Definition of Marijuana and Its Mechanism in the Body
There have been plenty of debates and conflicting views on marijuana, whether it is beneficial or detrimental to health, safe or dangerous to one, if it should be legalized or prohibited, allowed for medical purposes or barred. But before all the discussion on whether it should be legalized or not, a clear, good definition of marijuana and its effects to a normal, healthy person and a diseased person should first be examined.
Marijuana is the second most illegally used drug in the Philippines, next only to Methamphetamine Hydrochloride, or more commonly known as shabu (Dangerous Drugs Board, 2008). Marijuana is a greenish-gray mixture of dried, shredded flowers and leaves of the Cannabis sativa hemp plant. It is also commonly called weed, pot, grass, or Mary Jane. The smell is often described as pungent and distinctive, a mix of sweet and sour odor. Marijuana is most commonly smoked in joints (hand-rolled cigarettes), or bongs (water pipes), or even blunts (marijuana cigars). Sometimes, marijuana is used to brew tea or is mixed into foods such as brownies or cookies using hash oil, which is the concentrated resin of the plant. “Hash oil,” waxy “budder,” and “shatter,” which contain high doses of active ingredients of marijuana are increasing its popularity among both recreational and medical users (National Institute on Drug Abuse, 2014).
Cannabis contains delta-9-tetrahydrocannabinol (THC), a psychoactive chemical. It contains 70 other cannabinoids, which the body naturally produces to modulate pain (Zimmermann, 2015). Once it is inhaled in the body, THC is rapidly passed from the lungs to the bloodstream and then carried to the brain and the other organ systems. As previously mentioned, the second route of entry is through digestion, which is the slower route. Once ingested, the THC acts on the cannabinoid receptors found on the brain cells, which are part of the endocannabinoid system. These receptors are normally activated by a structurally similar chemical called anandamide. A high amount of the cannabinoid receptors are found in the areas of the brain that affect pleasure, memory, thinking, concentration, sensory and time perception, and coordinated movement. It is because of these affected areas in the brain that leads to marijuana being addictive. The receptors are also found in the liver, kidney and lungs. Once the cannabinoid receptor is activated, it releases chemicals to alleviate pain and other noxious chemicals (Zimmermann, 2015). Marijuana leads to the overactivation of the endocannabinoid system, leading to the “high” feeling that users experience (National Institute on Drug Abuse, 2014).
Benefits of Using Marijuana
The argument of the people who are for the legalization of marijuana, regardless if medical or not, is that helps treat a variety of diseases. According to Earleywine (2005), the earliest trace of marijuana use dated as far back as 2737 B.C., when China’s emperor, Shen Neng, used cannabis tea to treat gout, rheumatism, malaria and even poor memory. The following are some of the most notable conditions and diseases that have been proven to be modulated by marijuana:
Cancer, HIV/ AIDS and chemotherapy. As previously mentioned, marijuana contains the biologically active components called cannabinoids. The US Food and Drug Administration (FDA) has approved a few drugs containing cannabinoid to relieve of nausea and vomiting in lung cancer patients (Ahmedzai et al, 1983) and increase appetite in cancer and AIDS patients (Beal, et al, 1997). Moreover, it is also said to be effective at reducing neuropathic pain in HIV patients (Abrams, et al, 2007)
Alzheimer’s Disease. According to Scripps Research Institute (2006), THC, the primary active component in marijuana, inhibits amyloid plaque formation, the principal pathological marker for Alzheimer’s disease. It is described as a superior inhibitor of amyloid plaque formation by preventing the activity of acetylcholinesterase.
Multiple Sclerosis. Medical marijuana, in the form of oral sprays and pills, appear to decrease stiffness and muscle spasms in multiple sclerosis. Furthermore, pain related to spasms, painful burning, numbness and an overactive bladder, which are also symptoms of MS, are also alleviated (American Academy of Neurology, 2014)
Epilepsy. THC and other cannabinoid components of marijuana are suggested to have anticonvulsant properties. According to the study done by DeLorenzo, et al. (2003), marijuana plays a key role in controlling spontaneous seizures caused by epilepsy. Aside from having advantages in treating seizures in contrast to prescribed anticonvulsants, marijuana also limits the duration of the seizure.
Arthritis. Marijuana aids in reducing joint inflammation in arthritis. Dai, et al. (2013), confirmed in his study that certain components of marijuana can up-regulate the expression of a type of cannabinoid receptors, CB2R, which in turn, reduces production of proinflammatory mediators.
Glaucoma. When administered by smoking, orally, or intravenously, marijuana decreases intraocular pressure in 60% to 65% (Green, 1998).
Depression. According to a study done by Denson and Earleywine (2005), users who used once a week or less reported less depressed mood, more positive affect and lesser somatic complaints than non users. Moreover, daily users also had less depressed mood and a more positive affect than non-users.
Schizophrenia. Cannabidiol increases anandamide levels, which results to hindrance of anandamide deactivation. This results to the antipsychotic effects of cannabidiol, which can aid in the treatment of acute schizophrenia (Leweke, et al, 2012)
Morning Sickness. Ninety-two percent of the 40 pregnant women who used marijuana to treat nausea and vomiting evaluated it to be ‘effective’ or ‘extremely effective’ (Westfall, et al. 2006).
Hepatitis C. Moderate use of marijuana may have some symptomatic and virological benefit to patients with hepatitis C virus. Marijuana is said to aid in promoting effectivity of drug therapy. Furthermore, a patient who smoked at least once a day or every other day helped complete therapy for HCV (Sylvestre, et al. 2006)
Disadvantages of Using Marijuana
Those who are anti the legalization of marijuana would argue that the risks of using marijuana outweigh the possible gains. Most of them, although would agree that marijuana can potentially have some benefits, these are benefits that can also be found in other medications that have less side effects.
Using marijuana leads to an impaired coordination, along with altered mood and perception and difficulty with thinking and problem solving. It also leads to disrupted learning and memory (National Institute on Drug Abuse, 2014). Impaired coordination may lead to doubling the risk of injury or death while driving a car. Moreover, according to Seal, et al. (2012), long term users of marijuana may potentially lead to permanent detrimental effects on thinking and memory. It was also noted that the younger the cannabis habit begins, the worse the damage to the brain. Aside from the reduced white matter volume, disruptions to the white matter fibers of the brain were also observed. Furthermore, in another study done by Meier, et al. (2012) found that teenagers who routinely smoke marijuana could suffer from a long-term drop in IQ. Mental decline was only observed in subjects who started routinely smoking marijuana before the age of 18. Cognitive abilities lost were not completely restored to adults who stopped smoking marijuana.
Marijuana is considered a lung irritant. The same respiratory problems can arise from smokers of marijuana and tobacco. These respiratory problems include wheezing, phlegm production on most days, bronchitis and a higher risk of lung infection. Similar to tobacco, tar is also deposited into the lungs when marijuana is smoked, but four times as much tar into the lungs. More importantly, marijuana also contains 33 carcinogens; however, it is not associated with an increased risk for lung cancer for light to moderate users (American Lung Association, ND). Marijuana smoking also leads to injury to the large airways of the respiratory system and damages the alveolar macrophages. Conversely, graver pulmonary consequences arise from tobacco smoking compared to regular heavy marijuana smokers (Tashkin 2013).
It was previously mentioned in Green’s (1998) study that marijuana use is found to decrease intraocular pressure. However, he also noted that these effects are also present in other drugs, which are legal and do not have the adverse side effects that marijuana has. Thus, he concludes that use of marijuana to treat glaucoma is not advisable.
Also, although recreational marijuana users were reported to have a less depressed and more positive mood (Denson and Earleywine, 2005), it was also reported in the same study that medical users had a reported a more depressed mood and more somatic complaints than the recreational users.
The sperm is also damaged for marijuana smokers. Regular smokers were found to have a significantly decreased amount of seminal fluid and a reduced sperm count. Sperm was also found to swim too fast too early, making it more difficult for fertilization to occur. The exact mechanism of how marijuana use results to abnormalities in the sperm are still undetermined, but it is thought to be caused by THC (Burkman, 2002; Whan, 2006)
According to George Mason University (ND), marijuana use also has an effect on females. Aside from menstrual cycle interruption, marijuana, specifically THC, can lead to irreversible damage to the eggs in the ovaries. In a study done by Lamy, et al. (2014), marijuana use, along with tobacco and other drug use, resulted to higher chances of miscarriages and shorter gestation length, increased chances of uterine apoplexy and placenta previa, increased number of premature births. In addition, children with mothers who smoked during pregnancy were observed to have increased chances of growth disorders, learning or motor disorders, language disorders, cognitive disorders, ADHD and memory disorders.
Abrams, D., Jay, C., Shade, S., Visozo, H., Reda, S., Press, M., Kelly, M., Rowbotham, M., & Petersen, K. (2007). Cannabis in painful HIV-associated sensory neuropathy: A randomized placebo-controlled trial. Neurology, 68(7), 515-521. Retrieved March 2, 2015, from http://www.cmcr.ucsd.edu/images/pdfs/Abrams_2007.pdf
Ahmedzai, S., Carlyle, D., & Moran, F. (1983). Anti-emetic efficacy and toxicity of nabilone, a synthetic cannabinoid, in lung cancer chemotherapy. British Journal of Cancer, 48(5), 657-63. Retrieved March 2, 2015, from http://www.ncbi.nlm.nih.gov/pubmed/6315040
American Academy of Neurology. (2014). Guideline: Medical Marijuana in Pill Form or Oral Spray May Ease Some MS Symptoms; Little Evidence Other Complementary or Alternative Therapies Work. Neurology. Retrieved March 2, 2015, from https://www.aan.com/PressRoom/Home/PressRelease/1258
American Lung Association. (ND). Marijuana. Retrieved March 4, 2015, from http://www.lung.org/associations/states/colorado/tobacco/marijuana.html
Beal, J., Olson, R., Lefkowitz, L., Laubenstein, L., Bellman, P. Yangco, B., Morales, JO., Murphy, R., Powderly, W., Plasse, T., Mosdell, K., & Shepard, K. (1997). Long-term efficacy and safety of dronabinol for acquired immunodeficiency syndrome-associated anorexia. Journal of Pain and Symptom Management, 14(1), 7-14. Retrieved March 2, 2015 from http://www.ncbi.nlm.nih.gov/pubmed/9223837
Burkman, L., Schuel, H., Lippes, J., Crickard, K., Mahony, M., Giuffrida, A., Picone, R., & Makriyannis, A. (2002). Evidence that anandamide-signaling regulates human sperm functions required for fertilization. Molecular Reproduction and Development, 63(3), 376-387. Retrieved March 4, 2015, from http://www.ncbi.nlm.nih.gov/pubmed/12237954
Dai, S., Gui, H., Liu, X., Wang, Z., He, D., & Su, D. (2013). Expression of cannabinoid receptor 2 and its inhibitory effects on synovial fibroblasts in rheumatoid arthritis. Oxford Journals: Rheumatology, 53(5), 802-809. Retrieved March 2, 2015 from http://rheumatology.oxfordjournals.org/content/early/2014/01/16/rheumatology.ket447.long
Dangerous Drugs Board. (2008). Facts on Drugs. Retrieved March 2, 2015, from http://www.ddb.gov.ph/research-statistics/46-sidebar/58-facts-on-drugs
DeLorenzo, R., Wallace., M., Blair, R., Falenski., K., & Martin, B. (2003). The endogenous cannabinoid system regulates seizure frequency and duration in a model of temporal lobe epilepsy. The Journal of Pharmacology and Experimental Therapeutics, 307(1): 129-137. Retrieved March 2, 2015 from http://jpet.aspetjournals.org/content/307/1/129.full
Denson, T. & Earleywine, M. (2005). Decreased depression in marijuana users. Addictive Behaviors, 31(4), 738-742. Retrieved March 2, 2015 from http://www.ukcia.org/research/DecreasedDepressionInMarijuanaUsers.pdf
Eubanks, L., Rogers., C., Beuscher A., Koob., G., Olson., A., Dickerson., T., & Janda, K. (2006). A molecular link between the active component of marijuana and Alzheimer’s disease pathology. Molecular Pharmaceutics, 3(6), 773-777. Retrieved March 2, 2015 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562334/
Earleywine, M. (2002). Understanding marijuana: A new look at the scientific evidence. Oxford: Oxford University Press
Foundation for a Drug-Free World. (2014). Does Marijuana Kill Brain Cells? Harmful Effects on the Brain – Drug-Free World. Retrieved March 4, 2015, from http://www.drugfreeworld.org/drugfacts/marijuana/the-harmful-effects.html#footnote1_7wnpz53
George Mason University. (ND). Marijuana. Retrieved March 4, 2015, from http://www.gmu.edu/resources/facstaff/facultyfacts/1-2/grass.html
Green, K. (1998). Marijuana smoking vs cannabinoids for glaucoma therapy. Journal of the American Medical Association Archives of Ophthalmology, 116(11), 1433-1437. Retrieved March 2, 2015, from http://archopht.jamanetwork.com/article.aspx?articleid=264203
Lamy, S., Laqueille, X., & Thibaut, F. (2014). Consequences of tobacco, cocaine and cannabis consumption duringpregnancy on the pregnancy itself, on the newborn and on child development: A review. L’ Encephale, pii: S0013-7006(14)00202-4. Retrieved March 4, 2015, from http://www.ncbi.nlm.nih.gov/pubmed/25439854
Leweke, F., Piomelli, D., Pahlisch, F., Muhl, D., Gerth, C., Hoyer, C., Klosterkotter, J., Hellmich, M., & Koethe, D. (2012). Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Translational Psychiatry, 2, e94. Retrieved March 2, 2015 from http://www.nature.com/tp/journal/v2/n3/full/tp201215a.html
Meier, M., Caspi, A., Ambler, A., Harrington, H., Houts, R., Keefe, R., McDonald, K., Ward, A., Poulton, R., & Moffitt, T. (2012). Persistent cannabis users show neuropsychological decline from childhood to midlife. Proceedings of the National Academy of Sciences of the United States of America, 109 (40), E2657-64. Retrieved March 4, 2015, from http://www.pnas.org/content/109/40/E2657.full
National Institute on Drug Abuse. (2014, January 1). DrugFacts: Marijuana. Retrieved March 2, 2015, from http://www.drugabuse.gov/publications/drugfacts/marijuana
Seal, M., Zalesky, A., Solowij, N., Yucel, M., Lubman, D., Takagi, M., Harding, I., Lorenzetti, V., Wang, R., Searle, K., & Pantelis, C. (2012). Effect of long-term cannabis use on axonal fibre connectivity. Brain: A Journal of Neurology, 135(Pt 7), 2245-2255. Retrieved March 4, 2015 from http://brain.oxfordjournals.org/content/135/7/2245.long
Sylvestre, D., Clements, B., & Malibu, Y. (2006). Cannabis use improves retention and virological outcomes in patients treated for hepatitis C. European Journal of Gastroenterology and Hepatology, 18(10), 1057-1063. Retrieved March 2, 2015, from http://www.ncbi.nlm.nih.gov/pubmed/16957511
Tashkin, D. (2013). Effects of marijuana smoking on the lung. Annals of the American Thoracic Society, 10(3), 239-247. Retrieved March 4, 2015, from http://www.ncbi.nlm.nih.gov/pubmed/23802821
Whan, L., West, M., McClure, N., & Lewis, S. (2006). Effects of delta—tetrahyrocannabinol, the primary psychoactive cannabinoid in marijuana, on human sperm function in vitro. Fertility and Sterility, 85(3), 653-660. Retrieved March 4, 2015 from http://www.ncbi.nlm.nih.gov/pubmed/16500334
Westfall, R., Janssen, P., Lucas, P., & Capler, R. (2006). Survey of medicinal cannabis use among childbearing women: Patterns of its use in pregnancy and retroactive self-assessment of its efficacy against ‘morning sickness.’ Complementary Therapies in Clinical Practice, 12(1), 27-33. Retrieved March 2, 2015 from http://www.thevics.com/publications/cannabis_nausea2006.pdf
Zimmermann, K. (2015, January 14). Medical Marijuana: Benefits, Risks & State Laws. Retrieved March 4, 2015, from http://www.livescience.com/24554-medical-marijuana.html