'Letters To The Editor': Medical cannabis

After studying the available evidence, I believe the proposal to produce medical cannabis is premature and misguided for the following reasons:

Usage: The plant itself cannot be used as a drug. Only a particular purified and standardised cannabinoid or standardised mixture of cannabinoids can be used medically. However, extracting a single cannabinoid is a complex and expensive process.

In addition, not enough is known about these different chemicals to identify the most useful ones and how they affect the body.

Research: Research has produced little high-quality evidence about the clinical effects of cannabis-based medicinal products (CBMP).

It is proving difficult to implement randomised controlled trials because of the complex nature of cannabis extracts. Researchers are not sure where to start. Hence the difficulty in drawing up international and national guidelines. Very few places allow the medical prescription of any form of cannabis.

Extracting: Extracting and separating the active components of a cannabis plant is difficult because there are more than 140 different cannabinoid molecules, as well as flavonoids, terpenes, and other compounds within the flower of a cannabis plant, and the proportion of each differs according to the genetic makeup and environment of the plant.

Side effects: Serious side effects of various cannabis compounds are well known- increased heart rate, dizziness, poor concentration and memory, slow reaction times, negative reactions with  other drugs, increased risk of heart attack and stroke, increased appetite leading to weight increase, hallucinations or mental illness, potential for addiction and withdrawal symptoms.

Responses: Individuals' responses to CBMP vary greatly and are therefore unpredictable.  More research is needed on where and how cannabinoids work to produce changes in the human body.

High costs: High costs of the difficult research needed, and actual production of approved individual drugs will be high.

The dangers: Dangers exist when handling the highly reactive substances in cannabis plants (see side effects above). Farmers may be in danger of ingesting these substances inadvertently, even simply breathing the air around the plants. (Are some illegal marijuana farmers already addicted through their farms?)

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