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Cannabis used medically has several well-documented beneficial effects. Among these are: the amelioration of nausea and vomiting, stimulation of hunger in chemotherapy and AIDS patients, lowered intraocular eye pressure (shown to be effective for treating glaucoma), as well as general analgesic effects (pain reliever).b[›]
Less confirmed individual studies also have been conducted indicating cannabis to be beneficial to a gamut of conditions running from multiple sclerosis to depression. Synthesized cannabinoids are also sold as prescription drugs, including Marinol (dronabinol in the United States and Germany) and Cesamet (nabilone in Canada, Mexico, the United States and the United Kingdom).b[›]
Currently, the U.S. Food and Drug Administration (FDA) has not approved smoked cannabis for any condition or disease in the United States, largely because the FDA claims good quality scientific evidence for its use from U.S. studies is lacking. Eighteen states and the District of Colombia have legalized cannabis for medical use. The United States Supreme Court has ruled in United States v. Oakland Cannabis Buyers’ Coop and Gonzales v. Raich that it is the federal government that has the right to regulate and criminalize cannabis, even for medical purposes. Canada, Spain, The Netherlands and Austria have legalized some form of cannabis for medicinal use.
Though the long-term effects of cannabis have been studied, there remains much to be concluded. Many studies have investigated whether long-term use of cannabis can cause or contribute to the development of illnesses such as heart disease, bipolar disorder, depression, mood swings or schizophrenia. Its effects on intelligence, memory, respiratory functions and the possible relationship of cannabis use to mental disorders such as schizophrenia, psychosis, depersonalization disorder and depression are still under discussion.
Both advocates and opponents of cannabis are able to call upon numerous scientific studies supporting their respective positions. For instance, while cannabis has been implicated in the development of various mental disorders in some studies, these studies differ widely as to whether cannabis use is the cause of the mental problems displayed in heavy users, whether the mental problems are exacerbated by cannabis use, or whether both the cannabis use and the mental problems are the effects of some other cause.
It has been pointed out that as cannabis use has risen, rates of schizophrenia have not risen in tandem. Lester Grinspoon argues that the cannabis-causes-psychosis argument is disproved by the lack of “even a blip in the incidence of schizophrenia in the US after millions of people started smoking marijuana in the 1960s”. Worldwide prevalence of schizophrenia is about 1% in adults; the amount of cannabis use in any given country seems to have no effect on that rate.
Positive effects of the drug have also been observed. For example, in a recent study researchers found that compared with those who did not smoke cannabis, long-term cannabis smokers were roughly 62% less likely to develop head and neck cancers.
According to a 2011 study published in the American Journal of Epidemiology, obesity is lower in those who use cannabis users than in nonusers. Authors of the study looked at data from 2 representative epidemiologic studies for US citizens aged 18 and over. Obesity rates in those who didn’t use cannabis were 22% and 25.3%. Study participants who smoked cannabis at least three times a week had obesity rates of 14.3% and 17.2%. The association between cannabis smoking and lower risk of obesity remained strong after factors such as cigarette smoking, age and gender, which could have an impact on obesity, were taken into account.
Cannabis is known for inducing hunger, but two cannabinoids, THCV and cannabidiol, were found to have an appetite suppressing effect. In animal tests, the drug also had an impact on the level of fat in the body as well as its response to insulin. Cannabis compounds were shown to raise metabolism in rats, leading to lower levels of fat in the liver and lower cholesterol. Human trials are being conducted to find a drug targeting obesity-related diseases.
Dr. Jack E. Henningfield of NIDA ranked the relative addictiveness of 6 substances (cannabis, caffeine, cocaine, alcohol, heroin and nicotine). Cannabis ranked least addictive, with caffeine the second least addictive and nicotine the most addictive.
Adolescent brain development
A 35-year cohort study published August 2012 in Proceedings of the National Academy of Sciences and funded partly by NIDA and other NIH institutes reported an association between long-term cannabis use and neuropsychological decline, even after controlling for education. It was found that the persistent, dependent use of marijuana before age 18 was associated with lasting harm to a person’s intelligence, attention and memory, and were suggestive of neurological harm from cannabis. Quitting cannabis did not appear to reverse the loss. However, individuals who started cannabis use after the age of 18 did not show similar declines.
Results of the study came into question when in a new analysis, published January 2013 in Proceedings of the National Academy of Sciences, researchers from Oslo’s Ragnar Frisch Center for Economic Research noted other differences among the study group including education, occupation and other socioeconomic factors that showed the same effect on IQ as cannabis use. From the abstract: “existing research suggests an alternative confounding model based on time-varying effects of socioeconomic status on IQ. A simulation of the confounding model reproduces the reported associations from the [August 2012 study], suggesting that the causal effects estimated in Meier et al. are likely to be overestimates, and that the true effect could be zero”. The researchers pointed to three other studies which showed cannabis did not cause a decline in IQ. The studies showed that heavy smokers had clear reductions in IQ, but they were not permanent.
A July 2012 article in Brain reported neural-connectivity impairment in some brain regions following prolonged cannabis use initiated in adolescence or young adulthood.
A 2012 study conducted by researchers at UC San Diego failed to show deleterious effects on the adolescent brain from cannabis use. Researchers looked at brain scans taken before-and-after of subjects aged 16–20 years who consumed alcohol and compared them to subjects of the same age who used cannabis instead. The 92 person study was conducted over an eighteen-month period. While teen alcohol use resulted in observable reduced white matter brain tissue health, cannabis use was not linked to any structural damage. The study did not measure the subjects’ cognitive performance. Publication is scheduled for April 2013 in Alcoholism: Clinical and Experimental Research.
Memory, learning, and intelligence
Researchers from the University of California, San Diego School of Medicine failed to show substantial, systemic neurological effects from long-term recreational use of cannabis. Their findings were published in the July 2003 issue of the Journal of the International Neuropsychological Society. The research team, headed by Dr Igor Grant, found that cannabis use did affect perception, but did not cause permanent brain damage. Researchers looked at data from 15 previously published controlled studies involving 704 long-term cannabis users and 484 nonusers. The results showed long-term cannabis use was only marginally harmful on the memory and learning. Other functions such as reaction time, attention, language, reasoning ability, perceptual and motor skills were unaffected. The observed effects on memory and learning, they said, showed long-term cannabis use caused “selective memory defects”, but that the impact was “of a very small magnitude”.
Maturing female Cannabis plant
A 2012 study published in JAMA and funded by National Institutes of Health looked at a population of over 5,115 American men and women to see whether smoked cannabis has effects on the pulmonary system similar to those from smoking tobacco. The researchers found “Occasional and low cumulative marijuana use was not associated with adverse effects on pulmonary function.” Smoking an average of one joint a day for seven years, they found, did not worsen pulmonary health.
Dr. Donald Tashkin commented on the study, saying it confirmed findings from several other studies showing “that essentially there is no significant relationship between marijuana exposure and impairment in lung function.” He noted despite containing similar noxious ingredients, one reason cananbis smoke may not be as harmful as tobacco smoke may be due to the anti-inflammatory effects of THC. “We don’t know for sure but a very reasonable possibility is that THC may actually interfere with the development of chronic obstructive pulmonary disease”, Tashkin elaborated. In his own research, Tashkin unexpectedly found that smoking up to three joints a day appeared to have no decrease in lung function. Tashking said, “I think that the bottom line is that there does not appear to be any negative impact on lung function of marijuana smoking.”