any material derived from the plant such as the stem, leaf, seed, root, resin and any other part of the plant. Herbal marijuana can be smoked, vaporized, taken by mouth in food or drinks or processed into a variety of products. In addition, the marijuana industry for medicinal purposes includes the following classifications: ‘Edibles’, which are food products infused with marijuana (cakes, brownies, biscuits, candies etc.) and marijuana infused beverages. These may also be used for recreational purposes; and ‘Extracts’ - which may contain any combination of the constituents from the marijuana plant including the main cannabinoids THC or CBD. Two of the earliest preparations containing plant extracts (Canasol and Asmasol) were produced in the Caribbean.108
Beneficial Effects of Marijuana for Medicinal Purposes
5.23. A review of the literature has identified several potentially beneficial and therapeutic effects of cannabis/ marijuana. The scientific evidence is now strong in relation to some, while moderate in others. Cannabis/marijuana is beneficial in the treatment of the following diseases and ailments: Chemotherapy Induced Nausea and Vomiting - A substantial body of research suggests that natural and synthetic THC are effective in the treatment of chemotherapy induced nausea and vomiting;109 Glaucoma - A large body of research indicates that marijuana may be effective in reducing intraocular pressure in glaucoma and slowing the progression of glaucoma;110 Anorexia and Weight Loss - Numerous studies have found that marijuana improves the appetite and slows weight loss of those with cancer and undergoing chemotherapy. Marijuana has also been found to be helpful in improving appetite for those with anorexia nervosa (Medical Marijuana, 2010; Robson, 2001; Hazekamp & Grotenham, 2010; Kowal, Hazekamp & Grotenham, 2016)); Pain - Several studies have demonstrated that marijuana is efficacious in the treatment of chronic and neuropathic pain (Lynch and Campbell, 2011). Neuropathic pain is a form of severe pain involving the nerves. (Rahn & Hohmann, 2009). Other reviews have suggested mixed results across clinical trials as it relates to the analgesic effect of marijuana. (Hazekamp & Grotenham, 2010) (Kowal, Hazekamp & Grotenham, 2016); Multiple Sclerosis (MS) - This debilitating, autoimmune condition for which adequate treatment is lacking is characterised by muscle spasms, tremor, ataxia, weakness or paralysis, constipation, loss of bladder control and severe pain. Numerous researchers have reported that marijuana may reduce spasticity, pain, tremors, and ataxia and slow the progression of MS; Sleep Disorders - There is an accumulating body of research that shows Marijuana to be useful in the treatment of sleep disorders. 111 Mental Disorders - Preliminary data suggest a possibility for CBD in the treatment of Psychosis and Post-traumatic Stress Disorder but more robust studies need to be conducted to support these claims (Leweke et al); Other Disorders - A growing body of scientific research suggests that marijuana is effective in the treatment of diseases such as Migraines, Inflammatory Bowel Disease, Fibromyalgia, Arthritis Dronabinol (Marinol, Syndros) Nabilone (Cesamet)
Synthetic Synthetic
Cannabidiol (Epidiolex
Purified Plant Extract
CBD
USA, UK USA,
Nabiximols (Sativex)
Purified Extract/Synthetic Plant Extract Plant Extract
THC:CBD (1:1)
UK
Chemotherapy induced nausea & vomiting Anorexia & weight loss in AIDS patients Chemotherapy induced nausea & vomiting and adjunctive for chronic pain Intractable childhood seizures, e.g., Dravet, LennoxGastaut syndromes Pain, muscle spasticity in multiple sclerosis
THC THC
JA JA
Glaucoma Asthma
Canasol (1987) Asmasol
USA
Plant
Canada,
Sativex and Epidiolex a CBD extract which was approved for the treatment of seizures in 2018 in the USA are two other extracts available. West, Manley, Homi, J. ‘Cannabis as a Medicine’, Br J Anaesth, 1996, Jan 76 (1) 1-67. 109 (Robson, 2001; Hazekamp & Grotenham, 2010; Kowal, Hazekamp & Grotenham, 2016). 110 (West, 1996; Robson, 2001; Watson, Benson, Joy al. 2000; Hazekamp & Grotenham, 2010; Kowal, Hazekamp & Grotenham, 2016); 111 (Robson, 2001; Hazekamp & Grotenham, 2010). 108
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