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While medical research is making big strides in the field of Cannabis, the acceptance and legalization is not as universal. The first countries legalizing Cannabis for medical use were Canada and Uruguay. Uruguay is also the first country to legalize Cannabis for recreational use.
Center for Medicinal Cannabis Research (https://www.cmcr.ucsd.edu) is based in the University of California, San Diego and is coordinating research on Cannabis. In 1999, California State legislated and commissioned University of California to establish a scientific research program to expand public scientific knowledge on purported therapeutic usage of marijuana (2).
In 2010, CMCR submitted an initial report and showed the following pre-clinical and clinical studies published or submitted for publication.
- Donald Abrams, M.D. UC San Francisco Cannabis for Treatment of HIV-Related Peripheral Neuropathy
- Donald Abrams, M.D. UC San Francisco Vaporization as a Smokeless Cannabis Delivery System
- Jody Corey-Bloom, M.D., Ph.D. UC San Diego Short-Term Effects of Cannabis Therapy on Spasticity in MS
- Ronald Ellis, M.D., Ph.D. UC San Diego Placebo-controlled, Double Blind Trial of Medicinal Cannabis in Painful HIV Neuropathy
- Mark Wallace, M.D. UC San Diego Analgesic Efficacy of Smoked Cannabis
- Barth Wilsey, M.D. UC Davis Double Blind, Placebo Controlled Trial of Smoked Marijuana on Neuropathic Pain
During the last ten years, the pace and progress has been much faster.
National Center for Complementary and Integrative Health (https://nccih.nih.gov) reports that “The U.S. Food and Drug Administration (FDA) hasn’t approved marijuana (the plant) for treating any health problems. The FDA has approved three cannabinoids as drugs. In 2018, the agency approved Epidiolex (cannabidiol or CBD) oral solution for the treatment of seizures associated with two rare, severe forms of epilepsy. This drug is derived from marijuana. The FDA has also approved the synthetic cannabinoids dronabinol and nabilone to treat nausea and vomiting associated with cancer chemotherapy in people who have already taken other medicines to treat these symptoms without good results. Dronabinol is also approved to treat loss of appetite and weight loss in people with AIDS. Dronabinol contains synthetic delta-9-tetrahydrocannabinol (THC), a component of marijuana, and nabilone contains a synthetic substance with a similar chemical structure. In 2016, the FDA approved Syndros, a liquid form of dronabinol.”
Another interesting resource is www.clear-uk.org whose 2015 report was published in British Medical Journal (BMJ). The report concludes that “Cannabis clearly offers significant therapeutic benefits for a wide range of conditions without substantial risks or unmanageable side effects. Cannabis should be transferred from schedule 1 to schedule 2 of the Misuse of Drugs Regulations. Current MHRA policies and fees on traditional herbal products and marketing authorisations are an unnecessary obstacle to making medicinal cannabis available.”
Last year, the Pharma Market Magazine ran an article by its editor Lucy Muniz. It was titled ‘Research Shows Medical Cannabis to Become Major Part of Pharmaceutical Market’. The article nicely summarizes trends and gives pointers to the future. Couple of quotes are worth sharing.
“According to a research report by New Frontier Data, medical marijuana sales are forecast to grow to $5.3 billion in 2017, accounting for 67% of total cannabis sales. Medical sales in currently legal states are forecast to grow to $13.2 billion by 2025, at which point medical sales will account for 55% of all sales. In comparison, adult-use sales in 2017 are forecast to reach $2.6 billion, rising to $10.9 billion by 2025. Medical cannabis products are known to be beneficial for such conditions as chronic pain, post-traumatic stress disorder (PTSD), sleep disorders, anxiety, nerve pain and others.”
“The research points out that the United States constitutes 35% of the global pharmaceutical market, the largest market in the world, and a major driver of the U.S. economy, and it is estimated that cannabis and related products can replace $4.4 billion to $4.9 billion per year of current spending on existing treatments. “Looking at these numbers, it would appear that medical cannabis would be a drop in the bucket when it comes to impacting the total pharmaceutical industry. However, when you start to break down the numbers by specific sectors of the industry, like chronic pain or symptoms associated with chemotherapy, which are very lucrative markets for pharmaceutical companies, you will certainly see cannabis have a major impact,” said Aguirre De Carcer, CEO of New Frontier Data”.
United States is in the forefront of research and development and approval of Marijuana derived pharmaceutical products.
Britain is close to legalizing use of medical Marijuana; so are many other countries in Europe and elsewhere. Pakistan has not woken up to this development as yet; in fact, most Asian countries do not appear to be keen to go in this direction. One major reason may be the lack of controls to regulate the use of medical Marijuana. This is a genuine risk which can make things go out of hand if it is about legalizing the use of Cannabis in certain medical conditions. Hopefully, we may see some Cannabis Based pharmaceutical products registered, imported and marketed here in this category.
A large body of evidence so far points out that Cannabis Based or Derived Drugs open up a whole new and large avenue for developing useful drugs for the benefit of patients in several therapeutic areas. As mentioned before, over one hundred types of Cannabinoid compounds have been identified already and many more are in development. The psychoactive ingredient tetrahydrocannabinol (THC) has also been isolated and refined.
Cannabis Based Drugs (CBDs) hold a huge promise for future. Pakistan should also join the research activity Relevant authorities should not stick to the old thinking about Cannabis and facilitate research, funding and necessary approvals.
The issues associated with misuse, overuse, and abuse should be discussed separately.