Medical Cannabis: Debunking the MythA lot of air is being vented around the dichotomy of ‘Medical’ v ‘Recreational’ Cannabis. On the policy and public opinion level, this distinction is highly operative as countless legislative plans around the world are centered on it. However is there a sound scientific or medical basis that can support it?
The Plant & The Body: A Complex Interaction
In order to start the analysis of this question it is necessary to understand the plant & the human body holistically as a system of interaction. To the best of our current knowledge the Cannabis components active on the human body are Cannabinoids. These can, but do not necessarily carry with them psychotropic effects. Cannabinoids are particularly susceptible to interact in profound ways with the human body given a particularity of the latter. Humans have what has come to be known as the Endocannabinoid System (ECS). The ECS is a group of endogenous cannabinoid receptors located in the mammalian brain and across various parts of the nervous system – it plays an important regulatory role in pain, appetite, mood and others*. In short, the human body is naturally calibrated to recognize and utilize the chemical compounds produced in Cannabis. Even though true, this statement is in danger of producing the naïve conclusion that any/all cannabinoids in any form of intake are beneficial and free of negative side-effects – a conclusion that needs to be resisted. What is undeniable on the other hand is that cannabinoids have a strong effect on the human regulatory system (of which ECS is a major component).
Cannabis Sativa L. (Cannabis / Hemp) has been used by humans for thousands of years. With that in mind it is virtually impossible to give a comprehensive list of methods of consumption, let alone the psycho-social and / or medical and self-care motivations that underlie it. However interesting pointers can be given in order to commence an analysis relevant to the 21st century. A salient operative distinction is the presence (or absence) of a particular condition for which Cannabis is used. In the former case, from a usage point of view, it is appropriate to apply the label ‘medical use of cannabis’. Things, however, are never as simple as they seem initially – important considerations are needed to supplement this simplistic distinction. Firstly, it needs to be separated from the question of the Efficacy of the Treatment. The latter needs to be independently and objectively determined through appropriate scientific and quantitative standards. However the degree of efficacy doesn’t alter the motivation or use as medical from a subjective point of view. Furthermore, a distinction needs to be made between curative & condition management approaches. Cures are not the only relevant medical category. Secondly, the presence of a clearly defined condition is sufficient for the ‘medical’ label but not necessary inasmuch as one’s subjective experience of an ailment might not be represented in medical orthodoxy. More importantly, in line with the mood, sleep and appetite regulatory virtues of cannabinoids, maintaining an overall quality of life through their consumption has strong arguments for the ‘medical’ label. Illuminating examples are stress/anxiety management and insomnia suppression – both liable to have a huge impact in a person’s quality of life and overall health. Another important parameter to consider is which cannabinoids, or combination thereof, achieves the desired effects in an individual user, whether or not directly related to a specified treatment. There exists a general combinatory classification of cannabinoids and particular effects (see Table). However self-reported effects and outcomes are relevant given the uniqueness of each individual ECS. Furthermore, there is a strong a case to be made for ‘holistic’ effects of the plant as a combination of dozens of cannabinoids, terpenes and other micro-elements. A major dichotomy within the cannabinoids is effected between the psychotropic and non-psychotropic elements. The best representatives of each group respectively are THC and CBD. However it is wrong to presume that psychoactive cannabinoids are automatically associated with recreational or non-medical uses. Research shows that both these cannabinoids have major medical applications that range from mental conditions to cancer and multiple sclerosis. THC rich cannabis can therefore have medical applications in all its forms and methods of consumption. In conclusion it is misguided to naively conclude that the psychotropic effects of Cannabis are devoid of medical virtues.
Quality, Transparency and Ethical Responsibility
Transparency and accountability are the marks of any and all ethically sourced products. It is undoubtedly true that products marketed as ‘medical’ share a much heavier degree of responsibility however the principle is valid for all products destined to human consumption. In that respect there exist quality standards which can effect the Medical v Recreational distinction. Complete product characterization and ‘free of harmful exogenous substances’ are necessary conditions for the achievement of the desired medical effects as well as the protection of the user from potential harms (that could be caused from exogenous substances). If therefore a ‘Medical Cannabis’ legislation is adopted, it is necessary that the products available to consumers be of the accepted consumer, ethical and safety standards. As such, standardization and testing is necessary for a wide application of such a program, e.g. on a national level.
In conclusion it is important to say a few words on the semantics of the ‘Medical’ v ‘Recreational’ distinction. The very setting of the debate implies the mutual exclusion of each term involved. However this is, at the very least, a hasty assumption. The term ‘recreational’ has been further hi-jacked by the political debate and necessarily associated with pejorative connotations – with negative implications and stereotypes flourishing liberally. The point is not to defend one or the other use (or any use), rather illuminate the assumptions and premises of the argument and its modes of presentation. Cannabinoids are chemically relevant to the human body in ways which our scientific culture has come to label medical or medicinal. This is the base-fact of the plant as a relation to the human body, regardless of particular uses and regional legislation. From there on, particular uses of the plant can be for explicitly medical or non-medical purposes – however the modality through which cannabinoids interact with the body can always be viewed from the medical point of view. It is therefore a logical conclusion that appropriate use of cannabinoids, in light of the right evidence and research, can have medically positive outcomes. This concludes the end of Part A. of this presentation. In the second part (Part B.), policy implications will be explored and related with actual examples and developments on the European level in Part C.
*Non-Exhaustive list / Internet Sources