Austin Vote

Professor Campbell

UWRT 1104

3/30/14

The Drug Enforcement Agency (DEA) is the Federal Agency that is tasked with

enforcing federal drug laws. The DEA continues to defend their scheduling of Marijuana; it

remains classified in the same category as Heroin, LSD, MDMA (Ecstasy), Psilocybin (the

psychedelic component of mushrooms), and bath salts. Schedule 1 drugs are defined as

drugs, substances, or chemicals with no currently accepted medical use and a high potential for

abuse. As I will demonstrate, Marijuana is an effective medicine for cancer patients, epileptics,

muscle degeneration, and many other debilitating diseases. It has been found to relieve

symptoms and work as an anti-tumor agent (add source). Recent scientific studies pose

significant questions to the reasoning behind the DEA keeping Marijuana as a Schedule 1

substance.

Marijuana was classified as Schedule 1 after the passing of the Controlled Substances Act

in 1970; and was continuously targeted as a dangerous illegal substance throughout the war on

drugs. I will focus almost exclusively on the medicinal benefits of marijuana, in order to

objectively justify why Marijuana should be rescheduled. I will also give a brief overview of

other reasons it is still illegal, because they are relevant to the debate at large. Lobbyists remain

the single greatest barrier against legalization, with pharmaceutical companies being the most

influential. Public data shows that in 2012, 22 Million dollars was given to federal candidates,
committees, and parties (OpenSecrets). Why? Retired police officer Howard Wooldridge, who

lobbies for Marijuanas legalization, explained that next to police unions, the second biggest

opponent on Capitol Hill is big PhRMA, because marijuana can replace everything from Advil

to Vicodin and other expensive pills. From physicians to our own ancestors, Marijuana has been

used extensively in the past, not only as medicine, but also in textiles and food. The millennial

history of Cannabis, which effectively goes along that of human kind, testifies to its extensive

usefulness for many purposes, as fiber, food, and medicine, beyond its use as a psychotropic

substance. For example, in the mid-1800s, an Irish physician, William Brooke OShaughnessy,

Having ascertained its safety in animals, he administered alcoholic tinctures of Cannabis to

some selected patients who suffered from epilepsy, rheumatisms, cholera, or tetanus and deduced

that the plant had interesting analgesic and myorelaxant properties. Based on this observation, he

proposed that Cannabis could be a powerful remedy for seizures. In addition to this, he noted

that while not able to treat tetanus, it was effective in response to symptoms. I simply want to

stress this: even in cases where it cant directly combat ailments, it can work especially well

treat symptoms.

Moving forward, I will now focus on the science behind Marijuana; first starting with its

safety. Of course, for thousands of years, Marijuana has been used as a natural medicine in many

cultures. In the United States, it was used by apothecaries until the late 1800s. I want to stress

that its fall from grace was not in reaction to any specific event or sense of danger; rather, its

psychotropic effects. In fact, as early as the 1940s, the American Medical Association stated that

the pharmacological potential of Marijuana was greater than its adverse effects; and unlike other

classes of drugs in use today (most notably Opioids), negative effects on society and the user are

rarely appreciable (Pharmacological Sciences). There exists, without doubt, an opioid crisis in
the United States. According to CDC data, there were 33,000 opioid overdoses in the United

States in 2015, and nearly half of them were due to prescription opioids (CDC). Inhalation of

smoke remains the most clear and dangerous effect of Marijuana use, recreational or medicinal;

however, in these cases, the smoke from Marijuana is less dangerous than smoke from cigarettes,

which are legal. In addition, much fewer patients smoke Marijuana as opposed to eating edibles

or using concentrated oil, which pose no significant health effects. Edibles are also noted for

offering a more potent and longer THC therapeutic effect, which is most important when being

used as an adjuvant for symptom relief (Pharmacological Sciences). It should be noted that the

auxiliary effects of opioids are also highly addictive, exponentially moreso than Marijuana. In

the Trends in Pharmacological Sciences journal, they concluded that they were at least hopeful

for the future of Medical Marijuana and its research, stating Now that the scientific evidence

collected on the pharmacological potential of Cannabis is in agreement with the economic

interests linked to this enormous new market, moral and social concerns have been bypassed.

Exactly now, the lesson from the past is pivotal to manage the Cannabis affair in the right way,

emphasizing first of all the health benefits for patients. I would like to stress that while safety is

a concern, it is not the only one, and that is why we still see entire classes of comparatively

dangerous drugs (like opioids) still in use. In fact, as I will address, the efficacy of both opioids

and Marijuana increase as they are used together.

As I have laid out a groundwork asserting that Medical Marijuana is a safe and

reasonable idea, I will now address its efficacy in symptomatic relief. I will address the efficacy

of Marijuana as a treatment later. Medical Marijuana is currently prescribed to treat a number of

various diseases and disabilities, ranging from, but not limited to: Cancer, Glaucoma, Anorexia,

Migraines, HIV/AIDS, ALS, Depression, Anxiety, Panic Disorder, PTSD, chronic pain, chronic
nausea, seizures, and cachexia (wasting syndrome, a disease which is characterized by

excessive muscle atrophy, fatigue, weakness and loss of appetite). My goal in addressing the

efficacy of Medical Marijuana in symptom treatment was to focus on disabilities and diseases

with the most current research, as Medical Marijuana is definitely still in an infantile state.

Out of cancer patients, at least half report moderate to severe pain, which further

increases in patients with metastatic cancer or advanced cancer. This pain negatively impacts

on their life quality, functional status, and life expectancy (Agents). Currently, pain this severe

and chronic requires opioid treatment. These drugs have dose-limiting side-effects, and can be

extremely dangerous. More than half (52%) of women and a third (38%) of men reported

doctor-prescribed painkillers as their first contact with opioid drugs, a family of drugs which

include prescription medicines such OxyContin and codeine, as well as illicit drugs such as

heroin (McMaster University). Numerous studies have shown that physician directed system

administration of cannabinoids reduce pain in animal models, including humans. Cannabinoids

are lipid molecules (fat) and are the active components of Marijuana, and there are many kinds.

The two most common are CBD and THC. THC is a largely recreational cannabinoid,

responsible for the therapeutic high of Marijuana; however it still has medicinal effects that I

will describe later. CBD, while sometimes used in recreational settings, is more often used for

medical purposes. Different cannabinoids prefer different cannabinoid receptors. THC

usually bonds to receptors in the brain, whereas CBD usually bonds to receptors in the body.

Cannabinoids produce anti-nociception (pain-signal blocking) by activating CB1 receptors in

the brain, the spinal cord and nerve terminals. Endocannabinoids naturally function to suppress

pain by inhibiting nociceptive neurotransmission (Agents). THC has also been found to be an
effective stimulant for patients with anorexia (this particular journal referenced studies on

anorexia due to cancer treatment).

Some pain is too severe for Marijuana or its synthetic versions to treat alone, and it is

often used in tandem with other medicines; however, in some cases Marijuana is also the only

medicine that has been found to be effective against pain (Current Oncology). Current Oncology

also found that Medical Marijuana was effective in combating nausea from chemotherapy,

insomnia, and depression. Neuropathic pain, characterized usually by tissue damage, is another

type of pain common in cancer patients. A systematic review of six randomized, double-blind,

placebo-controlled trials of cannabinoids (five specifically addressing neuropathic pain) found

evidence for the use of low-dose medical cannabis in refractory neuropathic pain in conjunction

with traditional analgesics. Another analysis reviewed five trials of inhaled cannabis in patients

with hiv-related peripheral neuropathy and again found a positive effect for cannabis compared

with placebo. A recent small study showed a doseresponse effect for vaporized cannabis in the

relief of pain from diabetic peripheral neuropathy, a huge clinical problem estimated to affect

238 million people worldwide (Current Oncology). As previously mentioned, some pain is too

severe for Marijuana alone to combat. In these cases, when combined with other analgesics

(pain medications), Marijuana was found to increase the effectiveness of the other analgesic

used. This effect was not unique to cancer patients, and was reported with diabetics with

neuropathic pain. This is because cannabinoids and opioids have been found to have synergetic

effects. The pain-relieving effects of Marijuana are not reduced by opioids, and they work on

different receptors throughout the body. In laymans terms, the two substances can work

together because they are not necessarily fighting over the same space within the body

(Current Oncology). A source cited by NPR found that in states with legal Medical Marijuana,
the number of opioid prescriptions dropped. I would like to stress this: a reduction in opiate

dependence will lead to less abuse in the United States, and the first step in stopping the opioid

epidemic is reducing prescriptions. Marijuana does not remove the necessity, but it lowers it,

which is a very good start. A commonly ignored side-effect of long term opioid use is an overall

decrease in cognition, often reaching a point where patients have a hard time communicating

with their loved-ones during end of life care (Current Oncology). A WebMD survey reported that

82% of oncologists and hematologists were in favor of patients having access to medical

cannabis. This was the highest approval rating among all subspecialties that responded. A

doctor writing for Current Oncology reported that Clinically, I have observed that many cancer

patients benefit from adding cannabis to their pain regimen. In Cannabinoids for Medical Use

Dr. Penny F. Whiting summarized her research as such: there is moderate-quality evidence to

support the use of cannabinoids for the treatment of chronic pain

To conclude, I would also to mention that in Integrating Cannabis into Clinical Cancer

Care, Abrams mentioned that not only is cannabis effective versus pain, but that evidence

suggests that cannabinoids are not only effective in the treatment but also in the prevention of

chemotherapy-induced peripheral neuropathy suggesting that cannabis can also be considered a

preventative medicine, at least in the realm of neuropathy. More research is needed in

understanding the reason for this.

I would lastly like to focus on using cannabis to combat illness, not just alleviate its

symptoms. Medical Marijuana in recent years has offered potential applications in combating

illness, especially as anti-tumor medicine. This is because evidence supports the claim that some

cannabinoids can limit tumor cell proliferation (tumor growth). Marijuana can also induce

tumor-selective cell death, while keeping nearby cells unharmed. This same principle can be
extended further than just tumors. Mood and anxiety disorders, movement disorders such as

Parkinsons and Huntingtons disease, neuropathic pain, multiple sclerosis and spinal cord injury,

cancer, atherosclerosis, myocardial infarction, stroke, hypertension, glaucoma, obesity/metabolic

syndrome and osteoporosis are just some of the diseases in which an altered endocannabinoid

system plays an interesting role for pharmacological intervention (Agents). The

endocannabinoid system is where cannabinoids bond all throughout the body. More research is

needed in this young field of medicine, but researchers have been able to replicate results.

Anti-tumor results are due to the ability of certain cannabinoids to inhibit several key

functions of tumor cells. Firstly, cannabinoids are effective at stopping tumors from undergoing

angiogenesis, which is essential for tumor growth. Angiogenesis is the creation of new blood

vessels. Cancer sprouts blood vessels everywhere it goes, stealing nutrition from our bodies and

further feeding itself, spreading throughout the affected persons body. Cannabinoids can choke

out cancer in this sense: remove the source of nutrition, and the cancer will wither. That is not

the only way cannabinoids combat cancer, however. Cannabinoid agonists also directly

inhibited angiogenesis induced by basic fibroblast growth factor (bFGF) in vitro and in vivo in a

CB1-dependent manner, and reduced the invasiveness of different cancer cell lines through the

increased expression of tissue inhibitor of metalloproteinases. In addition to cannabinoid

agonists, inhibitors of endocannabinoid transport or degradation (VDM-11 and AA-5-HT) have

been shown to inhibit tumor growth and progression in numerous types of cancer, enhancing the

levels of endocannabinoids in the cells (Agents). Basically, by directly manipulating the

endocannabinoid system by introducing various cannabinoids, cell chemistry is changed in ways

that either kill cancer, or reduce its ability to spread. Important to note, is that in addition to being

effective, cannabinoids are also rated as having a good-safety profile (Agents). Some fear that
the psychoactive effects of THC and other mind-altering cannabinoids would make them a bad

candidate for cancer-treatment; however, THC delivery in glioma patients was done safely and

without psychotropic effects. Another alternative is simply using non-psychoactive cannabinoids

such as CBD, which is commonly used by people with seizures. It is also important to consider

that compared to all other currently used chemotherapeutic drugs, which all have toxic adverse

effects, Marijuana has a good-safety profile. It is not toxic at all. Potential adverse effects

of cannabinoid agonists are within the range believed acceptable for other drugs, especially

anticancer drugs. It is well known that the therapeutic activity of most anticancer drugs in

clinical use is limited by their general toxicity to proliferating cells, including normal cells.

Novel cytotoxic agents with known mechanisms of action have been developed, but they still

lack tumour selectivity and have not been therapeutically useful. Cannabinoid agonists do seem

to selectively target tumour cells, while normal cells are less sensitive or even protected. In

laymens terms, Marijuana has not only been shown to be effective against cancer, it has done it

without destroying healthy, unaffected cells, which can lead to even more damage in

conventional cancer treatment.

As demonstrated, Marijuana is much more than what is commonly accepted. Our own

Government demonizes it, leaving it Schedule 1, insisting it is good only as a path to harder

drugs. As I have laid out, Marijuana is a drug that has been found to aid in numerous cases, in

many fields of medicine. It is effective both as a treatment, and as a symptom-relief. I am

confident that as more research is done, we will find new and even more innovative ways to use

this medicine. The DEA should immediately, if they have the people of the United States good

fortune in mind, reschedule Marijuana, and allow for unimpeded research to be done with it.
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Oncology. 2017. Web. 12 Mar. 2017.
"After Medical Marijuana Legalized, Medicare Prescriptions Drop For Many Drugs". NPR.org.
NPR.org. 2017. Web. 12 Mar. 2017.
"Cannabis and Cannabinoids." National Cancer Institute. National Cancer Institute. Web. 12
Mar. 2017.
McMaster University. "Prescription painkillers source of addiction for most women."
ScienceDaily. ScienceDaily, 9 November 2015.
<www.sciencedaily.com/releases/2015/11/151109220353.htm>.
"Medical Marijuana And Parkinson's Part 3 Of 3". YouTube. 2017. Web. 12 Mar. 2017.
"Opioid Overdose." Centers for Disease Control and Prevention. Centers for Disease Control
and Prevention, 09 Feb. 2017. Web. 06 Apr. 2017.
Pisanti, Simona, and Maurizio Bifulco. "Modern History of Medical Cannabis: From Widespread
Use to Prohibitionism and Back." Science Direct. Trends in Pharmacological Sciences,
Mar.-Apr. 2017.
Pisanti, Simona, PhD, Anna Maria Malfitano, PhD, Claudia Grimaldi, PhD, Antonietta Santoro,
PhD, Patrizia Gazzerro, PhD, and Maurizio Bifulco, PhD. "Use of Cannabinoid Receptor
Agonists in Cancer Therapy as Palliative and Curative
Agents." Https://www.elsevier.com/. Science Direct
Whiting, PhD Penny F. "Cannabinoids for Medical Use." JAMA. American Medical Association,
23 June 2015. Web. 06 Apr. 2017.