Austin Vote

Professor Campbell

UWRT 1104

3/30/17

Medical Marijuana: Whats the Issue? Formatted: Centered, Indent: First line: 0"

For centuries, marijuana has found itself embedded in cultures around the world. For the

longest time, unabashed. It is with good reason Governments are hesitant to jump head first into

legalization, but their trepidation may be causing unnecessary problems for people that need

something to improve their quality of life. The Drug Enforcement Agency (DEA) is the federal

agency that is tasked with enforcing federal drug laws. The DEA continues to defend their

scheduling of Marijuana; it remains classified in the same category as Heroin, LSD, MDMA

(Ecstasy), Psilocybin (the psychedelic component of mushrooms), and bath salts. Schedule 1

drugs are defined as drugs, substances, or chemicals with no currently accepted medical use and

a high potential for abuse. As I will demonstrate, Marijuana is an effective medicine for cancer

patients, epileptics, muscle degeneration, and many other types debilitating diseases. It has been

found to relieve symptoms and work as an anti-tumor agent (add source). Recent scientific

studies pose significant questions to the reasoning behind the DEA keeping Marijuana as a

Schedule 1 substance. As I will demonstrate, the current scheduling is inaccurate and barring to

more research.

Marijuana was classified as Schedule 1 after the passing of the Controlled Substances Act

in 1970; and was continuously targeted as a dangerous illegal substance throughout the war on

drugs. The war on drugs has existed for around 100 years. We can see its initial vigor and aim
was during prohibition, when alcohol sales were forbidden. Later, especially during the

presidency of Ronald Raegan, the war on drugs shifted heavily, and set its sights on marijuana. I

will focus almost exclusively on the medicinal benefits of marijuana, in order to objectively

justify why mMarijuana should be rescheduled. I will also give a brief overview of other reasons

it is still illegal, because they are relevant to the debate at large. Lobbyists remain the single

greatest barrier against marijuanas legalization, with pharmaceutical companies being the most

influential. Public data shows that in 2012, 22 mMillion dollars was given to federal candidates,

committees, and parties (OpenSecrets). Why? Retired police officer Howard Wooldridge, who

lobbies for Marijuanas legalization, explained that next to police unions, the second biggest

opponent on Capitol Hill is big PhRMA, because marijuana can replace everything from Advil

to Vicodin and other expensive pills. As Woolridge explains, big PhRMA is worried about

market share. Right now, the market for medication is pills: pills that can be replaced in many

cases by other substances, such as marijuana. Thus, their lobbying is clearly anti-progress and

pro continuation on the dependence of the medications produced my pharmaceutical companies.

From physicians to our own ancestors, Marijuana has been used extensively in the past, not only

as medicine, but also in textiles and food. In Modern History of Medical Cannabis, is explained

that The millennial history of Cannabis, which effectively goes along that of human kind,

testifies to its extensive usefulness for many purposes, as fiber, food, and medicine, beyond its

use as a psychotropic substance. For example, in the mid-1800s, an Irish physician, William

Brooke OShaughnessy, Having ascertained its safety in animals, he administered alcoholic

tinctures of Cannabis to some selected patients who suffered from epilepsy, rheumatisms,

cholera, or tetanus and deduced that the plant had interesting analgesic and myorelaxant

properties. Based on this observation, heHe proposed that Cannabis could be a powerful
remedy for seizures. In addition to this, he noted that while not able to treat tetanus, it was

effective in response to symptoms. I simply want to stress this:Clearly, even in cases where it

cant directly combat ailments, it can work especially well treat symptoms.

Moving forward, I will now focus on the science behind Marijuana; first starting with its

safety. Of course, for thousands of years, Marijuana has been used as a natural medicine in

many cultures. In the United States, it was used by apothecaries until the late 1800s. I want to

stress that its Marijuanas fall from grace was not in reaction to any specific event or sense of

danger; rather, its psychotropic effects. In fact, as early as the 1940s, the American Medical

Association stated that the pharmacological potential of Marijuana was greater than its adverse

effects; and unlike other classes of drugs in use today (most notably Opioids), negative effects on

society and the user are rarely appreciable (Pharmacological Sciences).

There exists, without doubt, an opioid crisis in the United States. According to CDC Formatted: Indent: First line: 0.5"

data, there were 33,000 opioid overdoses in the United States in 2015, and nearly half of them

were due to prescription opioids (CDC). Inhalation of smoke remains the most clear and

dangerous effect of Marijuana use, recreational or medicinal; however, in these cases, the smoke

from Marijuana is less dangerous than smoke from cigarettes, which are legal. In addition,,

much fewer patients smoke Marijuana as opposed to eating edibles or using concentrated oil,

which pose no significant health effects. if the health risks from smoking are a concern, edible

forms of cannabis exists as both food and oils. Edibles are also noted for offering a more potent

and longer THC therapeutic effect, which is most important when being used as an adjuvant for

symptom relief (Pharmacological Sciences). It should be noted that the auxiliary effects of

opioids are also highly addictive, exponentially moreso than Marijuana. In the Trends in Formatted: Font: Italic

Pharmacological Sciences journal, they concluded that they were at least hopeful for the future
of Medical Marijuana and its research, stating Now that the scientific evidence collected on the

pharmacological potential of Cannabis is in agreement with the economic interests linked to this

enormous new market, moral and social concerns have been bypassed. Exactly now, the lesson

from the past is pivotal to manage the Cannabis affair in the right way, emphasizing first of all

the health benefits for patients. I would like to stress that while safety is a concern, it is not the

only one, and that is why we still see entire classes of comparatively dangerous drugs (like

opioids) still in use. In fact, as I will address, the efficacy of both opioids and Marijuana

increase as they are used together, furthing asserting the value of marijuana as a medicine..

As I have laid out a groundwork asserting that Medical Marijuana is a safe and

reasonable idea, I will now address its efficacy in symptomatic relief. I will address the efficacy

of Marijuana as a treatment later. Medical Marijuana is currently prescribed to treat a number of

various diseases and disabilities, ranging from, but not limited to: Cancer, Glaucoma, Anorexia,

Migraines, HIV/AIDS, ALS, Depression, Anxiety, Panic Disorder, PTSD, chronic pain, chronic

nausea, seizures, and cachexia (wasting syndrome, a disease which is characterized by

excessive muscle atrophy, fatigue, weakness and loss of appetite). My goal in addressing the

efficacy of Medical Marijuana in symptom treatment was to focus on disabilities and diseases

with the most current research, as Medical Marijuana is definitely still in an infantile state.

Out of cancer patients, at least half report moderate to severe pain, which further

increases in patients with metastatic cancer or advanced cancer. This pain negatively impacts

on their life quality, functional status, and life expectancy (Agents). Currently, pain this severe

and chronic requires opioid treatment. These drugs have dose-limiting side-effects, and can be

extremely dangerous. More than half (52%) of women and a third (38%) of men reported

doctor-prescribed painkillers as their first contact with opioid drugs, a family of drugs which
include prescription medicines such OxyContin and codeine, as well as illicit drugs such as

heroin For example, McMaster University reported that 52% of women, and 38% of men

admitted their first use of opioid drugs was via a doctors prescription. Opioid drugs often

prescribed include OxyContin and codeine.(McMaster University). Numerous studies have

shown that physician directed system administration of cannabinoids reduce pain in animal

models, including humans. Cannabinoids are lipid molecules (fat) and are the active components

of Marijuana, and there are many kinds. The two most common are CBD and THC. THC is a

largely recreational cannabinoid, responsible for the therapeutic high of Marijuana;

howeverhowever, it still has medicinal effects that I will describe later. THC is a recreational

cannabinoid because of its psychotropic nature. CBD, while sometimes used in recreational

settings, is more often used for medical purposes, because its effects are not on the mind.

Different cannabinoids prefer different cannabinoid receptors. THC usually bonds to receptors

in the brain, whereas CBD usually bonds to receptors in the body. Cannabinoids produce anti-

nociception (pain-signal blocking) by activating CB1 receptors in the brain, the spinal cord and

nerve terminals. Endocannabinoids naturally function to suppress pain by inhibiting nociceptive

neurotransmission (Agents). As suggested, cannabinoids activate CB1 receptors in the brain

which suppress the bodys pain signals. That is why marijuana can be an effective pain

management tool. THC has also been found to be an effective stimulant for patients with

anorexia (this particular journal referenced studies on anorexia due to cancer treatment).

Some pain is too severe for Marijuana or its synthetic versions to treat alone, and it is

often used in tandem with other medicines; however, in some cases Marijuana is also the only

medicine that has been found to be effective against pain (Current Oncology). Current Oncology Formatted: Font: Italic

also found that Medical Marijuana was effective in combating nausea from chemotherapy,
insomnia, and depression. Neuropathic pain, characterized usually by tissue damage, is another

type of pain common in cancer patients. A systematic review of six randomized, double-blind,

placebo-controlled trials of cannabinoids (five specifically addressing neuropathic pain) found

evidence for the use of low-dose medical cannabis in refractory neuropathic pain in conjunction

with traditional analgesics. Another analysis reviewed five trials of inhaled cannabis in patients

with hiv-related peripheral neuropathy and again found a positive effect for cannabis compared

with placebo. A recent small study showed a doseresponse effect for vaporized cannabis in the

relief of pain from diabetic peripheral neuropathy, a huge clinical problem estimated to affect

238 million people worldwide A review from Current Oncology which analyzed six controlled

medical trials of cannabinoids, found that lose doses of marijuana were effective in treating pain.

It was also found effective against neuropathic pain, common in people with diabetes.

Neuropathic pain occurs when nerve cells have died or degenerated. Another study which

included patients with neuropathic pain from HIV found vaporized cannabis to be effective

against pain. (Current Oncology). As previously mentioned, some pain is too severe for

Marijuana alone to combat. In these cases, when combined with other analgesics (pain

medications), Marijuana was found to increase the effectiveness of the other analgesic used.

This effect was not unique to cancer patients, and was reported with diabetics with neuropathic

pain. This is because cannabinoids and opioids have been found to have synergetic effects. The

pain-relieving effects of Marijuana are not reduced by opioids, and they work on different

receptors throughout the body. In laymans terms, the two substances can work together because

they are not necessarily fighting over the same space within the body (Current Oncology).

A source cited by NPR found that in states with legal Medical medical mMarijuana, the Formatted: Indent: First line: 0.5"

number of opioid prescriptions dropped. I would like to stress this: a A reduction in opiate
dependence will lead to less abuse in the United States, and the first step in stopping the opioid

epidemic is reducing prescriptions. Marijuana does not remove the necessity, but it lowers it,

which is a very good start. A commonly ignored side-effect of long term opioid use is an overall

decrease in cognition, often reaching a point where patients have a hard time communicating

with their loved-ones during end of life care (Current Oncology). A WebMD survey reported

that 82% of oncologists and hematologists were in favor of patients having access to medical

cannabis. This was the highest approval rating among all subspecialties that responded. A

doctor writing for Current Oncology reported that Clinically, I have observed that many cancer

patients benefit from adding cannabis to their pain regimen. In Cannabinoids for Medical Use

Dr. Penny F. Whiting summarized her research as such: there is moderate-quality evidence to

support the use of cannabinoids for the treatment of chronic pain

To conclude, I would also to mention that in Integrating Cannabis into Clinical Cancer Formatted: Font: Italic

Care, Abrams mentioned that not only is cannabis effective versus pain, but that evidence

suggests that cannabinoids are not only effective in the treatment but also in the prevention of

chemotherapy-induced peripheral neuropathy suggesting that cannabis can also be considered a

preventative medicine, at least in the realm of neuropathy. More research is needed in

understanding the reason for this.

I would lastly like to focus on using cannabis to combat illness, not just alleviate its

symptoms. Medical mMarijuana in recent years has offered potential applications in combating

illness, especially as anti-tumor medicine. This is because evidence supports the claim that some

cannabinoids can limit tumor cell proliferation (tumor growth). Marijuana can also induce

tumor-selective cell death, while keeping nearby cells unharmed. This same principle can be

extended further than just tumors. Mood and anxiety disorders, movement disorders such as
Parkinsons and Huntingtons disease, neuropathic pain, multiple sclerosis and spinal cord

injury, cancer, atherosclerosis, myocardial infarction, stroke, hypertension, glaucoma,

obesity/metabolic syndrome and osteoporosis are just some of the diseases in which an altered

endocannabinoid system plays an interesting role for pharmacological intervention In the

Curative Agents article, doctors emphasized that an altered endocannabinoid system, via using

cannabis, showed an interesting role for pharmacological intervention (treatment). (Agents).

The endocannabinoid system is where cannabinoids bond all throughout the body. More

research is needed in this young field of medicine, but researchers have been able to replicate

results.

Anti-tumor results are due to the ability of certain cannabinoids to inhibit several key

functions of tumor cells. Firstly, cannabinoids are effective at stopping tumors from undergoing

angiogenesis, which is essential for tumor growth. Angiogenesis is the creation of new blood

vessels. Cancer sprouts blood vessels everywhere it goes, stealing nutrition from our bodies and

further feeding itself, spreading throughout the affected persons body. Cannabinoids can

choke out cancer in this sense: remove the source of nutrition, and the cancer will wither.

That is not the only way cannabinoids combat cancer, however. Cannabinoid agonists also

directly inhibited angiogenesis induced by basic fibroblast growth factor (bFGF) in vitro and in

vivo in a CB1-dependent manner, and reduced the invasiveness of different cancer cell lines

through the increased expression of tissue inhibitor of metalloproteinases. In addition to

cannabinoid agonists, inhibitors of endocannabinoid transport or degradation (VDM-11 and AA-

5-HT) have been shown to inhibit tumor growth and progression in numerous types of cancer,

enhancing the levels of endocannabinoids in the cells (Agents). Research analyzed a team of

scientists lead by Simona Pisanti, an Italian scientist, found that cannabinoid agonists inhibit cell
growth and directly combated the advance of cancer. This was done by increasing the levels of

endocannabinoids in cells, via the use of medical marijuana. Basically, by directly manipulating

the endocannabinoid system by introducing various cannabinoids, cell chemistry is changed in

ways that either kill cancer, or reduce its ability to spread. Important to note, is that in addition to

being effective, cannabinoids are also rated as having a good-safety profile (Agents). Some fear

that the psychoactive effects of THC and other mind-altering cannabinoids would make them a

bad candidate for cancer-treatment; however, THC delivery in glioma patients was done safely

and without psychotropic effects. Another alternative is simply using non-psychoactive

cannabinoids such as CBD, which is commonly used by people with seizures. It is also

important to consider that compared to all other currently used chemotherapeutic drugs, which

all have toxic adverse effects, mMarijuana has a good-safety profile. It is not toxic at all.

Potential adverse effects of cannabinoid agonists are within the range believed acceptable for

other drugs, especially anticancer drugs. It is well known that the therapeutic activity of most

anticancer drugs in clinical use is limited by their general toxicity to proliferating cells, including

normal cells. Novel cytotoxic agents with known mechanisms of action have been developed,

but they still lack tumour selectivity and have not been therapeutically useful. Cannabinoid

agonists do seem to selectively target tumour cells, while normal cells are less sensitive or even

protected. In laymens terms, Marijuana has not only been shown to be effective against

cancer, it has done it without destroying healthy, unaffected cells, which can lead to even more

damage in conventional cancer treatment.

As demonstrated, Marijuana is much more than what is commonly accepted. Our own

Government demonizes it, leaving it Schedule 1, insisting it is good only as a path to harder

drugs. As I have laid out, Marijuana is a drug that has been found to aid in numerous cases, in
many fields of medicine, such as mental health, oncology, and rheumatology. . It is effective

both as a treatment, and as a symptom-relief. I am confident that as more research is done, we

will find new and even more innovative ways to use this medicine. The DEA should

immediately, if they have the people of the United States good fortune in mind, reschedule

Marijuana, and allow for unimpeded research to be done with it.

 Works Cited Formatted: Underline

Abrams, D.I. "Integrating Cannabis into Clinical Cancer Care." Current Oncology. Current
Oncology. 2017. Web. 12 Mar. 2017.
"After Medical Marijuana Legalized, Medicare Prescriptions Drop For Many Drugs". NPR.org.
NPR.org. 2017. Web. 12 Mar. 2017.
"Cannabis and Cannabinoids." National Cancer Institute. National Cancer Institute. Web. 12
Mar. 2017.
McMaster University. "Prescription painkillers source of addiction for most women."
ScienceDaily. ScienceDaily, 9 November 2015.
<www.sciencedaily.com/releases/2015/11/151109220353.htm>.
"Medical Marijuana And Parkinson's Part 3 Of 3". YouTube. 2017. Web. 12 Mar. 2017.
"Opioid Overdose." Centers for Disease Control and Prevention. Centers for Disease Control
and Prevention, 09 Feb. 2017. Web. 06 Apr. 2017.
Pisanti, Simona, and Maurizio Bifulco. "Modern History of Medical Cannabis: From
Widespread Use to Prohibitionism and Back." Science Direct. Trends in Pharmacological
Sciences, Mar.-Apr. 2017.
Pisanti, Simona, PhD, Anna Maria Malfitano, PhD, Claudia Grimaldi, PhD, Antonietta Santoro,
PhD, Patrizia Gazzerro, PhD, and Maurizio Bifulco, PhD. "Use of Cannabinoid Receptor
Agonists in Cancer Therapy as Palliative and Curative
Agents." Https://www.elsevier.com/. Science Direct
Whiting, PhD Penny F. "Cannabinoids for Medical Use." JAMA. American Medical Association,
23 June 2015. Web. 06 Apr. 2017.