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Medical Marijuana

Adi Ekmescic

Medical cannabis refers to the use of cannabis and its constituent cannabinoids, such as
tetrahydrocannabinol and cannabidiol, as medical therapy to treat disease or alleviate symptoms. The
Cannabis plant has a history of medicinal use dating back thousands of years across many cultures. Its
usage in modern times is controversial, and in recent years the American Medical Association, the
MMA, the American Society of Addiction Medicine, and other medical organizations have issued
statements opposing its usage for medicinal purposes.

Cannabis has been used to reduce nausea and vomiting in chemotherapy and people with AIDS, and to
treat pain and muscle spasticity; its use for other medical applications has been studied, but there is
insufficient data for conclusions about safety and efficacy. Short-term use increases minor adverse
effects, but does not appear to increase major adverse effects.

Medical uses

Medical cannabis has several potential beneficial effects. Cannabinoids can serve as appetite
stimulants, antiemetics, antispasmodics, and have some analgesic effects, The National Institute on
Drug Abuse states, "Marijuana itself is an unlikely medication candidate for several reasons: it is an
unpurified plant containing numerous chemicals with unknown health effects; it is typically consumed
by smoking further contributing to potential adverse effects; and its cognitive impairing effects may
limit its utility."

The Institute of Medicine, run by the United States National Academy of Sciences, conducted a
comprehensive study in 1999 assessing the potential health benefits of cannabis and its constituent
cannabinoids. The study concluded that smoking cannabis is not to be recommended for the treatment
of any disease condition, but that nausea, appetite loss, pain and anxiety can all be mitigated by
cannabis. While the study expressed reservations about smoked cannabis due to the health risks
associated with smoking, the study team concluded that until another mode of ingestion was perfected
providing the same relief as smoked cannabis, there was no alternative. In addition, the study pointed
out the inherent difficulty in marketing a non-patentable herb, as pharmaceutical companies will likely
make smaller investments in product development if the result is not patentable. The Institute of
Medicine stated that there is little future in smoked cannabis as a medically approved medication, while
in the report also concluding that for certain patients, such as the terminally ill or those with debilitating
symptoms, the long-term risks are not of great concern. Citing "the dangers of cannabis and the lack of
clinical research supporting its medicinal value" the American Society of Addiction Medicine in March
2011 issued a white paper recommending a halt on use of marijuana as medication in the U.S., even in
states where it had been declared legal.

Nausea and vomiting

Medical cannabis is somewhat effective in chemotherapy-induced nausea and vomiting Comparative


studies have found cannabinoids to be more effective than some conventional antiemetics such as
prochlorperazine, promethazine, and metoclopramide in controlling CINV, but these are used less
frequently because of side effects including dizziness, dysphoria, and hallucinations. Long-term
cannabis use may cause nausea and vomiting, a condition known as cannabinoid hyperemesis
syndrome.

A 2010 Cochrane review said that cannabinoids were "probably effective" in treating chemotherapyinduced nausea in children, but with a high side effect profile . Less common side effects were "occular
problems, orthostatic hypotension, muscle twitching, pruritis, vagueness, hallucinations,
lightheadedness and dry mouth".

HIV/AIDS

Evidence is lacking for both efficacy and safety of cannabis and cannabinoids in treating patients with
HIV/AIDS or for anorexia associated with AIDS. As of 2013, current studies suffer from effects of
bias, small sample size, and lack of long-term data.