Medications and YOU 11 of 11

Medical marijuana

What is marijuana? 

Marijuana (also known as cannabis) is a hemp plant.  The flowers and the leaves of the plant contain a chemical known as tetrahydrocannabinol (THC), which causes the effects felt with marijuana use.  It is the THC that is sought after for various medical applications.

What are the effects of marijuana?  

Marijuana may produce the following effects (note that the effects listed below are not experienced by everyone who uses marijuana, and some people may experience side effects other than those listed):

·    psychological and cognitive effects such as euphoria (commonly referred to as a "high"), dysphoria (a "low"), anxiety, personality changes, hallucinations, misperceptions, sedation, and memory impairment

·    fidgeting, muscle twitching, and general weakness

·    pain relief

·    suppression of nausea

·    increase in appetite

·    tolerance (with long-term use) - this seems to develop with most of the behavioural effects, including the "high"

·    increase in heart rate (with short-term use)

·    decrease in heart rate (with long-term use)

·    decrease in blood pressure (because of widened blood vessels; it is this effect that causes red eyes)

·    increase in breathing (at low doses)

·    expansion of airway and coughing - tolerance develops to these effects

·    smoked-related lung damage (with long-term use)

·    impairment of the body's ability to fight bacterial infections (with long-term use)

·    men:

o       hormonal imbalances and decrease in sperm count and mobility (with long-term use; tolerance may develop to these effects)

·    women:

o       hormonal imbalances and suppression of ovulation (with long-term use)

What are the medical uses of marijuana, and is there any evidence to support its use?

Many consider smoked marijuana to have anti-nausea benefits, but there is no evidence to support claims that marijuana is as good as or better than existing anti-nausea medications.  

The capsule form of cannabis (dronabinol) is used to treat chemotherapy-induced nausea and to stimulate a person's appetite in cases of AIDS-related weight loss.  It has been shown to significantly increase appetite, but it also causes undesirable side effects such as dizziness and confusion.  A major concern associated with its use by those with AIDS or cancer is the risk of increased difficulty in fighting infections.   

A few published studies suggest that smoking marijuana helps people with multiple sclerosis as well as those with spinal cord injuries to relieve their symptoms. 

Dronabinol was found to provide significant pain relief but it can cause drowsiness and mental clouding. 

The high intraocular pressure (pressure inside the eye) that occurs with glaucoma can be reduced by marijuana use (taken in capsule form, or smoked); this is supported by a few reports from treatment of glaucoma patients.   

Marijuana has also been considered for the treatment of many psychiatric disorders such as depression, sleep disorders, and Alzheimer's disease, but no evidence exists to prove its effectiveness in these areas. 

What forms does marijuana come in?

·    inhalation (smoked)

·    oral (capsules)

·    rectal (suppositories)

Is marijuana addictive?

It may be.  It's important to know that inappropriate use of marijuana can lead to physical dependence and addiction.  Physical dependence means that when a person stops using the substance, they develop withdrawal symptoms.  Dependence has been produced in experimental studies following a prolonged intake of high doses of marijuana.  Withdrawal symptoms include disturbed sleep, decreased appetite, restlessness, irritability, and sweating.  Physical dependence is not the same as addiction.  Addiction is a psychological need for the drug that leads to cravings, inability to control drug use, and an uncontrollable need to use the drug despite the harm it may cause.  Whether or not someone becomes addicted to marijuana will depend on a variety of factors, such as genetics.

What's the status of medical marijuana in Canada?

In Canada, possession of medical marijuana is controlled under the Marijuana Medical Access Regulations, which came into effect in the summer of 2001.  The regulations allow individuals with severe diseases to use marijuana to relieve their symptoms when the usual treatments for these conditions have failed. 

However, marijuana continues to be an illegal drug in Canada, and its use for medical purposes is largely unproven. 

Who can qualify to use marijuana for medical purposes?   How do I apply? 

Health Canada outlines the following three categories of individuals who may qualify to use marijuana medically. 

Category 1:

 This category applies to terminally ill persons who are expected to pass away within 12 months. 

Category 2:

 This category applies to those who suffer from specific symptoms of a serious illness where usual therapies have failed.  These symptoms include:

·    severe pain or muscle spasms from multiple sclerosis or a spinal cord injury or disease

·    severe pain, inability to eat, severe nausea, weight loss, and malnutrition from cancer or HIV/AIDS infection

·    severe pain from severe forms of arthritis

·    epilepsy seizures

Category 3:

 This category applies to those who have serious medical conditions and are experiencing symptoms that are not outlined in categories 1 and 2 where usual treatments have failed. 

You must apply to Health Canada's Office of Cannabis Medical Access (OCMA).  A medical specialist must complete and sign a medical declaration (an application form) indicating your symptoms and the dosage of marijuana being prescribed.  If you are authorized to use medical marijuana, you will be issued an identification card that must be presented to police on request. 

Where can I get medical marijuana?  

If you are permitted to possess medical marijuana, you can grow your own supply or select someone to grow it for you.  An identification card and a production license are required from Health Canada.  The person growing the marijuana must live in Canada and be at least 18 years of age.  The plants may be grown indoors or outdoors and the amount that can be grown or stored at any time depends on the daily dosage of marijuana prescribed by your doctor.  You can also apply to obtain dried marijuana grown by Health Canada. 

How much can I have at any one time? 

At any one time, you can only possess a 30-day treatment supply.  If you have more than this amount, you may be subject to prosecution. 

Where can I find more information? 

For more information on the regulations or to obtain application forms, visit Health Canada's Marihuana Medical Access Division at www.hc-sc.gc.ca.  You can also write to the Marihuana Medical Access Division, Drug Strategy and Controlled Substances Programme, Healthy Environments and Consumer Safety Branch, Health Canada, Address Locator 3503B, Ottawa ON K1A 1B9.