Cannabis use and medicine, the debate over benefits and harms

An excerpt from Uses and Abuses of Plant-Derived Smoke: Its Ethnobotany as Hallucinogen, Perfume, Incense, and Medicine.

by Marcello Pennacchio, PhD

Few plants have generated as much debate and controversy as cannabis (Cannabis sativa).

Throughout the ages, it has been labelled both a dangerous drug and potent medicine. Where the former is concerned, law-enforcement agents and governments spend millions of dollars fighting what many consider to be a losing battle, while fortunes are being pocketed by those who sell it illegally. This is in spite of the fact that cannabis produces a number of natural pharmacologically-active substances, the medicinal potential of which were recognized thousands of years ago. Chinese Emperor, Shên Nung, for example, prescribed cannabis elixirs for a variety of illnesses as early as 3000 BC. It was equally prized as a medicine in other ancient civilisations, including India, Egypt, Assyria, Palestine, Judea and Rome and may have been instrumental in helping Ancient Greece’s Delphian Oracle during her divinations.

While its more common contemporary uses are mostly recreational, cannabis continues to enjoy widespread use as a medicine. It is smoked to ease glaucoma, to help with the degenerative loss of condition and body mass associated with diseases such as HIV/AIDS, and it helps to ease chronic pain in people suffering from terminal cancers and other debilitating illnesses. It has been used for treating malaria, gout, multiple sclerosis, eating disorders, promoting euphoria, as well as for dispelling grief and sorrow. A number of serious side effects have also been linked to its use, however. These include heart problems, immune system suppression, cancer, depression, reduced cognitive function and poor fetal development. It can lead to a variety of psychological problems, too, such as psychosis and schizophrenia, as well as to addiction to this and other drugs. Then there is the added danger of inhaling dangerous chemicals generated during the combustion of organic matter. Chief among these are carbon monoxide and polycyclic aromatic hydrocarbons.

With so many pros and cons, it’s easy to see why the issue of cannabis has so significantly polarized sentiment around the world. Those in favour of its use want it legalized, with perhaps its most vocal advocates being in San Francisco. This is where one of the world’s first universities dedicated solely to cannabis, is located. Founded in 2007 by Richard Lee, Oaksterdam University was inspired by a similar college in Amsterdam and has since spread to include campuses elsewhere in California and in Michigan. So passionate are its founders and students about cannabis that they have taken the debate of legalizing it all the way to California’s November 2, 2010, ballot, a move that has since made world headlines. Many had hoped a similar proposal in Florida, known as the Medical Marijuana Initiative, would have made it into that state’s ballot, too, but the petition failed to gather the 700, 000 signatures required for it to qualify. Florida’s four-year rolling petition system means, however, that it may qualify for the 2012 ballot.

Surprisingly, the push to legalize cannabis includes former judges, politicians and other high-profile people, many of who themselves don’t use cannabis (including this author). They believe that penalizing and incarcerating its users is far more detrimental to them than smoking its parts are. They further contend that legalizing and taxing cannabis would raise significant revenue for governments. It would also alleviate the enormous drain of cash reserves needed to police its illegal use and, in the process, eliminate the criminal syndicates that sell it. Furthermore, they claim it would ensure that the quality of the product meets stringent regulations.

These are all convincing arguments, but it is difficult for many of us to get around the fact that smoking cannabis, and indeed many other plants, is potentially very harmful to humans. Not only can it cause ill health and lead its users to harder drugs, legalising it could encourage more people to start smoking it, as well as give license to its existing users to smoke more of it. New laws would therefore have to be introduced to regulate its use, like those for alcohol, with harsh penalties for driving and working under its influence, caring for infants and so-on. And while legalizing cannabis may raise revenue for governments, the health risks associated with its consumption could, like tobacco, become an enormous financial burden on already cash-strapped healthcare systems. To help lessen this potential burden we may, in the future, find ourselves pushing for costly educational campaigns to warn people of the dangers of using cannabis.

All this does not mean, however, that those who do legitimately smoke cannabis for its medicinal properties have to miss out on its benefits. It is obvious it does produce useful compounds. They just need to be teased out, identified and packaged into quality-controlled pharmaceuticals that are sold in regulated markets. This too would raise revenue for governments and benefit the human race. Fortunately, the process has already begun with the recent release of the cannabis-based medicine, Sativex®. Developed by GW Pharmaceuticals, this whole-plant extract is used to treat multiple sclerosis and neuropathic pain.

With such contrasting opinions, it is obvious the debate over cannabis use will, for years to come, continue to occupy the time and thoughts of law makers, social commentators and concerned citizens on both sides of the great cannabis divide. For now, though, the eyes of the world will stay focused on California to see how it deals with this controversial issue and perhaps gain even more insight into public sentiment over it.

Marcello Pennacchio is an ethnobotanist and author of Uses and Abuses of Plant-Derived Smoke: Its Ethnobotany as Hallucinogen, Perfume, Incense, and Medicine.This post originally appeared in the Oxford University Press blog.

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