The curious case of how doctors do not prescribe all natural marijuana

Usually, when a patient goes to their medical practitioner, they are quick to prescribe their patients with anything other than natural medical marijuana.

They push opioids, benzodiazepines, and synthetic man-made cannabinoids, but not the real thing. This is obviously due to the lack of physician education, but also, because physicians are just unsure about medical marijuana to recommend it to their patients.

Many types of prescribed synthetic cannabis

Cesamet and Sativex are two types of synthetic cannabinoids used by physicians to help treat a variety of symptoms. Both are FDA and Health Canada approved, so doctors are more inclined to prescribed these drugs over natural cannabinoids. Recently a new drug called Epidiolex has also arrived on the market, targeting children with epilepsy.

Nabilone, or cesamet, is a pill that mimics tetrahydrocannabinol (THC) and is used to treat nausea and vomiting caused by cancer chemotherapy and chronic pain. It is also modestly effective in fibromyalgia, multiple sclerosis, and irritable bowel syndrome. Physicians mainly use this medication as a last resort, after all, other conventional medications have failed. The manufacturer cautions that Cesamet, like inhaled Cannabis and oral cannabinoid-based medications, may not be safe for women who are pregnant or nursing, or for people who have heart conditions.

Sativex or nabiximols come in a mouth spray form and is used to relieve chronic pain, muscle spasticity, and overactive bladder. Each spray has about 2.7mg dose and it is Health Canada approved. Side effects are similar to medical marijuana with mouth irritation, dizziness, increased heart rate, decreased blood pressure, hallucination, among others.

Endocannabinoid system needs all compounds

The problem with synthetic cannabis is that they all suffer from the “entourage effect”, which essentially describes the combined benefit of all the cannabinoids working together to relieve symptoms. Naturally occurring marijuana contains over 100 cannabinoids and and frankly, medical researchers just don’t know where the effects of one end and the effects of another begin. Our bodies have natural receptors for all the cannabinoids working together.

The fact of the matter is that cannabis is entirely too complex for researchers to study and extract information from. The FDA simply lacks the resources it needs to study cannabis. FDA testing rubric is set up for single compounds, like the atorvastatin in Lipitor, or the fluoxetine in Prozac, not for hundreds of compounds like those found in cannabis.

Most patients who use these synthetic cannabis say their medications do not work well. But many doctors in Canada prescribe them anyway simply because they are unsure about medical marijuana and whether it would be helpful for treatment. Doctors also prescribe synthetic marijuana because of costs reasons. Generally, nabilone and sativex are covered by provincial insurance, whereas naturally occurring cannabinoids are not. This entices patients who view the two medications to be the same, into choosing synthetic cannabis.

Illegal synthetic cannabis can be fatal

Synthetic marijuana, sold in colorful packages with names like Cloud Nine, Maui Wowie and Mr. Nice Guy, sits behind the glass counter at a Kwik Stop in Hollywood, Florida. (File image via Getty images)

The real dangers of synthetic marijuana sets in when it is marketed and sold in stores. Unlike heroin and cocaine, these marketed synthetic cannabis are not made using just one chemical. Synthetic marijuana can be made with nearly 100 different chemicals that are often sprayed onto dried, shredded plant material. The chemicals used are unknown and foreign to the body to recognize, and thus produces a possibly fatal effect.

There have already been cases around the United States where people have died from consuming illegal synthetic cannabis called K2 and spice.

The bottom line seems to be that natural cannabis is better to treat ailments and for the body over synthetic cannabis, whether legally prescribed or bought. Patients and users must understand the difference of all the compounds before using any of the products.