punish the sick

Patients with inflammatory bowel disease may benefit from cannabis-based drugs, UK scientists believe.

One of the team of researchers, Dr Karen Wright, 'said that the psychoactive effects and the legal implications associated with herbal cannabis use made it unsuitable as a treatment.'

If the law is preventing people from getting effective medicines, then surely the law should be changed rather than the medicine denied. As Jimmy Carter said, the punishment for using a drug should not be worse than the effects of using it.

And what of these psychoactive effects? The 'legal implications' are due to it being banned because it is used recreationally. It is used recreationally precisely because the psychoactive effects are really nice.

A friend of mine has self-medicated with cannabis for inflammatory bowel disease. He finds the mood elevation and relaxation to be perfectly acceptable side-effects. Indeed, as the condition is exacerbated by stress, it is probably dealing with it preventatively as well as reactively.

If caught, he faces up to two years in jail. If he's used an economy of scale and just bought a big stash he could get up to 14 years for intent to supply.

The only problems he's had are erratic supply (due to illegality), and bad reaction to impurities in cannabis resin which he used when he couldn't get herbal cannabis (again, due to illegality).

'it might be possible to make a synthetic cannabis-like drug' says the report. There already is one, dronabinol (marketed as Marinol), which has been prescribed since 1986 in various countries. Whilst first labelled as an anti-nauseant and appetite stimulant, it has been prescribed for a lot of different conditions, mostly the ones associated with cannabis treatments such as multiple sclerosis and depression.

The problem is that it is given as an oral capsule. It has to to be swallowed and digested before it works. This takes over an hour, often considerably longer. If a patient is suffering from a vomiting condition like bulimia, or chemotherapy side effects, they simply puke the pill up before it's kicked in. Conversely, cannabis smoked delivers effects in seconds.

Additionally, the long kick-in of the pill means it's hard to judge an effective dose. Patients often find, too late to do anything about it, that they have taken too little or too much. As smoked cannabis hits instantly, it's easy to see if it's enough and top it up if not.

Furthermore, the effects of swallowed cannabinoids are different to when they're inhaled. They last a lot longer, and the chemistry itself is different. As the liver processes cannabis it transforms some into a substance called 11-hydroxy-tetrahydracannabinol. This stuff is incredibly psychoactive, much more than smoked cannabis, as anyone who's eaten a hash cake can attest. So in many ways, inhalation is a far safer method of consumption.

There's a further problem in isolating the active elements as a pill. Scientists working on the glacially-paced UK government medical cannabis tests have found that cannabis contains elements that counteract the rushing nausea people commonly suffer when taking refined cannabinoid medicines. Essentially, we need the whole plant.

Obviously smoking brings other risks, but this could be countered by giving a vaporiser. Even if a patient does smoke, if they do so without tobacco it's unlikely to be a serious threat to their health.

And more to the point, shouldn't that be for the patient to decide?

Why should a patient have to suffer for years whilst a possible cannabis-like drug is developed and tested? We already have a cannabis-like drug now; it's called cannabis.

Cocaine, heroin, solvents; all are used in medicine in the UK despite having psychoactive effects and being highly toxic. Cannabis, despite being non-toxic, is not allowed to be used medicinally even though there is a range of conditions with proven benefits, and far more with strong anecdotal evidence.

Most prescribed medicines have side effects, some of them horrific. Another friend of mine is on citalopram, antidepressants whose listed proven side effects include depression(!), lactation and hallucinations. Jeez, imagine if it gave you all three at once.

But any drug has different effects on different users. Some patients don't get the side effects, others do but think it's better than not having the primary effects.

Patients should be told of the side effects then given the option to choose whether to use a medicine.

To say to people whose lives are ruined by serious painful conditions 'we have a medicine but you can't have any even if the only effects are positive' is as cruel an act as I can imagine.