Medical Recreation with Cannabis

By Manny González, Winter 2010 - Online Exlusive

A month ago, I wrote an article against Proposition 19 and the legalization of recreational cannabis usage. In the aftermath of the election, several opinions have surfaced deconstructing why Prop 19 failed.

The Los Angeles Times argued that the results indicated that it is not a matter of when cannabis would be legalized, but a matter of how the legislation would read for legalization. Yet, with so much criticism that medicinal cannabis has received in California, this disapproval must be addressed before we begin looking at recreational usage. Demonstrating that California is managing medicinal marijuana effectively may serve as the necessary leverage for voters and the federal government to take cannabis legalization seriously.

Cannabis legalization, be it recreational or medicinal, needs to be conceptualized from a public health lens and from a criminal justice perspective. For example, most Californians are in agreement of the health risk factors that are associated with use of tobacco and alcohol, which are both legal substances. Even so, there are initiatives to educate the public to make informed decisions, while having laws to regulate usage. Laws against drunk driving or laws against smoking in restaurants attempt to protect the well-being of those that choose not to smoke or drink and drive. Cannabis should be viewed in a similar manner, yet laws need to be changed in order for public health policy to accommodate the medical utility of cannabis.

First off, Cannabis should be reconsidered as a Schedule II substance, which acknowledges its medical utility and its high propensity for dependence. Substances, such as cocaine or morphine are considered as Schedule II substances. California, in addition to seven other states, have approved medical cannabis initiatives, yet federally its medical utility is not nationally recognized. As it stands now, the federal government is simply turning a blind eye to the medicinal use of marijuana in states that have legalized it. Once federally approved, it could be listed as a Schedule II substance. Federal oversight would allow for a more uniform system to monitor cannabis prescription. Ultimately, this would legitimize the medical cannabis movement, as many are receiving prescriptions for medically unsanctioned disorders, such as attention deficit disorder.

Cannabis should be reclassified as a Schedule II substance, yet more research is needed for alternatives to smoking cannabis. The Institute of Medicine argues that smoking Cannabis is a crude delta-tetrahydrocannabinol (THC) delivery system that provides the harmful side effects associated with smoking any substance. There are already synthetic THC pharmaceuticals, such as nabilone and dronabinol. However, like cannabis, these produce side effects, such as dizziness, sleeplessness, concentration problems, and short-term memory problems.

The issue is that cannabis works by binding to neurotransmitter receptor sites called cannabinoids in the brain (yes, your brain effectively produces marijuana-like effects on its own). This process is akin to how morphine works, it binds to opiate receptors in the brain, in the same manner that endogenous opiates, such as endorphins, bind to the receptors. However, these receptor sites are located all over the brain, hence the produced effects: cerebral cortex (psychoactive power of Cannabis), hippocampus (memory impairment, mostly short-term), cerebellum (motor dysfunction), brain stem and spinal cord (reduction of pain), brain stem (suppression of the vomiting reflex), hypothalamus (stimulates appetite), and amygdala (emotional responses). Thus, when cancer patients use marijuana, they are treating their pain and nausea while stimulating their appetite. However, they also are receiving side effects of memory and motor impairment, hallucination production (cannabis is technically a hallucinogen), and the problems associated with smoking it.

One possible solution is developing a pharmaceutical that binds to specific sites, instead of triggering activation across all of the brain regions. Another solution is conducting research with already existing neurotransmitters. Dopamine, glutomate, and acetylcholine, all conventional neurotransmitters, have been found to influence the synthesis and release of endogenously produced cannabinoids. Thus, already existing pharmaceuticals that regulate the release, uptake, and production of these conventional neurotransmitters can produce the same effect.

By taking these two suggestions into consideration, California can demonstrate responsibility with its current legislation of medical cannabis. This may demonstrate that California is prepared to handle the concerns of opponents to recreational Cannabis. If California hasn’t demonstrated that it’s ready for medicinal marijuana, how is it ready for recreational Cannabis?