UK Home Secretary Sajid Javid’s announcement to review medical cannabis in the UK marks a huge turning point, and could save many people’s lives.
The cannabis plant has been needlessly demonised and politicised over the past 100 years. This movement culminated in the 1970s, with massive rafts of legislation brought in to schedule various drugs on a scale of I to V in the US, or A to C in the UK. Put simply, politics seeped their way into the classification process of drugs, with science taking the back seat.
The change in attitude is a rather recent one. Cannabis has been used as medicine by various cultures throughout history for thousands of years, and cannabinoid-based tinctures were available as medicine in pharmacists throughout the UK up until 1971, when the Misuse of Drugs Act was introduced.
As it stands, cannabis is a Class B drug in the UK, alongside amphetamines, barbiturates, codeine and synthetic cannabinoids. In the US, cannabis is a Schedule I drug, in the same class as heroin and cocaine. When looking at the safety profile of cannabis in comparison to other drugs in the same category, the classification systems we have in place in many countries across the world appears irrational.
Moreover, alcohol and tobacco are not classified in the same way, despite the personal and social harms they cause. This also means that drug policy is not entirely honest, which causes more devastation in the long run. Bad drug policies sow the seeds of mistrust amongst the public.
One of the key areas that current drug policies have caused damage, especially with regards to cannabis, is medical research. There are few if any plants in the world as unique as cannabis. There are around 483 known cannabis compounds, with 65 of them being cannabinoids, and we are still discovering more. Most of these cannabinoids have no psychoactive effect whatsoever, and could have uses for a huge number of chronic and life-threatening conditions. In addition, there have been no deaths attributed to an overdose of cannabinoids alone, even psychoactive ones such as THC.
There are a huge number of opioid-, benzodiazepine- and amphetamine- based drugs being prescribed to patients that could easily kill them. Some drugs even get approved for clinical use after only one or two trials. Yet we treat cannabinoids differently.
Cannabis is a medicine. Many who are purported to use cannabis recreationally may actually be self-medicating. One of the most important issues affecting our time is the increase in cases of anxiety, especially amongst the youth. Back in 2013, there were more than 8.2 million people suffering from anxiety in the UK, and this figure has only risen. Many current anxiety medications that are prescribed are much more harmful than medical cannabis, such as benzodiazepines (e.g. diazepam). These medications are highly addictive and can cause seizures upon withdrawal. In contrast, cannabis is not physically addictive.
Despite the fact that we have medical-grade opioids, the idea that we could also have medical-grade cannabinoids is alien to many people. Indeed, legalising cannabis for medical use may help us develop safe, well-tolerated medications for chronic pain, cancer, epilepsy, multiple sclerosis, Parkinson’s disease and irritable bowel disorders.
The list continues. As well as being an effective anti-anxiety and pain relief medication, medical cannabis could be used as a medication for numerous other diseases, and even mental health disorders, such as Anorexia. Medical cannabis has already been shown to be an effective medication for epilepsy, Parkinson’s disease, arthritis, autoimmune diseases, and glaucoma (an eye disease that can cause blindness). In fact, there are already two forms of cannabis medicine available on the NHS, one is Sativex by GW Pharmaceuticals for MS, which is only available in Wales. The other is Nabilone, which treats the nausea and vomiting that cancer patients experience while going through chemotherapy.
This may only be the tip of the iceberg, however, as medical cannabis has also been shown to have potential as a treatment for cancer itself. There have been studies showing that it can shrink tumors, such as Lung Tumors and Gliomas (brain cancers from glial cells) including the most aggressive form, Glioblastoma Multiforme. In research by the National Cancer Institute (NCI) in the US, Dr. Michael Masterman-Smith tested 11,000 compounds studied for potential anti-cancer properties. He found 11 that were of significant value – 6 of which were cannabinoids, including THC and CBD. With cancer rates increasing every year, it would make sense to study this more, and see if cannabis could be an effective part of cancer treatment plans.
Why can cannabinoids be used for so many conditions? Everyone has an endocannabinoid system (ECS), which plays a fundamental role in homeostasis. Many health problems may cause or be caused by an underlying “endocannabinoid deficiency”, and cannabinoids can be used to overcome this deficiency.
We need to do something, and fast. Use of pain medications, such as opiates, have been on the rise in the UK. Over the last four years, the number of reported drug misuse deaths involving opioids (including heroin) shot up by 58 per cent in England, 23 per cent in Wales and 21 per cent in Scotland. It seems that the UK is on the verge of an opiate crisis, like the one that has ravaged the US. However, medical cannabis could help avert this crisis. In the US in 2015, opiate-related deaths decreased by up to one third in the states that legalised medical cannabis.
Whilst cannabinoids are not necessarily suitable for every condition or every person, there is certainly enough scientific evidence to suggest that we should research what this amazing plant can and cannot do for us. Not embarking upon this research takes away an essential tool from the doctor’s toolbox and it effectively signs people’s death warrants.
There are already 37 countries in the UN who have medical cannabis programs, and they have all been successful. It is time for the UK to wake up and stop denying the clear evident benefits of cannabis.
Dr Frank D’Ambrosio is an orthopaedic surgeon and and leading expert in medical cannabis policy reform
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