An eye on medical marijuanaThis innocuous-looking plant is amongst the most contentious on our planet thanks to a history of abuse.  Strangely, in the US it’s used more by the ageing populations than by the youth.  That could be because the marijuana friendly Woodstock-hippies are now that age.  It’s more likely because there are more people in the older generations who are suffering with severe, debilitating medical illnesses.  More people suffering who are prepared to try herbs because pills don’t have all their answers and they’re reaching for something more.

Although marijuana is being legalised more and more world-wide, South Africa is only at the beginning phases of the legal process.  A recent court case declared that the laws should be rewritten to support personal use, but the government have taken it on appeal.  It isn’t legal unless you have a very specific medical certificate obtained from a duly authorised doctor.

The result is that people who are desperate for relief from extreme pain, nausea relief in chemo, certain Parkinsons symptoms etc then turn to questionable sources with varying results.  Cannabis provides proven assistance, and used responsibly can offer  relief for debilitating symptoms. I argue for controlled medical use because there is real need and scientific proof of efficacy.

Cannabis: marijuana versus hemp

Cannabis IndicaMarijuana and hemp are all strains of the same plant, but with different chemical components. How they are grown, the parts of the plant harvested and the timing of harvesting all affect chemical content and stability, so hemp is generally not allowed to be cultivated any more than marijuana is.  Hemp is the ‘legal’ version in terms of products, but unfortunately medically  it’s very much cannabis light.  It has less than a tenth of the active ingredients that marijuana does.  However, hemp does have some active components and is legal, so it’s worth testing for your specific symptoms.  Buy from a reputable health shop, but shop around first and ask for the percentage of CBD in it.  Buy from wherever has the highest Cannabidiol (CBD) content.  As with food, the reaction to hemp is individual and you need to test dosage.

Active ingredients of cannabis

There are four groups of active ingredients that have medicinal value for us.  The best known is Tetrahydrocannabinol (THC).  THC is the psychoactive component, so it’s what gives you the high.  Woodstockers and their hippy friends  have done us a dirty because plants have been increasingly bred for more of a high, so for higher THC levels.  That means there’s less of the other, equally important chemicals.

Cannabidiol (CBD) is the other major component.  Part of its function is to regulate the psychoactive THC.  CBD has important medical benefits of its own, but it also stops THC from over-stimulating the user.  Where THC has been bred to be over-present in the plant, there is a far greater likelihood that the person using that products will experience anxiety as the CBD isn’t there in sufficient quantity to keep it in check.

Other important medicinal components in the plant are terpenes and flavonoids.  Applied topically, cannabis is an anti-inflammatory and is said to resolve sunburn overnight, but that might have more to do with the terpenes and flavonoids than the other components.

These four medicinal components all serve different functions, but together and in tandem, they make this an important medicinal plant that provides a multitude of benefits, and more so if we don’t mess with the plant.

Quality sources count

And this is the first strike against buying on the black market or from recreational vendors.  You need to know that the source of your product is an old-fashioned cannabis plant with a high CBD content, otherwise it will have less medicinal effect and might cause anxiety, even a panic attack.  Second strike is that the manufacturing process of the oil must be clinically precise to maintain the active components.  It is unsettling at least to have a severe medical condition and use something that reacts one way on your symptoms the first time and another the second.  You can’t afford that confusion when you already have other, very real problems.

What your bodies does with the marijuana?

This is the interesting part – it couldn’t do anything if we didn’t have receptors for it.  We have CB1 and CB2 receptors.  We even produce some of our own CBD ourselves, without any help from 5-leafed plants.  They’re spread throughout our body – in our brains, our kidneys, our liver, heart, lungs, pancreas and immune system.  That means we have a purpose and need for these chemicals.  It also means we have to be careful none of these normal functions are messed with.  The physical management comes in not overdosing and over-utilising those receptors, so the suggestion from practitioners who use it in medical practise in the US is to start with the smallest dose possible and build up in little steps until you achieve efficacy, then stop there.

Our own cannabinoid system seems to be part of a signalling system for our own cells, particularly for nerve cells.  If you overdose on external cannabinoid products, you clog up those receptors and they can’t do their day job.  That could have long-term implications for you that could worsen symptoms, hence the medical advice to keep doses as low as possible.

How to use cannabis medicinally

Medical scientists prefer prescribing a daily pill as the most stable, measured way of taking cannabis.  They can carefully control the balance of the chemicals and amount taken and compare it with the results.  If I wanted to manage symptoms for an individual rather than gather repeatable, publishable data, pills would not be my first choice.  They rely on a digestive system that is already probably compromised if there is a serious illness.  The amount of the THC you absorb is also directly dependent on how much fat you eat because it needs the fat for absorption.  Pills, eating baked products or drinking tea also pass through the liver and convert some of the chemicals to other forms, potentially creating a more intense effect.  These options take longer to be felt, but the effect lasts for five to six hours.  The pill lasts for a day.

Drops of oil or tincture under the tongue are more bio-available because they bypass the digestion process, but the product must be from a reputable laboratory that produces exactly the same balance and quality time after time.  It also should be pure as this system bypasses your normal protective mechanisms and absorbs directly via your mucosa in your mouth straight into your blood stream.  It’s effects are quickly felt and dosage is three times daily.

Vaporising has not proven to be as effective as other methods of delivery.

Smoking marijuana has you feeling the effects faster, but for a shorter period, only one to two hours.  Smoking marijuana causes more lung damage than smoking tobacco, but is not associated with lung cancer like normal tobacco smoke.  The heat of the smoke might be what damages your lungs.  If so, using a water pipe would cool the smoke and the damage might be minimised. Practically I don’t see that marijuana would produce more smoke-heat than tobacco, so I think that the damage to the lungs must be chemical.  Personally, I would never recommend it as an option.

Dangers of marijuana

Like all things chemical, there are positives and negatives.  Higher THC brands can produce anxiety, panic attacks or even psychosis.  For some particularly susceptible people, this might even happen with a high CBD variety.  It will pass, but that’s scant comfort to the person experiencing the side-effect.

The other problem is that it stimulates melatonin production and so can make you sleepy in the daytime and not at night.  This is a transitory side-effect and should pass in a month or so.  In the meantime, consider medicating at night.

Call of support for radical medical transformation

Cannabis can bring some measure of relief to people suffering from conditions that medicine has been unable to relieve.  It’s a herb that should be available for responsible use.  Reform attitudes, minds and laws to add it to the medical doctors arsenal of tools to bring relief to their patients and for pharmacists to make available.