Is Marijuana The Remedy-All We Need It To Be?

By Dr. Mark Calarco, Nationwide Medical Director for Medical Diagnostics at American Dependancy Facilities.

As soon as thought of the drug of selection for laid-back stoner sorts (assume: Cheech & Chong), marijuana has garnered a brand new popularity as a panacea for every little thing from persistent ache and epilepsy to minimizing Alzheimer’s, Parkinson’s and PTSD signs, chemotherapy unwanted side effects and nervousness. In reality, in 2018 the FDA accepted the drug Epidiolex (cannabidiol), a cannabis spinoff, for sure kinds of seizure issues. Whereas as soon as stigmatized as a “gateway drug,” cannabis and its derivatives are actually authorized for medical and/or leisure use in 47 states. Apparently, that is in direct violation of federal legislation that also classifies marijuana as a Schedule I managed substance.

With a substance steeped in a lot controversy, it’s no shock there’s an awesome quantity of conflicting details about marijuana’s advantages and dangers—each documented and perceived. The reality is, it’s a powerful catch-22. Whereas some information reveals that marijuana could be helpful, it’s definitely not a cure-all, neither is it risk-free.

To assist shed some gentle on the cannabis debate, listed here are some info it is best to know:

• Marijuana might have helped to curb opioid prescribing. Quite a few research present that states the place marijuana is authorized for each medicinal and leisure functions have considerably decrease opioid prescribing charges. Sufferers not solely wanted fewer opioid prescriptions, however in addition they stuffed fewer day by day doses—as a lot as 2.211 million day by day doses much less within the states with a medical cannabis legislation (MCL) from 2010-2015. That is very true for hydrocodone (Vicodin) and morphine, which noticed 26.8% fewer and 20.7% fewer day by day doses stuffed, respectively.
• However, it hasn’t curbed the opioid overdose epidemic. Whereas early analysis analyzing information from 1999-2010 steered that states with MCLs had an almost 25% decrease annual opioid overdose mortality fee, newer information reveals it could have had the alternative impact. In reality, when Stanford researchers took a extra prolonged look via 2017—together with states that had legalized medical marijuana because the authentic examine—the development really reversed with a 23% greater overdose mortality fee in states with MCLs over that time period.
• Marijuana may very well be a substitute for opioids for ache administration. There may be some proof that medical cannabis could be helpful in managing persistent ache. Whereas it’s going to unlikely by no means be satisfactory by itself, marijuana may very well be an adjunct remedy that permits folks to make use of fewer opioids. In some research, medical cannabis use resulted in a 64% decrease opioid use, and 40% of sufferers even stopped filling opioid prescriptions altogether inside 18 months. Sufferers who’ve seen the advantages of medical cannabis overwhelmingly report that cannabis supplied reduction on par with different drugs, and over 80% mentioned cannabis alone was more practical at treating their situation than taking cannabis with opioids.

• However, it might trigger different points. Different research have straight refuted these claims, exhibiting no proof that cannabis use improved affected person outcomes, in truth simply the alternative: sufferers had better ache and have been much less efficient in self-managing ache. Much more troubling, in comparison with opioid use alone, opioid/cannabis co-use has proven to contribute to better nervousness and despair signs, together with issues with tobacco, alcohol, cocaine and sedative use.
• Marijuana is perceived as “safer.” The one clear good thing about marijuana is {that a} affected person can’t overdose and die, as they may with opioids.Other than that, research have proven sufferers expertise fewer unwanted side effects with medical cannabis than with opioid use, which contributes to an improved high quality of life and extra social and bodily exercise for sufferers. And, for years there’s been a notion that marijuana is much less bodily addictive than different medication, which contributes to the notion that it’s a “safer” drug with much less stigma.
• However, proof reveals it could result in better disposition for different substance use for some. Whereas not as addictive as heroin or cocaine, some folks develop marijuana dependence, leading to withdrawal signs. That is extra frequent in these already on the spectrum of dependancy, these with a predisposition to dependancy or who’ve hereditary, household historical past or environmental components that put them at better threat for substance use. There may be additionally proof that marijuana use can also be clearly related to elevated threat of different substance use issues. Along with alcohol use dysfunction, adults who use marijuana are 85 occasions extra doubtless to make use of cocaine, and almost 45% of cannabis customers progressed to different illicit drug use in some unspecified time in the future of their lives. Those that begin utilizing marijuana as youngsters are 17 occasions extra prone to develop a cocaine behavior, almost 60 occasions extra doubtless to make use of different illicit medication, 2.4 occasions extra prone to have alcohol dependence and have considerably greater odds of making an attempt suicide. With extra details about the personalised genome and the way particular people reply to different drugs, we would be capable of decide how the affected person would reply to medical marijuana remedy. However with out that out there proper now, it’s simply trial and error.

With all of the controversy and conflicting data, it’s understandably troublesome for most individuals to make an knowledgeable choice about whether or not marijuana is the following medical breakthrough or yet one more ill-fated try at a silver bullet. We should even be conscious that for some folks, relying on their genetic make-up, cannabis shouldn’t be solely addicting however also can trigger them to expertise psychiatric signs, corresponding to paranoia and schizophrenia-like habits. It’s vital that we perceive how folks course of or metabolize marijuana and its derivatives. With out extra analysis on this space, it’s nonetheless a guessing sport when it comes to efficacy and security.

RELATED: Science Nonetheless Confused Over Whether or not Marijuana Can Tame Opioid Epidemic

Complicating the difficulty, it’s extraordinarily troublesome to conduct correct medical analysis due to strict authorities rules and the truth that marijuana remains to be a Class I Managed Substance—unlawful in accordance with the federal authorities. That additionally makes docs reluctant to suggest it, out of concern they might lose their licensing with the Drug Enforcement Company.

To not point out, with no rules in place to standardize cultivation, preparation and dishing out/dosing pointers (pesticides, mould and different contaminants have all been problematic), this might probably create a critical security challenge. Are you getting what you assume you’re getting? There’s actually no method to make certain.

All of this factors to a “purchaser beware” scenario and needs to be a warning flag for anybody who makes use of or is contemplating the usage of marijuana for medicinal or leisure functions.

This text initially appeared on Benzinga and has been reposted with permission.