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GANJA - Is it harmful or useful?

Eulalee Thompson, Jamaica Gleaner News, 11th May 2005

CONTROVERSY OR not, local scientists, Dr. Henry Lowe and Professor Errol Morrison note in their book the History of the use of Marijuana that ganja is liberally used by the folk in soups, cakes and cookies. The leaves are brewed and the tea taken as tonic or crushed and applied as an ointment to cure various conditions. In common folk preparations, the green leaves or buds are soaked in white rum (sometimes tempered with fruit juice) and used for the relief of stomach ache, toothache and symptoms of asthma.

Clinical evidence supporting ganja’s effectiveness in treating symptoms, such as pain, nausea, vomiting and appetite loss has been compiled by the United States Institute of Medicine/National Academy of Sciences (1999), which also notes that ganja’s primary active ingredient, THC (or delta-9-tetrahydrocannabinoids), has been approved by the U.S. Food and Drug Administration (FDA) under the name dronabinol and marketed as Marinol.

PAIN
After reviewing the studies on ganja and pain, the Institute of Medicine (IOM) states “the available evidence from animal and human studies indicates that cannabinoids can have a substantial analgesic effect.”

The evidence, however, did not hold up in cases of experimentally-induced acute pain, which the IOM attributes to limitations in the design of those studies. They recommend further research to determine the “magnitude of the effect in different clinical conditions” and whether the effect is sustained.

Some side effects of ganja were noted here for further study such as sedation, anxiolysis (antianxiety effects), appetite stimulation, and antinausea and antispasticity.

GLAUCOMA
On the issue of eye disease, glaucoma, the IOM report states that “the potential harmful effects of chronic marijuana smoking outweigh its modest benefits in treating glaucoma” and that more research is required to isolate, its therapeutic effect against high intraocular pressure (IOP).

Most Jamaicans would already be aware that two highly-acclaimed local scientists, Drs. Manley West and Albert Lockhart, have already isolated ganja’s therapeutic compound and have developed two drugs, canasol and cantimol, that effectively treat glaucoma.

Cantimol is a combination of canasol, an alpha agonist and timolol maleate, a beta blocker.

West and Lockhart have stated in previous interviews that their local clinical studies on the glaucoma treatments are not recognised by the U.S. Food and Drug Administration. The drugs would not, therefore be available to the American market unless expensive studies are replicated there. West and Lockhart have also developed other drugs from ganja, such as asmasol to treat asthma attacks and canavert for motion sickness.

NAUSEA AND VOMITING
The IOM noted that the special treatment requirement by certain subgroups of patients suffering from nausea and vomiting. These patients, such as those suffering chemotherapy-induced nausea , do not respond to standard antiemetic drugs.

The IOM stated that “it is possible that the harmful effects of smoking marijuana for a limited period of time might be outweighed by the antiemetic benefits of marijuana, at least for patients for whom standard antiemetic therapy is ineffective and who suffer from debilitating emesis. Such patients should be evaluated on a case-by-case basis and treated under close medical supervision.”

APPETITE STIMULATION
Patients with cancer and AIDS sometimes suffer suppressed appetites and wasting/weight loss. The IOM stated that the effects of wasting can be mitigated by ganja. It stated that “although some medications are more effective than marijuana for these problems, they are not equally effective in all patients.

A rapid-onset (that is, acting within minutes) delivery system should be developed and tested in such patients”. The IOM warns against smoking ganja, especially long-term smoking, “particularly for patients with chronic illnesses” but stated that in terminal patients the benefits might outweigh the harm.

BRAIN AND SPINAL CORD PROBLEMS
Problems related to the brain, spinal cord or peripheral nerves and muscles are usually described by physicians as neurological disorders. The IOM’s evidence of ganja’s effect on these disorders is less conclusive. In relation to muscle spasticity, it states that the “observations are consistent with the possibility that cannabinoids have antispastic effect but do not offer any direct evidence”. They could not accept or dismiss ganja’s usefulness here and suggested further well-designed clinical studies.

On the topic of movement disorders IOM believes that ganja may provide some symptomatic relief in some of these disorders for example in parkinsonism and tics but the evidence was largely anecdotal and lacking in well-controlled clinical studies.

SIDE EFFECTS
The jury is still out on ganja’s role in mood and psychotic disorders such as schizophrenia. University of the West Indies’ Professor Frederick Hickling argued in a paper entitled “The Mental Health Perspective of Cannabis Use in Jamaica” that most authors conclude that cannabis psychosis “is a dubious clinical concept”.


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