Medical Cannabis

The medical cannabis (also called therapeutic cannabis , medical marijuana or therapeutic marijuana ) indicates the Cannabis, and, by extension, the Cannabinoïde S intended for a purely medical use, generally prescribed for their virtues Antiémétique S. To date, the medical use of the cannabis is legal only in one limited number of territories, among which the Canada, the Belgium, the Australia, the Netherlands, the the United Kingdom, the New Zealand, the Spain, and the States American of California , of Arizona, Alaska, Hawaii, the Maine, the Nevada, the Oregon and Washington. This use generally requires an ordinance and the distribution is generally done within a framework defined by the local laws.

Historical use

The history of the use Thérapeutique of the cannabis is difficult to recall, in particular because the legislations controlling its production, its distribution, its possession and its consumption are relatively recent, and the distinction between medical use and entertaining use is even more. The egyptologist Lise Manniche notes the mention of the “medical plant of the marijuana” in several text Egyptian, of which one goes back to the XVIIIe front century J. - C. One finds also mention of the cannabis in several old texts Chinese and Indian, in particular in the Shen nung PEN Ts' ao king , the oldest collection treating of medicinal plants, allotted to the emperor Shennong. The cannabis is prescribed there to treat Vomissement S, parasitic infectious illness and Hémorragie S.

The redécouverte by the Occident of the therapeutic virtues of the cannabis is generally allotted to Sir William Brooke O' Shaughnessy, which in 1831 publishes in the British medical check The Lancet its work grouting Intraveineuse of electrolyte S in solution to look after the Choléra. Its discovery is worth to him a station in India, where he studies the various traditional medicinal plants, of which the Opium. Starting from the end of the Years 1830, it tests with various concoctions containing Chanvre and its effects on patients suffering in particular from Rhumatisme S, Hydrophobie, cholera or Tétanos. It publishes its experiments and conclusions at the time of its return in England in 1841, where it brings back specimens of Chanvre and Strychnos nux-vomica for the royal Botanical gardens of Kew.

Many articles on various species of cannabis are published in Europe and North America during second half of the 19th century. The therapeutic use of the cannabis and the Hashish is current in the United States until in the Années 1930, and makes its appearance in the official Pharmacopée American in 1851. It is generally prescribed like a Analgésique, a Sédatif, a Antispasmodique or a Antiémétique.

Progressive prohibition

The second International convention of opium of Geneva, in 1925, adds the cannabis to the list of substances whose Importation must be controlled by its signatories, but it appears ineffective for the countries buying to the aforementioned drugs with countries not signatories. Convention to limit manufacture and to regulate the distribution of the narcotics, known as Convention of limitation of 1931, aims at curing this gap in the law.

To the United States, the setting in conformity with this convention leads Harry J. Anslinger, the first Police chief of new the Federal Office off Narcotics , to make vote in 1937 the Marihuana Tax Act , the first American federal law controlling the distribution and the possession of cannabis, imposing a tax of 1 dollar to the dispenseurs of cannabis, including for a medical use. The law causes of éradiquer the medical distribution of the plant, even if it remains listed in the federal pharmacopeia until 1940. Many transnational legislations are signed in the decades which follow, but it is only with the single Convention on the narcotics of 1961 that a harmonization takes place within the framework of UNO, including the cannabis in the substances controlled in table IV, that of the substances subjected to the most severe controls, on the insistence of the United States.

Reappearance of the medical use

Nowadays, the medical cannabis is employed before very relieving the side effects of the disease or the treatment.

Forms

The cannabis exists in several medical forms, of which the availability depends on the legislation on the country where it is authorized:

Marinol (Dronabinol): prescribed for the treatments of nauseas and the vomiting related to the Chemotherapy, like stimulating the appetite among patients of the AIDS;
Cesamet (Nabilone): prescribed for the treatments of nauseas and the vomiting related to chemotherapy;
Sativex: prescribed like anti-pain for the Multiple sclerosis.

It can also be prescribed in a natural state in order to be consumed smoked, out of herb tea or by vapor inhalation of THC (tétrahydrocannabinol) sublimated, and there still its most current regulation remains relating to the patients in final phase.

Properties

Many studies - more or less significant - exist or are in hand on its therapeutic qualities.

It is question of properties:

Analgesic S: patients in final phase and for the chronic pains resistant to the traditional treatments;
releasing and soporific: patients in final phase;
anti-spasmodic: multiple sclerosis, epilepsy;
anti-vomitory: treatment of the side effects of heavy chemotherapy or other treatments;
stimulating the appetite and giving again pleasure to eat: fight against the Cachexie (extreme thinness) and supports the catch of weight;
broncho-dilating: Asthma;
vasodilator: Glaucome.

Of other studies suggests that the cannabis could be:

an effective alternative for the Prurit cholostatic refractory;
a therapeutic agent against neuro-degenerative diseases and the dystonie (disturbance of the muscular tone) such as the Parkinson's disease or the syndrome of Tourette;
a anti-proliferative agent: remission of cancerous tumors to the brain (like deceleration of the progression of some Cancer S of the lung, center and of the Leukemia);
an agent inhibiting secretions of Acid gastric and which can exploit a favorable part the prevention of the ulcers;
an agent improving the behavioral disorders of the patients reaches Maladie of Alzheimer.

Legislation

The legislative installation of the medical cannabis generally relates to three shutters, respectively defining the access terms in the medical cannabis, the regulation relating to the distribution, and that touching with the culture and the production of cannabis at medical ends.

The majority of the legislations installation generally define the eligibility of the patients according to a list of medical conditions or symptoms generally including Cancer, Multiple sclerosis and AIDS/HIV. Some define or suppose the installation of a program managed by an emanation of the government maintaining a list of authorized patients, while other governmental entities simply legalized the medical use, relying on the simple delivery of a certificate by a doctor.

Belgium

Canada

In the Canada, the Payment on the access to the marijuana at medical ends, set up by Health Canada in July 2001, defines two categories of eligible patients for the access to the medical cannabis. Category 1 lists the individuals suffering from “acute pain”, “violent nauseas” and/or other serious symptoms caused by the following conditions: Multiple sclerosis, lesion of the Spinal-cord, disease of the spinal-cord, Cancer, AIDS /infection with HIV, serious forms of Arthritis and/or epilepsy. Category 2 “touches the applicants who present serious pathological symptoms other than those described in category 1”. The request of the eligible patient must be supported by a doctor.

The cannabis distributed by Santé Canada is provided under the CanniMed mark by the company Prairie Systems Inc. Seedling, according to which the request on behalf of the Canadian authorities would have increased by 80% in 2006 (production having reached 420 Kilogram S the previous year). It is however legal for the patients approved by Santé Canada to cultivate their own cannabis for their personal consumption, and it is possible to obtain a license of production as anybody indicated by a patient. Santé Canada specifies however that “no Opinion of conformity was given for the marijuana at medical ends. ”

The United States

The medical cannabis was the subject of legislations in several American States starting from the Années 1990.

In California, Proposal 215, baptized Compassionate Uses Act , is approved by the voters of the State to the elections of November 1996, ratifying the legalization of the medical cannabis the next day. The new Californian law, the first of the kind in the United States, dépénalise possession, the use and culture of cannabis for the patients having a recommendation “ written or orale ” of their doctor. Among the conditions considered to be eligible by the law are listed Arthrite, Cachexie, Cancer, pains chronic, HIV or AIDS, epilepsy, Migraine S and Multiple sclerosis. The law does not specify limit on the quantities which the eligible patients can have or cultivate.

The Californian law is in direct contradiction with the national legislation as regards narcotics, and in January 1998, the federal government prosecutes the Co-operative of the purchasers of cannabis of Oakland (OCBC), requesting the prohibition of the distribution of cannabis from the patients. The court of the district gives a judgment in favor of the federal government, and the OCBC is closed temporarily. The judgment is interjeté in front of the Court of Appeal of the United States for the ninth circuit, which cancels the preceding decision, calling upon the “medical need” setting ahead by defense. In May 2001 however, the Supreme court of the United States disabled person this decision by a vote of 5 against 3 (the judge Breyer being abstained).

In October 2003, the Californian legislative body adopts an emanating amendment of the Californian Senate, S.B. 240, coming into effect on January 1st 2004, and imposing of the limits on the authorized quantities. The eligible patients cannot thus have more than 8 ounce S of dried cannabis and/or six adult plants of cannabis, but of the exemptions are possible on doctor's certificate.

Several producers and Californian dispensaries of cannabis with medical use were the subject of descents and arrests by the Drug Enforcement Administration. The rate/rhythm of this type of operations during the last years suggests however that the federal authorities concentrate from now on their efforts on the organizations and individuals suspected of being too much laxist in their distribution, having bonds with the Organized crime, or carrying out profits considered to be excessive or potentially illegal. Several operations were carried out by the DEA in collaboration with the Internal Revenue Service, the federal tax service.

Criticisms of Proposal 215, among which the National organization for the reform of the laws on the marijuana ( National Organization for the Reform off Marijuana Laws , or NORM ), which militates for the legalization of the cannabis in the United States, assert that the legal text remains too vague as for the production of the cannabis with medical use, and for the benefits which the producers and dispensaries can carry out, letting the jurisdictions of the counties define their own standards. The DEA estimates in particular that “narcotrafiquants with great scale hide behind and call upon Proposal 215” like defense.

The voters of the Oregon approve a law legalizing the medical cannabis in November 1998, the Oregon Medical Marijuana Act . The program is managed by the Program of medical marijuana of Oregon within the Division of public health of the State, and distributes indentity cards to the members accepted by the program. At the beginning of 2007, close to 13 000 charts had been distributed. The near total of the patients profiting from the program state to suffer from “ pains sévères ” and nearly 2500 of “ nausées ”. The other called upon conditions are epilepsy, AIDS/HIV, Cancer, Cachexie, chronic Glaucome and tremors which had with the Maladie of Alzheimer.

The Neighboring state of Washington obtains a law similar to the same elections of November 1998, legalizing the use, the possession and the culture of cannabis for the patients provided with a doctor's certificate. The eligible conditions are the following ones: cachexy, cancer, HIV or AIDS, chronic epilepsy, differently intractable glaucome, pains and Multiple sclerosis.

Always at the same date, the medical use of cannabis is also ratified by 58% of the voters of the Alaska in November 1998, come into effect on March 4th, 1999. The law legalizes the possession, the culture and the use of cannabis for the patients having received a certificate of a doctor confirming that it can profit from the medical use of cannabis. The eligible conditions and symptoms are the following: chronic cachexy, cancer, pains, epilepsy and other conditions characterized by spasms, glaucome chronic, HIV or AIDS, multiple sclerosis and nauseas. The State maintains a list confidential of the patients to whom are allotted an indentity card. 200 charts would have been distributed.

The State of the Maine adopts a similar law in 1999 following a popular vote, and in 2000 it is the turn of the Colorado, Hawaii and the Nevada. In 2003, a law with the Maryland allows an individual stopped for possession of cannabis proving a medical need, which, if she is recognized by the court, does not involve that a maximum fine of 100 dollars. The voters of Montana and Vermont approve the legalization of the medical cannabis in 2004, and in 2006 the State of Rhode Island ratifies The Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act which legalizes the medical use of the cannabis through a program managed by the services rhode-Icelandic.

The medical use of the cannabis remains prone to polemic with the the United States, where the federal authorities continue to maintain their opposition to any therapeutic use of the substance. The Food and Drug Administration published in April 2006 an official statement recalling that it did not approve the cannabis like drug, and that a “ évaluation ” carried out by several government agencies concluded that “ no solid scientific study supported the use of cannabis as treatment in the United States”. The American Medical Association , while recommending the maintenance of the cannabis among the controlled substances, calls some with rigorous studies on the use of the substance and others Cannabinoïde S for the treatment of patients.

Spain

Finland

In Finland the medical cannabis is prohibited, however a patient obtained an authorization of l´ National agency of the drugs of Finland in December 2006 for the use of cannabis with a therapeutic aim.

Netherlands

The United Kingdom

Switzerland

As the consumption of Indien hemp is not prohibited in Switzerland, one does not discuss there that in the manner of prescribing it within the medical framework. The National council, the Lower House of the Swiss Parliament discusses of a parliamentary Initiative of the Commission of the social security and public health of the National council of May 4th, 2006, the Swiss Parliament took accepted on December 20th the paragraph of the proposal which aims at introducing the Cannabinoïdes into the official pharmacopeia. The debate is stopped and the law is not voted yet. If it is it, it will have to be discussed by the Council of the States. In the event of agreement, the law will be subjected to the optional referendum. It is written in this initiative that “the law on the narcotics must be the subject of a partial revision so that elements of the text rejected on June 14th, 2004, and who are likely to rejoin a majority of favorable voices (in particular the policy of the four pillars, prevention and therapy, the protection of youth and tasks of the Confederation) are quickly anchored in the law. Part 2: Moreover, the problems of the cannabis must be examined taking into account the parliamentary initiatives outstanding, and of the proposals must be elaborate. ”. In its project, the commission proposes, inter alia, “to make possible the medical application limited of narcotics for purpose of the cannabic type on exceptional authorization of the federal Office of the public health. In parallel, the substance must be able to be subjected to the mode of the Swiss Institute of the therapeutic products (ISPT) applicable to the drugs as of the moment when the corresponding narcotic is introduced as an active ingredient into a drug authorized by the ISPT. The doctors could then prescribe the drug in question for the authorized indications.”

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