and Rheumatoid Arthritis, Digestive Diseases, Gliomas, Hepatitis C, Huntington’s disease, Parkinson’s disease, HIV/AIDS, Post-Traumatic Stress Disorder and Depression, and Asthma – if prepared without smoking.112 Research has also credited marijuana use to the slowed progression of Alzheimer’s disease113. It is noteworthy that in the body of research conducted over the past four decades there has been no report of severe or fatal adverse events due to marijuana based medications,114 a point made often in the Commission’s Consultations by members of the public. SUMMARY OF EVIDENCE IN TERMS OF EFFECTIVENESS IN SEVERAL MEDICAL CONDITIONS 115 Conclusive or Substantial Evidence1 Chronic Pain Chemotherapy induced nausea and vomiting Multiple Sclerosis Spasticity Symptoms
Moderate Evidence 2
Limited Evidence 3
Insufficient Evidence4
Short term sleep disturbances Asthma
Appetite and Weight Loss due to HIV/AIDS Anxiety
Cancers
Post-Traumatic Stress Disorder Dementia/ Alzheimer’s Glaucoma
Irritable Bowel Syndrome Epilepsy116 Amyotrophic Lateral Sclerosis Schizophrenia
Addressing Concerns about Adverse Health Impacts
5.24. The concerns about marijuana in terms of health are being tested by undergoing intense research. In some cases, long held beliefs/ myths about adverse consequences are being disproved, while in a few, the evidence supports the concerns. In other instances, the results are inconclusive. The concerns include the following:
Health Considerations for Children and Young Persons
5.25. Given that the average age of initiation to cannabis/marijuana in the Caribbean is 13 years of age, it is important that its effect on children and adolescents be addressed. There is a large consensus with respect to the scientific evidence concerning the negative effect of cannabis on children and young adults. This necessitates an exception to whatever change to the legal status quo ensues, ensuring that strict prohibitions remain with respect to this group of persons. 5.26. The adolescent brain is in a stage of critical development and is not fully developed before the age of 24 years which makes it susceptible to the effects of marijuana. There is a convincing body of literature that recent use affects several domains of cognition such as memory, attention and learning. These effects appear to persist even after the drug is stopped.117 5.27. Studies indicate that marijuana use in adolescents is associated with, but not necessarily the cause of, lower academic achievement and education, compromised social relationships and roles. Significant risk factors for marijuana use include; younger age of alcohol use, nicotine use, parental substance use, childhood sexual abuse. Because of its ability to de-sensitise and calm, cannabis has also been demonstrated to have de-motivating effects especially on young people, which is a cause for concern. Eubanks et. al (2006); Thielmann & Daeninck (2013); Eubanks et al (2006); Reynolds (2016). Recent findings suggest that medical marijuana can be used as substitution therapy and may result in different and even positive effects on users who are affected by the effects of recreational marijuana on these consumers. Following 3 months of treatment, MMJ patients demonstrated improved task performance accompanied by changes in brain activation patterns within the cingulate cortex and frontal regions. Interestingly, after MMJ treatment, brain activation patterns appeared more similar to those exhibited by healthy controls from previous studies than at pretreatment, suggestive of a potential normalization of brain function relative to baseline (Sagar et al 2017). 114 (Robson, 2001). 115 Source: Information in this table has been taken from the National Academies Press, 2017. 1. There is conclusive or strong evidence from high quality studies; 2. There is some strong evidence of studies supporting effect, but also studies refuting effect; 3. There is some evidence to support, but the studies are of low quality; 4. There is no or insufficient evidence to support the conclusion. 116 Devinsky et al (2015) 117 Hanson, Winward, Schweinsburg, Medina, Brown & Tapert, 2010; Hall, 2009; Medina, Hanson, Schweinsburg, Cohen-Zion, Nagel & Tapert, 2007. 112 113
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