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Marijuana has shown great promise in treating a number of serious diseases from cancer to epilepsy.The pharmaceutical industry has been racing to develop patentable synthetic drugs to mimic marijuana but with an unnatural molecular formula that differs from the chemical make-up of marijuana-the-plant. The goal for pharmaceutical companies is to be able to charge patients a huge sum of money to get the synthetic marijuana drug. Big Pharma may also choose to shelve their marijuana-inspired drugs by claiming that they have serious side effects. Pharmaceutical companies that develop synthetic marijuana can tell doctors to avoid using these drugs unless all other “conventional” drugs have been tried first. Doctors believe these warnings are meant to protect patients from serious side effects. The understanding is that marijuana itself is dangerous. Many patients as a result are ambivalent about marijuana for cancer because of its reputation as a “gateway-drug” with synethic pharmaceutical versions that are “dangerous”. This is unfortunate because marijuana not only helps patients endure the awful side effects of chemotherapy, but when used outside of conventional medicine as a stand-alone therapy or a treatment used as part of a cancer protocol, marijuana has powerful medicinal effects that can lead to recovery from cancer.
Marijuana as a cancer treatment is a complex topic. Since most Americans have been socialized to believe that marijuana is a “gateway drug”, an illegal substance that leads to no good, there are important prejudices to surmount before discussing this plant’s value as a cancer treatment. State legalization of marijuana demonstrates that people’s minds are opening to this herbal medicine, but federal resistance to legalization demonstrates that there are still obstacles to overcome. For cancer patients who are struggling with pain either from the cancer itself or from a range of side effects from chemotherapy treatments, marijuana is a palatable option. Few people realize that this plant also has curative properties that can help prevent and treat cancer.
Medical marijuana, derived from the Cannabis sativa plant, has definitely caught on in cancer circles. It’s famous for helping patients deal with the awful side effects of chemotherapy, but some patients claim that cannabis has cured them of cancer. Though conventional medicine refuses to embrace the use of marijuana-the-plant, the FDA and pharmaceutical companies have been racing to come up with their own synthetic version of marijuana in the form of man-made, specially-designed molecules that roughly mimic the action of THC. And while there’s research showing that cannabis does have anti-cancer properties, drugs that are being developed to treat chemotherapy-induced nausea and vomiting do not make use of a wide-range of the cancer-killing molecules known as cannabinoids, many of which work synergistically to heal the body from a variety of ailments. Synthetic drugs (renditions of THC and CBD) on the other hand are made to mimic the action of only one cannabinoid: THC. Drug companies have then sought approval for these synthetic drugs by the FDA but for use only as a last-resort anti-emetic for chemotherapy patients after all other anti-emetic options have failed to produce positive results .
As the marijuana industry has grown, the naturally-occurring hallucinogenic molecules in the plant have been separated from naturally-occurring molecules that have other effects on the body which has made it possible for patients to experience the benefits of marijuana without having to experience the psychological “high” caused by the plant. While THC has mind-altering abilities, CBD does not produce these effects. The separation of THC from CBD has made it possible for patients to choose the right plant-derived molecules to treat whatever ails them .
As mentioned above, while THC and CBD are the two cannabinoids that have been researched the most, the cannabis plant itself produces over 100 different cannabinoids. Some of these cannabinoids enhance or modulate the effects of THC and CBD inside the body. This is known as the “entourage effect”. Plants often contain substances that appear to be inert, but that actually enhance or otherwise regulate the behavior of the other “active” molecules. Whole-plant medicine that does not remove the additional cannabinoids may be important in cancer treatment .
Studies with animals in laboratories have shown that cannabinoids (CBD and THC do in fact kill cancer cells. According to a study completed in 2014 and published in Oncotarget, the cannabinoids have an anti-proliferative effect on cancer cells. Another study undertaken in 2013 by Italian scientists demonstrated that non-psychoactive CBD was able to prevent migration, adhesion, and invasion of cancer cells .
Research has shown that marijuana has an anti-cancer effect via CB1 or CB2 cannabinoid receptor sites located on cancer cells. As such, marijuana can regulate important cellular signaling pathways that affect a cancer cell’s survival, invasion, the development of a blood supply, as well as its ability to spread to other areas of the body (metastasis). THC causes an increase in ceramide synthesis that leads to the death of the cancer cell. Ceramide is a molecule that can induce multiplication, growth, and migration of cells, but it also induces apoptosis or cellular death. Normal cells don’t produce ceramide in response to being exposed to THC so they aren’t affected by the use of marijuana .
The drugs Marinol (dronabinol) and Cesamet (nabilone), synthetic versions of cannabinoids, were approved by the FDA to treat the lack of appetite in cancer patients receiving chemotherapy. Patients need to know that synthetic versions of chemicals are not identical to their naturally-occurring counterparts. Slight variations in the chemical formula of a given molecule can significantly alter its effect on the human body and cause dangerous effects (such as death). While a given plant like marijuana may contain a molecule that’s extremely safe and effective, molecules that are manipulated in the laboratory are synthesized to be slightly different not because the different version is more effective but because it is more profitable (naturally occurring molecules can’t be patented and therefore are not profitable to Big Pharma). Marinol and Cesamet are no exception to this rule .
In surveys, only 1.8% of 953 patients preferred synthetic marijuana over natural versions of THC. The pill-form of THC can take hours to provide relief while inhaled or infused natural plant-marijuana treatments take effect immediately .
While it’s likely that the synthetic THC in Cesamet and Marinol does not interact with the body’s cells in exactly the same way as naturally-occurring THC, it’s hard to tell whether the safety profile of the synthetically produced Marinol and Cesamet are really as bad as the drug companies make them out to be or if these drugs might actually be useful in curing cancer too. The long list of negative effects attributed to these two drugs (see below) may have been written to scare doctors as well as patients from using this drug too frequently, lest it be discovered that they have anti-cancer properties similar to marijuana-the-plant. The use of linguistic tricks to overstate or understate “facts” derived from questionable research or statistics is common. For example, the pharmaceutical company write-up about the drug salinomycin severely understates its global health-giving potential since studies have shown that salinomycin can cure both cancer and malaria. It’s possible that the FDA clinical trial write-ups for Marinol and Cesamet conceal their value underneath carefully chosen words with negative connotations. Both the Marinol and Cesamet write-ups seem intent on encouraging doctors to only prescribe the drugs for patients who are taking chemotherapy and beyond that, for patients who have tried all other anti-emetics with no success. Valeant, the producer of Cesamet, stresses the addictive properties of nabilone, but Valeant also produces Wellbutrin, an anti-depressant that causes epileptic seizures (seizures that could, in theory, be treated with synthetic marijuana derivatives it produces or naturally-occurring marijuana) and suicidal thoughts and behaviors. So conscience is not part of the equation when these companies summarize the research they’ve done on these drugs. Solvay Pharmaceuticals, the producer of Marinol, also manufactures Androgel (a drug which significantly increases the risk of prostate cancer). So while it seems clear that the pharmaceutical industries intend to use these drugs to compete with marijuana industries across the nation, it’s hard to say whether the drugs themselves are dangerous to consumers or if they actually represent a danger profit-wise to Big Pharma should their true value be discovered someday 
Cannabis is a Schedule I controlled substance which makes it difficult for scientists to gain the necessary support to conduct clinical trials on human subjects in order to get FDA approval. What this means is that it’s hard for scientists to prove experimentally that marijuana kills cancer cells in patients who are suffering from cancer. Scientists who would like to study marijuana’s effects on cancer find it difficult or impossible to find funding to do the kind of research that would produce statistics proving its efficacy. But statistics required by the FDA by their nature must include a control group, and the marijuana industry isn’t interested in depriving patients of the plant in order to create a control group and get FDA approval. Statistics are often used to buttress questionable information anyway. It’s a well-known fact that statistics can are easily manipulated for political purposes .
The prohibition on marijuana began with a ban placed on the sale, cultivation, and use of the plant by the federal government 80 years ago. At the time of this writing, the federal government still prohibits Americans from prescribing, possessing, or selling marijuana. But, despite a lack of federal support or legalization at the federal level, states have begun legalizing marijuana for medical use (and in some cases for recreational use as well). In fact, today, the majority of states have legalized marijuana for medical use and in 2017, marijuana sales increased by 33% over the year prior .
Because marijuana and cannabinoids are naturally-occurring substances, they cannot be patented. And the FDA hasn’t approved marijuana (as a plant or as an oil derived from the plant) for medicinal use. But recently, a drug called Marinol and another known as Cesamet, pharmaceutically synthesized forms of THC and cannabinoids, were developed and approved by the FDA. Both drugs were approved by the FDA as an appetite stimulant for people suffering with AIDs as well as for patients who are receiving chemotherapy . By developing a synthetic cannabinoid, the pharmaceutical companies can now proceed to put a negative spin on its perceived effectiveness by encouraging patients to undergo chemotherapy while adding this drug to the regimen. Marinol and Cesamet are drugs that compete with the marijuana industry while promoting the use of chemotherapy to treat cancer (despite the fact that studies have shown that chemotherapy has an “cure” rate somewhere between 2.1% and 2.3%).
The politics surrounding medical marijuana is complex and constantly changing. The federal government still regards marijuana as illegal, but 29 states (at the time of this writing) have legalized it for medical use. The states listed below have all legalized medical marijuana :
- New Mexico
- North Dakota
- West Virginia
- New Jersey
- Rhode Island
- New Hampshire
- Washington D.C. 
Safety and Effectiveness
The relationship between man and marijuana goes back several hundreds of years. Our bodies naturally produce cannabinoids which work within a system known as the endocannabinoid system. Marijuana-the-plant contains over a hundred cannabinoids that work on the human body via the endocannabinoid system. Through this system they act as neuromodulators, affecting the release of a variety of neurotransmitters. They also play a role in reducing inflammation. They affect insulin sensitivity, fat and energy metabolism, mood, appetite, pain, and memory among other things .
Marijuana-the-Plant and Its Derivatives: Safety and Effectiveness
Marijuana-the-plant, has an excellent safety profile. An annual report issued by the Drug Awareness Warning Network contains a statistical compilation of all drug deaths that happen in the United States. According to this report, there has never been a death from the use of cannabis, despite the administration of huge dosages of it .
In 1988, DEA Chief Administrative Law Judge, Francis Young said,
“In strict medical terms, marijuana is far safer than many foods we commonly consume. Marijuana in its natural form is one of the safest therapeutically active substances known to man. By any measure of rational analysis marijuana can be safely used within the supervised routine of medical care” .
The lethal dose of cannabis is equivalent to smoking about 1,500 pounds in 15 minutes, which is physically impossible. This lethality has never been demonstrated .
In an article published in the Journal of the American Medical Association, Dr. Grinspoon commented on marijuana’s addictive properties:
“Marijuana is also far less addictive and far less subject to abuse than many drugs now used as muscle relaxants, hypnotics, and analgesics. The chief legitimate concern is the effect of smoking on the lungs. Cannabis smoke carries even more tars and other particulate matter than tobacco smoke. But the amount smoked is much less, especially in medical use, and once marijuana is an openly recognized in medicine, solutions may be found; ultimately a technology for the inhalation of cannabinoid vapors could be developed” .
Vaporizing devices have since been developed to mitigate the risk of inhaling cannabis smoke .
Marinol: Safety and Effectiveness
Marinol (dronabinol), the synthetic cannabinoid produced in a laboratory, is less safe than marijuana-the-plant and its derived products. According to the clinical trial summary written for the FDA, Marinol can have a negative effect on mood, cognition, memory, and perception, as well as appetite. Tolerance develops to the drug within 12 days. All other side effects are said to disappear within 12 days and appetite stimulation continues indefinitely .
According to FDA trials, Marinol can cause the following side effects:
- Euphoria (experienced by up to 10% of patients)
- Vision difficulties
- Dry mouth
- Somnolence (experienced by up to 10% of patients)
- Abnormal thinking (experienced by up to 10% of patients)
- Conjunctivitis (red eyes)
- Decreased motor coordination
- Slurred speech
- Dizziness (experienced by up to 10% of patients)
- Heart palpitations
- Fecal incontinence
- Hepatic enzyme elevation
- Runny Nose
- Paranoia (experienced by up to 10% of patients)
- Abdominal pain (experienced by up to 10% of patients)
- Nausea (experienced by up to 10% of patients)
- Vomiting (experienced by up to 10% of patients) 
Note: Marinol may cause the symptoms it is prescribed to treat. Also, patients receiving treatment with Marinol to treat vomiting and nausea are more likely to experience the following symptoms:
- Ataxia (lack of muscle coordination, a neurological symptom that signals that there is a dysfunction in the cerebellum)
- Hallucinations 
Cesamet: Safety and Effectiveness
Cesamet (nabilone) is listed in Schedule II of the Controlled Substances because, according to the research, it has a high potential for abuse. The pharmaceutical company that produces this drug recommends that doctors only prescribe a limited amount of Cesamet at a time—enough for a single cycle of chemotherapy .
Cesamet (nabilone) side effects include:
- Elevated heart rate
- Postural hypotension
- Psychiatric symptom exacerbation
- Dry mouth
- Euphoria 
How Medical Marijuana Is Administered
In states where marijuana is legal, doctors can prescribe the treatment. The dosage varies, but doctors will prescribe a specific amount to be taken at certain times of the day . There are a wide variety of different ways in which a patient might self-administer a marijuana treatment including:
- Inhaling vapors
- Consuming marijuana in food
- Oils (topical application)
- Tinctures 
Marinol is given to patients 3 to 4 times daily in 5 milligram doses to prevent vomiting that’s caused by chemotherapy. It is not to be prescribed unless the doctor has tried giving the patient other anti-emetics that didn’t work .
Cesamet is given in 1 to 6 milligram dosages twice to three times daily. Doctors are cautioned to only provide patients with enough of the drug for one cycle of chemotherapy at a time. Patients are advised to take Cesamet 1 to 3 hours before their chemotherapy is administered .
An overdose of Marinol, the synthetic pill-version of THC, can cause the following negative effects :
- Emergency hospitalization requiring supportive care, benzodiazepines, and fluid replacement
- Death 
Chronic users of dronabinol experience withdrawal symptoms .
Overdosage with Cesamet is expected to produce the following signs and symptoms (though overdosage was never observed during the clinical trials):
- Psychotic episodes
- Anxiety reactions
- Respiratory depression
- Coma 
In addition to being used by cancer patients, cannabis has been used to treat the symptoms associated with a number of diseases including:
- Crohn’s disease
- Huntington’s disease
- Multiple sclerosis
- Rheumatoid arthritis
- Doose syndrome
- Alzheimer’s disease
- Parkinson’s disease
- Chronic pain
- Head trauma
- Dravet syndrome
- Opioid dependence
- Spinal cord injury
- Myocardial infarction (heart attack)
- Obesity/Metabolic syndrome
- Migraines [18}
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