by Richard Boyd, Body Mind Psychotherapist, Energetics Institute, Perth, West Australia
The Marijuana debate has always created a casualty and that is the role that Marijuana could and should have as a legitimate medicine or substance for application to medical or mental health issues in society. The casualty is that this debate has struggled to occur and for Marijuana to be elevated beyond its negative reputation as an addictive drug of a negative social impact.
This debate is an emotional one that spans multi-generational critics and users. There are other problematic substances or drugs such as opiates which have spanned the divide and are in legitimate use within medicine whilst also being social drugs of abuse and addiction.
Even Panadol and other legitimate painkillers represent a whole drug class of applicability to medicine and also which are high on the list of drugs of abuse and addiction within our community.
Despite this set of outcomes the entrenched views around the legitimate use of Marijuana in medicine has resulted in two polarised camps. Sadly each camp tends to remain stuck in their corners but there is an existing body of knowledge which brings some objectivity to the debate.
The debate came back into the spotlight again this week when it was announced that Washington was holding a referendum about legalising the use of Marijuana. The referendum would go beyond decriminalisation and give the drug full legal status, meaning it may one day be possible to legally set up a dope products shop.
Recreational cannabis is already on sale in Colorado and Washington State and momentum is growing for legal status in Alaska and Oregon. Medicinal marijuana is available in half the country and polls show that for the first time a majority of Americans, around 58pc, support full legalisation nationally.
The legal problem with marijuana is that a criminal conviction can result which can lead to job loss, refusal for insurance, and potential family court issues around child custody and access. In 2010, 91pc of all marijuana arrests in Washington DC were of black people and it has long been alleged that low level prosecution of persons for small personal use of such drugs is a tool of harassment and the excuse to stop and search a person for other reasons.
Societal trends are such that the pendulum has swung towards the controlled use of marijuana for both medical and social use. For instance a European Commission poll of all 28 member states found that 56% of 15-24 year olds said that the cannabis market should be regulated and 43% said it should be banned.
There is also a growing body of medical professionals who are taking a second look at marijuana and its historical and modern use in pain and nausea management. The internet has seen the publication of a large body of opinion, testimony, fact and science around marijuana usage and while social usage is problematic, medicinal usage is actually a potential positive outcome for marijuana.
Medicinal use of marijuana still attracts the same legal sanction as recreational users and this is the main problem. It is the medicinal use of marijuana that deserves consideration as having a context whereby it is a positive and legal choice for persons with certain ailments.
Marijuana has been used in Western society for both medicine, in quack cures, and for social reasons since the early Victorian times. At the start of the 20th century Marijuana was a legal substance with acknowledged medicinal properties.
The advent of medical research into narcotics and opiates, particularly in between the two great wars, saw a focus on medical military supplies for war situations. The aftermath of World War 1 had seen the rise in addictions, both those caused by the way people tried to deal with "shell shock" war trauma, and also from legitimate addiction to opiates when wounded.
The medical profession subsequently saw a need to ban substances which were deemed addictive and marijuana was one of those substances that became illegal to possess and use. Marijuana was typically used by those in society who suffered pain and nausea and so World War 1 and 2 gave legitimacy to those who often came out of those years affected in this way.
The strange thing is that alcohol which is also addictive did not become illegal despite its own set of health and addictive issues. So society banned marijuana and embraced alcohol and so we had a rise in alcoholism after both wars as adults tried to numb out their trauma and pain.
Yet the medicinal use of Marijuana is known and alcohol serves no useful medicinal purpose. Alcohol is however part of the largest sector of the economy and so has powerful legal, political and money backers which keep it legitimised as a part of adult life.
I am not advocating removing that freedom. The fact is that Marijuana is still demonised in an era of scientific fact is unfortunate for many of our best painkillers have their basis in bark or plant derivation. Think of aspirin.
It was surprising that the thought leadership body for medicine, the WA branch of the Australian Medical Association(AMA) runs the argument that we need more research and that medical marijuana is a risk and dangerous.
There has to be a separation of the medical context for marijuana and the social or addict's use of Marijuana. The two are quite different and we already have in society prescription drugs that are legitimate and prescribed, yet can be abused and become a dangerous drug.
Prescription drug abuse is on the rise yet the AMA does not advocate withdrawing from use those legitimate drugs that can be abused such some strong painkillers, Panadol, and opiate based drugs. They can however justify the opposite outcome for a medicinal drug not yet on the legally approved list.
The AMA does not tend to stick to the oft trotted out claims of medicine and psychology of their stance being based on "evidence based research". The AMA claims there are no valid studies supporting the medicinal use of Marijuana to aid sufferers of glaucoma and asthma.
There are studies into the medicinal use of Marijuana which have been peer reviewed. Why they are not acceptable to the body of knowledge of medicine is an unanswered question as they were apparently conducted under the processes, controls and rigours of medical academia.
The problem appears to be more social than factual. If the facts were compared on the Iatogenic (side) effects of some of our pain killer medicines in use today versus the potential side effects or Iatogenic effects of Marijuana then one would note that less potential harm accrues under the Marijuana choice than some of the painkillers we all pop legitimately now.
Yet the drug industry and the AMA already have a headache they cannot and will not face or deal with prescription medication abuse. Statistics show that this category of addiction is a major form of new addiction in both existing addicted persons and persons without a prior history of addictions.
One problem is that the legitimate use of these medications can create addiction that then gets out of control. So if a person has surgery and then goes home they can use a strong IfoBrufen based anti-flammatory drug and some strong painkillers on prescription for a week or so.
However some people become either emotionally or physically dependent on the drugs and may find doctors will continue to prescribe the drugs and so a downward spiral starts that no-one really understands is happening. Painkillers can cause death through overdose and addiction due to their impact on key heart and organ functions of the body in a form of hypo or low arousal state of being.
Marijuana can be addictive but has not been found to itself create death through overdose or addiction. If you refer to my article on Marijuana addiction you will see it can affect people in many way, and the younger person is often vulnerable to its addictive effects.
Nausea in particular responds well to Marijuana and sufferers report that it often is the only substance that reduces or eliminates nausea without creating other unintended effects outside the potential addictiveness that is also present in painkillers given for Nausea at present.
Joe Kosterich, M.D. recently wrote an article on this same subject, and must have been researching the same topic as me at the same time. He notes that "The other problem with opiate painkillers is that people develop tolerance and then the dose needs to be increased - contributing to overdose and deaths. So the legal option may be less effective and is certainly more dangerous than the illegal alternative(Marijuana).
Joe also found some relevant statistics that "A survey of overdose deaths from opiates saw a four-fold increase in the US between 1999 and 2010. Yet there was up to a 30 per cent reduction in deaths in states with legalised medical marijuana."
I am not a stoner and have no vested interest in this debate. I have never used Marijuana courtesy of childhood and teenage bronchitis that made the idea of smoking anything a horrible thought. The article is just a companion piece to my wider one that looks at the whole societal picture of Marijuana use and notes its harmful effects as a substance that we should avoid.
However in medical context it appears to have beneficial use and appears to have less issues than the drugs we use now. There are some 30 states in America which have legalised medicinal use of Marijuana so there is a body of knowledge and evidence that can now be examined and summarised.
I think we need to move from demonising Marijuana in all its forms and all its uses. If it works in the medical context then we owe it to sufferers to work out a way to make its safe use a legitimate outcome for the betterment of society.