Karen Shabano Stalin. AIETI Medical School, Lubliana Street, Tbilisi, Georgia

Abstract

Marijuana is an illegal psycho-active drug with about 60 pharmacologically active compounds (cannabinoids).  Popularly known as “weed”, the recreational use of this drug is wide-spread among youngsters and adults globally. There has been a rapid rise in the rate of usage of weed from 10% to about 51% of the population of the US in just 12 years. The drug is known for the variety of psychological and systemic effects it has. There have been studies on how it affects the mental health of those that take it on a regular basis. Short-term effects like hallucination, anxiety, panic attacks change into long-term effects like impaired cognition, decline in IQ, addiction and anti-social behavior. Very surprisingly, Marijuana is also considered a therapeutic drug for various neurological and chronic pain syndromes. This is a practice that began early in the 18th Century when doctors “prescribed” Marijuana to patients. In the present age, this has created so many controversies in the medical as well as the ethical view of the society. Do the medical properties of Marijuana over-shadow its potential addictive/harmful effects? Will it lead to drug-dependence in young patients? What consequence will Marijuana have on mental health of patients, if doctors are allowed to prescribe it? In reality, there is a very thin line between effects and side-effects of this concept. In this presentation I am planning to answer some of these questions with both a medical and an ethical perspective in regards to mental health and drug use.

Introduction

Recreational use of drugs is undoubtedly increasing rapidly in the present world with more than half the users being teenagers and young adults. Among many drugs out there, the most commonly used is Marijuana. Marijuana is notorious for the effects it has on the mood and behavior of the user. This is likely linked with concerns of mental health with its usage. On the other hand, for certain terminal conditions for which other drugs might not be as effective, Marijuana has been proven to help. Case studies with Marijuana have shown success. But the issue of legalizing the drug still remains. In this paper, we research on why Marijuana isn’t legal. And with regards to its medical uses, what it would mean if it was legal and the effects on patient health with usage. Information concluded here are based on past researches listed in the bibliography

Content

Action of Marijuana on the brain

The most significant psychoactive component of Marijuana is Tetrahydrocannabinol (THC). It is able to bind to Cannabinoid receptors CB1 and CB2 and mediate G-protein coupled reactions that lead up to the feeling of being “high”, a sense of well-being. In addition to that other effects on the brain can be as varied as impaired memory, anti-emesis, anti-spastic, increased appetite, sleep-promotion, impaired cognition and IQ with prolonged use.

Mental health concerns in Marijuana use

With most of Marijuana users being teenagers whose brains have not entirely developed yet, the major concern is that the drug affects the IQ and decreases the efficacy of thought and processing. The rates of anxiety and depression have also been shown to increase directly with increased use of Cannabis. There is invariable sedation associated with the use of the drug. In addition there could also be short-term memory loss, perceptual alterations, confused state, disorientation. Marijuana has also been shown to precipitate psychotic episodes in people with pre-existing personality disorders. With chronic use it could result in an “amotivational syndrome”, learning disabilities, cognitive impairment, personality changes among many others.

How Medical Marijuana came about

Earliest records of using Marijuana for medical purposes dates back to 2000 B.C when herbs of many kinds were used to treat diseases. While some societies still continue to do it, till date, the conditions that Cannabis can treat is numerous! But doctors generally do not prescribe it now-a-days due to the growth in Pharmacology that we have experienced. So, unless the person has exhausted all other options or is unable to take some other medication indicated, Marijuana is the “last resort”. A set of boxes need to be checked off because of legal restrictions that prevent prescription usage in this age as we will see later. Despite that, Cannabis has been used with success in Chronic neuropathic pain, as an anti-emetic, appetite-stimulant, in seizure disorders, cancer syndromes, Parkinson’s Tourette’s, Autism and many others.

Scheduling of Marijuana

Marijuana, as mentioned above, is a drug that is completely illegal in any form of usage under the US government. It is classified as a Schedule I drug, placing it in the same class as Heroin and LSD. Schedule I translates to increased potential for abuse and no accepted use. Other drugs like Morphine and Codeine fall into Schedule II which means it is accepted for medical use but still has a high potential for abuse. This classification has led to a lot of debate on whether Marijuana really does belong in the category or not, especially considering the fact that health risks with Marijuana are significantly lower, if not non-existent compared to other drug of the same class.

Legalization of Marijuana

Many uprisings around the country and around the world wanting to legalize/ “decriminalize” the use of Marijuana has emerged in the recent times. With regards to the above-mentioned reasons, legalization would mean less-strict rules and easy access to researchers, so that more studies could be conducted and more about this drug will be apparent. Legalization would also likely permit prescription so that other highly-harmful prescription medications can be replaced with Marijuana. This will significantly reduce the tolerance seen with many of these drugs making it easier to treat difficult cases.

Against legalization of Marijuana

As is the case, people speaking against the legalization of Marijuana also have their own good reasons which are just as acceptable. Legalization might mean increase in crime rate and apparently increase in abuse rate as well. Increased numbers of teenagers would be using the drug on a regular basis. Known as a “gateway drug” to many hard-drugs that are highly lethal, Marijuana poses a problem of raising the abuse potential of those drugs as well. As it is easier to overdose on hard-drugs and not on Marijuana, this is also a cause for concern.

Role of the government

The role of the government in this issue is more than one would expect to find. In many papers these flaws have been pointed out, but here, it suffices to say that issues other than the “medical” ones have a huge part in this debate. One thing that becomes clear is that immediate legalization or declaration for suspension of all medical usage is not possible for reasons that are beyond the scope of this paper. There are currently 22 states that have “decriminalized” Marijuana and accepted its medical use, if appropriate documents and proof of needing the drug can be provided. The number is only expected to rise but all of that depends on how much the benefits out-weigh the risks.

Conclusion

Medical use of Marijuana is a widely debated topic and the fact that it lacks much research-backed proof is quite disappointing. With some people wanting it legalized and some not wanting it legalized, the reasons on both the sides are too many to name. As much as Marijuana is a useful alternative medically, the mental health risks can’t be over-looked. At the same time, patients can’t be put-off of effective treatment that has the potential to make them better with lesser compromises, solely because it is not allowed by law in a  certain place to prescribe it. This is a matter of deep thought and concern as it stands, only time can provide the answer.

Bibliography

  • Legalization of Medical Marijuana and Incidence of Opioid Mortality. (n.d.). Retrieved from https://www.researchgate.net/profile/Marie_Hayes2/publication/265049022_legalization_of_medical_marijuana_and_opioid_mortality/links/545292df0cf2bccc490948c6.pdf
  • Marijuana: federal smoke clears, a little. (n.d.). Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.175.4080&rep=rep1&type=pdf
  • (n.d.). Retrieved from Clinical Perspectives on the Toxicity of Marijuana: 1967-1981