Medical cannabis refers to the use of cannabis and its constituent cannabinoids, such as tetrahydrocannabinol and cannabidiol, as medical therapy to treat disease or alleviate symptoms. The Cannabis plant has a history of medicinal use dating back thousands of years across many cultures. Its usage in modern times is controversial, and in recent years the American Medical Association, the MMA, the American Society of Addiction Medicine, and other medical organizations have issued statements opposing its usage for medicinal purposes. Cannabis has been used to reduce nausea and vomiting in chemotherapy and people with AIDS, and to treat pain and muscle spasticity; its use for other medical applications has been studied, but there is insufficient data for conclusions about safety and efficacy. Short-term use increases minor adverse effects, but does not appear to increase major adverse effects. Medical cannabis has several potential beneficial effects. Cannabinoids can serve as appetite stimulants, antiemetics, antispasmodics, and have some analgesic effects, The National Institute on Drug Abuse states that "Marijuana itself is an unlikely medication candidate for several reasons: it is an unpurified plant containing numerous chemicals with unknown health effects; it is typically consumed by smoking further contributing to potential adverse effects; and its cognitive impairing effects may limit its utility". The Institute of Medicine, run by the United States National Academy of Sciences, conducted a comprehensive study in 1999 assessing the potential health benefits of cannabis and its constituent cannabinoids. The study concluded that smoking cannabis is not to be recommended for the treatment of any disease condition, but that nausea, appetite loss, pain and anxiety can all be mitigated by cannabis. While the study expressed reservations about smoked cannabis due to the health risks associated with smoking, the study team concluded that until another mode of ingestion was perfected providing the same relief as smoked cannabis, there was no alternative. In addition, the study pointed out the inherent difficulty in marketing a non-patentable herb, as pharmaceutical companies will likely make smaller investments in product development if the result is not patentable. The Institute of Medicine stated that there is little future in smoked cannabis as a medically approved medication, while in the report also concluding that for certain patients, such as the terminally ill or those with debilitating symptoms, the long-term risks are not of great concern. Citing "the dangers of cannabis and the lack of clinical research supporting its medicinal value" the American Society of Addiction Medicine in March 2011 issued a white paper recommending a halt on use of marijuana as medication in the U.S., even in states where it had been declared legal. Nausea and vomiting
Medical cannabis is somewhat effective in chemotherapy induced nausea and vomiting Comparative studies have found cannabinoids to be more effective than some conventional antiemetics such as prochlorperazine, promethazine, and metoclopramide in controlling CINV, but there are used less frequently because of side effects including dizziness, dysphoria, and hallucinations. Long-term cannabis use may cause nausea and vomiting, a condition known as cannabinoid hyperemesis syndrome. A 2010 Cochrane review said that cannabinoids were "probably effective" in treating chemotherapy-induced nausea in children, but with a high side effect profile . Less common side effects were "occular problems, orthostatic hypotension, muscle twitching, pruritis, vagueness, hallucinations, lightheadedness and dry mouth". HIV/AIDS
Evidence is lacking for both efficacy and safety of cannabis and cannabinoids in treating patients with HIV/AIDS or for anorexia associated with AIDS; studies as of 2013 suffer from effects of bias, small sample size, and lack of long-term data. Pain...
References: Further reading
, links to websites about medical cannabis.
from the U.S. National Cancer Institute
from Health Canada
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