THC Essay, Research Paper

THC (Cannabis) Between 1840 and

1900, European and American medical journals

published more than 100 articles on the

therapeutic use of the drug known then as

Cannabis indica (or Indian hemp) and now as

marijuana. It was recommended as an appetite

stimulant, muscle relaxant, analgesic, hypnotic, and

anticonvulsant. As late as 1913 Sir William Osler

recommended it as the most satisfactory remedy

for migraine headaches . Today the 5000-year

medical history of cannabis has been almost

forgotten. Its use declined in the early 20th century

because the potency of oral ingestion was high,

and alternatives became available — injectable

opiates and, synthetic drugs such as aspirin and

barbiturates. In the United States the Marijuana

Tax Act of 1937 was passed. It was designed to

prevent non medical use. This law made cannabis

so difficult to obtain for medical purposes that it

was removed from the pharmacopoeia. It is now

confined to Schedule I under the Controlled

Substances Act as a drug that has a high potential

for abuse, lacks an accepted medical use, and is

unsafe for use under medical supervision. In 1972

the National Organization for the Reform of

Marijuana Laws petitioned the Bureau of

Narcotics and Dangerous Drugs, later renamed

the Drug Enforcement Administration (DEA), to

transfer marijuana to Schedule II so that it could

be legally prescribed. As the proceedings

continued, other parties joined, including the

Physicians Association for AIDS Care. It was in

1986, after many years of legal maneuvering, that

the DEA acceded to the demand for the public

hearings required by law. During the hearings,

which lasted 2 years, many patients and physicians

testified, and thousands of pages of documentation

were introduced. In 1988 the DEA’s own

administrative law judge, Francis L. Young,

declared that marijuana in its natural form fulfilled

the legal requirement of currently accepted

medical use in treatment in the United States. He

added that it was "one of the safest therapeutically

active substances known to man." His order that

the marijuana plant be transferred to Schedule II

was overruled, not by any medical authority, but

by the DEA itself, which issued a final rejection of

all pleas for reclassification in March 1992.

Meanwhile, a few patients have been able to

obtain marijuana legally for therapeutic purposes.

Since 1978, legislation permitting patients with

certain disorders to use marijuana with a

physician’s approval has been enacted in 36

states. Although federal regulations and

procedures made the laws difficult to enact, 10

states eventually established formal marijuana

research programs to seek FDA approval for

Investigational New Drug (IND) applications.

These programs were later abandoned, mainly

because the bureaucratic burden on physicians

and patients became intolerable. Growing demand

also forced the FDA to Institute an Individual

Treatment IND for the use of physicians whose

patients needed marijuana because no other drug

would produce the same therapeutic effect. The

application process was made complicated, and

most physicians did not want to become involved,

especially since many believed there was some

disgrace on prescribing cannabis. Between 1976

and 1988 the government reluctantly awarded

about a half dozen Compassionate INDs for the

use of marijuana. In 1989 the FDA was

overwhelmed with new applications from people

with AIDS, and the number granted rose to 34

within a year. In June 1991, the Public Health

Service announced that the program would be

suspended because it undercut the administration’s

opposition to the use of illegal drugs. After that no

new Compassionate INDs were granted, and the

program was discontinued in March 1992. Eight

patients are still receiving marijuana under the

original program; for everyone else it is officially a

forbidden medicine. Many people know that

marijuana is now being used illegally for the nausea

and vomiting induced by chemotherapy. Some

know that it lowers intraocular pressure in

glaucoma. Patients have found it useful as a muscle

relaxant in spastic disorders, and as an appetite

stimulant in the wasting syndrome of HIV

infection. It is also being used to relieve phantom

limb pain, menstrual cramps, and other types of

chronic pain, including (as Osler might have

predicted) migraine. Polls and voter referenda

have repeatedly indicated that the vast majority of

Americans think marijuana should be medically

available. One of marijuana’s greatest advantages

as a medicine is its safety. It has little effect on

major physiological functions. There is no known

case of a lethal overdose; on the basis of animal

models, the ratio of lethal to effective dose is

estimated as 40,000 to 1. By comparison, the

ratio is between 3 and 50 to 1 for barbiturates and

between 4 and 10 to 1 for ethanol. Marijuana is

also far less addictive and far less subject to abuse

than many drugs now used as muscle relaxants,

hypnotics, and chronic pain relievers. The chief

legitimate concern is the effect of smoking on the

lungs. Cannabis smoke carries even more tars and

other particulate matter than tobacco smoke. But

the amount smoked is much less, especially in

medical use, and once marijuana is an openly

recognized medicine, solutions may be found.

Water pipes are a partial answer; ultimately a

technology for the inhalation of cannabinoid

vapors could be developed. Even If smoking

continued, legal availability would make it easier to

take precautions against aspergilli and other

pathogens. Right now, the greatest danger in

medical use of marijuana is its illegality, which

imposes much anxiety and expense on suffering

people, forces them to bargain with illicit drug

dealers, and exposes them to the threat of criminal

prosecution. The main active substance in

cannabis, tetrahydrocannabinol (THC), has been

available for limited purposes as a Schedule II

synthetic drug since 1985. This medicine,

dronabinol (Marinol), taken orally in capsule form,

is sometimes said to prevent the need for

medicinal marijuana. Patients and physicians who

have tried both disagree. The dosage and duration

of action of marijuana are easier to control, and

other cannabinoids in the marijuana plant may

modify the action of THC. The development of

cannabinoids in pure form should certainly be

encouraged, but the time and resources required

are great and at present unavailable. In these

circumstances, further isolation, testing, and

development of individual cannabinoids should not

be considered a substitute for meeting the

immediate needs of suffering people. Although it is

often objected that the medical usefulness of

marijuana has not been demonstrated by

controlled studies, several informal experiments

involving large numbers of subjects suggest an

advantage for marijuana over oral THC and other

medicines. For example, from 1978 through 1986

the state research program in New Mexico

provided marijuana or synthetic THC to about

250 cancer patients receiving chemotherapy after

conventional medications failed to control their

nausea and vomiting. A physician who worked

with the program testified at a DEA hearing that

for these patients marijuana was clearly worked

better than both chlorpromazine and synthetic

THC.