Medicinal effects cannabis

The very low water solubility of key cannabis constituents aggravates still further the well-known variability of absorption from the gastro-intestinal tract, resulting in poor predictability of both the timing and intensity of peak effects by the oral route. Titration of dose against symptom relief, as is the norm for most individuals who smoke cannabis medicinally, is very difficult in these circumstances. An additional drawback is the production of larger quantities of the reputedly psychoactive metabolite 11-OH-THC as a result of the hepatic first-pass phenomenon. The use of whole plant cannabis-based medicinal extracts in liquid form delivered by a pump action oromucosal spray (Whittle et al. 2001) represents an attempt to overcome these problems and permit the patient to self-titrate to an optimal individualised daily dose. 

The components of marijuana that create both the drug s high and its medicinal effects belong to a family of chemicals called cannabi-noids. Marijuana contains more than sixty different cannabinoids, all found only in the cannabis plant. Furthermore, when marijuana is heated or burned, chemical changes occur that increase the number of cannabinoids and their derivatives. The resulting large number of chemicals interact in complex ways. This is one of the reasons marijuana is so difficult to study. 

Cannabis sativa, one of the oldest plants farmed by man, has been known for its medicinal properties for at least four millennia (Peters, 1999). The psychoactive-euphoric effects of this plant, as well as its facile and wide climatic range of cultivation, have rendered it a very popular recreational drug. Today, cannabis, or marijuana, is still the focus of strong social, legal, and medical controversy over its therapeutic utility. 

Wade. D. T., P. Makela, P. Robson, H. House, and C. Bateman. Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis A double-blind, randomized, placebo-controlled study on 160 patients. Mult Scler 2004 10(4) 434-441. 

Baker, et al. Medicinal cannabis is delta9-tetrahydrocannabinol necessary for all its effects J Pharm Pharmacol CS324 2003 55(12) 1687-1694. 

For thousands of years, cannabis has enjoyed historical significance as a recreational drug, a useful fiber, an oil, an edible seed, and a medicine. It has been used to aid religious practices, alter mood (psychoactive effect), stimulate creativity, treat disease, relieve anxiety and boredom, enhance sensory experience and pleasure, rebel against authority, and go along with peer influence. That is a lot of work for one plant to do. This probably explains why cannabis has always been an important cultivated crop and is currently a cornerstone of controversial debate in all sectors of U.S. and international society. 

Despite society s focus on the marijuana high, cannabis historically has provided many meaningful industrial and medicinal values that are not attributed to its psychoactive effects. Researchers discovered that cannabis crops farmed as far back as 12,000 years ago yielded hemp, a distinct variety of the cannabis plant associated with little or no psychoactivity. The first evidence of the medicinal use of cannabis can be traced to a Chinese health publication from... 

By the early nineteenth century, the medicinal use of cannabis spread from Asia and the Middle East to Europe, and finally to the Americas by the mid 1800s. A Western physician named W.B. O Shaughnessey who was working in Calcutta, India, observed the use of cannabis there. After performing tests on animals, the doctor assured himself that cannabis was safe. He developed a solution of cannabis in alcohol, known as a tincture. When placed in the mouth, this tincture proved an effective analgesic (pain reliever). The doctor was also impressed with its muscle relaxant and... 

The cannabinoids are a class of psychoactive substances contained both in Cannabis and Echinacea plants. The first reliable evidence of the effects of drugs derived from cannabis is a compendium of Chinese medicine (a herbarium), dated 2700 bc today it has become very common in many parts of the world. 

Of 220 patients with multiple sclerosis in Halifax, Canada 72 (36%) reported ever having used cannabis (56). Ever use of cannabis for medicinal purposes was associated with male sex, the use of tobacco, and recreational use of cannabis. Of the 34 medicinal cannabis users, 10 reported mild, eight moderate and one strong adverse effects none reported severe adverse effects. The most common adverse effects were feeling high (n = 24), drowsiness (20), dry mouth (14), paranoia (3), anxiety (3), and palpitation (3). 

Three cannabis-based medicinal extracts in sublingual form recently became available for use against pain. In a randomized, double-blind, placebo-controlled, crossover study for 12 weeks in 34 patients with chronic neuropathic pain THC extracts were effective in symptom control (59). Drowsiness and euphoria/dysphoria were common in the first 2 weeks. Dizziness was less of a problem. Anxiety and panic were infrequent but occurred during the run-in period. Dry mouth was the most common complaint. 

Concerns have been raised about the possible adverse effects of acute as well as chronic medicinal and recreational use of cannabis on cognition and the body (104). The author, while acknowledging the therapeutic role of cannabinoids in the management of pain and other conditions, expressed concern that in recent years the prevalence of recreational cannabis use (especially in the young) and the potency of the available products have markedly increased in the UK. 

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