Herbal Marijuana is used as a medicine for one or more of the following reasons.

(3) Because it is remarkably versatile-- it is useful in the treatment of a number of syndromes and symptoms. Today, herbal marihuana is most commonly, but certainly not exclusively, used in the treatment of:

The Severe Nausea and Vomiting of Cancer Chemotherapy

Glaucoma

Epilepsy

Hyperemesis Gravidarum

There are several reasons why medicine has not been quicker to recognize the value of readmitting cannabis to the pharmacopeia. One is the lack of incentive of pharmaceutical companies to develop it as a medicine because it is not possible to patent a plant. In fact, there is a disincentive because this versatile medicine would successfully compete with many of their extant products. But the most important reason is the low regard with which medicine holds anecdotal data, and almost all that we know about herbal marijuana as a medicine is anecdotal. Anecdotal data is less reliable than that derived from double-blind controlled studies which were introduced in the early 60s and which modern medicine now relies on. Still, it must not be forgotten that modern medicine was built upon a foundation of anecdotal data and it continues to point to new therapeutic possibilities, some of which, as in the case of cannabis, turn out to be valuable. Now, attitudes toward the anecdotal nature of most of the data on cannabis are slowly changing. In a paper recently published in Trends in Neurosciences (May, 2005) the authors write as follows:

Use of cannabis as a medicine for numerous conditions has a well- documented history stretching back thousands of years. With the identification of an endogenous system of receptors and ligands in recent years, abundant experimental data have reinforced the anecdotal claims of people who perceive medicinal benefit from the currently illegal consumption of cannabis. This, combined with data from recent clinical trials, points to the prospect of cannabis as a medication in the treatment of multiple sclerosis and numerous other medical conditions.

The medical marijuana problem is a Janus-like conundrum; one view of the problem is seen through the eyes of patients and another through those of their government. One face regards with dismay the problem of denying herbal marihuana to the growing number of pained, impatient patients who find it useful, often more useful, less toxic and cheaper than the legally available medications. Through the patients’ eyes the problem is, of course, how to acquire and use this medicine without swelling the ranks (already more than 750,000 annually) of those who are arrested for using this illegal substance and how to avoid jeopardizing job security through random urine testing. The other face, the backward looking one, is that of an obdurate government as it defensively and inconsistently insists that "marijuana is not a medicine", and backs up this illinformed, arrogant position with the full force of its vast legal power as it is presently doing in the state of California.

In 1985 the Food and Drug Administration (FDA) approved dronabinol (Marinol) for the treatment of the nausea and vomiting of cancer chemotherapy. Dronabinol is a solution of synthetic tetrahydrocannabinol in sesame oil (the sesame oil is meant to protect against the possibility that the contents of the capsule could be smoked). Dronabinol was developed by Unimed Pharmaceuticals Inc. with a great deal of financial support from the United States government. This was the first hint that "pharmaceuticalization" of cannabis might be what the government hoped would solve its problems with marijuana as medicine, the problem of how to make the medical properties of cannabis (in so far as the government believes such properties exist) widely available as a medicine while at the same time prohibiting its use for any other purpose. But Marinol did not displace marijuana as "the treatment of choice"; most patients found the herb itself much more useful than dronabinol in the treatment of the nausea and vomiting of cancer chemotherapy. In 1992, the treatment of the AIDS wasting syndrome was added to dronabinol’s labeled uses; again, patients reported that it was inferior to smoked herbal marihuana. Because it was thought that it would sell better if placed in a less restrictive Drug Control Schedule, it was moved from Schedule II to Schedule III in the year 2000. But Marinol has not solved the marijuana-as-a-medicine problem because so few of the patients who have discovered the therapeutic usefulness of marijuana use dronabinol. In general, they find it less effective than smoked marijuana; it cannot be titrated because it has to be taken orally which causes a long delay in the manifestation of its therapeutic utility, and even with the prohibition tariff on street marijuana, Marinol is more expensive. Thus, the first attempt at pharmaceuticalization proved not to be the answer. In practice, for many patients who use marijuana as a medicine the doctor-prescribed Marinol serves primarily as a cover from the threat of the growing ubiquity of urine tests.