Generality
The use of marijuana for therapeutic use has been approved in Italy for several years, although the debate in this area continues to remain on arousing conflicting opinions.
In truth, the use of marijuana in the medical field dates back to a far more distant past than one can imagine. Suffice it to say, in fact, that the first documentation mentioning marijuana for therapeutic use is represented by Chinese medical texts dating back to 3000 years ago.
However, some of the therapeutic properties traditionally ascribed to marijuana by folk medicine have been largely confirmed by numerous studies and clinical trials, so much so that it has come to approve its use in therapy.
Therapeutic indications
When is Marijuana used for therapeutic use?
Marijuana for therapeutic use (or cannabis for medical use, if you prefer) is used in the following cases:
- To relieve chronic pain, particularly of neuropathic type, such as that caused by spinal cord injuries and pathologies such as multiple sclerosis and ALS ( pain therapy ).
- To counteract nausea and vomiting induced by chemotherapy, radiotherapy, drug therapies against HIV and AIDS.
- To stimulate appetite in AIDS patients, in cancer patients and in patients suffering from anorexia nervosa.
- To counteract involuntary movements in Tourette syndrome patients.
- To counter the excessive intraocular pressure in patients with glaucoma resistant to other conventional therapies.
Please note
In Italy, marijuana for therapeutic use can be prescribed by the doctor only when conventional treatments do not give satisfactory results or are no longer sufficient to control the symptoms induced by the aforementioned diseases.
Other Potential Indications of Marijuana for Therapeutic Use
Although not officially approved for indications other than those listed above, marijuana for therapeutic use could also be used in the treatment and control of the symptoms of other diseases.
tumors
As mentioned, marijuana for therapeutic use is useful to counteract the symptoms induced by anticancer therapies. However, some studies conducted both in vitro and in vivo have shown that the active ingredients (cannabinoids) contained in the plant - when placed under certain conditions - are able to inhibit the growth of cancer cells. Despite these encouraging results, more and more in-depth studies are still needed before we can approve the use of marijuana as a possible anticancer treatment. Furthermore, it is important to point out that the methods of taking marijuana for therapeutic use are very different from those used in the aforementioned studies. Therefore, the potential therapeutic power of cannabis in this area is still to be evaluated.
Psychiatric disorders
Some cannabinoids present within marijuana for therapeutic use appear to be able to exert a positive action in the treatment of psychiatric disorders such as anxiety, schizophrenia and bipolar disorder.
In detail, to demonstrate these potential therapeutic activities was cannabidiol (or CBD, if you prefer), ie a non-psychoactive cannabinoid . THC (or delta-9-tetrahydrocannabinol), on the other hand, would not seem particularly useful in this sense. Indeed, it has been shown that a high consumption of THC predisposes to the onset of the aforementioned psychiatric diseases.
For this reason, at the moment, many varieties of marijuana for therapeutic use with a high CBD content are the subject of several studies in this area.
Seizures
The CBD contained in marijuana for therapeutic use has also proved effective in combating epileptic seizures - reducing their frequency and severity - in various studies conducted on both animals and humans, albeit on a small scale.
Active principles
Active Principles of Marijuana for Therapeutic Use
The active ingredients that justify the use of marijuana for therapeutic use are the so-called cannabinoids . In particular, the medical-pharmaceutical interest is directed towards THC or delta-9-tetrahydrocannabinol and towards cannabidiol or CBD .
In fact, THC is mainly responsible for the pain-relieving, antinausea, anti-emetic, relaxing and appetite-stimulating activities attributed to marijuana; while CBD increases the latter's pain-relieving properties, prolonging its duration of action and at the same time reducing its side effects, in particular those affecting the cardiovascular system and the respiratory system. Furthermore, CBD contributes to the reduction of intraocular pressure and is equipped with interesting anticonvulsive, sedative and antipsychotic properties.
Since the active ingredients of greatest medical interest present in cannabis are THC and CBD, the marijuana for therapeutic use currently marketed and approved must necessarily be standardized and titrated in these two active ingredients.
Administration routes
Routes of Marijuana Use for Therapeutic Use
Marijuana for therapeutic use can be taken substantially through two different routes of administration: oral and inhalation .
Although smoking is the most well-known intake method, marijuana for therapeutic use can also be taken orally in tea form by boiling the inflorescences of the plant in water; or by inhalation of vapors that develop after heating (not combustion) of the plant at high temperature ( vaporization ). The main advantage of this last method of administration is represented by the rapid onset of therapeutic effects without the risks connected to smoking, therefore the risks deriving from the inhalation of substances that are released following the combustion of the plant. Unfortunately, however, although numerous vaporizers created for this purpose are available on the market, only a few have been subjected to strict quality controls and tests. At the moment, the only approved medical vaporizer (moreover, only in Canada and Germany) appears to be Volcano Medic®.
Side effects and contraindications
Side Effects of Marijuana for Therapeutic Use
Like any other substance, marijuana for therapeutic use can also cause side effects and its use can be contraindicated in some situations.
Among the main side effects that can occur when taking marijuana for therapeutic use, we mention: dizziness, disorders of the oral mucosa (in case of oral administration), psychotic reactions and increase in liver enzymes. Furthermore, the potential for abuse of marijuana is not to be forgotten.
However, it is right to point out that not all patients manifest these side effects, since their appearance and the intensity with which they occur are influenced by various factors, such as the route of administration chosen, the dosage, the type of disorder to be treated and the patient's sensitivity to the substance.
Contraindications of Marijuana for Therapeutic Use
Currently, the main contraindications of marijuana for therapeutic use concern pregnant and breast-feeding women, pediatric patients and adolescents, patients suffering from psychiatric diseases, diseases of the cardiovascular system, hepatitis, liver failure and / or kidney failure and patients with a history of drug addiction.
Legislative aspects
Marijuana Legislation for Therapeutic Use
In Italy, the use of marijuana for therapeutic use has been permitted by the law since 2006. Initially, however, the marijuana in question could not be produced in Italy and, for this reason, it was imported from Holland.
Since December 2016, on the other hand, the first batches of marijuana for therapeutic use, entirely produced in Italy and, more precisely, in the military chemical-pharmaceutical plant in Florence have entered the market. In detail, the marijuana for therapeutic use produced here in Italy is called Cannabis FM-2, it contains THC in concentrations ranging from 5% to 8% and CBD in concentrations varying from 7.5% to 12% and was born thanks to a pilot project of the Ministry of Health in collaboration with the Ministry of Defense.
Of course, the production, preparation, distribution to pharmacies, marketing and dispensing of marijuana patients for therapeutic use are strictly regulated by law. In this regard, we recall that the proposed law governing the use of marijuana for therapeutic purposes was recently approved (2017) by the Chamber of Deputies. Approval that has stirred many criticisms and perplexities, since many believe that this law can then lead to a future legalization of the substance also for recreational purposes.
Please note
The approval of the aforementioned law concerns solely and exclusively marijuana for therapeutic use and does not in any way provide for the legalization and liberalization of the substance .
More precisely, the text of the law establishes a set of uniform criteria throughout the national territory, in order to guarantee patients access to the product. Furthermore, the text of the law in question contains rules that:
- They promote scientific research on the possible medical uses of marijuana;
- Provide information campaigns and periodic updates of doctors and health personnel involved in pain therapy;
- They support the development of processing, production and processing techniques to simplify product intake.
Dispensing Mode
How is Marijuana Dispensed for Therapeutic Use?
As mentioned, even the dispensation of marijuana for therapeutic use is strictly regulated by law.
In fact, it can be prescribed by the doctor only and exclusively when conventional therapies are not effective . The recipe must be of a non-repeatable type and must contain all the data relating to the magistral preparation of the drug, such as dose, posology, method of intake and duration of treatment which must not exceed three months.
In fact, marijuana for therapeutic use is not available in the form of ready-to-use industrially prepared medicines, but must be prepared by the pharmacist - following the Good Preparation Rules - following the presentation of a special non-repeatable master's prescription.
Finally, we recall that the marijuana for therapeutic use prescribed by the doctor for uses authorized by the Ministry of Health is dispensed by the National Health System .
