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The Marijuana Plant Should Not Be Legalized for Medical Use

The Legalization of Marijuana, 2016

From Opposing Viewpoints in Context

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"Legalizing the marijuana plant ... and allowing open access to it is not necessary and may even create a public health danger for seriously ill patients."

In the following viewpoint, the Drug Free America Foundation, Inc. (DFAF) argues that there is no justification for legalizing use of the marijuana plant as medicine. DFAF claims that there is already a synthetic marijuana-component pharmaceutical product on the market prescribed for medical purposes, and more research is under way for potential effective and safe use of natural or synthetic components of the marijuana plant. DFAF is a drug policy and prevention organization committed to creating an environment where citizens live free of illicit drugs.

As you read, consider the following questions:

What is the generic name of the pharmaceutical product available in the United States made from synthetic THC, according to DFAF?
According to the author, Sativex is now approved in how many countries?
The author claims that a medicine made from natural THC rather than synthetic THC is in what phase of clinical development in the United States?

Legalizing the crude marijuana plant is not necessary and not a scientific approach to providing safe and effective medicine. A number of modern medicines are derived from plant material, including the marijuana plant. Examples include Taxol, which comes from the yew tree; opiates, which come from the poppy plant; anesthesia, which comes from the coca plant; aspirin, which comes from the willow tree; and dronabinol, which is derived from the marijuana plant.

The Medicinal Component of Marijuana

None of these medicines, however, are the raw plant rolled up and smoked. They are rather derived from specific extracts of the plant and delivered through a safe delivery system in a form that is stable where dosing is known and controllable. Some of these plants, such as the yew, actually contain some compounds that can be deadly, so separating the specific compound that has medicinal value and has been shown to be more beneficial than harmful is extremely important.

Marijuana contains hundreds of compounds, many of which are very harmful to one's health. Marijuana does, however, contain at least one compound, and possibly more, that are supported by science as being medicinal.

Decades ago, the tetrahydrocannabinol (THC) in marijuana was isolated after research proved it to be medically effective. After being isolated from the other compounds, it was synthetically replicated and produced in capsule form. Known as dronabinol generically, it is marketed in the United States under the brand name of Marinol. It is approved by the Food and Drug Administration (FDA) and typically prescribed for appetite stimulation and nausea control associated with chemo and radiation treatment.

Research on Medical Marijuana Efficacy

Another compound in marijuana, cannabidiol (CBD), is currently undergoing research to determine its medical efficacy.

Research is now under way by a European pharmaceutical company GW Pharmaceuticals (GW) to develop a THC-CBD product known as Sativex that is a natural extraction from two marijuana plant strains (one high in THC and one high in CBD), as opposed to a synthetic product. A distinction about the marijuana plants that are cultivated for this research is that the plants are cloned, providing identical plants. GW has developed a safe delivery system rather than promoting the smoking of medicine.

Sativex is now approved in 24 countries. It is indicated as a treatment for symptom improvement in patients with moderate to severe spasticity due to multiple sclerosis (MS) who have not responded adequately to other anti-spasticity medications and who demonstrate clinically significant improvement in spasticity-related symptoms during an initial trial of therapy. Sativex is also in Phase III clinical development for the treatment of cancer pain, the lead indication for the U.S. market....

The Use of Charlotte's Web

Charlotte's Web most often refers to oil extracted from marijuana plants that are bred with the representation that the plants are low in THC (the intoxicating compound in marijuana) and high in CBD content (a nonintoxicating compound in marijuana). The ratio in Charlotte's Web varies, however, and "low in THC" is an uncertain term since it has been reported to have levels of 4-6% and sometimes even higher.

The product getting most of the publicity refers to one of the many marijuana strains cultivated and sold by the Stanley brothers, Joel, Jesse, Jon, Jordan and Jared, in Colorado. It is described as a shorter plant that grows slower than other marijuana plants cultivated at their dispensary. Although the ratio has not been disclosed, it is said to be high in cannabidiol (CBD) and low in tetrahydrocannabinol (THC). How high, and how low is unknown. In their process, they report that the marijuana is soaked in grain alcohol to extract the cannabinoids and then the resulting liquid is put through an evaporator to remove the alcohol. The Stanley brothers report that they named the strain after one of their customers, Charlotte Figi, a young girl with Dravet syndrome. Others report that the name Charlotte's Web comes from the web-like leaves that are distinct to this plant breed.

The Stanley brothers promote Charlotte's Web for use by children through their foundation known as Realm of Caring. Their website, while portraying compassionate photos and personal stories of sick children who they claim have been provided a "better quality of life" through the use of their product, acknowledges that: "The statements have not been evaluated by the Food and Drug Administration (FDA). These products and statements are not intended to diagnose, treat, cure or prevent any disease. Any and all of Realm of Caring representatives, are not doctors in any way or claim to be." ...

In addition to the product marketed by the Stanleys, a growing number of other dispensaries and online stores market products under the name of Charlotte's Web or as "Low-THC," although sometimes the THC levels have been found to be as high as 15%. Marijuana labeled as "Charlotte's Web" or "Low-THC" varies and consumers have no way of knowing exactly what they are getting.

Potential dangers of using "Charlotte's Web" or "Low-THC" marijuana as a "medicine" are many, including

There is no standardized dose.
A patient who takes purported dosage of CBD a day could also be taking unknown amounts of THC.
These marijuana products could have molds and microbes that are not removed by the ethanol process that converts it into a non-smokable form. (Physicians in Colorado have reported that some children have shown up with bacterial infections, presumed to be from the medical cannabis they are using.)
There is no way to standardize or purify the compounds in marijuana. In fact, no one knows what the exact THC-CBD ratio is, and the labs that purport to "test" these products are not FDA or DEA [Drug Enforcement Administration] registered. The exact ratio is not identified. The growers are not able to assure batch-to-batch consistency because the plant material is variable, and the manufacturing process itself can affect the CBD-THC ratio.
We have no way of knowing which patients (ages, diagnoses) have benefited, what side effects they might have experienced, and which patients have gotten no benefit. Only a few "selected" cases are known to have been publicized. All the cases should be reported (without names, of course).
The product could have harmful chemicals in it that were used in the cultivation (pesticides, herbicides) or extraction processes.

There is a better approach. Following its work with Sativex, GW Pharmaceuticals began to look at the other 99 non-psychoactive cannabinoids in marijuana. Research was conducted using CBD that showed promising results in treating epilepsy. Once published, parents began contacting the researcher asking if they could use this for their children. The researcher then contacted GW. Extensive toxicology research had been done, as well as limited human trials.

GW has continued the research and has developed a product that is basically pure CBD, extracted from cloned marijuana plants, known as Epidiolex. This product is undergoing the necessary scientific scrutiny required of legitimate medicines and is a pure product that overcomes the obstacles listed above. The medication is currently going through the process to obtain approval from the Food and Drug Administration and is now available to patients through clinical trials.

No Need to Legalize the Plant

Legalizing the marijuana plant—even the strain known as Charlotte's Web—and allowing open access to it is not necessary and may even create a public health danger for seriously ill patients.

The THC in marijuana, which science demonstrates has medicinal value, is already available in prescription form as a synthetic medication. A non-synthetic medication containing pure THC is also available in 21 countries and is in Phase III clinical development in the United States. A non-synthetic medication containing pure CBD is now in clinical trials in the United States and available to patients desiring to try the drug.

While GW Pharmaceuticals has obviously led the way in the development of Sativex and Epidiolex, other research is ongoing and it is anticipated that we will see other similar medications brought to market. Efforts should focus on supporting the research and development of modern medicines rather than circumventing our nation's established process for protecting the public from harmful human experiments with substances that could prove to be more harmful than helpful.