Cannabis has been used as medicine for thousands of years. Already in the 2000s BC was discovered in China that the plant had medicinal properties, for example, that it was the painkillers, and that it could give the virus. In India, cannabis has been used against diseases such as malaria and rheumatism in millennia.

In the mid 1800s, cannabis use as medicine in the western world, but in the early 1900s came the modern, more effective drugs. In Sweden there were cannabis drugs against whooping cough and depression until 1950, but were abolished because it gave the side effects and were addictive. The effect was not sufficiently ensured by scientific studies.

There is evidence that cannabis has medicinal effects, such as alleviating the pain, nausea, appetite loss and cramping of muscles. However, side effects such as hallucinations, anxiety, depression and irritation in the lungs, is often  worse than the benefits. Today there are also drugs that are more effective against these symptoms. A patient may feel better when he or she smokes cannabis, because of intoxication, but that does not mean that the patient gets better.

The medical effects of marijuana have led to the prepared pure cannabinoids from the plant for testing drugs. Marinol, which contains pure THC, came back in 1985 and is approved in the US for the treatment of nausea

chemotherapy and wasting in AIDS. Marinol is not widely used because it provides moderate effect and side effects. Sativex is an oral spray that is used against spastic cramps in MS. It is approved as a drug in Sweden since 2011 and contains both THC and CBD. It can be printed on a prescription by specialists in neurology and is used for patients who can not tolerate or who do not get sufficient effect of other medicines.

Both within the established pharmaceutical industry and illegally ongoing intensive efforts to develop synthetic cannabinoids. The preparations are sold over the net and police and customs has been able to make numerous seizures of these substances.

The difference between medicine and drugs

Medicine and drugs are sometimes used interchangeably, but medication is a much broader concept. It includes both drugs, herbal remedies and popular home remedies.

For a preparation to be called drugs in Sweden must be approved by the FDA or the European Medicines Agency within the EU.

There are high demands on a drug to be approved. The company, which was manufactured in the need to show that the drug is effective and safe. The substance must have been tested on animals and humans in several steps. It must be proven that the preparation is effective against the disease to be treated and it can not hurt more than help. A dose of medication should always contain exactly the same amount of active substances. It must not have more or more severe side effects than other available treatments and side effects must be documented. Manufacturing and distribution should be closely monitored. Most drugs today are completely synthetic in the factories.

Therefore, marijuana is not approved as drugs

There are many reasons that marijuana is not approved as drugs. The missing research on the benefits of smoking cannabis as medicine, both in experimental animals and in humans. Smoking is no safe way to take the medicine and there is no other medicine that is smoked. It is not possible to calculate the dose when you smoke marijuana because it is impossible to determine how much actually inhaled. The patient can not determine the strength of the dose. THC content of cannabis varies, ranging from 2 to 30 percent and there is no table of contents for cannabis as medicine. Nor someone recommended dose or treatment time for disease states.

There is no established side effect profile of cannabis as medicine. Smoke tion of marijuana entails great risks. It can cause intoxication, anxiety, depression, acute psychotic reactions, lung damage, cancer of various organs and dependence. New research shows that teens who smoke often and for several years, while the brain is still developing, risks a diminished IQ. There is also suspicion about other adverse effects, such as the immune system. Harmful chemicals and carcinogens that are byproducts of smoked marijuana, can create health problems. A study shows for. Ex. that those who smoke cannabis may be four times more tar in the lungs than those who smoke tobacco. The production of cannabis is completely uncontrolled, amongst other things, high levels of pesticides.

There are other drugs that are more effective when it comes to, for example, reduce pain and nausea.

 

The situation in Europe

In some European countries there are political proposals on the medical use of cannabis. In the Netherlands, doctors since 2003 print cannabis on prescription although cannabis is not approved as drugs. Many Dutchmen rely on self cannabis to various symptoms and authorities believe it will be easier to help them if they have contact with a doctor. Patients were offered three different medications that can be drunk as a tea or smoked in a vaporizer where the vapor is inhaled. The medicines from Holmen country also exported to Finland, Italy and Germany.

Through local referendums has 18 US states approved marijuanarök- up as medicine. California was the first 1996.

Under federal law, the laws of the United States, it is forbidden to possess, transfer or sell cannabis and it is forbidden to drive with cannabis in the body. Almost all laws in the US are state laws, that is, it is the state parliament that decides on them. In some states, discussions, or has in practice already introduced non-prosecution for some small drug offenses, such as possession of marijuana for personal use. It is prohibited on paper but not in practice, because it considers that the offense is trivial and does not bother to prosecute. This does not make the government in Washington somewhat.

Autumn 2012 voted two states, Colorado and Washington, for the legalization of cannabis. How the federal government will handle this remains to be seen, since the United States signed the UN drug conventions and pledged to prohibit cannabis.

The campaigns to push through the draft bills on to smoke cannabis as medicine in the United States have been well-organized and well-funded. For example, it has been broadcasting TV spots with old, sorely afflicted patients testified about how smoking marijuana eased their pain, for example in chemotherapy treatment for cancer. It has thus appealed to people's compassion and many who do not use cannabis have therefore voted in favor.

How does it work in practice in the United States?

Cannabis as medicine sold in the US in special shops, called dispensaries. If a doctor believes that the patient's illness or symptoms could be alleviated by marijuana he can write a recommendation, not a recipe, if that. A  relative or friend can be appointed as carers and both the patient and caregiver can buy a certain amount of cannabis, cultivating a certain number of cannabis plants and possess marijuana without being prosecuted for this in the state.

There is no monitoring of how much an individual patient grow or buy and it goes to shop every day and in different places. Doctor's recommendation is usually sufficient for one year, regardless if the patient is healthy or not and can be easily renewed. There is no requirement to follow the physician's part.

Smoking cannabis as medicine is questioned by many medical organizations. Among other things, advises US dependence Medical Association, ASAM, strong all doctors from recommending their patients to smoke marijuana because of side effects. The federal Food and Drug Administration, the FDA, the equivalent to the Swedish Medical Products Agency, rejects all use of cannabis as medicine. FDA approves new drugs in the US and sets the same high standards as the Medical Products Agency in Sweden. Because marijuana is not an approved drug, physicians have no insurance coverage if the patient is harmed. Although the Drug Enforcement Administration, DEA, US federal narcotics and the Office of National Drug Control Policy, ONDCP, anti-drug coordinator at the US President's Office, clearly distanced themselves from smoking cannabis as medicine.

 

Patients

Those who use marijuana for medical purposes are recorded more often than not, but a study in California showed that just over half were under 30 and 12 per cent were under 21 years old. The most common diagnoses were sleep disorders, anxiety, depression, and muscle pain. Only 2 percent had diagnoses of cancer, glaucoma or AIDS diagnoses that occur frequently in ad campaigns for voting connections that allow smoking marijuana as medicine.

In the state of Colorado voted cannabis as medicine through 2000. Ten years later, the Colorado nearly 100 000 registered users, approximately two percent of the population. The highest percentage of patients were in the more affluent parts of the State, in the skiing districts, and 94 percent received medical marijuana because of a painful diagnosis.

Implications of allowing cannabis as medicine

In the states that allow cannabis as medicine, the proportion of drug addiction higher, as well as the proportion of people who used drugs last month. Marijuana use among adolescents is higher in states that allow cannabis as medicine and the young people there believe that marijuana is less dangerous than in those where it is not permitted. It's hard to get young people to understand that marijuana can be dangerous if the message is that marijuana can be used as medicine. Not even the argument that other drugs, such as morphine or fentanyl, is also used medicinally, even though they are dangerous seems to bite in this context.

Target regularization

Since the 1970s, legalization advocates in the United States used various policies to achieve their goal - the legalization of all use of cannabis. The propagation of cannabis as medicine is a method. With the help of poorly substantiated science and ignorance among the population and by appealing to human compassion for seriously ill people labor organizations to legalize the drug. Among the organizations running campaigns on cannabis that Member icin found The Marijuana Policy Project (MPP), The Drug Policy Alliance (DPA), the National Organization for the Reform of Marijuana Laws (NORML). All of these wants to legalize cannabis.

Proposal for depression

David Evans, Esq. Drug Free Schools Coalition, New York (video):  http://wfad.se/wfad2010-video-and-audio/277-wfad-2010-special-session-da... g-evans qmedicalq marijuana

Bertha Madras, professor of psychobiology, Harvard (Report):  Medical Marijuana Reflects an Indifference to Public Health  http://www.drugfreebusiness.org/media/documents/Reference%20documents/ madras_Cannabis_Feb_2011.pdf

Scientific article:  Medicinal Applications of Delta-9-Tetrahydrocannabinol and Marijuana,  Eric A. Voth, MD; and Richard H. Schwartz, MD Ann Intern Med. May 15 1997; 126 (10): 791-798

Newspaper article:  Richard G. Soper, MD. Medical Marijuana: Clinical Considerations and Concerns. AZ Medicine, 2011.

Conference Lecture:   Christian Thurstone. The Impact of MMJ legalization on Colorado's youth. Presentation at the World Forum Against Drugs, Stockholm May 22, 2012

 

Writer / editor:  Pernilla Rönnlid

Fact checking:  Kerstin Source,  with. dr., Chief Depending Clinic Linköping University Hospital