Marijuana has been used as a medical treatment for many centuries. We have been hearing more about so-called medicinal marijuana because of the recent United States Supreme Court ruling that essentially concluded that state laws permitting medicinal marijuana must bow to federal law prohibiting marijuana. This is quite a sea change from earlier in the last century, when marijuana was listed by the United States Pharmacopeia (the organization which sets the quality standards for approved drugs in the United States) until the 1940s, just a few years before Robert Mitchum got busted. By that time, there was quite a bit of resistance toward the increasing recreational use of marijuana.
Marijuana refers to the dried flower, leaves, stems and seeds of the Cannabis sativa plant. Not only do these components of the plant contain the compounds responsible for the mind-altering effects that recreational users seek, but they also contain components with pain-relieving properties.
These chemical components are referred to as cannabinoids. These cannabinoids have many distinct pharmacologic properties, including pain-relieving, anti-oxidative, anti-nausea and anti-inflammatory, in addition to modulation of certain tumor growth.
When smoked or taken orally, some of these cannabinoids attach to receptors in the brain. These receptors are mostly concentrated in the areas of the brain that control body movement, memory and nausea/vomiting. The cannabinoids can also make a person very hungry.
While cannabis may be ingested orally, this delivery route has greatly different pharmacokinetics compared with inhalation. In addition, the onset of action is delayed, dose titration is made more difficult, and the time the drug remains is the body is much longer. Interestingly, cannabinoids may also be incorporated into a topical treatment which is absorbed through the skin -- this was used for arthritis in the early 20th century, but it was the least efficient mode of delivery.
Those suffering pain used marijuana rather extensively in the 1800s, and the analgesic effects of cannabinoids have been proven in several studies. One study showed that one of the cannabinoids, THC, appears to work as well as codeine in treating pain in cancer patients. In addition, cannabinoids appear to increase the effects of opiate pain medications, allowing for the provision of pain relief at lower dosages.
Pharmaceutical companies are currently directing research that will utilize what we have learned from cannabinoids in order to produce better pain control.
As mentioned earlier, the United States government does not agree with those who advocate the legitimate use of marijuana. Specifically, the federal law currently classifies marijuana as a Schedule 1 drug: a dangerous drug with no recognized medical use. It follows that a patient or a doctor may land in jail if they are found in possession of this drug.
Another precaution to keep in mind involves the potential health risks. These include: