Marijuana, known scientifically as Cannabis sativa, has been used for its medicinal properties for thousands of years. In recent decades, scientific research has begun to validate many of these traditional applications, opening up new possibilities for the therapeutic use of cannabis in modern medicine.
History of the Medicinal Use of Marijuana
The use of marijuana for medicinal purposes dates back to ancient civilizations. In China, the oldest records date back to 2737 BC, where Emperor Shen Nung mentioned its benefits for the treatment of various diseases such as gout, rheumatism and constipation. In India, cannabis has been used in Ayurvedic medicine for thousands of years to treat a variety of ailments, including pain and nausea.
In the 19th century, cannabis was introduced into Western medicine. In 1839, Irish physician William O'Shaughnessy published a study on the analgesic and anticonvulsant effects of cannabis, leading to its widespread use in Europe and North America. However, with the increasing regulation and eventual prohibition of cannabis in the 20th century, its medical use declined significantly until the recent resurgence of interest in its therapeutic properties.
Active Compounds in Marijuana
Marijuana contains more than 100 chemical compounds known as cannabinoids, the most studied being tetrahydrocannabinol (THC) and cannabidiol (CBD).
Tetrahydrocannabinol (THC)
THC is the main psychoactive compound in cannabis. It is responsible for the feeling of euphoria commonly associated with marijuana use. In addition to its recreational effects, THC has significant medicinal properties. It has been shown to be effective in relieving pain, reducing nausea, stimulating appetite, and reducing muscle spasticity in diseases such as multiple sclerosis.
Cannabidiol (CBD)
CBD, on the other hand, is non-psychoactive and does not produce the euphoric effects of THC. This cannabinoid has gained popularity due to its anxiolytic, anticonvulsant, and anti-inflammatory effects. CBD is used to treat a variety of medical conditions, including epilepsy, anxiety, chronic pain, and inflammatory diseases.
Medicinal Uses of THC and CBD
Chronic pain
One of the most documented uses of medical marijuana is in the treatment of chronic pain. Both THC and CBD have analgesic properties. Studies have shown that cannabinoids may be effective in treating neuropathic pain, pain associated with arthritis, and pain related to cancer. The use of medical marijuana may offer an alternative to opioids, thereby reducing the risk of dependence and serious side effects associated with these drugs.
Epilepsy
CBD has shown particular promise in the treatment of certain types of epilepsy. In 2018, the FDA approved Epidiolex, a CBD-based medication, for the treatment of two rare and severe forms of childhood epilepsy: Dravet syndrome and Lennox-Gastaut syndrome. Clinical trials have shown that CBD can significantly reduce seizure frequency in patients with these conditions.
Anxiety and depression
CBD has also been used to treat anxiety and depression disorders. Preliminary studies suggest that CBD may help reduce symptoms of generalized anxiety, post-traumatic stress disorder (PTSD), and social anxiety. Although more research is needed, CBD could offer an alternative to traditional antidepressant and anti-anxiety medications, which often have undesirable side effects.
Sleep disorders
Medical marijuana may be useful in the treatment of sleep disorders. THC has sedative effects that can help people with insomnia fall asleep. CBD, although not sedative, can improve sleep quality by reducing anxiety and pain that can interfere with a night's rest.
Neurodegenerative diseases
Recent research suggests that cannabinoids may have neuroprotective properties, which could be beneficial in the treatment of neurodegenerative diseases such as Alzheimer's and Parkinson's. Although the evidence is still preliminary, some animal studies have shown that CBD and THC can help reduce inflammation and neuronal damage, as well as improve motor and cognitive symptoms.
Cancer
Medical marijuana is often used to relieve symptoms related to cancer treatment, such as pain, nausea, and loss of appetite. Additionally, laboratory studies have suggested that cannabinoids may have antitumor properties, inhibiting the growth of cancer cells and promoting their death. However, more clinical research is needed to confirm these effects in humans.
Inflammatory and Autoimmune Diseases
CBD has anti-inflammatory properties that make it useful in the treatment of inflammatory and autoimmune diseases such as rheumatoid arthritis, Crohn's disease, and ulcerative colitis. Studies have shown that CBD can reduce inflammation and alleviate symptoms associated with these conditions, improving patients' quality of life.
Eating Disorders
THC is known for its ability to stimulate appetite, which may be beneficial for patients with eating disorders or medical conditions that cause loss of appetite and weight loss, such as HIV/AIDS and certain types of cancer. Increasing appetite and food consumption can help improve the nutrition and overall health of these patients.
Administration Methods
Medical marijuana can be administered in several ways, depending on the patient's medical condition and preferences.
Inhalation
Inhalation through vaporization or smoking allows for rapid absorption of cannabinoids into the bloodstream, providing almost immediate symptom relief. However, smoking marijuana can have negative effects on the lungs, so vaporization is often preferred as it is less harmful.
Ingestion
Marijuana can be consumed in the form of edibles, tinctures or capsules. The effects of ingestion are slower to appear (can take anywhere from 30 minutes to 2 hours), but tend to last longer than inhalation methods. This form is useful for the treatment of chronic conditions that require long-term relief.
Topics
Topical cannabis-based products, such as creams and balms, are applied directly to the skin to relieve localized pain and inflammation. This method does not produce psychoactive effects, since the cannabinoids do not enter the bloodstream in significant quantities.
Sublingual
Sublingual tinctures and oils are administered by placing a few drops under the tongue, where the cannabinoids are quickly absorbed through the mucous membranes. This method provides relatively quick relief without the harmful effects of smoking.
Legal and Ethical Considerations
The medicinal use of marijuana is subject to a variety of regulations and laws that vary significantly between countries and states. In many places, medical marijuana is legal only for certain conditions and with a doctor's prescription. In others, its use remains illegal.
Legalization
Countries such as Canada and several states in the United States have legalized the medicinal use of marijuana, allowing patients to access this therapy under medical supervision. However, elsewhere, laws remain restrictive, limiting patients' access to cannabis treatments.
Ethics
The use of medical marijuana also raises ethical questions. Some argue that marijuana should be available to all patients who can benefit from it, while others express concerns about the potential for abuse and the lack of long-term research into its effects.
Investigation and development
Scientific research on medical marijuana is crucial to better understand its benefits and risks. However, legal restrictions have historically limited research. With growing recognition of its therapeutic potential, it is hoped that more clinical studies will provide robust data that can guide the safe and effective use of marijuana in medicine.
As research advances and laws evolve, we are likely to see an increase in the use of marijuana as a therapeutic tool in medicine. It is essential that doctors and patients are well informed about the possibilities and limitations of this treatment, and that policies are developed to ensure safe and equitable access to medical marijuana.