What's the alternative to medical marijuana?

During the US Democratic presidential candidates debate in Las Vegas this Tuesday, they advocated for legalizing marijuana use so that young "innocent" users would not go to jail and people in need for medical reasons would not have to fight the system to get relief and cure.

While users (mostly "recreational") are not so "innocent", it is fair to admit that the real criminals are the ones selling the drug and inducing others to try it. Cannabis is a very addictive drug with serious long term effects.

As for "medical marijuana" use, advocates promote it to help treat symptoms like pain, nausea, vomiting and lack of appetite. It's often used by people who have conditions like cancer, AIDS, or multiple sclerosis. In fact, advocates have succeeded in more than a dozen states to pass laws that allow people with certain health problems to buy or grow marijuana for their own unrestricted use.

However, serious medical studies don't agree on how safe it is or how well it works. On the other hand, it is proven that marijuana may impair your memory, judgment, and coordination. It can increase your risk of being in a car accident. It will certainly harm your lungs. And it is extremely addictive to the point of developing increasing tolerance that in the long run seriously limits its therapeutic effects.

However, scientists have succeeded in developing non addictive alternatives to Cannabis. They found that its side effects are produced via its actions at cannabinoid CB1 receptors in the brain. Thus, scientists tested an agent with similar mechanistic actions, but one that activate CB2 receptors instead, thus eliminating the unwanted side effects while maintaining an equivalent level of efficacy.

Dr. Andrea Hohmann and her colleagues at Indiana University tested this strategy and found that, unlike the side effects of Cannabis, repeated dosing with the cannabinoid CB2 antagonist AM1710 suppresses chemotherapy-induced pain without producing tolerance, physical withdrawal, motor dysfunction, or hypothermia. Their findings are reported in the March issue of Biological Psychiatry (Volume 77, Issue 5, Pages 475–487).

Furthermore, a San Diego company is already producing and selling a legal and effective alternative to medical marijuana using the chemistry developed in these studies. HempMedPX is creating hemp oil rich in CBD or cannabidiol. Unlike THC in marijuana, CBD does not cause the “high” effect. Rather, recent studies indicate “CBD to be well tolerated and safe”. Therefore, it is being tested to treat children with uncontrolled seizures.

NBC 7, a San Diego TV station, interviewed Dr. Steven Poceta earlier this year, who is a neurologist at Scripps Clinic Torrey Pines and the president-elect of the San Diego County Medical Society. He says some patients with epilepsy are using CBD, and there is some suggestion that the component is highly effective.

Advocates also hail marijuana for pain control. However, a report published in the "British Medical Journal" that reviewed nine trials that compared marijuana with other pain medications found that marijuana was no more effective than codeine in controlling acute, chronic, or cancer pain. Some conditions may respond better to certain pain medications than others and patients should always discuss their use of pain medications with their doctor, because some medications are contraindicated with certain health conditions and because doctors may control dosage effectively with a combination of non-addictive drugs.

It is crystal clear that promoters of marijuana are greedy to make a fortune selling it with practically no risk for their newly "legalized" business. On the other hand, if further studies find proper medical use of substances extracted from the cannabis plant, government regulations should make them available only under doctor's prescription from registered pharmacies. Our society does not need more drug addicts resulting from an ill conceived legalizing policy.

The American Academy of Pediatrics published recently a policy statement that, among other things, advise legislators about the potential impact of changes in the legal status of marijuana:

In Colorado, the passage of the amendment to legalize recreational marijuana occurred in November 2012. Although sales of recreational marijuana did not start in Colorado until January 1, 2014, the postlegalization 2013 rates of youth use increased.4 It is possible that public health campaigns that effectively communicate the harms associated with teen marijuana use could reduce youth use despite legalization. Legalization campaigns that imply that marijuana is a benign substance present a significant challenge for educating the public about its known risks and adverse effects. Therefore, it is unclear what the impact of legalization of marijuana for adults will have on the prevalence of marijuana use by adolescents, especially if the implementation of legalization includes messaging that minimizes the health and behavioral risks.
Substance abuse by adolescents is an ongoing health concern. Marijuana remains classified in the Controlled Substances Act (21 USC §801-971 [2012]) as a schedule I drug. This classification implies that it has a high potential for abuse, has no currently accepted medical use in the United States, and lacks accepted safety for use under supervision by a physician. Despite this classification by the federal government, marijuana has been legalized for medical purposes in a number of states, in direct opposition to federal law.