Let sleeping dogs lie

When Catriona Gray was asked her opinion on the legalization of marijuana use, her answer, while albeit short and safe, has been taken out of context by some ignorant sectors.

Let sleeping dogs lie is a phrase that means to “avoid interfering in a situation that is currently causing no problems but might do so as a result of such interference”.

The naïveté of some people regarding the legalization of cannabis has been made too simplistic.

Marijuana is often equated by the layman as “chongki” or “joint”. In this form, marijuana is illegal – with a tendency to be misused, abused, and for recreational purposes.

Without sounding too facile, let me clear the air with the correct medical information.

Cannabis, hemp and marijuana are often confused to be interchangeable.  They are NOT the same. 

Cannabis is a family of plants with two primary classifications – Indica and Sativa. Hemp and marijuana are species of cannabis and both are members of the Cannabis Sativa family. Hemp and marijuana therefore share certain similarities, but their biological structures are distinct and it is what differentiates them.

Cannabis contains a variety of different compounds called cannabinoids. The most dominant are THC (tetrahydrocannabinol) and CBD (cannabidiol). Both have been found to provide profound benefits physiologically and pharmacologically. However, THC has psychoactive effects. CBD does not.

These two abbreviations will repeatedly by used in this blog. They are important to remember.

Hemp contains a very low concentration of THC (<0.3%) while Marijuana is abundant in THC (20-40%). Hemp is grown for industrial purposes, while Marijuana is used for recreational and medicinal purposes.

Hemp for industrial use include paper, clothing, building materials, oils, biofuel, clothing etc. Because of the increasing value of CBD, hemp is now being used to produce a variety of THC-free CBD products.

Medical vs Recreational Use

The legal basis of the each plant is based on the presence (or absence) of THC. Because the story of Marijuana (as a plant for recreational use) is different due to its high THC-content (hence the psychoactive effects), the justification for use in the clinical setting should be made clear.

Just like many “dangerous drugs”, the medical uses of cannabis are abundant and endless. The largest therapeutic evidences are in the ability of cannabis to reduce chronic pain, nausea and vomiting in patients undergoing chemotherapy, and spasticity of muscles from multiple sclerosis.

The medical use of marijuana is to address health conditions – getting relieved of symptoms AND NOT GETTING HIGH. While the marijuana plant is obviously the cheaper version, it is always at its most raw form. You cannot calculate the exact dose (and neither can it be replicated) for every “joint” that is taken (or you get a hit from). How many “hits” is equivalent to an antiemetic effect? Or how much cannabinoid oil should your son take in order to control his seizures? No one knows! The ED50:LD50 ratio (effective dose:lethal dose at 50%) is not determined with dried plant and weeds or oil preparations. So, while the ingredients are the same for pleasure and the treatment of pain, the final form in its exact dosage format is important for medical use.

Marijuana contains some of the chemicals found in tobacco and that smoking it can be harmful to the lungs. There is scientific evidence that lung health is a problem seen among marijuana smokers. The THC content is addictive and like any recreational drug, it can serve as a “gateway” to other prohibited and regulated medicines. The higher the THC contents, the more often it is used, the more likely one becomes dependent.

from medium.com

Cannabidiol

Unlike THC, CBD does not give the euphoric effect nor cause intoxication. As I previously discussed, it is THC that causes the psychoactive high for marijuana. Obtaining the active substance CBD from the marijuana plant is vital to drug development – drugs with uniform strength and consistent delivery system that provides the appropriate dosing for patients that need to get treated for any indicated disease. Making unapproved products with uncertain dosages and formulations for the treatment of serious and fatal diseases is like making poor quality guns and ammunition readily available for use by the general public. You’re not really protecting yourself when you need it most.

Dronabinol and Nabilone were the first two available cannabinoid drugs approved for the treatment of nausea and vomiting from chemotherapy. Both are synthetic derivates (not plant based but the chemical structure is laboratory derived). The cannabidiol, Epidiolex, oral solution was recently approved (June 2018) for the treatment of seizures associated with Lennox-Gastaut Syndrome and Dravet Syndrome in patients 2 years and older. Epidiolex is the first FDA-approved drug that contains a purified drug substance derived from marijuana (unlike Dronabinol and Nabilone which are synthetic forms).

These basic information should hopefully provide a bit of awareness to the reader – both lay and those with medical background experience – on the differences between what medical and recreational marijuana are. The legislative policies should also be taken into consideration. But that’s taking too much space on my blog.

You need to understand that not all apples are the same.

And that we need to let sleeping dogs lie.

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