By Carol Bell
As the time gets closer to voting on the ballot for the legalization of marijuana, we want to help you understand what this truly entails. In order to understand something more fully, we have to look at all aspects, whether good or bad. So what we are focusing on here is how marijuana is treated by everyone as a drug.
Marijuana, aka cannabis, is a chemical substance which is used both recreationally and medicinally, same as opiates (e.g. Morphine and Percocet) and benzodiazepines (Klonopin and Ativan). When used medicinally, they are prescribed in a controlled manner, i.e. to a specific person for a specific therapeutic dosage. When used recreationally, they are not controlled. Some of the main reasons for controlling prescriptions are reducing risk for abuse/addiction/withdrawal, preventing/limiting side effects, and promoting safe/appropriate use.
We live in a state where people are able to get prescriptions for marijuana use. The fact that people can get a prescription for it has led many people to believe that its use is OK. But let’s take a step back here and think about this.
How are medications approved? Regulated? Monitored? Through research and approval by the FDA. In order for a medication to be approved, it has to go through numerous clinical trials, which begin on the basic level of looking at the chemicals, then proceed to studying their effects on animals, then examining their effects on humans. It is through these studies that risk vs. benefit analyses are completed and effective therapeutic/safe dosages are determined. Once the FDA has found that the drug has a positive enough effect, then it is approved as a prescription medication.
In terms of cannabis, what has the FDA actually approved as a prescription? Dronabinol/Marinol and Nabilone/Cesamet. Both of these drugs contain tetrahydrocannabinol (THC ) oil. They are approved as last resort drugs for treating nausea caused by chemotherapy and Nabilone is also prescribed for increasing appetites in patients experiencing extreme weight loss caused by AIDS. The U.S. is also conducting clinical trials for utilizing Nabaximols, an oral spray containing both THC and cannabidiol (CBD) oil, to determine whether it is a safe treatment option for cancer pain.
Do you see a pattern here? All of these drugs are oils. Why is that? The FDA has neither recognized nor approved the cannabis plant as medicine. Why is that? Plants are not able to be controlled. Each plant varies, even though they may be the same type of plant. The FDA has approved these oils for being prescribed or researched because they can be controlled. Scientists are able to control the amount of THC and CBD by breaking down the plants and producing oils out of them.
So what are the controlled dose recommendations when it comes to medical marijuana? In Maine, a doctor may prescribe cannabis for treating nausea, glaucoma, anxiety, or pain, etc. When a doctor provides a prescription, a patient is able to purchase up to 2.5 ounces every 15 days, whether oils, edibles, or smokable form. There often aren’t more specific dosage instructions than that.
Often it is when meeting with the dispenser when they go over the symptoms for which the person received the prescription and recommend certain amounts of Indica (CBD) or Sativa (THC). While one could purchase oils, which are potentially more likely to have the percentage of THC/CBD reported by the dispenser, the effects of that percentage of THC/CBD have not been clinically shown to be the same for everyone.
This goes back to how ultimately, for cannabis use, there is limited knowledge besides self report, historical record review, or smaller research studies. In time it may be different, but for right now, more research is needed.
Carol S. Bell of Presque Isle is partnership director for Healthy Aroostook, a Healthy Maine Partnership.
