Medical Cannabis: A Review of Medicinal Cannabis: History, Pharmacology, and Implications for the Acute Care Setting

By Margaux Albiez

Medicinal Cannabis: History, Pharmacology, and Implications for the Acute Care Setting by Mary Barna Bridgeman and Daniel T. Abazia underlines the complex and confusing nature of legalizing medicinal cannabis use. According to the World Health Organization, marijuana is the most commonly cultivated, trafficked and abused illicit drug worldwide. Evidence shows that marijuana has a long history of use. It was widely used in the U.S. in the 19th and early 20th centuries. It was first restricted by the 1937 Marihuana Tax Act and was fully criminalized by the Controlled Substances Act of 1970, in which it was declared a Schedule I drug, defined as “having a high potential for abuse, no currently accepted medicinal use in treatment in the United States, and a lack of accepted safety data for use of the treatment under medical supervision.” California was the first state to allow legal use of medicinal cannabis with the Compassionate Care Act of 1996.

The studies conducted on adverse effects of cannabis usually gather data from recreational users of marijuana. In a review of studies on medicinal cannabis use, it was found that the majority of adverse effects were deemed non-serious, the most common being dizziness (Bridgeman 183). Other adverse effects included impaired coordination, anxiety, and psychotic symptoms. Long term studies on the effects of cannabis are lacking but necessary. Studies of medicinal uses of cannabis are also lacking and fail to establish their efficacy for specific illnesses or symptoms. Data indicates that cannabis works as a safe and moderately effective pain reliever (Bridgeman, 183). Studies have also been done on cannabis alleviating nausea in chemotherapy patients which show that it is a viable alternative for patients that do not respond to conventional antiemetics (nausea alleviating drugs) (Bridgeman, 183). Despite limited data on medicinal cannabis, 33 states, along with the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands have legalized medical cannabis use.

Use of medical cannabis has been highly debated, partially due to there being few studies on its effects and benefits. Regulation of medicinal cannabis is hindered by the lack of data on the drug. The DEA regulations of cannabis make it difficult to acquire for research. There are other issues as well, the Center for Medicinal Cannabis Research at the University of California-San Diego had approval, access to the drug, and funding for several trials, however, it was cancelled because too few participants signed up (Bridgeman, 186). Lack of clinical research leaves policy makers and clinicians to rely on anecdotal evidence. The contradiction of federal and states laws, along with the lack of research, complicate the implementation of regulatory policies.

Use of medical cannabis has been highly debated, partially due to there being few studies on its effects and benefits. Regulation of medicinal cannabis is hindered by the lack of data on the drug. The DEA regulations of cannabis make it difficult to acquire for research. There are other issues as well, the Center for Medicinal Cannabis Research at the University of California-San Diego had approval, access to the drug, and funding for several trials, however, it was cancelled because too few participants signed up. (186) Lack of clinical research leaves policy makers and clinicians to rely on anecdotal evidence. The contradiction of federal and states laws, along with the lack of research, complicate the implementation of regulatory policies.

Another issues in this is the use of medicinal cannabis in acute care settings. Hospitals often receive federal funding and the Schedule I designation of cannabis causes concern that they may lose funding if they permit the use of cannabis (Bridgeman 186). Nonetheless, the U.S. Attorney General in 2009 recommended that in states where medicinal cannabis is legalized, enforcement of federal laws should not be prioritized. Within acute care settings, issues of medicinal cannabis use are largely logistic include concerns over administration, storage, and means of ingestion. (Bridgeman 186) Proponents of medicinal cannabis use say that discontinuing the use of the drug in acute care settings can disrupt the patient’s treatment.

This article shows that medicinal cannabis, despite growing support and legality, requires more clinical studies to understand its effects. Without such data, regulation and policy fail to properly address the drug. This hinders individual’s ability to receive proper treatment for their medical conditions as health care officials are forced to work within a narrow and complicated framework of policies.

References

Bridgeman, Mary, and Daniel Abazia. 2017. “Medicinal Cannabis: History, Pharmacology, and Implications for the Acute Care Setting.” P&T 42, no. 3 (March): 180-188.

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