Therapeutic cannabis: how it works and what are the side effects

Some use it to get rid of chronic pain; who to fight epilepsy and who to counter the side effects of chemotherapy. Despite its effectiveness
is challenged by a part of the scientific world, cannabis is now used in dozens of diseases, primarily those neurodegenerative:

«It rebalances the functions of the immune system and is a natural anti-inflammatory,» explains Dr Gianpaolo Grassi, the first researcher at Crane-Ci di Rovigo, the only Italian research centre authorized to study this plant.

How it works

The therapeutic value of the plant seems connected to the way our brain works: “The human organism already possesses an endocannabinoid system. This consists of receptors that open and close like locks, regulating the psychological state, the immune system and much more.

When the locks are closed due to a malfunction, the plant cannabinoids can be used as a lubricant to regulate nerve signals and restore the balance distorted by the disease, “explains Dr Grassi.

To know well the effects of therapeutic marijuana is Melissa V., a 26-year-old girl who has multiple sclerosis: “The traditional drugs I use to counteract the Sla give me many side effects. Since I take cannabis, I can sleep five or six hours a night, and I can walk, even with crutches.

Furthermore, I no longer need to use massive doses of opiates “. “Marijuana is also useful for removing nausea from cancer patients and keeping Tourette’s syndrome under control, a neurological disorder that causes uncontrolled spasms,” adds Dr Carlo Privitera, a surgeon who has been dealing with therapeutic cannabis for years.

Its active ingredients

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The products based on “grass” are divided according to the variety of plant used and the concentration of two active ingredients: tetrahydrocannabinol (Thc) and cannabidiol (Cbd).

Although every disease responds more or less well to the first or second principle, it is a rough distinction because the functioning of cannabis is still little known: “This plant contains more than 600 molecules – explains Dr. Privitera – for this we do not know well what is the winning formula “.

It is no coincidence that in laboratory studies that have falsely recreated the THC, the phytocomplex extracted from the plants was more effective than the single synthetic molecule.
From this consideration, however, another problem arises: the phytocomplex cannot be patented as in the case of a single molecule, and therefore the pharmaceutical companies are not interested in subsidizing in-depth studies.

According to a meta-analysis of the Gimbe institute, an organization that deals with research in the health field, there is still little evidence of the analgesic effect of cannabis on pain caused by injuries to the nervous system; while there is insufficient evidence regarding other types of pain.

But despite the lack of long-term studies, cannabis has become the salvation of Serena B., a twenty-year-old from Vicenza who suffers from drug-resistant epilepsy
from birth: “My daughter has an extreme disorder – says the mother of the young Vicenza – before using marijuana had crises in which it threatened to suffocate.»

After so many unnecessary treatments, marijuana was the only one to give results: “Now the crises have been reduced in intensity. Serena can even sleep, which was previously Unthinkable “. But if cannabis was a “miracle” for Serena, the last months of this year did not go as the family would have hoped because of the lack of medicine in our country.

In fact, the needs for 2017 have been underestimated, and cannabis has become almost impossible to find as early as autumn: “For months, through the Facebook groups we have exchanged information on where to find the drug – says Stefano, Serena’s brother – a few weeks ago we went to a pharmacy in Emilia Romagna because no one has got it in Veneto ».

The risks of the black market

In Emilia Romagna, in Bologna, lives Elisabetta Biavati, who has been using marijuana for two years to treat a rare disease: “Without cannabis, I cannot even swallow. And as soon as I finish the stock of the drug I will not also be able to eat alone.

In the past, I also turned to the black market, and I had a big epileptic crisis: we need safe drugs, we can not rely on do-it-yourself, “says Elisabetta.

In addition to being a potential danger to all, illegal marijuana has no value as a therapy: “It is not comparable to the drug produced by the state,” explains Dr. Privitera. “We do not know how it is obtained; it could contain toxic molds or be mixed with some drugs.

The products for therapeutic use are cultivated and cataloged under precise standards ». Although cannabinoid-based treatments have been legal in Italy for ten years, production in Italy began only at the end of 2016 at the Florence chemical-pharmaceutical institute, which in 2017 produced 50 kilos of a product against a target estimated at 100.

Too little to meet the national need: “The importation from Holland in 2017 was 200 kg,” Dr Privitera intervenes. “An order that did not take into account the growing trend of drug use. It would have served a ton to guarantee everyone a minimum of continuity “.

Patients are now waiting for supplies in 2018, hoping that their right to treatment will be assured.

Side effects and contraindications

Studies on long-term side effects of therapeutic cannabis are scarce, and it is not possible to overlap toxicological studies done on illegal marijuana users.

At present no severe side effects have been tried, but for doctors there are contraindications: cannabis, in fact, should not be given to those with heart problems because it could lead to tachycardia.

It is not recommended for use in psychiatric patients because it could speed up the manifestation of a latent psychosis, although there is no evidence that the plant complex is linked to the onset of mental disorders.

Although it does not lead to addiction, cannabis has not been shown to have the same analgesic potential as opioids such as morphine and therefore is not always a valid substitute.