• Petra Krilić

Understanding the misunderstood: Marihuana as medicine

Updated: Nov 25, 2020

Source: Lemur Legal

There are not many topics that are able to cause so much powerful emotions and heated debates among doctors, researchers, policy makers and the public than the question whether we should allow the use of marijuana for medical use (i.e. medical marijuana or medical cannabis) as there are still so many questions evolving around this subject – is it safe, is it addictive, how effective it really is, should it be legal?

To start with, medical marijuana denotes the medical use of the Cannabis Sativa or Cannabis Indica plant to treat various diseases, conditions and to relieve different symptoms thereof. One of the most common uses for medical marijuana is for pain control – although the plant is not strong enough for severe pain, it is very soothing for chronic pain. In addition, the drug is also most commonly used to manage weight loss and nausea. Usually medical marijuana products are available with a wide range of THC and CBD concentrations.

Although there are many types of conditions for which medical marijuana can provide relief, experts say it is important to approach this field with caution, especially due to the fact that the research of this area is very limited, meaning that there is still a lot we don’t know.

Medical cannabis is most commonly administered by smoking or in the form of edible preparations, whereas none of these approaches has been standardized in any way, which also means that its effectiveness has not been confirmed in any clinical trial. One of the biggest safety concerns experts have in connection with the usage of medical cannabis is the possibility of medical use to transition into recreational use, which could cause many side effects, such as intoxication, impaired cognition and motor function and elevated heart rate. An additional concern is also that we don’t have enough data about the long-term effect of its use on the human body.

The emergence of interest in medical marijuana and the fact that it is a Schedule I controlled substance also contributes to the very lively debates on whether medical marijuana should be legal. In short, we could say that regulation of cannabis for medical purposes is complex and unique, however the landscape is slowly becoming to change as the number of countries which allow medical cannabis is slowly rising. Such countries have established individual laws and restrictions on the sale of cannabis for medical purposes.

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As already mentioned above, in recent years various countries have introduced specific laws and programs, which allow patients to use cannabis preparations in various forms in in order to help them relieve the symptoms of their diseases.

If we start in Europe, it is only natural that we begin our overview with the country with the longest “tradition” of using the cannabis for both, medical and recreational use. Of course, I am talking about the Netherlands, where patients have been able to get prescriptions for medical marijuana for more than 10 years. Moving from one of the most liberal countries in Europe to a country with one of the strictest drug acts in Europe, Germany, where they passed a law, which allows the medical use of Cannabis sativa only in March 2017. In accordance with the law, the doctors are allowed to prescribe to people with severe diseases mainly dried cannabis flowers or cannabis extracts.

Somewhere in between those two extremes we can find other European countries. Italy first authorized the medical use of cannabis in 2007, however only in 2014 they have adapted their legislation in order to obliterate long and complicated bureaucratic processes which were required to obtain prescription for medical cannabis. In 2013 Czech Republic joined numerous countries in the European Union that have legalized medical cannabis and since then patients can obtain medical cannabis in the pharmacy if they have a prescription from a certified doctor. Romania is another country that legalized medical use of cannabis. They joined the “club” in 2013, however it is good to note that the country allows doctors to prescribe medications with cannabis derivatives under the same regulations that narcotics have, which indicates the strict regulation of the cannabis-related medication. Portugal is another country with relatively liberal drug laws, however medical cannabis became legal only in 2018 - it has to be prescribed by a doctor and dispensed in a pharmacy in order to be legal.

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Over the Atlantic, Canada legalized medical cannabis in 2001, which enabled authorized patients to obtain a license to grow cannabis at home. In 2014 they introduced a new regulation in accordance with which they set up a licensing scheme, which authorizes producers to produce and sell dried and fresh cannabis flowers as well as cannabis oil to patients with appropriate medical documentation.

Looking over the USA, in 1996 California become the first state to permit usage of medical cannabis for medicinal purposes under medical supervision. Several states followed in 1998 (Alaska, Oregon, Washington) and in 2000 Hawaii became the first state to legalize medical cannabis through an act of statute legislature. Overall, as of January 2019 the use of medical cannabis is legal in 33 states, four out of five permanently inhabited U.S. territories and the District of Columbia.

It is evident that more and more countries all over the world are legalizing cannabis for medical use. I would argue that this is mostly due to the fact that the public opinion has swung in favor of medical cannabis, creating more and more pressure on governments to act accordingly. From the brief overview above, we can observe that the first results are already here, however in my opinion there is still a long way to go - not just from legal perspective, but also from medical one as our ultimate goal should be safe usage of medical cannabis for those who need it, while combining “normal” drugs with cannabis in order to provide the best possible care for patients.

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