Contributions to the Debate on the Legalization of Marijuana as Medicine in Colombia
DOI:
https://doi.org/10.17533/udea.rfnsp.v35n1a03Keywords:
marijuana, therapeutic uses, cannabis, legalization debate, health risksAbstract
Currently there is an intense debate regarding the legalization of marijuana for therapeutic uses seeking to decrease consumer criminalization. Paradoxically, despite the evidence of hazardous effects of marijuana with high prevalence of life, and new varieties of more powerful and more dangerous cannabis. Objective: Analyze the available information on marijuana describing the evidence that exists and, in this way, contribute to the current debate on the legalization of this substance for medicinal uses in Colombia. Methodology: This study is a bibliographical review based on the components of marijuana, adverse effects and evidence of therapeutic effects. Results: The marijuana plant contains more than 400 active components, the toxicity of the majority of these components is unknown, and it also contains approximately 66 cannabinoids. There is scientific evidence of the medicinal effect of some components, yet there is still not enough research. One thing is synthetic cannabinoids from pharmaceutical research and derived from the marijuana plant, and another thing is the use of the plant as “weed”. Discussion: Technically up-to-date, the beneficial components of the marijuana plant cannot be separated from the toxic ones, so when it is used for therapeutic or recreational purposes people ingest both. Cannabinoids produce in human beings a syndrome which alters important brain functions like memory, mood, sleep, attention, humor, coordination, cognition, time perception, and distortion of information, among others. This also includes dependence, tolerance, addiction and withdrawal syndromes already proven. Conclusions: A lack of knowledge of the adverse effects of the use of the marijuana plant as such poses a serious health risk when used as medication without knowing exactly what a person is using.
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Gobierno Nacional de la República de Colombia.Observatorio de Drogas. Ministerio de Justicia et al. Estudio Nacional de Consumo de Sustancias Psicoactivas en Población Escolar Colombia 2011. www.descentralizadrogas.gov.co
Comunidad Andina, Programa Antidrogas Ilícitas en la Comunidad Andina, Unión Europea. II Estudio Epidemiológico Andino sobre Consumo de Drogas en la Población Universitaria Informe. 2012.
Ministerio de la Protección Social. República de Colombia, Dirección Nacional de Estupefacientes. Estudio Nacional de Consumo de Sustancias Psicoactivas en Colombia. [Internet]. 2008. Available from: http://www.corazonesresponsables.org/Estudio_Nal_Completo_Psicoactivas.pdf
Elsohly MA, Slade D. Chemical constituents of marijuana: the complex mixture of natural cannabinoids. Life Sci. 2005 Dec 22;78(5):539–48.
Ashton CH. Pharmacology and effects of cannabis: a brief review. Br J Psychiatry J Ment Sci. 2001 Feb;178:101–6.
Hampson AJ, Grimaldi M, Lolic M, Wink D, Rosenthal R, Axelrod J. Neuroprotective antioxidants from marijuana. Ann N Y Acad Sci. 2000;899:274–82.
André, F. Haschich, Chanvre et Cannabis: L’éternel retour [Internet], 2011. Paris: Editions l’Harmattan.
Pertwee RG, Howlett AC, Abood ME, Alexander SPH, Di Marzo V, Elphick MR, et al. International Union of Basic and Clinical Pharmacology. LXXIX. Cannabinoid Receptors and Their Ligands: Beyond CB1 and CB2. Pharmacol Rev. 2010 Dec 1;62(4):588–631
Trigo JM, Martin-García E, Berrendero F, Robledo P, Maldonado R. The endogenous opioid system: a common substrate in drug addiction. Drug Alcohol Depend. 2010 May 1;108(3):183–94.
Sugiura T, Kondo S, Sukagawa A, Nakane S, Shinoda A, Itoh K, et al. 2-Arachidonoylglycerol: a possible endogenous cannabinoid receptor ligand in brain. Biochem Biophys Res Commun. 1995 Oct 4;215(1):89–97.
Di Marzo V, Petrocellis LD. Plant, synthetic, and endogenous cannabinoids in medicine. Annu Rev Med. 2006;57:553–74.
Grotenhermen F. Clinical Pharmacodynamics of Cannabinoids. J Cannabis Ther. 2004 Feb 26;4(1):29–78.
Brizzi A, Brizzi V, Cascio MG, Corelli F, Guida F, Ligresti A, et al. New resorcinol-anandamide “hybrids” as potent cannabinoid receptor ligands endowed with antinociceptive activity in vivo. J Med Chem. 2009 Apr 23;52(8):2506–14
Caffarel MM, Moreno-Bueno G, Cerutti C, Palacios J, Guzman M, Mechta-Grigoriou F, et al. JunD is involved in the antiproliferative effect of Delta9-tetrahydrocannabinol on human breast cancer cells. Oncogene. 2008 Aug 28;27(37):5033–44.
MD, Stevens RJ, Rogacki N, Featherstone RE, Senyah Y, Giardino O, et al. AVE1625, a cannabinoid CB1 receptor antagonist, as a co-treatment with antipsychotics for schizophrenia: improvement in cognitive function and reduction of antipsychotic-side effects in rodents. Psychopharmacology (Berl). 2011 May;215(1):149–63.
NM, Mechoulam R. Cannabinoids in health and disease. Dialogues Clin Neurosci. 2007;9(4):413–30.
National Institute on Drug Abuse. ¿La marihuana es un medicamento? [Internet]. 2014. Available from: http://www.drugabuse.gov/es/publicaciones/drugfacts/la-marihuana-es-unmedicamento
Svízenská I, Dubový P, Sulcová A. Cannabinoid receptors 1 and 2 (CB1 and CB2), their distribution, ligands and functional involvement in nervous system structures--a short review. Pharmacol Biochem Behav. 2008 Oct;90(4):501–11.
Wang T, Collet J-P, Shapiro S, Ware MA. Adverse effects of medical cannabinoids: a systematic review. Can Med Assoc J. 2008 Jun 17;178(13):1669–78.
Croxford JL. Therapeutic potential of cannabinoids in CNS disease. CNS Drugs. 2003;17(3):179–202.
Abood ME, Martin BR. Neurobiology of marijuana abuse. Trends Pharmacol Sci. 1992 May;13(5):201–6.
Maldonado R, Rodríguez de Fonseca F. Cannabinoid addiction: behavioral models and neural correlates. J Neurosci Off J Soc Neurosci. 2002 May 1;22(9):3326–31.
Hutcheson DM, Tzavara ET, Smadja C, Valjent E, Roques BP, Hanoune J, et al. Behavioural and biochemical evidence for signs of abstinence in mice chronically treated with delta-9-tetrahydrocannabinol. Br J Pharmacol. 1998 Dec;125(7):1567–77.
Bass CE, Martin BR. Time course for the induction and maintenance of tolerance to Delta(9)-tetrahydrocannabinol in mice.Drug Alcohol Depend. 2000 Aug 1;60(2):113–9.
Di Marzo V, Berrendero F, Bisogno T, González S, Cavaliere P, Romero J, et al. Enhancement of anandamide formation in the limbic forebrain and reduction of endocannabinoid contents in the striatum of delta9-tetrahydrocannabinol-tolerant rats. J Neurochem. 2000 Apr;74(4):1627–35.
Rubino T, Viganò D, Massi P, Parolaro D. Changes in the Cannabinoid Receptor Binding, G Protein Coupling, and Cyclic AMP Cascade in the CNS of Rats Tolerant to and Dependent on the Synthetic Cannabinoid
González S, Cebeira M, Fernández-Ruiz J. Cannabinoid tolerance and dependence: a review of studies in laboratory animals. Pharmacol Biochem Behav. 2005 Jun;81(2):300–18.
Paquette JJ, Wang H-Y, Bakshi K, Olmstead MC. Cannabinoidinduced tolerance is associated with a CB1 receptor G protein coupling switch that is prevented by ultra-low dose rimonabant. Behav Pharmacol. 2007 Dec;18(8):767–76.
Deadwyler S., Heyser C., Hampson R. Complete adaptation to the memory disruptive effects of D9-tetrahydrocannabinol following 35 days of exposure. 1995;17:9–18.
Gonzalez S, Manzanares J, Berrendero F, Wenger T, Corchero J, Bisogno T, et al. Identification of endocannabinoids and cannabinoid CB1 receptor mRNA in the pituitary gland. Neuroendocrinology. 1999;70(2):137–45.
Di Forti Marta, Marconni Arianna, Carrá Elena, Trotta Antonella, Bonomo Mateo et al. Proporción de pacientes en South London con primer episodio de psicosis atribuible a Marihuana de alta potencia: Estudios de casos y controles. The Lancet Psychiatry Vol 2 Nro. 3 March 2015
Reece AS.Chronic toxicology of cannabis.Clin Toxicol Phila Pa. 2009 Jul;47(6):517–24
Anthony JC. The epidemiology of cannabis dependence. In: Roffman RA, Stephens RS, eds. Cannabis Dependence: Its Nature, Consequences and Treatment. Cambridge, UK: Cambridge University Press; 2006:58-105.
Murphy L, Bartke A, editors. Maternal cannabinoid exposure and brain development: changes in the ontogeny of dopamine neurons. Marijuana/cannabinoids: neurobiology and neurophysiology. Boca Raton, Fla: CRC Press; 1992.
Brunton LL, Lazo JS, Parker KL. (editores): Goodman & Gilman. 2006 Las Bases Farmacológicas de la Terapéutica. Undécima Edición. México. 2006. Mc Graw-Hill, Interamericana 2045 pags
Lee ML, Novotny M, Bartle KD. Gas chromatography/mass spectrometric and nuclear magnetic resonance spectrometric studies of carcinogenic polynuclear aromatic hydrocarbons in tobacco and marijuana smoke condensates. Anal Chem. 1976 Feb;48(2):405–16.
Sherrill DL, Krzyzanowski M, Bloom JW, Lebowitz MD. Respiratory effects of non-tobacco cigarettes: a longitudinal study in general population. Int J Epidemiol. 1991 Mar;20(1):132–7.
World Health Organization. Cannabis: a health perspective and research agenda. 1997.
Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet. 2003;42(4):327–60.
Calignano A, La Rana G, Giuffrida A, Piomelli D. Control of pain initiation by endogenous cannabinoids. Nature. 1998 Jul 16;394(6690):277–81.
Rice ASC, Farquhar-Smith WP, Nagy I. Endocannabinoids and pain: spinal and peripheral analgesia in inflammation and neuropathy. Prostaglandins Leukot Essent Fatty Acids. 2002 Mar;66(2- 3):243–56.
Ortiz Lobo A. Cannabis: ¿medicina o droga? Psiquiatr Pública. 1998;10(6):68–72
Ungerleider JT, Andyrsiak T, Fairbanks L, Ellison GW, Myers LW. Delta-9-THC in the treatment of spasticity associated with multiple sclerosis. Adv Alcohol Subst Abuse. 1987;7(1):39–50.
Maurer M, Henn V, Dittrich A, Hofmann A. Delta-9-tetrahydrocannabinol shows antispastic and analgesic effects in a single case double-blind trial. Eur Arch Psychiatry Clin Neurosci. 1990;240(1):1–4
Sieradzan KA, Fox SH, Hill M, Dick JP, Crossman AR, Brotchie JM. Cannabinoids reduce levodopa-induced dyskinesia in Parkinson’s disease: a pilot study. Neurology. 2001 Dec 11;57(11):2108–11.
Hartley JP, Nogrady SG, Seaton A. Bronchodilator effect of delta1- tetrahydrocannabinol. Br J Clin Pharmacol. 1978 Jun;5(6):523–5.
Järvinen T, Pate DW, Laine K. Cannabinoids in the treatment of glaucoma. Pharmacol Ther. 2002 Aug;95(2):203–20.
Russo E. Future of Cannabis and Cannabinoids in Therapeutics. J Cannabis Ther. 2004 Jan 29;3(4):163–74.
Gordon E, Devinsky O. Alcohol and marijuana: effects on epilepsy and use by patients with epilepsy. Epilepsia. 2001 Oct;42(10):1266–72.
Gilson I, Busalacchi M. Marijuana for intractable hiccups. The Lancet. 1998 Jan;351(9098):267.
Grinspoon L, Bakalar JB. The use of cannabis as a mood stabilizer in bipolar disorder: anecdotal evidence and the need for clinical research. J Psychoactive Drugs. 1998 Jun;30(2):171–7.
Mikuriya TH. Cannabis substitution. An adjunctive therapeutic tool in the treatment of alcoholism. Med Times. 1970 Apr;98(4):187–91.
Aggarwal SK, Carter GT, Sullivan MD, ZumBrunnen C, Morrill R, Mayer JD. Medicinal use of cannabis in the United States: historical perspectives, current trends, and future directions. J Opioid Manag. 2009 Jun;5(3):153–68.
Craig W M. Efficacy of marijuana in treating chronic non cancer pain. A short review. Clinical Services, Worker and Employer Services; 2006.
Zajicek J, Fox P, Sanders H, Wright D, Vickery J, Nunn A, et al. Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial. Lancet. 2003 Nov 8;362(9395):1517–26.
Abrams DI, Jay CA, Shade SB, Vizoso H, Reda H, Press S, et al. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology. 2007 Feb 13;68(7):515–21.
Levitt M, Faiman C, Hawks R, Wilson A. Randomized double blind comparison of delta-9-tetrahydroicannabinol (THC) and marijuana as chemotherapy antiemetics. Proc Am Soc Clin Oncol. 1984;3(91).
Bennett D. Growing pains for metabolomics [Internet]. 2005. Available from: http://www.the-scientist.com/?articles.view/articleNo/16400/title/Growing-Pains-for-Metabolomics/
World Health Organization. Final draft: Good Manufacture Practices: update supplementary guidelines for the manufacture. 2005
Cañigueral S, Vila R. La Fitoterapia como herramienta terapéutica. Ginecol Obstet Clínica. 2005;6(1):43–51
Blanché C. Situación actual del sector de las plantas medicinales en España. Rev Espec En Anestesiol Reanim. 2005;52:451–2.
Hoffmann DE, Weber E. Medical Marijuana and the Law. N Engl J Med. 2010 Apr 22;362(16):1453–7.
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