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Marijuana: a medical mystery!

The cannabis plant itself is a fascinating organism, one that humanity has used for thousands of years for reasons ranging from religious rituals to performance enhancement to just plain partying. But within that plant there are somewhere around 400 chemical compounds, more than 60 of which are special compounds known as cannabinoids.

MANIKYA DHEEREN


These bonds with a relatively recently discovered system in our brain that interacts with naturally-produced cannabinoids, these natural (endogenous) cannabinoids play multiple roles, affecting mood, appetite, memory, consciousness, pain response, blood pressure, and more.

The cannabinoids from marijuana tap into that same system, which is why the plant has such wide-ranging effects.

 There are many reasons for wanting to understand what science has so far revealed—and what remains unknown, about marijuana’s medical potential. Can marijuana really help people with AIDS (acquired immune deficiency syndrome), cancer, glaucoma, multiple sclerosis, or any of several other conditions it is purported to relieve? How does marijuana affect the human body? Could the potential benefits of legalizing marijuana for medicinal use possibly outweigh the risk of encouraging drug abuse? All of these questions remain to be answered completely, but over the past two decades, scientists have made significant progress in revealing how chemicals in marijuana act on the body.

There are over ten thousand documented studies available that confirm the harmful physical and psychological effects of marijuana. The cannabis plant (marijuana) has therapeutic benefits and could ease the suffering of millions of persons with various illnesses such as AIDS, cancer, glaucoma, multiple sclerosis, spinal cord injuries, seizure disorders, chronic pain, and other maladies.

Marijuana contains a complex mixture of chemicals. Marijuana leaves or flower tops can be smoked, eaten, or drunk as a tea. People who use marijuana in these ways expose themselves to the complex mixture of chemical compounds present in the plant. One of these chemicals, tetrahydrocannabinol (THC), is the main cause of the marijuana “high.” Thus, the effects of marijuana on the body include those of THC, but not all of marijuana’s effects are necessarily due to THC alone.

According to federal law, marijuana belongs to a category of substances that have a high potential for abuse and no accepted medical use. Other drugs in this category include LSD (lysergic acid diethylamide) and heroin. By contrast, doctors can legally prescribe THC, in the form of the medicine Marinol (a brand name for a specific formulation of the generic drug dronabinol), under highly regulated conditions. Dronabinol, the “synthetic” THC in Marinol, is identical in every way to the “natural” THC in marijuana.

The psychoactive chemicals in marijuana are members of a family of molecules known as cannabinoids, derived from the plant’s scientific name, Cannabis sativa. Most cannabinoids are closely related to THC. Scientists also refer to chemicals that are not found in marijuana but that resemble THC either in their chemical structure or the way they affect the body as cannabinoids.

Marijuana is not modern medicine. Although people have used marijuana for centuries to soothe a variety of ills, it cannot be considered a medicine in the same sense as any drug, like aspirin. Aspirin’s chemical as a remedy for pain. But unlike marijuana, aspirin has been proven safe and effective through rigorous testing. Aspirin tablets contain a pure measured dose of medicine, so they can be relied on to give consistent and predictable results.

“It’s obviously important because there’s so much of it. And we never knew it existed before,” said J. Michael Walker, a Brown University psychologist who has conducted some of the first studies of how cannabinoids block pain.

By contrast, two identical-looking marijuana cigarettes could produce quite different effects, even if smoked by the same person. If one of the cigarettes were made mostly from leaves and the other from flower tops, for instance, they would probably contain different amounts of active chemicals. Growing conditions also affect marijuana’s potency, which can vary greatly from region to region and even from season to season in the same place. This variability makes marijuana at best a crude remedy, more akin to herbal supplements such as St. John’s wort or ginkgo than to conventional medications.

Aspirin originated from Willow bark contains a pain-relieving compound; marijuana contains cannabinoids such as THC, which lessens nausea. Marijuana used as medicine is not a recreational drug. People who use marijuana solely as medication do so in order to relieve specific symptoms of AIDS, cancer, multiple sclerosis, and other debilitating conditions. Some undertake the advice or consent of doctors after conventional treatments have failed to help them. For medical marijuana users, referring to the people who smoke or eat marijuana exclusively as a treatment for medical symptoms. The fact that many such patients may have prior recreational experience with the drug does not mean that they are using illness as an excuse to get high, although it is possible that some patients might do so. Surveys of marijuana buyers’ clubs indicate that most of their members do, in fact, have serious medical conditions.

Medical marijuana users tend to come from different segments of the population than recreational users. Medical marijuana advocates assert that patients usually obtain relief with smaller doses of the drug than would be used recreationally and that they rarely feel high when treating their symptoms with marijuana, marijuana and its constituent chemicals can produce both physical and psychological dependence. These risks must be taken into account if marijuana or cannabinoids are to be used as medicines.

Many effective medicines have side effects. The fact that marijuana affects the human body adversely does not preclude its use as a source of useful medicines. Many legitimate drugs- including opiates, chemotherapy agents, and steroids, have side effects ranging from the dangerous to the merely unpleasant. When used carefully, though, the benefits of these medications far outweigh their drawbacks. Patients may also develop tolerance, dependence, and withdrawal conditions associated with marijuana use. when taking proper doses of several commonly prescribed medications.

Finding a rapid way to deliver cannabinoids to the body, other than smoking, could lessen some of marijuana’s worst side effects. It may also be possible to reduce the adverse effects of specific cannabinoids through chemical modification. Marijuana’s effects vary with different delivery methods. Traditionally, medicinal marijuana has not been smoked but rather swallowed in the form of an extract or applied to the underside of the tongue in the form of an alcohol-based tincture. Although the later method allows the THC to pass directly into the bloodstream, it is far less efficient than smoking. When swallowed, drugs pass through the stomach, intestine, and liver before entering the bloodstream, so they act slowly. This is especially true of the main active ingredient in marijuana. Because THC is barely soluble in water, the body absorbs only a small fraction of the available drug when it is swallowed.

The FDA has approved Marinol for the treatment of nausea and vomiting associated with cancer chemotherapy and also to counteract weight loss in AIDS patients. Currently classified with controlled substances such as anabolic steroids, Marinol was moved from a more restrictive category, which included cocaine and morphine, in July 1999.

The same is true of Marinol, which is simply THC in capsule form. Marijuana smoke, on the other hand, efficiently delivers THC into the bloodstream via the lungs. Inhaled THC takes effect quickly, allowing patients to use just enough to relieve their symptoms; it is not so easy to fine-tune the dose of oral medications. For this reason, pharmaceutical firms are investigating the use of smokeless inhalers and nasal sprays to deliver THC and possibly other cannabinoids.

Our brains contain receptors that interact with the anandamide we produce. In an accident of nature and chemistry, compounds in the pot are shaped similarly and therefore trigger similar but more potent effects. The same is true of the plant drugs nicotine and cocaine.

“We’re opening doors now we couldn’t even have predicted existed,” said Childers, president of the International Cannabinoid Research Society.

scientists at the Neurosciences Institute in San Diego showed that cannabinoids block the formation of new memories in slices of animal brain tissues. This power to forget might keep the brain from filling up or getting overwhelmed with unimportant memories. Cannabinoid research in animals already has scientists considering drugs that might be quite powerful in exploiting an untapped chemical system within the brain to solve an array of medical problems.

Cannabinoids enhance morphine’s power; combining the drugs could vastly reduce the dosages needed to kill pain, offsetting problems of addiction and drug tolerance. Cannabinoids also counteract nausea, another plus for patients with cancer and AIDS.

“Based on much evidence, from patients and doctors alike, on the superior effectiveness and safety of whole cannabis (marijuana) compared to other medicines for many patients — suffering from nausea associated with chemotherapy, the wasting syndrome of AIDS, and the symptoms of other illnesses … we hereby petition the Executive Branch and the Congress to facilitate and expedite the research necessary to determine whether this substance should be licensed for medical use by seriously ill persons.”

— American Academy of Family Physicians

Scenario in India

As of 2000, per the UNODC the “prevalence of usage” of cannabis in India was 3.2%. A 2019 study conducted by the All India Institutes of Medical Sciences reported that about 7.2 million Indians had consumed cannabis within the past year. The Ministry of Social Justice and Empowerment’s “Magnitude of Substance Use in India 2019” survey found that 2.83% of Indians aged 10-75 years (or 31 million people) were current users of cannabis products.

In July 2019, the Delhi High Court agreed to hear a petition, filed by the Great Legalisation Movement Trust, challenging the ban on cannabis. The public interest litigation argues that grouping cannabis with other chemical drugs under the NDPS Act is “arbitrary, unscientific and unreasonable”

As bhang, cannabis is still popular in India.

Cultivation of cannabis for industrial purposes such as making industrial hemp or for horticultural use is legal in India. The National Policy on Narcotic Drugs and Psychotropic Substances recognizes cannabis as a source of biomass, fiber, and high-value oil. The Government of India encourages research and cultivation of cannabis with low THC content

The Central Council For Research in Ayurvedic Sciences (CCRAS), a research body under the Ministry of AYUSH, announced the results of the first clinical study in India on the use of cannabis as a restorative drug for cancer patients on 25 November 2018. The pilot study was conducted in collaboration with the Gujarat Ayurved University, Jamnagar on cancer patients undergoing treatment at the Tata Memorial Hospital in Mumbai. CCRAS Director General Vaidya K.S. Dhiman stated, “In the pilot study conducted earlier this year, cannabis leaves-based drugs have been found effective in alleviating pain and other symptoms in cancer patients post- chemo and radiotherapy.”

Bombay Hemp Company (BOHECO) co-founded by Mr. Jahan Peston James collaborated with CSIR and hosted a conference to promote the use of cannabis-based medicines in Delhi on 23 November 2018. The conference, called “Cannabis R&D in India: A Scientific, Medical and Legal Perspective”, was attended by Minister of State for PMO Jitendra Singh and MP Dharamvir Gandhi. On the same day, the Indian Institute of Integrative Medicine (IIIM) of the CSIR announced that it was developing three cannabis-based medicines to treat cancer, epilepsy, and sickle-cell anemia.

The first medical cannabis clinic in India was opened in Koramangala, Bangalore on 1 February 2020.The clinic, operated by Odisha-based HempCann Solutions, sells cannabis infused tablets and oils under the brand name Vedi Herbals.

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