How much do you know about marijuana?

Dr Jacqueline E Campbell

Sunday, October 29, 2017

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CANNABIS, otherwise known as marijuana and ganja, is widely used by individuals from all socio-economic groups in Jamaica — ranging from the boys hanging around the street corner to elderly women suffering from arthritic pain.

Recently one of my elderly patients visited me complaining about knee pain. She admitted that the “ganja remedy” that I had advised her to use was “working a bit, but I need something a little stronger”.

I had advised her to soak ganja in rum and use the solution to rub her painful knees. She had done so, but occasionally.

After discussing with her the merits of consistent use, she said: “You know doctor, I drink some of the ganja and rum too, it helps with the pain and it doesn't spin my head.”

Subsequently I recommended an oral cannabis formulation which has been used to alleviate pain.

The cannabis sativa plant is one of the oldest medicinal plants known to man.

For thousands of years, prior to its prohibition in the 20th century, cannabis was used as a medicine. As early as 2737 BC, Emperor Shen Neng of China was recommending cannabis for the treatment of constipation, gout, rheumatism, malaria, poor memory, and “female weakness”. Its use spread from China to India and then to North Africa and reached Europe at least as early as AD 500.

Prior to the 10th century BC, bhang, a cannabis preparation, was used as an anaesthetic and anti-phlegmatic in India. In ancient Greece, the drug was used as a remedy for earache, oedema and inflammation. Cannabis was used in Africa to restore appetite, to relieve pain of haemorrhoids and as an antiseptic.

However, physicians also warned against overuse of marijuana, believing that too much consumption caused impotence, blindness and “seeing devils”.

Dr William O'Shaughnessy, a physician with the British East India Company, popularised marijuana's medical use in England and America. He discovered that marijuana eased the pain of rheumatism and alleviated the discomfort and nausea observed in cases of rabies, cholera and tetanus.

In 1860 the Ohio State Medical Society acknowledged favourable outcomes for treating pain, inflammation and cough. In 1890 Dr J Russell Reynolds, fellow of the Royal Society and the Physician in Order to Her Majesty's Household, stated in the journal The Lancet that cannabis is “one of the most valuable medicines we possess”. He prescribed cannabis to Queen Victoria for treatment of her pre-menstrual syndrome.

During the 19th century, cannabis was sold by major drug companies such as Eli Lilly, Squibb and Parke-Davis. In fact, a potent extract of the drug was one of the top three most prescribed medical agents in the United States.

The Governments of Egypt and South Africa first claimed that there was physical and mental deterioration among cannabis users and pushed for the first international control of cannabis use in 1925. In 1961 cannabis was added to the Single Convention of Narcotic Drugs. The derivatives of cannabis were added to the convention on psychotropic substances in 1971. The US Marijuana Tax Act of 1937 was the first regulation of marijuana. This Act required anyone who produced, distributed or used marijuana for medical purposes to register and pay a tax that effectively prohibited non-medical use of the drug.

The United States Pharmacopeia listed cannabis until 1942, after which it was removed under political pressure. It was recommended for the treatment of more than 100 illnesses such as fatigue, cough, rheumatism, asthma, delirium tremens, migraine, and the cramps and depression associated with menstruation.

The non-medical use of cannabis was introduced into Western Europe by Napoleon's soldiers. In Southern Africa and the Caribbean, the use of cannabis was mainly confined to poor, non- European, unemployed individuals and the working class. It was Mexican immigrant workers who influenced the widespread use of cannabis in the USA in the 20th century. During the 1960's the social use became widespread.

Uses of cannabis

Cannabis is comprised of cannabinoids, including cannabidiol (CBD) and tetrahydrocannabinol (THC). THC is the main psychoactive agent in the plant, while CBD may be able to attenuate adverse effects of cannabis while mediating a range of medicinal benefits.

There is substantial evidence supporting the medical use of cannabis. In Jamaica, the pioneering work of Dr A Lockhart, ophthalmologist, and the late Professor Manley West led to the development of Asmasol, a cough mixture that has proven very useful in the treatment of asthma; and Canasol, which is used in the treatment of glaucoma.

Cannabis has been proven to be useful in the treatment of many diseases and conditions, including the alleviation of symptoms of chemotherapy. It has been used in the treatment of poor appetite, nausea, cancer, AIDS, multiple sclerosis, muscle spasm, anxiety, epilepsy, glaucoma, and chronic pain.

The need for research

There is need for extensive research to unlock the potential of this amazing medicinal plant. The University of the West Indies is at the forefront of research activities relating to cannabis.

The Faculty of Medical Sciences Annual Research Conference and Workshop

The Faculty of Medical Sciences at The University of the West Indies, Mona Campus, will host the 26th Annual Research Conference and Workshop on November 5 and 8-10, 2017 at its Teaching and Research Complex.

This year's overarching theme is 'Cannabis and Cannabinoids: Research, Opportunities and Challenges'. The conference will begin on Sunday, November 5 with the annual ethics seminar under the theme 'Optimising the Health and Wellbeing of the Health Care Team'.

The official opening ceremony for the research conference starts at 5:30 pm on Wednesday, November 8, and will feature the delivery of the Sir Kenneth Standard Distinguished Lecture by Marilyn Huestis, president, Huestis & Smith Toxicology, and adjunct professor at the University of Maryland School of Medicine.

Professor Huestis will speak on the 'Long- and Short-Term Consequences of Cannabis Medicalization and Legalization'.

On November 9, the diverse work of the faculty's esteemed and emerging researchers will be showcased via oral and poster presentations. Then on November 10, a workshop embracing this year's theme will be conducted. Topics to be discussed include Jamaica's experience with pharmaceuticals and edibles derived from cannabis, as well as topical psychiatric, societal, economic, and legal considerations of cannabis use.

Dr Jacqueline E Campbell is a family physician, university lecturer and pharmacologist. She is the author of the book A patient's guide to the treatment of diabetes mellitus.





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