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De Jong, Prentiss, McFarland, Machekano & Israelski (2005) note in one study that medicinal marijuana use may be particularly useful in patients suffering from HIV with moderate to severe nausea. There study points out that adherence to antiretroviral therapy (ART) is an essential and critical component for successful treatment of HIV infections. Further a recent study conducted by the researchers suggest that smoking marijuana improves adherence to ART, and thus leads to more successful treatment of HIV infections in patients (De Jong, et. a, 44).
The relationship that existed in this study was confirmed using a multivariate analyses controlling "for the interactions between nausea and marijuana use" in which "other illicit drug use remained a factor related to nonadherence" (De Jong, et. al, 44). This study confirms the notion that medicinal cannabis may be beneficial where other therapies or drugs have not. However to demonstrate further benefits or a more causal relationship the researchers do acknowledge that longitudinal and controlled studies would be required.
In another study conducted by Wade, Makela, Robson, House & Bateman (2004) the effects of medicinal extracts of cannabis are examined on specific symptoms associated with the disease multiple sclerosis. The double blind, randomized, placebo-controlled study of patients showed that use of medicinal cannabis reduce spasticity among patients and other troublesome symptoms including fatigue and patients self-assessment of their disability (435). The side effects patients experienced during the study were generally considered mild, with only minimal adverse effects on cognition and mood noted.
The results of studies related to medicinal use of marijuana and chronic pain are perhaps the most promising, because chronic pain historically has been so difficult to treat. Berman, Symonds & Birch (2005) conducted a randomized study with the objective of investigating the effectiveness of cannabis-based medicines for the treatment of chronic pain, particularly that associated with brachial plexus root avulsion. The researchers claim that this type of pain is an "excellent human model of central neuropathic pain" because with regard to anatomical location, it represents a "homogenous group" (Berman, Symonds & Birch, 300).
The results of their study show that cannabis is relatively well tolerated among all patients experiencing pain with only minimal adverse side effects, including "intoxication type reactions" which typically "resolved spontaneously" (Berman, Symonds & Birch, 301). Further the study suggests that quality of life assessments from patients improved, which is a difficult achievement when dealing with chronic pain candidates.
Smith (2004) conducted a study to determine the potential use of medicinal extracts of cannabis specifically to help relieve pain and spasticity in patients suffering from multiple sclerosis. Whereas previous to 2002 there had been relatively few studies supporting cannabis extract for medicinal purposes, since then there has been a large number of studies including this one that support the use of cannabis for treatment of pain and pain related disorders. The results of Smith's 2004 study suggest that the "endogenous cannabinoid system" may help regulate spasticity and pain in multiple sclerosis patients, and is thus worthy of further exploration.
Disadvantages Medical Marijuana
Despite the numerous reported advantages of medicinal cannabis, there have also been a number of studies which have focused on the disadvantages. A majority of these studies have focused on the adverse effects associated with cannabis use, including impaired cognitive functioning in some cases. Additionally, many of the disadvantages associated with cannabis use focus on the fact that medical marijuana may not help all medical conditions and situations where standard medications may be the treatment of choice, and there is not enough research on many if not most medical applications of cannainoids in order for scientists to draw firm conclusions regarding its efficacy (Earleywine, 167).
Many believe that allowing marijuana for medicinal purposes sends a message particularly to young people and children that marijuana is acceptable to use and may even provide positive benefits (O'Brien, 11). There is in fact a large movement of citizens and parents as well as community representatives that claim the disadvantages of marijuana are all minimal with the exception of the potential negative effect acceptance of the drug may have on young people (O'Brien, 11). Because marijuana can so easily be produced and distributed, there is a real risk that it will become more readily available to young people that are not well equipped to judge appropriate use of the drug. Withdrawal, dependency and toxicity issues are much more likely to be severe among this population than the population at large. Many opponents of medicinal cannabis argue that it would be far to difficult to establish adequate safety measures to ensure that children were not overly exposed to cannabis if it were to be legalized for any purpose (O'Brien, 11).
One of the disadvantages or risks associated with medicinal use of marijuana include the relatively few empirical studies that have been conducted of the drug. There have been a number of studies that show that medicinal cannabis may provide some benefits, but few of these have examined the long-term and long reaching effects of use, including the number of individuals that are likely to develop dependency issues after long-term treatment with cannabis (O'Brien, 11).
In one study conducted on the use of cannabis in the UK, subjects reported that medicinal marijuana was more likely to be used for patients suffering from chronic pain, multiple sclerosis and depression (Ware, Adams & Guy, 292). All three of these conditions have historically been difficult to treat effectively, particularly chronic pain and multiple sclerosis, which for many have no cure (Ware, Adams & Guy, 292). However even this study is limited, with the authors concluding simply that medicinal cannabis use is more likely among people that are male and younger; they further suggest that caution "must be exercised in interpreting data" and point out that further clinical studies are a necessity particularly with standardized and quality controlled products (Ware, Adams & Guy, 292).
As with any drug, standardization is a key element that will determine the drugs efficacy and safety in the long-term. This may be problematic in the case of medicinal marijuana, unless a huge investment is made in long-term clinical studies of cannabis and cannabinoids (Ware, Adams & Guy, 294).
Still other studies suggest that medicinal marijuana studies, particularly those of the nervous system, show no convincing evidence of the effectiveness of the drug (Renckens, 380). It is important to note however that though this is a disadvantage, it is one that is seen in many different medications. Many medications are touted for their effectiveness when in reality they may only be effective in treating a certain percentage of the population with a specific disorder. Every person is unique, as is there body chemistry, thus the manner in which one person reacts to a drug is not the same as the way in which another will. This can also disadvantage medicinal marijuana seekers, as it would be extremely difficult to regulate and perhaps standardize the effects of the drug.
There are some studies that have pointed out that marijuana has potentially psychosis inducing effects on some patients (Leweke, Gerth & Klosterkotter, 895). Specifically in patients with a predisposition toward certain mental conditions, use of cannabis may result in longer lasting or persistent schizophrenia like disorders (Leweke, Gerth & Klosterkotter, 895). Admittedly researchers investigating this phenomena point out that cannabis has been used since the dawn of tie for medicinal and recreational as well as religious purposes; however they also note that there have been several reports of adverse effects that result from or are associated with consumption of cannabis including psychotic episodes, that might be short or longer term lasting (Leweke, Gerth & Krosterkotter, 895).
More research is needed to determine what strategies might be used to combat these negative side effects. At this time adequate case management strategies have not yet bee adopted, as a better understanding of the psychological effects of cannabis must be examined.
Walsh, De Gier, Christopherson & Verstraete (2004) suggest that introduction of medicinal marijuana increases the risks of not only toxicity in the long-term but also increases the risks of patients using drugs and driving, thus potentially harming innocent victims. Their studies suggest that laws need to be established that specifically hinder drugged drivers before medicinal marijuana can be legalized, because the drug affects drivers behaviors, analytical techniques and general demeanor (Wash, et. al, 242). The researchers like many others suggest that simply too few studies have been conducted of the long-term studies in order to support use of marijuana for medicinal purposes, particularly because the risks of this drug with regard to traffic safety may be too high.
As with any narcotic substance, there is the risk of dependency and withdrawal symptoms with use of cannabis (Bursetin, Karst, Schneider & Zurier, 1515). While the psychotropic effects of medicinal use are typically reported as much less severe than unregulated use, many patients still report some adverse effects.
There are relatively few empirical analyses available at this time that have…[continue]
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