Marijuana's Medicinal Value, Brain Science, and Legalization

Introduction: Marijuana's Risk Profile and the Case for Regulation

Marijuana is not as lethal to human beings as cigarettes or alcohol. It is much less addictive and is generally consumed in far lesser quantities. It is also not strongly linked to accidents, risky sexual conduct, or violence in the way alcohol is. Critically, no one can die from a marijuana overdose. While a small share of individuals who consume marijuana do develop addiction, this issue can be effectively treated. In medicinal form, marijuana has proven effective in dealing with various acute symptoms, including those associated with wasting diseases, nausea, and vomiting. Marijuana is very commonly used throughout the United States (DPA).

The marijuana sold and used across the nation varies greatly in quality and may contain potentially dangerous levels of adulterants or pesticides. The Drug Policy Alliance (DPA) supports the implementation of a regulatory framework for controlling potency, educating consumers through labeling, and protecting against toxic pesticides or additives. Appropriate regulation could govern the product at every stage — from cultivation to preparation, packaging, and distribution — thereby protecting consumers and reducing accessibility to minors. Marijuana prohibition fails to offer these protections (DPA).

A total of 14 states have implemented regulations permitting marijuana's use as a medicine for treating diseases such as cancer, AIDS, glaucoma, and multiple sclerosis. Although studies focusing on marijuana's likely medicinal applications have been restricted domestically, international scientific research has identified an increasing number of advantages of the substance (DPA). Organizations including the American Nurses Association, American Public Health Association, Leukemia and Lymphoma Society, National Association of People with AIDS, AIDS Action Council, American Academy of HIV Medicine, and Lymphoma Foundation of America have all supported medical marijuana access. Moreover, the American Medical Association, in 2009, adopted a resolution calling on the government to reconsider its marijuana classification in order to facilitate additional research into marijuana's medicinal applications (DPA).

Thesis: The plant marijuana has been considered damaging and even potentially fatal to human beings; however, on the basis of its medicinal advantages and economic value, cannabis displays several positives that outweigh its negatives.

Government Crackdown and Its Unintended Consequences

In Chapter Three of The Botany of Desire, Michael Pollan explains that "most of the marijuana smoked in America was grown in Mexico until the mid-1970s, when the Mexican government, at the behest of the US government, began cracking down on pot smugglers. Soon after, the growers moved their operations indoors and continued to cultivate the plant. By embarking on the War on Drugs, the government only strengthened cannabis, a plant whose intoxicating qualities are so desirable that almost 15 million Americans risk arrest each month by smoking it" (Pollan, p. 130). Pollan further notes: "America jailed more of their citizens than any other country in history, and every three of those were in prison because of their involvement with drugs, nearly fifty thousand of them solely for crimes involving marijuana. In the last years of the 20th century, a series of Supreme Court cases and government actions specifically involving marijuana led to a substantial increase in the power of the government at the expense of the Bill of Rights. As a result of the war against cannabis, Americans are demonstrably less free today" (Pollan, p. 126). The federal government maintains that marijuana must be subject to the same thorough scientific examination and clinical trials applied by the FDA to every other novel medication, a process intended to ensure the highest standards of efficacy and safety (FOCUS).

The American government's marijuana ban had the unintentional effect of ensuring that considerable quantities of cannabis were secretly grown indoors, where they could be cultivated under controlled conditions. This environment allowed growers to steadily increase levels of THC — the psychoactive ingredient in the plant. Owing to indoor growers' intense attention to every need of the plant, Pollan describes these illegal cannabis cultivators as "the best gardeners of my generation." Latin American drug policies modeled on those of the United States have not succeeded in reducing illegal drug supply. Instead, they have resulted in a bloodbath that claimed over 60,000 lives in Mexico alone since 2006 (Newman). Several European nations have adopted public health approaches such as safe injection facilities and medical heroin prescriptions aimed at reducing overdose and HIV/AIDS-related deaths. Both Republican and Democratic states are also lowering inmate populations by offering alternatives to incarceration for minor drug-related offenses (Newman).

THC's Molecular Structure and the Discovery of Cannabinoid Receptors

Dronabinol, or tetrahydrocannabinol (THC), a sweet-smelling terpenoid, is the key psychoactive constituent in cannabis. In 1964, Raphael Mechoulam, Habib Edery, and Yechiel Gaoni isolated it at the Israeli Weizmann Institute. Pure THC is solid and glassy when cold; when warmed, it becomes thick and sticky. It exhibits extremely low water solubility but dissolves well in butane, hexane, and most other organic solvents. As with caffeine and nicotine, THC's apparent function within the cannabis plant is to protect it from pathogens and herbivores (Johansson, Halldin, Agurell, Hollister, & Gillespie). THC also possesses superior UV-B (280–315 nm) absorption properties, which further shields the plant from environmental harm.

In 1988, William Devane and Allyn Howlett used radioimmunoassay methods to characterize the existence of cannabinoid receptors within rats' brains (Herkenham, Lynn, et al.). Two years later, Miles Herkenham and colleagues mapped cannabinoid receptor locations within humans and numerous other mammalian species. Receptors were found to be most densely concentrated in the cerebellum, basal ganglia, and hippocampus, and sparsely located in lower brainstem regions that control lung and heart functioning. As Herkenham and colleagues observed, "high densities of receptors in the forebrain and cerebellum implicate roles for cannabinoids in cognition and movement" (Herkenham, Lynn, et al.).

Billy Martin's 1986 analysis confirmed what several scholars had suspected: marijuana's impacts may be caused by receptor systems or by membrane effects. The membrane-effects hypothesis had seemed more logical because marijuana chemicals, like anesthetics, resided within fatty cells. Although certain factors pointed in that direction, no technology was yet available for researching it adequately. Herkenham and colleagues' findings ultimately revealed that the field had been pursuing the wrong pathway.

Around the same time that brain cannabinoid receptors were localized, Thomas, Martin, and Compton published a paper characterizing the relationship between cannabinoids' behavioral potency and their lipophilic (fat-loving) nature (Thomas, Compton, Martin).

The location of cannabinoid receptors in the brain corresponds directly with marijuana's characteristic effects. Of particular confirmatory value is the fact that receptor sites bind selectively to cannabinoids — or at least to no other drug within the extensive list tested by the study authors (Herkenham). This receptor characterization enabled Matsuda and coworkers to identify a previously cloned but unidentified receptor gene as the endogenous cannabinoid receptor (Matsuda, Lolait, et al.).

Martin and Lichtman subsequently identified convergent lines of evidence suggesting that cannabinoids reduce pain by producing antinociception through several mechanisms at both supraspinal and spinal levels of the central nervous system (Lichtman, Martin).

Conclusion: Medical Legalization and the Science of Marijuana

The idea that cannabis possesses clinical advantages is especially important in supporting the legalization of medical cannabis. The growing body of evidence corroborating cannabis's clinical benefits will likely lead to increasing numbers of people across society recognizing those advantages. This can in turn strengthen societal support for legalization. Drug policies in this area are undergoing swift reform: an increasing number of jurisdictions worldwide — including 23 American states, Canada, the Netherlands, and Israel — are legalizing cannabis for particular patient populations (Sznitman and Bretteville-Jensen). Meanwhile, other countries such as Australia and New Zealand are actively considering similar policy changes. In several other nations, however, legalization of medical cannabis has yet to become a prominent subject in public debate or on the policy agenda.

This analysis also points to a reason underlying marijuana-linked sensory enhancement: a shift of attention from deliberate, decisional consciousness toward open awareness. Although attention and consciousness are often treated as synonymous, consciousness requires more than attention alone — yet it cannot exist without it. Under marijuana's influence, attentional energy appears to migrate toward sensory processes and away from deliberative, decisional cognitive functions. If this occurs, far more energy becomes available for attending to sensory information, resulting in a more vivid and detailed sensory experience (Tart). Taken together, the pharmacological, evolutionary, and policy dimensions explored in this paper suggest that a reassessment of marijuana's legal and medical status is both scientifically warranted and increasingly unavoidable.

Bibliography

DPA. Marijuana and Health. New York: Drug Policy Alliance, n.d.

FOCUS. U.S. Government Position on Cannabis/Marijuana. 2017. Accessed 13 June 2018.

Herkenham, M. "Cannabinoid Receptor Localization in Brain: Relationship to Motor and Reward Systems." In P.W. Kalivas and H.H. Samson (eds.), The Neurobiology of Drug and Alcohol Addiction, Annals of the American Academy of Sciences. 654: 19–32, 1992. p. 19.

Herkenham, M., Lynn, A.B., et al. "Cannabinoid Receptor Localization in Brain." Proceedings of the National Academy of Sciences, 87: 1932–1936, 1990.

Johansson, E., Halldin, M.M., Agurell, S., Hollister, L.E., Gillespie, H.K. "Terminal elimination plasma half-life of delta 1-tetrahydrocannabinol (delta 1-THC) in heavy users of marijuana." European Journal of Clinical Pharmacology 37(3): 273–277. PMID 2558889. 1989.

Lichtman, A.H., Martin, B.R. "Spinal and Supraspinal Components of Cannabinoid-Induced Antinociception." Journal of Pharmacology and Experimental Therapeutics. 258: 517–523. 1991.

Martin, B.R. "Cellular Effects of Cannabinoids." Pharmacological Reviews 38: 45–74. p. 46. 1986.

Matsuda, L., Lolait, S., et al. "Structure of a cannabinoid receptor and functional expression of the cloned cDNA." Nature 346: 561–564. 1990.

Newman, Tony. Connecting the Dots: 10 Disastrous Consequences of the Drug War. 01 February 2013. Accessed 13 June 2018.

Pollan, Michael. The Botany of Desire: A Plant's-Eye View of the World. London: Bloomsbury, 2003.

Sznitman, Sharon and Anne Line Bretteville-Jensen. "Public opinion and medical cannabis policies: examining the role of underlying beliefs and national medical cannabis policies." Harm Reduct J. (2015).

Tart, Charles T. "Scientific foundations for the study of Altered States of Consciousness." ATPWeb (1971).

Thomas, B., Compton, D., Martin, N. "Characterization of the Lipophilicity of Natural and Synthetic Analogs of D9-Tetrahydrocannabinol and Its Relationships to Pharmacological Potency." Journal of Pharmacology and Experimental Therapeutics. 255(2): 624–630. 1990.