Does The Medical Marijuana Helps?

Smoking of marijuana for therapeutic purposes is still banned in France. On Wednesday, the Belfort correctional court sentenced a 300 euro fine to a young man suffering from myopathy for consuming and storing marijuana.
 Atlantico: Many European countries (Spain, Germany …) allow medical marijuana. What results did the states that made such a decision achieve?
 Alexander Baratta: Marijuana can be used as an analgesic in various ways. Tetrahydrocannabinol or THC, which is the main active ingredient in Indian cannabis, can be inhaled with smoke, taken in tablets or as a sublingual spray. The tablet has a very weak analgesic effect, unlike a cigarette or a spray. Their analgesic effect has been scientifically proven in the case of chronic pain of various origins (cancer, HIV, multiple sclerosis). The problem with smoking is quite obvious: the effectiveness depends on the type of plant, the methods of collection and preparation. Standardization of procedures is required here.
 There were also suggested more interesting alternatives: synthetic analogs such as nabilon and dronabinol. They are extremely effective as a means of fighting nausea during cancer treatment, but their analgesic properties are not very good. Finally, there is the drug “Savitex”, which combines the molecules of two different cannabinoids. In general, the results of studies confirm its effectiveness in the fight against chronic pain. Nevertheless, according to this indicator, he still can not get around Codeine. In addition, during the study, almost half of the patients did not experience any improvement, and a quarter did not take the drug at all because of side effects.
 Thus, marijuana can indeed be of interest in certain cases and make life more comfortable for some chronic pathologies. But its analgesic effect is still lower than that of morphine. Mostly it can be used as an addition to morphine, in order to reduce its dosage.
 Finally, a 2005 survey of HIV-positive people who used medical marijuana gave eloquent results: it was found that only 27% actually used it as an analgesic, while the remaining 73% smoked “grass” just to enjoy it.
 William Lovanstein: There is no consensus in science on this score. First of all, there are a lot of different recipes. Further, there are two systems. The first was introduced in 19 US states: there you can get a prescription for marijuana for a variety of indications, in connection with which it is difficult to assess the situation. The Italian and Spanish systems in turn allowed research to be conducted that, in general, did not yield satisfactory results, because most of the medicines present in the market contain two or three cannabinoids, while there are about 60 of them.
Nevertheless, 11 years ago in The Hague, a European conference on this problem was held, at which encouraging results were announced. First of all, it concerns neurodegenerative diseases (multiple sclerosis …), in which case there were interesting results in terms of increasing comfort and easing pain. Medical marijuana also showed positive results when taking some heavy drugs (they are used in the fight against HIV or hepatitis C): it allowed the patient to better tolerate the treatment and led to an increase in appetite. As a whole, it is not yet possible to talk about any concrete conclusions, but this does not mean that we should not listen to patients who say that it has become easier in a country where, for example, phytotherapy or homeopathy is allowed.
 The difficulty lies in the fact that now we are moving from the medical sphere to the political one. Some fear that the use of marijuana for therapeutic purposes can lead to a general lifting of the ban on its use in our country, although these two points, of course, should not be confused. This initiative should have a purely medical nature, but for it create political and legal obstacles. From a medical point of view, it is simply amazing that a person who tries to take pain through self-medication can be judged.
 – Are there abuses in the use of marijuana for therapeutic purposes? From this point of view, what can be learned from foreign experience?
 William Lovanstein: I would not say that. In modern drugs based on marijuana, molecules of two or even three substances are used, so they are practically not addictive, unlike many painkillers, such as derivatives of morphine and codeine. When we see that in France Efferalgan does not create any problems, while the issue of codeine dependence is quite acute, this can not but lead to certain thoughts. In an effort to stifle the pain, there is nothing shameful. All drugs, even those that are addictive, can bring a huge benefit here. Patients in their overwhelming majority are reasonable people who just want not to experience pain.
 Nevertheless, political considerations often overshadow the medical. We still do not know much about cannabinoids, and therefore it is absolutely necessary for us to continue our research. It is impossible to create political and legal obstacles to medical initiatives, if they bring relief to patients, and medical research, when they can lead to the creation of new methods of treatment. It is not enough just to give out marijuana in addition to existing therapeutic methods, you need to find a way to alleviate the suffering of patients.
 Alexander Baratta: Of course, there is a danger of abuse. And to be convinced of their existence, it is not necessary to go to Canada. Look at what happens here, for example, in the Subutex trade. “Subutex” is used as a substitute in the treatment of dependence on opiates and, first of all, heroin. This drug is prescribed for the treatment of drug addicts, and very strict rules apply here. Despite everything, cases of fraud are still quite frequent: unscrupulous patients bypass physicians and pharmacies in order to receive several doses of the drug. Further, they sell it at a double or even triple price: we get a real drug trade, which is funded by a health insurance system. A similar situation may arise with marijuana.
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