Medical Marijuana, A Doctor’s Assessment

Marijuana is one of the most commonly used drugs in the United States. Marijuana’s use and effect on our society are enormous. Many states have legalized marijuana for medical purposes, and a few have legalized its use for recreation. This has created a dilemma for many people in what to do regarding marijuana. Should we as Christians be in favor of medical marijuana in its crude form, and should we be in favor of recreational marijuana?

Marijuana refers to the dried leaves, flowers, stems, and seeds from the hemp plant Cannabis sativa, which contains the psychoactive (mind-altering) chemical delta-9-tetrahydrocannabinol (THC), as well as other related compounds. Marijuana plants have hundreds of chemicals known as cannabinoids. The two main chemicals are THC and CBD. This plant material also can be concentrated in a resin called hashish or a sticky black liquid called hash oil.

THC gives some of the pleasurable effects, but many today say it may also have some medicinal use.

CBD doesn’t give pleasurable effects, but again there is the question if it has any medicinal benefit.

Marijuana, in its crude form, is usually smoked. When an individual smokes marijuana, the effect is almost immediate. Eating marijuana takes about one hour before the effect is felt. When THC is smoked, it first enters the lungs, and then it quickly enters the bloodstream into the brain, where it causes the increase of the concentration of one of the brain’s neurotransmitters called dopamine. The elevated concentration of dopamine results in the pleasurable feelings or the “high” people report from using marijuana.

THC acts on specific molecular targets on brain cells, called cannabinoid receptors. These receptors are ordinarily activated by chemicals similar to THC that naturally occur in the body (such as anandamide) and are a part of a neural communication network called the endocannabinoid system. This system plays an important role in normal brain development and function.

The argument for medical marijuana:

The following list describes the main reasons to legalize marijuana for medicinal purposes:

1. It will ease the pain.

2. It will decrease nausea.

3. It will increase appetite for those with diseases that cause anorexia. (HIV) (Rx Marinol or Dronabinol already available)

4. It may decrease seizure activity. (Rx Epidolex pending approval)

5. It may decrease some symptoms associated with Multiple Sclerosis (MS).

6. Sativex, an oral mouth spray developed from a blend of two marijuana extracts (one strain high in THC and the other in CBD, which counteracts THC’s psychoactive effect), has already been approved in dozens of countries and is in late stages of approval in the United States.

The state of California was the first state to legalize medical marijuana, and now about 50% of states have legalized marijuana for medicinal purposes.

When most people think of medical marijuana these days, they don’t think of a pill with an isolated component of marijuana, but rather the smoked, vaporized or edible version of the whole marijuana plant

The negative consequences of marijuana use:

Although there may be some medical benefits with the use of crude marijuana, the side effect profile of crude marijuana is huge, with many of the side effects carrying great debility.

The following is a list of the side effect profile of using marijuana:

1. It decreases short-term memory. This was found on a study that looked at the effect of marijuana on two parts of the brain: nucleus accumbens (NAC) and the amygdale. People that use marijuana have been found to have abnormalities in their working memory, which is fundamental to everything we do. It will affect our memory, our judgments, our decision-making process, how we plan things, and it disrupts our mathematical skills.

2. It can lead to hallucinations, delusions, and paranoia.

3. It can decrease our motivation called amotivation syndrome. This is where an individual is less orientated toward their goals and purposes in life, as well as seems less focused in general.

4. It can lead to anxiety and depression.

5. There is an associated increase in mental illness with those that use marijuana.

6. It can hurt the child within the womb.

7. It can increase suicidal thoughts.

8. Lung damage can occur with the smoking of marijuana. Smoking marijuana is bad for the lungs, heart and blood vessels.

9. Driving while high on marijuana doubles or triples the risk of a car crash. Driving high on marijuana and alcohol is more harmful than driving on either alone.

Rather than isolate active ingredients in the marijuana plant – as we do with the opium plant when we create morphine, for example – many legalization proponents advocate vehemently for smoked (or vaporized) marijuana to be used as medicine. But the science on smoking any drug is clear: smoking – especially highly-potent whole marijuana – is not a proper delivery method, nor do other delivery methods ensure a reliable dose. And while parts of the marijuana plant have medical value, the Institute of Medicine (IOM) said in its landmark 1999 report: “Scientific data indicate the potential therapeutic value of cannabinoid drugs…smoked marijuana, however, is a crude THC delivery system that also delivers harmful substances…and should not be generally recommended…”

A more recent IOM report from 2017 concluded that there was insufficient evidence for marijuana as a medicine as it pertained to dementia, glaucoma, chronic pain-associated depression, cancer, irritable bowel syndrome, amyotrophic lateral sclerosis, epilepsy, and chorea. There was evidence of derivatives of marijuana to be used for nausea, multiple sclerosis, and chronic pain, but the IOM did not recommend smoking marijuana for these conditions.

It is the conclusion of almost every review of the science that smoked, crude marijuana is not a medicine, even though its isolated components have shown promise medically. Smoking is not a proper delivery method, and it delivers harmful substances to the body.

Science has proven – and all major scientific and medical organizations agree – that marijuana is both addictive and harmful to the human brain, especially when used as an adolescent. One in every six 16-year-olds (and one in every 11 adults) who tries marijuana will become addicted to it. More young people are in treatment for marijuana abuse or dependence than for the use of alcohol and all other drugs. States with medical marijuana laws also show much higher than average marijuana use by adolescents, and lower perceptions of risk from use, than non-medical marijuana states.

Marijuana may contain medical components like opium does. But we don’t smoke opium to get the effects of morphine. We don’t need to smoke marijuana to get its potential medical benefit.

It is not hard to see the tremendous negative health consequences associated with crude marijuana use versus the possible benefit it may have.

American Cancer Society (ACS) – “The ACS is supportive of more research into the benefits of cannabinoids. Better and more effective treatments are needed to overcome the side effects of cancer and its treatment. The ACS does not advocate the use of inhaled marijuana or the legalization of marijuana.

American Society of Addiction Medicine (ASAM) – “ASAM asserts that cannabis, cannabis-based products, and cannabis delivery devices should be subject to the same standards that are applicable to other prescription medications and medical devices, and that these products should not be distributed or otherwise provided to patients unless and until such products or devices have received marketing approval from the Food and Drug Administration. ASAM rejects smoking as a means of drug delivery since it is not safe. ASAM rejects a process whereby state and local ballot initiatives or legislative efforts approve medicines because these initiatives are being decided by individuals not qualified to make such decisions.”

Marijuana and opiates:

There are an estimated 115 deaths per day associated with opiate use. That equals 16,000 deaths per year from prescription opiate use alone.

Most people who misused opiates used marijuana first. People that use marijuana are two times more likely to abuse prescription opiates.

Marijuana use, even among adults with moderate to severe pain, was associated with a substantially increased risk of nonmedical prescription opiate use according to The American Journal of Psychiatry 2017.

Conclusion:

Medical marijuana should only be about bringing relief to the sick and dying, and it should be done in a responsible manner that formulates the active components of the drug in a non-smoked form that delivers a defined dose. However, in most states with medical marijuana laws, it has primarily become a license for the state-sanctioned use of a drug by most anyone who desires it.

Developing marijuana-based medications through the FDA process is more likely to ensure that seriously ill patients, who are being supervised by their actual treating physicians, have access to safe and reliable products.

The Bible tells us in Galatians 6:10, “As we have therefore opportunity, let us do good unto all men…” Can we honestly say in our soul and spirit that we are doing good to others by allowing them to partake of crude marijuana that can literally destroy them spiritually, soulically and physically?

The Bible gives us a principle to live by that we are not to be “drunk with wine, wherein is excess…” Ephesians 5:18. I believe this same principle can be said for crude marijuana use. It is a mind and mood-altering drug.

Let all of us strive to have the Spirit control us and that no other person or substance take the place of the Spirit of God in our lives.

General statements:

1. Marijuana should never be smoked.

2. Marijuana should never be used recreationally.

3. Medical marijuana should never be the crude marijuana but the individual components of the marijuana plant that have been isolated, tested and approved by the medical community and used under the supervision of a physician.

4. Marijuana should never be used by an individual with a history of addiction.

Dr. George T. Crabb (D.O., F.A.C.O.I.) is a Board Certified Internal Medicine physician and a Fellow of the American College of Osteopathic Internist. In addition to practicing Internal and Addiction Medicine in Naples, Florida, Dr. Crabb writes medical communications for Reformers Unanimous International. Dr. Crabb’s passion has always been to help others through the liberating truth of Jesus Christ. Jesus said, “I am come that they might have life, and that they might have it more abundantly.” John 10:10