The use of cannabis for medical purposes

There is widespread global discussion about the use of cannabis for medical purposes. Often termed 'medical marijuana', the matter has reached high levels of government in many countries. Of interest is the fact that the concept of 'medical marijuana' did not originate from those in the medical profession, but rather through a drug legalization lobby. These lobby groups generally focus on 'smoked' marijuana as the vehicle for administering cannabis. World-wide, there are many well-informed government authorities who are continuing to stand firm against such pro-drug lobby groups. For example, in Australia, the Therapeutic Goods Administration, does not endorse the use of marijuana for medical use, nor does the Drug Enforcement Agency (DEA) in the United States. In addition numerous high profile medical and allied health organizations oppose the concept of 'medical marijuana'. The challenge arises because cannabis is, globally, the most used illicit drug, with current research indicating that Australia and New Zealand have the highest prevalence of cannabis users. The research also confirms that the early uptake of cannabis is a likely cause for lifetime adverse health issues - both physical and psychological. Legalizing 'medical marijuana' leads to increased use and misuse, which, in turn exacerbates cannabis-related harms. The following facts are not controversial in that they are settled in the epidemiological and scientific literature. The long term smoking of cannabis is associated with numerous respiratory complaints and numerous psychiatric disorders. Cannabinoids are known to shut down synaptic transmission between neurones which accounts for its sedative effects. Since synaptic function and traffic intensity rates are coupled to synaptic structure and neuronal network architecture, cannabis use in key developmental periods, such as adolescence and intrauterine growth, is believed to alter brain microstructure and network function accounting for the various neuropsychiatric deficits. Cannabis is associated with driving under the influence of cannabis (DUIC) and high rates of motor vehicle accidents and fatalities. Long-term longitudinal studies have repeatedly shown that adolescent cannabis use is associated with a gateway effect increasing the use of other hard drugs in later life, and of severely impairing the long -term life trajectory reducing the attainment of normal life goals such as marriage, and continuing productive employment. Other effects which have been demonstrated in the literature include genetic and chromosomal damage, harm to cellular metabolism and mitochondrial energy production, alteration of the appetite control mechanism, association with eight cancers, various circulatory disorders including heart attack, and impaired fertility and germ cell defects. When exposure occurs in utero, there is an association with many congenital abnormalities including cardiac septal defects, anotia, anophthalmos, gastroschisis and anencephaly. This paper will address the key issues about legalizing 'smoked marijuana' for medical purposes. We acknowledge that currently there is some research on the development of processed 'nabiximols' - non-smoked extracts of cannabis. Some contend that this could be a way forward for regulated medical use of extracts of cannabis that are neither smoked nor psychoactive. However, it is concluded that the overall harms of legalizing the use of cannabis for medical purposes far outweigh any perceived benefits. These conclusions are based on modern epidemiological and scientific studies, and confirm the case against increased cannabis use, because of the high health risks to users, their children, and in the overall costs to the wider community.