The Laws Get Looser, Its Uses Get Broader & Questions Continue About Its Effectiveness
For thousands of years, marijuana has been a recreational, ceremonial, or medicinal substance. Queen Victoria took it to ease her menstrual cramps. It's been used as a painkiller, sedative, anti-inflammatory, muscle relaxant, anticonvulsant (to control seizures) and even as an asthma remedy.
Marijuana (cannabis, grass) contains more than 400 chemical compounds called cannabinoids. Delta-9 THC (THC) is probably the cannabinoid that causes you to get high. Scientists suspect it's the combination of THC with the other cannabinoids that sometimes makes marijuana more effective than pure THC.
The National Institute on Drug Abuse (NIDA) is the only legal source for marijuana. For years, NIDA has paid a farmer at the University of Mississippi to grow marijuana. NIDA gives this marijuana only to scientists whose research was funded by the National Institutes of Health (NIH). The catch is, the NIH has rarely given a grant to scientists wanting to study marijuana's medical uses.
In May 1999, the rules changed, allowing NIDA to sell marijuana to privately funded scientists. This means researchers can finally study marijuana's medicinal qualities, and investigate methods of delivery other than smoking.
Locally, the person most often associated with legal medical marijuana is Dr. Robert Killian, a family practitioner in Seattle. It was Dr. Killian who wrote most of Initiative 692, and he continues to help patients individually in his practice and to make medical marijuana available to all who might benefit from it. Dr. Killian estimates that about 10 percent of his HIV patients use and benefit from medical marijuana and he considers it a "first-line" medicine for AWS. He advises patients not to smoke marijuana (or anything else!). Smoking is particularly dangerous if you have or have had any lung disease.
When I-692 was written it listed certain conditions and diseases. The door, however, was left open to add other diseases and conditions as more was learned about them. Recently, Dr. Killian petitioned the State Department of Health to add Crohn's disease to the list. This is an important step, not only for those with Crohn's disease, but because it's also the first test to find out if the petitioning process included in I-692 really works.
Lots of people know that marijuana can be enjoyable and relaxing to use. Because of the laws restricting research on marijuana, very few scientific studies have been done to test the effectiveness of marijuana as a medicine. Most of the information we have is from word-of-mouth or from surveys of people who use marijuana.
There's no question that many people find marijuana helps ease pain, controls nausea and vomiting, stimulates the appetite, and encourages plain relaxation when sleep can seem seem almost impossible.
While critics argue that marijuana can be addictive, morphine and codeine can be, too. Some studies have shown that marijuana is far less addicting than alcohol, which many people use regularly and legally. And if your condition is terminal, the whole "addiction" argument doesn't make a lot of sense.
Some argue there are already plenty of regular medications scientifically proven to be useful. While there isn't much scientific proof of marijuana's usefulness, nobody can deny there are many people who have tried all the usual medications without success. If that's you, you might want to "give grass a chance."
The following discussion may help you decide whether you want to discuss medical marijuana with your doctor. You should be advised that, for many reasons, people who have never smoked or used marijuana before are less likely to be helped by it. The following are some of the potential medical uses.
Pain Relief. The pain caused by cancer, AIDS, or other diseases is often hard to control. Why marijuana eases pain is not known. It may just be a side effect of the relaxation; it may be psychological; it may actually work. No one knows for sure, but many people say it has helped them.
Combating Aids Wasting Syndrome. AWS and cancer cachexia have received the most attention from those interested in medical marijuana. With these complications, you can starve to death, and AWS may affect as many as 31 percent of HIV-positive people.
Medications have been developed to treat AWS, cachexia, and related conditions. Marinol (generic dronabinol), which is available by prescription, contains synthetic THC dissolved in sesame oil, but THC without the other cannabidoids doesn't seem to be as effective as marijuana. Megace (megestrol) has been more effective than Marinol in increasing appetite and promoting weight gain, but the usual dose is 800mg/day, which can cost $800 to $1,200 a month. However, there are no direct comparison studies on prescription THC versus marijuana versus prescription drugs.
No one knows why marijuana stimulates the appetite, but studies on people who aren't HIV-positive confirm what many already knew. Marijuana causes the munchies, even in persons suffering from AWS. If you get hungry or thirsty, keep nourishing, easy to eat snacks handy and drink fruit or vegetable juices instead of coffee, tea, or sodas to get the greatest benefit from the effect.
Controlling Nausea And Vomiting. These symptoms feel horrible whether they're from chemotherapy, radiation, protease inhibitors, other medications, or your illness. If you can't control them, you can't gain, or even maintain, your weight. Even doctors who favor medical marijuana are more likely to prescribe drugs such as Phenergan, Zofran, Compazine or a combination of Compazine and Marinol to control nausea and vomiting. These medicines help most people, but if they don't help you, marijuana might. People who have a history of using marijuana to control their nausea and vomiting often say it helps a lot and is more pleasant than pills.
A very important thing to know about using medical marijuana is that until you find the dose and method that's best for you, you should always use it with people who make you feel safe and who'll take care of and support you. Sometimes marijuana causes tachycardia (very rapid heart beat), which can make you feel anxious and uneasy rather than relaxed and comforted. If that happens, try breathing deeply and exhaling fully. Sometimes eating something, or holding someone's hand, will calm you down. Tachycardia will pass in time, and you'll know to reduce your next dose until you find the one that's right for you.
When you smoke marijuana, the effect is almost immediate. You can smoke less if you use flowers rather than leaves, because the flowers on the female plant have the highest concentration of the cannabinoids that affect your body. Smoking is also the easiest way to find the dose that's right for you. If you're able to smoke marijuana, inhale deeply and hold the smoke in your lungs for 20 to 30 seconds or as long as possible.
Using a water pipe (bong, narghile, hooka) cools the smoke and might filter out some of the toxins produced by burning. If you don't have the equipment, rolling your own is always a reliable standby.
Note that smoking is NOT good for your lungs. Doctors who recommend medical marijuana advise you to not smoke, particularly if you have or have ever had any problems with your lungs.
When you eat or drink marijuana, the effect isn't as instantaneous as it is when you smoke. Once it kicks in, however, the effect is greater than when you smoke. This means a smaller amount of marijuana goes further when you eat or drink it. It also means it may take a while before you learn what dose is best for you.
No matter how you use your marijuana, always remember that using drugs like marijuana (or alcohol, LSD, cocaine, heroin, morphine or anything else that affects your brain) puts you at higher risk for unsafe sex, interactions with other medications, and driving accidents. So be careful. Talk to your doctor. And good luck.
This article was provided by Seattle Treatment Education Project. It is a part of the publication STEP Perspective.