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【Marijuana Topics】Responsible view on the use of marijuana with medicinal effects and risks

【Marijuana Topics】Responsible view on the use of marijuana with medicinal effects and risks

Report: Yang Qianni Editing: Liang Yingxiu

(Kuala Lumpur News) In English, both cannabis and marijuana are translated as marijuana, but there is actually a difference.

It is precisely because of the confusion of nouns that some businesses took advantage of the loopholes to promote the efficacy of marijuana, which led to confusion among many people. Some people ignorantly support the legalization of marijuana and regard it as a “miracle medicine”;

In fact, there are several FDA-approved medical marijuana in the world, including oral capsules used to increase the appetite of cancer patients and AIDS patients, to combat weight loss, to treat convulsions caused by severe epilepsy, and to treat spasticity and neuropathic pain in patients with multiple sclerosis.

Associate Professor Anne Yee Hway Ann, consultant of psychiatry and addiction medicine at the University of Malaya Medical Center, pointed out that before explaining medical marijuana, it is necessary to clarify what the marijuana is talking about.

UM Medical Center Psychiatry and Addiction Medicine Specialist Consultant:
Associate Professor Yu Anyu

Possession of 200 grams of marijuana is considered drug trafficking

“Cannabis and marijuana are both translated into marijuana in English, but there is actually a difference

of. “

She said that it is precisely because of the confusion of terms that some businesses took advantage of the loopholes to promote the efficacy of marijuana, which led to confusion among many people, causing some people to ignorantly support the legalization of marijuana and regard it as a “magic medicine”;

Cannabis refers to a psychoactive product (psychoactive product, a substance that affects thinking, emotion, volition, etc. after being used by the human body) extracted from the cannabis plant.

Usually cannabis is extracted from common cannabis (cannabis sativa) or Indian cannabis (cannabis indica), and contains at least 3% tetrahydrocannabinol (Tetrahydrocannabinol, THC).

“As for marijuana, it refers to products made from the dried flowers and leaves of the cannabis plant. There are more than 400 known chemicals in the cannabis plant, and more than 60 phytocannabinoids, many of which have unknown functions.”

Therefore, the correct term for medical marijuana should be “medical cannabis”, which contains more than 3% THC, which is about 40 mg of THC in 1 gram. It is very important to clarify these cognitions. For example, the effect of extracting rose essence into essential oils is completely different from drying roses directly to apply to the face.

In addition, hemp is adopted from a different genus. Since the content of THC is very low, it has almost no psychoactive properties, and its main component is cannabidiol (CBD), which has also been proven to have medicinal effects in medicine. Cannabis varieties with less than 0.3% THC are now also classified as hemp.

“Hemp, also known as ‘industrial hemp’, has a variety of uses, including textiles, food and industry. Its fibers are light and strong, which makes it a good advantage in aircraft manufacturing. You may have heard some people support the cultivation and production of hemp for industrial development, and it is actually feasible.”

It is a pity that, as in the Chinese context, whether it is cannabis extract, cannabis plant or hemp, our country treats it equally and calls it ganja. Malaysian law stipulates that as long as possession of 200 grams of marijuana is regarded as drug trafficking, it will be sentenced to death; possession of 50 grams or less will be punished with imprisonment for up to 10 years. Even possession of hemp constitutes the same penalty.

Therefore, she hopes that everyone will not think of marijuana as a drug as soon as they hear it. In fact, marijuana, like other drugs, has medicinal effects and risks. Nor is it the answer to every ailment, such as diabetes, high blood pressure or bipolar disorder. We must view and use marijuana rationally from a scientific perspective.

THC is psychoactive

She pointed out that the cannabinoid receptors in the human body mainly refer to CB1 and CB2. The former is mostly stored in the brain and the entire central nervous system, while the latter is mostly distributed in other organs of the body and is more related to the immune system.

Before mentioning the two cannabis components, THC directly binds to the CB1 receptors, affecting the brain in a specific way. The effects of THC are well established, similar to the effects of morphine (an opioid drug), including psychoactive effects, relaxation, analgesic and appetite stimulation.

“As for CBD, it does not directly stimulate CB1 and CB2 receptors, but plays an indirect role. However, the real mechanism of action is still under study. Therefore, the medical community is still not sure about the real “strength” or effect of CBD. Basically, we know that CBD is non-psychoactive, and ingesting CBD will not cause symptoms such as pleasure or relaxation, but this does not mean that CBD is completely harmless, and more research is needed.”

“What’s more special is that CBD has been found to have an antipsychotic effect. Simply put, the effects of THC and CBD can be restrained from each other. This has to lament the magic of nature, there are ingredients that can resist each other on the same plant.”

Alternatively, CBD also has pain-relieving and anti-depressant effects, but it suppresses appetite. In any case, some merchants on the market often claim that CBD oil has many benefits, but it is actually “out of context”. In terms of “enhancing immunity”, only when the CB1 and CB2 receptors are contacted at the same time, the T cells of the immune system will be activated, thereby enhancing immunity. CBD alone won’t do the trick.

Therefore, the public should not trust these commercial propaganda.

There are several medical marijuana approved by the US Food and Drug Administration (FDA) in clinical practice, such as oral capsules dronabidol and nabilone. The former is mainly used to increase the appetite of cancer patients and AIDS patients to combat weight loss. It can also reduce the nausea and vomiting caused by chemotherapy; the latter can reduce the symptoms of nausea and vomiting caused by chemotherapy.

Cannabis used when painkillers don’t work

“The other is a high-purity CBD liquid preparation (CBD purified form), which is mainly used to treat spasticity caused by two severe epilepsy, including rare Lennox Gastaut syndrome and Dravet syndrome. It is usually used when patients cannot respond to general spasticity drugs.”

Oral sprays combining THC and CBD have also been approved in the UK, Canada and several European countries for the treatment of spasticity and neuropathic pain in patients with multiple sclerosis.

“In terms of analgesic use, medicine also has a corresponding protocol. Unless the patient has tried all types of painkillers and still cannot work, or causes a lot of side effects, medical marijuana will be considered. In fact, morphine is already a fifth-stage analgesic drug, but one of its biggest problems is reducing appetite and causing constipation. Therefore, medical marijuana may help these patients.”

She emphasized that, in fact, when we refer to the legalization of medical marijuana, mainly in the hope that doctors will prescribe or patients use marijuana for treatment, it will not constitute a crime.

“For example, when I treat patients with heroin addiction, I use methadone, which is also an opioid substitute. Since there is no stimulant ingredient, it is not a crime for a doctor to prescribe methadone to a patient for treatment.”

“Former Health Minister Kerry once disclosed that medical marijuana that complies with the regulations can be imported and used. In fact, an Australian company introduced medical marijuana a few years ago, but few doctors in Malaysia use marijuana for treatment. For them, the market sales are not large, so the contract has not been renewed after it expires.”

As such, there are currently no medical marijuana suppliers available in our country.

Recreational or decriminalized use of marijuana should be regulated

Regarding the legalization of marijuana, Yu Anzhen hopes that the public should clarify several concepts.

Yu Anzhen pointed out that the first is the legalization of recreational marijuana, which means that there will be no criminal punishment for any purpose. There is no need to be arrested, ticketed or convicted of marijuana if the laws on age, location and dosage are followed. Simply put, home growing marijuana is allowed and recreational use is legal.

“However, this is not a concept we are advocating because cannabis use should be regulated.”

Patients must carry a medical marijuana card

“What we are committed to promoting is the legalization of medical marijuana, which means that when eligible patients are certified by a doctor to benefit from medical marijuana, possession or use of marijuana is legal and will not be arrested or sentenced to death. At the same time, patients must carry a medical marijuana card.”

“Another concept is the decriminalization of marijuana. This does not mean that the public can smoke marijuana legally, but that when a person possesses marijuana and uses it for himself (not for sale), he will not be prosecuted, have a criminal record or be imprisoned.”

In fact, prisons in many countries are overcrowded due to harsh punitive drug laws. The Malaysian government spends at least 1 million ringgit a year to crack down on and detain drug-related persons, and corruption incidents have emerged in an endless stream.

In fact, there are many drug addicts who do not want to quit marijuana, and have tried many methods but are still unsuccessful; some are even being used for the first time, and they are directly judged as criminals, and their lives are ruined.

“Prison is not a place for me to treat a disease. Marijuana addiction itself is a brain disease, and any disease in prison is very difficult to treat. So it’s not hard to see a lot of cases coming in and out of prison, proving that the underlying problem is not being addressed.”

The scope of decriminalization is limited to “self-use users”

For example, if the law stipulates that the blood sugar of diabetic patients should not exceed a certain value, and once it is detected that the blood sugar exceeds the standard, the patient will be imprisoned for 3 months.

“During this period, although their blood sugar would drop due to the restricted food in the prison, if they were not properly educated and treated, they would still be unable to withstand the temptation of delicious food and eat and drink after they were released from prison, causing their blood sugar to soar again. At this time, the police arrested the patients again and put them in prison. The same thing happened repeatedly, which shows that prisons cannot solve the drug problem.”

It should be noted that the scope of marijuana decriminalization is limited to “self-use”. The decriminalization of marijuana will not only reduce the number of prisons and reduce the financial burden on the government, but also allow more drug addicts to rehabilitate and return to society.

Long-term use leads to hallucinations and anxiety

Question 1:What does marijuana do to the nervous system?

Answer 1:This can be divided into 4 major areas:

Emotion: Produces a sense of pleasure, but long-term use or high doses can cause reactions such as hallucinations and anxiety.

Perception: Interfering with perception of time and space

Physiological Symptoms: Relaxation at first, fatigue, motor coordination problems or dizziness after prolonged use.

Long-term use can cause cognitive impairment, including confusion, difficulty concentrating, and impairment of short-term and working memory.

Advance the onset time by 3 years

Question 2:Can cannabis treat mental illnesses such as depression, post-traumatic stress disorder (PTSD), and OCD?

Answer 2:Long-term use of marijuana can lead to irritability, depression, decreased motivation, stress, etc., and high doses can even cause acute psychosis, usually paranoia (paranoia).

Many literatures have confirmed that if heavy marijuana users themselves have the risk of schizophrenia, not only will it not be effective in treatment, but it will also advance the onset time by 3 years.

Although some businesses place the “selling point” of marijuana on the treatment of mental illness, so far there is not enough evidence to prove its efficacy. There are also some businesses that promote the cultivation of marijuana in the backyard of their homes, and pick it when it is not suitable for drinking or making tea, “curing all diseases”, which is also quite incorrect.

Difficult to obtain approval due to lack of clinical trials

Question 3:Why isn’t the marijuana plant (marijuana) approved for medicinal use?

Answer 3:The scientific evidence to date has been insufficient for the FDA to approve the cannabis plant for two main reasons:

1/ A substance must have defined and measurable components that are consistent from one unit (like a pill or injection) to the next, but cannabis has 100s of variable compounds with different effects.

2/ There are not enough clinical trials because it is often difficult to get approval.

CBD efficacy is low to moderate

Question 4:Since CBD in marijuana can “gram” THC, can CBD be used to treat marijuana addiction?

Answer 4:According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), if you have at least two of the following symptoms within 12 months, you can be diagnosed with cannabis addiction or Cannabis Use Disorder (CUD):

◆Using more or longer than expected marijuana;

◆ Difficulty controlling or reducing marijuana use and craving;

◆A large amount of time revolves around marijuana use or acquisition;

◆craving marijuana;

◆Marijuana use leads to problems at work, school, and at home. ;

◆ Continued marijuana use despite social relationship problems. ;

◆Give up or reduce other important social, occupational, or leisure activities because of cannabis. ;

◆Repeated use of marijuana in high-risk situations, such as knowingly doing so;

◆ continue to use cannabis despite physical or psychological problems caused by cannabis;

◆Tolerance occurs, requiring an increase in the dose of cannabis;

◆Withdrawal reaction, very hard when not in use.

In this regard, the medical community has tried many drugs, such as antidepressants, antipsychotic drugs, mood stabilizers, etc., but most of them are ineffective or not ideal for the treatment of cannabis addiction.

As for the curative effect of CBD is low to moderate, it can help alleviate the withdrawal reaction of patients.

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