Critics of the medical use of marijuana say
- There are traditional medications to help patients and marijuana is not needed; and,
- Permitting the medical use of marijuana sends the wrong message to kids.
How do you respond to these concerns?
For many patients, traditional medications do work and they do not require or desire medical marijuana. However, for a significant number of serious ill patients, including patients suffering from AIDS, cancer, multiple sclerosis and chronic pain among others, traditional medications do not provide symptomatic relief as effectively as medicinal cannabis. These patients must not be branded as criminals or forced to suffer needlessly in pain.
Dronabinol (trade name Marinol) is a legal, synthetic THC alternative to cannabis. Nevetheless, many patients claim they find minimal relief from it, particularly when compared to inhaled marijuana. The active ingredient in Marinol, delta-9-tetrahydrocannabinol, is only one of the compounds isolated in marijuana that appears to be medically beneficial to patients. Other compounds such as cannabidiol (CBD), an anti-convulsant, and cannabichromine (CBC), an anti-inflammatory, are unavailable in Marinol, and patients only have access to their therapeutic properties by using cannabis.
Patients prescribed Marinol frequently complain of its high psychoactivity. This is because patients consume the drug orally. Once swallowed, Marinol passes through the liver, where a significant proportion is converted into other chemicals. One of these, the 11-hydroxy metabolite, is four to five times more potent than THC and greatly increases the likelihood of a patient experiencing an adverse psychological reaction. In contrast, inhaled marijuana doesn’t cause significant levels of the 11-hydroxy metabolite to appear in the blood.
Marinol’s oral administration also delays the drug from taking peak effect until two to fours hours after dosing. A 1999 report by the U.S. Institute of Medicine (IOM) concluded: “It is well recognized that Marinol’s oral route of administration hampers its effectiveness because of slow absorption and patients’ desire for more control over dosing. … In contrast, inhaled marijuana is rapidly absorbed.” In a series of U.S. state studies in the 1980’s, cancer patients given a choice between using inhaled marijuana and oral THC overwhelmingly chose cannabis.
As to the message we are sending to kids, NORML hopes the message we are sending is that we would not deny any effective medication to the seriously ill and dying. We routinely permit cancer patients to self-administer morphine in cancer wards all across the country; we allow physicians to prescribe amphetamines for weight loss and to use cocaine in nose and throat operations. Each of these drugs can be abused on the street, yet no one is suggesting we are sending the wrong message to kids by permitting their medical use.