It is often said that there is no reason to permit the use of natural marijuana by patients because they can instead use Marinol. The argument goes that Marinol is marijuana in pill form. It is not. Marinol is a synthetic copy of the delta9-THC molecule. Natural marijuana contains a number of active ingredients, or cannabinoids, not just THC. One of the major cannabinoids that marijuana contains, but Marinol does not, is cannabidiol, or CBD.
Cannabidiol, or CBD, is a non-psychoactive ingredient of marijuana. On the Counterpunch website Weekend Edition of December 22/23, 2007, Fred Gardner’s review of studies on CBD credited it with being an anti-inflammatory, anti-convulsant, anti-psychotic, anti-oxidant and an immune system modulator with neuro-protective properties. In Revista Brasileira de Psiquiatria, vol. 30 no.3 Sao Paulo, Sept. 2008 (English translation) Antonio Waldo Zuardi of the Dept. of Neurology at Universidade de Sao Paulo reviewed many studies and concluded that CBD has a beneficial effect on several conditions. He listed Parkinson’s disease, Alzheimer’s disease, diabetes, rheumatoid arthritis, other inflammatory diseases, nausea and cancer. Since Marinol does not contain CBD, or any cannabinoids other than THC, there is no reason to believe it will be helpful to a patient suffering from any of these disorders. Natural marijuana will be helpful for these ailments, as many patients have discovered.
Oral administration of Marinol creates two problems. When taken orally, Marinol is transformed into several metabolites. One is 11-hydroxy-THC, which is considered to be much more psychoactive than delta9-THC. It is produced in far greater amounts when taken orally than when marijuana is smoked or vaporized and inhaled. Furthermore, the synthetic THC in Marinol is absorbed unevenly in the gastro-intestinal tract. Given the uneven absorption rate and the increased psychoactivity of 11-hydroxy-THC, a patient may find a dosage that is perfectly adequate on one day will, on another day, leave him or her dysfunctional due to an unpleasantly powerful high that lasts for hours. On a third day, that very same dose may prove to be inadequate, having little effect at all. By contrast, smoked or vaporized marijuana can be inhaled one small hit at a time only until the desired effect is achieved.
Marinol is also more expensive than marijuana. A likely monthly cost for most marijuana patients is between $75.00 and $300.00. Marinol often costs a patient between $200.00 and $800.00 monthly, with many reports of patients spending over $1,000.00 per month.
Marijuana is cheaper, more consistent and dependable in its effects on the user. Most importantly, unlike Marinol, it contains all the cannabinoids that are helpful for a much larger number of conditions than Marinol is. Natural marijuana really is necessary for many patients and Marinol should not be passed off as an acceptable substitute.
-- contributed by ASA guest blogger T. Dubb
Thanks T. Dubb for the critical insight! This is just one piece of the puzzle out of many, which our friends, neighbors, and LEGISLATORS need to be educated on so that Maryland can move forward in protecting medical patients...
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