Proponents of Marijuana legalization premise their agitations on the claims that the components of Marijuana closely resemble endogenous chemicals, making it safe to smoke, and also on the exaggerated claims that Marijuana has medicinal value yet there’s no research that establishes the safety, evidence, and efficacy of Marijuana.
Marijuana is a cannabinoid with over 100 unique phytochemicals. Tetrahydrocannabinol (THC) has been identified as the most psychoactive component. Endocannabinoids are cannabinoids naturally found in the body whereas exogenous cannabinoids are administered into the body from foreign sources. Marijuana is an example of the exogenous sources of cannabinoids. Proponents of Marijuana legalization tend to postulate on its safety from this basic nexus.
Marijuana has a complex chemistry with over 100 unique phytochemicals and comes in three cultivars; Cannabis sativa, Cannabis indica, and Cannabis ruderalis.
This complexity in the chemistry and ethnopharmacology of Cannabis is at the center of its contentiousness as a phytomedicine- the plant’s benefits and contradictory confusions. The different varieties (cultivars) of the Cannabis plant acclimatize to different environmental and climatic conditions and therefore different in proportions of the cannabinoids that can be extracted. The Sativa strain, for example, survives the tropicals and is mentally and creatively stimulating compared to the Indica strain which is relatively calming. The question, therefore, would be, if Marijuana was to be legalized today, which strain would be legalized as the most potent or efficacious?
The potential benefits of Marijuana that have been widely peddled to include its anti-inflammatory, antispasmodic, analgesic, and antiemetic properties and its ability to lower intraocular pressure and therefore its use in glaucoma. These postulations are mostly from retrospective studies since Marijuana has long been classified as a Schedule I drug- drugs with a high potential for abuse which has made it impossible to conduct randomized, double-blind, placebo-controlled studies necessary to access its safety and efficacy. The retrospective studies are however inaccurate because they involve a small number of subjects and the concentrations of the cannabinoids vary. Reports from the subjects used are also bound to be subjective because most of them are proponents with a prejudiced thought.
Marijuana users are also likely to abuse other drugs including heroin, cocaine, and opiates; this role of Marijuana as a gateway drug can be explained by their desire to obtain optimal stimulation of the reward centers of the brain.
Proponents of Marijuana legalization also argue that tobacco which is more hazardous and with a potential to induce dependence is legal yet marijuana which they argue has medicinal value and low propensity to develop dependence is illegal. What they fail to understand is that the hazardous effects of tobacco are not because of the addictive substance nicotine but because of the carcinogens, mutagens, and toxins present in the tobacco smoke.
This, therefore, means that even marijuana smoke would be hazardous, and would similarly be implicated in pulmonary and cardiovascular diseases. And even though less addictive, long-term users of Marijuana are likely to develop dependence and withdrawal symptoms. Dependence on substance abuse refers to the compulsive urge to use a drug and this may lead to tolerance where relatively higher doses are required to elicit similar pharmacological actions. Statistically, about 9% of Marijuana users become dependent, comparatively, about 15% of alcohol users become dependent and up to about 32% of nicotine users become dependent. This invalidates the pedestrian street talk that Marijuana unlike other substances of abuse is less addictive.
Marijuana is a hallucinogen with both auditory and visual hallucinations, with users having a higher risk of developing psychosis. Anecdotal reports from users also show that smoking marijuana exacerbates anxiety, depression and attention disorders. Research also shows that dose-related adverse effects of Smoked Marijuana include a declined cognitive processing, amnesia, and short-term memory, impaired judgment, loss of sustained concentration, impaired visuospatial processing, and increased appetite.
Having a cognitive impairing substance available would be tragic as it would come with heavy societal costs. Slowing down of Cognitive processes is a normal process of aging, can you imagine the societal costs of having a younger portion of our populace simulating the geriatric population because of marijuana-induced decline in cognitive processes- thinking and memory?
Marijuana users are also likely to abuse other drugs including heroin, cocaine, and opiates; this role of Marijuana as a gateway drug can be explained by their desire to obtain optimal stimulation of the reward centers of the brain. Drug addiction is mediated by the dopamine system in the mesolimbic system, long-term use of cannabinoids decrease the reactivity of the dopamine reward centers. To optimally stimulate the reward centers users would need to use other drugs and therefore their vulnerability to abuse other drugs. Increased substance abuse with Marijuana as a gateway drug would not only lead to a zombified generation but would also exacerbate crime and other social evils as users are likely to resort to crime to obtain the drugs and continue rewarding their brain centers.
From scientific data it’s therefore overwhelming that the adverse effects of Marijuana override its speculated health benefits, discourses on legalization of Marijuana should, therefore, be hinged on evidence and especially in this era of evidence-based medicine and Policy on Marijuana use should not be informed by pedestrian street talk, if anything those who shout that Marijuana should be legalized for its medicinal value don’t intend to use it for its medicinal purposes.
If future or the ongoing researches are going to confirm the safety and efficacy of Marijuana then the individual phytochemicals should be extracted and formulated as conventional drugs. Safe doses should be established and the products should be regulated as narcotics and psychotropic. Currently, there are efficacious drugs for emesis and pain where Marijuana is mostly thought to have benefits, legalization of Marijuana for analgesia and anti-emesis is therefore not a fierce urgency of today.
Politicians should stop with the populist approach towards this discourse and should rely more on scientific research and clinical data. Healthcare professionals, caregivers, and researchers must remain candid with the public and tell the public that the scientific knowledge regarding safety and efficacy of Marijuana remains limited.
David Jesse is a Kenyan Pharmacist.