Since September 2003, doctors have been able to prescribe cannabis for medicinal use and pharmacists have been allowed to dispense it on prescription. The Cannabis plant has been used throughout the centuries for its sedative and analgesic effect, and in the last century also in modern medical science. However, American research shows that its alleged positive effect is moderate. Not a panacea, but certainly beneficial.
Medical cannabis
In the 20th century, it was found that ocular pressure decreased with cannabis use during a study of THC levels in cannabis users, which later led to experiments with medicinal cannabis use in glaucoma patients. At the time, Vietnam veterans in America regularly used cannabis to reduce joint pain in particular. In recent decades, cannabis has mainly been prescribed for chronic pain, MS, chemotherapy, epilepsy, HIV/AIDS and Parkinson’s disease. In some cases it is prescribed to counteract the side effects of medications, such as decreased appetite or nausea during chemotherapy. In the Netherlands, the use of cannabis for medicinal purposes is permitted, provided it is prescribed by a doctor. In Belgium, medicinal cannabis use is prohibited by law and is only permitted in the context of scientific research.
In the Netherlands, cannabis for medicinal use can be supplied by a pharmacy, where in the early years patients had to buy it themselves at a coffee shop, or at a reduced rate. There are some health insurance policies that do not yet reimburse medicinal use, or only in very specific cases. In America, medical cannabis use has been slowly introduced in recent decades and has been recognized in 23 states as a possible treatment for various symptoms, where previously its use circulated mainly in illegal circles.
Logically, most forms of medicinal cannabis are smoked. However, in recent decades, variants have also become available in tablet and drink form and even a mouth spray. The latter variants are preferred, as they do not have the undesirable effects of smoking cannabis, and are also easier to administer for people with reduced coordination.
In contrast to cannabis intended for recreational use, medicinal cannabis has a lower THC content, which means that the well-known side effect of getting ‘high’ occurs less quickly. This composition makes long-term use during the day more possible.
Research
Scientific research that provides evidence of the positive effects of medicinal cannabis use has long been very limited and has only really started to take off since 2000. Due to the criminalization of the cultivation, production and distribution of cannabis, it was impossible for scientists to conduct research into the effects of (medical) cannabis use for a long time.
In an American meta-analysis, where the results of 79 different studies on the use of medicinal cannabis were combined, it appears that there is only moderate evidence for the alleged positive effects of medicinal cannabis. In total, more than 6,000 people were treated with a form of medicinal cannabis or a placebo. Different results were reported for different conditions studied. The results of the application of medicinal cannabis use are so far positive, but not entirely overwhelming.
It also appears that in edible forms of medicinal cannabis, the labels were not found to be 100% accurate when it came to components such as THC.
In addition, many side effects were reported, which in most cases were very undesirable. These side effects of medicinal cannabis use are similar to recreational cannabis use. Examples include dry mouth, drowsiness, increased appetite (and weight gain in the long term), dizziness, confusion, hallucinations, euphoria and nausea. Symptoms increased sharply in various psychiatric disorders, as was already known with recreational use of cannabis.
And further
In Colorado, America, where cannabis was one of the first states to legalize cannabis use, researchers are using cannabis in war veterans to potentially alleviate symptoms of post-traumatic stress disorder. For the time being, researchers are positive about the expected results.
The controversy surrounding the research is mainly political: several studies were cited in the legalization of cannabis in America. Now that studies show that the evidence for these assumptions is incomplete, the discussion surrounding (medical) cannabis use has flared up. The legalization of cannabis use is mainly based on reports from patients themselves or incomplete scientific studies and therefore lacks scientific evidence.
In the meta-analysis, psychiatrists from Yale University in America write about the hype surrounding (medical) cannabis use in recent years. Legalization gave this use a significant boost in popularity, which may have caused the results of research to be embraced too enthusiastically. Some restraint will be appropriate, the psychiatrists say. In addition, they write that repeated recreational cannabis use can indeed be addictive, and in the future the effects on the growing brain of children with medicinal cannabis use by children must be examined.
