacco cigarette."(8)

"In view of the many similarities in the smoke contents of marijuana and tobacco,
it has been argued that habitually smoking a few marijuana cigarettes a day may have a
proportionately less harmful long-term effect on the lungs than regularly smoking
several times more tobacco cigarettes. This argument assumes that the number of
cigarettes smoked is directly proportional to the dose of smoke contents inhaled;
however this assumption ignores the ways in which the characteristics of smoking may
influence the delivery of the combustion products of cigarettes."(9)

One reason the authors provide to explain the delivery of greater tar to the lungs
is that unlike tobacco cigarettes, marijuana cigarettes do not have filters. Also, they
report that the increased carboxy hemoglobin levels are a result of the manner of
smoking rather than the carbon monoxide content of the substances. This is very
interesting in a public health context, because these factors can be addressed by

12

changes in smoking techniques. Other factors that contribute to the differences in the
tar and gas content is the density of the cigarettes. Tobacco cigarettes are tightly
packed, providing more filtration. Marijuana cigarettes are comparatively loosely
packed, and provide more complete combustion of the smoking material.

In a 1990 review article, Tashkin places these recent findings in perspective.

"It is also noteworthy that most tobacco cigarettes currently in use are filter-tipped
and have a relatively low tar content, but marijuana cigarettes do not contain filters and
generate about twice as much tar as tobacco per unit of weight, assuming a similar
smoking profile. Furthermore, the techniques for smoking marijuana and tobacco differ
substantially: on the average, with marijuana the inhalation, or "puff," volume is about
two-thirds larger, the depth of smoke inhalation about 40% greater, and breath holding
about four times longer than those characteristics of tobacco smoking. These
differences in filtration and smoking technique can result in about a fourfold greater
amount of tar delivered to and retained in the lungs from the smoking of marijuana than
from a comparable amount of tobacco, thus potentially amplifying the harmful effects of
marijuana on the lungs."(10)

The exposure of the lungs to harmful particulates represents one of two possible
health threats provided by marijuana use. The other possible threat is whether or not
marijuana smoke affects the lung's ability to protect itself from harmful bacteria and
clean itself of the harmful particulates produced by the smoke.

The results of various studies

"Imply that marijuana smoking, like tobacco smoking, impairs the lungs' defense
against microbial invasion, thereby increasing the tendency to respiratory tract
infection."(11)

A 1991 study by this team addressed this second possible health problem. Here is an
explanation of the function of alveolar macrophages.

"Alveolar macrophages (AM) are the principle defensive cells of the lung against
inhaled particulate matter and have a primary role in the inflammatory responses of the
host lung. Therefore, increased numbers of AM in the lungs of cigarette smokers
wouldbe anticipated and, in fact, have been observed in the lungs of humans habitually
exposed to the irritating fumes and particulates contained in the smoke of tobacco
and/or marijuana cigarettes. Because AM are constantly being lost from the lung, their
continued replacement would be important in maintaining the health and integrity of the
host lung."(12)

This result of this study is that marijuana smoke stimulated macrophages to

action, but not as aggressively as tobacco smoke. Many substances stimulate

13

macrophage production, macrophage cell division is a normal physiological response to

foreign particles.

"Overall, the total number of bronchoalveolar lavage (BAL) macrophages that were . .
.labeled from either tobacco or marijuana smokers was significantly greater than that
obtained from nonsmokers. . .the nonsmoking group had the least number of . . .labeled
macrophages (1.01) and the marijuana smokers had the next lowest number of dividing
macrophages (2.90). The subjects who smoked tobacco had a nearly 19-fold greater
number of . . .labeled macrophages (17.9) compared to non-smokers, and the subjects
who smoked both marijuana and tobacco had the second highest number of labeled
macrophages (10.5), with a 10-fold increase."(13) (numbers in parenthesis are x 10-3)

These results illustrate the complexity of arguing that marijuana smoke is more
harmful than tobacco smoke. It may even be the case in this area that marijuana smoke
mitigates against some of the damage of tobacco smoke. This study contradicted an
earlier study by the same team that showed a worse effect of combined marijuana and
tobacco smoking on alveolar macrophages.

"Interestingly, it appears that the substance(s) in marijuana smoke may be less

stimulatory than the substance(s) in tobacco smoke, and, in fact, our data suggest that
marijuana smoke may even inhibit tobacco induced proliferation. The reason for this
phenomenon is unclear . . .[and] is based on only six individuals in the combined
tobacco- and marijuana-smoking group and may be different with a larger sample."(14)

The same year Tashkin worked on a study on Pulmonary Alveolar Macrophages

(PAM), considered one of the primary defenses the lung has to infection.

"We conclude that marijuana smoking does not alter phagocytic behavior or the
respiratory burst of human PAM, but marijuana smoking does decrease the ability of
human PAM to destroy ingested Candida albicanus. These findings contrast with the
effects of tobacco smoking, which not only decreases the fungicidal activity of human
PAM but also increases their respiratory burst."(15)

However, the authors explain that Candida albicanus (a yeast) is a relatively

large organism, and a decreased ability to destroy it may not indicate a decreased
ability to destroy bacteria.

"An appropriate question to ask is whether fungistatic or fungicidal activity by

PAM bears any relationship to the intracellular killing of bacteria. As opposed to fungi
pathogens, bacteria are more likely to be encountered during lung infections of MS or
TS. Human PAM from healthy volunteers were recently compared with respect to their
ability to ingest and kill Pseudomonas aeruginosa, Staphylococcus aureus, and
Candida albicanus. (16) Although bacterial killing was complete in 2 [hours], 4-6 [hours].

14
were needed for PAM to kill a stationary phase, agerminative strain of C. albicanus for
PAM."(17)

Returning to the issue of particulate exposure, Tashkin has also hypothesized in

1991 that "prolonged breathholding characteristics of marijuana smoking enhances THC
absorption and possibly the associated rise in heart rate and the level of
intoxication."(18) If long breathholding determines intoxication efficiency, "then it may be
difficult to modify this topographic variable in an attempt to reduce the cardiorespiratory
hazards of marijuana smoking."(19) These hypotheses were based on the findings of
this study that the longer breathholding of marijuana smokers contributed to the greater
exposure to tar and noxious gas quantified in earlier studies. (20)

Tashkin and his research team have also characterized the differences in the
delivery of tar, carbon dioxide, and D9-THC from the first and second halves of a
marijuana cigarette:

"An important clinical implication of the findings from this study is that smoking
fewer marijuana cigarettes down to a shorter butt length to deliver more D9-THC and
achieve a greater "high" will also result in the delivery of more tar and carbon monoxide
to the smoker's respiratory tract that the consumption of a comparable amount of
marijuana from more cigarettes smoked to a longer butt length. Because of the
respiratory irritant and carcinogenic effects of some of the components of marijuana-
derived tar, and the adverse effects of inhaled carbon monoxide on oxygen transfer in
the lung, transport in the blood and delivery to the tissues, the common practice of
smoking marijuana down to a short butt length may augment its potentially harmful
effects on cardiorespiratory health."(21)

"Another of Tashkin's teams has studied the impact of marijuana smoking on lung
macrophage oxidant release, a mechanism that contributes to emphysema. In this study
important differences were found between marijuana smoke and tobacco smoke.

"In summary, pulmonary alveolar macrophages recovered from marijuana-only

smokers have a spontaneous and stimulated release of oxidants that is equivalent to
nonsmoker's macrophages. This finding coincides with the absences of small-airway
dysfunction or diffusion abnormality in both groups of subjects. In contrast, pulmonary
alveolar macrophages from tobacco smokers generate more oxidants under basal and
stimulated conditions, and tobacco smokers do have demonstrable evidence of small-
airways disease."(22)

Also in 1991, a team led by Gary Huber reported on "Marijuana and Tobacco
Smoke Gas-Phase Cytotoxins."(23) They note that PAM is depressed in vitro, but the
results are not replicated in vivo (the same clash of theory and result Tashkin has
clarified above.) The primary cytotoxins appear to be water soluble. Furthermore, stale
smoke rapidly loses cytotoxic properties. The authors hypothesized that proximal

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airwaves remove the water-soluble cytotoxic constituents from the gas phase of the
smoke. They created a model system that successfully tested this hypothesis.

"These results may explain to a significant degree, the discrepancies that exist in
literature between in vitro and in vivo cytotoxicity of marijuana and tobacco smoke.
These results also raise the consideration that the potentially injurious effects of water-
soluble, gas-phase constituents on alveolar macrophages on lung explants may not be
relevant to the health and integrity or the lung of the intact smoker in everyday life."(24)

Certainly other aspects of marijuana or tobacco smoke may have an adverse

effect on macrophages.

"Although the gas-phase cytotoxins have received much of the earlier

investigative attention; the data presented herein, however, would appear to render
them less suitable culprits."(25)

In 1992 a team of Tashkin's explored the effect of THC potency on respiratory

functions.

"The present study was carried out to investigate the effects of escalating doses
of THC administered in smoked marijuana on the ventilatory and mouth occlusion
pressure responses to both hypercapnia [high levels of CO2] and hypoxia [low levels of
O2] and on resting minute ventilation and metabolic rate in young, healthy experienced
male users of marijuana."(26)

The study found no effect of THC on ventilation, oxygen consumption, carbon

dioxide production, or metabolic rate. The only effects of THC noted were that:

"The habitual marijuana smokers participating in this study exhibited a significant

increase in heart rate, subjective intoxication (high), and decrease in airway resistance
after smoking the active preparations of marijuana, but not placebo marijuana. These
findings are consistent with the known cardioaccelerator, psychotropic, and
bronchodilator effects of THC."(27)

This study used marijuana cigarettes from the National Institute on Drug Abuse of
0, 1.55%, and 2.65% THC. While the authors can not account for the possible effect of
tolerance to marijuana, they do argue that the potencies used in their study are relevant
to common use of the drug.

"These doses of THC are comparable with those delivered from the recreational
smoking of "street" marijuana (500 mg marijuana containing 1 to 6% THC) or the oral
ingestion of U.S. Food and Drug Administration-approved synthetic marijuana (7.5 to
22.5 mg) for control of nausea and vomiting due to cancer chemotherapeutic agents.
Our results therefore suggest that THC in doses commonly used either recreationally or

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medicinally neither stimulates nor depresses central or peripheral chemoreceptor-

mediated ventilatory drive in habitual users of marijuana."(28)

In 1993 Tashkin and colleagues studied the effect of marijuana smoke on airway
hyperresponsiveness (AHR), a risk factor for development of or a marker of airway
injury in individuals susceptible to chronic airflow obstruction. There results:

"In summary, in a convenience sample of 542 nonsmokers and habitual smokers

of marijuana, cocaine, and/or tobacco, cocaine had no demonstrable influence on
nonspecific AHR, whereas marijuana appeared to have an inconsistent effect and heavy
tobacco smoking a modest but statistically significant positive influence in both men and
women, independent of the effect of lung function on AHR. Neither marijuana nor
cocaine appeared to potentiate the effect on AHR of other smoked substances,
including tobacco."(29)

The fact that several studies indicate that marijuana smoke is not as harmful as
tobacco smoke does not change the validity of Tashkin's original assertion that
marijuana smoke is harmful to the human lungs, and that this harm is compounded in
individuals who also smoke tobacco.

In a recent editorial, Tashkin argued that:

"Several lines of evidence suggest that marijuana smoking is also associated

with an increased risk for the development of respiratory tract malignancy."(30)

Tashkin explicitly notes that advocates of the legalization of marijuana are wrong
when they contend that no evidence exists linking marijuana smoking to serious health
effects. Some diseases take a long time to develop, but other respiratory problems do
not.
 "One might conclude from the dearth of information concerning marijuana-related
morbidity [indicating acute respiratory illness such as bronchitis and pneumonia] either
that such health effects are too infrequent to be measured or that such effects are
occurring at greater than expected frequency but have not been documented because
of the lack of a systematic effort to "capture" these events."(31)

One additional complication created by marijuana's illegality is that doctors (32)

and health care professionals do not ask patients about marijuana use, or patients are
reluctant to disclose such use. (33) While the research of Tashkin and others suggests
that the harmful effects of marijuana could be minimized through introducing filtration
and the idea honest disclosure and discussion with health care professionals to
marijuana smokers. This introduces a critical issue which will be discussed in section 6,
that is, what public policies will best reduce the harm associated with marijuana use.

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Otherwise, the research of Tashkin and others on the effect of marijuana smoke on the
lung contributes a great deal to understanding and characterizing the pharmacology of
marijuana and its smoke. Marijuana smoke is the primary vehicle that introduces the
active ingredients in marijuana into the human body; smoking is the primary route of
administration. It is important in understanding the pharmacology of marijuana to
distinguish between the effects of the smoke and the effects of the active ingredients,
cannabinoids. Furthermore, understanding the absorption of the active ingredients from
the smoke is crucial to understanding the effects of the constituent chemicals, the
cannabinoids, on the rest of the body.

Local Studies

Medical Cannabis has been proven to minimize the risk of cancer and cure
illness such as multiple sclerosis, glaucoma, relieves pain for those people who undergo
therapy such as chemotherapy and the likes. People here in our country need to know
more about cannabis. They were blinded from the very beginning about the real facts
about Cannabis. I think it is the time that we make some changes about the law and let
us be more open about the positive effects of the plant. There are a lot of studies and
researches that give us facts on Cannabis is all about. In some countries this has been
legalized and in some states in the U.S. as well. I think Philippines needs to check the
data again and consider legalizing the plant and if not at least give the people choices if
they are going to take pharmaceutical drug (chemical) or Cannabis (natural) like what
they are doing in CA. People in CA who choose to use Medical Cannabis is given a
card that they can use so that they will not be included in the prohibition of the said
plant. I know it will be hard but in the long run I know this will bring good to our country
and our people.

Poverty can end as well, world hunger could end. A large variety of food products
can be generated from hemp. The seeds contain one of the highest sources of protein
in nature; they have two essential fatty acids that clean your body of cholesterol. These
essential fatty acids are not found anywhere else in nature! Consuming pot seeds are
the best thing you could do for your body. Eat uncooked hemp seeds. You can live
healthy for the rest of your life eating nothing but hemp seeds.

These are just few facts about Cannabis, I hope that the people who have read
this petition will do research on their own and I do hope you will see the light. Let us
make this change, even not for us, think of this as an investment for our future
generation. We don't want our siblings to undergo the same mistake. Let us think of
the people who are fighting for their lives and their last option is Cannabis but they can't
have it, now even they do, they have a big chance of ending in jail for the rest of their
lives. Please have courage to fight for what we know is right. People are dying
because of not knowing, not knowing the cure to their illness, not knowing where to get
Cannabis, not knowing their right to have access to it. One signature can make a big
difference.

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