Medical marijuana is helping some patients to find relief from pain, nausea, loss of appetite, and neurological spasms. Because of its’ reported benefit to certain patients with cancer, AIDS, medical sclerosis, glaucoma, and other chronic conditions, medical marijuana is slowly gaining acceptance in the community. Since 1998, sixteen states and DC have enacted legislation to legalize the medical use of marijuana.
It is not without risk. Most states have not yet chosen to legalize cannabis for medical use. A look at the long term health considerations may shed light on the controversy.
Cannabis and Cancer
A PBS documentary recently discussed the work of Dr. Prakash Nagarkatti, who has had some success killing cancer cells in a test tube, using cannabis synthesized in the lab. In addition, recent research in Spain suggests that THC found in marijuana was an active agent in killing brain cancer cells, while sparing cells that did not have cancer. This all appears to be promising news. However, THC is also strongly linked to respiratory cancers, and cancers of the head and neck! Figures vary somewhat, but studies show that around 5 joints a day irritate the lungs to the same degree as a full pack of cigarettes. It is well established that chronic lung irritation leads to many types of respiratory distress and illness, including bronchitis and cancer.
Marijuana is especially irritating to the throat and lungs, because it is deeply inhaled. Marijuana, like cigarettes, contains tar and even many more carcinogens. None of the carcinogens are filtered when smoking marijuana. This is likely the reason that smoking marijuana is associated with cancer of the pharynx and larynx. It is likely associated with lung cancer also, especially in long term users and those who smoke both tobacco and marijuana.
In addition to cancers of the head and neck and some cases of lung cancer, marijuana has been linked to certain reproductive cancers in both sexes. These include cancers of the prostrate and cervix. Numerous studies, such as one performed at the Fred Hutchinson Cancer Research Center, provide convincing evidence that marijuana may trigger an aggressive form of testicular cancer known as nonseminoma testicular cancer.
Testicular cancer is primarily diagnosed in young men in their twenties. Young men who were regular marijuana smokers before the age of 18 have almost double the risk! It is believed that marijuana has an influence on the hormone testosterone.
This would be suggested in part by the observation that adolescent male marijuana smokers may develop enlarged breasts. Smoking marijuana also is linked to inadequate sperm and impotence in habitual users. There appears to be a synergistic interplay between the hormones of puberty, marijuana smoking, and the development of testicular cancer. Even when other potential risk factors are controlled, young men who smoke marijuana have an exponential risk.
Cannabis and Immune System
Besides the irritating effect of marijuana smoke on the airways, respiratory illness may also be increased because of depressed immunity. Some studies have suggested that the T cell function is compromised in the lungs of marijuana smokers. Physicians and medical centers treat coughs and bronchitis in many patients who smoke medical marijuana.
At least one study also showed that medical marijuana may interfere with the maturation of monocytes, a subtype of white blood cells. White blood cells are what the body uses to launch an attack against aggressive viruses and bacteria which cause various illnesses. The degree of immunosuppression caused by medical marijuana is controversial. However the significance may lie in the fact that any degree of immunity suppression may be especially harmful in a sick patient who cannot fight off infection normally.
Some users of medical marijuana certainly fall into this category, such as patients with AIDS. Multiple sclerosis has been linked to the Epstein Barr virus, and even some cancers may be discovered to have a viral link.
Cannabis and the Heart
Researchers have learned that the heart responds very quickly to cannabis use. The pulse increases and blood pressure drops almost immediately after use. These side effects have caused researchers to conclude that medical marijuana elevates heart attack risk.
There are many risk factors associated with the occurrence of heart attack, and the effects of medical marijuana would be an added risk. Certainly this would be of more significance in a patient who has multiple prior risk factors for heart disease.
Cannabis and the Mind
The effects of mental relaxation make medical marijuana useful in pain management. Indeed, pain management is one of the most common uses of cannabis.
There are other intriguing studies and anecdotal testimonials which indicate that medical marijuana may have positive mental effects in certain persons. A few parents are claiming that medical marijuana has made a world of difference in their autistic children, primarily due to its’ calming effect on an excitable brain. There is even a study at the Snipps Research Institute which suggests marijuana may discourage the formation of Alzheimer plaques.
Casual users of marijuana are well aware of its’ effects on the mind. It is called “dope” on the streets because it appears to generally slow cognitive processes. There have been a few studies that suggest IQ is compromised in young , habitual smokers of marijuana.
However, marijuana can also trigger the altered mental states of paranoia, delusions, and hallucinations. Some patients who have terminal illness may perceive this to be more detrimental than the symptoms being treated by medical marijuana. It can be presumed that many such patients nearing the end of life would want to have a clear mind to experience it.
The altered mental states associated with marijuana may also put severely debilitated patients receiving it at significantly elevated risk for an accident. Medical marijuana is reported second only to alcohol found in the bloodstream after an accident. It is easy to see the dangers of driving a car, or even taking a bath while under the influence of delusions or hallucinations.
Hanging in the Balance
Medical marijuana remains engaged in a heated battle for widespread acceptance in the community. That’s because it’s complicated! Research is really in its’ infancy, and results are sometimes contradictory.
Doctors prescribing medical marijuana, and patients considering using it, must weigh the individual’s medical condition, degree of suffering, and availability of alternative treatments, against identifiable risks. They must also stay abreast of ongoing research.
One thing is certain. Medical marijuana is not an inert substance. It is a complex pharmaceutical containing over 300 substances! Much further research is needed into the long term and synergistic effects of these chemicals on the human body.
“Clearing the Smoke,” PBS Documentary; Western Journal of Medicine; Cancer Journal; Merck Manual; Health Day News; About.Com Lung Cancer