Should Medical Use Of Marijuana Be Legal?

Dr. Manasi Rege

JR-1, M.D. Pharmacology

L.T.M.M.C. and G.H., Mumbai

Medicine has always been a double-edged sword. It’s often a marvel to see how something which can help us can also harm us. Whenever a new drug is invented, Phase 1 of clinical studies is always conducted for ensuring the safety of the drug. And after this, we start conducting trials to ensure efficacy too. This indicates the fact that safety while using a drug has always been more important than efficacy. Drugs have always come with their share of side effects in varying measures. So, whether to use a drug or not has always depended on whether the benefits are higher than the risks or vice versa.
Certain recreational drugs which are known to cause harm have always been under the radar of the law. But yet we have certain drugs which have their benefits as well as harmful effects in equal measure, which make them a topic of debate ‘Should they be legalised’. And one such debate has been on an age-old substance; Marijuana.

Marijuana is the dried leaves and flowers of the Cannabis plant. Native to Central and South Asia, marijuana has been deep-rooted in Indian culture with Cannabis being named as one of the five most sacred plants on Earth in the sacred Hindu texts of Atharva Veda. The text refers to it as a source of happiness or a ‘liberator’. Its use is often associated with Lord Shiva, who was known to consume Bhang. While Bhang is made from the leaves of Cannabis, Ganja, the dried female inflorescence, is more potent and is smoked while the flowering buds of the plant are used for making Hashish. Hemp seeds and hemp oil is known to have many nutritional benefits.

Tetrahydrocannabinol (9Δ THC) is the active principle of Cannabis. It produces potent analgesic, antiemetic, anti-inflammatory, and many other pharmacological actions.

With all these considerations, we would often wonder why the is the legalization of marijuana a question at all.

Marijuana has been an age-old entheogen (psychoactive substances that induce alterations in perception, mood, consciousness, cognition, or behavior for the purposes of spiritual development or otherwise in sacred contexts.) The pharmacological effects of Δ9-THC show variability. It depends on the presence of multiple factors such as the dose, route of administration, experience of the user, vulnerability to psychoactive effects, and setting of use. It is known to have hallucinogenic potential. The hallucinogens produce a dream-like state with disorientation. There is a loss of contact with reality with the field of vision appearing to sway. Objects seem distorted and face grotesque. On closing the eyes an unending series of colorful, realistic images appear to surge; time sense is altered, and music appears tangible. The most sought-after effects are the ‘high’ and ‘mellowing out’. Approval of marijuana in certain states of the U.S. has shown reports of increasing automobile accidents. The use of marijuana in the early years has also seen a higher rate of students dropping out of school. Long-term effects have shown neurocognitive impairment and exacerbations of psychosis in vulnerable individuals

But that would set us thinking, why can’t it be used as a medication? If used as a medication, wouldn’t it definitely have more regulations on its supply? Why do we have this huge debate on the legalization of marijuana even as a medication?

The medical benefits of marijuana come at the cost of the psychoactive effects that often impair normal activities. Legalizing marijuana as a medication, besides the pharmacological effect, will lead to greater availability of the drug in the market, thereby leading to an increase in the accessibility and procurement of the drug. For a drug with multiple short-term and long-term risks and dependence properties, do we really need such a drug in the market, especially when we have other effective drugs to compensate for the anti-inflammatory, anti-emetic, and other such properties that marijuana has? Permitting marijuana even as a medication, rather than recreation, will still pose a risk for drug-seeking behavior and dependence. Hence, for a fraternity that teaches ‘primum non nocere’ (first, do no harm), we need to rethink if legalizing the use of marijuana will be a boon or bane.